Learning or Memorization: Self-Directed Medical School Curriculum and the Dangers of Overemphasizing Student Selected Ancillary Resources

This article is a response to an opinion article, authored by Wu JH et al. and published in JAMA 2021, vol 326 (20) which suggested the that pre-clinical (first two) years of medical school curriculum should revolve around “high-yield” resources as the dominant teaching tool. The article posited that this highly controversial view was the best way to engage with students and was published in a well-read and utilized medical journal. Due to the growing divide between learning resources provided by medical schools and outside resources actually utilized by students, the conclusions drawn in the mentioned opinion article were understandable but interpreted in the wrong vein. Herein, the authors review landmark changes in medical education over the last century and the underpinning rationale to preface their examination of the suggested changes from the mentioned opinion article. The authors conclude with recommendations from a student perspective and a continuation of the last 100 years of advancements

Utilizing Proximity for Increasing Student Knowledge Retention: A Near-Peer Tutoring Program Needs Study

The purpose of this study was to demonstrate the desire and need for peer-to-peer tutoring programs at Division 1 Dell Medical School at the University of Texas. Materials and Methods. Two sets of surveys were created and sent to students at the Dell Medical School, University of Texas, USA. One survey asking about the need or desire to engage with a peer tutor was sent to first-year students, and another one asking about the desire to provide these services to underclassmen as a potential leadership course option was sent to third-year students. Results. For the first-year student survey, 52.9% of respondents disagreed or strongly disagreed of being aware of near-peer tutoring and 70.5% of respondents either agreed or strongly agreed that it would be an option utilized by students. For the third-year student survey, 75% of students either disagreed or felt neutral in being aware of near-peer tutoring as an option to serve underclassmen, whereas 65% of upperclassmen either agreed or strongly agreed that if near-peer tutoring had been offered, they would have chosen this leadership course option in the effort to teach their underclassmen peers. Conclusions. Numerous studies have demonstrated peer-to-peer tutorial options to be of high utility to students in the medical education space. This particular paper obtained results demonstrating students’ desire to engage in peer tutoring voluntarily for their own course success goals and upperclassmen’s desire to participate as near-peer tutors for the benefit of underclassmen

A Comparison of Australian and American Medical School Admission Experiences

Attaining admission into medical school has been described as a very competitive process by successful matriculants. The processes that medical schools use to classify applicants can greatly differ among institutions. These systemic differences flow over onto the applicant level, such that individuals from different geographic regions can have varied and diverse application experiences depending on local medical school admissions protocols. This piece compares the medical school admission processes of Australia and the United States of America, in the form of a narrative recount of a successful medical school matriculant in each country, with the individual experiences of matriculants from alternative pathways blended into the piece. The authors discovered significant differences in admissions protocols between the two countries, with the greatest differences revolving around admissions exams, applicant profile (high school students versus college students), degree types, and alternative entrance pathways

Part I. SARS-CoV-2 triggered \u27PANIC\u27 attack in severe COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has produced a world-wide collapse of social and economic infrastructure, as well as constrained our freedom of movement. This respiratory tract infection is nefarious in how it targets the most distal and highly vulnerable aspect of the human bronchopulmonary tree, specifically, the delicate yet irreplaceable alveoli that are responsible for the loading of oxygen upon red cell hemoglobin for use by all of the body\u27s tissues. In most symptomatic individuals, the disease is a mild immune-mediated syndrome, with limited damage to the lung tissues. About 20% of those affected experience a disease course characterized by a cataclysmic set of immune activation responses that can culminate in the diffuse and irreversible obliteration of the distal alveoli, leading to a virtual collapse of the gas-exchange apparatus. Here, in Part I of a duology on the characterization and potential treatment for COVID-19, we define severe COVID-19 as a consequence of the ability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to trigger what we now designate for the first time as a ‘Prolific Activation of a Network-Immune-Inflammatory Crisis’, or ‘PANIC’ Attack, in the alveolar tree. In Part II we describe an immunotherapeutic hypothesis worthy of the organization of a randomized clinical trial in order to ascertain whether a repurposed, generic, inexpensive, and widely available agent is capable of abolishing ‘PANIC’; thereby preventing or mitigating severe COVID-19, with monumental ramifications for world health, and the global pandemic that continues to threaten it

Part II. high-dose methotrexate with leucovorin rescue for severe COVID-19: An immune stabilization strategy for SARS-CoV-2 induced \u27PANIC\u27 attack

Here, in Part II of a duology on the characterization and potential treatment for COVID-19, we characterize the application of an innovative treatment regimen for the prevention of the transition from mild to severe COVID-19, as well as detail an intensive immunotherapy intervention hypothesis. We propose as a putative randomized controlled trial that high-dose methotrexate with leucovorin (HDMTX-LR) rescue can abolish \u27PANIC\u27, thereby \u27left-shifting\u27 severe COVID-19 patients to the group majority of those infected with SARS-CoV-2, who are designated as having mild, even asymptomatic, disease. HDMTX-LR is endowed with broadly pleiotropic properties and is a repurposed, generic, inexpensive, and widely available agent which can be administered early in the course of severe COVID-19 thus rescuing the critical and irreplaceable gas-exchange alveoli. Further, we describe a preventative treatment intervention regimen for those designated as having mild to moderate COVID-19 disease, but who exhibit features which herald the transition to the severe variant of this disease. Both of our proposed hypothesis-driven questions should be urgently subjected to rigorous assessment in the context of randomized controlled trials, in order to confirm or refute the contention that the approaches characterized herein, are in fact capable of exerting mitigating, if not abolishing, effects upon SARS-CoV-2 triggered \u27PANIC Attack\u27. Confirmation of our immunotherapy hypothesis would have far-reaching ramifications for the current pandemic, along with yielding invaluable lessons which could be leveraged to more effectively prepare for the next challenge to global health

Treating MS after surviving PML: Discrete strategies for rescue, remission, and recovery patient 1: From the National Multiple Sclerosis Society Case Conference Proceedings

A 38-year-old woman with MS receiving natalizumab presented to the neurology clinic with the complaint of a new neurologic symptom

Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease☆

The COVID-19 pandemic has devastated individuals, families, and institutions throughout the world. Despite the breakneck speed of vaccine development, the human population remains at risk of further devastation. The decision to not become vaccinated, the protracted rollout of available vaccine, vaccine failure, mutational forms of the SARS virus, which may exhibit mounting resistance to our molecular strike at only one form of the viral family, and the rapid ability of the virus(es) to hitch a ride on our global transportation systems, means that we are will likely continue to confront an invisible, yet devastating foe. The enemy targets one of our human physiology’s most important and vulnerable life-preserving body tissues, our broncho-alveolar gas exchange apparatus. Notwithstanding the fear and the fury of this microbe\u27s potential to raise existential questions across the entire spectrum of human endeavor, the application of an early treatment intervention initiative may represent a crucial tool in our defensive strategy. This strategy is driven by evidence-based medical practice principles, those not likely to become antiquated, given the molecular diversity and mutational evolution of this very clever “world traveler

“What IVC?”: Deep Vein Thrombosis in the Context of IVC Dysgenesis

Among young, otherwise healthy adults with unprovoked deep vein thrombosis (DVT), uncommon causes like variation in the normal sequential development of the inferior vena cava (IVC), must be explored. Anomalous IVC conditions are estimated to occur in up to 9% of the general population, with the rarest anomaly being IVC agenesis at 0.0005% - 1% general population prevalence. DVTs are more likely to develop in this population due to venous stasis from decreased venous return, even with the formation of extensive collateral veins. Herein, the authorial team presents a 22-year-old patient with leg pain and swelling who was found to have acute DVT, and, incidentally, the absence of the suprarenal IVC with a robust collateral system on further imaging studies. The morbidity of DVTs in this population is very high, and attention should be given to young patients who present with new-onset DVT in the setting of normal coagulation studies and lack of personal or family history of clotting disorders, as the need for specialized imaging such as venograms is necessary to secure the proper diagnosis