Dr. Peter Gill, Director and Co-Founder, PedsCases
Dr. Peter Gill (BMSc, MSc, DPhil, MD), co-founder of PedsCases, is a pediatric resident at the Hospital for Sick Children, University of Toronto. He completed a DPhil in Primary Health Care and MSc in Evidence-Based Health Care at the University of Oxford as a Rhodes Scholar (Alberta & Magdalen, 2009). Peter is also an Honorary Fellow at the Centre for Evidence-Based Medicine (CEBM), University of Oxford.
How did you first become interested in medicine? In Medical education?
I first became interested in medicine as a child. I had a fantastic pediatrician who made going to see the doctor fun and enjoyable. I haven't really looked back since and have loved every minute of medicine. In medical school, my interest in medical education was sparked by a handful of engaging, creative and innovative teachers. It was because of my passion for child health, combined with strong Faculty support and mentorship, that I was inspired to set up a free online educational tool to supplement the pediatric curriculum. PedsCases.com was founded as a free resource developed for students by students.
Where would you like to see PedsCases in the next year? Five years?
In the next year, I would like to see PedsCases develop podcast and case content for the core objectives in pediatric undergraduate medical education. Our podcasts have been downloaded 725,000 times, and I would like to see us surpass 1 million podcast downloads by the end of 2016. I would also like to establish relationships with national organizations, such as the Canadian Pediatric Society, to create summary podcasts on newly published position statements.
In the next five years, I would like PedsCases to become a comprehensive, 'one-stop-shop' resource for medical students and learners who want to learn about pediatrics. I envision a website with a repository of podcasts, cases and educational resources that are aligned with the Canadian national curriculum, and cover all the major clinical presentations and diseases encountered in pediatrics. PedsCases will also include links to other relevant clinical tools such as physical exam videos, clinical practice guidelines and multiple-choice questions.
Beyond a repository, I envision creating an international network of students, trainees and Faculty who will create, edit and update PedsCases educational resources. I envision PedsCases at the forefront of medical educational advocacy, innovation and research, acting both as a resource where students can advocate for change to meet their evolving demands and a virtual platform to research optimal ways to learn. Students should be at the center of medical education, and should continue to drive education to meet their evolving demands, and PedsCases will facilitate these agents of change.
What are some obstacles you have encountered in your medical career and specifically in the development of PedsCases?
I have encountered several obstacles along my journey in medicine. The first major obstacle was returning to complete 4th year medical school after spending four years in Oxford completing my MSc and DPhil. It was incredibly challenging to return to clinical medicine after such a long absence, especially as I had just finished two graduate degrees. All in all, I finished three degrees in the span of 12 months, which was difficult. However, the main on-going challenge is the difficulty balancing the heavy clinical demands of pediatric residency with the on-going pursuit of PedsCases and other projects.
Over the years, we have faced numerous challenges in the development and expansion of PedsCases. First, and most salient, is time. Our team members, myself included, are all engaged in full-time education, training or employment, and our passion for medical education takes up our evenings and weekends. As the site has grown, it has required greater time commitments, which has proved difficult while trying to balance clinical requirements.
Second, funding is an on-going challenge. At the outset, the founding medical students covered most of the costs, which were small. Over time, a Faculty mentor stepped forward to cover the on-going hosting and web maintenance costs, but these have grown over time as site usage increases. We have successfully been awarded grants in the past, most notably to develop a new PedsCases website, but identifying a steady funding stream for website improvements and upgrades has proved challenging.
Third, lack of web development knowledge skill set is a limitation. The initial web developer of PedsCases.com was a fellow medical student, so it was easy to ask him to fix and tweak the site. I learned how to write HTML to update the site. However, as our needs changed and grew, we needed to build a new website from scratch, and this was hard. It took years to identify the company for the right price, and we encountered a steep learning curve, but we are thrilled with the result. Yet, we still need to refine and update the site on an ad hoc basis.
However, each of these obstacles has been overcome with the hard work and dedication of the PedsCases team. I have been fortunate to work with, and learn from, dozens of medical students over the years who have dedicated countless hours of their spare time to PedsCases. In particular, Mel Lewis, Alkarim Velji, Mara Tietzen, Chris Novak and Karen Forbes have been instrumental, but there are countless others who have played vital roles.
What advice do you have for current medical students?
Being a physician is one of the most rewarding but humbling professions. Patients allow you to invade their privacy in the pursuit of diagnosis and cure. This is an incredible privilege, and worth reminding yourself of. You will be exhausted, sleep deprived and stressed, but always remember people do not choose to be sick at 3am. Immerse yourself in patient care. Each patient you encounter is like going to a lecture; you can always learn, and each patient will teach you something. Pursue your passions, and work hard. Lastly, I cannot stress the importance of mentorship. My life has been irreversibly changed because I sought career advice from Faculty, and in return was provided guidance, support and encouragement. But mentorship does not come passively; seek it out, and be open to constructive feedback.
Do you have any final thoughts regarding the medical profession as a whole, for either Canada or the United States?
The widespread availability of electronic resources has allowed for easier access to point of care resources. Yet, this is a double-edged sword as the exponential increase in published research has made managing this data overwhelming. Practitioners' will need to learn how to manage this information overload to make good decisions for individual patients, which means going back to basics, and understanding what medical research applies to the patient in front of you.
Medicine is shifting towards a greater reliance on diagnostic technologies (e.g. point of care ultrasound) in favor of history and physical exam. While in many ways this is appropriate, and leads to earlier diagnosis and management, an unintended consequence is the deterioration in clinical skills and potentially more unnecessary investigations. Judicious use of new technologies, and new application of technologies, is needed to avoid the pitfalls of over-diagnosis and mismanagement of limited healthcare resources.
Lastly, patients' are more actively engaged in their health and expect more from physicians today than a decade ago. Patients' often look up information before seeking medical care and ask pointed questions about the risks and benefits and diagnostic tests and interventions. This puts a greater onus on practitioners to know these data, and to understand how to communicate it clearly and effectively to patients. It is an exciting time to be in medicine!