Harvard Medical Student Review
type: channel
description: The Harvard Medical Student Review (HMSR) is a student-run open access medical journal. Its mission is to provide a platform for students to contribute to important issues facing health and medicine through scholarly articles, reviews, editorials, and original artwork. Contributions are invited from medical students and other professional graduate and health-related programs.
publisher: Harvard Medical Student Review
language: en
publication name: Harvard Medical Student Review
issn: 2380-5420
items: Are medical students biased toward chronic pain patients?
items: Evidence-Based Policy Can Help Massachusetts Stay On Top Of Gun Violence
items: All that Glitters: A Perspective on Peer Reviewed Publications
items: Large benign granular cell tumor with skin involvement: a case report
items: Stem Cells To Cure Sickle Cell Anemia
items: The Neural Underpinnings of Sacral Neuromodulation Therapy for Functional Gastrointestinal Disorders
items: Self-Tracking, Hacking, or Slacking? Health Justice in an Era of mHealth Technology
items: Too Loose, Too Tight, But Never Just Right: Adhesions, Aspirations, and Atelectasis
items: The Danger of Genetic Risk Scores for Worsening Race-Based Disparities in Healthcare
items: Reducing Childhood Respiratory Infections through Interventions in Indoor Household Air Pollution in Rural Underdeveloped Countries
items: Addressing Pervasive Homophobia in Medical Education
items: Race and Medicine: Black People Are Not Born Sick
items: Gun Violence is Every Doctors' Lane: Ways Healthcare Providers Can Protect Public Health
items: Advancing Preclinical Medical Education through High Fidelity Simulation and Standardized Patient Families
items: What's in the Cauldron: Witches, Folk Remedies, and their Contributions to Modern Medicine
items: Mental Health Referrals in Physician Aid in Dying Laws
items: A Look at South Korean Plastic Surgery
items: How the Texas Heartbeat Bill Will Affect Low-Income Women of Color Across the U.S.: A Commentary
items: Colorectal Cancer Screening During COVID-19: FIT testing as the Suggested Solution
items: Integrating a Smoking Cessation Initiative for the Uninsured at a Student-Run Free Clinic
items: Completing the Results of a Pan-Canadian Survey on the State of Oncology Education in Family Practice Residency Programs: Comparison of One Province to the Rest of Canada
items: Primary Care Selection and the Financial Burdens of Medical Education
items: Vibration-based Microphones as a Solution for Non-invasive Ventilation Related Communication Impairment
items: About Time: Making Space in the Classroom for Students' Experiences of Trauma
items: Medical Student Perspective on Resident Maternity Leave Policy
items: The Role of Estrogen in Ovarian Cancer and the Pathways by Which Estrogen Acts
items: How to Define Death: Variation in Donation After Circulatory Death Policies
items: On Dying
items: Suggestions Implemented During the COVID-19 Pandemic to Improve Medical Student Dermatology Exposure and Education
items: Dendritic Cell Vaccines in Ovarian Cancer: Have We Reached Their Potential?

Are medical students biased toward chronic pain patients?
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description: Background: Little research has been done into exploring medical students' perspectives of chronic pain patients despite increasing media attention on the opioid epidemic and their encounters during medical school. Methods: To investigate, all medical students at Michigan State University College of Human Medicine were emailed an invitation to voluntarily participate in an online survey. Students were randomized between two identical patient vignettes, one was the control and the other was identical with the exception of a history of chronic back pain and opioid dependence. Students were then asked a series of questions regarding their perceptions, biases, and attitudes towards the patient in their vignette. Eleven questions were asked using a 0-10 scale. Results: Results between the control and pain patient were quantified using an unpaired t-test. Students rated the chronic pain patient worse than the control in 8 of the 11 questions. Discussion: Our survey showed that medical students had more negative perceptions of chronic pain patients in terms of their health, self-care, self-discipline, and compliance.
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creator: Genevieve Pourzan
creator: Alberto Tamayo
creator: Muhammad Nabeel
rights: Copyright (c) 2020 Genevieve Pourzan, Alberto Tamayo, Muhammad Nabeel (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 37
ending page: 42
doi: 10.65539/w1fgz146

Evidence-Based Policy Can Help Massachusetts Stay On Top Of Gun Violence
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description: The following essay provides an argument for the implementation of evidence-based gun control policies in Massachusetts. This argument is based on the disturbing trauma witnessed in the emergency room at Brigham & Women's Hospital, as well as the stagnant gun control rate over the last decade in our state. The argument is further supported by Dr. Hemenway's gun policy research and international policies that highlight the effectiveness of laws that strengthen background checks and limit gun ownership.
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creator: David E. Velasquez
creator: Pooja U. Neiman
creator: Bethany Strong
rights: Copyright (c) 2020 David E. Velasquez, Pooja U. Neiman, Bethany Strong (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 7
ending page: 9
doi: 10.65539/b847yk45

All that Glitters: A Perspective on Peer Reviewed Publications
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description: As trainees and even as established clinicians, we are often gifted the following wisdom: pursue your passions, but make sure your passions are productive. The hidden meaning embedded in this term "productive" is that these passions should culminate in not just any form of scholarly material, but a peer reviewed paper. In an exploration of the origins and present state of peer review and its role for both the individual clinician and academic medicine at large, what follows is a discussion of the peer-reviewed publication as the "gold standard" of productivity, and what alternatives might be considered.
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creator: Danielle Jameison
creator: Sheila Lee
rights: Copyright (c) 2020 Danielle Jameison, Sheila Lee (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 4
ending page: 6
doi: 10.65539/4yj42w18

Large benign granular cell tumor with skin involvement: a case report
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description: Granular cell tumors (GCT) are a rare soft tissue neoplasm of Schwann cell origin. This form of tumor is generally benign (0.5-2% malignant) and in these cases, involvement of the skin and deeper structures are not common, presenting usually as a solitary, slow-growing, painless mass. This case report presents a 43-year-old woman with multiple benign slow growing masses on the back for 15 years, later biopsied to reveal benign granular cell tumor. Wide local excision of 2 masses and placement of wound VAC was performed by plastic surgery team with primary specimen measuring 11.5 x 12.5 x 2.5cm with skin and deep structure involvement, and a smaller mass measuring 6 x 3.1 & 5 x 2.1cm. Split-thickness skin graft was performed a week after confirmation from pathology on its benign nature. This case highlights an abnormal presentation of benign GCT due to size, skin and deep structure involvement, multiple lesions and appropriate management.
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creator: Tristan Nguyen-Luu
rights: Copyright (c) 2020 Tristan Nguyen-Luu (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 32
ending page: 36
doi: 10.65539/ewpbzq16

Stem Cells To Cure Sickle Cell Anemia
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description: Sickle cell anemia (SCA) is one of the most prevalent genetic disorders in the world and the most common congenital anemia in the United States. The severity of SCA spans from mild clinical cases, managed by careful living, to severe cases involving bone crises, infection, stroke, and multi-organ failure. Hematopoietic stem cell transplantation (HSCT) is the most widely known and effective method to cure the disease and is used today in only severe cases due to risks of graft rejection and fatal infections. The use of stem cells for the cure of sickle cell disease from the early days of transplantation to the most recent breakthroughs in stem cell therapy, gene therapy and genome-editing will be examined in this review.
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creator: Tolulope O. Rosanwo
rights: Copyright (c) 2020 Tolulope O. Rosanwo (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 27
ending page: 31
doi: 10.65539/056mjw33

The Neural Underpinnings of Sacral Neuromodulation Therapy for Functional Gastrointestinal Disorders
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description: Sacral Neuromodulation (SNM) is an established nerve stimulation treatment for Functional Gastrointestinal Disorders (FGIDs) such as Faecal Incontinence (FI), Slow Transit Constipation (STC) and ileus. SNM may involve the surgical placement of electrodes against the sacral roots of the spinal cord to alter the physiological function of the target organs. It can also be performed by using Transcutaneous Electrical Nerve Stimulation (TENS) which is a non-invasive and cost-effective SNM technique consisting of placing electrodes on the intact skin instead of implantation. However, despite the increasing application of this therapy, the neural underpinnings of SNM are poorly understood. One of the consequences of this poor understanding is that currently SNM is administrated on a trial-and-error basis and there are no standard guidelines on the optimal therapeutic parameters.
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creator: Mitra Shokrollahi
rights: Copyright (c) 2020 Mitra Shokrollahi (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 19
ending page: 25
doi: 10.65539/pgdgpe69

Self-Tracking, Hacking, or Slacking? Health Justice in an Era of mHealth Technology
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description: As the doctor-patient relationship continues to evolve, there is increased enthusiasm for the role of mHealth technologies (smartphone apps or wearable sensors that monitor/log health-related functions) in the promotion of precision medicine. But numerous challenges have also emerged in the collection, transmission, and storage of personal health data. This paper addresses the ethical, legal, and public policy implications of mHealth use in the just allocation of health care resources. First, it utilizes Beauchamp and Childress' four principles of medical ethics (autonomy, beneficence, nonmaleficence, and justice) to weigh ethical considerations; next, it reviews privacy issues (e.g. informed consent, use of personal health information), and marketing influences, all of which raise legal concerns; and, finally, it looks at practical implementation of mHealth data/analysis, discussing evidence of current and future impacts upon health policy.
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creator: Nancy Tuck
rights: Copyright (c) 2020 Nancy Tuck (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2020-02-28
publication date: 2020-02-28
starting page: 10
ending page: 18
doi: 10.65539/3jyb7p56

Too Loose, Too Tight, But Never Just Right: Adhesions, Aspirations, and Atelectasis
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description: This case report presents a detailed autopsy examination of a 72-year-old woman who died following complications from ventral hernia repair surgery. The case illustrates how multiple factors including post-surgical adhesions, atelectasis, a pleural effusion, gastroparesis from a previous Nissen fundoplication, and an aspiration event combined to cause respiratory failure. The report also includes an educational discussion of biofilms and their clinical significance in medical device infections, demonstrating the intersection of materials science and clinical medicine.
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creator: Layla Siraj
rights: Copyright (c) 2022 Layla Siraj (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 37
ending page: 44
doi: 10.65539/ypvyhg38

The Danger of Genetic Risk Scores for Worsening Race-Based Disparities in Healthcare
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description: This review examines how polygenic risk scores, developed primarily using data from white European populations, may worsen existing healthcare disparities. The author explains why these scores perform poorly in non-white populations, discusses the danger of clinical deployment without diverse representation in genetic databases, and proposes solutions including increasing diversity in genetic research and developing new analytical tools to improve prediction accuracy across different ancestry groups.
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creator: Sohail Zahid
rights: Copyright (c) 2022 Sohail Zahid (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 25
ending page: 29
doi: 10.65539/87xk2m02

Reducing Childhood Respiratory Infections through Interventions in Indoor Household Air Pollution in Rural Underdeveloped Countries
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description: Introduction: Acute lower respiratory infections (ALRIs) are a major cause of mortality in young children, especially for those living in rural areas of underdeveloped nations. A major risk factor for lower respiratory infections is indoor household air pollution. A common source of this pollution in rural areas of underdeveloped nations is cooking. This review sets out to assess interventions related to cooking to see if they provide any long-term clinically important outcomes. Methods: A literature review using PubMed in July 2019 using terms relating to childhood pneumonia and air pollution. Full-text reports for relevant studies were included in this review. Results: Interventions for the reduction of indoor air pollution generally fell into one of three categories, i) switching from polluting fuels to cleaner fuel types, ii) alternative-cooking devices, and iii) behavioral modifications. Findings regarding the use of clean fuel over biomass fuels and alternative-cooking devices were controversial. Behavioral modifications were more consistent in findings of decreased respiratory infections. Conclusion: It was concluded that interventions for indoor household air pollution, and in particular, behavioral modifications, have the potential to provide significant reductions in ALRI in young children. However, more research is needed to elucidate how best to enact interventions in rural areas of underdeveloped nations.
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creator: Lisle Blackbourn
creator: Erin Walton-Ball
rights: Copyright (c) 2022 Lisle Blackbourn, Erin Walton-Ball (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 30
ending page: 36
doi: 10.65539/eq9dtq45

Addressing Pervasive Homophobia in Medical Education
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description: This reflective viewpoint explores the experiences of a gay medical student in the Deep South and examines the persistent homophobia within medical education. The author discusses personal encounters with discrimination, the impact on LGBTQ+ medical students, and provides recommendations for creating more inclusive medical learning environments, including increasing LGBTQ+ representation, establishing allied organizations, and implementing mandatory diversity training.
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creator: Michael H. O'Brien
rights: Copyright (c) 2022 Michael H. O'Brien (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 3
ending page: 6
doi: 10.65539/vvq1cf45

Race and Medicine: Black People Are Not Born Sick
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description: This viewpoint critically examines the use of race-based corrections in medical diagnostic tools, particularly in pulmonary function tests. The author, a Black medical student, traces the historical origins of race-based medicine and argues that social determinants of health, rather than inherent biological differences, account for health disparities. The piece calls for medical education to better integrate discussions of structural racism and social conditions when teaching about health outcomes.
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creator: Tiana Walker
rights: Copyright (c) 2022 Tiana Walker (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 11
ending page: 13
doi: 10.65539/26qvme49

Gun Violence is Every Doctors' Lane: Ways Healthcare Providers Can Protect Public Health
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description: This viewpoint examines the role of healthcare providers in addressing gun violence as a public health issue. The author describes a personal experience with establishing credibility on gun violence policy and reviews evidence-based interventions including safe storage counseling, violence intervention programs, and extreme risk protection orders. The article argues for the legitimacy of healthcare providers to counsel patients on firearm use and safety.
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creator: Alexander Pomerantz
rights: Copyright (c) 2022 Alexander Pomerantz (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 7
ending page: 10
doi: 10.65539/q21fg944

Advancing Preclinical Medical Education through High Fidelity Simulation and Standardized Patient Families
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description: Introduction: Simulated patient encounters in preclinical medical education are being implemented at various medical schools throughout the United States. In this study, we aimed to evaluate the perceived effectiveness of early preclinical simulations on medical students' education. Methods: Two classes of osteopathic medical students, class of 2019 and class of 2020, participated in two simulated clinical experiences using high-fidelity patient mannequins and standardized family members during their second year of medical school. These same students, who are now completing their clinical rotations, completed a survey to assess if the experience with a simulated patient/family Results: A total of 379 students were emailed a survey. Out of 379 total students, 122 surveys were completed (59 from the Class of 2019, 63 from the Class of 2020). The overall response rate was 32%. A majority of the respondents responded positively, with 63% of students stating in their free responses that the simulated patient encounters were experiences that improved their ability to interact professionally and appropriately with patients and family members. P-values between the classes for each survey question was greater than 0.05, indicating that there were no statistically significant differences between the classes of 2019 and 2020 in their survey responses. Conclusion: This study provides evidence that early simulated patient encounters provide a self-reported experience that improves empathy and communication for the students during their clinical rotations.
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creator: Benjamin W. Cooper
creator: Nicholas A. Jaeger
creator: Maureen A. Hirthler
creator: Cathy J. King
rights: Copyright (c) 2022 Benjamin W. Cooper, Nicholas A. Jaeger, Maureen A. Hirthler, Cathy J. King (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 45
ending page: 50
doi: 10.65539/pmz6e489

What's in the Cauldron: Witches, Folk Remedies, and their Contributions to Modern Medicine
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description: Disease is a part of the human condition and before the rigor of the scientific process and peer review, healers had to work with anecdotal folk remedies and word of mouth medicines. These folk remedies were often known by women and shaman who, throughout time, passed on their esoteric knowledge. Some of these remedies, like excretions from toads, Hemlock, Yew, and Foxglove have persisted for centuries and were used for a wide range of ailments. In modern days, with the use of the scientific process and peer review, these plants form the foundation of many medications. This demonstrates the benefit that can be gained with the investigation of folk medicine.
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creator: Mason Tate Bennett
rights: Copyright (c) 2022 Mason Tate Bennett (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 19
ending page: 24
doi: 10.65539/4pqm0w69

Mental Health Referrals in Physician Aid in Dying Laws
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description: This review examines the provisions related to mental health referrals in physician aid in dying (PAD) statutes across U.S. jurisdictions. The authors analyze the varying statutory language regarding when and how mental health professionals should be involved in evaluating patients requesting PAD medication. The article proposes standardizing the statutory language and recommends adding guidance for early, continuous supportive counseling for qualified terminally ill patients, rather than focusing solely on eligibility determination.
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creator: Raquel Atencio
creator: Matthew Deblinger
rights: Copyright (c) 2022 Raquel Atencio, Matthew Deblinger (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-03-24
publication date: 2022-03-24
starting page: 14
ending page: 18
doi: 10.65539/de2zp755

A Look at South Korean Plastic Surgery
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description: With increasing globalization in communication, travel, economics, and innovation, medicine and plastic surgery have also made great advancements. The following essay looks at plastic surgery in South Korea, and the innovations South Korean plastic surgeons have made in the field. We explore the cultural, societal, and economic influences that may have impacted the development and popularity of plastic surgery in South Korea, and the rise of South Korean medical tourism. We also compare South Korean plastic surgery versus American plastic surgery, showing differences and similarities in procedures performed, costs, and in patient demographics. Additionally, we look at the possible impacts of plastic surgery on mental health.
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creator: Annie Jin
creator: Ian Whittall
rights: Copyright (c) 2022 Annie Jin, Ian Whittall (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 25
ending page: 31
doi: 10.65539/4mzxze25

How the Texas Heartbeat Bill Will Affect Low-Income Women of Color Across the U.S.: A Commentary
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description: Governor Greg Abbott of Texas signed a law in May 2021 that will prohibit healthcare providers from performing abortion services after the detection of a fetal heartbeat. With this, Texas has joined several other states, mostly concentrated in the South and Midwest, that ban abortions after approximately six weeks. In this commentary, we discuss how the loss of access to abortion in the heavily populated, diverse state of Texas will overwhelmingly affect low-income individuals and women of color. We also seek to explain how this law is part of a larger agenda that will have a greater impact on all fifty states. Ultimately, we aim to demonstrate how laws aimed at restricting access to abortion will disproportionately affect Black, Hispanic, and low-income women, exacerbating racial health disparities already faced by marginalized groups.
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creator: Natalia Eugene
creator: Anna Kheyfets
creator: Mackenzie Bennett
rights: Copyright (c) 2022 Natalia Eugene, Anna Kheyfets, Mackenzie Bennett (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 32
ending page: 36
doi: 10.65539/ghx6t411

Colorectal Cancer Screening During COVID-19: FIT testing as the Suggested Solution
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description: In March 2020, healthcare in the United States changed, with primary care and preventative care, particularly colorectal cancer screening, grinding to a halt. COVID-19 brought to the forefront the racial healthcare disparities in the United States with the pandemic disproportionately affecting minority communities, reflecting the well-established disparities in colorectal cancer outcomes which are expected to be exacerbated by the lack of screening. This article aims to promote the use of FIT testing for colorectal cancer screening during this pandemic particularly for minority communities. Studies have shown that FIT tests have a high sensitivity and specificity, are inexpensive, and have better adherence than colonoscopies.
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creator: Aleeza J. Leder Macek
rights: Copyright (c) 2022 Aleeza J. Leder Macek (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 21
ending page: 24
doi: 10.65539/xngqed14

Integrating a Smoking Cessation Initiative for the Uninsured at a Student-Run Free Clinic
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description: Cigarette smoking is the leading cause of preventable deaths and diseases in the United States. Student-run clinics play an invaluable role in connecting underserved patients with preventative care. To reduce smoking in uninsured communities, the University of Missouri student-run free MedZou Community Health Clinic developed a Smoking Cessation initiative as part of a preventative health service in 2013. Patients utilizing the smoking cessation services receive a combination of motivational interviewing, patient education, and pharmacotherapy. There is currently limited literature on the structure and implementation of student-run preventative health clinics. The smoking cessation initiative described here can provide an example for other student-run clinics to successfully implement similar programs.
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creator: Cynthia Y. Tang
creator: Lauren E. Flowers
creator: Emra Bosnjak
creator: Tricia Haynes
creator: Jamie B. Smith
creator: Laura E. Morris
rights: Copyright (c) 2022 Cynthia Y. Tang, Lauren E. Flowers, Emra Bosnjak, Tricia Haynes, Jamie B. Smith, Laura E. Morris (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 45
ending page: 51
doi: 10.65539/6qb52t10

Completing the Results of a Pan-Canadian Survey on the State of Oncology Education in Family Practice Residency Programs: Comparison of One Province to the Rest of Canada
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description: Introduction: The incidence and prevalence of cancer in Canada is rising, and family physicians will increasingly provide care at all stages of a patient's cancer journey. This highlights the importance of adequate oncology education in family practice training programs. A survey study done in 2017 to assess the state of oncology education in Canadian family practice residency programs did not include the University of British Columbia (UBC). The purpose of our study was to obtain this data for the UBC family practice residency program and to compare the results to those from the rest of Canada. Methods: A web-based survey was emailed to UBC family practice residents and program directors. The survey assessed depth of the oncology curriculum, current teaching methods and perceived gaps. Results were compared to the non-UBC survey data and interpreted with descriptive statistics. Results: 54/348 UBC family practice residents and 10/20 program directors completed the survey. 3% of UBC and 7% of non-UBC family practice residents felt their program adequately prepared them to care for oncology patients. There was uniformity among all participants in ratings of perceived importance of a list of oncology topics expected to be covered in training for residents. There was discordance in the perceived frequency of topics taught between all family practice residents and program directors. Conclusion: This study can inform further development of oncology specific curriculum in family practice residency programs. Further study is required to understand areas of discordance between family practice residents and program directors.
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creator: Alanna Janz
creator: Lisa Wang
creator: Svetlana Bortnik
creator: Jaspreet Garcha
creator: Vincent Tam
creator: Steven Yip
creator: Paris Ann Ingledew
rights: Copyright (c) 2022 Alanna Janz, Lisa Wang, Svetlana Bortnik, Jaspreet Garcha, Vincent Tam, Steven Yip, Paris Ann Ingledew (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 37
ending page: 44
doi: 10.65539/7rfh5n34

Primary Care Selection and the Financial Burdens of Medical Education
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description: Preventative medicine and primary care services are the foundations to building healthier communities. Unfortunately, the resources are often limited, and it is estimated that by 2032, the United States could face a shortage of up to 21,000 to 55,200 primary care physicians. This deficit of physicians is even more pronounced in rural areas where residents are almost five times as likely to live in a county with a physician shortage. There are a multitude of factors that contribute to this decline in workforce, but one pressing issue is the impact of medical student specialty selection. In this commentary, we discuss the Geisinger Abigail Scholars Program which is a program offering free medical education and a living stipend in exchange for a commitment to Geisinger employment in primary care fields upon residency completion.
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creator: Christin Spatz
creator: Kara Romanowski
creator: Tanja Adonizio
creator: Michelle Schmude
rights: Copyright (c) 2022 Christin Spatz, Kara Romanowski, Tanja Adonizio, Michelle Schmude (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 17
ending page: 20
doi: 10.65539/wj09qr84

Vibration-based Microphones as a Solution for Non-invasive Ventilation Related Communication Impairment
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description: The incidence of acute respiratory failure (ARF) has dramatically increased in the past few decades in the United States. From 2002 to 2017, there was a 197% increase in the annual incidence of ARF, and in response, a 437% increase in the use of noninvasive mechanical ventilation (NIV). Multiple studies have demonstrated that use of NIV frequently causes communication impairment (CI), which is strongly associated with anxiety and can in turn contribute to NIV intolerance and failure, and ultimately, mortality. CI also prevents accurate evaluation of patients by providers, which can contribute to worse clinical outcomes. Recently, Lee et al at Pohang University, South Korea, published their development of a flexible, wearable vibration sensor that can amplify speech while minimizing ambient noise. Although this device is intended for use in portable devices such as cell phones, it also poses as a viable solution for NIV-related communication impairment.
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creator: James Lee
rights: Copyright (c) 2022 James Lee (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 13
ending page: 16
doi: 10.65539/2h64t961

About Time: Making Space in the Classroom for Students' Experiences of Trauma
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description: Many medical students have experienced trauma and conditions affecting their mental health. Throughout medical school, especially during psychiatry portions of the curriculum, students and educators may face challenges navigating course material. Adverse classroom and patient interactions can lead to further traumatization, isolation from course content, and lapses in professionalism. Contemporary educational environments have become increasingly sensitive to the prevalence of trauma among students, but debate remains over how to simultaneously respect student needs and ensure engagement with important course content. Principles of trauma-informed medical education (TIME) support medical educators and medical students to work together to create curricula and learning environments that are psychologically safe and appropriately challenging.
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creator: Christine Xu
creator: David A. Hirsh
creator: Jennifer C. Kesselheim
rights: Copyright (c) 2022 Christine Xu, David A. Hirsh, Jennifer C. Kesselheim (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 9
ending page: 12
doi: 10.65539/8qnjf196

Medical Student Perspective on Resident Maternity Leave Policy
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description: Since 2017, women have comprised the majority of enrolled U.S. medical students, marking a milestone in the gradual diversification of America's next generation of physicians. As the number of women in medicine increases, so does the number of women starting families during their graduate medical education (GME) years. However, there is a concerning absence of consistent, standardized parental leave policies across GME programs. This article reviews the importance of parental leave policies for the health and well-being of residents and offers unique perspectives and recommendations as female medical students to members of the Accreditation Council for Graduate Medical Education (ACGME).
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creator: May M. Kyaw
creator: Angela Pham
creator: Gaia Linfield
creator: Zoe Burger
creator: Sara Toulouie
creator: Olivia Yang
rights: Copyright (c) 2022 May M. Kyaw, Angela Pham, Gaia Linfield, Zoe Burger, Sara Toulouie, Olivia Yang (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2022-08-29
publication date: 2022-08-29
starting page: 4
ending page: 8
doi: 10.65539/kp710905

The Role of Estrogen in Ovarian Cancer and the Pathways by Which Estrogen Acts
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description: Ovarian cancer remains a prevalent and deadly cancer in females. While anti-estrogen therapies have been useful in the treatment of other cancer types, their effectiveness in the treatment of ovarian cancers remains limited due to the limited understanding of estrogen's effects on carcinogenesis and growth promotion in these tissues. This paper aims to summarize the role estrogen plays in ovarian cancer tumorigenesis and its potential value in targeted therapeutics. Estrogen's effects are secondary to interactions with estrogen receptor (ER) α, ER β, and the G protein coupled receptor, GPR30. Genomic signaling of ER-α has been shown to be primarily carcinogenic, while that of ER-β has been shown to be a negative regulator of carcinogenesis. Additionally, ER-α has been found to have carcinogenic effects through non-genomic signaling of the p53, MAPK, EGFR/Her2, PI3K, and IGF/IGFR pathways. GPR30's effects have been found to be more variable and specific to tumor classification. For example, GPR30 is primarily carcinogenic in ovarian epithelial tumor types but appears to have protective effects when highly expressed in granulosa cell tumors. While the above generalizations can be made, a better understanding of estrogen's effects on molecular signaling pathways will potentially allow for development of more effective targeted therapies against ovarian cancer.
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creator: Timothy Ehmann
creator: Stephanie Barel
creator: Amitabha Ray
creator: Daniel Borsch
rights: Copyright (c) 2023 Timothy Ehmann, Stephanie Barel, Amitabha Ray, Daniel Borsch (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2023-12-04
publication date: 2023-12-04
starting page: 41
ending page: 56
doi: 10.65539/g9h4pg82

How to Define Death: Variation in Donation After Circulatory Death Policies
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description: Organ transplantation utilizes a shared and scarce resource. In order to best utilize this resource, a network of organ procurement organizations, hospitals and individuals must work together. National societies make recommendations for policies that govern organ transplantation recoveries, however at each tier of the network there is room for variability. Donation after circulatory death (DCD) policies are one example of organ transplantation policies that are not standardized. The American Society of Transplantation Surgeons defines death in DCD recoveries as "irreversible cessation of cardiac and respiratory function." However, many individual hospitals have policies that may differ from this practice of observing pulseless electrical activity (PEA) for the ASTS recommended wait time of 2 minutes. In this study, we examined the DCD protocols of 50 adult hospitals representing a single OPO within Michigan. We hypothesized there would be institutional variance in the definition of death, the provider who can declare death and maximum wait time for the donor to expire after extubation until organ recovery is no longer pursued. We found that there was substantial variation in how each hospital defined death, with the most common definition being asystole. Most hospitals require a physician to declare death in DCD and the minutes to expire range from 60 to 120 minutes. Given that the difference between PEA and asystole may result in time lost and organs to become nonviable, we recommend that standard policies are created and there is increased education to physicians and designees that declare death in DCD recoveries.
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creator: Devon E. Cassidy
creator: Meredith Barrett
creator: Michael J. Englesbe
creator: Valeria S. M. Valbuena
rights: Copyright (c) 2023 Devon E. Cassidy, Meredith Barrett, Michael J. Englesbe, Valeria S. M. Valbuena (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2023-12-04
publication date: 2023-12-04
starting page: 5
ending page: 8
doi: 10.65539/95xxeq76

On Dying
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description: A poem reflecting on the profound experience of witnessing death in clinical practice, exploring themes of hope, grief, and the human connection between healthcare providers and patients and their families.
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creator: Qiang Zhang
rights: Copyright (c) 2023 https://creativecommons.org/licenses/by-nc/4.0
date: 2023-12-04
publication date: 2023-12-04
starting page: 4
ending page: 4
doi: 10.65539/2p7j3c53

Suggestions Implemented During the COVID-19 Pandemic to Improve Medical Student Dermatology Exposure and Education
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description: The COVID-19 pandemic has drastically changed medical education for both preclinical and clinical students. Virtual learning, shortened rotation schedules, cancelled away rotations, decreased interactions with faculty and mentors, and other curriculum adaptions have had a profound effect on the learning opportunities students receive during their medical training. Research studies surveying US medical schools show students interested in dermatology have limited exposure to this specialty in the medical school curriculum, and the COVID pandemic has exacerbated this lack of clinical experience. This article serves as a review of proposed improvements and current adjustments that have been implemented amid the COVID-19 pandemic in medical schools across the country to address the unforeseen changes in dermatology medical education. General changes have included virtual dermatology electives, student involvement in teledermatology, and online mentorship programs.
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creator: Scout M. Treadwell
creator: Maxwell R. Green
creator: Sowmya Ravi
rights: Copyright (c) 2023 Scout M. Treadwell, Maxwell R. Green, Sowmya Ravi (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2023-12-04
publication date: 2023-12-04
starting page: 32
ending page: 40
doi: 10.65539/3yz3fs25

Dendritic Cell Vaccines in Ovarian Cancer: Have We Reached Their Potential?
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description: Ovarian cancer is the most lethal gynecological malignancy, largely driven by high rates of relapse and chemoresistance. Ovarian cancer is thought to be immunogenic, making it amenable to immunotherapy. However, immunotherapies such as PD-L1 inhibitors and T cell transfers have produced modest, if any, survival benefit. One particular immunotherapy of interest is the dendritic cell vaccine, which delivers mature dendritic cells loaded with tumor antigens with the goal of mounting a T cell response against tumor cells. This review will focus on the role that dendritic cells play in the ovarian tumor microenvironment, general approaches to engineering dendritic cell vaccines and assessing their efficacy alone and in combination with other immunotherapies and systemic chemotherapies. Finally, we will discuss important areas of ongoing research in the field, including the development of personalized neoantigen-targeting DC vaccines.
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creator: Jennifer Rowley
rights: Copyright (c) 2023 Jennifer Rowley (Author) https://creativecommons.org/licenses/by-nc/4.0
date: 2023-12-04
publication date: 2023-12-04
starting page: 24
ending page: 31
doi: 10.65539/f020tm68