“Before I was matched with my patient during that first year, I hadn’t really given much thought to rheumatic diseases, and I didn’t know all that much about them. I didn’t really even realize that young children could develop arthritis,” explains Morral. “After spending the year meeting with my patient and her family, I was struck by how great an impact this chronic disease can have on those who have to deal with it and I started to develop an interest in pediatric rheumatology. I knew I wanted to learn more.”
With her interest sparked, Morral set her sights on a summer research project in the area of pediatric rheumatology. She connected with Barbara E. Ostrov, MD, a pediatric and adult rheumatologist, who agreed to let Morral participate in Dr. Ostrov’s clinical research project—a study exploring the risk factors leading to pseudoporphyria, a condition that can cause chicken pox–like scars on the body and is linked to NSAID therapy in young patients.
While Morral was working on the research project, Dr. Ostrov—a longtime mentor familiar with the REF Preceptorship program—encouraged her to consider the ACR REF/Abbott Medical Student Clinical Preceptorship.
“Even though it would mean a really busy summer for me, the timing was perfect,” recalls Morral. “Dr. Ostrov’s research project was clinical. The preceptorship experience would be clinical, and more importantly, Dr. Ostrov would be my preceptor. I already enjoyed working with her and knew she had a lot to teach me. Plus, this would be the perfect crash course in rheumatology, still affording me an opportunity to explore other specialties and subspecialties during future summers.”
Morral and Dr. Ostrov applied for and were accepted to participate in the ACR REF/Abbott Medical Student Clinical Preceptorship program. While Morral worked with Dr. Ostrov on the pseudoporphyria research project, she also shadowed Dr. Ostrov while she saw patients—a cross-section representing a mix of both adult and pediatric cases—as part of her preceptorship.
“This was my first clinical experience,” recalls Morral. “Dr. Ostrov was amazing at dealing with her patients, striking a great balance between friend and physician with them. I really learned a lot about successful patient-physician interaction. I also gained a great deal of confidence in my own emerging bedside manner. As the summer progressed, Dr. Ostrov let me see some of her patients on my own, without her initially being in the room.”
Another highlight of Morral’s summer experience came when she got to spend a few days with Dr. Ostrov at a pediatric rheumatology summer camp for children and teens. “That was such an illuminating experience,” Morral says. “To see kids who are dealing with rheumatic diseases getting to be kids and finding out that they aren’t alone, that there are other kids out there with the same conditions, made the work that I was doing on the research and during the clinical rounds all the more meaningful.”
Though the clinical rounds portion of her preceptorship experience is now complete, Morral will be attending the 2006 ACR/ARHP Annual Scientific Meeting in Washington, D.C., as the final part of the program. Morral and Dr. Ostrov talk or e-mail weekly, and Morral considers Dr. Ostrov one of her most trusted advisors.
Maribeth Morral, ACR REF/Abbott Medical Student Clinical Preceptorship winner
Morral believes her preceptorship experience will have a lasting effect on her medical career, though she’s not yet sure the direction her career will take. “The summer clinical preceptorship was an amazing experience, and I learned so much about rheumatology and how I might build a career for myself in this subspecialty. It’s definitely at the top of my list of possibilities, but there are a few other areas I want to explore before deciding on my path,” admits Morral.
Though she’s not quite ready to commit to a rheumatology career, Morral says, “I now understand that rheumatic diseases literally affect nearly every part of the body. Diagnosing these diseases can be challenging, often involving many differentials, and successful treatment can be equally complex. Yet, the opportunity to provide chronic care for these patients seems so rewarding to the rheumatologists I’ve encountered. What I learned from them about diagnosis, treatment, and bedside manner will make me a better physician, no matter what subspecialty I decide to pursue.”
