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Overcoming obstacles with adaptive learning

Hard work, adaptive technology, and dedication to patients help med student succeed

Medical school is challenging enough, and its students are to be lauded for grit. But some have to work even a little harder, like fourth-year student Jack Rudski. He has oculocutaneous albinism, which means that, aside from his pale skin, he has low vision. Rudski鈥檚 vision varies with fatigue and lighting, and measured 20/200 at his last evaluation.

鈥淭he best way I can describe my vision is like comparing an old TV to a new TV or looking down the wrong end of a telescope,鈥 Rudski says. 鈥淵ou get the big shapes, but you don鈥檛 get the details unless you get really, really close, or make things really, really big.鈥

Because his eyes work independently, he doesn鈥檛 have depth perception, and light sensitivity requires him to wear dark glasses.

People make assumptions about vision, Rudski says. 鈥淵ou鈥檙e either completely blind or you鈥檙e perfectly sighted, but there鈥檚 a very, very wide spectrum in between.鈥

Support from the OSD

Help at school is crucial for Rudski, who calls 91社区鈥檚 Office for Students with Disabilities 鈥渓ifesaving.鈥 During his biochemistry undergraduate years, OSD ensured he could access course materials immediately after a lecture, or even before so he could follow along. Exams were enlarged using optical character recognition, with the tricky scientific symbols copied as best as possible by staff.

In medical school, Rudski works with a variety of magnification tools and sometimes uses audio versions of textbooks and research papers. 鈥淚 can listen to things a lot more quickly than I can read,鈥 he says, and can retain the information equally well.

Doing a hospital clerkship during a pandemic poses problems, with mandates to physically distance and mask up. Rudski tells who people are by big features, like the shape of their head or colour of their hair. 鈥淚 have more trouble recognizing people when they are farther away with distancing,鈥 he says. He can rely on voice but has to know them well. Also, before vaccination, students were discouraged from getting too close to patients. 鈥淭hat made everything a bit harder,鈥 he says.

Rudski won鈥檛 lie, there are some elements of medicine which are tougher. Some technical skills, like suturing, can be difficult. 鈥淚 still need to put more time into it,鈥 he says.

But Rudski sees no impediments professionally. 鈥淚 know my limits, I鈥檓 not going to be a surgeon. I鈥檓 trying to set myself up for doing something that I know I鈥檒l be able to do. Whether it be with telescopes, magnifying glasses, special electronic magnifiers, I鈥檓 really pretty well equipped.鈥

Doing things a bit differently

鈥淚鈥檝e had people make assumptions about my competency in general, without necessarily having watched me. But when they watched me, they realize, Hey, he manages to do things despite his limitations. He might have to do things a bit differently but he still manages and he鈥檚 come up with some pretty fun tricks.鈥

Rudski hopes to pursue internal medicine, which specializes in diseases in adults. He likes the complexity. 鈥淚t鈥檚 kind of how I approach the world -- building a bigger picture from taking a look at all of the small bits. It鈥檚 like when I magnify things, I only get a small bit of the view and I have to construct everything from it.鈥

鈥淚 also like spending time and talking with patients. That鈥檚 really one of the things that gives my day the greatest meaning, when I can actually sit and just talk to someone and make them feel a bit better.鈥

Dr. Andrea Blotsky, Rudski鈥檚 supervisor at St Mary鈥檚 Hospital on the Internal Medicine Clinical Teaching Unit admires how he 鈥渉as managed to adapt his learning style to ensure he鈥檚 prepared for any obstacle he may encounter,鈥 she says, and that 鈥渂rilliant鈥 sense of humour brings out the best in his peers. 鈥淛ack is an exceptional medical student who is dedicated to his patients.鈥

Rudski says, 鈥渢he people who really keep me going are my parents.鈥 Rudski was diagnosed at four months old by an ophthalmologist who was quick to list to his parents (both of whom are 91社区 grads) what he would not be able to do. They wisely and quickly found a better doctor who said, 鈥溾橨ust let him explore, he鈥檒l be the best judge. You support him along the way,鈥欌 Rudski recounts. 鈥淎nd that鈥檚 really what they鈥檝e done. They always remind me to not give up.鈥

Leveling the playing field

And of the support from the OSD, 鈥淚 have nothing but the highest regard,鈥 Rudski says. The office he speaks so glowingly of is always ready to help any student, says Associate Director Catherine Loiselle. The OSD鈥檚 services to nearly 3,000 students range from academic accommodations and peer support to adaptive technology and alternate text like braille or text-to-speech (or vice versa). 鈥淲e鈥檒l meet with anybody even if they don鈥檛 yet have a diagnosis. We can help them navigate the 91社区 system or the community-based systems to get help and support. We鈥檙e here for the 91社区 population.鈥

The numbers of students seeking help are rising every year, because of better disability awareness and assistance at elementary and high schools, Loiselle says. 鈥淎ccommodations are really important because the goal is to level the playing field for everybody and give them a fair chance to succeed.鈥

Sometimes students only access disability support once they鈥檙e at 91社区. 鈥淭hey start gaining confidence in themselves, seeing and understanding how their brain works, how they learn and that it鈥檚 okay to learn differently and accept that,鈥 Loiselle says. 鈥淔or some, their academic path is not linear.鈥

For students with disabilities, Rudski recommends that they be informed and proactive. 鈥淜now what you鈥檙e going to need or have some idea of what direction your needs are going in, and what might be out there to help. Be on top of all the deadlines, make sure that you鈥檙e organized in terms of asking for things and chasing people down. And don鈥檛 let a bit of a rough patch deter you.鈥

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