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Obesity Week 2019

I had the chance to attend Obesity Week 2019 in Las Vegas from November 3-7. Obesity is not really a topic or area that I had much exposure to during training. But in the past few years I have wished that I knew more about it. After residency I worked exclusively in the inpatient setting as a hospitalist. For those of you unfamiliar with this term, it means that I only worked in the hospital treating patients who were sick enough to be admitted in the hospital. During this time I would frequently encounter patients with chronic medical conditions, many of which would improve with significant weight loss. But the extent of my intervention was to advise the patient about the importance of lifestyle changes and to follow up with their primary care physician. Because for the hospitalist, the physician-patient relationship ends when the patient is discharged from the hospital.

A few years ago I asked around our division why our outpatient Internal Medicine clinics did not have an obesity clinic. After all, I thought, this should be well within the scope of practice for an internist. This is not to say that no one at my institution was treating obesity. In fact, we had a medical weight loss program as well as a bariatric surgery program. But Internal Medicine did not have a dedicated clinic for obesity. Instead, internists had to address obesity along with any other medical conditions during a patient visit.

Fortunately, while I was asking around and looking into obesity treatment, I discovered that one could become board certified in obesity medicine by the American Board of Obesity Medicine. And, through asking around, I learned about the annual Obesity Week meetings held by The Obesity Society (TOS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

Over the last year I have transitioned out of inpatient medicine. Currently I see patients in the Internal Medicine clinic at my institution as a primary care physician. But I am also starting a new learning/educational journey with the obesity medicine. I am not sure where this journey will take me. But as with the journey thus far, I’ll continue to try and write and reflect on it here.

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Academic Internal Medicine Week 2017 (AIMW)

This past week I had the opportunity to go to Baltimore, MD to attend Academic Internal Medicine Week 2017. It was put on by the Alliance of Academic Internal Medicine (AAIM), an alliance made up of five different organizations:

The last time I participated in an academic conference like this was for the 2015 APDIM Chief Resident’s Meeting. Each year, APDIM invites upcoming Chief Residents for several days of workshops and training. They provide education about the role and a sort of network for those who are interested in it.

This year I attended the CDIM meetings in my role as one of the Associate Clerkship Directors at my institution. My first impression was that I felt out of place. I looked around at people who have been in their roles for their entire careers. I saw people who have published numerous articles in the field of medical education. It was, I’ll admit, a bit intimidating.

I flew out on Saturday afternoon and arrived at nearly 11 PM at BWI. Picking up my checked bag from baggage claim took longer than I had hoped. By the time I was able to get a taxi to the Marriott in downtown Baltimore, check in, and get settled in my room it was past midnight. By the time I was in bed and trying to fall asleep it was past 2 AM. My alarm was going to go off just under 4 hours later at 6 AM.

The following morning I headed out to get find registration and pick up my ID badge. I picked up the program and a free bag — one of those bags they always give out each year. I had pre-resistered for a pre-course. Officially, AIMW would kick off later in the afternoon with an opening session in the evening. Starting at 8 AM, I would be at a pre-course designed for new clerkship directors.

One nice thing about sitting down at the new clerkship directors course was that I got to sit down with people who were new to their roles. All — at least as far as I could tell — of them seemed to be there as the Clerkship Director, though. They weren’t there as an associate clerkship director like myself. It was comforting to hear people talk about how they were feeling overwhelmed as they waded through the responsibilities of their new positions. I started to feel like I could understand a little more about how much the clerkship director had to do. I’ll admit there was some relief that I was not attending this conference as a new clerkship director. I think that role would be quite overwhelming for me at this stage of my career.

The rest of the conference was quite a blur. It was fast-paced. There were plenary sessions and workshops galore. I felt like I learned a lot. I tried to scribble or type notes as fast as I could. Hopefully some of it sticks.

I don’t know where life will lead me. I dont’ know where I will be in 10 years as far as my career goes. But I do know that going to a conference like this has the ability to fire you up about what you’re doing. It’s refereshing and re-energizing to be surrounded with people so dedicated to passing on knowledge to their learners.

Maybe one day, in the future, I’ll find myself at another one of these conferences. But instead of being the new guy on the scene, I’ll be a seasoned veteran who is excited to share and teach and help out.

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On Teaching

The following is something I wrote in 2009 while still a medical student:

Teaching is a hard thing. By teaching I don’t mean explaining or instructing. Take, for example, teaching basketball to someone. Telling someone the rules of the game is not, to me, teaching them how to play basketball. Explaining what the rules mean and how and when they apply is not teaching either. Teaching involves more. It is showing someone how to dribble the ball, demonstrating the correct form, and then helping the student develop these skills. Teaching is not merely conveying knowledge. It is imparting excellence — or, at the very least, competence in a particular area or field.

Teaching involves lifting a student up with compliments while simultaneously providing criticism that is at the same time constructive, painful, and humbling. Delivering these two — compliment and criticism — can be tricky. How does one find the right balance? It’s unfortunate that there is no formula. Each person is different. The combination of compliment and criticism that motivates and inspires one student could very well devastate and discourage another. Maybe the truly amazing teachers are able to read their students and expertly walk that fine line.

In the absence of truly amazing teachers, or truly amazing teachers with plenty of time to spend with us, a student must resort to other means of attaining competence. One alternative is learning from multiple teachers. Good teachers have different methods, techniques, and personalities. Each one can provide a different, yet helpful angle.

As this academic year inches closer and closer to an end, my mind seems to frequently wander to the future. One of the things I think about is my position as one of the chief residents next year. I hope that I will able to be a good teacher. I may even be willing to settle for an “ok” teacher too.

Maybe I am getting ahead of myself. Maybe I should just concentrate on learing as much as I can as a resident.

Teaching, I feel, is such a great responsibility. Especially when you are training people to take care of patients. The good thing is that I won’t bear this responsibility on my own. I will merely be a cog in a larger wheel; I will only be one part in a larger system. There will be plenty of seasoned attendings who will gladly teach the residents, and I am sure myself as well.

Teaching, I hope, is something that one can learn. And I hope that through the next year I will be able to develop my own teaching style. I’m sure I won’t be able to develop in a year — it’ll take time. But I do hope I am able to make a significant evolutionary leap in my development as an educator and teacher.