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The missing element of TEDMED - critical discussion

TEDMED is a conference that bills itself as, “… a safe place where people with very different ideas can come together to talk, to learn and to celebrate the amazing world we live in.” Speakers and performers—all leading experts in their respective fields—come together to share their ideas about the future of medicine and technology. Presentations are only limited by the speaker’s imagination and the 18 minute time limit. TEDMED’s openness to imaginative ways of thinking about medicine, health care, biomedical research, and well-being produces 4 days of mind-bending talks and performances.

Despite TEDMED’s decidedly forward-thinking subject matter and format, one critical element is missing from the formal structure of the conference—critical discussion of presentations. Almost every single “traditional” medical conference features talks followed by a brief period for public discussion with the presenter about their ideas. TEDMED is devoid of such public critical discussion. Instead, discussions are relegated to the attendees analyzing presentations amongst themselves during breaks in the Social Hub (TEDMED’s sponsor venue) or short exchanges on Twitter or blog posts weeks after the event when the videos are posted online.

Jay Walker—TEDMED’s chairman and emcee for the event—provides some faux analysis after each speaker in the form of a brief summary and a few crowd-sourced questions. However, this serves more to simply reinforce the speaker’s thesis and stroke their ego than critically analyze what he or she said.

The lack of critical analysis consequently allows some speakers to freely conflate marginally related ideas and invoke anecdotal evidence in support of their hyperbolic assertions. It also misses a tremendous opportunity. TEDMED is much more than the small lineup of speakers; its attendees (TEDMED calls them “delegates”) are also innovators and broad-thinkers at the cutting edge of medicine and health care. Why not allow them to engage with the speakers in a public forum for all to hear? While at TEDMED this year, I had some of the most engaging discussions with other attendees and a hundred such discussions occurred at each break. It is a shame a piece of these discussions are not captured for the public.

As often as I am able, I like to suggest a solution whenever I see a problem. I think the solution here is to add a component to the TEDMED Connect app whereby attendees can verbally ask questions and engage with the speakers in a brief discussion session after each talk. During the talk, attendees in the room can jump onto the TEDMED Connect app and touch a button indicating they would like to ask a question at the end of the presentation. At the conclusion of the speaker’s talk, persons indicating they had a question would be recognized one by one. Their smartphone (via the TEDMED Connect app) would become a microphone so that their question could be broadcast over the speakers in the auditorium and the video feed. They would stand up, ask their question into the microphone of their smartphone and engage with the speaker, then sit down and let the next person participate. Time is always an issue, so this could be limited to 3 people or so.

Regardless of its implementation, TEDMED needs to allow for attendees to engage with the presenters after each talk. Critical analysis is the chief means of raising the discourse at conferences. For TEDMED to cement its place as the preeminent event for discussing the biggest ideas in medicine and health care, its discourse could certainly use a boost.

TEDMED recap

TEDMED was an amazing experience. I am grateful to all of the people and organizations that made my attendance possible. I met some of the most incredible people, most were medical students with a passion for changing the caliber of medical care provided in this country for the better and helping better the quality of care around the world.

Unfortunately, TEDMED was so jam-packed with incredible events that I was unable to provide much feedback and insight into the various sessions in real-time. I also realized that because the different talks will be released online, I ran the risk of unnecessarily misrepresenting speakers’ positions by funneling their words through my own viewpoint.

As the TEDMED talks are posted online in the coming weeks, I will highlight some of the talks I thought were particularly noteworthy and provide some of my own insights. I also hope to write more about TEDMED in general as I take some time to reflect on the conference and my experience. TEDMED will be one subject among many here in the coming weeks. Stay tuned!!

TEDMED 2012 - Day 1

Despite only having a single 2 hour session of speakers, the first day of TEDMED was almost overwhemling. The Kennedy Center is beautiful. The program put together by the the TEDMED organizers is phenomenal and jam-packed with great stuff at every turn. However, the delegates (attendees) are by far the most impressive aspect of TEDMED. It is a huge and diverse collection of peolpe looking for solutions to health care’s biggest problems.

A few thoughts on the first day:

• The very first performance was an urban acrobatic show called “Traces”, performed by the Montreal-based troupe, 7 Fingers. It was a beautiful Cirque du Soleil-esque show that demonstrated the incredible abilities of the human body. Watching this amazing work of body movements and contortion as art, I couldn’t help but think that we absolutely need more art in medicine. I don’t mean more pretty pictures adorning the walls of our hospitals. We, health care professionals, need a deeper understanding and appreciation of art and the human capabilities that go into creating beautiful art. Preserving this human capability is at the core of medicine. Not only that, but the practice of medicine is an art-form in and of itself. Stitching layers of tissue together to treat a deep wound is a form of visual art. Conveying treatment options to a sick patient is a form of performance art. We need to embrace art as a fundamental component of medicine.
• Bryan Stevenson, a public interest lawyer and Executive Director of the Equal Justice Initiative, reminded us of the need to think about the most disadvantaged among us. In his bio in the TEDMED program, he says his greatest hope for the future of health and medicine is, “That every advance, innovation and success we achieve in healthcare is hared fully and equally with the poorest of the poor, the most marginalized, and the most condemned.” The potential health gains brought through leveraging mobile technologies and social media are likely to be disproportionately distributed among the wealthy. The wealthy have the most access to technologies and the most time to engage in the health promoting behaviors promulgated through new apps and social media outlets. This situation has the potential to further exacerbate existing health disparities. As tomorrow’s innovators, we need to take into account this aspect of our technology-based health care solutions and ensure mechanisms exist for equal access to the benefits of these solutions.
• Rebecca Onie, co-founder and CEO of Health Leads, first explained to us that health care is not solely about prescriptions and procedures. Health and illness are inextricably related to social conditions—food security, good housing, affordably utilities, etc. Without addressing these needs, we can’t impact health no matter how creative our health care solutions are. She also provided us with the inspiration all innovators need—when you have an important, game-changing vision, you have an obligation to realize that vision. No everybody has such visions and we cannot take them for granted. We must act on our dreams of a better future.

There were too many great moments and incisive observations to capture here. (That is why TEDMED puts up the videos for all to see). I hope to capture the essence of each day, so keep following here.

TEDMED 2012 updates

Today is Day 1 of TEDMED 2012 in Washington DC. I am in attendance at TEDMED because I have been very fortunate to be selected as a TEDMED Front-Line Scholar. Without the support of this scholarship—which has been provided by Siemens—I would not be able to attend TEDMED so I am very grateful for the generosity of Siemens and others who provide support to the Front-Line Scholarship Program. My attendance at TEDMED is also generously supported by Children’s Mercy Hospitals & Clinics in Kansas City. I am currently taking a year away from medical school to spend a year at Children’s Mercy working on several innovative projects. Children’s Mercy is a pediatric hospital dedicated to supporting innovative solutions to pediatric medicine’s most difficult challenges. Their support of my attendance at TEDMED is evident of such a commitment and I am grateful for their generosity.

Over the next 4 days, I will be providing insights from the conference. My plan is to have an update at the conclusion of each day. Please follow along here to get the perspective of a medical student at TEDMED. Can’t wait for the first session!

My best piece of USMLE Step 1 advice

About one year ago, I was contemplating what many second year med students across the country are currently losing sleep over—what is the best way to prepare for Step 1?

Instead of trying to provide an exhaustive and comprehensive roadmap for board prep, I will give you my single best piece of advice (and what I truly believe is the key to doing well on Step 1):

Do as many blocks of practice questions under testing conditions as you can.

The basic format of Step 1 is seven sections consisting of 46 questions apiece with 60 minutes to complete a section. In order to get in the rhythm of this format, use a question bank (there are many out there and you all already know what the best one is) and set it up as the actual test would be. This means (and I believe all the major question banks allow for these choices), select to receive a random set of 46 questions with timing on (it should automatically select 60 minutes based on the 46 question choice).

Do not do untimed question blocks. Do not do blocks less than 46. Do not select a specific subject area you are weak in.

The test will be timed, it will be random, and you will have to bite off 60 minute chunks of 46 questions at a time. The sooner you acclimate yourself to this, the better.

Of course you will want to review the blocks to learn from your mistakes and reinforce what you do know. Spend 60 minutes doing this and only 60 minutes. This is difficult to do because you can easily spend 2 or 3 hours reviewing. However, if you do this, you are now spending 70% - 80% of your time reviewing which is taking away from answering questions under testing conditions (which is your primary objective).

It is not necessary to do consecutive blocks of questions, especially in the beginning. Do one block of questions and review, then move on to whatever other study activities you think will help and come back a few hours later to do another block of questions and review. As you get closer to your test date, you will want to increase the number of blocks you do per day and start doing 2 and 3 consecutive blocks.

Hundreds of strategies and programs for board prep exist; no one is the best. They all have their merits and strengths for particular types of students. Whatever strategy or program you choose to follow, make doing questions under testing conditions a core component.

My final piece of advice and almost equally as important—don’t worry about how horrible you do answering questions in the beginning. You will get better.

Any other tips from seasoned med students who have conquered Step 1 already?