Over the past week, I’ve been taking advantage of a flexible fourth-year schedule to be in San Diego, CA for the American Medical Association (AMA) 2019 Interim Meeting. This year, I serve as the student voice on the AMA Council on Medical Service, which seeks to understand the social and economic aspects of health care delivery in order to recommend relevant policy changes to the AMA House of Delegates.
One of the reports produced by the Council addressed additional mechanisms to address high and rising pharmaceutical prices, with recommendations that were adopted by the House of Delegates. The Council also addressed Financial Incentive Programs (FIP), in which insurers or employers encourage patients to use tools to compare prices on health care items and services. The House adopted a set of guiding principles that employers and insurance companies should incorporate into FIP design to promote transparency, prevent sacrificing quality, and avoid fragmentation of care.
View from the Michigan State Medical Society reception
The Medical Student Section introduced several policies this meeting that passed, and one that I am particularly proud of asks all medical schools to protect medical students from the financial costs of potential needle-stick injuries (and other exposures to infectious or environmental hazards in the course of their medical student duties). Timely intervention is needed to prevent disease and cost should not be a barrier for students.
Throughout the residency interview process, I’ve run into friends and colleagues from around the country that I’ve met through the AMA. I’m grateful to be able to hear their perspectives on all the places they’ve trained. During interview season, I’ve also been grateful for our medical school’s HOST program, which has helped me connect with medical school alumni to stay with for interviews. It has made the process more enjoyable and affordable. Only 120 more days until Match Day!
In addition to crafting policy, I fit in a visit to the San Diego Zoo!
During the last term semester for my dual-degree program at the Ross School of Business, I worked as a student consultant for Dexcom, a company based in San Diego that makes continuous glucose monitors (CGM). This engagement was a part of the Michigan Ross Multidisciplinary Action Project (MAP) course.
Our task was to evaluate a potential new market for these devices beyond Dexcom’s core market of type 1 diabetic patients. The project was a perfect opportunity to apply my clinical and business knowledge in tandem. One of the best parts of MAP was being able to draw from the expertise of my fantastic team members. Among us, one teammate had worked in financial regulation in Japan, another worked as a yield strategist for an airline, and another had experience in health care software.
As a part of the experience, we had the opportunity to try the devices on our ourselves for 10 days. I was impressed that I couldn’t feel the sensor at all, and it stayed put despite a week that included surfing and rock climbing. My main insight from having my glucose monitored around the clock was that earlier dinners significantly decreased my morning fasting blood sugar.
I was surprised by how much the research skills I built up through years of quality improvement work translated to a business environment. I also enjoyed the opportunity to dust off my clinical vocabulary. During the project, I felt lucky to be part of the University of Michigan network. Our requests to connect with physicians and other experts were quickly answered, and it was invaluable to be able to tap into their expertise.
The experience was also educational in terms of best practices for team work. In a clinical environment, almost all of the work we do is in teams, but I have been part of very few teams where norms and expectations for the whole team are clearly laid out at the outset, in part due to a hectic schedule or due to frequent team turnover. Creating a team charter at the start of the project and intentionally thinking through the division of labor helped keep our workload balanced. It certainly helped that all of our team members were motivated to contribute.
This month, I am back in Ann Arbor seeing patients on endocrinology consults and clinic, and experiencing firsthand the impact that technologies like CGM can have in improving patient care.
At first glance, it may not seem that increased access to identification cards for homeless individuals, front-of-packaging labels on food products, and accountability in reporting for Medicaid waiver projects have much in common. But all are topics of new policies passed at the November American Medical Association (AMA) Interim Meeting that came from student action! In fact, of the 13 items that the medical student section brought to the House, ALL were passed.
This year, I’ve had the privilege of serving as a Delegate to the AMA. Thinking back to my first AMA meeting, I’ve since learned a tremendous amount about how policy is crafted and implemented. Especially during this Thanksgiving week, I’m thankful to serve as a voice for what medical students find important, especially on policies designed to protect the most vulnerable among the patients we serve.
My stellar policy analysis team for this meeting
One of the things I’ve appreciated most about my time with the AMA is the new friendships with students and physicians from around the country. For this meeting, I had the opportunity to serve as the Delegate lead for reference committee review, and I really enjoyed mentoring students who were new to the process. Much of our work happens in advance of the meeting, including in-depth policy review, providing feedback to student authors of resolutions, and conference calls to determine the medical student section stance on all resolutions and reports. I love having the chance to get to know team members personally after collaborating with them virtually for weeks!
Michigan delegation members in the House of Delegates
As a dual-degree student pursuing an MBA this year, I was also able to apply my new skills and knowledge when thinking through the economic implications of proposed policies. I’m glad to have this flexibility at Michigan to pursue these additional interests and learn more about our health care system through a broader lens.
I’m looking forward to the holiday season, time for reflection this Thanksgiving, and re-connecting with Medical School classmates through Friendsgiving and Tag Days.
As a clinical student, sometimes the days are long but the weeks and months seem to just zip by. It is hard to believe that it is already fall, and harder still because we had a 80-degree day here in Ann Arbor. (I can’t promise those always in October.)
Our AAP prescription to #PutKids1st
The past six weeks I’ve been on my surgery rotation, which was probably the toughest all year in terms of the hours. Despite the challenge of the rotation, I still made time to travel to Chicago with my research mentor for the American Academy of Pediatrics (AAP) National Conference! We gave an oral presentation on how often the AAP recommended newborn discharge criteria are followed at our children’s hospital. It was exciting to share our work with a national audience and hear their feedback and hear how newborn care is handled at their institutions. This was a project that I started through the Summer Biomedical Research Program (SBRP) and have continued through the clinical year. Working on research now happens in bits of borrowed time on rotations, and often gets pushed through when it’s time to meet a deadline.
Before surgery, I had completed ob-gyn, psychiatry, pediatrics and internal medicine. It has been very rewarding this year to feel my knowledge building upon itself. Even when it seems like disciplines would have little in common, I’ve been surprised how much some information is reinforced with each rotation. Learning from my patients — really trying to understand each of their medical conditions, medications and individual histories — has been much more gratifying than spending time with books and slides.
The beautiful beach in Saugatuck, MI
Taking time for breaks and wellness has been essential to thriving this year. A particularly memorable break was spending 24 hours on the west coast of Michigan in Saugatuck with my college roommate and her family! Even just that day gave me enough of a breather to reset and come back with renewed energy after a tough couple of weeks on inpatient pediatrics. Looking forward to finding more ways to recharge with our Step 1 study period coming up!
This is my first week as a clinical student! It’s exciting to start my first clerkship – obstetrics and gynecology. It was a little bit nerve-racking to be given a schedule for the month on the first day without any idea of what to expect. However, before I tell you about my first week, let me give you a glimpse of how incredible it was to have a few weeks off between second year and third year.
Up near Yavapai point before we hit Slim Shady trail
I spent my vacation in Arizona and Texas. Even though we’ve had a mild winter in Ann Arbor, it was great to spend time in warmer places! This was a chance to truly decompress: I was without my computer for a whole week for the first time in a long time. I enjoyed taking in the sights with my fellow classmate Crystal as we hiked many of the trails in Sedona, and had an awesome time at the botanical gardens in Phoenix learning all about cacti. We even tried fried cactus in Sedona (really interesting flavor, would recommend).
One of my favorite parts of the trip was looking out on the night sky in Sedona and realizing how many more stars I could see than when I’m in Ann Arbor. Having a chance to reset my brain was fantastic given the chaos that can come with learning in medical school and also with being in the hospital. I’m hopeful that I’ll be able to take some of that calm and relaxation with me. Even when things are really busy, it’s nice to be able to remember and to channel those quiet moments of peace.
Amazing pies in Dallas with Michelle! After hearing about Emporium Pies from M3 classmate Kayla, I had to go.
In the second half of my trip, my close friend Michelle showed me around Dallas, Texas. We had a wonderful time trying out many of the restaurants in the city while catching up. I don’t think my taste buds have been happier.
After coming back to a busy week of M3 orientation, I also went to watch the 99th annual Galen’s Smoker, an incredible musical production put together by medical students to roast the faculty. It’s crazy to think we are in our “third year” of medical school since it has been closer to 18 months since we started. We are the first class at Michigan to start clerkships before taking our first board exam (Step 1). I’m currently on the labor and delivery floor and have started in an Ob-Gyn continuity clinic. I have loved my first few days! It just feels like magic to go from having one patient to two. I’m also loving taking a deeper dive into women’s health than we do in the pre-clinical curriculum. It is taking some time to learn how to approach self-directed learning based on clinical encounters, but I’m hopeful that I’m on the right path.
Speaking of which, it’s time for me to hit the books and read more about my patients!