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On Top or Down Low: The Status Hierarchies in Medicine ft. Tania Jenkins, PhD

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What you should know about the super hierarchical world of medicine

Have you ever wondered what the world of medicine would look like to an ethnographer? To University of North Carolina Chapel Hill Professor Tania Jenkins, perhaps it looks like a ladder of status, from the lowly med student to the exalted attending (and even higher). For her book Doctors’ Orders: The Making of Status Hierarchies in an Elite Profession, Professor Jenkins spent years looking at the construction and consequences of those distinctions for doctors before, during, and after their training, especially among American, international, and osteopathic residents in two US hospitals.

Cohosts Emma Barr (M3), Bryn Myers (M2), and Greta Becker (M2) discuss with Dr. Jenkins why status hierarchies seem so important in medicine, what they accomplish and inhibit, and why they may be short-changing the system, the practitioners, and the patients.

Dr. Jenkins also helps us answer a question from “Glisten Rumpybottom” about the future of medicine as the scope of practice for mid-level practitioners like nurse practitioners and PAs continues to expand. Is this a safety issue or a turf war?

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How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

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Chronic Conditions in Medical School

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What having a chronic health issue means to medical students varies…except that it will make them even better doctors.

Listener Michael has type one diabetes and “an incredibly rare form” of epilepsy. He’s pretty open about this and plans to use his experience to inform his education on patient care. He got in touch to ask us to discuss chronic health conditions and how they interact with medical school and the patient experience. We were lucky enough to find a few medical students to offer their own journeys for discussion to cohosts Emma Barr, Aline Sandouk, and newbies AJ Chowdhury and Alex Belzer.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

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The Doctor is Burned Out ft. Jeff Moody, MD

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We are honored to talk with author and physician Jeff Moody, University of Iowa College of Medicine class of ’92, and urologist, here to talk with us about physician burnout, It’s the topic of his new book The Doctor is Burned Out:  A Physician’s Guide to Recovery.

Co-hosts Madi Wahlen, Aline Sandouk, Ananya Munjal, and Nicole Hines talk about ‘wellness,’ the ways that med students and physicians look at medicine and medical education that contribute to burnout, like the dangers of maximizing everything you do and a reliance on external metrics for success, why some specialties are more likely to have burnt out docs than others. Dr. Moody also encourages us to understand our own value to the system–in dollars–as a way to ask for solutions for burnout. He encourages us to remember that our lives effect burnout, too–docs and students aren’t exempt from adverse childhood experiences, divorce and other stressors of life! And of course, we talk about his prescription for how to fix burnout if it happens to you.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

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Flyover Country? Far From It!

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Things happen in Iowa. They really do. That’s why Dave put together a little trivia contest for his co-hosts–Sahaana Arumugam, Emma Barr, Aline Sandouk, and Brandon Bacalzo–to test their knowledge of the excitement that is Iowa.

But first, we discuss the news that, as alleged by a whistleblowing nurse, a doctor in Georgia has been forcing sterilization on women at an Immigrations Customs and Enforcement detention center. Whether this is true or not remains to be seen, but we note with concern how America treats incarcerated people. And we discuss Brandon’s research experience on a horse tranquilizer’s potential as treatment for psychiatric disorders.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

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Liver Bits, Cold Glocks, and Cancer of the Cancer

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“He who laughs has not yet heard the bad news.”

Photo by firepile

Co-hosts Nathen Spitz, Brandon Bacalzo, Mariam Mansour, and Greta Becker rehash their recent microbiology exam which they say kicked their butts, and how they deal with that nasty feeling. Dave discusses what Naegleria Fowleri means to him. Nathen and Mariam reminisce on their experiences with patient instructors and standardized patients.

And the gang practices giving bad news to their patients, using made-up diseases with names created by neural networks and assisted by their attending “Dr. Etler.”

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

Short Coat Podcast

Recess Rehash: MD/MBA: Why Physicians Must Know More About Business

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Does a physician need to know everything about healthcare, even the *shudder* money stuff?

money photo
Photo by free pictures of money

[Dave was out of the office on recording day last week, so enjoy this rerun!]

Physicians go through years and years of school to be great at this calling, so why on earth would anyone want to tack on an MBA, too? Co-host Gabe Conley decided to do just that. He’s been thinking about this for a while, but hadn’t pulled the trigger on the idea. Then, as he was about to become a fourth-year medical student, SARS-COV-2 came along and gave him a nudge in the right direction. Gabe explains why he thinks it’s vital to understand business principles as a physician–and it’s not just to make more money.

And Dave prompts Gabe and his fellow co-hosts Aline Sandouk, Brandon Bacalzo, and Madi Wahlen to answer some conversation starters. As a result, some conversations were started and we all learned a thing or two.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

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BONUS: The challenges of Refugee Healthcare with Dr. Akihiro Seita

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The UN Relief and Works Agency has a tough job, especially in Palestine.

In this bonus episode (recorded prior to the US pa we talk with Dr. Akihiro Seita, the Director of Health and WHO Special Representative to The United Nations Relief and Works Agency for Palestine Refugees.  He joins thanks to our Global Health Programs unit and its director Robin Paetzold as well as the University of Iowa Lecture Committee.  MD/PhD student Aline Sandouk, M2 Abby Fyfe, MD/PhD student Ossama Abu-Halawa, and our former intern Joel Horne, who has a strong interest of his own in global health, talk with Dr. Seita about the difficulties of providing refugees with healthcare when everything seems stacked against their health.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!

Short Coat Podcast

“Preference Signaling” –the Future of Applications?

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Preference Signaling Tokens may be a way to combat over-applying for residencies, but the schemes have a ways to go yet before they’re ready for prime time.

Dear Residency Program: I love you. Do you love me? Check YES or NO!!!

Dave noticed something he’d never heard of before: a company offering ‘tokens’ (for a fee) that could be used by residency program applicants to signal their love for particular programs.  The general idea is to combat the common applicant strategy of applying to as many residency programs as possible to be sure  the applicant gets a match.  While this strategy is quite reasonable from the individual applicant’s perspective, it causes problems for both programs and the general body of applicants because those extra applications flood programs with candidates that may not actually be interested. 

Then he found out that the Otolaryngology Program
Directors Organization will be doing something similar, and Aline Sandouk, Eric Boeshart, Emma Barr, and Nicole Lacina explore a analysis of who wins and who looses in such a scheme.  

Plus Dave creates an educational game to help students plan how they’ll react to common odd situations.  And by educational, he clearly meant “educational.”

We Want to Hear From You

Do you think Preference Signalling is a good idea? What if medical schools adopts the idea?  Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a kick to hear from you!

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does a DO Degree Ruin your Speciality plans?

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Listener Shivam wrote to theshortcoats@gmail.com to ask his question: does becoming a DO hinder one’s chances in competitive specialties? MD/PhD students Aline Sandouk and Sahaana Arumugam, M2 Nathan Spitz, and M4 Marisa Evers weigh in, while Dave uses his tiny brain to try and parse the National Residency Matching Program’s statistics to find an answer.

Photo by chaddavis.photography

The gang considers whether it would help their anxiety to adopt an alter ego to overcome their anxiety surrounding upcoming events. Then Nathan clues them in to the defacing of the famous George Floyd mural in Minneapolis by a medical student. All that and a smattering of Ellen Degeneris news–is she cancelled?

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How’d we do on this week’s show? Are we cancelled because we angered you? Or did we do okay in the discussion? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  Then, call home. They miss you.

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A COVID Puzzle in a Rural Iowa Community

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Why was the Hispanic population in Clarion, Iowa seeing so many more infections?

Wright County Courthouse, Clarion, Iowa. Photo by Brandonrush (Creative Commons CC0 1.0 Universal Public Domain Dedication)

Dr. Michael McLoughlin, internist at Clarion Clinic, was puzzled. Why were 95% of the patients who showed up with novel coronavirus infections Hispanic? And what interventions would best help his community?

Meanwhile, M2 Abby Walling was looking for a summer project centering on health disparities after her overseas global health experience was cancelled.

Global Health Programs Director Robin Paetzold knew them both (Dr. McLoughlin graduated from CCOM in 2013), and helped get them together to find answers and develop solutions. M4 Sophie Williams-Perez, M2 Ananya Munjal, and M4 Marisa Evers sat down to talk to Abby and Dr. McLoughlin to discuss what they found.

As a bonus, Dr. McLoughlin discusses his life as a rural medicine practitioner in his town of 3,000.

We Want to Hear From You

How’d we do on this week’s show? Did we miss anything in our conversation? Did we anger you? Did we make you smile? Call us at 347-SHORTCT anytime  or email theshortcoats@gmail.com.  It’s always a pleasure to hear from you!