Looking at Diabetes as a First Year Med Student

Dr. Fran Cogen Health Pro
  • One of the joys of practicing medicine in an academic setting is working with patients, medical students, residents, and fellows. There are continued learning opportunities in this rich environment. It is, therefore, a wonderful prospect to both learn and feel through the perspective of a trainee’s eyes.


    My responsibilities at Children’s National Health System include teaching first-year medical students “Professional Development” at the George Washington University School of Medicine & Health Sciences. This course is part of an overall experience to help medical student trainees develop as physicians in terms of emotional experiences, as well as accumulation of medical knowledge, in an effort to provide balance. As such, through didactic experience and direct experience working with healthcare professionals in the clinical setting, our students learn about wellness and disease.

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    Several weeks ago I had the opportunity to work with one of my first-year students in the pediatric diabetes outpatient setting. As part of our student’s overall learning experience, we ask them to reflect upon the interactions that have the most meaning to them and write about it. My student, who has actually had vast experience working with children previously in Disney World was greatly moved by one of my 4-year-old patients. She took the opportunity to write a journal entry and has given her permission to publish excerpts in today’s blog.


    “I have diabetes,” I was told by a 4-year-old. As the weeks pass, I cannot stop thinking about it. What does this mean to this adorable child? How does it affect his self-image or self-esteem? How do his parents explain going to the doctor or giving him shots? As I thought more about how I would explain it, I ended up with a nursery rhyme, something I would picture as a children’s story with beautiful illustrations.


    I have a booboo in my body, it won’t go away

    You can’t see it, I can’t feel it if I don’t delay

    After I eat sugar, my body does not know what to do

    So I get a little prick of medicine, and my body says “phew!”

    I can still grow big, smart, and strong

    I just have to sing this song.

    If I take my medicine with no pouts,

    I will be safe and healthy with no doubts.

    We are in school learning a new language-medical jargon. What good is my knowledge if I cannot express it to my patients?                                                         

                Alexa Lean MS 1

                George Washington University School of Medicine and Health Sciences

                Washington, DC


    Alexa sent this entry to me in the middle of an insanely busy clinic right before Christmas break. I actually stopped reading and began to reflect myself: 18 children/adolescents, 18 parents or other caregivers, one interpretation of clinical status and suggestion of treatment plans.

    • How do I provide understandable information in a manner to both accommodate caregiver and child in the short time we have together?
    • How do I use my technical glucose download to download what is actually happening inside the little person or adolescent with diabetes and their caregiver?
    • How do I find the time to accomplish these truly important tasks?

    I don’t always have the answers; however, if I don’t continually take the time to reflect upon these mega issues, I will become less available to my patients, which is not an option.


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    I would like to take the opportunity to thank my first-year medical student, Alexa, as well as my patients and families for reminding me to look at my practice of pediatric diabetes in different perspectives.

    Happy Holidays,


Published On: December 23, 2014