Leah Pierson @leah_pierson Twitter profile | Pikagi

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Leah Pierson

@leah_pierson

4,167

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Medical student @HarvardMed | Global Health PhD @HarvardChanSPH | Co-host of @biounethical

https://t.co/8qdn5Vai6L

Joined May 2014

Don't wanna be here? Send us removal request.

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@leah_pierson

Leah Pierson

1 year

We ( @sophiehgibert + I) are super excited to announce our new podcast, Bio(un)ethical! Today, we're releasing our first two episodes—Ep 0: Background on us + the podcast and Ep 1: An interview with Robert Steel on whether research can be too risky. 1/4

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Bio(un)ethical | Bioethics Podcast

Bio(un)ethical is a podcast miniseries where Leah Pierson and Sophie Gibert interview experts on bioethical issues, and question existing norms in medicine, science, and public health.

www.biounethical.com

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@luvheechuu

@Goomy_5

@ookandaemi41174

@EllenMittma

@aroniverse

@le_vova

@leah_pierson

Leah Pierson

3 years

Some of my friends and I overcommit to things, so we made "Saying No to Things" punch cards. If you say no to 10 things, your friends have to buy you an ice cream. In a pilot study, we found participants both said no to more things and got more free ice cream.

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@leah_pierson

Leah Pierson

10 months

I have a PhD!!!!!!!!

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@leah_pierson

Leah Pierson

4 years

when your resident forgets to send you home

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@leah_pierson

Leah Pierson

9 months

went on a post-PhD/post-retirement backpacking trip with my dad ❤️

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@leah_pierson

Leah Pierson

4 years

Another small thing medical schools can do to improve student wellbeing: give us our schedules far in advance. This helps us make doctors appointments, visit SOs who live far away, see friends, and generally commit to anything.

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@leah_pierson

Leah Pierson

4 years

That feeling when, after 7 years of long distance, your fiancé matches in the same city as you for residency. #MatchDay2020

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@leah_pierson

Leah Pierson

2 years

Do any medical residency programs cover the costs of fertility preservation? Given that female physicians are 2x more likely to experience infertility, and a single cycle of egg freezing can cost 20% of a resident's salary, this seems like a benefit it'd make sense to offer.

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@leah_pierson

Leah Pierson

4 years

me: *asks fiancé, an intern, a medical question* fiancé: I dunno, why don't you look it up and tell the team about it tomorrow?

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@leah_pierson

Leah Pierson

5 years

Med students should meet with a billing representative to review a hospital bill for a patient they have followed from admission through discharge. This would give us a better sense of how much things cost, who pays for what, and which care is high value. #MedEd #medtwitter

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@leah_pierson

Leah Pierson

5 years

Expectation: Getting an MD-PhD will allow me to defer existential crises for 8 years! Reality: Has existential crisis, every day, for 8 years. #doubledocs #medtwitter

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@leah_pierson

Leah Pierson

2 years

Doctors routinely discharge patients to rehabs or skilled nursing facilities (SNFs), but during our training, many of us never set foot in a rehab or SNF. It seems like having a better understanding of patients' post-discharge care could prevent bouncebacks and improve outcomes.

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@leah_pierson

Leah Pierson

4 years

Med students (who are smart/educated/have a lot at stake) are increasingly forgoing classes they spent thousands on in favor of free resources on Reddit. And rather than taking this seriously + pursuing real #MedEd reform, a lot of admins are like "they only care about Step 🙄."

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@leah_pierson

Leah Pierson

2 years

My friends and I fear rejection too much, so we made "Getting Rejected from Things" punch cards. If you get rejected 10 times, your friends have to buy you an ice cream. (These became necessary after we all started using Saying No to Things punch cards.)

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@leah_pierson

Leah Pierson

4 years

In medical school, social science lessons are often independent of the rest of the curriculum, and can feel tacked on. It would be good to integrate social science throughout; for instance, when discussing why we have good treatments for some diseases and not others.

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@leah_pierson

Leah Pierson

4 years

@nytdavidbrooks I'm not sure med school has given me the emotional strength to watch tens of thousands of Americans needlessly die from gross political mismanagement and social inequities, but maybe this is because my parents accommodated my dietary preferences as a child?

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@leah_pierson

Leah Pierson

4 years

More than 50% of medical students come from the wealthiest 20% of American families. If medical schools want to change this, they need to pay to keep resources like these available:

@khanacademy

Khan Academy

4 years

We hear you. We know our MCAT course has been important for so many of you. As a small nonprofit, we don't have the resources to maintain it at our high standards of quality. Based on your concerns, we are extending availability through 9/30/20, the end of this testing year.

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@leah_pierson

Leah Pierson

9 months

The "effective altruism lost its way when it started to focus on AI safety rather than bed nets" narrative tends to overlook the fact that bed nets EA still exists, but has changed for the better. Here are some ways I think global health EA has improved:

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@leah_pierson

Leah Pierson

2 years

My sister @2plus2make5 and I argue in @bmj_latest that because the American health care system routinely fails to disclose the cost of care to patients, it routinely provides care without consent. #MedTwitter

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@leah_pierson

Leah Pierson

5 years

As a woman who will finish my MD-PhD in my 30s + hopes to have kids at some point, I don't feel that I can choose a residency that lacks any semblance of work-life balance. This is bad for #DoubleDocs and for the fields that miss out on us. #WomenInMedicine #MedTwitter

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@leah_pierson

Leah Pierson

2 years

Most medical students come from high SES backgrounds, and MD-PhD students come from even *higher* SES backgrounds than MD students. Given this, it seems regressive for the government to spend hundreds of millions of dollars each year giving MD-PhDs full rides to med school. 1/2

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@leah_pierson

Leah Pierson

4 years

What Prometric and @TheUSMLE are doing to thousands of med students right now—canceling many #Step1 and #Step2 dates by "random selection" is bad. A thread on four ways this is harmful and four ways these harms could be mitigated. #medtwitter #medstudenttwitter

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@leah_pierson

Leah Pierson

3 years

Some people (me) do an MD-PhD in part to keep our career options open. I don't think this reasoning makes much sense because: 1) Doing an MD-PhD greatly limits your options for 8 years at a time (your 20s) when many would otherwise have tons of options (e.g., because no kids).

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@leah_pierson

Leah Pierson

4 years

A big determinant of what gets covered in medical school is: "how well understood is this process?" So our curricula reflect disparities in research funding. Perhaps this is partly why we spent more time on the Lac operon than on eating disorders (which have been underfunded).

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@leah_pierson

Leah Pierson

5 years

Most of the popular books I've read about medicine were written by men. Why is this? Do women physicians have less time to write/face more bias in publishing ()? In any event, I'd welcome recommendations of great books by women physicians. #MedTwitter

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@leah_pierson

Leah Pierson

4 years

the team:

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@leah_pierson

Leah Pierson

2 years

@KelseyTuoc setting a new bar for misguided late-night DMs!

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@leah_pierson

Leah Pierson

4 years

7 ways AAMC could help reduce medical school debt: 1) Reduce application costs 2) Reduce MCAT costs 3) Research harms of rising debt 4) Advocate for better aid 5) Advocate for slower tuition increases 6) Advocate for loan forgiveness 7) Advocate for more efficient training paths

@AAMCtoday

AAMC

4 years

While the cost of attending medical school is high, it is not insurmountable. Here are 7 ways that can help you reduce medical school debt:

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@leah_pierson

Leah Pierson

3 years

Shout out to the brave first participants, @_Haley_Sullivan and @thesophiegibert

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@leah_pierson

Leah Pierson

5 years

Can we make #MDPhDStudentTwitter a thing, too? Would love to facilitate connections between MD/PhD students at different programs. Please comment if you're an MD/PhD student (or aspiring MD/PhD student)! #MedStudentTwitter #MedTwitter #SoMeDocs @somedocs @TravisABenson

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@leah_pierson

Leah Pierson

1 year

The socialization you get as a medical student is so powerful that even though I: 1) Saw unanesthetized women in sheer agony during gynecological procedures 2) Knew we could safely control procedural pain ... I still assumed we were doing this to people for a good reason. 1/

@leah_pierson

Leah Pierson

1 year

"We don't have good pain control options for IUD placement" isn't a medical fact; it's a value judgment. Once agonizing surgeries are now painless due to anesthesia. Failing to control pain during IUD placement reflects the judgment that effective pain control isn't warranted.

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@leah_pierson

Leah Pierson

4 months

There's consensus on certain issues: For instance, most bioethicists think it's ethically permissible to: - Select embryos based on medical traits, but not based on non-medical traits - Pay blood donors, but not organ donors (See figure)

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@leah_pierson

Leah Pierson

2 years

Is it possible that "do no harm" actually *does* harm by: 1) leading clinicians to place outsize weight on risks when balancing risks + benefits 2) taking decisions that should be made by patients re: acceptable risks away from them?

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@leah_pierson

Leah Pierson

10 months

Starting a PhD during COVID was rough, and I'm immensely grateful for all the people/cats who've gotten me here.

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@leah_pierson

Leah Pierson

4 months

Our article, Bioethicists Today: Results of the Views in Bioethics Survey (VIBeS), is now out in AJOB! We surveyed 824 US bioethicists on: (1) Major issues in bioethics, like medical aid in dying, paying organ donors, abortion, and many others (2) Their backgrounds 🧵

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@leah_pierson

Leah Pierson

9 months

Sometimes it feels like effective altruism is a sport only one team (call them EAs) showed up to play. EAs shouldn’t have a monopoly on the “using evidence and reason to figure out how to benefit others as much as possible” tagline (call this effective altruism), because… 1/4

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@leah_pierson

Leah Pierson

9 months

New blog post! "Six bad reasons to do an MD/PhD" It includes some (angsty) reflections + advice for people considering doing an MD/PhD. 1/2

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@leah_pierson

Leah Pierson

1 year

"We don't have good pain control options for IUD placement" isn't a medical fact; it's a value judgment. Once agonizing surgeries are now painless due to anesthesia. Failing to control pain during IUD placement reflects the judgment that effective pain control isn't warranted.

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@leah_pierson

Leah Pierson

3 years

Happy Thanksgiving to everyone except @Spotify , who hates physician-scientists

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@leah_pierson

Leah Pierson

4 years

This is bad because: 1) It incentivizes worse research 2) It likely makes med students enjoy research less 3) You learn less being middle author on many projects vs leading your own 4) It harms students with access to fewer research opportunities 5) Students *pay* to do this

@jbcarmody

Bryan Carmody

4 years

The research arms race for U.S. medical students The average *unmatched* applicant in 2020 had more abstracts, presentations, and publications than the average *matched* applicant did in 2009. (Data from @TheNRMP Charting Outcomes in the Match)

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@leah_pierson

Leah Pierson

3 years

In case anyone in your life needs one, @thesophiegibert has designed beautiful Saying No to Things Punch Cards in packs of 5, with an🍦or a🍹: All proceeds will be donated to @GiveDirectly . (You can also make your own—or not.)

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Saying No to Things Punch Card COCKTAIL Pack of 5 Motivational Loyalty Reward Card Self Care...

This Note Cards item by sophiehollandart has 120 favorites from Etsy shoppers. Ships from Cambridge, MA. Listed on Aug 1, 2024

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@leah_pierson

Leah Pierson

5 years

@JAMA_current @WSJ @PhillyInquirer @one1iron @zacharymeisel @CarolynCannu @UPenn_MedEthics @PennLDI @PennMedicine This is a false dichotomy. Scientists should acknowledge and respond to injustice. Alienating entire populations through unethical research, directing 90% of research resources towards 10% of the population, failing to make drugs accessible, etc = bad for science and medicine.

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@leah_pierson

Leah Pierson

2 years

Do we know whether the shift from in-person to Zoom interviews benefitted shorter applicants?

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@leah_pierson

Leah Pierson

1 year

no one should ever have to read a transcript of themselves talking

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@leah_pierson

Leah Pierson

5 years

I recently got engaged to my former fourth-grade classmate @MaretSchool . So, here's this:

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@leah_pierson

Leah Pierson

2 years

People who think EAs place insufficient value on interpersonal morality should look at EA Twitter. The prevalence of snarky quote tweets, uncharitable interpretations, and ad hominem attacks is low, despite the high prevalence of hot takes.

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@leah_pierson

Leah Pierson

3 years

Doctoral programs should offer a class where they teach basic skills academics need, like: - How to review a paper - How to apply for a grant - How to find a therapist during a pandemic - How to mentor students etc

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@leah_pierson

Leah Pierson

4 months

My first solo-authored paper, Accounting for future populations in health research, is now out in Bioethics! It addresses a basic question research funders face: how forward-looking should they be? 1/5

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@leah_pierson

Leah Pierson

4 years

The NBME announced they were making Step 1 pass-fail in February, yet they still haven't told #doubledocs (and others applying to residency after 2022) whether our exams will be reported as pass-fail or with numerical scores attached. #medtwitter

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@leah_pierson

Leah Pierson

3 years

I am really glad I'm doing an MD-PhD, and think there are many great reasons to do one, but keeping your options open is generally not one of them imo.

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@leah_pierson

Leah Pierson

4 years

An open letter by medical students across the country to @NBMEnow and @TheUSMLE regarding Step exam cancelations and strategies for reducing the burdens trainees face as a result: Please consider signing and sharing. #medtwitter #medstudenttwitter

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@leah_pierson

Leah Pierson

2 years

Medical students—including those at the 80 medical schools in states where abortion is/likely will be banned—should be able to learn about abortion if they want to. To the extent permitted by the law, @AAMCtoday + @AACOMmunities should take steps to ensure this, like: 1/

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@leah_pierson

Leah Pierson

4 years

my dad makes me this really nice pre Step 2 breakfast and all I can see is this

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@leah_pierson

Leah Pierson

4 years

In other industries, this exodus would prompt a reckoning, but in part because medical schools have little financial incentive to reform (students still have to pay 4 years of tuition) and because medical students often aren't taken seriously, this hasn't happened. #medtwitter

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@leah_pierson

Leah Pierson

3 years

More than a decade after the passage of the ACA, health insurers still don't have to cover much of the care people at high genetic risk need. My sister, @2plus2make5 , and I share our story and policy recommendations in the @nytimes today.

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Opinion | Genetic Risks for Cancer Should Not Mean Financial Hardship (Published 2021)

People with markers for cancer often need more screenings. But health insurers are not required to fully cover them.

www.nytimes.com

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@leah_pierson

Leah Pierson

4 years

I am working on an article about medical students and access to COVID-19 vaccines. #medstudenttwitter + #medtwitter : If your school is not vaccinating medical students, I’m interested in hearing about it; please DM me!

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@leah_pierson

Leah Pierson

1 year

Harvard should cover @DataColada 's legal fees because Harvard: 1) Benefitted from Data Colada's report 2) Is responsible for its researchers' conduct 3) Stands to set an important precedent @_Haley_Sullivan 's and my op-ed is in @TheCrimson today:

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Harvard Should Protect Whistleblowers | Opinion | The Harvard Crimson

Harvard Should Protect Whistleblowers | Opinion | The Harvard Crimson

www.thecrimson.com

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@leah_pierson

Leah Pierson

4 years

Students who have signed our open letter to @NBMEnow will spend $9,000,000 on Step exams in exchange for the opportunity to have exams canceled with <24 hours notice.

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@leah_pierson

Leah Pierson

2 years

My first impression of this guy was him sticking his finger in the pencil sharpener on the third day of fourth grade. Against all odds, we're now married! It was the best day, and I couldn't be happier about spending my life with him.

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@leah_pierson

Leah Pierson

5 years

If you're hoping to do an MD/PhD in the social sciences and want advice, I will talk to you or help you find someone to talk to! Other social science #doubledocs , please comment if you'd also be willing. (Disclaimer: I'm only an M1, but happy to help however I can.)

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@leah_pierson

Leah Pierson

2 years

@juan_cambeiro Also who thought the emojis were a good idea

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@leah_pierson

Leah Pierson

5 years

@JAMA_current As a humanities major + med student, two reasons I disagree: 1) People should study what they want (ironically, "autonomy" is derived from ancient Greek) 2) Correlation =/= causation: studying the humanities did not make us compassionate; it's what drew us to the humanities

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@leah_pierson

Leah Pierson

3 years

All @Harvard students and employees now have free access to the @NYTimes . Thanks to the amazing librarians at @HMSCountway for following up on my push to get access for @HarvardMed students. You can sign up here:

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Harvard Library - New York Times

library.harvard.edu

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@leah_pierson

Leah Pierson

4 years

And for people who are saying this is too hard to do: There are robots that can suture grapes. It is not impossible to get a medical student their schedule several weeks out. It's just a question of making it a priority and committing resources to doing it.

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@leah_pierson

Leah Pierson

3 years

things I will miss about doing grad school remotely:

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@leah_pierson

Leah Pierson

4 years

How people talk about vs. think about choosing a medical school

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@leah_pierson

Leah Pierson

2 years

MD-PhD students spend tons of time studying in a bunch of programs (MD, PhD, MD-PhD). We thus have lots of opportunities to see how academic environments can help or hurt students. I hope MD-PhDs use this experience to become more student-centered mentors, teachers, and admins.

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@leah_pierson

Leah Pierson

10 months

Some research projects are vastly and predictably more socially valuable than others, and researchers should choose the more socially valuable ones.

@ScientistsLift

Scientists Who Lift

@ScientistsLift

10 months

What unpopular academia opinion would get you in this situation?

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@leah_pierson

Leah Pierson

2 years

MD-PhD programs are great and the NIH should fund them, but it should also: 1) Promote/monitor the accessibility of MD-PhDs 2) Help get medical school tuitions under control 3) Give scholarships to low SES MD-only students pursuing research careers 2/2

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Association Between Socioeconomic Background and MD-PhD Program Matriculation

Journal of General Internal Medicine -

link.springer.com

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@leah_pierson

Leah Pierson

2 years

she’s still losing

@2plus2make5

Emma Pierson

2 years

ah, yes, that stage of family vacation where you tire of losing to your family at games and begin writing an AI to beat them instead

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@leah_pierson

Leah Pierson

4 years

Kind of amazing that we learn all this minutia about drugs for Step—which receptor, which ion, vanishingly rare side effects—but almost nothing about cost, which matters a lot to both patients and our healthcare system.

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@leah_pierson

Leah Pierson

3 years

Clinicians often understate pain. In this post, I focus on IUD placement, which many clinicians describe as "uncomfortable," but many patients say is "blinding agony." I argue that greater transparency would promote trust, effective pain management, and meaningful consent.

@PetrieFlom

Petrie-Flom Center

3 years

Read @leah_pierson 's latest, which makes the case for greater transparency around pain when clinicians discuss medical procedures with patients:

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@leah_pierson

Leah Pierson

10 months

@jbcarmody It’s not clear to me why the passing threshold should continue to increase, assuming a score consistently correlates with getting a given percent of qs right. Most doctors who took Step 2 in 1994 earned what would now constitute failing scores—does anyone think this is a problem?

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@leah_pierson

Leah Pierson

3 years

2) Doing an MD-PhD preserves options you likely won't care about in 8 years because interests change 3) Doing an MD-PhD eliminates other options (e.g., for me, starting a surgical residency in my 30s feels untenable) 4) There are less burdensome ways to keep your options open

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@leah_pierson

Leah Pierson

4 years

*becomes fine with continuing Zoom grad school indefinitely*

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@leah_pierson

Leah Pierson

3 years

For most of the pandemic, I—a grad student—have had better access to COVID testing than my fiancé—a doctor. This is pretty wild, since 1) he needs the testing way more than I do, and 2) universities built their testing infrastructure from the ground up and hospitals didn't.

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@leah_pierson

Leah Pierson

3 years

My paper with #JoeMillum —Health Research Priority Setting: Do Grant Review Processes Reflect Ethical Principles?—is out! We look at health research disparities and propose a strategy for better aligning research funding with the global disease burden. 🧵

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@leah_pierson

Leah Pierson

2 years

It seems like the more virtue-laden an action is—in either a positive or a negative direction—the less socially acceptable it is to talk about having done that thing. Obviously, this is very context-dependent, but this is roughly what I mean:

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@leah_pierson

Leah Pierson

9 months

One thing I’ve found surprisingly nice about vegetarianism is that there’s a positive feedback loop—like, the longer you don’t eat meat, the weirder it feels to eat meat. (Giving up other things often doesn’t work this way.)

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@leah_pierson

Leah Pierson

3 years

hierarchy of academic needs

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@leah_pierson

Leah Pierson

1 year

A lot of people go to medical school because they want to work on the social determinants of health, global health, health policy, and other medicine-adjacent things. I think there are often other paths that make more sense if this is your primary goal, the reasons being: 1/4

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@leah_pierson

Leah Pierson

3 years

A lot of young people will become eligible for COVID vaccines this week. Professors: please preemptively tell your students that it's ok to miss class to get vaccinated!

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@leah_pierson

Leah Pierson

9 months

1) Increased focus on major causes of noncommunicable disease burden (e.g., lead, air pollution), a growing threat many global health actors have been slow to address 2) Scientific research into historically neglected areas (e.g., HCV vaccines, tuberculosis diagnostics) 2/6

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@leah_pierson

Leah Pierson

10 months

I used to think it was the “being at the library” part of coming to campus that motivated me, but I think it’s also that universities are just beautiful and inspiring places

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@leah_pierson

Leah Pierson

2 years

There's a lot more discourse about high-level EA priority setting (eg, longtermism vs. not; AI safety vs. global health) than low-level EA priority setting (eg, how grant decisions are made; which people + projects get funded). I'd love to see more discussion of the latter. 1/2

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@leah_pierson

Leah Pierson

4 years

live photo of my DNA before and after requesting a letter of recommendation

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@leah_pierson

Leah Pierson

1 year

It was a good lesson to me that—even when I was witnessing what I now consider unethical behavior—I didn't say anything. It would be easy to justify this as: "I was a med student; I lacked power to," but what *actually* happened was that I didn't recognize it was wrong. 3/3

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@leah_pierson

Leah Pierson

9 months

There are multiple ways to cash this out and reasonable people can reach different conclusions. EAs do reach different conclusions about how to do altruism effectively, but EAs clearly have an ideological bent that is not, imo, inherent to the project of effective altruism. 2/4

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@leah_pierson

Leah Pierson

4 years

Ethically, it seems like pregnant people should have been included in early COVID vaccine trials. The lack of this data (+ as a result, clear guidance) shifts the burden of this choice––and risk of getting it wrong––from a small number of consenting adults to all pregnant people.

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@leah_pierson

Leah Pierson

7 months

When you and your partner are working opposite shifts so must communicate every 12 hours via cookie

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@leah_pierson

Leah Pierson

9 months

Two years ago, @sophiehgibert , @_Haley_Sullivan , and I came up with "Saying No to Things" punch cards. Sophie sells these in her Etsy shop and proceeds go to @GiveDirectly ($928 this year). If you want to say no to more things in 2024, check them out (link below): 1/2

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Leah Pierson

4 years

We've grown a lot in 7 years

@leah_pierson

Leah Pierson

5 years

I recently got engaged to my former fourth-grade classmate @MaretSchool . So, here's this:

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Leah Pierson

3 years

Thrilled to have received the 2021 @AmerSocBioHum Student Paper Award for my paper, Accounting for Uncertainty in Global Health Priority Setting. Thanks to @GPIOxford and to everyone who has supported this project. I look forward to sharing the paper when it comes out!

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Leah Pierson

4 years

The medical schools implementing anti-racism summer reading programs for students should also assign these readings to faculty and admins and hold them accountable for doing the reading.

@bcunningMDPHD

Brooke Cunningham, MD, PhD

4 years

STOP relying on students to fill the gaps in curriculum. It is the RESPONSIBILITY of #meded to teach students and also to re-educate faculty that race is a social construct and that racism is a health risk. @AAMC #meded #BlackMedTwitter #MedStudentTwitter

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Leah Pierson

9 months

3) Efforts to improve public health policies (e.g., alcohol taxes) (One major critique of original bed nets EA was that it failed to address the structural causes of global health problems; 2023 EA increasingly does this.) 3/6

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Leah Pierson

2 years

It’s weird that kids are taught not to quit things; knowing when/how to quit things seems like a pretty important skill.

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Leah Pierson

4 years

Got a med school survey asking: "How satisfied are you with the availability of programs/activities to support student well-being?" I'm glad they're asking, but wellbeing surveys that focus on adding programs—but not on reducing burdens and barriers—are incomplete.

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Leah Pierson

3 years

What does informed consent even mean in the context of a healthcare system where the greatest risk to patients is often financial and clinicians can rarely describe the costs patients will face?

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Leah Pierson

4 years

A bad #doubledocs admission policy: making applicants apply either MD-PhD or MD, rather than allowing applicants who do not advance in the MD-PhD pool to be considered MD-only (if they want). This leads qualified applicants who want to do MD-PhDs to instead apply MD-only. 1/2

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Leah Pierson

2 years

Nominating Grandma Betty for most committed EA over age 88

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