Undergraduate Medical Education

Permanent URI for this community

https://hdl.handle.net/1805/28231

Browse

Browsing Undergraduate Medical Education by Author "Aksu, Eric"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Fostering Leadership in a Student-Run Free Clinic Medical Executive Board and Across Interdisciplinary Partners.
    (2022-03-30) Haddad, Aida; Khan, Maria; Gensel, Annie; Barber, Mckenzie; Aksu, Eric; Klipsch, Eric; Class, Jon; Brown, Lucy; Kabir, Jason; Etling, Mary Ann
    Background: Being a member of a healthcare executive board requires a unique sense of resolve and passion for service. Not only are these leaders operating a student-run free clinic, but they are also full-time professional students while balancing extracurricular activities to discern their healthcare vocation. Board members feel pulled in many directions, resulting in imposter syndrome and possibly untapped leadership potential. Leadership succumbing to this pressure in 2021 might have resulted in the permanent closure or dysfunction of a clinic after COVID-19 required closure for one year. This study will discuss the interventions employed by the clinic’s Chair, Vice-Chair, Women’s Health co-chairs, and Operations chair to overcome the burden felt when faced with reopening a large, interdisciplinary, free clinic serving approximately 34 patients per weekly clinic day. Though fostering interpersonal relationships best encompasses the theme with which the above leaders encouraged hope during a time of global suffering, relationships were encouraged through multiple discrete interventions forming camaraderie and trust within and between interdisciplinary executive boards. Interventions: Medical Executive Board: In anticipation of the added pressures of reopening the clinic amid COVID-19, the Chair took special care to create a culture of collegiality and mutual vulnerability by facilitating various ways to ‘check-in’ with her board. She hosted preterm and midterm check-ins with each leader to discuss their vision for their role on the board. The Chair and Chair-elect also hosted the clinic’s first annual leadership retreat to support each member in finding their leadership style, and in turn, becoming familiar with their colleagues’ leadership styles. The Chair and Chair-elect will also perform exit interviews with all graduating board members. Partners: Reopening during the pandemic meant reorganizing the entire clinic flow and limiting the number of volunteers present. As a result, many interdisciplinary partners could not participate in the initial reopening and had to be brought in slowly throughout the year. Partner participation was encouraged by monthly meetings with all partners (regardless of clinical presence), and an active group chat with leaders. The Vice-Chair also emphasized alternate means of participation. Some partners organized winter clothes and food drives, while others fundraised for the clinic. All partners were encouraged to develop telehealth plans. The fall partners’ retreat fostered community, during which all partners brainstormed 2022 goals. Results/Conclusion: Medical Executive Board: As a result of the above interventions, clinic leadership not only reopened the free clinic but fulfilled many years-long goals, which include rolling out a weekday telehealth protocol, serving record numbers of patients during a time of immense need, publishing the inaugural clinic-wide monthly newsletter, and formulating the clinic’s first-ever mistreatment policy. The leadership retreat inspired our Women’s Health Coalition to host a retreat; a check-in with the Women’s Health chair led to a midterm co-chair election to sustain the coalition long-term. Finally, the Operations chair spearheaded changes to clinic flow to avoid COVID-19 outbreaks–in doing so, she inspired a record turnout for this position at the 2022 elections. Partners: By the end of 2021, all interdisciplinary partners had resumed in-person care. However, the regular monthly meetings, alternate projects, and retreats fostered community and interest in the clinics even when all could not physically participate.
  • Thumbnail Image
    Item
    Pre- and post-conception planning in autoimmune disorders
    (2020-03) Kumar, Nimisha; Aksu, Eric; Gensel, Annie; Burger, Taylor; Pease, Kensey
    Background: Autoimmune diseases are often multisystem, requiring many specialists. However, there are no clear recommendations for many of these disorders for planning pregnancy and preventing exacerbations. Intervention: Little time is devoted to patient counseling about contraception or care antepartum, intrapartum, and postpartum. Contraception and many first-line interventions can have varying effects in different diseases, which can be further complicated by multiple diagnoses. Many of these disorders also can have postpartum complications, making follow-up essential. Results:Systemic lupus erythematosus (SLE) is known to cause exacerbations during pregnancy and has serious adverse outcomes for both mother and baby. Active disease is associated with higher rates of preterm birth, pre-eclampsia, thromboses, fetal loss, and neonatal lupus. Patients are at increased risk of these complications with a history of lupus nephritis, cessation of hydroxychloroquine, and primigravidity. Multiple sclerosis (MS) has lower rates of relapse during pregnancy, but higher rates in the first postpartum year. This has been attributed to the rapid increase in progesterone during pregnancy improving symptoms, while the rapid decrease after pregnancy promotes relapses. Additionally, neonatal morbidity does not increase as a result of MS. For other autoimmune diseases such as Sjögren's Syndrome or Grave’s Disease, the clinical picture may be complicated by the physiology of pregnancy, but is unclear whether pregnancy exacerbates the autoimmune component of the disease. Conclusions: Pregnancy and contraception could improve or worsen symptoms in autoimmune diseases, even up to a year postpartum. There is a significant gap in practice guidelines regarding contraception and pregnancy despite many diseases’ onset during childbearing years. Pregnancy and contraception counseling should be part of initial conversations at diagnosis to prepare women.