Monica – Final Thoughts

Sadly, my shadowing has come to an end. These past weeks have been amazing- I have gained tons of knowledge, experience, and insight into the medical field and made life-long memories along the way. Observing Dr. Isenberg and his colleagues was a dream and I’m very grateful I received the opportunity to do so.

I watched him interact with his patients in the clinical environment, right before surgery, and his follow-up consultation with the patient about a few days or a week later. I was able to learn, in this particular profession, how he builds the doctor-patient relationship in its entirety throughout the different stages from their initial visitation, to surgery, to their follow-up visits. It shows the continuity in his practice and how he can get to know his patients, not just their case.

During the second half of the shadowing program, I finally was able to mostly distinguish the different parts of the colon on the screen when watching a colonoscopy. I even had an opportunity to try doing one on my own! Through a simulation screen, of course. I was elated to give it a go after weeks of watching, and I managed to reach the cecum, but I found out that it’s not nearly as easy as Dr. Isenberg makes it to be.  It was shockingly intense and saddening to watch a surgery on some patients that were around my age. I couldn’t imagine being in their situation, especially when some were suffering from  excruciating pain. On the flip side I also observed him helping elderly patients who were suffering from multiple issues. It made me realize that anyone can be exposed to unwanted ailments no matter the age, gender, or race, so being able to help people in their time of need is very rewarding.

I very much enjoyed the environment at Thomas Jefferson. Due to it being a university hospital, I was able to spend a good amount of time with Dr. Isenberg’s team, which consisted of a fellow, residents, and medical students. Everyone there was really amicable and explained cases to me and answered my questions. One of the medical students taught me how to tie square knots, and I was able to practice suturing. The fellow doctors in Dr. Isenberg’s department were also very friendly and I shadowed them as well, in clinic and in the OR. Before any surgery, the doctors always say “safety is a team effort so speak up” or something similar, which is nice because everyone in the room plays a role and needs to be working together to produce the desired outcome. It was good to learn that teamwork is very valuable in this profession as well.

Some new types of cases I observed were creating an ileostomy, reversing a colostomy, removing multiple metastasized tumors, and a perianeal proctectomy. It was still surreal seeing organs outside of the body, especially if they were damaged. Some of the surgeries were performed laparoscopically, some open which was my favorite, and some robotically which was also very cool since I was able to sit on the robot and see the 3-dimensional view from the eyes of the robot. I was fortunate to witness a rare situation where they needed to brainstorm the diagnosis in the operating room for various reasons and make decisions on the spot. I also observed that they were stressed at times, which I actually appreciated because it showed how much they cared about their patients and wanted to give them the best possible treatment.

I couldn’t have asked for a better shadowing experience! I would like to thank the Brandeis pre-health department for matching me with this program, and my sincere thanks to the colorectal team at Thomas Jefferson, especially Dr. Isenberg, for allowing me to shadow him and providing such a valuable life experience. I could only hope that one day I can be as good of a surgeon as he is. I’m excited for what the future holds!

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Penh – Final Thoughts

This program has truly been a great experience and far exceeded my expectations. Going into the program, I was extremely nervous but Dr. Cataldo and his team immediately put me at ease on the very first day. My expectations for the experience consisted of simply observing the inner workings of the hospital, understanding the complexity of patient-provider interactions and applying some of my academic knowledge to my observations. While spending numerous hours in the clinic and OR, I feel like these goals have been achieved. I have witnessed the importance of teamwork whether it be in more dire situations like in the OR or in a friendly environment such as in the office. Everyone from the medical assistants to nurses, RNs and residents help the appointments go smoothly. 

This experience at Beth Israel has certainly clarified my career interest in becoming a doctor. Not only that but it has opened my eyes to the realm of surgeons which I have learned is extremely demanding. While I had the luxury of leaving the operation room at any time for bathroom breaks or a lunch, my colorectal surgeon pushed forward to finish his surgery at hand before considering any breaks. Although surgery is exciting, I am not sure whether I can handle the demanding schedule and pressure with becoming a surgeon. 

My advice to a student interested in shadowing is to not be afraid to speak out. Firstly, if you are trying to land a shadowing position, it would be beneficial to call the doctor’s office and/or email to ask. While shadowing, ask questions and be engaged. At Beth Israel, the staff is very friendly and knowledgeable. I was actually encouraged to ask questions by them. For those who are interested in shadowing at other institutions, I am sure this advice would also apply. 

I am most proud of getting rid of my shyness and nervousness by the end of the experience. I felt intimidated by the staff at the beginning and was afraid of asking “stupid” questions. Of course, everyone was very welcoming and I eventually felt comfortable at the hospital.

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Tracy – Midway Point

It’s been about 3 weeks ever since my internship started, and to be honest, this has been a much more valuable experience than I ever thought it would!

My main task has been to populate a RedCap database with patient information concerning vaginal lacerations during childbirth. Ultimately, our goal is to find out what sort of factors correlate with severe lacerations, along with any “breakdowns” of the surgical laceration repairs – which means that somehow, the repair might break and the wound would rupture. In order to enter data, I’ve been reading previous notes on the patient’s condition concerning their pregnancy. Even though this is a retrospective study, reading those notes has actually been very interesting because it’s almost as if I’m reading along with the patient’s journey! I get to read how the patient has been doing health wise concerning their pregnancy, their pregnancy details, and how both they and the baby have been doing after the pregnancy. It’s a little silly to say, but it always makes me happy whenever the mother and the baby are doing well postpartum! I have also been learning so much about obstetrics – for example, different surgical procedures for laceration repairs, details about childbirth, potential factors that correlate with difficult pregnancies – and even though I’m not intending to go into this field, it’s been quite interesting nonetheless.

In addition to my database entry responsibilities, I am also shadowing OB / GYNs during their consultations and surgeries. Even though I didn’t think I would be that interested in obstetrics or gynecology, it’s been so wonderful and heartwarming to watch how doctors treat their patients – how kind and patient the doctors are, how they make the patients comfortable by talking about other things in life, and how talented the doctors are at teaching patients about their health conditions and treatment options, especially in such a field as this where patients may feel embarrassed or ashamed of themselves. It’s also been incredible watching surgeries – so far I’ve only seen surgeries related to prolapses and urinary incontinence – but they have been laparoscopic surgeries, which means the doctor makes a small incision in the abdomen, inserts a camera, and does all their surgery work inside while looking at a monitor. It seems so difficult, making small stitches while only looking at a 2D monitor! But the attending doctors and fellows have all been so great at it! And during the surgeries, more experienced physicians will often be teaching residents and medical students as well. It’s a wonderful relationship to see, and it makes me a bit happy too because it feels more personable when you see interactions between people in all stages of their health careers.

Overall, even though it’s only been 3 weeks (and I pretty much only go 2 – 3 days a week), I’ve been learning and experiencing so much that I find meaningful to me, regardless of whatever profession I’m interested in! I think something especially wonderful that I’ve been able to see is the patient to doctor interaction; how in this clinical space where we’re talking about the patient’s health, there is no judgement or blame – it’s all about how we can help you do better and feel better, and how we can help you feel more comfortable. To me, that’s something so valuable and precious; the trust between a patient and a doctor – and I would love to become someone like that in the future! All in all, I am incredibly thankful to all the faculty at MGH and the prehealth department at Brandeis for being so considerate, and for helping me grow and learn!

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Jasmine – Midway Point

We having been working as research assistants for Female Pelvic Medicine and Reproductive Surgery for about a month now. The main goal of this program is to encourage women to build the courage and be comfortable with health problems that they may have been too embarrassed to seek help for due to social stigmas. I have been going into the hospital Monday through Friday to either work on the database or shadow or a combination of both. The majority of the week I spend working on the Perineal Database which creates a log of all women at Massachusetts General Hospital who have had a perineal laceration as a result of vaginal child birth. Using a compiled excel sheet of all the patients that have endured some kind of perineal laceration, we search them through EPIC, a program containing all patient history, and read through and upload the details asked for by the database.

Dr. Hudson has been amazing to work with and learn from. She has been very helpful in that every Tuesday morning; we meet to discuss any problems or questions that we may have come across when working on the database. In these meetings, Dr. Hudson has also been wonderful in teaching us about the different cases of perineal lacerations we may come across so that we do not feel lost in the information we are working with.

This being my first research experience, working on the Perineal Database has been a fast learning experience. As explained above, the Perineal Database is a retrospective clinical database. Therefore, all the information that is compiled is information that had been logged as long as 10 years ago. I have learned that one of the benefits of a retrospective clinical research is that the information that you need is already available for you in the patients’ history. However, a major downside to a retrospective clinical research is that you only have the information that is available to you. We found that while reading and searching through the patients’ history, there are many cases where there are missing details or even missing documents as a whole. In these cases, the only option we have is to left those fields in the database blank. Nonetheless, working as a research assistant for perineal lacerations has been an amazing experience so far.

Once a week, we are shadowing in the clinic with whomever the attending of the week happens to be. The clinic mostly consists of consults with mostly older women who have already experienced menopause or are experiencing menopause, that have concerns about prolapse. So far, I have gotten to shadow multiple routine examinations and the taking of vaginal measurements to diagnose a prolapse. Other appointments include pre-operation and postoperation consults. Lastly, I have noticed that there are a lot of patients that are referred pelvic floor physical therapy, a far less invasive form of treatment, that is close to the patients’ home.

Shadowing in the operating room has also been a new experience. The main procedures that I have been shadowing have been sacrocolpopexies. In a sacrocolpopexy, a mesh sling is places to fix a prolapse or treat urinary incontinence. Furthermore, it has been interesting to see that they minimize invasion by proceeding with a laparoscopic approach. Furthermore, earlier this summer, I shadowed in the operating rooms in a public care hospital in Budapest. One huge difference that I noticed is that prepping the patient for surgery in Budapest would take a minimum of thirty minutes, especially because doctors in the public system were very understaffed. However, at Massachusetts General, by the time the surgeon shows up to the operating room, everything is prepped and in place. The hardworking nurses and the system that is in place makes everything go smoother and faster. I look forward to continuing my learning experiences at MassGeneral with Dr. Hudson for the weeks to come.

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Monica – Midway Point

I can’t believe it’s already halfway through! I’ve seen so many incredible procedures and interactions, met and had conversations with various people, and have gained so much knowledge these past few weeks. The first day I began shadowing was probably the most nervous I’d ever felt entering a new environment, mainly due to the fact that there were so many thoughts running through my head. Immediately Dr. Isenberg got to work, and I had only just started to grasp how jam-packed his workdays are. He is very friendly and made me feel comfortable being there, especially since I initially felt like I was constantly in the way. Although seeing a colonoscopy has since become normal for me, the first time I saw him perform one I was awed at how easy he made it look, and was captured by seeing the inside of a colon through a camera. Though I have to admit it was weird to see it at first, weird was quickly replaced by fascinated. I’ve seen him remove polyps inside the colon to preemptively get rid of any causes for cancer, and I am constantly amazed at how he can distinguish the different parts of the colon on the screen, since they all look the same to me!

I also witnessed him interacting with lots of patients. I like how he is able to communicate effectively and succinctly while still maintaining an amiable and caring persona. He goes into each appointment with a game plan already in mind, and asks more questions from the patient to confirm his thinking. It’s interesting to me to see how quickly he is able to draw conclusions by hearing about a patient’s worries or by checking them, because it shows how knowledgeable he is in his field. Many of the patients he sees have similar cases, but some have had different issues and some more serious conditions, namely cancer. I was shocked the first time when I heard Dr. Isenberg talking to his patients about the threat of cancer and ways to immediately start fighting it, because cancer can completely change a person’s life. However, after observing such cases for some time, it is no longer shocking and now I understand the seriousness of the situation and how a cancer can be life threatening. It was also amazing to see how the doctors set their emotions apart while treating their patients, knowing fully well that at times the results may not be very favorable and in some cases even fatal.

Another situation I observed was when doctors did not have all the answers to help solve the patient’s issue. When patients complained about having certain ailments to Dr. Isenberg, all he could tell them was to wait since nothing else would fix their problem immediately. I could understand the frustration from the patient’s side, but it was also interesting to see if from the doctor’s perspective: waiting was the best option because giving medicine or immediately operating wouldn’t help at all. Though patients come to doctors expecting for a quick fix, I learned that sometimes it’s not the case, and I also witnessed how some took the news well, while others not so much.

The coolest part of these past few weeks was definitely surgery. I’ve been able to see different surgeries ranging from cases such as fistulotomy and hemorrhoidectomy to more invasive ones like a laparoscopic removal of the colon and perineal proctectomy. I get to stand in the ER and watch everything- the patient getting put under, sterilizing the patient with betadine, the incisions and the actual surgery, suturing the cuts, and dressing up. The environment is a bit more relaxed than I thought it would be since they play music in the background! The doctors are still completely focused, of course. When Dr. Isenberg removed the colon from one patient, I couldn’t believe how big it was when he kept pulling and pulling it out from the incision he made! Then, the colon was just put in a pile on the table for a few minutes, and I was just staring at that patient’s colon. It was surreal, seeing a major organ outside of the body just lying there. Seeing surgeries and the work/effort that goes into it is giving me a new appreciation and perspective for the development of the medical world and the amount of procedures surgeons are able to accomplish.

Finally, being in the heart of Philadelphia where the all the actions are has been such a blast. It’s the perfect location for me to be in the hospital all day, and then walk around the city in the evening and explore everything that it offered, such as museums, restaurants, and outdoor activities. The hospital is located in the heart of the city, so there are a lot of patients that check-in with a wide variety of ailments so I get to see a varied types of cases. I’m very much looking forward to the next few weeks to see what else is in store!

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Katherine Final Thoughts

I have just finished my 6 week shadowing program at CHA. It has been an incredible opportunity to learn more about the medical profession. I would like to start off by thanking everyone who has made this experience possible, especially the Brandeis pre-health department, Dr. Sheth, and all of the staff at CHA.  I am grateful that so many people have been willing to help me out and teach me about their lives.

During my experience, I have been able to observe surgeries up close, shadow diverse specialties such as podiatry and vascular, observe patient care in the clinic and emergency room setting, and interact with surgeons, nurses, PAs, surgical techs, medical students, residents, and patients.

My main goal for this experience was to help decide my future career goals. Although I still do not know for certain which career I want to pursue, I think that I have definitely made progress in making a decision. While I’m still interested in being a doctor, I’ve learned about other paths that I could pursue, and have gained a better view of the different healthcare actors and how they contribute to providing care. For example, I had previously had very little knowledge about PAs, but now have a much better understanding of how PAs and doctors interact to provide patient care. In addition, going into the experience, I was most interested in general surgery. However, by shadowing other specialties such as opthamology, I realized that there are other fields that interest me, even those which I had previously dismissed. This experience has helped me to discover new possibilities in terms of fields that I could pursue, and helped me gain a more realistic understanding of the medical profession.

This experience has helped me to gain confidence in the hospital setting, understand the organization of the OR and clinic settings, and learn the difference between various types of hospitals. All of this will help me if I work in the hospital setting in the future. While I still have more time to decide on my future career goals, I am now much more equipped to ask the right questions and make an informed decision.

 

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Jen – Pre Departure

When I was a first year student at Brandeis University, I had slight idea that I wanted to go into the medical field. After three full years filled with its own hardships and rewards, I began to solidify my desire to have a career working with patients in a hospital setting. I am still unsure if I want to attend medical school or physician assistant school. I enjoy the social aspect of interacting with patients and I would like to incorporate my academic knowledge in my future career. Since I have never shadowed a physician before, I only have a vague idea of what their day to day life is like.

While volunteering at Massachusetts General Hospital in the Emergency Department, I have overheard many physician-patient, PA-patient, as well as nurse-patient interactions. I noticed a familiar trend with most physicians and other medical professionals. Physicians know how to interact with a wide variety of people, while being able to apply their medical knowledge and skills to treat their patients. I view physicians as being excellent leaders and care-givers. Perhaps my view of what a physician is may not yet be entirely reflective of the entire profession. However, after my shadowing experience with Dr. Denoya, I hope to have developed a clearer idea of what being a physician means.

For three weeks in the month of July, I will be shadowing Dr. Paula Denoya, a colorectal surgeon at Stony Brook Medicine. When considering possible medical specialties, I have contemplated fields such as dermatology, neurology, surgery, and emergency medicine. I am not entirely sure what the profession of a colorectal surgeon specifically entails; however, I am excited to begin my shadowing experience. I hope to observe how physicians interact with other medical professions and their patients. I aim to learn key communication skills from observing Dr. Denoya consult her patients. I believe this shadowing experience is a wonderful opportunity to learn and meet new people that can mold my mindset on the medical field.

I believe it would be extremely rewarding and fascinating to observe Dr. Denoya in the operating room and her interactions with her patients. Since I am still unsure if medical school and being a physician is the right path for me, I hope to leave Stony Brook Medicine with a sense of clarity. The shadowing experience will either confirm my desire in attending medical school or reveal an unexpected thought – that a physician’s career is not the right fit for me. Either way, I hope to end up with a solid decision to attend medical school or PA school.

The first couple of days shadowing Dr. Denoya was truly inspiration. On the first day I arrived at Stony Brook Medicine, I was able to go into the OR and observe a laparotomy performed by Dr. Denoya and a fellow. Not only was I able to see Dr. Denoya perform her duty as a colorectal surgeon, but I was also able to see how she interacts with the anesthesiologist, and nurses. The second day of shadowing Dr. Denoya consisted of something a little different. We were in a clinical setting and I observed Dr. Denoya’s interactions with patients in an outpatient environment. I have learned a copious amount in these two days and Dr. Denoya plays a key role role in expanding my knowledge of colorectal surgery. I never really knew what a colorectal surgeon was until I began my shadowing; hopefully, I will develop a more complete understanding for the profession by the end of my stay at Stony Brook Medicine with Dr. Denoya. I am excited to see what the remaining few weeks will entail.

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Itay – Pre Departure

Words cannot explain my excitement to begin my internship at Massachusetts General Hospital’s Center for Pelvic Floor Disorders. In this world renowned hospital, I will have the opportunity to learn from the co-director of the department, Dr. Liliana Bordeianou, and be guided by Nurse Practitioner Lieba Savitt. This is a very unique opportunity that the Brandeis Summer Shadowing program offers in that it threads together shadowing and research regarding a fascinating subdivision of medicine. However, I think that the true meaning of this experience will lie behind the interaction invoked between the observation and research that I will be exposed to.

These two cornerstones of medical practice will season each other, maximizing the value each other yields for me as a participant. Knowledge about what I am observing, and the understanding of its place towards slowly furthering the medical world through retrospective research, will enrich the taste I take away from my presence observing surgeries. Likewise, shadowing will create a more emotional and picturesque connection to the investigations I will be doing. Medical terms will paint images, charts will tell stories, and publications will be written memoirs of what will hopefully roll out to be motivational and impactful summer internship.

I look forward to being in the high-paced, intense hospital setting and to being an involved, difference-making member of the department. With that in mind, as the start date gets closer, I realize that I must make a point to prepare myself for this experience mentally and academically so that I am truly ready to begin. I made sure to be sent plentiful material to read about past and current research going that Dr. Liliana Bordeianou and the department has published and have further fulfilled this with materials I have found online. I believe that understanding and mastering what you do does a lot more than to teach you what you are doing, it teaches you why you are doing it. As the looming start day creeps up I can proudly say I now know what needs to be done and why, and am excited to take on the responsibility of doing it.

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Cameron – Midway Point

In my earlier post I noted my uncertainty and tentative excitement for the summer ahead, and while waiting for my badge to be printed on my first day, I found myself again filled with these feelings — and with a couple questions too: Who will I work most closely with? What projects will I get to work on?

Looking back at my time here at MGH, my first few weeks have been filled with so many new experiences and people — and together they’ve more than answered my initial questions. MGH is the largest hospital I’ve worked in, and I’m continually impressed by the seemingly endless labyrinth of hallways and staircases. Still, I hope sharing my experiences can lend some insight beyond the hallways: From clinical research in the office to surgeries in the OR.

I spent my first days entering patient surveys and charts into databases for the Center for Pelvic Floor Disorders and the Department of General and Gastrointestinal Surgery. Once I was comfortable with data entry, I was tasked with updating and designing some new database surveys for MGH and collaborating surgery centers. From there, I worked through journal articles to collect ranges of recommended ages for colorectal cancer screening. While working through databases and articles I started asking: Why is it important for clinicians to collaborate on clinical journal articles? Physicians and Nurse Practitioners are often the first ones in the office after rounds, and the last ones to leave after finishing up patient notes — so how do they prioritize publishing and discussing articles?

During my second week, I shadowed surgeons in the OR. While explaining the procedures, surgeons didn’t hesitate to reference recent clinical research discoveries as support for performing a specific type of surgery. Throughout my weeks at MGH, surgeons and research residents have frequently discussed how studies guide decisions in the clinic (for example, risk factors for cancer), during surgeries, and during post-operative care (to reduce readmission). From this, I can see how essential it is for surgeons to continually review recent screening, surgical, and post-surgical statistics.

Above, I asked how clinicians prioritize being immersed in the scientific literature. When something a nurse practitioner reads today can affect the patient of tomorrow, and when a surgeon collaborates on an article for next month that could in turn help multitudes more patients — the benefits can be powerful and far reaching. For these reasons, I’m continually inspired to work through even repetitive tasks like data entry, because I admire the potential that data could one day have. Still, I have yet to turn down an invitation to escape patient files for a trip to shadow in the OR.

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Monica – Pre Departure

This summer I have been given the opportunity to shadow at the Thomas Jefferson University Hospital in Philadelphia, Pennsylvania through the Brandeis program! I am looking forward to shadowing Dr. Gerald Isenberg, professor of surgery and program director for the Colorectal Surgery Residency.  I intend to shadow him as he meets, interacts with, and examines patients. I am truly excited about the opportunity to be able to witness him and his colleagues performing surgery in the OR.

Since young I have always wanted to become a doctor. In high school I attended a summer camp for students interested in pursuing a career in medicine, and also volunteered in a university hospital recovery room where I assisted nurses by attending to patients’ needs.  I witnessed firsthand how stressful the environment can be and how those nurses handled the patients with care. These experiences reaffirmed my goal to work in the medical field and help others.

This being my first shadowing experience, I hope to learn as much as I can from a doctor’s perspective by observing what goes on behind the scenes during pre-and post surgery activities in a hospital environment, and the teamwork that it takes to fully treat patients. I have watched a few medical shows on TV, but I’m guessing that in reality, hospitals may not be as dramatic at all times!

I would really like to learn how Dr. Isenberg communicates with his patients about their condition- the approach he takes to relate to the patients, the types of questions he asks them, the medical terminology he uses to articulate his thoughts, the steps to diagnosis, and the decision-making that goes into providing treatment options. I look forward to hearing about his experiences over the years, and how he got to where he is today. It would be nice to also witness doctors collaborating with other specialists to understand how they come to conclusive diagnoses. In addition, I’m excited to meet and network with others who work there, such as fellow doctors, nurses, and interns, so I can gather as much information as I can about what it takes to be a doctor and work in a hospital environment.

The knowledge I gain this summer will hopefully transfer to the research I am involved in on campus during the school year. Furthermore, this summer will provide experiences that I’ll carry with me for a lifetime. I can’t wait to start!

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