“Half of what we will teach you in medical school is right, and half of it is wrong – the problem is we don’t know which is which.” This quote, or some variation of it, is relayed by many educators at medical schools across the globe. At AHA19, these words rang in my ears as my head was spinning from attending lecture after lecture being given by experts in the field of cardiology. What I found to be most educational (and hilarious), were the debates on controversial topics.
The debates I attended ranged from the age-old IABP vs impella in cardiogenic shock patients, to thought-provoking jabs at conventional practice, such as whether or not sodium restriction is necessary in acute decompensations of heart failure. However, I’m not here to convince you that one form of mechanical circulatory support is superior to another, or that perhaps some of the things we put a lot of stake in (hello salt restriction), might not be true in all cases.
With each debate, when a physician explained their reasoning for being Pro-X or Anti-Y, I couldn’t stop nodding in agreement. Gaining insight into their reasoning was thought provoking in and of itself! I found myself agreeing, disagreeing, and scratching my head at different concepts. It helped me discover gaps within my own knowledge, and pushed me to review the primary literature in a way that no amount of pimping on the wards ever could.
One of my favorite debates was watching Dr. Gregg Stone debate with Dr. Obadia on the merits of mitral valve clipping for secondary mitral regurgitation (the lead investigators of 2 separate trials that basically showed totally different results). Neither physician said the other was wrong! In fact, they both more or less agreed with one another, and helped highlight key differences that a discerning physician should look for when faced with such discrepancies.
And the lectures that weren’t meant to be debates ended up sparking hot debates anyways! I’m looking at you #ISCHEMIA trial. The #Cardiotwitter explosion that began that ensued has been so eye-opening to me as a trainee. Not only did it help highlight some details of landmark trials I might have missed, but it gave me a great window into the line of thought of many skilled clinicians.
Coming through college, medical school, and residency, I’ve been exposed to many different styles of teaching, and I’ve seen conventional medical education evolve from a bunch of disjointed sciences taught in school to a formal systems-based curriculum. Social media has changed the landscape of many fields, and medical education is not immune to its effects. FOAMed (Free open access medical education) and social media have become staples in how some trainees learn, and we must embrace that. The way that the AHA sought to integrate this into their programming was a great experience that truly helped to cement new knowledge for me, and ultimately improve my patients’ care. And as I’ve come to learn, when it comes to these debates, it’s not about who is right or wrong, it’s about how much you can learn form hearing both perspectives.
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Adham Karim is a 3rd year resident going into cardiology. He plans to join the burgeoning field of cardiology critical care, and when he’s not taking H&P’s, he’s outdoors trying to get as much sunlight as possible. Adham enjoys rock climbing, soccer, and the occasional Spartan Race. For more articles by Adham, check out his blog www.critcarecardio.com. Follow on Twitter: @critcarecardio