Thursday, September 15, 2011

A Trip to Chi-town for Science!

Dr. Christos Coutifaris, me, Dr. Clarisa Gracia
This past week I traveled to Chicago for the Oncofertility consortium, an annual conference held at Northwestern to discuss advances in the field of fertility preservation for cancer patients. As mentioned in my previous post, I am currently taking a year out from medical school to conduct clinical research in infertility, my field of interest. Oncofertility is an area in which my mentor, Dr. Clarisa Gracia, specializes.

The field looks at cancer treatments like chemotherapy and radiation that are toxic to the reproductive organs. For a long time these effects have been a medical afterthought, as the focus on survival after cancer diagnosis took precedent over other health concerns. But as improved cancer therapies result in better prognoses, it is necessary to consider the side effects associated with treatment. Specifically it is important to think about fertility preservation before cancer treatment begins so that patients may have options down the road for building families. While relatively easy for men to accomplish via sperm banking, for the women that Dr. Gracia sees the options are significantly more challenging and invasive. If there is adequate time before a cancer treatment begins she will work with the patient to bank embryos or eggs. And if there is not time to undergo a stimulation cycle, she offers patients the option of a small surgical procedure in which a piece of tissue from the ovary is removed and stored so that it may be used in the future to obtain eggs. This technology is not yet fully developed, however, and it must be explained to the patient that the procedure does not guarantee that they will be able to have biological children- we hope that by the time they are finished with their cancer treatments the science will have advanced.

I could go on and on about this topic, and being at the conference this week has gotten me more fired up, as I heard directly from all of the people working tirelessly to address some of the concerns of this new field. Basic scientists spoke about the advances in preserving the tissue samples and maturing eggs from them, lawyers and patient advocates spoke about the difficulties financing these procedures for patients, ethicists spoke about important moral considerations as the field advances, and cancer patients spoke about how grateful they were that these options were available. All of the members of the consortium come together each year (and at teleconferences throughout the year) with the idea that if they wait to read each others' papers when published in medical journals then the pace of advancement in the field will suffer. Thus, there was an incredible spirit of open collaboration, group problem-solving, and the sharing of everything from lab techniques and tips to cohorts of clinical research data. As this was my first real academic conference I can't yet say if this level of openness is unique, but it made me proud and in awe of those working in my chosen field.

Now that I have returned from Chi town I'm looking forward to starting a new epidemiology and study design class, beginning journal club for the Doris Duke students, and also working as a student preceptor in Doctoring class. Doctoring is a class for all first year medical students that focuses on the doctor-patient relationship and helps prepare students for life on the wards by addressing topics like cultural awareness and communication skills. Importantly, it is also a place where students can talk openly about the challenges they're facing, both academically and personally, and discuss difficult issues that may arise throughout medical school. My job as an older student is just to listen and occasionally chime in when asked a question about how things work in the wards. My group is incredibly insightful and I was blown away by some of their comments last session. This week's topic is cultural competency and I am excited for the discussion on Thursday!

Monday, September 12, 2011

Hello From The Clerkships

Hello to everyone in the Perelman-verse:

My name is Sarah Ginsburg and I am a third year in the midst of my clinical rotations. Incredibly, I am almost 75% done with my clerkship year. As a quick primer on the curriculum here, pre-clinical classes run from the fall of first year to December of the second year. After that, the clerkship rotations run from January of second year (staring 4-6 months earlier than other medical schools) to December of third year. The remaining time before graduation (15+ months) is really want you want it to be - some combination of electives in the hospital, a research project (Scholarly Pursuit), residency applications/interviews, and whatever else you can think of. I'm quite excited to be nearing the "whatever I can think of" stage. It really is great to have the extra time for electives to aid in the process of figuring out what you want to be when you grow up.

2+ years of med school learning. With empty space
because there is so much more to go. And shelves
trying valiantly to hold up so much knowledge.
Metaphor, anyone?
I've been trying to think about the best way to describe "Life in the Clinics". The honest answer is that I really don't have an answer. Each week - each day even - is a different adventure. Your patients change, your team changes, your location changes. And even when all of those things stay the same for a few weeks, each day brings a new set of questions and challenges. You come into the hospital each day trying to find the best way to help your team, whether it be performing the initial history and physical on a new patient, calling a consult or tracking down old records. The clerkship year is about figuring out how to integrate yourself into the clinical team on the fly just as much as it is about learning the facts of medicine and developing rapport with patients. Each team has its own vibe and expectations for medical students. It is a whirlwind, exhausting, sometimes baffling, but ultimately incredible ride. Which is probably med school - and medicine - in a nutshell.

I will now sign off for the night after spending two paragraphs on clerkships without actually talking about the clerkships. Tomorrow, ridiculously adorable children await at my outpatient pediatrics site. As a student, I work one on one with a preceptor, first seeing patients on my own then presenting to the physician. We then formulate a plan (on a good day, the final plan hopefully resembles whatever I suggested in my initial presentation) and go see the family together. Which gives me double the opportunity to interact with said adorable children. After one week (with two more to go) my favorite age is 9-12 months.

More updates to come as the fall rolls along.
Sarah Ginsburg