End of the semester!!!

I can't believe that I've made it to the end of the term. we started in late June and have covered almost three blocks of material. I also published a solo paper, presented a poster at OMED 22, and submitted an abstract to a public health conference that is coming up. That is a lot... Saturday, Eboni and I embark on a cruise for some much needed "us" time and hopefull, we'll recharge and refresh. She has to start on her dissertation and I have to consolidate the first four weeks of unit 3 as we will only have three weeks till finals when we return from fall break.

On another note, if you are reading this and will be starting medical school, do yourself a favor and get a subscription to Medical School Bootcamp. Medical School Bootcamp is one of the best self-teaching resources on the market. It comes with excellent notes, lecture videos, and problem sets to test your knowledge. I find it to be more engaging than Boards and Beyond, more in depth than Osmosis, and easier to find relevant material than Lecturio. At my school, faculty don't lecture and instead, the use the socratic method to deliver content. This doesn't work for me, so I self teach with Bootcamp, Osmosis, and Lecturio. I do have Boards and Beyond, Sketchy, and Anki, but of all of these resources, Bootcamp is my favorite...

Is it worth it?

Is it worth it?

I’m still trying to come to a conclusive answer to this question. Last night, I noticed that Eboni wasn’t in the greatest of moods. I chalked it up to some negativity that had occurred with one of her cousins earlier in the week. As we were having breakfast today, Eboni said that she feels like we’re married but not really married. She went on to say that while she knew that the path through medical school would be tough, she did not think that it was going to be this tough. She also mentioned that she is lonely. No surprise there; she works 12-14 hours a day, from home, as a medical educator, and then when I get home, we spend a few minutes together and then I’m studying for the rest of the evening. I can tell that she is intensely unhappy. I wouldn’t say that she is ready for a breakup or divorce, but I also think that something must change on my part. The problem is time.

My birthday is this week, on the 10th and Eboni wanted to do something nice for my 51st. Unfortunately, however, final exams are next week, starting on the 14th and ending on the 16th. I must use this remaining time to study/cram as much as I can. I saw how disappointed Eboni was because we didn’t get to do anything special for my 50th because of the pandemic and I know that she really wanted to do something special for my 51st.

Medical school is this all-consuming beast and despite. My best efforts, I have still not figured out how to lead a balanced life (if that is possible) while being a medical student. There is just so much information to master and any day that is not spent studying sets you back. Its. Tough when you have a spouse/significant other and/or children. You want to spend time with them, but so much of your time must be spent in the books and doing school-related things. I’m going to investigate the spouses support group at school to see if that might be a way that Eboni can make some friends with like-minded folks as well as give her an outlet. She also admitted that the main reason why she went back to school for a second doctorate was to keep herself busy. Now that she is nearing completion and her semesters are getting lighter, she has more time on her hands to think and notice how life is not what she had hoped it would be at this stage of our relationship.

If you are thinking about medical school, just know that there will be sacrifices. As much as you try to live a balanced life, its very hard to do and there are things that will fall through the cracks. There will be birthdays that you miss. There will be funerals that you miss. There will be times when you want to do something special four birthday and you’ll be forced to decide, do I do something on this day, or do I study? And if you have a significant other/spouse on this ride with you, do everything that you can to ensure that they have a support network outside of you so that they can survive the journey as well. Time to go study…

Its been awhile...

It’s been some time since I last had a chance to share my thoughts. As some of you know, I had to take a medical leave of absence last year to have a cornea transplant. I went on leave shortly after Unit 1 and the time off gave me the chance to determine if I really wanted to continue on with medical school or resume my teaching and research career. I obviously made the decision to return to medical school, but I realized that if I were going to continue, I would need to do things totally differently than I had done last year.

I started this year with making selfcare a priority for me. I spend three to four days, an hour and a half each day, doing some type of physical training and I have doubled down on making sure that I am in bed no later than 10 PM on most nights. Additionally, Eboni and I have revamped our diets and we are cutting out processed foods and adopting a more Mediterranean eating pattern. When I have days that I don’t feel like studying, I don’t make myself study, I will rest instead. I’m also taking time to spend time with family; I didn’t miss my paternal grandmother’s birthday this year and after Unit 1 exams, Eboni and I flew to Atlanta to celebrate one of her cousin’s graduations from graduate school. All-in-all, I am MUCH happier and that has paid dividends in terms of my productivity, memory/retention, and most importantly, exam scores. We just had our exam results from Unit 1 released and I passed everything. Its nice to be able to continue in Unit 2 without fear of having to remediate an exam next summer…

I’m still a work in progress; I had to take three days off this week due to a nasty cold (or COVID or the flu) and I felt guilty that I wasn’t studying at all. Truth is, I was (and still am) sick as a dog. I haven’t slept so much in YEARS (12-13 hours daily) so clearly, my body was telling me that I needed the rest. Stil I couldn’t shake that feeling of needing to do SOMETHING. Still a work in progress. As long as God wakes me every day, I have a chance to be a better man tomorrow than I was today…

Other changes have taken place since I last wrote. We have a new dean. He came from Western University-COMP Northwest. He’s likable enough, but he’s bought some major changes to the curriculum that have riled up the student body and faculty. For starters, we now have mandatory classes. To me, its not that big of a deal because we are only on campus for four hours each day, but I understand why some students find this irritating. Some students do learn best by watching videos or reading on their own; our “lectures” are mostly a waste of time unless Dr. Sanchez is delivering the lecture. Some students have been calling for open rebellion though but it really isn’t that serious.

The other big change is that we are moving away from written, free response exams to board style questions. I think that this is a GOOD thing and I am happy about this. Starting in this unit, our CE exam will consist of two blocks of written questions and one of board style multiple choice questions. By the time we start Unit 5, we are supposed to be 100% board style MCQs. The faculty don’t like this, but Dr. Pham says that if we can’t pass boards, there is not point to teaching us to think like clinicians. Our COMLEX first time pass rate is sitting at around 85-86%; that needs to drastically improve over the next two years so I think that Dr. Pham is right on the money with this…

Time for SIGS case study; I’m still feverish as can be but I’m gonna do my best to be attentive today!

Drawing in medical school

Medical school makes you quickly figure out the best way to learn. One thing that I miss about being a PhD student is having the time to read and truly absorb & become one with the information. Sadly, medical school doesn’t leave that sort of time. I’m learning to skim, read short descriptions of basic sciences facts, and most importantly, I draw ✍🏾 & label anything that I can. I’ve found that drawing really helps with my memory retention (though I wonder how much of this will actuslly be useful in clinical practice…) The sad thing is that when I was a PhD student, I read for pleasure and the love of learning. Now I read for the sake of cramming what I can into my head. Reading doesn’t feel the same to me and the last time I tried to sit to read for enjoyment, I found that I didn’t like it. I hope that my love of reading isn’t permanent… #learning #medical #phd

Webinar: Primary Care Provider’s role in PrEP Provision to LGBTQ Patients in Virginia

SESSION TITLE: Primary Care Provider’s role in PrEP Provision to LGBTQ Patients in Virginia

DATE: July 13, 2022

TIME: 12:00 PM (EST) (45 minutes)

SESSION INFORMATION/DESCRIPTION: The purpose of this webinar is to discuss the importance of the primary care provider (physicians, APRN’s, and PA’s) role in prescribing PrEP to LGBTQ patients.

SESSION OBJECTIVES: At the conclusion of the webinar, attendees will be able to:

· Describe what PrEP is

· Identify Virginia populations at risk for HIV acquisition

· Describe evidence of the need for PrEP in Virginia

· Identify barriers to PrEP acquisition for LGBTQ patients

· Identify the role of primary care providers in screening for HIV risk and PrEP provision

· Describe components of HIV screening and PrEP education

· Identify and implement facilitators to offering PrEP LGBTQ patients

· Identify HIV screening and PrEP resources for primary care providers

Registration Link

SPEAKER BIO:

NAME AND TITLE; Daryl Traylor

Daryl Traylor is an Army veteran, university instructor, and public health professional turned medical student and HIV/PrEP researcher. A native of Houston, Texas, Daryl earned his PhD in Nursing from the University of Missouri-Columbia in June 2021.

While a student at Mizzou, Daryl studied the PrEP prescribing practices of Southern primary care providers who serve African American communities. Other research projects that he collaborated on while in his PhD program included studying stress, coping, and resilience in communities of color during the COVID-19 pandemic and examining barriers and facilitators to PrEP uptake in African American communities in Southern Nevada.

He is a summa cum laude graduate with a B.S. in Health Promotion from Northern Arizona University. He also earned a second bachelor’s in Microbiology from Arizona State University and master’s degrees in Pharmacology and Public Health from Michigan State University. Daryl is currently a first-year osteopathic medical student at the University of the Incarnate Word School of Osteopathic Medicine in San Antonio, Texas. He hopes to pursue a career in family medicine or emergency medicine with a focus on providing HIV care to marginalized communities in the Southwestern United States.

Trust: The True Measure of Healthcare

Though I am a medical student and want to work in medicine, I have long struggled to trust physicians, and more broadly, U.S. healthcare. Throughout my life, there has been a lack of representation, or providers who look like me and understand me, and I’ve dealt with my share of discrimination and bias in healthcare. All of this has added up to significant barriers to care when I have needed it.

The first time that I can remember experiencing bias related to my treatment was in 2012. That spring, I’d ruptured my Achilles tendon, and I had to drive myself to the Chandler Regional Medical Center in Chandler, AZ. I was seen in the Emergency Department by a Physician Assistant. He did the Thompson Test and promptly diagnosed me with a complete rupture of my Achilles. Though I was obviously in pain, he didn’t so much as address my pain, even after I asked if he could prescribe something for me to get through the weekend. Instead, he told me that I needed to see an orthopedic surgeon and he sent me on my way. No crutches, no boot, nothing for pain. I had to limp back to my truck, and I drove myself home.

Later that year, I had the surgery to repair my tendon. From the moment that Eboni and I walked into the outpatient surgery center, it seemed that the staff was more concerned about collecting my deductible payment. After about an hour, Eboni and I were led back to the surgical waiting area. Both of us were very nervous and had questions for the surgeon and anesthesiologist; the surgeon came in and explained that the procedure would only take 45 minutes to an hour, but the anesthesiologist never came in to explain things. At one point, a nurse came in and marked my right leg for surgery, and I told her that the surgery should be on my left leg. Instead of listening to me, she left the room in a huff but returned after about 30 minutes to mark the correct leg. She barely made eye contact with me as she turned to leave.

I was wheeled into surgery around 2:00 PM that day and I remember waking up in recovery around 5:45 PM. At no point did anyone go to the waiting area to let Eboni know that the surgery had been a complicated one and that I’d almost died on the table. In fact, no one told me either. The surgeon came into the recovery room and said that he’d run into a little “snafu” with repairing my tendon, but that was it. It wasn’t until a few years later, when I obtained my medical records, that I discovered that I’d had a bad reaction to the anesthesia and my heart rate plummeted. They spent several hours trying to stabilize my heart. Oh, I forgot to mention that I was sent home from the surgery with no pain control. In any case, to this day, I have been deathly afraid of going in for my colonoscopy because of my fear of anesthesia and being put to sleep.

In 2914 – ’15, as my mother-in-law was fighting for her life in the Scottsdale Honor Health ICU, little did Eboni and I know that Pam was living out her last days. Pam had been ill for some time and over the course of that year, she’d lost probably 40 or 50 pounds. That year was a blur of doctors’ visits and hospital stays until that final stay at Honor Health. We never did get an exact diagnosis for what ailed Pam; one doctor told us that she had systemic vasculitis and that if the infectious disease doctors could ever clear her C. diff infection, they could start a powerful chemotherapeutic that would likely save her life. Based on this information, Eboni and I decided to keep fighting. We couldn’t ask Pam what she wanted because she was in an induced coma.

Day after day for several months on end, Eboni and I traded shifts at the hospital. I would stay during the day when Eboni was at work, and then she would come to relieve me so that I could go to work and write on my master’s thesis. Day after day, the nurses and doctors would tell us that, despite what we could see, Pam was getting better. There came a time when Eboni asked me, “Daryl, do you think that momma is ever going to leave here alive?” I honestly had this growing doubt that the clinical team wasn’t telling us everything, so I told Eboni that we were going to request a conference with the team that day. When we met, I asked. The question, point blank, “Is there any chance that Pam is going to live?” One of the doctors, a female, I can’t remember her name now, spoke up and said, “No. Your mother’s chances of coming out of her condition alive are slim to none.” I don’t think that Eboni caught any of the next 30 minutes of the conversation, but at the end of it, it was decided to wake Pam up so that we could ask her what she wanted.

After Pam was awake, we asked her want she wanted but she refused to speak to us and wouldn’t look at us. We asked her several more times if she wanted to continue treatment or stop. She looked at Eboni and said, “Bitch! I want to go home!” There was so much fire and anger in her eyes and she repeated this repeatedly that night as we sat at the hospital that night with Pam. As you might imagine, Eboni was very distraught and thought that her mother hated her, In actuality, Pam was undergoing delirium from having been in that induced coma for three weeks or so and was communicating in the only way that she knew how. After a few days, we arranged for transport to the Hospice of The Valley and Pam and Eboni were able to strengthen their bonds in the final two days of Pam’s life. When she went to be with God, she left this existence with a smile on her face.

Eboni has always blamed herself for holding on to her mother too long, but the truth is that our decisions were made based on the communication, or lack of honest communications, that we had with Pam’s care team. Since that time, the trust that we had in the healthcare system was destroyed. Between the lack of communication, the implicit bias that we’ve dealt with, the judgement (recently, as I was preparing for my cornea transplant, one of the doctors that I saw questioned how I knew that I have Keratoconus…) regarding our knowledge, and the lack of compassion, neither of us has wanted anything to do with healthcare in the U.S. Odd considering that I want to be a physician and Eboni educates medical students.

Well, God works in strange ways. The cornea transplant that I had on the 27th of April, or more accurately, the care that I received has gone a long way towards healing the fractured relationship between us and the healthcare system. On the day of the surgery, Eboni and I were petrified, particularly concerning the anesthesia. The surgical nurse who took us to the back could sense it so she asked the anesthesiologist to come speak to me and explain what I could expect. He did so very carefully and in laymen’s terms so that Eboni could understand. The surgeon came in and explained in detail what his part of the operation was going to be and the surgical nurse promised to call Eboni if anything came up during the surgery that would extend it. After Eboni went back to the front waiting area, the nurse took my hand, prayed with me, and then she sat there and talked to me for the next 30 minutes or so (I was the last case of the day). I went into the surgery a lot more calm that I arrived at the surgical center.

I was under conscious sedation so that I could follow the commands of the surgeon. At one point, I started to feel claustrophobic because I had a surgical mask on and then on top of that, there was a sterile drape that adhered to my face (My claustrophobia developed while I was in the Army. That is a story for another day…) My heart rate started to go up and I felt like I wanted to burst out of my skin. The anesthesiologist asked if I was in any pain and I told him that I was feeling a bit claustrophobic with all of the layers of stuff on my face. The surgeon stopped what he was doing and asked the nurse to tent the sterile field so that it wouldn’t be on my face. This made him have to adjust his technique somewhat and the surgery was extended by 20 or so additional minutes, but I appreciated him considering my feelings and his and his teams efforts to make me comfortable.

After the surgery, when I was recovering, the recovery nurse did what my previous recovery nurse from my Achilles tendon surgery didn’t do: She gave me something for nausea. If you’ve ever come out of anesthesia, you know that you are very nauseous, and vomiting is a real risk. When I had the Achilles surgery, I didn’t get anything for nausea, and I ended up vomiting all over my truck as Eboni drove me home. My recovery nurse took her time in explaining to Eboni and I what I needed to do that first night after the surgery and she offered us both some water. Later, she wheeled me out to the truck and wished us a good evening.

Some of you who are reading this may be saying, “So what? What’s the big deal? The team did what they were supposed to do.” That is the big deal however. For so many people, but particularly for people of color and females, we are used to being unheard, unseen, and judged by the healthcare system and our providers. For many, this has terrible consequences as they avoid seeing doctors, NPs, and PAs when they need to because they expect that they will be treated poorly. This was certainly the case with Pam and as I mentioned above, its one reason why I haven’t scheduled my colonoscopy. However, my experience with the team who performed my cornea transplant went a long way towards restoring the faith that I need to have to not only work in this system but to also receive care from this system when I need it. Always listen to your patient and don’t judge them. When your patients have needs, try to meet them. And if you can’t do anything else, just display some compassion and honesty. Believe me when I say, that will go a long way towards building and keeping the trust of your patients.

Research Study: Understanding Stress and Coping among people living in the U.S. in the Age of COVID-19--2nd Wave

Hi. My name is Daryl Traylor and I’m a osteopathic medical student at the University of the Incarnate Word School of Osteopathic Medicine and am working with colleagues from the University of Nevada, Las Vegas to conduct a study that seeks to understand stress, depression, resilience, and coping during the COVID-19 pandemic.

I am asking you to please complete this anonymous survey that will take about 15 minutes to complete. The following link provides more information about eligibility. If eligible, would you please take a few minutes to complete this survey?

Here is the link: https://bit.ly/3otkuDL

I am also asking you to please distribute this survey to your colleagues. This survey may provide valuable insights that will allow for the development of interventions that are focused on helping communities overcome COVID-related stress and depression. Thank you so much for your time and assistance!

NREMT Certification Exam - DONE AND PASSED!

I wrote the National Registry of Emergency Medical Technicians certification exam on Monday the 21st. The exam is what they call a "computer adaptive test" in that it starts with an easy question and if you get that question correct, you move on to a harder question. If you get that question correct, you move on to an even harder question. If,however, you get that harder question wrong, you get an easier question. If you get that easy question wrong, you get another easy question. And so goes the exam until it can eastablish a baseline for your passing score. The thing is that for some people, the exam will stop at 70 questions. For others, it may be 80 questions and still for others, it could be 110 questions. For me, the exam stopped at 68 questions. I was last certified at the EMT level in 2012, 10 years ago. The exam was MUCH easier and as I recall, the exam stopped for me around question 80 or so. I'd always heard that 70 was the minimum number of questions needed to establish a baseline score (You have to get a minimum of 70% correct) and I read somewhere that if the exam stops at less than 70 questions, you probably failed and did so poorly that even if you did the full exam, you would still fail.

So I left the Pearson Vue testing center pretty certain that I'd failed. Yesterday morning, at 0500, I checked the NREMT app on my phone and... I passed!!!! I had to have gotten a minimum of 48 questions out of 68 correct to pass. So now I can officially say that one of my medical school graduation requirements is checked off. At my school, we are required to pass an EMT class AND the NREMT cert exam to graduate. The EMT class isn't hard but its extra work ON TOP of our medical school coursework and adds quite a bit of stress to the days and weeks. After the course, you have to wait weeks, sometimes a couple of months, before you can schedule the EMS ridealong that is part of the EMT class. Then, once all of that is done, you wait another week or two to be cleared to sit for the NREMT exam. The whole process can carry into Unit 3 of medical school and I know some of my classmates who failed a unit or two because they were trying to stay caught up with the EMT business. It would be better if the school gave students access to the EMT class maybe in late April or early May so that the didactic portion could at least be completed BEFORE medical school starts. After that, they would just need the hands on skills and the two associated testing days. Then students could start the EMS ride alongs earlier and finish the NREMT earlier. But, this is all above my paygrade. All I know is that I passed and I dont have this hanging over my head anymore. When I return to school in July, ALL I have to do is be a medical student...

2022 NRMP Match

This week has been one that has been filled with great highs and the lowest of lows. On the one hand, I've been able to celebrate the happy stories of friends and acquaintences who matched into their chosen specialities. On the other hand, I have seen a lot of people on Twitter who did not match. I also have five friends, one who took his life on Tuesday, who did not match and who have, so far, failed to land a position in the SOAP.

I cannot begin to imagine what its like to open your email and find that you didn't match. There are not a lot of great helps out there to help unmatched students cope with this new-found reality or to develop a plan to apply for the match again. And the reality is that each year you try to match, your odds of matching go down by about 25%. Thus, its really in your best interest to match the same year that you graduate. I've been talking to my friends who didn't match, and to hear the despair in their voices has been heartbreaking. But its also served as a huge wake up call. Just because I am in medical school, there is no guarantee that I will match.Even though I am in a U.S. school, about 5%-6% of US students don't match each year. There is no guarantee that you will match just because you get into medical school. Thus, I'm now thinking about what I need to do to make sure that my odds of matching are as maximized as possible...

Why is HIV activism and research so important to me?

When I was in my doctoral program, I had to take a grant writing course. As part of that course, we had to give a mini-seminar on our proposed research to the department. At the time, I was considering an HIV intervention where by hair stylists would be trained to deliver the intervention to their African American female clients. After I presented my talk, one of the faculty members in attendance made some disparaging remarks to the effect that she couldn't understand why I am so "obsessed" with HIV in the Black community. It was almost like she was trying to say that HIV is no longer an issue. While my dissertation topic did change out of a need to graduate in time to start medical school, it still focused on HIV and the Black community. If I could go back in time, I'd like to explain why HIV and BIPOC communities obsesses me so.

When I was in the Army, my best friend, Jeavon Luceina, and I went through basic training and AIT together. It was while we were at Ft. Sam Houston in San Antonio, TX that I found out that Jeavon was non-binary. This was in 1991 so I don't even know if the term "Non-Binary" was a thing back then but whatever, I just saw Jeavon as Jeavon. Jeavon was an outstanding soldier, an immensley skilled medic, and one of the best people that I knew. Jeavon suffered though. At the time that we were in the Army, the "Don't Ask, Don't Tell" policy was in place so while on duty, Jeavon had to be "he" and when off duty, they could be themselves, but never fully. If you have ever lived in a military town, these towns tend to be small and everyone knows everyone. I can't imagine what it would be like to have to walk around everyday, all day with my guard up.

Anyway, after AIT at Ft. Sam Houston, we went our seperate ways. I heard from Jeavon periodically over the years but finally, I just stopped hearing from them until 1998. Jeavon must've gotten in touch with my pop. I was living in Houston by now and was off of active duty. I was working as a patient care tech at St. Lukes Hospital. Jeavon let me know that he had AIDS and probably didn;t have long to live. They wanted to go home to Guam but their family was not accepting of Jeavon's queerness. The Chamorro people were traditionally very accepting of the LGBTQIA community, but after Spanish and then American colonization, the people started to adopt a more Western-centric view of the LGBTQIA community. Things started to change in Guam in 1978 but unfortunately, there are some families that hold on to the Western view (i.e., American) view of the LGBTQIA community. Jeavon wanted to go home to die but couldn't. I took Jeavon in and cared for them for the last six or seven months of their life. A group of our friends got the money together to hold proper remembrance services. Those last months of Jeavon's life were sad because they could not be with their family. I cannot fathom what it would be like to face the end of my life in a place that is foreign to me while not being around the people that I love. The stigma and ignorance that Jeavon faced contributed to their death...

In 2006, I met the woman who would become my wife. Her father, Derrick L. Anderson, was an HIV positive gay Black male. Derrick was an internationally known HIV and human rights activist but more importantly, he was a father, brother, uncle, son, and one of the finest people that I ever met.

On Nov. 23rd of '06, Derrick suffered what seemed like a minor car accident. He didn't go to the hospital or anything and the next day, he celebrated Thanksgiving with his family. By that evening, he wasn't feeling well and he later vomited blood and was rushed to the hospital. At the time, I was living in Portland, OR so I couldn't be with Eboni as she narrated everything that was happening at the hospital ER. During triage, Derrick was asked his HIV status and when he said that he was positive, the way that the hospital treated him changed. Instead of doing an ultrasound of his belly or any other imaging tests, the hospital spent about 12 or 13 hours trying to transfer him to a different hospital. Why? Because the ER docs and truama surgeon on duty were afraid to potentially perform a surgery on Derrick because of him being HIV positive. Early in the morning on the 2th of November, the hospital realized that there was not going to be a transfer (It was snowing and the roads were iced over) so they decided to do something. They did an ultrasound of Derrick's belly and it was full of blood. By this point, he'd lapsed into a coma and the attending physician told Eboni that she needed to make a call regarding keeping him on life support. She opted to let her daddy go. As it turned out, Derrick had suffered a small tear in his descending aorta and had bleed out over the course of those few days between the time that he had the accident and his passing at the hospital. This isn't what killed him though. The ignorance, fear, stigma, and indifference of the people who should have tried to save him is what killed him.

This is why I am so obsessed with HIV, PrEP, HIV interventions, and ending HIV in the BIPOC community. I have seen to many Black and Brown people suffer, needlessly, because of HIV-related fear and stigma, ignorance, hate, and discrimination. Black and Latinx gay males and cis-Black women are still contracting and dying at rates far higher than the general population. Trans-Black and Latinx women are at particular danger from HIV-related morbidity and mortality and the violence that they are particularly vulnerable to. I'm 50 years old now and will be 54 by the time I finish medical school and 57 by the time I finish residency. I pray that the Lord will allow me to have a 30-35 year career in medicine so that I may do my part to see a day when HIV no longer affects BIPOC communities in the way that it does. Better yet, I pray that the Lord allows me to live to see a day when HIV is no longer an issue for ANY community in America or around the world. This is why I do what I do. No matter what my former professor or people like her may say, nothing will deter me from fighting this fight.

TNP Pulse - Published a brief on my dissertation research

I would have NEVER finished my dissertation research on time without the Texas Nurse Practitioners. I was granted permission to send my survey to their membership via two email blasts and they got me the numbers to finish my participant recruitment in exactly eight weeks. I return, they wanted me to submit a brief report on my research but I didn't know that they were going to publish it. This was a nice surprise.

Research while in medical school

There has always been an expectation that research in medical school will be a part of your eventual residency application. And not only is research an expectations, there is generally an expectation that you will also participate in some kind of scholarly activity such as submitting a publication, abstract, and/or poster presentation. While you won't be expected to conduct research or have scholarly activity to the volume that a PhD or postdoc student might, now that COMLEX Level 1 and USMLE Step 1 are pass/fail, its been hypothesized that residency program directors are going to start to place more emphasis on research and scholarly activity (along with the results of COMLEX Level 2 and USMLE Step 2) in the selection of residency applicants to interview. We don't yet know if this will be the case, but in the next year or two, we should have a firm handle on this. In the meantime, how would a medical student go about seeking research opportunities in medical school?

The simplest way to get some research experience would be to maintain any existing research connections/collaborations with undergrad and/or graduate research labs. For example, when I was in my PhD program, I started working with Dr. Melva Thompson-Robinson at UNLV during my research practicum and I continued that relationship through the COVID pandemic and into medical school. Its resulted in a textbook chapter, three peer reviewed journal articles, three webinars, two poster presentations, a fourth peer reviewed article that has just been submitted, and a fifth peer reviewed article that my wife and I are working on now. I'm also currently working on turning my dissertation into several first author peer reviewed journal articles, and I presented a poster at the 2021 AMA Research Challenge and I will be presenting the following poster at the 2022 Beyond Flexner Alliance Conference at the end of the month.

What do you do if you do not have these existing research collaborations though? You'll have to start looking at your medical school (or lovcal medical schools) to inquire about research opportunities.

You first want to understand what research is available at your school and then determine if it fits your interests and future specialty plans. If you do not care so much for laboratory research projects, look for faculty who are doing community and public health realted work, clinical research studies, epidemiological studies, retrospective studies, or case studies. These experiences may be more interesting and they have the benefit of being relatively quick as compared to laboratory bench research. If you decide that you want to do research, you need to speak to the primary investigator and you need to be super clear about the time committment and expectations they will have of you in relation to your work as a medical student. Do not forget, your primary purpose in medical school is to graduate and become a doctor. You do not want to fail out because of your time being taken by extracurricular activities. Sometimes it can be hard to find a good PI or research opportunities that you may be interested in. You should speak to upperclassmen and graduates of the school in addition to looking at the website. Once you have committed to a project, ask about the opportunity to produce some scholarly work from the project. Make sure to get a clear understanding of authorship in the case of papers, abstracts, and/or posters. Lastly, if you find that you like research as much as I do, you might consider taking a gap year in medical school to do a research project or you may even want to pursue a research-based masters or doctoral degree.

Now that I am thinking about specialties, I need to start thinking about getting a research project that aligns with that. I've identified a project at Highland Hospital in Oakland that I would like to do as it would be a perfect way to show continued interest in emergency medicine and primary care. I also have a growing interest in gastroenterology and clinical research, so I may seek a bench research project in GI physiology at UTSA or something. Decisions, decisions, decisions!

Clinical Shadowing and Mentorship Program: Opportunities for Premedical Students, Medical Students, and Physicians

Clinical Shadowing and Mentorship Program: Opportunities for Premedical Students, Medical Students, and Physicians

*Various Deadlines CSMP Mentee Application: Monday, March 21st by 5 PM EST CSMP Physician and Medical Student Mentor Application: Friday, April 15th by 11:59 PM EST CSMP Leadership Team Application: Friday, April 1st by 11:59 PM EST

The Clinical Shadowing and Mentorship Program (CSMP) is a nationwide initiative serving Associate premedical members of the SNMA. The 12-month program seeks to address and overcome the systematic barriers that interfere with success among pre-medical students who are underrepresented minorities in medicine (URM) by providing them with clinical exposure (in-person or virtual), culturally sensitive guidance, individual and group mentorship, community service, team research, and professional development training as they pursue medical school admission and careers as future physicians.

There are several ways to get involved with the CSMP as a Mentee (Premedical Students), Mentor (Physician or Medical Student), or Leadership Team Member (Premedical or Medical Student). The following details information about prospective mentees, mentors, and leadership team members, including mentee eligibility, informational sessions, and application deadlines.

CSMP Premedical Mentees: Program Eligibility

Current premedical student (undergraduate, graduate, post-baccalaureate, career-changer, gap year, and other non-traditional students) Current Associate (national dues-paying) member Available to attend monthly workshops and mentorship sessions Available to attend regular (weekly or bi-weekly) virtual shadowing sessions (individual or collective) Able to complete all program surveys and assessments

To apply: https://lnkd.in/eEffiBPa

Busy week

Busy week. I'm submitting an R15 grant to NIH on the 22nd and I've been busy putting the final touches on it. Also drove up to N.E. Texas with Eboni and my sister to see my mother. That was emotional.... UIWSOM's SNMA chapter highlighted me for Black History Month. That was a nice way to end a busy week and I appreciate the plug and the chance to highlight my research.

My UIWSOM EMT Clinical Experience

Today, I did a 12-hour EMS ride along with Acadian Ambulance; the ride along is part of the UIWSOM EMT curriculum and is a medical school graduation requirement. I’ve been a military and civilian medic in the past, so the EMT-B course and the required ride along did not present any new information or situations that I haven’t seen before, but the EMS ride along did serve a useful purpose as far as helping to remind me of my “Why medicine?”

We got started at 0600. Unlike crews that I have worked with in the past, the crew that I worked with today did not take much time preparing their unit for the day. To their credit, they did change out the main oxygen cylinder, but the unit ran low on gloves (I ended up loaning some of mine to the Basic that was on the rig), the heart monitor was on the fritz, the portable oxygen cylinder regulator did not work, and there were a few other key items that were in short supply. Luckily, while we had a very busy day, we ended up having enough to get through the shift.

Our first call came in at 0630; we received a call about a stabbing victim but we didn’t have any other information about the scene or what to expect. When we got to the scene, San Antonio PD was present and the victim, while having a deep stab wound, was otherwise stable. I just threw myself into the day and I think that the Basic was OK with that. That was really the pattern that ensued all day. I would volunteer to do everything that I could, and the paramedic and I worked each patient.

The next call came at 0922; she was a 42-year-old Latina female who had metastatic cancer. Her husband called because his wife had been complaining of worsening right upper quadrant pain and blood in her urine for the previous three days. This was an emotional call for me as Eboni recently lost a 29-year-old cousin to metastatic throat cancer. I had to work really hard to not transfer my emotions to the patient, but I got through it. There wasn’t much that we could do to help this patient, but what stood out to me was her reaction at me holding her hand and helping her to slow her breathing. I don’t know if what I did helped with her pain at all but I believe that I gave her something else to focus on outside of her pain. After we arrived at the hospital, the paramedic gave report to the nurse and the basic took the gurney back to the ambulance. I stayed in the room and asked the patient if I could pray for her; she said yes and we prayed. After our prayer, she looked at me, smiled, and with tears in her eyes, said, “Thank you.”

The day was very busy with different calls but one that left me feeling some kind of way was one of the last calls. We were sent to do an interfacility transfer; the patient at hospital A was a baby that we were to pick up at NICU and then transport to hospital B. When we got to hospital A, the parents were adamant that they did not want a Black man working with their child. The paramedic explained that I am a medical student and that this would be a valuable learning experience for me, but the parents would not back down. The medic asked me if I wanted them to call another unit to handle the transfer, but I told her to continue the transfer, but I would stay at hospital A and then they could come back for me after the transfer. This satisfied the parents and did not delay the care of the child. This still impacted me however and I felt a great deal of sadness at the fact that people would allow their racism to potentially compromise the care of a loved one or themselves. I follow a number Black physicians on Twitter and many share similar stories. I guess I will just have to develop thicker skin.

After our final call, we made it back to the station at 1830. My preceptor gave me a great evaluation and asked if I wanted to work part time for Acadian through my first two years of medical school. I told them that I would think about the offer. For anyone who is considering attending UIWSOM, the EMT curriculum is a nice addition (would be nicer if it were better integrated into our Unit 1, but that is a subject for a different posting…) and if you have never worked in emergency medicine, use this opportunity to throw yourself into what could be an EXCELLENT experience. You will get out of it what you put into it. Next on the docket? I have to take and pass the NREMT-B exam; it will be the final graduation requirement of the EMT part of our curriculum.

A better day....

Today, my wife and I had our first couples therapy session. There were a lot of tears, hugs, and end of session WORK, but I feel hopeful that we will come through this with a stronger marriage and I will be a better man and father as well. One of the things that I told the therapist today was that the weight of this, well, I wouldn’t call it a secret since we always knew that there was a possibility that I could have a child, I would call it an ignored issue. The weight of this was ALWAYS somewhere in my thoughts. Sometimes, it would pop up randomly in my sleep or I would think about it when I was taking an exam. I can recognize now how when you have unresolved issues, no matter what they are, you can’t run from or ignore them. They will affect everything that you do. In my case, getting through my PhD and now medical school, has been up to this point, more difficult because this issue was a 200-pound albatross hanging around my neck. While the last few days have been emotionally hard, I feel lighter than I have at any point in the last 10 years. Having my unresolved issue out in the open so that I can DEAL WITH IT is a wonderful feeling. I would urge you all to take time to deal with any unresolved issues that you may have in your life. They don’t just go away. No matter what the issue (or issues) is, it will haunt you at the most inopportune moments in your life. Certainly if you are going to be attending medical school, you don’t need things popping up at random moments; you have too much to lose….

Anyway, I have scheduled an individual therapy appointment with a therapist, and I have that appointment on the 26th. This is a good time for me to work on the anxiety and self-esteem issues that have cropped up since starting medical school. I also want to work on some of the stuff that I’ve been harboring in relation to my family/parents; there are things that I now see that influenced my thinking and were a part of some of the bad choices that I made in my youth. I want to break the cycle and not carry these things forward into this next half of my life. When I turned 50, I told my wife that this represented an opportunity for me to be happy; there weren’t a ton of happy moments in my youth and up until I met my wife in 2006, there wasn’t a ton that I took joy in. But God has given me the gift of continued life so I want to make it the best life that it can be going forward.

Outside of reviewing old material to keep it fresh, mostly gross anatomy and OMT, I am working on turning my dissertation into three publishable articles and my wife and I have a joint manuscript that we are working on along with an abstract that we want to submit to APHA. We also are going to be speaking at the Beyond Flexner Conference in March. This is going to be a busy spring and I’m hoping to get all of this stuff done before my medical school classes resume in July. Keep me lifted friends!

Asking for prayers

Today is one of those days when I wish that I had a good spiritual advisor or an older male who has lived life that I could speak with and get some advice from. I did something very stupid in 2009 and the results of that stupidity have come back to bite me. There is this saying that what is done in the dark will come to the light, Its only a matter of time when it comes out...

I’m requesting prayers for my wife, myself, and our marriage. Back in the summer of 2009, I hooked up with an ex and had a one-night stand. Later, maybe 4-5 months later, she called my wife (who was then my grlfriend) and said that she was pregnant. At the time, we didn’t know if the child was mine or the guy that my ex was dating, but as you can imagine, my wife was quite angry and hurt. At the time, she asked me to prove to her, one way or the other if the child was mine or not. She’d also said that she didn’t know if she could be a stepmother and didn’t know if she would stay or leave if the child did prove to be mine. Out of fear of losing my relationship, I made the selfish decision to not do anything and really, I just pretended that the issue didn’t exist. The issue was always somewhere on my wife's mind and from time to time, we would argue about it. Well, this past Sept. I arranged for a DNA test and the results came back yesterday (Sat., 1/22/2022): I have a son. As you can imagine, my wife is hurt but she agreed to marital therapy though there is no telling what will happen long term. And of course, I must figure out how to move forward with a son that is 10 or 11 and has never met me. This is a mess of my own creation and no matter what happens, I must accept the consequences, but I will need prayers for strength, patience, and understanding and if it is God’s will that my wife forgives me and keep me as her husband, we’ll need prayers for continued healing, patience, and understanding.

So, I sit here, in tears with a part of myself feeling ike I have no right to ask for forgiveness from my wife or God, I humbly ask you, the reader, to send prayers so that I can emerge from this as a stronger man who has an intact marriage and hopefully, a relationship with a son that he has never met.

Signs...

It’s funny that sometimes, when you doubt your path and you ask God to show you a sign that you are either doing the right thing or need to transition to a new path, he hits you in the head with a bag of bricks sometimes to make it crystal clear as to what you need to be doing. I obviously listen to my wife in these matters, but sometimes, you need to hear things from other people who God is speaking through.

Last week, I was asked to participate on the DEI council at the Southern California University of Health Sciences PA program. After the initial meeting, the chair and I spoke but before we did, she said, “Daryl, are you a praying man?” I said, “Yes.” We prayed and afterwards, before we started to discuss our DEI business, she told me, and Eboni was there, “God told me to tell you to go back to what you are meant to do. Stop being disobedient.” She went on to tell me how she was so PROUD to not only see a Black male as a medical student but to see one that was older. She described her story of being a 24-year-old PA back in 1984 and seeing her first patient and not knowing how to talk to or relate to the patient. She ended our conversation by saying that I wouldn’t know peace if I didn’t walk my path, no matter how difficult.

That was sign one.

This week, I had sign two and three. I’d applied for two faculty roles, one at Concordia University-Irvine and the other at Arizona State University. I interviewed well at CU-Irvine and after the second round of interviews, the Dean of the College of Health Sciences and the Department Chair said that I was the number one candidate AND that they were offering me the position. They went on to say that after a year, they envisioned me being promoted to director of the Master of Public Health program so that I could shepherd them through the CEPH accreditation process. They also talked about how I could help raise the research profile of the department given my current research and the fact that I’d had a hand in recently applying for a PCORI grant. They ended the conversation by saying that on 4-January, I would be getting an offer letter from HR and that they supported me negotiating a relocation package and a higher salary. I was ESTATIC! I thought that this was the sign that God was sending me and Eboni and I started visioning what life was going to be like going back home to the West where we love it so much. Well, imagine our surprise when on the 4th instead of the offer, I was told that I would need to go through ANOTHER round of interviews, this time with the President of CU-I and the Provost AND I was going to have to participate in a 2 ½ hour teaching demonstration. I asked the Department Chair if this was in error, and she told me that this had been an oversight on their part. Later that day, I asked HR if there were a salary range for the position and she referred me to the Dean. The Dean responded by saying that the school couldn’t afford me. I have my own reasons why I think things went down the way that they did but essentially, I feel that this was another sign from God. Earlier today, I received a turndown from ASU saying that while my “background and accomplishments are impressive, they have decided to move in a different direction. We’ll keep your CV for 90 days, and if we have future openings, we will consider you. Good luck.” Another sign from God.

The last sign from God came earlier this morning. To make money for things that my VA scholarship and stipend do not cover for medical school, mainly those high as board exams that will be coming up, I took a contract teaching gig for a new medical school that is opening in SoCal. I met the assistant. Program director today and she said that the primary reason why she hired me is because she’d listened to a podcast interview that I did last year, and she said that my authenticity and story of perseverance really touched her and she said that I was the sort of facilitator that the students in her program needed to guide them to their paths to medical school. She then admitted that she had always wanted to attend medical school but thought that she was too old but after seeing that I am a medical student, she said that she now is giving her dream a second thought.

Earlier this evening, God hit me in the head one last time for good measure. This person sent me a message from out of the blue. You guys can read it below but what I realized is that my journey, especially starting with getting into a PhD program when so many people said it was going to be impossible, has not been just about me. Over the last month, I have been getting all sorts of random emails, and messages on LinkedIn and Facebook from people who’ve said that my journey is inspiring to them to reach heights that they never thought that they could. I realize that me walking this path, as tough as it is, isn’t only about me finishing medical school for the benefit of me and my wife/family, but it’s also to let others know that they too can accomplish any goal that they set their mind to. So, I’m feeling renewed and have a sharper sense of purpose. I’m rededicated to finishing what I’ve started. I see my eye doctor one last time this week and then I’m looking forward to being back in class with my classmates and friends at UIWSOM in July.