Visiting Student Reflections

Sameer Mittu

Dayanand Medical College And Hospital, Ludhiana, Punjab, India
Emergency Medicine - Sub-Internship
April, 2016

I obtained an opportunity to rotate at NewYork-Presbyterian Queens Hospital from 04/04/2016 - 05/01/2016. This Sub-Internship with the Department of Emergency Medicine was an exclusively privileged grounding for me. The Director of Emergency Medicine, Dr. Nao Yoneda, was a brilliant person. Due to the pre-formulated excellent schedule and her directions, I could discern how things would be at the ED. The encyclopedic exposure to patients from various ethnicities with intricate presentations, and their management in the pecking order of momentousness was a pristine experience for me. Working in discrete zones such as the trauma room, the urgent care, pediatrics, and with the ultrasound team deployed my cognizance about the contemporary system of emergency management in the United States. Everyone in the ED, from the consultants to the residents to the nursing staff, despite being immensely busy due to the copious patient load, were not only exceptionally cooperative and harmonious but also entitled me to assist in numerous critical procedures like LP, ET intubation, CT insertion, etc. They empowered me to do procedures like I&Ds, wound dressings, peg replacements, etc independently and were there to observe me on request as well. The tact and prudence of the ED doctors, their stoicism, and compassion in dealing with the patients, especially the agitated ones, as well as their families, enlightened and reinforced me towards the significance of professionalism in medicine.

The systematized conferences every week included enthralling case/topic discussions, and simulating labs with the residents explaining the recognition and management of precarious patients. The morning case reports (I presented a case on "side-effects of anti-psychotics") disclosed a new way of practical learning and experience sharing which I found to be a very majestic and potent method of education. Through the procedure labs marshalled by Dr. Yoneda, I could comprehend the basic emergency procedures like US guided IV/central line placement, splinting of comminuted upper and lower extremity fractures, varied suturing techniques, etc. This enabled me to gain a skillful grasp over them.

The diverse experience comprised of day shifts, night shifts, 12 hr, and 8 hr shifts, succoured me to develop endurance in this exacting profession. Everyday I worked with a new attending who indoctrinated me the innovative and goal-oriented style of proceeding with enigmatic case presentations. One example was a renal case who presented as bradycardia and hyperkalemia. Through this encounter as a sub-intern, I could put my capabilities to the test. The encouraging attitudes and the positive reviews on my evaluations from the faculty at the end of each shift ameliorated me and boosted my confidence. This rotation in Emergency Medicine has literally revamped my reasoning to opt for it as my choice of residency in the future and I distinctly endorse this rotation for all my fellow scholars.

In fact, I feel fortuitous to have been appointed to this sub-internship by the two charming personalities I met at the WCMC Global Health Department: Dr. Madelon L. Finkel and Mrs. Dianne E. Young. Meeting them was an enchantment as they encouraged us to consider the elective experience whole-heartedly, but simultaneously, reminded us not to forget to enjoy the beauty of NYC. Their guidance benefited me in making my visit to NYC a journey beyond amazing ! Mrs. Dianne, notably, was an astonishing neoteric for me during the hilariously indelible Staten Island trip and the NYC Holi festival. After exploring the divergent departments in Weill Cornell, whether the Global Health, the Library, the Clerkship Office, the Cornell Store, the Cafeterias, or the Housing Office (stupendous individuals), I perceived the rationale behind Weill Cornell's illustrious success and its immutable supreme status in New York/United States.

I wish I could be a part of this foundation one day!

Nabeela Kajee

University of Stellenbosch, Cape Town, South Africa
Clinical Nephrology
December, 2015

November/December 2015

Tom Wolfe once remarked that “One belongs to New York instantly; one belongs to it as much in five minutes as in five years”. I was reminded of his eloquent assertion on my first day at New York Presbyterian Hospital (NYPH). I felt an undeniable sense of belonging. As I reflect on this opportunity, it remains a remarkable honor to have been the first medical elective student from South Africa at Weill Cornell Medical College (WCMC).

My medical elective was served in the Clinical Nephrology department, from 11/23/2015 – 12/18/2015. I worked closely with the Renal Fellow, Dr. Zain Mithani, as well as my Attending physician, Dr. Muthukumar Thangamani. Our daily rounds were a particularly transformational learning platform, and Dr. Thangamani encouraged my intellectual curiosity.

My elective time was divided between the renal consultation and follow up of referred inpatients, the attendance of our departmental Grand Rounds, Journal Clubs and Case Discussions. The academic activities which I participated in, including clinical patient cases, were an integrative experience. On closer appraisal, I appreciate how considerably my medical knowledge and skills have grown. Furthermore, I realize the professional depth I have gained from the opportunity to work closely with the Clinical Nephrology team at NYPH.

Having an interest in Global Health, I was in the prime position to learn more regarding the structures and policies of the United States Healthcare System. Having joined the Weill Cornell Global Health Grand Rounds, I was captivated by the diverse learning environment present at Weill Cornell, the access to ground-breaking science – and the comprehensive patient care that the facility offered.

I deeply appreciate the opportunity to have shared my elective with fellow elective students of numerous countries; we have created lasting connections and gained profound global perspective. I wish to thank Dianne Young and Dr. Madelon Finkel for their efforts in making this opportunity possible for medical students such as myself, from across the globe. This medical elective has certainly been one of the most interesting experiences of my medical career so far.

Martha Martin

King's College London, UK
September, 2015

I have just spent one of the best months of my life in New York - for anyone thinking about coming to Cornell, I highly recommend undertaking an elective here. I spent the first two weeks at New York Presbyterian Hospital (NYPH) completing a Radiology elective, beginning with Pediatric Radiology and then moving on to the ER Reading Room.

The hospital's small Pediatrics team was welcoming and allowed me to learn side-by-side with the residents, along with giving me the opportunity to ask questions. My mornings usually involved watching the team read the images; when fluoroscopy or more complicated studies were required, I would observe as the team undertook the study. The ER had a similarly friendly environment to Pediatric Radiology, and shared their emphasis on facilitating medical students' learning. One of the best things about the Radiology elective was the emphasis on teaching, exemplified by the number of conferences that students could attend. I came away from these two weeks feeling much more confident in reading images and recognizing different radiological signs of pathology.

The staff and faculty (Dianne Young and Dr. Finkel) were accommodating in organizing for me to spend further time at NYPH to gain first-hand experience of the US healthcare system, and also to attend numerous extra conferences and tutorials. These included the Healthcare Policy Colloquia on Wednesday afternoons, and talks by the group "Physicians for a National Health Program". This was particularly interesting for me, coming as I do from a country where this system of health delivery is already a reality.

I spent my time in hospital in Internal Medicine with the hospitalist Dr. Joseph Shin which was an invaluable experience. I accompanied Dr. Shin on Rounds, together with a Physician Assistant, from 8am until noon each day; he would include me in dialogues with the patients and about their management, using every case as a teaching opportunity. In the afternoon, we would revisit the morning's patients, and note their progress during the day. While conducting these revisits, Dr. Shin would also give me at least an hour of his time, in which we would engage with a clinical topic (for example, heart failure - as many of our patients came in with an exacerbation of CHF) or a healthcare system reading-based discussion. It was such a privilege to have this one-on one time which allowed me to ask an expert questions about what I had seen during the day, as well as questions about the US healthcare system, which I had wondered about before having the opportunity of coming to the USA. Observing such high quality care being delivered, and then learning about the complexities in funding and insurance systems that are the background to it, was fascinating.

Dr. Shin's gift for teaching, combined with his thoughtfulness in helping me to achieve my original objectives to learn about Healthcare Policy and Public Health, was the highlight of my elective.

Based on my observations, I believe that Cornell chooses its faculty based on the physicians' enthusiasm and passion for their profession. As a student coming here, I found this attitude and energy to be contagious - I want to go back!

Reanna Gobin

University of the West Indies, St. Augustine, Trinidad
Pediatric Hematology-Oncology
September, 2015

The 4 weeks I spent in Pediatric Hematology-Oncology at New York Presbyterian were absolutely wonderful. The experience provided me with a unique glimpse into a very interesting sub-specialty while allowing me to observe the way that the American health care system worked.

During my elective, I worked with the residents and fellows to see patients every day in the outpatient clinics. The structure of the elective allowed me to work with 5 attendings in the department and, as a result, I was able to learn about a wide range of disease presentations. The resident or fellow and I would conduct the patient consultation and then discuss the case with the attending for that respective clinic. This afforded me the opportunity to be a part of in-depth discussions about the patient’s condition, covering everything from etiology and pathophysiology of the disease to the appropriate evidence-based management for the patient.

Teaching was very important to the attendings and they would often spend time going over interesting diseases, starting from the basics and moving on to current studies and research papers, ensuring that we had a thorough understanding of the condition, often using their own slides and videos to illustrate key concepts. Evidence-based medicine was an area of focus since we had patients with rare conditions whose management protocols are still being elucidated. It was very interesting to be able to conduct a literature search and then discuss the findings with the fellows and attendings (whose papers were often one that was found and discussed!).

Every morning and at noon, there were conferences which were attended by the medical students and residents. These included presentations on pediatric conditions and allowed me to learn about different diseases outside of the Hematology-Oncology spectrum. The Wednesday afternoon department rounds consisted of reviewing all of the inpatients and discussing their progress and management. These meetings involved all of the attendings, fellows and residents as well as the nurse practitioner, social worker and other patient support staff. This was a novel concept for me, as we do not have this level of collaboration in Trinidad.

I am extremely thankful for the opportunity to spend my elective at Weill Cornell New York Presbyterian and I highly recommend it to other international students. Thanks must be expressed to the staff at the Global Health Office, Dr. Finkel and Mrs. Young, who was especially helpful during the entire process. Mrs. Dianne Young, in particular, was tremendously supportive and her assistance was integral to making this experience enjoyable. I must also thank the attendings, fellows and residents for being so welcoming and for taking the time to teach me and provide such an enriching and memorable elective experience.

Christopher Uschnig, MSc

King's College London, UK
September, 2015

During my rotation in pediatrics, I was working mostly with children from low-income families. It was a valuable experience to get a clinical insight what kind of services are offered for children and their mothers through public funding. Cornell's pediatrics department offers prevention programs such as Health for Life that support obese kids on all levels independent of their parents income. As a MD student from Austria that is having a universal health care, this clinical elective gave me a good understanding how patient care takes place in a publicly and privately funded setting in the U.S..

Reporting back, consulting, and deciding with residents and attending physicians how to treat a patient, is a concept that slightly differs from Austria where usually less time is dedicated to confirm findings or diagnosis with other doctors. This approach allowed me to be in constant dialogue with other physicians and very much enriched my educational experience as a clinical scholar. Moreover, I enjoyed the opportunity to visit conferences daily which are also an integral part of the education of MD students and residents at Weill Cornell.

Personally, I achieved my goals to learn more about medical conditions in children of all ages, got a clinical insight in the U.S. health care system, but also got more confidence in evaluating children's health status such as child development.

Thanks to Dr. Maura Frank for supervising me, Dr. Madelon Finkel and Mrs. Dianne Young from the Global Health office for their great support and assistance, but also to all residents and attending physicians who took the time to teach me. All of them made my time at Cornell a memorable experience.

Weill Cornell Medicine
Office of International Medical Student Education
1300 York Avenue (C-118) New York, NY 10065 Phone: (646) 962-8058