Journey to DMS | Chapter 10

It’s been a year since I started the Doctor of Medical Science program at Lincoln Memorial University. The 3rd semester ends tomorrow with one more to go. This also marks the end of the “modules” and the beginning of our cognate or specialty-specific training. 

We had a few new students join our group this semester. I’m not sure if they’re on the slightly longer PA education track or the university is starting to stagger start times. Most of us started the program together last August. For the Fall 2020 cohort, here’s how the first year of the program, i.e. “the modules”, has looked:

  • First Semester – 15 Weeks
    • Cardiology
    • Nephrology
    • Hematology/Oncology
  • Second Semester – 15 Weeks
    • Endocrinology
    • Infectious Disease
    • Neurology
  • Third Semester – 15 Weeks
    • Pulmonology
    • Psychiatry
    • Gastroenterology

The fourth and final semester for most of us will be spent concentrating on one of three medical specialties, the program refers to them as cognates: primary care, emergency medicine, or internal medicine. 

The Final Stretch

There won’t be any more MKSAP readings or anatomy/imaging readings or lectures. Also, no more weekly quizzes. We will still be working on collaborative cases and meeting weekly for Sunday Zoom with a physician. But instead of spending 5 weeks with a particular specialist, each week could be with a different doc. I’m in the primary care group and we’ll have 8 different physician group leaders this semester. All of the docs are new to us at this stage in the program with the exception of the neurology MD who will be returning. Several of the physicians are assigned more than one week.  

I don’t know this for a fact yet, but I suspect the Zoom sessions will be shorter with only two case presentations instead of 5-6. During the modules, we averaged 5 groups of 5 but there are only two groups of 4 in the primary care cognate.

Besides these main cases, we’ll also have a weekly interactive case from the NEJM Resident 360 program. We’ve had to complete 75 board-prep questions in the NEJM Knowledge+ app for each module and we’ll now have to complete 300 more for a total of 900 before the end of the last semester. 

Each week we are to identify a clinical question in our cognate, research it, and then summarize our findings. 

There’s also a course on professionalism and some of the non-clinical aspects of medicine. We’ll be required to attend several Project Echo meetings which should be cool. From what I understand, Project Echo is another grand rounds-type meeting where community clinicians present their challenging cases for specialty physicians in order to disseminate the most current literature and treatment protocols. 

We’ll have a week off for Thanksgiving and then graduation activities are on a Thursday and Friday in December. I’ll have to take off work for those days but I won’t be traveling back to campus. We have been given the option to travel or attend virtually. Graduation is on the following Saturday and I’m not sure what that will look like for those of us staying home. It would have been fun to participate in graduation itself but the time and expense to travel back to Tennessee make it tough. 

Extra Curriculars

There are still several sections of MKSAP that I’d like to read and I’m considering working through these for my own benefit. They include Dermatology, General Internal Medicine, and Rheumatology. It takes me about a week or 15 hours to go through a MKSAP chapter but I feel like these sections would be valuable. 

I also just completed the 8-hour Medication-Assisted Treatment (MAT) training from the American Society of Addiction Medicine. It was excellent. I’ve started the 16-hour training but it seems that there’s quite a few bugs and missing videos. I decided to do this on my own–it had nothing to do with the DMS program though our first reading assignment and writing prompt for the professionalism course was on the opioid epidemic. 

So I now have an X-waiver and have started prescribing buprenorphine for opiate use disorder. So far, I only have one patient on my roster. But it’s kind of interesting how it all came together. He was very frank about his addiction and need for help. He told me that he spends most of his day trying to secure his next dose and that he just couldn’t take it anymore. It was a great feeling to be able to help him myself rather than scrambling to refer him somewhere before he had a bad outcome. 

This gets at the core of why I chose to pursue advanced clinical training as a Doctor of Medical Science. I wanted to help people. I was already pretty capable as a seasoned PA but medicine is so complex that there’s always more to learn. And if you don’t keep learning, what you once thought you knew quickly fades or becomes outdated. 

Journey to DMS | Chapter 11

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