Medicine is More than Clinical Signs & Diagnoses – Portfolio

Being a UofT student, I am privileged to have a diverse curriculum. The external reputation of UofT for some is a school that provides you with endless amounts of information through didactic lectures, which you must swallow up, even if it does not fit your learning style. This was one of the reasons I was initially hesitant to go to UofT, until interview day when I was shown the structure of their curriculum and spoke with students firsthand. That is when my perspective shifted. I can tell you confidently, that my experience here has been anything but a series of didactic lectures.

Recently, UofT has done a major revamp of their pre-clerkship curriculum which is known as Foundations. I will spare the specific details of the revamp which you can read about on their website. For this post, I would, however, like to focus on one aspect of our curriculum in this post which I underestimated for the last year, but only came to truly appreciate recently. That aspect is portfolio. Portfolio is a component of our curriculum which was added to provide us the opportunity to start developing our identities as physicians. It also provides us time to reflect on difficult situations we have faced in the past and continue to face going forward. I strongly believe that reflection is one of the best ways to learn and grow as an individual, for it is through reflection one can identify past flaws along with motivators and develop strategies to tackle these issues and grow as an individual. In portfolio, we are provided dedicated/protected time in our schedule to discuss difficult issues with one or two physicians (known as our tutors) and a small group of our colleagues in a safe space. Each session has a different theme which we discuss, and through these sessions we can really open up and learn from not only ourselves, but also our colleagues and mentors.

Just recently I had my first portfolio session of the year. Being completely honest, in my first year of medicine I did not truly value portfolio. I went into this session with an open mind, as I do with most things, but was really hoping to leave as soon as possible so I could get back to studying for my upcoming neuroanatomy bellringer and neurology exam. I previously thought of it as time out of my day that I could be spent doing other chores, studying, or relaxing, and it seemed like a hassle. Being a first-year medical student, I did not yet start to experience or truly grasp the difficulties the profession of medicine throws at each and every one of us. I was naïve and felt indestructible. It was my session today, after a lot growth that took place over the last year, where I started to truly appreciate what this provides for us. Our groups remain the same throughout our four years, which allows for longitudinal relationships to form. This also provides a sense of comfort for us to share personal stories because it is always with the same individuals.

In our portfolio session today, it was a beautiful day outside, so to start us off on the right foot and mentality, our tutors took the liberty of taking us outside and we sat in the grass under the shade. Immediately, being in a more relaxing and easygoing environment, along with having fresh air, I felt less trapped, and I was more comfortable. Our tutors also started off the session by sharing their own personal stories. This set the tone and showed that they are not just here because “they need to be”, but rather they wanted to be there. They wanted us to actively engage in reflection and discussion, so as an equal participant, they shared their own story of difficulties in the profession. Hearing my tutor’s story made them seem more human, and I could tell that everyone in our group was more motivated to share their own story. From there, experiences were spilling out, emotions were high, and everyone was discussing different hardships and ordeals they have had recently which shifted their perspectives. Through memorizing various bumps on the brain, to predicting clinical findings from various lesions of vessels feeding the brain and spinal cord, it was quite refreshing to have it all brought back to us being humans. Many times, physicians and medical trainees are seen as indestructible beings who should not let emotions get in the way. This is not only a view on physicians from the general population, but also expectations amongst individuals within the profession itself. Historically set, difficult to break, how can we shift the paradigm? Having sessions like portfolio definitely seems like a step in the right direction.

As I go further along in my training, more and more difficulties and hardships will come up. It is hard to truly mess up as a pre-clerkship medical student, but I know for a fact that I will start to have much greater hardships beginning next year when my clinical rotations, or clerkship, begins. That is when true responsibility begins, time becomes less and less available, and sleep appears more and more optional. It is in those times that I will really look forward to my portfolio sessions to check in with my colleagues and see how everyone is doing. To have a true safe environment to discuss hard ships I have experienced without fear of discrimination. I will also carry forward past reflections which took place in these sessions not only from my own experiences, but also by listening to others, for the rest of my career and life. There are certain moments you will never forget. These moments can carry you through the tough times by reminding you of the big picture. If you have had the real challenges life can throw you, you are able to orient yourself in the struggles of everyday life and remind yourself about the big picture. Sure this 30-minute delay on the subway sucks. Sure, it is a tough week with a lot of studying and tests coming up but think of the big picture. Are you healthy? Do you have a secure place to sleep at night? Do you have to worry about your next meal? These are the big issues in life, and if they are covered then a lot of other worries should be cleared. Think of the big troubled times you have had the next time you are stuck in the tough times of everyday life and that should put things in perspective. While these are obvious sentiments, it is through constant reflection that forces one to bring these reminders up to your immediate cognition.

So thank you UofT for providing me, a medical student, this opportunity. It is through initiatives like this that I believe we can foster more well-rounded physicians, and help to reduce physician burn-out. By taking baby steps towards a more supportive professional environment. I regret not having had appreciated it as much in my first year, but I attribute my growth in this past year, and the increased challenges I have faced to my newfound appreciation. To anyone reading this thinking about which medical school they would prefer, I can tell you honestly that UofT provides you not only a high quality education, but also fosters your growth in a multimodal fashion, so I personally would recommend.

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