DOCTORS IN TRAINING
Real-life hospital experience shapes future caregivers
Siqi Xue, a third-year medical student at the University of Toronto, just finished her first sixweek rotation at Markham Stouffville Hospital (MSH) this fall.
Every day, at 8:30 a.m., she would look over the electronic medical records of the patients she would see at the hospital’s family medicine clinic, Health for All. She’d duly note their questions and concerns.
Then, when the clinic opened at 9 a.m., patients would begin arriving for their appointments. With each patient, she would conduct an interview, perform a brief physical examination and present the case to her medical supervisor, Dr. Alan Monavvari, chief of family medicine. Together, she and Dr. Monavvari would discuss how to attend to the patient’s medical issues – which ran the gamut from interpreting chest X-rays to managing diabetes – and create a treatment plan.
At that point, she would return to explain the treatment plan to the patient and make sure the patient mutually agreed to follow it. During her rotation, Xue couldn’t get enough of the hands-on experience. “Markham Stouffville Hospital provides such a wonderful, positive learning environment,” says Xue. “I experienced so much passion and dedication on the part of the medical staff.”
Xue is just one of about 117 first- to fourth-year medical students and 20 interns and residents who receive their training at Markham Stouffville Hospital, totalling 17,383 teaching days every year. This year’s number of medical trainees represents a whopping 208% increase since the institution became a teaching hospital only five years ago.
“We try to provide a well-rounded experience so that we expose our medical students to real-life situations,” says Dr. Monavarri. The areas of study include family practice, paediatrics, psychiatry, general surgery, obstetrics, internal medicine, emergency medicine, palliative care and more.
One unique drawing card of the hospital is its initiative in global health, launched under the former chief of family medicine, Dr. Jane Philpott, now the federal minister of health. In partnership with the University of Toronto, Dr. Philpott created a residency program in Africa, with the hospital exporting its family medicine model to countries such as Ethiopia.
The Global Health initiative is one reason Xue chose Markham Stouffville Hospital for her first rotation. She had specialized in microbiology and global health during her undergraduate years at the University of Toronto. “Once a week, we had a lunch-and-learn with doctors who had worked in that area overseas,” says Xue. “It was a real opportunity to see the challenges and opportunities. It might be a field I could pursue later in my career.”
Since Markham Stouffville Hospital serves a multi-ethnic population including South Asians and Chinese, Xue was able to use her native tongue, Mandarin, with some patients who were not fluent in English. The hospital also provides training to overseas doctors. Currently, there are two residents – one from Jordan and another from Saudi Arabia – who will be at the hospital for the next three years. Medical students can take part in original research now taking place at the hospital. The studies include topics such as patient safety, pet therapy and obesity.
Markham Stouffville Hospital also encourages high-school students to volunteer, and in the process many of them decide to become doctors. That is what happened to Dr. Atul Bansal, who now works in the Critical Care Unit at the hospital.
As a teenager, Dr. Bansal worked in the hospital stock room, on the communications desk and also shadowed emergency room doctors. As it happened at that time, Dr. Bansal’s father suffered a heart attack and was brought to MSH. The boy watched as Dr. Wendy Iseman, the on-duty emergency doctor, admitted his father and immediately ran the necessary tests. “As charged as the situation was at the time, I was amazed at all that was happening around me,” Dr. Bansal says. “That was probably one of the key moments in my wanting to become a doctor.”
It took Dr. Bansal 14 years to reach his goal. He got his Bachelor of Science degree at the University of Toronto, attended the American University of the Caribbean in St. Maarten, and did clinical rotations at Barts and The Royal London Hospital shadowing some of the Queen’s physicians. He finished his critical care training at McMaster University in Hamilton and, in 2007, he joined MSH. He’s been there ever since.
Like Dr. Bansal, Xue also had the opportunity to shadow specialists. In her case, a pharmacist and a dietitian. What’s more, she spent a day on the palliative care unit. But what she appreciated the most was the time Dr. Monavvari took to explain case histories with her after working hours. “He was the perfect combination of science and the art of healing. He is so empathetic, and patients really appreciate his caring ways. He exemplified all the qualities I aspire to as a doctor.”
One particular case in which she witnessed Dr. Monavvari’s extraordinary empathy involved a young woman who had suffered a spontaneous miscarriage. Dr. Monavvari helped the woman grieve her loss. “It was the first experience of death for me as a medical student,” says Xue. “It lead me to do an academic project on screening for depression after miscarriage.”
Back at university to finish out her year, Xue is already planning for her future training. A return to Markham Stouffville Hospital is in her sights. “I would definitely come back to MSH to do my residency!” says Xue.