Introduction: Medical education research has emphasized graduate medical education with few studies describing clinical experiences of medical students. Fourth year medical students often complete a sub-internship in the intensive care unit (ICU), where they confront a steep learning curve of managing complex patients, engaging in challenging conversations, and exposure to death. Reflective practices like storytelling have proven effective in promoting wellness, preventing burnout, and fostering empathy in medical professionals, though opportunities for students to participate are limited. At our institution, critical incident reflections are integrated in the ICU sub-internship to help students process impactful experiences. In this study we qualitatively analyzed these reflections to identify key themes and emotions, aiming to guide curricular improvements and enhance the students’ experiences. Methods: Students were introduced to the reflection assignment and research project at the start of their clerkship and asked to write about one of the following: 1) an issue or experience that was distressing, 2) a scenario that created an opportunity for quality improvement, 3) an interaction that highlighted a pre-existing health inequity, 4) any other experience that was impactful for them. Deductive qualitative research methods were used to identify major themes and elements (sub-themes) in a sample of narratives. Once saturation was achieved, a code book with definitions of themes and elements was created and used to test code for inter-rater reliability (IRR). Any code with a kappa IRR < 0.65 was revised. The remaining reflections were qualitatively analyzed using the revised coding schema. Results: Of the 236 students who completed the assignment, 120 consented to having their essay included in the analysis, 67 declined, and 49 did not answer. We deduced 6 major themes which included: “navigating social challenges”; “addressing an ethical dilemma”; “witnessing role modeling”; “communicating with a patient, family, care team”; “grappling with end of life care, dying, death”; and “coping with emotions”; and 15 minor elements (Table 1). Themes with the highest IRR (kappa> 0.8) were communicating with patients, grappling with end-of-life-care, and coping with emotions. Elements with the highest IRR agreement were “teamwork” and “bias”. Conclusion: Medical students on critical care sub-internship rotations frequently encounter a patient experience or scenario that will have a lasting impact on their professional trajectory. Qualitative analyses of student reflections could help inform ways to better prepare and support learners during and after their ICU sub-internship.

In this narrative essay, a hospitalist describes the experience of visiting the parents of a 3-month-old patient discharged to hospice.

A patient photo in an electronic medical record can capture only one isolated moment in a long journey of health and illness — but such moments are often all that a hospitalist can get.

We step into the room, and after a few words of greeting, the medical student informs her patient of the assessment we had developed together in the hallway. She confidently rattles off the sudden drop in hemoglobin she had noted on his morning labs, the blood thinner he is on for his history of clotting, the steroids we have had him on since admission—all adding up to our concern for an occult bleed.Her confidence falters, however, as she approaches the topic we had just discussed outside the room. “We’ll have GI see you, but…one last thing…we just need to…uh…if you can just…”I step in, as she trails off. “We need to do a rectal examination to see if the bleeding could be in your GI tract.”He looks skeptical but nods his acquiescence.I ask if it is okay if the student does the examination with my guidance.He studies her. And despite the barely suppressed panic in her eyes, he nods again.As I walk her through the preparation and positioning, I make sure to project a calm assurance. Because I remember my own first time so well.***We huddled in the crowded examination room, checking our watches and chatting. Quietly. Nervously. The boldest of the 5 of us swiveled atop the round metal rolling stool reserved for the absent clinician. The rest of us leaned against walls or the examination table, shying away from the pile of water-based lubricant packets lying atop it. Through the thin walls, we could hear the rise and fall of preceptors’ voices in other examination rooms already giving our classmates an introduction to the examination maneuver we had come to the urology clinic to learn.I had been dreading the arrival of this strange medical school milestone. Fumbling my way through such an invasive physical examination maneuver in front of a group of peers made me intensely uncomfortable. The mood in the room as we waited suggested that the other members of my small group felt the same. “It’s almost 7:15. Someone should ask what’s going on.”Before we could come to a consensus on exactly who that someone should be, there was a knock on the door.We came to attention, expecting a figure in scrubs and a long white coat to stride in and authoritatively guide us through the exercise. Instead a small man in faded jeans and a black leather NASCAR jacket entered. He smelled strongly of cigarette smoke. The hair peeking out from under his Tennessee Titans cap was graying, but his horseshoe mustache was still a dark brown.Our standardized patient surveyed the room. “Where’s the boss?” he asked. His broad Middle Tennessee drawl was a good match for his attire. “No one has shown up yet,” my classmate on the stool answered.“Dang doctors. Never on time,” he said with a wink.He disappeared into the hallway. Through the cracked door we could hear him talking to the staff member at the front desk. “Your preceptor got tied up,” he said as he returned to the room. “Looks like it’s just us.”His relaxed tone was a poor match for the rising unease in the room. “Uh…we can just email the course director and try to come to another session,” I said, hoping that I might be able to delay the awkwardness, if only for another day or so.“Or we can see if we can join the other groups,” offered one of my peers.“Nah. I’m here. You’re here. That’s all we really need,” he replied. “Students have been learning this on me for years. I can teach y’all better than any resident. So, who’s going first?”I looked to my classmates, seeking solace but finding only a matching of my own alarm. This was not how the morning was supposed to go. “Don’t be shy now. One of y’all put gloves on and get over here. Or I’m going to pick one of you.”No one moved. No one spoke.The silence amplified the awkwardness. And my anxiety. “No takers?” My panic spiked as his eyes locked on mine. “This guy, then,” he said pointing at me.I was terrified, but he was clearly the one in charge. I reached for a pair of gloves. He tossed me a packet of lubricant. “Be sure to use a lot. A dry glove is bad news for both of us.”He unbuckled his worn black belt. Unbuttoned and unzipped his jeans. Let them fall in a bunch around his ankles. He didn’t bother to remove his NASCAR jacket. Jeff Gordon’s number 24 car sped toward me as he turned around.He bent over, bracing himself against the edge of the table.“Ready?” he asked.“Not really.” I said, trying and failing to match his joking tone.“It’s no big deal,” he reassured me. “It’s just an asshole. We’ve all got one.”I let out a chuckle and felt the knot of the tension in my body begin to fray–—more from his casual use of profanity than from his reminder of the mammalian universality of anuses.“So I just…go for it?”“Nah. Finding the right spot can be pretty hard unless you want to get eye to eye with it. Just start toward the top and move your finger down until you feel it give.”I followed his instructions and slowly moved my tremulous finger inferiorly along the gluteal cleft. “You don’t have to be so precious about it,” he chided. “Just swipe it like a credit card. You’ll know when you’re in the right spot.”The remaining tension in the room evaporated as my classmates erupted in laughter at the absurdity of the analogy.I swiped. Not confidently. And not exactly like a credit card. But close enough to find the target. “There it is,” he said. “Now just ease it in. Try to be slow and smooth about it. It won’t hurt if you take your time.”“There you go. Nice and easy.” he said. “Okay then, sweep from side to side…Feel that smooth, firm area. Yep, you got it. That’s the prostate right there. And that’s it. You’re done. No big deal, right?”I agreed and stepped aside, relieved.As I removed my gloves and washed my hands, my classmates lined up to take my place. He stayed in position as one by one, they repeated the process.***I don’t recount any of this to the student or our patient, but I channel my unlikely teacher’s calm nonchalance in an attempt to pass along to her what he taught me—that robbed of the awkwardness we project onto it, this is, ultimately, an examination maneuver like any other.I can sense her anxiety dissipate as I walk her and our patient through the steps that I learned while staring at the number 24 car embossed on black leather. She uses plenty of lubricant. She moves superior to inferior until she identifies the sphincter. She applies steady and gentle pressure.And just like that, she is done.No big deal.The author would like to thank Anthony Williams, MD, and Maren Olson, MD, MPH, MEd, from the University of Minnesota Center for the Art of Medicine for their valuable feedback and suggestions to improve this piece.

Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event.

Context: Storytelling is a powerful tool for encouraging reflection and connection among both speakers and listeners. While growing in popularity, studying the benefits of formal oral storytelling events within graduate medical education remains rare. Our research question was: could an oral storytelling event for GME trainees and faculty be an effective approach for promoting well-being and resilience among participants?Methods: We used multiple approaches to gather perspectives from physician participants (storytellers and audience members) at an annual oral storytelling event for residents, fellows, and faculty from seven academic health systems in Minnesota. Data sources included short reflections written by participants during the event, an immediate post-event survey exploring participants' experiences during the event, social media postings, and targeted follow-up interviews further exploring the themes of connection and burnout that were raised in post-event survey responses. We performed a qualitative analysis using both deductive and inductive coding to identify themes.Results: There were 334 participants, including 197 physicians. At the event, 129 real-time written reflections were collected. There were also 33 Twitter posts related to the event. Response rate for the post-event survey was 65% for physicians, with 63% of physician respondents volunteering for targeted follow-up interviews. Of those, 38% completed the follow-up interview. Themes that emerged from the multi-modal qualitative analysis included a sense of connection and community, re-connection with meaning and purpose in work, renewal and hope, gratitude, and potential impact on burnout.Conclusion: The large turnout and themes identified show how an oral storytelling event can be a powerful tool to build community in graduate medical education. Qualitative analysis from multiple sources obtained both in real-time at the event and upon deeper reflection afterwards showed the event positively impacted the well-being of participants and that oral storytelling events can be an effective approach for promoting resilience in GME.

In Springsteen on Broadway, Bruce Springsteen tells a story about an early morning, when he and his wife were waiting for the imminent birth of their first child and were surprised by a knock at their door. Springsteen was shocked to find his own father, with whom he had shared a strained relationship, standing outside. As the father and son sat in the dining room nursing “morning beers,” it became apparent to Springsteen that his father had driven across the country to make both an apology and a petition—an apology for the failures of his past and a petition for reconciliation. On the eve of Springsteen's transition to fatherhood, his own father was asking for the opportunity to alter their relationship.Springsteen says, “We are ghosts or we are ancestors in our children's lives. We either lay our mistakes, our burdens upon them, and we haunt them, or we assist them in laying those old burdens down, and we free them from the chain of our own flawed behavior. And as ancestors, we walk alongside of them, and we assist them in finding their own way, and some transcendence.”When a friend first showed me a clip of Springsteen telling this story, I found myself fighting back tears in the middle of a crowded coffeeshop on a sunny summer morning.For weeks after, I struggled to understand why these words struck me with so much force. There was gratitude in my reaction for sure—I am fortunate in that my own experience with family has been filled with far more ancestors than ghosts. But there was also sadness. Inside me, there was something unexamined that resonated with the Boss's words. What was this haunted part of me, crying out to be named?Finally, while watching the video again at the end of a particularly long and exhausting week in the hospital, that haunted part of me made itself known. The walls that had been holding the tears back tumbled down, and I allowed myself to enter into the valley of memory that contains both the haunted house and the hall of ancestors that have made me the doctor I am today.Mastering the art of medicine is difficult, and the apprenticeship system that is medical education provides an effective path to competence. Many of the relationships that make up medical training are short-lived, but this brevity belies the intensity and long-term impact of the days and weeks that comprise them. Alongside the opportunity for growth and support, there is also ample opportunity for abuse and trauma, both overt and subtle.I am certain I am not alone in noting that my early years in medicine are as full of ghosts as they are of ancestors.Some ghosts haunt through the memories of active trauma. There is the department chair who attended every morning report, not to teach and support, but to belittle and terrify the residents and students in attendance. There is the attending who smiled the smile of a used car salesman as he handed his business card to every patient on rounds, but who behind closed doors never missed an opportunity to remind his trainees of the many ways in which we disappointed him and failed our patients. There is the fellow who refused to come into the hospital to see a critically ill patient in the middle of the night, but who then made a point to come to the hospital early to track me down to yell at me about a minor mistake in replacing electrolytes before I left in the morning. There are the many attendings whose increasingly esoteric questions about their subspecialty were clearly meant not to probe and extend the boundaries of my knowledge but to intimidate and diminish.Too often trauma disguises itself as teaching. The facts and protocols learned via fear and intimidation are not easily forgotten, but each remembrance demands its pound of flesh.But as painful and persistent as the hauntings are, I know that I am blessed that there are as many ancestors walking beside me as there are ghosts following behind.There is the preceptor who took care to make time not just to share knowledge but to explain how to think like a doctor—leading my developing mind through the valleys of ambiguity and uncertainty. He walks beside me every time I try to help a learner make sense of situations in which there is no “right” answer, only what seems to be the “best” option at the moment, and how we will proceed if it turns out that we were wrong.There is the hospitalist whose warmth and generosity of time and spirit radiated out in all directions. Working with him was a daily lesson in how to treat coworkers, learners, and patients with genuine kindness, curiosity, and compassion. His light was extinguished far too early, but he continues to walk beside me. His example guides me through every personal encounter I have in the hospital.There is the prominent cardiologist, who I had previously seen as somewhat unapproachable and aloof. But when a young patient who had presented with rejection of her heart transplant abruptly coded, just an hour after I had last seen her, he noticed that I seemed unusually withdrawn during rounds and pulled me aside afterward. He took time to help me walk through our patient's death and to unpack my feelings around the long and unsuccessful code. He affirmed my feelings of shock. He assured me that I had made no mistake in this patient's care—that there was nothing I could have done that would have saved her. He sits beside me every time I sit down to help a learner debrief around the death of a patient or other bad outcome.And now, every morning as I prepare to walk through the doors of the workroom where I will meet the team of trainees who have been entrusted to my care as a teacher, I remind myself of both the burden and the buoyancy of my own medical education. And I ask myself a version of the questions that Bruce Springsteen asked his audience in that Broadway theater: “Who will you be to these learners? Will you lay the burdens of your own training and mistakes upon them, or will you be an ancestor who continues to walk beside them long after you are gone?”

Journal of Hospital MedicineVolume 17, Issue 1 p. 54-58 CLINICAL CARE CONUNDRUMS A traumatic traveler Ancil J. Abney MD, FAAP, Corresponding Author Ancil J. Abney MD, FAAP abney013@umn.edu Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, Minnesota Correspondence Ancil J. Abney, MD, Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MN. Email: abney013@umn.eduSearch for more papers by this authorBradley Monash MD, FACP, FAAP, Bradley Monash MD, FACP, FAAP Departments of Pediatrics and Medicine, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this authorBernard Trappey MD, FACP, FAAP, Bernard Trappey MD, FACP, FAAP Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MinnesotaSearch for more papers by this authorAndrew P.J. Olson MD, FACP, FAAP, Andrew P.J. Olson MD, FACP, FAAP Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MinnesotaSearch for more papers by this author Ancil J. Abney MD, FAAP, Corresponding Author Ancil J. Abney MD, FAAP abney013@umn.edu Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, Minnesota Correspondence Ancil J. Abney, MD, Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MN. Email: abney013@umn.eduSearch for more papers by this authorBradley Monash MD, FACP, FAAP, Bradley Monash MD, FACP, FAAP Departments of Pediatrics and Medicine, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this authorBernard Trappey MD, FACP, FAAP, Bernard Trappey MD, FACP, FAAP Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MinnesotaSearch for more papers by this authorAndrew P.J. Olson MD, FACP, FAAP, Andrew P.J. Olson MD, FACP, FAAP Departments of Pediatrics and Medicine, University of Minnesota Medical School, Minneapolis, MinnesotaSearch for more papers by this author First published: 18 March 2020 https://doi.org/10.12788/jhm.3379 This icon represents the patient's case. Each paragraph that follows represents the discussant's thoughts. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume17, Issue1January 2022Pages 54-58 RelatedInformation

When addressing a new problem in a patient with a chronic condition, it is crucial to first understand the chronic condition and then consider whether the presenting symptoms relate to that condition or stem from an unrelated inciting event. Patients with DMD are at risk of pulmonary complications relating to their underlying disease. For instance, dysphagia and ineffective cough can predispose them to recurrent aspiration pneumonitis and/or pneumonia, whereas decreased lung compliance (from scoliosis, atelectasis, and/or pulmonary fibrosis) and respiratory muscle weakness can progress to ventilatory failure. In addition, patients with DMD are at risk for pulmonary thromboembolism in the setting of immobility. Patients with DMD may also develop congestive heart failure resulting from myocardial fibrosis and nonischemic cardiomyopathy. The ejection from his wheelchair signals potential trauma-associated conditions that could explain his respiratory distress. Respiratory complications of blunt thoracic trauma include pulmonary contusion, pneumothorax, flail chest (resulting from fractured ribs), and acute respiratory distress syndrome (ARDS). Lower extremity injury can result in venous thrombosis and pulmonary thromboembolism. While classically associated with long bone fractures, fat embolism syndrome (FES) may rarely occur with rib fractures and soft-tissue trauma. Respiratory compromise may also result from cervical spinal cord injury or severe anemia from trauma-associated hemorrhage.

As those who work in medical education are painfully aware, burnout is a major problem among physicians-in-training. In our area, there are 102 residency and 41 fellowship programs, which are all part of the Metro Minnesota Council on Graduate Medical Education (MMCGME). The MMCGME is a consortium that provides support and collaboration to the Twin Cities and Greater Minnesota GME programs and sponsoring institutions. Given how rampant burnout is among trainees, the MMCGME board has struggled with how to develop a strategy that would foster well-being and resilience for nearly 1400 resident and fellow physicians across a wide spectrum of specialties, training environments, and hospital systems.We opted to try a creative approach to improve well-being among residents and fellows grounded in research that shows meaningful connections with others can promote resilience and decrease burnout among physicians. Storytelling and shared vulnerability can foster connectedness, so we decided to host a Story Slam night. This idea was inspired by The Moth radio program and a storytelling event held at a member institution that has a well-established narrative medicine program. A planning committee was convened with faculty and residents from a broad sampling of programs and institutions. A popular local brewery was selected as the event site and a call was put out for 750-word stories related to the theme “Connections.” The committee selected which stories would be presented. Residents, fellows, and faculty were invited to attend. Raffle prize donations were solicited from local businesses, focusing on products and services that could contribute to well-being, such as gift certificates for house cleaning, food delivery services, and massages.The Story Slam had 160 attendees and we had to close registration due to size restrictions at the venue. Eighty-eight percent of those who replied attended the event, which was free of charge for attendees. The event opened with a social hour. We had a mix of 17 residents, fellows, and faculty who shared stories. A faculty member well known in the community for his support of the arts served as emcee. Raffle prizes were awarded during the course of the evening and a drawing for larger prizes for the storytellers was held at the end. The total cost of the event was $6,500 and was sponsored by the member teaching hospitals.We received a great deal of spontaneous feedback about the event, which has been universally positive. In a follow-up survey sent to attendees, 82% said they would be extremely likely to attend a future Story Slam event and almost all would recommend it to a colleague. In response to the question, “One goal of the Story Slam was to help create a sense of connectedness among those who attended. How well did the event accomplish that goal?” the mean response was 4.8 of 5, with 5 meaning extremely well. Residents also described the most-valued aspects of their Story Slam experience. One resident said, “The openness of the story tellers was absolutely amazing. The intensity and thoughtfulness of the stories was inspirational.” Another commented, “Presenters' stories were impassioned, personal, and emotional. People were not afraid to share their true feelings.” Finally, one resident noted that the event met the goal of building connections: “I loved hearing everyone's stories and hearing that we are all not alone!”Given the overwhelmingly enthusiastic response to Story Slam, we have planned to make this an annual community-wide event. In addition, several MMCGME member organizations are hoping to host storytelling events at their own institutions.

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Background: Internal medicine physicians and trainees are increasingly using, and seeking training in, diagnostic point of care ultrasound (POCUS). Numerous internal medicine training programs have described their curricula, but little has been written about how learners should be assessed, supervised, and allowed to progress toward independent practice, yet these practices are imperative for safe and effective use. Entrustable professional activities (EPAs) offer a practical method to assess observable units of professional work and make supervision decisions. Methods: An EPA for POCUS is used as a framework to assess and determine appropriate levels of supervision in an internal medicine residency program. Results: All learners have been able to advance to level 2 with a mandatory introductory boot camp course. Learners have been able to advance to higher levels of independence, often after taking formal elective programmatic coursework. However, not all learners taking the same coursework have been granted the same level of independence. Conclusions: It is feasible to assess and supervise internal medicine residents' ability to use diagnostic point of care ultrasound using an EPA.

I described in the piece.I knew then that I, personally, could not do something that I thought would intentionally end the life of the patient lying in front of me.That conflict and that feeling were my focus in the telling of the story.In reality, I worried in community with several of my partners.After I made the decision that I described in the piece, I stepped out of the room and spoke with his primary team attending and the palliative care clinicians.I also consulted with several of my colleagues who staff our procedure team.Given the detailed circumstances of this patient's clinical scenario (not all of which were provided in the piece), all of these other clinicians agreed that they would not "take it all" and deliberately end the patient's life.Despite this, I did not (and do not) feel completely absolved of the decision that I made.That is why I wrote the piece the way I did, bringing into focus the difficult decisionmaking that physicians go through every day.I entered medicine to help alleviate suffering, but in that moment, I realized that the compulsion to alleviate suffering only goes so far.In response to this piece, a colleague shared with me a quote from bioethicist Edmund Pellegrino: "The physician-patient relationship, like any ethical relationship, is a reciprocal relationship.In the justifiable concern for patient autonomy, we must remember that the physician is a moral agent, as well as the patient.When the two are in conflict, the patient's wish does not automatically trump the physician's." 1 I hope to remember this as I continue to wrestle with the decision I made that day.

Program Goals: Trainees participating in global health (GH) electives face significant emotional and ethical challenges. The University of Minnesota GH Track holds a one-day GH preparatory course for trainees participating in an elective. This session has not formally addressed wellness abroad in the past. We aimed to incorporate wellness preparation into GH pre-departure training via a novel moderated activity we called Wellness Rx. …

Cannabis hyperemesis syndrome (CHS) is a condition in which some patients with long-term, frequent use of cannabis paradoxically develop recurrent episodes of nausea and vomiting. The pathophysiology underlying this condition is poorly understood, as is the explanation for its common association with patients’ discovery that hot-water bathing alleviates symptoms. We describe the case of a 24-year-old male with daily marijuana use and a history of CHS who was found to have rhabdomyolysis induced by a period of 15 h of continuous jogging after he discovered that this activity helped to alleviate his symptoms. To our knowledge, this is the first reported case of exercise-alleviated CHS symptoms, and we propose that this case provides support to the theory of redistribution of enteric blood flow as the mechanism behind the learned hot-water bathing behavior seen so commonly in CHS.

Global health initiatives from academic medical centers have rapidly proliferated over the last decade. This paper endeavors to describe our 5-year experience as an academic medical collaborative supporting healthcare delivery, medical training, and research at Hôpital Saint Damien-Nos Petits Frères et Soeurs, the only freestanding children’s hospital in Haiti. Descriptions of the history and current activities of our academic medical collaborative, its partnership and communication structure, its evolution to fill the expressed needs of our host site, its funding mechanisms, and its challenges and opportunities for the future are included.

It is important to detect splenomegaly as it can have important diagnostic implications. Previous studies, however, have shown that the traditional physical examination is limited in its ability to rule in or rule out splenomegaly.

student development of one or more of the CanMED roles. This is not only a way of standardizing the value obtained from student experiences but it also promotes the “core competencies” that are integral to effective physicianship. In addition, SHINE hosts monthly journal clubs, quarterly workshops (on leadership, advocacy, preventative medicine, etc.), and annual events with world-renowned leaders, to allow SHINE students to envision their own impact in the greater context and receive feedback and insight from individuals who have dedicated their lives to improving the human condition. Results (Scientific Abstract)/Collaborative Partners (Programmatic Abstract): SHINE partners with institutions and communitybased organizations (CBOs) serving marginalized populations, both in Calgary and abroad. Partnerships entail a reciprocal relationship that enable medical students to develop their CanMED roles (“core competencies” integral to effective physicianship), while at the same time assisting CBOs/institutions to achieve a desired program goal/ execute their mandate. Current partners include 1. the YMCA (to develop a Youth Wellness Program targeting Youth Age 12-17), 2. Bo School of Community Health Sciences and Bo Government Hospital (to create a sustainable Neonatal Resuscitation Program that aims to reduce neonatal mortality attributable to birthing asphyxia by increase the number of health professionals in Bo trained in neonatal resuscitation), 3. WoodsHomes (to create of a framework and curriculum for addiction cessation that uses a combination of harm-reduction strategies, and targets youth 16-24), and 4. Remand Center (to sensitize students to the unique challenges of working with prison populations and develop a tailored health assessment questionnaire). Summary/Conclusion: Sixteen students across a multitude of disciplines have been enrolled for the 2013-2014 program. Each placement is supported by a physician mentor. A sustainability plan has been created to ensure placements remain available from year to year.