American Medical Students Association: 2010 Convention Report

The following report on the 2010 AMSA Convention was sent to Intact America by John Geisheker and is shared with his permission:

March 17, 2010

This is my "debriefing" report based on the three days I, my wife Michaelle Wetteland, and Dr. Ron Dempsey spent staffing an Intact America booth at AMSA, the American Medical Students Association convention in Anaheim, CA, March 10-14, 2010.

Intact America: Say NO to circumcision!The IA booth was well-positioned, near the lunch venue (and thus the attendees), at the end of a long aisle, easily seen from a distance, and well-lit. The new IA (8x8?) banner was easy to erect, the work of 20 minutes as Eoin promised. We used the table, set well into the booth, to give room for the smaller vertical banner out front, and borrowed a chair so that we would have room for two students to sit down in front and take a "quiz" while one of us as "proctor" also sat.

(More about that in a moment.) I might have wished that the large banner artwork and text was up higher so that it was not hidden by us or the attendees, but that is a quibble; the message got across.

Oddly, other exhibitors with actual booths were constrained to stay within them by the rules; we, with only a table and vague turf boundaries, seemed free to roam about into the aisle, an added benefit we cheerfully exploited.

The fundamental message, I might add is that the very presence of IA says that there is SOME opposition to a practice so ubiquitous it has been shrouded by what some have called the "great silence." In other words, the very suggestion that circumcision inspires controversy is itself a message, and an intellectual challenge for med students, in itself, even those who chose not to engage us./p>

AMSA is a mix of pre-med (college undergraduates) and actual med students, M-1 to M-4, so our visitors ranged from university sophomores to those about to earn an MD and become residents. That is quite a range of age and maturation. On our issue it seems not to matter, as neither group knows much on this topic and all is fresh and new. (As to M-4's of course, more's the pity, on basic anatomy and bioethics.) The older med students tend to be victims (or beneficiaries) of C... as an idée fixe; the undergrads are more malleable as one might expect. Mostly, I sense in the AMSA agenda a restless need to create a different medicine than the one they see around them; an emphasis on universal coverage, for instance, and more primary care.

The good news is that we were very well received, we all agreed. After many such conferences (and I have been abused at other AMSA conferences in the past) one becomes wary of the 'love-fest-factor.'(Ones allies rush in to receive a compliment for their epiphany; ones foes studiously avoid the booth and even eye contact. Counting converted visitors as representative is thus slightly naïve.)

That said, the quality of our interested visitors was real enough. We encountered at least 200 out of 900+students registered for the conference, engaged at length more than 75 students, those willing to take our 'quiz' on anatomy, an activity I invented at the last minute the night before. The first 50 quiz-takers earned a $5 Starbucks gift card, perhaps the best freebie at the conference. The others were willing to take the quiz even after the cards ran out.

Notable encounters:

The M-3 daughter of a physician / mohel who listened attentively, disagreed politely, and defended bris only with canned enthusiasm, seemed stunned by my polite suggestion that we never know what the religious beliefs of an eight-day old might be. She gave me my quote of the conference, "Wow, our seder dinner this Passover is going to be extra interesting when I challenge my dad!" (I'd like to be a fly on the wall for that one.)

A combined JD (attorney) / M-3 interested in bioethics and committed to a career defending children 'got it in one' and was an easy convert to CO status, one of only two in four days. It probably helps that she did her law degree before her MD.

The new Physician-Director of the Carr Center for Human Rights Policy at Harvard-Kennedy came over to engage us and wish us well in our work. We took the liberty of inviting him to join IA.

Even some staff at the conference center, a largely Hispanic group, regularly gave a thumbs-up when they walked past our booth on some errand, and we had cheery visits from other exhibitors as well.

The students were amazingly receptive to our message. In addition to the IA materials, which are very professional, well-written, and nicely presented, I created an easy eight-question multiple-choice "quiz'" about anatomy and the early history of circumcision, which we 'challenged' the students to take to earn a Starbucks coffee card. We ran out of cards the second day. The quiz was not intended to be scientific or to trip up the students, merely to provide a reason for an interaction and some fodder for discussion. Many of the male students, for example, thought that the male glans is the seat of male erogenous sensation, when it clearly is not, such is the power of myth that it erases even the evidence instantly available to an owner.

A fun detail — AMSA exhibitors are given a large packet of double raffle tickets, which we were instructed to hand out to attendees coming to our booth. Every few hours the organizers drew names for donated prizes. The prizes were quite valuable -- iPods, iTouchs, stethoscopes, medical reference books, lab coats. Our booth became famous the last day when FOUR of our visitors won prizes, three of them two prizes each with one student winning three. At that point we had students coming over to rub our blue tablecloth at the "good-luck anti-circumcision booth" as they termed it. That was a Karmic bonus.

Here are my concise recommendations from observation and experience of numerous conferences, including this last:

1) The AMSA crowd is an important constituency for IA, more important than physicians who have settled on a position and are not about to re-examine it at our urging. Consider, for instance how well the IA mission fits within the aims of AMSA, found on a tee-shirt they sell members:

"Reclaiming the Ethics of Medicine"
"Removing Conflicts of Interest"
"Restoring the Sanctity of the Patient/Physician relationship"

... IA could not have said it better—and note that they put 'patient' in front of physician.

2) Having something – anything – sensible for students to do upon arrival at the booth is important. Quizzing them makes sense; they take quizzes all the time and would not be med students if they were not naturally competitive and proud to show what they know. I think this should be a regular tactic, as long as the quiz or activity is informational and not too demanding or likely to embarrass them.

3) These students are hungry to learn. We must remember that. They are especially impressed by medical articles and published studies. Our two best handouts were the one on normal foreskin anatomy and the one refuting the Africa studies, which came up constantly. I wished I had remembered to take along my looseleaf reference volume of articles from the British Journal of Urology, etc., for the even more curious.

Even the M-4's (fourth year of medical study) students themselves admitted they were taught nothing about the innervation of the genitalia or the normal development of the infant. IA can help fill that void.

4) Considering the other costs of the conference, the Starbucks cards at $250 total cost were the least expensive element—and the most popular with students, who will remember us at their Starbucks visit, and perhaps mention it to colleagues, sparking a discussion. We could double the number of cards next time and get good mileage out of it.

5) In addition to the Starbucks cards, we also had condoms to give away. I would have thought the students would grab handsful and we'd be at pains to restrain them. But I think maybe we only gave away 150 or so, as not every student would take them, and most took only one. They were a source of good-natured chatter of course, itself useful. One night we left about 20 on the table as a test, and only 10 were there in the a.m., the  others likely finding their way into the pocket of a randy (or optimistic) security guard I suppose. Men usually took only one, women sometimes none, even when we offered. I did not see any other exhibitors giving away free condoms. I think it was a very good idea even so. I recall one exhibitor saying "I found one of your condoms on a table. What does a condom have to do with Circ...?" (Which of course for me is like putting a dollar in a jukebox.)

6) All three of us, Dr. Ron, Michaelle, and I used Marilyn's Milos' simple demonstration of Meissner corpuscles by having students draw their fingernail across the back of their hand, and then compare that sensation with a similar test on their palm. This is an amazingly quick, engaging, and memorable way for students to learn the intense innervation of the foreskin. It never fails to educate.

Finally, I'd like to thank the staff at Intact America for their work in putting this event together and hope that you will call on me and the other members of DOC to cooperate in our common mission in the future.

John V. Geisheker, J.D., LL.M.
Executive Director
General Counsel
Doctors Opposing Circumcision