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The Human Touch in Teaching

June 28, 2022

During Capstone, the final course of the Yale School of Medicine (YSM) MD curriculum, students were asked to name the faculty member who had the biggest impact on them. When the results were displayed in a Word Cloud, Joseph DeMayo, MD, MPH, was one of the names appearing in a large font, reflecting that multiple students had chosen him. DeMayo is a retired geriatrician who has taught in the Clinical Skills (CS) and Medical Coach Experience (MCE) courses as volunteer faculty for almost ten years.

Nurturing students as people

Barry J. Wu, MD, professor of clinical medicine, who directs Capstone and MCE, emphasizes how impressive it is that a volunteer faculty member, who typically engages with students for a short time during medical school, would have this impact. Wu says this reflects how DeMayo “appreciates that mentoring is about so much more than teaching history taking and physical exam techniques. It is nurturing students as people, as human beings.”

DeMayo’s approach toward mentoring is intentional. While he had some great instructors when he was a trainee, DeMayo shares that they did not focus on him as a person, and these experiences made him realize he wanted to be a different kind of mentor.

DeMayo got involved with teaching at YSM in 2013, when Associate Professor of Internal Medicine and of Pediatrics Jaideep Talwalkar, MD, who directs Clinical Skills for the MD Program, encouraged him to help teach physical exam (PE) to Yale medical students. PE entails engaging with a group of four first-year students each week for about three hours.

Talwalkar knew DeMayo from St. Mary’s Hospital in Waterbury, CT, where DeMayo was teaching residents. An element DeMayo enjoys about training medical students, versus residents, is that when you teach learners as they are first developing skills, “you can more effectively alter their path.” DeMayo also notes that he was teaching residents how to make clinical diagnoses; with medical students, he is focused on getting them comfortable with the physical exam experience, including touching a patient, so that they can complete exams competently and compassionately, gaining patients’ trust.

When the COVID-19 pandemic began, PE shifted to a virtual model because of Yale’s restrictions on gatherings. DeMayo was pleased when it reverted to in-person since PE teaching happens, he explains, “at the point of need,” and during a physical exam that often involves touch. If a student feels comfortable, DeMayo will shift a student’s hand if it is not placed correctly when they are practicing an exam and then conduct the exam along with them, so that they can experience how to do the exam. DeMayo enjoys when he can “see the light go on” for students during moments such as this, when he has helped students understand a new concept and develop their skills.

Four years ago, DeMayo also began volunteering as a coach for the MCE course. In MCE, four students are paired weekly for about eight months with one or two doctors in the clinical setting, starting in the spring of their first year until just before they begin their clerkship year. When Wu mentioned to him they needed more MCE coaches, DeMayo said Wu “didn’t have to ask twice”— DeMayo knew he would find working with students in the hospital environment rewarding. Several of DeMayo’s PE students asked to be in his MCE group, so he got to spend a year with them. “It was a nice experience, to watch them apply what they had just learned practicing on each other in PE in the hospital setting with real patients,” and also see them practicing such new skills as presenting cases.

The long-lasting relationship I developed with Dr. DeMayo through my MCE course is certainly one of the things I will cherish the most from my experience as a medical student at YSM

Gathe Kiwan, MD ’22

Building a mentor relationship

A priority for DeMayo is making PE and MCE the part of the week that his students look forward to. He wants them to feel comfortable so they will not be hesitant, because they will only build the PE skills that make a doctor a doctor by practicing. An example of DeMayo’s success at this is reflected in the remarks of Gathe Kiwan, MD ’22, who is starting his integrated interventional radiology residency at Yale. Kiwan, who was in DeMayo’s MCE group, was nervous when he first met him, because Kiwan had no medical experience and knew DeMayo was a seasoned physician. But Kiwan explains that DeMayo “made it very clear from day one that he was there to not only teach us skills, but build a mentor relationship that exceeds the practical skills needed in the hospital.” DeMayo would go out of his way, Kiwan says, “to make sure we felt comfortable and confident when we spoke and performed physical exam maneuvers,” adding that he was “genuinely curious to know more about me as a person and to encourage my unique personality to shine as a physician.”

Kiwan is grateful for how DeMayo had the MCE group to his house to meet his family and even invited them to his daughter’s wedding. Important to Kiwan, this relationship continued beyond MCE: DeMayo attended the Fourth Year Show, Match Day, and Commencement. “I have had many teachers and mentors over the years,” Kiwan says, “but the long-lasting relationship I developed with Dr. DeMayo through my MCE course is certainly one of the things I will cherish the most from my experience as a medical student at YSM.”

DeMayo’s colleagues share this gratitude and respect. “The students love working with Dr. DeMayo and I think this stems from his commitment to humanistic patient care,” Talwalkar says, describing how DeMayo’s dedication to students in their development as future physicians mirrors the deep care he demonstrates to his patients. “His commitment to teaching and mentorship doesn’t end when class is over,” Talwalkar adds, noting that DeMayo meets with students for extra sessions outside of class to ensure they have a handle on the material, and also “to be sure they are finding some balance in life despite the demands of medical school.”

Assistant Professor of Medicine Joe Donroe, MD, MPH, who worked with DeMayo in PE and partnered with him mentoring an MCE group, says DeMayo is always “quick to volunteer his time when we need instructor support for our PE sessions,” and “one of the most reliable people I know.” Donroe adds that DeMayo “is genuinely a caring person,” and “also incredibly wise and knowledgeable. I’ve personally learned a lot from working so closely with him and I know the students have as well.”

Reflecting back on the Word Cloud, Wu emphasizes that DeMayo exemplifies the immense value retired physicians can have impacting the future generation of medical professionals.

Submitted by Abigail Roth on June 28, 2022