My guest this week is Charlie Gillihan, my youngest brother. At the time of this recording, Charlie was a few weeks away from graduating from medical school. I was interested in his take on medical education in the 21st century since he not only went to medical school but is an experienced teacher himself.

Charlie was very open about his own experiences in a way that I think will be helpful to many people. It was a great discussion as we explored many issues related to learning, medicine, and stress, including:

• What medical school should look like in the twenty-first century
• Evidence-based medical education
• Fixed vs. growth mindset as learners
• The brain’s ability to learn even without our conscious effort
• The challenges of learning in medical school
• What it takes to get through medical school, vs. what it takes to be a doctor
• High rates of physician burnout and suicide
• Mental health training in medical school
• What to look for in a great primary care doctor
• The importance of being listened to as a patient
• How people heal, and how it’s not often because of medical treatment
• Nortin Hadler and the Number Needed to Treat (NNT) measure (see TheNNT.com)
• How to promote a healthy gut microbiome

Charlie referenced the Whipple procedure—here’s a link to that if you’re interested: Whipple procedure.

He also highlighted Pamela Wible’s work on physician suicide; here’s her TEDMed talk about it: Why Doctors Kill Themselves.

Our grandfather whom Charlie mentioned, Dr. Alec Spencer, was a doctor for over 50 years in a small town in eastern Kentucky. Here’s a write-up about his life and what made him so beloved by his patients and community: The Doctor Will Hear You Now.

Here’s more information about the author Vinay Prasad. Charlie referenced his book, Ending Medical Reversal which is available on Amazon. For more from Nortin Hadler, see The Citizen Patient and Worried Sick. (A percentage of each purchase made through these affiliate links will be used to support the podcast, at no additional cost to you.) 

Charlie was enthusiastic about a measure called the Number Needed to Treat (NNT), which determines the number of people needed to treat in order to change one outcome for the better. For example, if 100 people get a treatment and 10 show improvement, compared to 9 out of 100 who got the placebo, then the NNT would be 100. That is, for every 100 people treated, one person would show improvement who wouldn’t have gotten better without the treatment.

The Voltaire quote Charlie cited was, “The art of medicine consists of amusing the patient while nature cures the disease.”

Charlie Gillihan was born and raised in Indiana and graduated from Columbia University with a degree in creative writing. After graduation he taught chemistry and other science courses for three years in the New York City public schools.

He will graduate from New York University’s School of Medicine in May 2019, and will continue his training in NYU’s internal medicine residency. Charlie is fluent in Spanish, having spent considerable time in Central and South America, and his bilingualism is often useful in his clinical work.

To see what he’s up to, find him on Twitter.