International Journal of Medical Students

Credits & Content

2025-09-05T12:37:32-04:00

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Cerebellitis as a Rare Manifestation of HSV Encephalitis: A Case Report

2025-02-11T18:53:04-05:00

Background: Herpes Simplex Virus (HSV) is a common cause of encephalitis. A feared complication of HSV encephalitis is hemorrhage and necrosis of the brain parenchyma most commonly in the temporal lobe(s). Less common sites of focal necrosis include the insula and inferior frontal lobes. A rare presentation of HSV encephalitis is cerebellitis.

Case: A 74-year-old female presented with a 1-month history of progressive balance difficulty and dizziness. The neurological exam showed truncal ataxia and scanning dysarthria. Serum labs were largely unremarkable, except for elevated sedimentation rate (ESR). Brain MRI revealed diffuse cerebellar swelling and T2 signal changes, with left medial enhancement. Cerebrospinal fluid (CSF) analysis showed elevated red blood cells (WBCs 5, RBCs 438, protein 54.7, glucose 64) and was positive for HSV-1 PCR. The CSF autoimmune encephalopathy panel was negative. She was treated with acyclovir 10 mg/kg every 8 hours for 14 days and IV methylprednisolone 1000 mg daily for 5 days, followed by an oral prednisone taper. Clinical improvement in ataxia and dizziness was observed soon after treatment began, with decreased cerebellar edema and enhancement on repeat MRI. After discharge, the patient was lost to follow-up, and long-term neurological status remains unknown.

Conclusions: Recognition of atypical HSV encephalitis is crucial as encephalitis has a broad differential and CSF HSV PCR is a widely available and highly specific test. Rapid administration of acyclovir is the current standard of care. Addition of pulse dose methylprednisolone may also impart symptomatic and radiographic benefit.

When Fire Meets Shadow: A Rare Case of Tolosa-Hunt Syndrome Associated with Discoid Lupus Erythematosus

2025-02-11T19:45:01-05:00

Background: Tolosa-Hunt Syndrome (THS) is a rare inflammatory disorder presenting with painful ophthalmoplegia due to granulomatous involvement of the cavernous sinus or superior orbital fissure. Though autoimmune diseases such as systemic and discoid lupus erythematosus (SLE/DLE) are known to overlap with other disorders, their association with THS remains poorly documented. DLE, a chronic photosensitive condition with scarring skin lesions, is particularly rare in conjunction with THS. This report explores a case of THS associated with DLE, highlighting diagnostic complexities and therapeutic strategies.

Case: A 54-year-old woman presented with right-sided headache, diplopia, and ocular pain. Examination revealed right third cranial nerve palsy, hyperpigmented macular lesions, and alopecia areata. Imaging demonstrated cavernous sinus inflammation, and laboratory findings included elevated ESR, positive dsDNA titers, and a homogeneous immunofluorescence pattern. A biopsy confirmed DLE, aligning with clinical and imaging findings of THS. The patient was treated with corticosteroids and mycophenolate mofetil, resulting in sustained symptom resolution with no relapse during follow-up.

Conclusion: This case underscores the need to consider autoimmune conditions like DLE in patients with THS, suggesting a possible shared autoimmune mechanism. Early recognition and timely initiation of immunosuppressive therapy with corticosteroids and mycophenolate mofetil were key to achieving remission, supporting their use as first-line treatment. This report adds to the limited literature on DLE-associated THS and highlights the importance of thorough diagnostic evaluation and long-term follow-up to monitor progression and prevent recurrence. Additional reports are needed to improve understanding of the pathophysiology, clinical features, and optimal management of these rare coexisting conditions.

A Rare Case of Extensive Bilateral Fibroadenomas in a Young Woman

2025-07-12T11:47:37-04:00

Background Fibroadenomas are benign, solid nodules in the breast commonly found in women less than 35 years of age. Typically, fibroadenomas do not exceed 3-4 per breast, and the occurrence of five or more is uncommon. Case We present a case of an 18-year-old female, initially diagnosed with bilateral fibroadenomas, progressing to an extensive presentation of over 25 fibroadenomas per breast by age 26, a rarity in the medical literature. Despite recommendations for a mastectomy due to the lesion burden, the patient, after consulting with the physician and understanding the risk of progression, opted for watchful waiting, citing concerns about future breastfeeding. Conclusion This case underscores the importance of shared decision-making in managing extensive fibroadenomas in young women, considering their impact on future reproductive choices. We aim to raise awareness of such uncommon presentations and encourage further reporting to broaden understanding and management strategies.

The Impact of Social Determinants of Health on the Diagnosis of Anaplastic Oligodendroglioma: A Case Report

2024-11-05T15:08:36-05:00

Background: Anaplastic oligodendroglioma is a rare brain tumor (0.5% of primary brain tumors) usually found in the frontal lobes. Its non-specific symptoms often lead to delayed diagnosis. In bilingual patients, expressive aphasia may be mistaken for limited English proficiency, further delaying care. Recognizing social determinants of health is essential to avoid such delays. The Case: A 75-year-old bilingual woman presented to a routine Cardiology appointment and reported word finding difficulties that worsened over the past 6 months. Five months later at her visit with Geriatrics, she reported more recent issues with expressive aphasia in both English and Spanish and difficulty speaking that started 1-2 years prior. A brain MRI revealed a left frontal lobe mass extending into the genu and body of the corpus callosum. Patient underwent a brain biopsy, which identified an IDH-mutant, 1p/19p co-deleted WHO-III anaplastic oligodendroglioma. Conclusion: Assessing social determinants of health such as language can help physicians diagnose medical conditions presenting with non-specific symptoms. In this case, the diagnosis of expressive aphasia was delayed likely because patient’s symptoms were attributed to limited English proficiency. After careful examination and identifying her symptoms as aphasia in a bilingual patient, a work-up led to the diagnosis of anaplastic oligodendroglioma. Physicians should be aware of the social determinants of health and how they affect individual patients to avoid diagnostic biases, as delays in care such as this one have been shown to result in worsened outcomes, including increased length of hospital stay and mortality.

Mental Health of Medical Students

2025-07-28T16:11:07-04:00

In this Letter to the Editor, I respond to the article "A Cross-Sectional Institutional Survey of Depression, Suicidal Ideation, and Stigma in Medical Students" published in the IJMS. I appreciate how the authors have brought out the often-unspoken reality of mental health challenges within the medical student community. I discuss how medical school marks a significant turning point, not only in terms of academic rigor but also in the emotional and personal demands placed upon students. I call upon medical educators, administrators, and students to work together and create a more supportive and nurturing environment in medical education.

Blueprints for Discovery: The Anatomy of a Global Medical Student Research Conference

2025-09-22T19:34:00-04:00

Medical student research conferences are emerging as a critical platform to bridge the accessibility gap in early research training, foster collaboration, and enhance professional development. This editorial draws upon the experience of the International Journal of Medical Students (IJMS) in organizing the World Conference of Medical Student Research (WCMSR), an annual global, student-led virtual event. Research involvement is increasingly expected in residency applications, yet barriers such as perceived complexity, lack of mentorship, and limited opportunities hinder student engagement. The WCMSR offers a model for overcoming these challenges by providing medical students with roles as presenters, reviewers, organizers, and moderators, transforming conferences into experiential learning spaces. The article outlines essential components of planning, including defining conference vision and scope, forming a multidisciplinary organizing team, establishing transparent abstract review processes, and structuring programs that balance academic sessions with networking and wellness. Considerations for in-person, virtual, and hybrid formats are discussed, emphasizing inclusivity, affordability, and the logistical demands of each. Promotion strategies highlight the importance of social media, partnerships, and co-branding to maximize outreach. The editorial also stresses the role of clear evaluation criteria, awards, and post-conference dissemination to ensure fairness, recognition, and visibility of student research. Ultimately, student-led conferences like the WCMSR demonstrate how small-scale, well-structured initiatives can amplify medical student voices, build leadership and teamwork skills, and inspire future physician-scientists. By sharing these insights, the authors aim to provide a practical blueprint for peers worldwide to design similar conferences, advancing research accessibility and fostering a culture of global scholarly exchange.

Beyond Mentoring: What Medical Students Learned from an Intervention Program with Teen Mothers Experiencing Homelessness

2024-08-01T22:10:53-04:00

Background: Toxic stress from childhood trauma increases risk for chronic diseases such as heart disease and cancer. Prior studies show that trauma’s effects can be buffered by compassionate caregiving. This study aimed to bring trauma-sensitive care to Worcester, train medical students as advocates for underserved groups, and assess how an intervention might influence biological and psychological stress in young mothers experiencing homelessness. Methods: Medical students, trained by a parenting coach, delivered an evidence-based parenting and mental health curriculum to teen mothers in a shelter. Data came from surveys, focus groups, and hair cortisol samples, with twelve women in the intervention and six in a comparison shelter. Results: Surveys, focus groups, and interviews suggested that mothers in the intervention felt more prepared to be supportive caregivers than those in the comparison group. Hair cortisol samples showed no significant changes. A focus group with medical students highlighted increased passion and confidence in advocating for young mothers. Conclusion: This pilot demonstrated feasibility and acceptability of workshops and mentoring for young women in shelters. Preliminary results suggest positive shifts in how unhoused mothers viewed parenting and mental health. Although the small sample limited statistical significance, the findings indicate promise for future studies exploring biopsychosocial impacts of such programs. Importantly, educating medical students may generate a ripple effect, as they carry forward skills and commitment to advocating for this diverse and often overlooked population in medical training.

Awareness and Perspectives on the Role of Artificial Intelligence in Primary Care: A Cross-Sectional Survey of Rural and Urban Primary Care Physicians in Alberta, Canada

2025-04-06T20:00:43-04:00

Background: Artificial intelligence (AI) is increasingly integrated into healthcare, yet physicians’ awareness and perspectives remain underexplored. While often associated with imaging, AI applications also include online scheduling, digitized records, virtual consultations, and drug dosage algorithms. This study surveyed Canadian primary care physicians (PCPs) to assess their awareness and attitudes toward AI in healthcare.

Methods: A cross-sectional survey was distributed via email and newsletters to family physicians across Alberta, including both urban and rural settings. Responses were collected through Qualtrics.

Results: Of 79 responses, 46 met inclusion criteria. Most respondents practiced in urban areas (63%) and had no prior AI training (65%). Rural physicians reported greater comfort and interest in AI, including its use for monitoring treatment adherence (p=0.043) and analyzing EMR data for health management (p=0.027). Knowledge of AI varied widely: only 30% recognized that deep learning involves artificial neural networks, while 44% reported no knowledge of the concept. Commonly used AI tools included ECG interpreters (65%) and language translators (37%). Physicians showed interest in expanded medical uses of AI.

Conclusion: There is a lack of knowledge and use of AI tools in medicine, with both urban and rural physicians’ responses suggesting a need for more education and training in AI. The “Lack of human connection” was the main fear that was expressed regarding the use of AI in healthcare suggesting concerns about potential impacts on patient-provider relationships. This survey's findings may inform future research into the development and implementation of AI in primary care.

Experiences of Medical Students with Dyslexia in a Post-COVID-19 Curriculum

2024-09-16T14:15:41-04:00

Background: Dyslexia in medical school is a common condition. With the COVID-19 pandemic, the medical school curriculum has changed. This might lead to differing experiences faced by dyslexic medical students compared to previous literature. AIM: This paper explores the experiences of medical students with dyslexia post-COVID-19, specifically on study methods, support, and attitudes towards their diagnosis. Methods: A qualitative study involving online interviews of five medical students with a formal dyslexia diagnosis was done. Data was collected over two months, from February to March 2023. Transcripts were analysed using an iterative constant comparative approach, forming themes on the experiences of these medical students. Results: Participants experienced a general need to work harder than their peers in certain areas of medical school, especially about traditional learning methods. However, participants highlighted strengths in visual and kinaesthetic learning. They viewed dyslexia as an advantage in areas such as pattern recognition and creative problem-solving, emphasising the concept of neurodiversity. COVID-19 delayed diagnosis and support services but fostered flexible, asynchronous learning that participants found beneficial. While participants valued support such as extra time, they highlighted the need for more inclusive teaching methods. They were more open to disclosure of dyslexia but expressed stigma still exists. Conclusion: This study examined the experiences of dyslexic medical students in the UK, uncovering their unique challenges and strengths. While COVID-19 prompted beneficial changes, stigma remains a barrier. We advocate for greater dyslexia awareness, rethinking curriculum design to improve accessibility, and embracing innovative teaching methods to support diverse learners.

Frontlines and Crossroads: The Impact of COVID-19 on the Motivations of Medical Students from Selected Philippine Medical Schools in Pursuing Their Medical Studies

2025-04-30T04:54:46-04:00

Background: Because the Coronavirus disease 2019 (COVID-19) pandemic forced Philippine medical education to shift online, the loss of practical skills and face-to-face clinical interactions affected many students to cope with lifestyle and learning changes. This study aimed to assess the strength and nature of motivations of medical students to pursue their studies during the pandemic, and to propose recommendations to support them through the pandemic and beyond. Methods: Inductive thematic analysis was done of semi-structured interviews with 17 medical students selected through purposive convenience, purposive and stratified sampling. Recruitment was carried out through the Association of Philippine Medical Colleges. Eligible respondents were pre-clinical and clinical medical students enrolled in School Year (SY) 2020-2021 who experienced the transition to an online setting. Results: The desire to serve motivated most pre-clinical medical students, while financial reward was a factor for clinical medical students. Despite the limitations of online education, lack of social interaction and skills training, medical students had strengthened motivations to continue as the pandemic highlighted the need for physicians, reinforcing their intrinsic desire to serve others despite mental health and financial issues. Conclusions: While most medical students felt more motivated in pursuing their studies during the pandemic, there was a desire and call for more support in their studies and training. Their personal stories suggested there is room for improvement in certain aspects of local medical education. Addressing concerns through financial and educational support, and bridging clinical skills with online learning would help create quality healthcare beyond the pandemic context.

Impact of Reduced Clinical Time on NBME and OSCE Performance in the Ob/Gyn Clerkship: A Quasi-Experimental Study

2025-03-26T18:47:56-04:00

Background: Clinical clerkships are crucial in medical education for developing competent physicians. This study examined reduced clinical time during an Obstetrics and Gynecology (Ob/Gyn) clerkship on performance in the National Board of Medical Examiners (NBME) and Objective Structured Clinical Examination (OSCE). It arose from the need to modify curriculum due to pandemic-related restrictions such as social distancing and lockdowns.

Methods: This retrospective quasi experimental study evaluated four student groups with different clinical exposures. Group 1-7 (n=110) completed standard rotations, while Groups 8-10 had reduced clinical time: Group 8 (n=15) by 50%, Group 9 (n=19) with no clinical time but made up 2 weeks later, and Group 10 (n=14) by 17%. Reductions were supplemented with virtual learning and independent study. NBME and OSCE scores were analyzed to assess the effects of reduced clinical time on performance.

Results: Analysis using the Wilcoxon rank-sum test revealed no significant difference in NBME and OSCE scores. Groups 8 and 10 displayed slight improvements in median NBME performance, while OSCE scores varied minimally. These findings suggest that reduction in clinical experience did not affect the performance on examinations.

Conclusion: The results demonstrated no significant differences in NBME and OSCE scores when comparing the experimental groups to the control group. Confounding variables include the differences in motivation levels, varying workloads, and student’s sense of burnout. Given the small sample size, the study is quite underpowered. To optimize the learning environment, future studies are recommended to collect data from other clerkships at other universities with similar curricula.

Prevalence and Patterns of Gender-Based Violence Among Undergraduate Students in Nigeria

2025-02-13T13:56:50-05:00

Background: Gender-based violence (GBV) is any harmful act including physical, sexual, and emotional abuse based on gender norms, with significant health, social, and economic consequences. Despite its devastating impact, GBV among males and other under-recognized groups remains understudied. This study assessed the prevalence and pattern of GBV among undergraduates, and respondents’ knowledge of its effects. Methodology: A cross-sectional study of 413 University of Calabar undergraduates was conducted using multi-stage sampling. The questionnaire inquired about the experience of GBV and respondents’ knowledge of its effects. Data was analyzed using Statistical Package for Social Science (SPSS), with logistic regression assessing the association between GBV and age, sex, marital status, and academic year, reporting odds ratios (ORs), 95% confidence intervals (CIs), and p-values to evaluate statistical significance and the precision of estimates. Results: GBV prevalence among participants was 19.4%, with emotional violence (threats, intimidation and verbal abuse) being most common (18.6%). Prevalence was slightly higher in males, but not significantly so (p>0.05). The logistic regression analysis revealed no significant relationship between GBV and age, sex, marital status, academic year, though older individuals had slightly lower odds of experiencing GBV, while males had slightly higher odds compared to females. Most respondents agreed that GBV has psychological, social and health implications. Conclusion: The study showed that GBV affects both male and female Nigerian students. Universities should implement strict policies, awareness programs, and student support systems including a formal GBV reporting system, survivor support services, and mandatory training for students and staff to address GBV effectively.

Residency-Affiliated Academic Neurosurgeons (RAAN): A Cross-Sectional Analysis of Neurosurgery Residency Program Rankings

2025-02-13T14:39:37-05:00

Background: Existing neurosurgery residency rankings do not assess programs based on graduate placement in academic faculty positions. We sought to develop a novel ranking system of neurosurgery programs to identify programs that produced academic faculty and evaluated these programs relative to established ranking systems. This novel ranking system, the Residency Affiliated Academic Neurosurgeons, was compared to the Doximity Residency Navigator, and Blue Ridge Institute for Medical Research. Methods: We evaluated neurosurgeons with positions in Accreditation Council for Graduate Medical Education neurosurgery programs. We looked at those programs websites and faculty under neurosurgery. Certain programs were excluded based on the data not being publicly available. We analyzed the relationship between Residency Affiliated Academic Neurosurgeons with Doximity Residency Navigator and Blue Ridge Institute for Medical Research. We analyzed the median rank of the ranking system per program and the percentage of legacy faculty. Results: We included 1623 faculty members in our analysis. This novel ranking system was evaluated against Doximity Residency Navigator and Blue Ridge Institute for Medical Research, revealing strong correlations (r=0.73, p<0.0001, r=0.45, p<0.001, respectively). Notably, the percentage of legacy faculty (defined as faculty who are appointed at the same location as residency training) had a significant association with Residency Affiliated Academic Neurosurgeons and Doximity Residency Navigator (r=-0.33, p<0.05 and r=-0.38, p<0.001, respectively). Conclusion: We developed a ranking of neurosurgery programs based on the placement of graduates in academic positions. RAAN rankings align with existing systems and provide an objective measure of residency program effectiveness in producing academic neurosurgeons.

Global Impact of Burnout Syndrome in Medical Students During the COVID-19 Pandemic: A Systematic Review

2024-09-16T13:13:38-04:00

Background: The prevalence of burnout syndrome among medical students is a growing concern, warranting comprehensive exploration, particularly in the context of the COVID-19 pandemic. This review aims to elucidate the burnout phenomenon, considering its impact on medical students' mental health, physical well-being, and academic performance.

Methods: A thorough analysis was conducted, drawing on data from 31 studies encompassing over 37,000 participants in 25 countries. A systematic search across PubMed, Google Scholar, APA PsycNET, and Scopus utilized specific keyword combinations related to COVID-19, medical students, and burnout syndrome. The selected studies were evaluated to ensure relevance to the research aim.

Results: The review reveals burnout complexity, highlighting its diverse manifestations, exacerbated by the pandemic. Varied outcomes emerged from the studies, reflecting contrasting impacts on students. During lockdown, some reported having spent quality time with their families and delved into their academic interests, while others suffered due to the absence of clinical engagement. A notable correlation between burnout levels and academic year was observed, though interpretations differed among studies. Factors such as gender, family status, coping mechanisms, and the absence or presence of a supportive network were identified as influencers of burnout likelihood.

Conclusion: Medical student burnout persists as a significant challenge, intensified by pandemic disruptions to academic and clinical experiences. Urgent proactive measures by academic institutions are crucial to safeguard future physicians' well-being, with implications for enhancing healthcare delivery. This study underscores the immediate need to prioritize strategies for burnout prevention and management in medical education.

Public Health Experience Creating a Nature Space for Undergraduate Students

2025-03-04T11:21:02-05:00

The creation of a monarch butterfly waystation and student greenspace at the University of Utah represents a multidisciplinary effort to integrate ecological restoration with public health promotion. Students from architecture, urban planning, biology, and medicine collaborated through a nonprofit initiative to transform an unused, mulch-covered hillside into a biophilic space designed to support both pollinators and student well-being. Motivated by the decline of western monarch populations—down by more than 90% since the 1980s—and the growing stress experienced by college students, the team secured a $3,000 Sustainable Campus Initiative Fund grant to finance the project. After nine months of planning, departmental approvals, and plant procurement, the group partnered with Friends of Monarchs Utah and community donors to install 125 native plants, including five Utah milkweed species and complementary flowering plants that provide staggered blooms throughout the year. The planting was accomplished in one day with 11 volunteers, and the site was completed with an accessible walking path, automated watering, and monthly weeding days. Since its establishment, the waystation has been actively used by students and faculty as a restorative microenvironment, with anecdotal evidence suggesting reductions in stress and opportunities for reflection. The project illustrates the challenges and rewards of navigating university bureaucracy, highlights the importance of collaboration across disciplines, and demonstrates how small-scale conservation initiatives can yield both ecological and mental health benefits. Beyond its immediate impact, the initiative serves as a model for integrating nature into urban spaces, inspiring future student-led projects that link sustainability and wellness.

The Power of Perseverance: My 31-Year Journey to Finish Medical School

2025-06-17T15:29:10-04:00

This experience-based narrative recounts the author’s return to medical school after a 31-year hiatus, highlighting the unique challenges and personal growth associated with completing a medical degree later in life. The aim of this reflection was to illustrate how nontraditional pathways can still lead to meaningful academic achievement and professional development. The author withdrew from medical school due to financial hardship and a family tragedy. Over the following decades, they built a successful global career in the pharmaceutical industry, eventually leading a professional organization dedicated to the Medical Science Liaison profession. The onset of the COVID-19 pandemic created an unprecedented opportunity to resume medical education through virtual instruction. At the age of 48, the author re-enrolled and began medical school from the beginning, all while continuing to manage their responsibilities as a Chief Executive Officer. The narrative follows the integration of academic demands with ongoing executive leadership, the emotional and intellectual challenges of returning to school at a later stage in life, and the insights gained from unique clinical rotations, including those at internationally recognized institutions. The story culminates in graduation at age 51 with top academic honors. This account aims to inspire readers by demonstrating that persistence, adaptability, and discipline can overcome nontraditional barriers to completing a medical degree.

Associations Between Physical Activity and Age-Related Anti-Mullerian Hormone Decline: Insights from All of Us Research Program

2025-03-07T18:14:03-05:00

Background: Anti-mullerian hormone (AMH) is used to measure ovarian reserve and female fertility levels. Physical activity is thought to influence fertility and warrants further investigation, especially using objective measures. Methods: Using the All of Us Research Program dataset, the relationship between normal age-based decline in AMH and levels of physical activity were examined. Inclusion criteria were: ≥ 1 AMH test in electronic health record, AMH level < 7 ng/ml, and ≥ 30 days of valid Fitbit data within 1 year prior to AMH test. Final dataset included 24 participants. Results: Generalized linear regression models were fitted between log transformed AMH level and daily average activity intensity minutes (sedentary, lightly active, fairly active and very active) and daily step counts. Daily average of “very active” minutes showed a trend towards a positive effect on preventing the decline of AMH levels (B = 0.02 (95% CI 0-0.04), p = 0.136), though results were not statistically significant. Conclusion: Despite its small sample size, this study is one of the first to report a positive correlation, approaching significance, between objectively measured physical activity and preserving AMH, suggesting that daily high intensity physical activity may extend ovarian reserve. Further studies, with large, diverse samples are needed to provide clearer numbers for optimal engagement in physical activity and AMH level for fertility.