“I graduated this July and took the QE (written general surgery boards) on July 19th. I got my results today, and I failed. Not only did I fail but my score placed me in the 5th percentile. Needless to say, I’m disappointed. You hear stories about CE (oral exam) failure but never about QE failure. I never blew the ABSITE out of the water (50, 29, 20, 34, …
You failed your surgical boards. What’s next?
Left to our own devices, most of us physicians try our best to provide high-quality care to our patients. But almost none of us provide perfect care to all of our patients all of the time. In fact, many of us get so caught up in our busy clinic schedules we occasionally forget to, say, order mammograms for women overdue for such tests, or we don’t get around to weaning …
The bureaucratic hassles physicians face are extraordinary
Donald Trump is talking about Hillary Clinton’s health as are two doctors who have never evaluated Clinton. This attention on Clinton has renewed some interest in the letter Donald Trump released last year from his personal physician.
Many outlets have picked it apart, but I want to tell you as a doctor exactly how bad it is. I would never write …
Donald Trump’s medical letter has so many things wrong with it
I graduated medical school in 1995. I believe in a single-payer health system. I am about championing for my patients. I left a salaried position in academic medicine to go an underserved area of rural Maine and start a practice. This is the letter I wrote to the CEO of a large health insurance company recently.
Dear Mr. CEO,
My name is Cathleen Greenberg London. I am a family medicine physician who …
A physician tells a health insurance CEO what she really thinks
Sometimes, the loudest sounds I hear in the emergency department are laughter. It may seem irresponsible. It may seem discordant. It may seem callous. To me, it is the sound of survival. It is the sound of resiliency. It is the sound of making it through the day.
My father was at work when he suddenly became cold, clammy, and collapsed to the ground unresponsive. His staff did the right thing …
Laughter? That’s the sound of resiliency you hear.
I knew it was bad when she couldn’t tell me her name. I watched her face fill with frustration as a word she had uttered countless times over eight decades somehow got lost between her brain and her lips.
It was 2 a.m. and I was on call as the surgical resident. I had been told that a patient with bladder cancer was being transferred from another hospital, and, as these …
Death is not the enemy. More physicians need to realize that.
I recently took care of a young patient whose case left an impact on me. When I admitted him, he was fighting a lost battle with cancer.
A few months prior to admission, he had been experiencing new headaches. When he sought medical attention, he was diagnosed with an extremely aggressive brain tumor that had spread to his spine, and was given a very poor prognosis.
Unfortunately, his condition deteriorated quickly thereafter, …
A reminder that life is indeed too short
I was in the break room at the hospital scarfing down a power bar between three-hour cases. The truth is, I was multi-tasking: eating, writing on a chart, and checking my email on my phone.
I had received an email from a businesswoman, whom I have known for a few years. She wanted to know if I wanted to join her for lunch next week.
I had to laugh out loud.
The rest …
Doctors experience the world differently
Even the most honest among us do not tell the truth all of the time. We are flawed human beings. We covet, we gossip, we steal, we lie, and we stand idly by. You don’t think you steal? Have you ever “borrowed” someone else’s idea and represented it as your own?
A few weeks before I penned this, I was presented with two opportunities to lie in order to save a …
When should physicians lie for patients?
Dear Pamela,
You’ll never guess what happened to me today. Hours after the National Day of Solidarity to Prevent Physician Suicide volunteer web page went live, I received an email stating that I am officially terminated from my psychiatry residency program.
On this web page, I spoke about the fact that I had become interested in this event during my …
Hospital fires doctor for having cancer
She fit into the palm of his hand. That long nine months. Waiting desperately for that baby they thought they could never have.
Jeff, football player from his high school days, met the love of his life, Bridget, at the school party. She was smart and beautiful; Jeff was big and burley, but as kind and gentle as a kitten. They hung out through their college days.. And finally said their …
A miracle in the intensive care unit
To close out my first week of medical school, the class was treated to a talk by a stuffy but soft-spoken lecturer on the relationship between poverty, education, and poor population health. “Social determinants of health,” he labeled them, a clunky and unwieldy term if ever I’d heard one. In those days, audiovisual aids consisted of an overhead projector for black-and-white transparencies. And boy did that talk have transparencies. Chart …
Social determinants matter most to a person’s health. Here’s one story.
After rotating in the ICU, I began to wonder about the limitations of modern medicine. In a short time, we have come a long way with the discovery of antibiotics, high-resolution imaging, and the development of advanced surgical procedures. The medical field saves millions of lives. Nowadays, people do not go to a hospital to die; they go to be healed. As physicians, we are very skilled at extending life.
Heart …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 26-year-old woman is evaluated for a 10-year history of recurrent episodes of acute-onset feelings of fear and anxiety. These episodes initially occurred approximately 4 times per year but for the past 3 months have been occurring once or twice per month, especially when she is under stress. She describes the episodes as …
MKSAP: 26-year-old woman with recurrent feelings of fear and anxiety
Summer is heating up, and so is the election rhetoric. In this year’s campaign for the White House, when it comes to verbally attacking each other, neither candidate seems to recognize any limits. Personally, I think this behavior reflects poorly on both candidates.
In heath care, it’s almost impossible to escape this negativity. The media devours and thrives upon it. In our hospitals, televisions in the doctor’s lounge, cafeteria and in …
It’s time to stop using the language of war in health care
Starting this fall, second-year students will no longer have the stress of grades at our medical school, Washington University in St. Louis (WashU). In extending the pass-fail system from the first year to the second preclinical year, WashU joins the other 18 of the top 20 research medical schools on U.S. News and World Report that grade the entire preclinical curriculum on a pass-fail basis. (The sole holdout is Penn, …
Pass-fail is here to stay in medical schools. And that’s a good thing.
It’s that time of year where upcoming fourth-year students are frantically preparing applications for their chosen specialties. Statements like “I LOVE psoriasis,” and “’I’m fascinated by the colon,” are heard from eager, smiling, seemingly-passionate faces when asking preceptors for a “strong letter of recommendation.’”
But what about you? You know, the one whose specialty decision-making process feels more like being tossed into an M.C. Escher lithograph than the instant, undeniable attraction …
You don’t have to love your specialty. Here’s why.
I am blessed to love being a doctor. As the child of two physicians, and the fifth generation of physicians in my family, I had no choice but to go to medical school. But from the first day of medical school, I loved it. What a privilege, to know how the human body works! And I didn’t think medical school was particularly fun: I thought it was hard. The first …
10 pieces of advice for new physicians
“Code fifty-two, emergency room. Code fifty-two, emergency room,” blared over the loud speaker in the hospital. Simultaneously a chorus of beepers went off, like crickets on a sticky summer day.
I glanced down at my pager that echoed the same message “CODE 52, EMERGENCY ROOM.” The same message flashed across the screen three more times as I ran quickly down the main hallway. Code 52 meant trauma. I was about to …
A medical student’s first trauma
The only thing I love more than complaining about being a doctor is actually being a doctor. Intern year sucks. There’s no way around it. I wake up at 5:15 a.m. to get to the floor at 6:00 a.m. and I rarely leave at 5:00 p.m. when my shift is scheduled to end assuming I’m not on call until 9:00 p.m.
I often feel my stomach growl at 9:00 a.m. and …
The worst thing about being an internal medicine intern
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