In this edition of Nosta & Friends, John Nosta welcomes his friend, Chanel Fischetti, a fourth year medical student at the University of California Irvine. With her binary brilliance, practical mindset, and compassionate approach to medicine, Chanel represents tomorrow’s physician—a “digital native” who might represent a fundamental driver in the adoption of digital health in medicine.
Think. It’s my favorite verb. It’s what I like to do and it’s also what I like to engage others to do. Nosta & Friends is an opportunity to bring great thinkers together and help foster a dialogue that’s smart, relevant and fun.
Today’s friend is Chanel Fischetti, a fourth year medical student at the University of California Irvine. Chanel has the unique distinction of being a “digital native”. In other words, she’s grown up with technology as part of her childhood and adult life. Interestingly, Chanel’s medical education has also been greatly impacted by technology—from her education to direct clinical experience.
She’s tomorrow’s physician who combines her binary brilliance with a practical and compassionate approach to medicine. And it’s just this “digital native” who might represent a fundamental driver in the adoption of digital health in medicine.
As a medical student, what sense are you getting from your professors and teachers about medicine and the prospects for the future? Are you sensing the same pessimism that seems to be widespread?
Actually, before medical school I had a lot of physicians—mostly in private practice—try to talk me out of going to medical school. They said the compensation wasn't the same, that the politics and responsibility were a lot more involved than the job description reflected, and that the patient-physician relationship has been strained by the demand to see and do more with less time.
Now that I am at this transition point (about to graduate from medical school and begin my own journey into the world of medicine), I can reflect on the past few years of medical school and find less of that than I expected. Maybe it's a tribute to the program I'm graduating from, or my decision to ignore the pessimism that can definitely infiltrate the purest of intentions. But I think that like most things in life, your experiences are what you make of them.
I have been fortunate to come from a very supportive program and have mentors who choose to see the best in people and medicine. Do I think this is the sentiment for the majority of those about to graduate from medical school? No. Having now experienced this process and realizing how much of my youth I have sacrificed to get to this point, how many loans I have taken on, and how much work is still ahead of me—I can definitely understand how pessimism can be prevalent in such a career.
Have there been days when I have wished there were other things I was doing? Absolutely. Do my loans scare me? Yes. But at the same time, I can't think of a more rewarding and stimulating career than the one I've chosen. I feel so privileged to have the job I do and find that intimacy and trust with another human being in the doctor-patient relationship. But most importantly, I hope that my training will hopefully one day help to save someone's life.
Was it worth the sacrifice? Without a doubt—but it has been a long and hard road to even get here.
Every career is hard and comes with its own sacrifices. No job is perfect. But I think that by choosing to look at the greater purpose, the greater good, and the positive aspects of it—medicine can be nothing short of an incredible career.
I'm so incredibly excited (and nervous) to start working as a resident physician this coming June. I've worked my whole life to get to this point and if I was asked to do it again, I would without a hesitation.
How has technology impacted you as a medical student? And how, from your perspective, has technology impacted medicine from an overall perspective?
I am a millennial who has grown up in a world where the advancements of technology have not only changed my childhood, but also my education. At my institution, we were some of the first medical students in the nation to have all of our medical books fully loaded onto our iPads. I received four years of bedside ultrasound training starting my first year of medical school. Has technology influenced me as both a student and future physician? Yes.
And I can honestly not even imagine my relationship with my patients without it. Whether it's using bedside/portable ultrasound to help with my patient encounter, or looking up vitals and labs on my iPad during rounds, I am constantly using it for the betterment of my patient interactions.
Additionally, I see technology as a way to communicate and distribute information to other patients, students, and physicians, as well. I have had the opportunity to work with individuals all over the world to help them expand their medical education curriculums to include ultrasound.
Using basic technology advancements such as Google Hangouts or sharing online documents, it has been incredible to experience how much the ability to share knowledge, experiences and techniques can change the status quo of how we learn and practice medicine. I have only had positive experiences thus far with technology within my medical education.
What are some of the most exciting technologies that you have used in your education and in clinical practice?
I think Google Hangouts has definitely been an important one. With working across time zones and in different parts of the same state, it's hard to coordinate everyone's schedules. The opportunity to meet with others face-to-face provides so much more of an experience and opportunity to communicate. So Google Hangouts has definitely been an important technology.
iPads have also helped me immensely on the wards. I have used them extensively to research patient information and prepare to present my patients' cases—or even simply to look up diseases and treatments.
Slack is another platform I have found very useful. I've used it to be part of an exchange of technology endeavors and ideas through ALiEM that Dr. Michelle Lin, Dr. Nikita Joshi and others run. It's just fascinating how much can get accomplished when time zones and schedules don't limit the opportunity to create and dream.
Additionally, there have been a variety of apps that have also influenced my education. They usually serve as references on wards or throughout the day.
There's this idea of FOAMed (free open access medical education) in medicine that really plays into a lot of what I believe and what I think the fusion of technology and medicine truly captures—that applying technology in the right way can truly enhance medical education and medicine all over the world.
There are so many creative and brilliant innovators in medicine who are using their knowledge and experience to expand medicine beyond what we solely experience and practice based on our locations. The exchange of ideas between cultures and countries that is available with the application of technology is truly fascinating. I'm really excited to see how medicine will change within the next few decades—even with the advancements we have now.
There are so many interesting and useful technologies out there, it's hard to give credit to just one that has influenced me. I think overall though, those I have found to be the most helpful allow for better collaboration between teams and individuals.
Take a look into the future. What do you see your career being like in ten years?
I have loved learning medicine and I will always choose to practice clinically. However, I will say, that by graduating from a medical school that has chosen to incorporate technology as part of their mission, I now know that the future of my career will also include some aspect of a fusion between technology and medical education.
Ideally, I would love to be an academician, practicing and teaching medicine to other residents and also helping to develop and adapt technology within medical education. I've still got a ways to go before getting to that point, but I have had incredible mentors who have really helped me build a foundation towards getting there. Dr. Chris Fox, Dr. Warren Wiechmann, Dr. Matt Dawson and Dr. Mike Mallin have been some of the most influential individuals in stimulating that interest. Similarly, Dr. Nikita Joshi, Dr. Vicki Noble, and Dr. Michelle Lin are some of the female mentors I've had along the way who have helped spark this interest.
I'm currently working on an app and project that will hopefully improve the social community for the adult autism population. We are finalizing a Kickstarter that we will be launching soon and finishing the NYU Stern Business School Social Venture competition that will hopefully give us the platform to launch into that community. I don't know if I would have known that I had this interest had it not been for the fostering from my mentors.
It's exciting to see how you can put creative minds together for the initiative of helping the greater good. I think that's what I've learned to appreciate the most from the integration of technology into medicine—that there are so many opportunities to make medicine more efficient and effective with even the most basic of ideas.
And also that there are so many different ways to collaborate as a team. I have met so many incredible engineers, software developers and filmmakers, who have somehow influenced the way I choose to create and integrate technology. So, if nothing else, these experiences and exposures help me become a more well-educated individual about other ways to help my patients and how to relate to others.
Do you use any health or fitness trackers or devices?
In a former life, I used to run track and cross country. That is the only avenue that I try to keep technology out of. For the purity of the sport. I definitely will use my iPod from time to time, but usually I keep my fitness and technology separate.
As much as I love technology and see so much benefit in using it within that realm, I also love the solitude of being outside—but that is a personal decision. And my opinions may change as technology changes. But for now, in general, I don't use technology applied within my own athletics.
Finally, what’s in your (lab coat) pocket?
Hmm, in my lab coat pocket... Usually, you can find my stethoscope, iPad, iPhone, trauma shears, bandages, pens. I try to keep it as light as possible.
What I really wish was also in my lab pocket was a portable/mini ultrasound. I typically take an ultrasound with me into most patient rooms to supplement my physical exam—especially in the ED. I'm rarely without a phone though, because I'm always looking things up and referencing values or medications or disease processes.
It's always great to hear the perspectives of young, bright individuals like Chanel—who offer a glimpse into what our future will hold. Her generation provides a different paradigm for medicine, since the fusion of technology with practice is a given rather than a vision—which is exactly what the future holds in the era of digital health.
The nuviun blog is intended to contribute to discussion and stimulate debate on important issues in global digital health. The views are solely those of the author.