Reem Alzafiri, MSc Candidate, Translational Medicine
At the medical ground rounds on November 28, the Department of Medicine had the pleasure of welcoming chief residents Dr. Ovtcharenko and Dr. Poon from the Internal Medicine program. The role of a chief resident focusses on leadership, advocating for fellow residents, and has a large administrative obligation within the program. The path that led the two doctors in becoming chief residents were very different. Dr. Ovtcharenko has a Bachelor of Science in political science and a concentration in human biology; global health. As a physician, her work in critical care is inspired from her passion of being able to experience different specialties.
Dr. Poon’s background in basic science led to a career in medicine, specializing in oncology. His interest focusses on communicating bench-side science with clinical practice within the field of oncology as he believes it’s an exciting field that continues to grow and change through translational research.
Dr. Ovtcharenko began the medical ground rounds with her talk introducing a very important and under-recognized historical event that continues to have repercussions today. She brought awareness to the Canadian tuberculosis epidemic where the segregation within the healthcare system, between Indigenous people and Caucasians, caused harmful treatment of indigenous people that lead to an increase in their mortality rates. The mistreatment of indigenous people was centered around racial bias and the development of Indian hospitals.
Canada has a long history of colonialism that is rooted in the cultural genocide of Indigenous people, as stated by the Truth and Reconciliation Commission Report of 2015. Further marginalizing the community, from the 1930s to 1970s, the Indian Hospital system was formed in order to racially segregate federal healthcare institutions for Indigenous peoples. These hospitals were strategically selective when taking in indigenous patients. They only took in patients who had a high probability of being cured from tuberculosis, leaving the fatally ill to spread their disease in their home communities. This led to the public concern of “Indian diseases” creating the ‘racially careless’ stereotype of Indigenous people. This stereotype affected the way Indigenous people are seen in the medical community, how they are treated by physicians, and ultimately being isolated and feeling alone. Dr. Ovtcharenko touched on how the medical community can reconciliate with the indigenous community and how physicians today should continue to learn and expand their knowledge on these issues, as they are in the business of patient care.
Following Dr. Ovtcharenko, Dr. Poon’s talk introduced a very interesting topic that focused on ordering tests for patients using a systemic approach where the implementation of care and its outcome is based on a feedback mechanism. When examining a patient, figuring out their diagnosis is based on the amount of testing done for the patient, whether it is standard tests or going the extra mile when the symptoms presented are complex. Dr. Poon brought to our attention that, as a resident, the amount of testing a physician conducts can have repercussions when facing the board if tests are not supported. This can cause a lot of stress as one must keep in mind whether the benefits outweigh the harm when considering different tests.
Dr. Poon also introduced a new method of screening for colorectal cancer. Transitioning from the old test, the guaiac fecal occult blood test (gFOBT), the fecal immunochemical test (FIT) is a safer and painless stool-based test that checks for early signs of colorectal cancer or pre-cancerous lesions via the presence of occult blood within the stool. Research has shown that the FIT test is better at detecting colorectal cancer without having to worry about it mistaking other substances for human blood, making it a more valid screening approach.
In our post-round discussion, Dr. Ovtcharenko and Dr. Poon touched on their experience going through residency. They mentioned that there is a level of comfort in practicing independently that builds over time but sometimes imposter syndrome can kick in and you fear about making mistakes and having bad outcomes. However, in this specialty, you are always learning and there are always people who will help you. The most important thing to keep in mind is to be confident in yourself and your expertise among accepting that bad outcomes are inevitable. It’s how you act in the face of adversity that will steer your success in the future.
On behalf of Queen’s University and the Translational Medicine graduate program, thank you Dr. Ovtcharenko and Dr. Poon for bringing awareness to important issues and sharing your academic experiences.