Flourishing in Medicine: From Surviving to Thriving explores ways that health professionals- physicians, nurses and nurse practitioners, physician assistants, mental health providers, therapists, and others- can truly flourish in the complex and challenging world of health care.
The ability for physicians and other health professionals to practice high quality care and attain professio ...
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This episode’s guest, Dr. Gail Gazelle, with 25 years as a practicing internist and hospice physician, combines practical, evidence-based strategies with her extensive medical and mindfulness expertise. She is a recognized figure in the media, featured in outlets like CNN, NPR, Oprah Magazine, and has been published twice in the New England Journal of Medicine as well as other leading medical journals. Her latest book, “Mindful MD: 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout,” underscores her significant contributions to wellness. Utilizing mindfulness to become the master of the mind, she shares the keys to reducing reactivity, decreasing burnout, and restoring the true autonomy that we can all retain. Using dozens of real-life stories, she helps readers see that they don’t have to hand over their happiness to a complex and dysfunctional healthcare system. In this podcast Dr. Gazelle shares insights into her work addressing physician burnout and fostering flourishing. Reflecting on her own journey, she discusses her initial interest in end-of-life care, shaped by complex family experiences. The conversation explores burnout roots in medical training, discussing self-critical thoughts, perfectionism, and the imposter syndrome among physicians. Dr. Gazelle advocates for mindfulness as a key tool in regaining autonomy, reconnecting with purpose, and challenging negative thought patterns. She introduces a coaching model incorporating mindfulness to help physicians find meaning and acknowledge positives, emphasizing individual empowerment and systemic healthcare challenges. Gail defines mindfulness in terms of awareness and mind training. In addressing health professional burnout, she stresses the need to focus on present moment experiences and work with what is-how things actually are- accepting the current state in healthcare as lived reality as an honest and workable starting point for transformation. She also explores the impact of stories in our professional lives, differentiating between helpful stories that add meaning and purpose to our work and unhelpful narratives that keep us stuck with an unrealistic and unworkable view of ourselves and our situations. Finally, the conversation touches on the transformative power of flourishing in healthcare, both as a recipient of healthcare and as a provider of care to others. Guest: Gail Gazelle, MD Website: www.gailgazelle.com Email: drgazelle@gailgazelle.com LinkedIn: @gailgazelle Facebook: facebook.com/groups/539466187211003 X: @gailgazellemd Other resources: Mindful MD: 6 Ways Restores Your Autonomy and Cures Healthcare Burnout- available at Amazon and free chapter download available at Dr. Gazelle’s website. Other resources available on Dr. Gazelle’s website: The Daily Dose of Calm; Imposter Syndrome Guide; Everyday Resilience Book; Leading in a Time of Crisis; and 10 Steps to Avoid Physician Burnout 3 Minute Guided Meditation with Dr. Mick Krasner
This episode continues an investigation of medical education that began with last episode’s interview with Dr. Bonvin, now with a 4th Year Medical Student, Malayna Hocker, who shares her journey into medicine as a career and evolution as a teacher. Initially resistant to the idea of pursuing medicine due to negative childhood experiences in hospitals, she explored various paths but eventually found her way back to medicine through teaching. Inspired by her love for science and a desire to serve the community, Before entering medical school Malayna taught in challenging environments, facing issues like student violence and family difficulties. As she navigated this non-traditional path to medical school, Malayna's teaching experiences continued to shape her perspective, as her teaching focus has evolved into an advocacy role, addressing discomfort and questioning aspects of medical culture. Malayna emphasizes the need to break the stereotypes in medicine, challenging the notion of perfection and the acceptance of toxic aspects within the profession. She believes that open conversations about challenges, doubts, and well-being are essential in reshaping the culture of medicine. Malayna also sees teaching as a means to advocate for both patients and fellow trainees, fostering a culture of empathy, understanding, and collaboration. Malayna emphasizes the need to break the cycle of isolation and shame ingrained in medical training and advocates for fostering a culture of support and openness. She believes that finding connection and breaking out of isolation are crucial for addressing burnout in the future. Malayna expresses joy in learning, helping patients live the lives they want, and engaging in teaching. She highlights the importance of maintaining one's personhood and finding fulfillment both in and outside of the medical profession. Guest: Malayna Hocker, 4th Year Medical Student University of Rochester School of Medicine and Dentistry Other resources: America Reads Program: existing in amny institutions of higher education, this website describes the program at Arizona State University: https://communityengagement.education.asu.edu/programs/america-reads Shame in Medical Education: Bynum WE 4th, Varpio L, Lagoo J, Teunissen PW. 'I'm unworthy of being in this space': The origins of shame in medical students. Med Educ. 2021 Feb;55(2):185-197. doi: 10.1111/medu.14354. Epub 2020 Sep 13. PMID: 32790934. The Shame Conversation: A short documentary film created by Dr. Will Bynum depicting conversations about experiences with shame in healthcare. https://www.theshamespace.com/film
This episode’s guest is Dr. Raphäel Bonvin, Vice President of Education, Section of Medicine at Université de Fribourg - Universität Freiburg and Professor of Medical Education, Fribourg, Switzerland. Raphäel discusses his journey into medicine, highlighting his initial interest in physics, biochemistry, and medicine, ultimately choosing medicine for its humanistic dimension. His early training in traditional Chinese medicine and parallel training in acupuncture and homeopathic medicine influenced his decision to continue his studies, as he recognized early on a disconnect between how he was being taught and the educational elements and approaches necessary to become a skilled physician. His interest in this topic deepened, and through a series of events, his career path turned toward a central focus on medical education. He has been an influential and effective leader in shifting the focus of assessments in medical education from knowledge-centric assessments to a system of formative assessments, ones that are designed as truly learning tools, and emphasizing the role of student reflection and the development of critical competencies beyond only knowledge and skills. In his work at the University of Fribourg medical school, Raphäel discusses the programmatic assessment approach in medical education, emphasizing the importance of considering multiple sources of information rather than relying solely on grades. The speaker explains the concept of measuring points as pieces of information, like how we use multiple data sources in the clinical setting such as lab data, clinical interpretation, and personal experience to influence clinical decision-making. Here, multiple data points and sources are used to provide a holistic view of a student's progress. The program aims to move away from traditional grading and focus instead on providing this assessment information openly to students, with the expectation that they reflect on those data and use them to build learning plans to address key competencies necessary to be successful as a physician, including self-awareness skills and self-care. Guest: Raphäel Bonvin MD Professor, Faculty of Medicine Vice President of Education, Section of Medicine University of Fribourg, Switzerland PHD Candidate, Maastricht University, The Netherlands Faculty Page, University of Fribourg https://www.unifr.ch/med/de/section/staff/prof/people/229455/d8dea Other resources: Bonvin R, Bayha E, Gremaud A, Blanc PA, Morand S, Charri I, Mancinetti M. Taking the Big Leap: A Case Study on Implementing Programmatic Assessment in an Undergraduate Medical Program.Educ. Sci. 2022, 12:425. https://doi.org/10.3390/educsci12070425 Rey A, Bonvin R, Cantin B. Étudiant-e-s en médecine face à la mort: chassez le spectre, il revient au galop [Medical students facing death: death is the only certainty in life]. Rev Med Suisse. 2023 Dec 20;19(855):2399-2401. French. doi: 10.53738/REVMED.2023.19.855.2399. PMID: 38117109. Walker M, Grandmaison G, Bonvin R, Mancinetti M. Pédagogie de l’incertitude en médecine [How To Teach Uncertainty Management]. Rev Med Suisse. 2023 Feb 8;19(813):264-266. French. doi: 10.53738/REVMED.2023.19.813.264. PMID: 36753342. Gustin MP, Abbiati M, Bonvin R, Gerbase MW, Baroffio A. Integrated problem-based learning versus lectures: a path analysis modelling of the relationships between educational context and learning approaches. Med Educ Online. 2018 Dec;23(1):1489690. doi: 10.1080/10872981.2018.1489690. PMID: 29966510; PMCID: PMC6041782.
The guest for this podcast Ghazala Radwi MD, a hematologist and transfusion medicine specialist in Edmonton, Alberta, Canada. She also teachers widely through Canada on topics of trauma-informed leadership and Mindful Practice in Medicine. She shares here her journey into medicine, tracing it back to her early childhood influences, especially that of her father, who was a physician. From the age of four, Ghazala expressed a strong desire to become a doctor, driven by a sense of calling and a passion for healing. Her unwavering determination led her to pursue internal medicine and hematology. Reflecting on her path, she acknowledges the role of mentors and a sense of intuition, emphasizing the importance of trusting the journey. The conversation also touches on the challenges faced by health professionals in Canada, particularly in Alberta, highlighting political turbulence, system changes, high rates of burnout, and issues related to racism and trauma within the healthcare system. The impact on physicians' well-being, including increased suicide rates, shortage of healthcare professionals, and the closure of medical facilities, paints a complex picture of the healthcare landscape in the region. Overall, the interview provides insights into Kala's personal and professional journey in medicine, as well as the broader challenges faced by healthcare professionals in Canada. Speaking about the inevitability of encountering trauma during medical training and medical practice and advocating for a proactive approach to addressing and working with traum Ghazal discusses the importance of transparency and context in organizations and leadership and the need for leaders to share their challenges and vulnerabilities, thus fostering a sense of connection and collaboration within healthcare teams. Exploring the themes of joy, play, and the need for intentional efforts to incorporate them into the medical field, she emphasizes the positive contribution of these qualities to teamwork and professional well-being, underscoring the human aspects of leadership, communication, and connection within organizations. Her commitment, broad experience from training in Saudi Arabia to sharing her talents and passion across Canada, and here engaging desire for supporting her colleagues led to a delightful interview that I hope you enjoy listening to. Guest: Ghazala Radwi, MD Hematologist, Transfusion Medicine Physician, Physician Leader, Mindfulness Practitioner, Trauma Informed Leadership. She is the Medical Lead, for Transfusion Medicine for North Sector at Alberta Precision Laboratories. She is also a Clinical Assistant Professor in the Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry at the University of Alberta, and the Wellness and Safety Representative on the Hematopathology Residency Committee. She collaborates with the Office of Advocacy and Wellbeing at the University of Alberta to help develop programs that support physician wellbeing. LinkedIn Page: https://www.linkedin.com/in/ghazala-radwi-md-7aab0881/?originalSubdomain=ca Other mentions or references during the podcast: WellDoc Alberta, www.welldocalberta.org Bonobos studied in the Congo by Ethologist Isabel Behncke: https://en.wikipedia.org/wiki/Isabel_Behncke Trauma Informed Approaches: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Bessel van der Kolk, M.D. Help for the Helper: Preventing Compassion Fatigue and Vicarious Trauma in an Ever-Changing World, by Babette Rothschild Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing by David A. Treleaven, Willoughby Britton, et al.
The guest for this podcast was Professor of Integrative Physiology and co-director of the Graduate Program in Integrative Medicine & Health Sciences at Georgetown University Medical Center (GUMC). A graduate of Brooklyn College (CUNY), he received a PhD in Physiology from the University in Cincinnati College of Medicine, and came to Georgetown 38 years ago, after 5 years at Mayo Clinic. In 2013, he was named the Founding Director of the Center for Innovation and Leadership in Education (CENTILE) at GUMC. His research interests for over 25 years addressed renal and electrolyte homeostasis, but in the past two decades he has focused on medical education and rethinking how health professionals are trained. Dr. Haramati has taught physiology for over 40 years and been recognized with 11 Golden Apple awards from medical and graduate students at Georgetown. In addition, he was awarded the Arthur C. Guyton Teacher of the Year award by the American Physiological Society, the Alpha Omega Alpha Robert J. Glaser Distinguished Teaching Award from the Association of American Medical Colleges (AAMC), the Master Scholar Award from the International Association of Medical Science Educators (IAMSE), and named Distinguished Educator by the GUMC Teaching Academy for Health Sciences. He chairs the Council of Faculty and Academic Societies of the AAMC and currently serves on the AAMC Board of Directors. Dr. Haramati has advocated that mindful practices together with small groups be integrated in the training of health professionals to foster resilience and improve well-being in the learning and work environments at academic health centers. He has been a visiting professor at over 100 medical schools worldwide. In this podcast Dr. Haramati shares his unique journey from studying physiology to becoming a leader in mind-body medicine education. He initially pursued physiology due to a fascination with the science underlying medicine, having no desire to work directly in a hospital setting. Over the years, he sought mentors and eventually transitioned into a role where education became a significant focus. The pivotal moment occurred during a meeting at Harvard Medical School, where the importance of medical education in training professionals was emphasized. This realization led him to integrate mind-body medicine into the curriculum, addressing the need for a more holistic approach in medical training. The conversation also touches on the evolving landscape of medical education, including the recognition of stress and burnout and efforts by organizations like the AAMC to address these challenges. Guest: Aviad Haramati, PhD Faculty Page, Johns Hopkins University: https://centile.georgetown.edu/aviad-haramati/ Other mentions or references during the podcast: Vanderweele TJ. On the Promotion of Human Flourishing. PNAS (2017) 114 (31): 8148-8156 Kern National Network for Flourising in Medicine. https://knncaringcharactermedicine.org/ Goleman, Daniel. What Makes a Leader. Harvard Business Review, January, 2004. CENTILE: The Center for Innovation and Leadership in Education: https://centile.georgetown.edu/