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IMPORTANT DATES

NYCOM Pulse

V O L U M E

NYCOM STUDENT GOVERNMENT ASSOCIATION

August 13: Class of 2014

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orientation 

August 18: Big Brother Big Sister Cook-out

August 20: Activities Fair

September 6: Labor Day (no classes)

September 7: Class of 2013 and 2014 Exam

October 5: SGA Meeting

October 11: NBOME Subject Exams

April 7: DO Day on the Hill

INSIDE THIS ISSUE: Message from the Director of Student LIfe

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UAAO Preceptorship

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So You Think You Can Diagnose

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NYCOM Visits the Black Star

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Hospital for Special Surgery

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Funny Bone: OrganYuck

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Renewing the Fight Against HIV/AIDS

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S.Y.T.Y.C.D. Answers

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Pura Vida

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AHEC

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Welcome from the Student Government Association! Welcome NYCOM studentphysicians to the 2010-2011 academic year! The school year is off to a fast and exciting start as students from the Class of 2011 begin to showcase themselves at potential residency programs. Third year students took Level I of the Comprehensive Osteopathic Medical Licensing Exam (COMLEX) this June and completed the Introduction to Clinical Medicine course including Advanced Cardiac Life Support certification, setting the stage for students to start their clinical clerkships. The Class of 2013 is one week into their Cardiovascular and Respiratory system courses but are already dreaming of being in the hospitals, and the first-year students are completing orientation and gearing up for Introduction to Osteopathic Medicine. As NYCOM sets the stage to welcome its 32nd entering first-year class, the administration, faculty, and current students have been hard at work this summer planning for the academic year. The administration has fine-tuned the Lecture-Discussion Based curriculum to better integrate material and improve clinical skills in addition to strengthening the Doctor-Patient Continuum curriculum. Improvements and additions are underway to facilities, technology infrastructure, the medical library, and several other

key student resources. The faculty has been busy incorporating new approaches to classroom learning and teaching and is planning for a year of student interaction and critical thinking. The Student Government Association (SGA) and all the student organizations and class officers have been busy planning events for this entire academic-year, and familiarizing themselves to their new leadership roles. With an improved transition of organizations last year, organizations have been fast at work this summer. From the AOA headquarters in Chicago to the nation‟s capital, organization officers have been meeting nationally to learn from other student leaders from medical schools around the country. The SGA is currently taking steps to strengthen student organizations and activities. We are constantly striving to better incorporate and represent the experiences of all NYCOM students and organizations. All students expect sound representation and a process through which they can be heard, and the SGA is equally committed to these goals. We are optimistic that through a focus on long-term and short-term planning, an increase in national organization affiliations, and an improvement in communication and avail-

able resources through technology, the SGA can continue to meet its vision of being a cohesive, productive, enthusiastic team that guides, represents, and unites the student body with faculty, staff, administrators, the local community, and the national osteopathic medical family. Welcome back NYCOM! To the summer researchers, international medical volunteers, medical student clerks, local volunteers, summer travelers, the busily employed, and the “life is too short” unemployed- welcome to the start of the 2010-2011 school year! With a vibrant and active student body and a dedicated faculty and administration, this year is shaping up to be one of collaboration and communication. On behalf of the NYCOM student body, welcome Class of 2014! We look forward to getting to know you and welcoming you, our new peers and colleagues, into the osteopathic medical profession. We hope you are as excited as we are for the 2010-2011 academic school year. May it be a fulfilling year! Your 2010-2011 SGA Executive Board Nick, Sally, Anuja, Emily, and Harsh


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UAAO Preceptorship Written by: Chantal Bruno, OMS II For most students, summer vacation means being “free” from a classroom, professors, and big textbooks. For 35 NYCOM students, however, the first six weeks of summer vacation between their 1st and 2nd year of medical school were filled with workshops and shadowing physicians in the Riland Academic Health Care Center. The 2010 Undergraduate American Academy of Osteopathy (UAAO) summer preceptorship offered students the opportunity to perform OMM outside the classroom and witness how different physicians approached and treated a variety of patients. In addition, the summer preceptorship included 14 workshops that further expanded the students‟ knowledge beyond what was learned during their first year at NYCOM. The workshops were given by several physicians from NYCOM as well as by a few visiting physicians and addressed a large array of topics. The workshops included: “Sports Medicine and Knee Injuries,” “OMM and Nutrition,” “OMM and Acupuncture,” and “OMM and the Asthmatic Patient.” The program also featured a workshop given by Dr. Stanley Schiowitz on Facilitated Positional Release (FPR), which is an OMM technique that treats both superficial and deep hypertonic muscles. What better way to learn FPR than from the doctor that invented it! All workshops during the preceptorship were hands-on and allowed students to practice various techniques and treatments on each other. During the six week program, students in the preceptorship were scheduled to rotate with various physicians (both OMM physicians and Family Practice physicians) practicing at the Health Clinic. Each student was given approximately five rotations during the preceptorship. The program had both morning (912pm) and afternoon (1-5pm) sessions. The students worked one-on-one with the physician as well as with any 4th year NYCOM students also assigned to that physician. Joseph Ewy, one of the preceptorship participants states, “The preceptorship is the perfect opportunity for students who just completed their first year to put their newly learned OMM skills to use under the supervision of accomplished physicians. There is no better way to learn OMM.” In addition to practicing OMM skills, the students also learned about the history of each patient pertaining to the chief complaint as well as why certain techniques and treatments were preferred for use on a particular patient. Overall the 2010 UAAO summer preceptorship was a big success and offered NYCOM students a great learning experience beyond the four walls of a classroom!

Message from the Director of Student Life On behalf of the Office of Student Life at the New York College of Osteopathic Medicine of New York Institute of Technology, I would like to welcome you as a member of the Class of 2014. The class of 2014 will be the 9th class that I have welcomed to New York College of Osteopathic Medicine of New York Institute of Technology, and I‟m very excited about getting to know you. The Office of Student Life and my role at New York College of Osteopathic Medicine of New York Institute of Technology are to ensure that you have a positive co-curriculum experience from Orientation to Graduation. The Office of Student Life oversees co-curriculum programming on and off campus from SGA to guest speakers to the AOA convention and much more. We have an open door policy in our office and all students are welcome. You can stop in to see me or e-mail (ldarroch@nyit.edu) for an appointment so that I can set time aside for you. I hope that as I get to know all of you, I will be able to make a small impact on your life. Welcome again. - Linda Darroch-Short, M.S., ACA Director of Student Life

So You Think You Can Diagnose? Written by: Eric Steinberg, OMS IV Ceosherpa.com Welcome back from your summers, for those of you who actually had a few days to enjoy it. The following are some questions that are guaranteed to be on your boards in some way, shape, or form. To the class of 2014, this is meant to scare you into studying. To the class of 2013, you should get at least half of these right. Class of 2012, I‟m expecting 100% . And to the class of 2011, we‟re gonna be doctors in a few months, so yeah, whatever. 1. A 34yo recently-divorced female went on a dissociative fugue to Cancun, Mexico and came back to Long Island 3 days later with bloody, foul-smelling, straight-up nasty diarrhea. About 10 days later, while getting a pedicure, she noticed weakness in her toes. 2 days after that, she couldn‟t breathe. What‟s the dx? What do we see on CSF analysis (hint to the dx!)? How is it treated? 2. A 25yo female from the Jersey Shore named Snookie-BangBangs comes to you, her lucky gynecologist, with dysuria, increased urinary frequency, and a milky cervical discharge. UA shows positive nitrites and WBCs. You suspect chlamydial infection and treat her with a mega-dose of azithromycin. 2 weeks P A G E 2 later, she comes back, and she is not happy. She has pain in her left knee, right wrist, and at the thoracolumbar junction, which at first she thought was a direct result of “fighting the beat at Surf Club.” When you ask her to remove her humongous sunglasses, you also notice that her conjunctivae are bright red… which she attributes to falling asleep by mistake in the tanning salon. She complains that her „problem down there‟ was better for a few days, but now she is in pain, even at rest. Upon cervical motion testing, she jumps up and reactively punches you in the face. What is going on? 3. A 4 year-old Cambodian child presents to your office with a 6-day history of fever over 105, bilateral conjunctivitis, a diffuse maculopapular rash, and swelling of his hands and feet. On physical exam, you also note a swollen tongue with red spotting as well as anterior cervical lymphadenopathy. What is the diagnosis? Treatment? After treatment what needs to be done? 4. A primigravid mother with gestational diabetes finally vaginally delivers a 12lb baby after being in labor for 42 hours and comes into your office with her baby. She states that her baby‟s right arm is in this „weird‟ position, and that her baby doesn‟t seem to be able to move her right eye. Birth history reveals shoulder dystocia. On physical exam, you notice that her right pupil is smaller than her left. What is the diagnosis? 5. A 65 year old woman 2 weeks s/p chemotherapy for Hodgkin‟s lymphoma presents with a 4-day onset of paroxysmal nocturnal dyspnea, pillow orthopnea, and bilateral pitting edema up to her ankles. She states that she can no longer walk to Bingo night which is at the church 2 blocks away because she runs out of breath. She is adopted so she cannot provide a family history. Before her battle with breast cancer, she had no medical history and was only taking a multivitamin. What happened? *Answers on Pages 5-6


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NYCOM Visits the Black Star Written by: Sriniketh Sundar, OMS II and Jiten Patel, OMS II

money they had on malaria medication. During the year, there are two nurses that keep the clinic running. Our experience in rural Ghana made us not only appreciate the hospital system and the availability of resources back home, but it gave us a greater veneration to the lives that were waiting for us across the ocean. We were told that the Rohde Foundation was so proud of us for having sacrificed so much to help the Ghanaians in need. However, by the end of the trip, it was we who felt proud to have spent time in Ghana. Whether it was cheering for the Black Stars national football team through every minute and goal of the World Cup, to helping locals prepare some delicacies, to walking back and forth to a water pump in order to shower and do laundry, an immense wave of pride for Ghana

Two flights and a five hour bus ride on a dirt road later we arrived in the rural village of Oworobong, Ghana to the clinic established by Dr. Jesse Rohde, who is the founder, President, and CEO of the Jesse M. Rohde Foundation. Once a government yam storage warehouse, the clinic was transformed by Dr. Rohdeâ€&#x;s vision, enormous dedication, and effort. We embarked on a tour of the village and were greeted by the local children who were more than happy to walk with us, play games or sit and teach us Twi, the local language. The village and its beauty from the river to the waterfall to the scenic views offered by the valleys and mountains amazed us all. It took everyone a couple days to get used to the lack of electricity and running water, blistering heat and humidity but we all got used to the seemingly uncomfortable lifestyle and found a new home in the Oworobong Clinic. At sunset we would put on our headlamps and enjoy the company of everyone on the trip. Every night we would fall asleep under a starry sky and wake to the call of

roosters and goats. During the day we would embark on hikes to villages to conduct surveys or stay in the clinic and treat patients. We saw a wide variety of cases and had to improvise to diagnose and even treat patients with our limited resources. While HIV/AIDS is not prevalent throughout Ghana, many of its people would come to us only to find out they are suffering from malaria. The majority of the patients seen did not have insurance, which costs about $7.00 a year for adults and about $3.00 for kids, and they would spend whatever

came over us all. Without a doubt, any one of us would go back in a heartbeat just to be with the people, enjoy the simplistic lifestyle once more, and provide whatever help we can with our skills and knowledge.

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Hospital for Special Surgery

Funny Bone

Written by: Eric Rosenberg, OMS II

Organ-Yuck

Kidshealth.org

Not long ago I ducked into a Whole Foods simply looking for aspirin for my headache. What Robotic/mechanical testing of the should have been a routine knee consumer transaction turned into a slightly unThe Medical Student comfortable situation, Summer Research Fellowship is a where I became hostage to an eager employee‟s enprogram offered by HSS every thusiasm for all things orsummer. With a large number of ganic. When I looked at qualified students applying, the the young man and simply program funds up to 15 asked “Aspirin?” I was percandidates, each working on a sonally escorted to the variety of projects. In addition to the research, the 8-week program natural remedies aisle. What followed was a ten is supplemented with a clinical experience in the form of a senior minute original love song, entitled, if I accurately reattending assigned to each call, “Gaia, My Flax Seed student. Once a week, the Mama, Part Two”, by a student is invited to scrub into slightly anemic, hemp the OR to watch and learn about smelling guy who extolled an assortment of surgeries by the virtues of natural living. some of the top orthopedic He proceeded to offer me a physicians in the country. variety of root barks and dirt siftings that he assured me would “…take the edge off of the pain, without

Written by: Griffan Randall, OMS II

taking an edge off of Mother Earth”. However, the only thing it took the edge off of was the sensation of my tongue. But as I smiled to the passersby cocking their heads quizzically at my newly browned teeth, I reassured them in a lispy, numbed manner “Oh dhon‟t wo-wee; ith oganic”. Now, I‟m not against organic products by any means. Certain foods are best if organic. For example, yogurts, peanut butter, and especially local fruits and vegetables in season. But just slapping the word „organic‟ onto a product does not automatically make it better. “Then add two teaspoons of organic capers”. Organic or not, capers serve no useful purpose and in no way improve the taste of anything. And fur-

thermore, just because it‟s organic does not guarantee its functionality: Tom‟s Natural Care deodorant, I‟m looking at you. In all seriousness, though, many of us are yearning to return to a simpler, more natural existence in an increasingly synthetic world. Perhaps that accounts for the popularity of the colloquialism “Just let it happen organically”. Before we give ourselves over entirely to the organic movement, though, we should pause and consider what the consequences might include: wooden teeth, braidable armpit hair, and a body odor so strong it announces our arrival. So as with anything in life, I believe a considered balance is the best answer. Organic chocolate and wine, anyone?

The over-arching focus of my study was to elucidate how morphology affects the mechanical behavior of the knee joint, especially with respect to ACL deficiency and reconstruction. Contact stress and load-displacement data obtained via in-vitro mechanical testing of the knee joint were compared with the morphological data extracted from MRI, CT, and dissection of the specimens. 3D model of ligament insertions mapped by the digitizer into the bony architecture of the knee extracted from a CT image

Morphological parameters include curvatures and slopes of the tibial plateau, condylar width, and locations of the deep ligament insertions (ACL,PCL,MCLd/s/ob,LCL, etc.). The ligament insertions were directly identified using a 3D digitizer. Mechanical testing of the knee was performed using a 6-degree of freedom robot, while simultaneously collecting contact stresses at the knee joint using a pressure sensor. After thorThis summer I was afforded the opportunity to work ough processing, the aim of the project is to create a more complete computerized along side Carl Imhauser, Ph.D, model of the knee joint, which will hopefully aid in future surgeries by giving a comprehensive view of the total biomechanics. and Thomas Wickiewicz, M.D.


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Renewing the Fight Against HIV/AIDS For decades the global community has been fighting an enemy that is relentless, elusive and inevitably deadly. The war against HIV has been a losing fight, but the month of July has seen new promise and hope from government initiatives to cutting-edge research. On July 13, 2010 the White House announced the National HIV/AIDS Strategy for the United States (NHAS), the nation‟s first strategy to fight the disease within our borders. While previous administrations have devoted resources to fighting HIV/AIDS abroad, this strategy outlines specific initiatives and goals in the United States‟ struggle against this global public health crisis. The NHAS states that by 2015 the number of new infections should be reduced by 25% and 90% of seropositive people should know that they are HIV positive, significantly higher than the current 79%. These goals will be accomplished by targeting communities heavily concentrated with HIV patients, increasing funding for treatment and educating all Americans about how to prevent the spread of HIV. While the results are not guaranteed, the NHAS aims to curtail the spread of HIV/AIDS all the while improving the quality of life for those already living with the disease.

Written by: Sridhar Patel, OMS II

While a comprehensive national strategy is a long-awaited and necessary step, we cannot disregard the impact of innovative prevention of HIV/AIDS. Most notably, scientists have reported that a preliminary trial of a vaginal gel containing 1% tenofovir has reduced the risk of HIV transmission by 54% among women who used it consistently. This trial, conducted in South Africa, is a big step toward curbing the spread of HIV in SubSaharan Africa where 60% of infections occur among women and girls. Furthermore, since a big vector of transmission is due to partners unwilling to use condoms, this gel provides women with a way of protecting themselves against contracting HIV. The gel is still awaiting a Phase III trial where several thousand volunteers will be enlisted, but this drug offers a glimmer of hope to a continent that has been ravaged by HIV/AIDS. Also on the research frontier, scientists have discovered three powerful antibodies against HIV, one of which can neutralize 91% of HIV strains. These very early results reported by the Wall Street Journal and published in Science are promising, but are only the first step toward an effective and lasting vaccine against the most devastating virus of our time. The combination of new government policy and groundbreaking research discoveries aims to usher in a new era in HIV prevention and treatment. While the future of HIV/AIDS is not certain, one thing is for sure; the goal of treating those infected and finding a cure has not been abandoned nor forgotten. Victory in this war may well be within reach.

Answers to S.Y.T.Y.C.D. 1.

Classic Guillain-Barre Syndrome secondary to a Campylobacter jejuni infection. Campylovbacter jejuni is the most common cause of infectious diarrhea in the world (along with Salmonella spp.). Look for bloody diarrhea and a travel history. This is also one of the known, rare (but common on COMLEX, USMLE) causes of Guillain-Barre syndrome. GBS is an acute inflammatory demyelinating polyneuropathy, an autoimmune disorder affecting the peripheral nervous system, usually triggered by an infectious process. GBS is rare, with an incidence of 1 or 2 people per 100,000. The typical CSF finding is ALBUMINO-CYTOLOGICAL DISSOCIATION. As opposed to infectious causes, this is an elevated protein level (100–1000 mg/dL), without an accompanying increased cell count (very high yield). It is frequently severe and usually exhibits as an ascending paralysis with weakness in the legs spreading to the upper limbs and face along with complete loss of deep tendon reflexes. With prompt treatment by plasmapheresis or intravenous immunoglobulins and supportive care (on boards choose RESPIRATORY SUPPORT d/t the possibility of PHRENIC NERVE PARALYISIS), the majority of patients will regain full functional capacity. However, death may occur if severe pulmonary complications and autonomic nervous system problems are present. Guillain-Barré is one of the leading causes of non-trauma-induced paralysis in the world.

2.

Reactive arthritis, previously known as Reiter's syndrome, is an autoimmune condition that develops in response to an infection in another part of the body. Coming into contact with bacteria and developing an infection can trigger reactive arthritis. It is a type of seronegative spondyloarthropathy. The former name Reiter’s syndrome, after German physician Hans Conrad Julius Reiter, became discred-

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Answers to S.Y.T.Y.C.D., Cont’d ited in the past decade as Reiter's history of eugenics, Nazi party membership, human experiments in the Buchenwald concentration camp, and prosecution in Nuremburg as a war criminal came to light. The manifestations of reactive arthritis include a combination of three seemingly unlinked disorders: an inflammatory arthritis of large joints, often including the spine; inflammation of the eyes in the form of (conjunctivitis or uveitis); and urethritis in men or cervicitis in women. A useful mnemonic is "the patient can't see, can't pee, can't bend the knee" or "can't see, can't pee, can't climb a tree.". Not all affected persons have all manifestations, and the formal definition of reactive arthritis is the occurrence of otherwise unexplained noninfectious inflammatory arthritis combined with urethritis in men or cervicitis in women. Reactive arthritis is an RFseronegative, HLA-B27-linked spondyloarthropathy (autoimmune damage to the cartilages of joints) often precipitated by genitourinary or gastrointestinal infections. The most common triggers are sexually transmitted chlamydial infections and perhaps, less commonly, gonorrhea; and Salmonella, Shigella, or Campylobacter intestinal infections. Reactive arthritis most commonly strikes individuals aged 20–40, is more common in men than in women, and is more common in white men than in black men. This is owing to white individuals' being more likely to have tissue type HLA-B27 than black individuals. People with HIV have an increased risk of developing reactive arthritis as well. Don’t forget the ‘PAIR’ mnemonic for HLA-B27 diseases. Psoriasis, Anklyosing Spondylitis, Inflammatory Bowel Disease, and Reactive Arthritis. 3.

Kawasaki’s disease is another rare disease that is commonly tested on the boards. The classic presentation is most easily remembered by the mnemonic ‘CRASH and BURN”: C-conjunctivitis, R-rash, A- adenopathy, S-strawberry tongue/skin findings, H-hand and feet swelling, BURNfever for at least 5 consecutive days. The treatment is IVIg and high-dose aspirin (one of the only times you’ll give a kid aspirin). After treatment, it is important to get serial echocardiograms (about 6 months) because these children are at risk for coronary artery aneurysms (very very very high yield).

4.

Erb's palsy (Erb-Duchenne Palsy) is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the upper trunk C5-C6 is severed. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5-C8, and T1. These injuries arise most commonly, but not exclusively, from shoulder dystocia during a difficult birth. Depending on the nature of the damage, the paralysis can either resolve on its own over a period of months, necessitate rehabilitative therapy, or require surgery. The most commonly involved nerves are the suprascapular nerve, musculocutaneous nerve, and the axillary nerve. The signs of Erb's Palsy include loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis muscle. "The position of the limb, under such conditions, is characteristic: the arm hangs by the side and is rotated medially; the forearm is extended and pronated. The arm cannot be raised from the side; all power of flexion of the elbow is lost, as is also supination of the forearm". The resulting biceps damage is the main cause of this classic physical position commonly called "waiter's tip."The involvement of T1 can also result in a ipsilateral Horner’s syndrome (again, rare, but highly tested) presenting with ptosis, miosis, and anhydrosis. Many babies recover on their own, but some may need specialist intervention, especially if an avulsion fracture is suspected.

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This is cardiotoxicity due to doxorubicin. When it comes to pharm on the boards, MOA and adverse effects are the most important things to know. When the cumulative dose of doxorubicin reaches 550 mg/m², the risks of developing cardiac side effects, including congestive heart failure, dilated cardiomyopathy, and death, dramatically increase. Doxorubicin cardiotoxicity is characterized by a dosedependent decline in mitochondrial oxidative phosphorylation. Reactive oxygen species, generated by the interaction of doxorubicin with iron, can then damage the myocytes (heart cells), causing myofibrillar loss and cytoplasmic vacuolization. Additionally, some patients may develop palmar plantar erythrodysesthesia, or, "hand-foot syndrome," characterized by skin eruptions on the palms of the hand or soles of the feet, characterized by swelling, pain and erythema Check out CHEMO-MAN and you’ll never get a chemo-adverseeffect-question wrong, I promise.


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“Pura Vida”

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Written by: Derek Cheng, OMS II

According to a 2010 New York Times article, Costa Rica ranked in the top spot out of 148 nations—not for GDP, GNP, or wealth, but for happiness. Yes, happiness. In fact, there exists a World Database of Happiness, recently compiled by a Dutch sociologist on the basis of answers to global surveys by Gallup and others. However, statistics will always be statistics, and when it comes down to smiles, laughter, and pure happiness, nothing beats the raw experience of it all. “Okay guys put your paddles down! For the next rapid you are all going to stand up, close your eyes, and lock your arms with the person standing next to you to make a circle. Spread your feet apart or you are going to fall out!” says the river guide. Here I am, standing in a raft with five people, with my eyes closed. We are deep in a canyon in the middle of the beautiful Pacuare River, surrounded by abundant waterfalls, lush vegetation, and tropical wildlife. The sound of rushing water, screaming, and the idea that we are about to blindly enter a class IV rapid at the mercy of our river guide sends a surge of adrenaline through my body. The dual sensations of cold refreshing water splashing in, and spatial disorientation consume me for the next 20 seconds. And then I hear, “Okay, open your eyes! One, two, three--paddles up! Pura Vida!” On June 3, 2010, three NYCOM students: Alyssa Bennett, Veronica Coppersmith, and I arrived in San Jose, Costa Rica. We embarked on a three-week medical Spanish program at the Adventure Education Center, where we took Spanish language classes, medical classes, cooking classes, and dance classes. We traveled through the mountainside and lived with host families in a small town called Turrialba, and explored the Pacific coast while living in cabinas in the small surf town of Dominical. Since our host families spoke little to no English, we were truly immersed in the Spanish language; within days, conversational abilities drastically improved. The diverse wildlife was astounding; macaws, monkeys, dogs, sloths, poisonous frogs, wild boars, lizards, and a plethora of other animals and brilliantly colored flowers were everywhere. Our taste buds were spoiled by delicious local cuisine—fresh organic fruits, handpicked organic coffee, and zesty plates of carne asada with rice, beans, and fried plantains—all for the price of one meager hamburger back in the States. Through our program, we met other medical students from across the country, made wonderful friends with locals, and interacted with patients at a local clinic. Classroom learning and outdoor adventure complemented each other extremely well. From white water rafting, ziplining through the rainforest, and rappelling down waterfalls, to horseback riding, surfing, snorkeling, and being followed by a school of dolphins while on a catamaran, we were beginning to realize what “Pura Vida” meant. Though our trip seemed very much an extravagant vacation in paradise, it would be silly to gloss over the realities of life in Costa Rica. It is still a developing country with estimated poverty rates between 16% to 24%, according to recent United Nations Development Program reports. Some of our host families did not own a car. Some had never been to a restaurant down their street, because they could not afford to do so. And, there are many problems with narcotics trafficking, prostitution, and thousands of Nicaraguans illegally crossing the border to find work each year. So, why are the Costa Ricans the happiest people in the world? What really is “pura vida?” In America, we work hard, we compete, and we strive to continually improve, seek, and attain better things in life. In Costa Rica, satisfaction and contentment with what one already has in his or her life is the norm; this is a fundamental difference in ideals. In the small town of Turrialba, we found ourselves living in a community of genuinely happy locals. There was no boasting of materialistic goods and our host parents put the greatest value in spending time with their families. In fact, every Sunday, Alyssa, Veronica, and I strangely found ourselves a part of some sort of family gathering—a weekly ritual that was unusual to us at first, but which we quickly adored and perhaps became jealous of later on; the enormity of love for the family was endearing and a priceless lesson in life. Finally, as medical students, we learned about chagas, dengue fever, and practiced conducting physical examinations in Spanish, amongst other things. We learned about the healthcare system in Costa Rica in the classroom, but were fortunate enough to be granted access to a public hospital and local clinic to see firsthand. Irrespective of political views, the physicians taught us about the importance of a social safety-net; in Costa Rica, every working citizen pays into their healthcare system, which covers all the medical needs for its citizens and emergency visits for foreigners. Private and other mixed systems also exist as choices for wealthier individuals, but the fact that anybody—regardless of his or her socioeconomic status—can be effectively treated by a primary care physician or even surgical specialist, is, perhaps, admirable. The sense of well-being for all is a way of life. In the end, we learned that “Pura Vida” is exactly just that. It encompasses the contentment with what one has, it is love for ones family, it means unity in the word community, and it means good and well. It is happiness.


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NYCOM & AHEC PROVIDE COMMUNITY HEALTH EXPERIENCES IN UNDERSERVED AREAS Across New York State, NYCOM students participated with the Area Health Education Center (AHEC) in the Community Health Experience Program this summer. AHEC is a nationwide program designed to enhance the quality and access to health care, to improve health outcomes, and to address health workforce needs of the medically underserved communities. The students worked in a multitude of settings to gain exposure to the cultural diversity of the underserved communities. Below is a brief glimpse of many students’ experiences:

Priyal Patel, OMS II: LGBTQ Center (Kingston, NY) “Helping my students realize

I conducted a research project on lesbian, gay, bisexual, transgender, queer (LGBTQ) health issues and how medical professionals could make their practices more inclusive. By sitting in on youth group meetings, talking to medical professionals, and attending meetings with Senator Gillibrand‟s staff, I learned to not let my “straight privilege” blind my ability to fully respect and understand LGBTQ individuals.

their dreams of becoming health professionals reaffirmed my desire to become a physician.” -Jacqueline Bogan, OMS II

Alvin Varghese, OMS II: Institute of Family Health (Manhattan, NY) I worked on the Clinical Decisions Support Systems and Smart Tools Project with a physician and a public health administrator. I analyzed the Best Practice Alerts used by the Institute of Family Health and North General Hospital and verified that it was up to date with the current epidemiological studies. I also attended grand rounds at Beth-Israel Medical Center, and provided free screenings for cholesterol, diabetes and hypertension in underserved communities.

Sonia Borker, OMS II: Bronx Westchester Area Health Education Center (Bronx, NY) I was the student project coordinator for the Summer Health Internship Program (SHIP). I worked with the Program Director to educate 22 high school and college aged students about the health professions. I designed and taught an academic curriculum to help students identify community health issues and visited students' clinical placement sites to gather their first glimpses into healthcare. Educating students further empowered me to continue working toward my goal of becoming a doctor.

Jacqueline Bogan, OMS II: Brooklyn Queens Long Island Area Health Education Center (Brooklyn, NY) As a mentor for high school and college students from Brooklyn, Queens, and Long Island, I gave presentations about osteopathic medicine, and provided guidance for their summer research projects on various genetic diseases. I also visited several hospitals, including Lutheran Hospital and SUNY Downstate Medical Center in Brooklyn. Helping my students realize their dreams of becoming health professionals reaffirmed my desire to become a physician.

Trishla Kanthala, OMS II: Commissions of Public’s Health System (NYC) I was placed with Judy Wessler, the Director on the Commissions of the Public's Health System. On the forefront in the fight against health disparities, she advocates for accountability for hospitals receiving millions of dollars of federal funding, specifically for the care of the undocumented and poor. I learned about the Health Care Reform Act and about health policies in New York City. It was a great learning experience---especially the political aspects of medicine, a side of medicine you don't normally get to see.


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Anup Patel, OMS II: Community Health Action of Staten Island (Staten Island, NY) I worked in the HIV/AIDS and Addiction Treatment Case Management office, Youth storefront, and Mobile Health Unit. My duties included: entering client satisfactory and Y.O.U.T.H. risk assessment survey data into the computer system, analyzing the data, and writing up a report. As a student-physician, I also performed a youth assessment and client intake, assisted the Mobile Health Unit staff perform blood pressure screenings, distributed contraceptives, and aided in the syringe exchange program. Moreover, I educated the public on overdose prevention, HIV/AIDS and general health care maintenance.

Mehak Swami, OMS II: Mt. Hope Family Clinic (Bronx, NY) I collaborated with an onsite dietitian to develop a culturally-sensitive template for healthy meal plans to control blood sugar in a population of diabetes patients. Additionally, I worked with an obese youth population and taught them better options for their daily living and weight management. Lastly, I designed informative pamphlets, which will be used in "Diabetes Family Day", a collaborative event of several family clinics in the Bronx. Through my experience, I realized how unaware our society is of the simplest medical terms. Educating patients is a key step in prevention, and it is for patients to be empowered with the right to seek help when their health is declining.

Beatrice Desir, OMS II: Manhattan Staten Island Area Health Education Center (Manhattan, NY) Mentoring students in the Summer Health Internship Program students, I assisted with their research projects, gave presentations on medical terminology and osteopathic medicine, and designed an online weekly blog for this AHEC site. I attended weekly didactic sessions, where I learned about health disparities, immigrant health and health policies. Learning what makes each community underserved allows me to better serve its members; I possess a newfound understanding of my future patientsâ€&#x; communities.

Deepika Agrawal, OMS II: The Institute of Family Health (Manhattan, NY) My goal was to advocate for the integration of mental health services at Federally Qualified Health Centers (FQHC), government sponsored health centers, to provide medical care to the underprivileged and uninsured. Among other accomplishments, my department met with public health administrators and created a survey to evaluate the quality and extent of medical health at FQHC. The Institute hopes that information found will be implemented at the national level to push for policy changes that provide underserved populations with the care that they deserve!

Kristine Jang, OMS II: The South Bronx Mental Council (Bronx, NY) I researched the rights of mentally ill patients and developed and conducted surveys to assess the patientsâ€&#x; level of awareness about their rights. I also conducted surveys in the neighborhood, allowing me to gather the general publicâ€&#x;s opinion about the rights of mentally ill patients. After analyzing the results, I was able to lead sessions of group lessons on patient rights, which will be implemented into their regular behavioral therapy curriculum. I have also produced a flyer on patient rights in both English and Spanish, which will be distributed at their annual health fair. This experience allowed me to recognize the needs and the challenges of working with the mentally ill in underserved and culturally diverse populations.

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Welcome Class of 2014!!!!

Marty Bucella

From Your Friendly SGA

September 2010 - NYCOM Pulse  

The online publication of the NYCOM Student Government Association