Students, residents, and educators writing on KevinMD about how physicians are made: medical school, the match, residency, duty hours, supervision, assessment, mistreatment, and the path from student to practicing physician. Many contributors write while still in training, and many write anonymously. For a maintained record of what students and physicians have said about medical school since 2004, see Medical school: what students and physicians say, in their own words. For what residents and attendings have said about residency itself, see Residency: what residents and attendings say, in their own words.
The practice of medicine is changing structurally, technology, and financially at an unprecedented rate. Scientific advances in genomics, electronic medical records, an increased focus on quality improvement, and changes in the health insurance structure are a few of the areas in which the landscape of medicine is changing. However, in many of these processes physicians seem to be bystanders. Medicine requires innovative physicians to be part of this change. At …
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Be an innovator in medical school
The third year of medical school is definitely an interesting one. You leave the classroom and enter the big bad world of medicine, and you quickly realize that much of what you’ve learned is for naught. You also realize that the medical student next to you could become your best friend, or the bane of your existence — or fall anywhere along that spectrum. Here is a list of the …
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The 7 types of medical students you’ll meet
The resident’s training can be compared to the one received by Navy Seals or U.S. Marines in many ways. Physical endurance, psychological warfare towards the trainee, long service hours and quick life or death decisions are all aspects of both types of preparation. In most cases, this turns out to be a great burden on the resident’s life, especially on the interns, whose lives have dramatically changed from one day …
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Happy residents do much more for their patients
I’ve heard applying to medical schools can be a soul crushing process, but I didn’t really quite get it until I got hurled into the process myself. Although I still wouldn’t describe this as “soul crushing,” it has certainly brought out a lot of insecurities in me and my accomplishments. Do they not like my stated reasons for pursuing medicine? Do my extracurricular activities seem phony and under-whelming? Is this …
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Lessons from applying to medical school
A popular teacher at our school recently gave a lovely talk about “emotional intelligence.” I was at once proud of my school for offering such a lecture and disturbed that it was necessary. Our schedules are flooded with lectures devoted to issues such as professionalism and emotional awareness. We’ve all heard stories about insensitive doctors with terrible bedside manner and outrageous faux pas by medical students, transmitted in whispers, and …
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Why emotional intelligence matters for doctors and medical students
I never thought I would call cancer “cool.”
It was the last day of anatomy lab. Finally, we had dissected through everything: starting with the back, moving through arms and legs, hands and feet, chest cavity with lungs and heart, abdominal cavity with gastrointestinal organs, pelvis, and ending with head and neck.
Looking at our cadaver was disorienting. There were insides where outsides should be. Organs completely removed. The head literally sawed …
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Care about people as people, not just as hosts of disease
The study of medicine can be overwhelming. We’ve simply discovered too much for one person to master completely. This is the challenge medical educators are tasked with – what’s so important that it must be allotted time in the brief 2 years of dedicated book learning doctors-to-be receive?
Students face a similar time-management challenge – first, we must decide what’s important enough to focus on, but the real question I think …
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Nutrition needs to be taught in medical school
Some medical schools have altered their admissions process by replacing the traditional applicant interview with the Multiple-Mini Interview (MMI). MMI resembles speed-dating: applicants rotate through numerous interview stations, where they act out scenarios and solve puzzles, sometimes alone and sometimes in groups. A July New York Times article presented a good overview of MMI, as implemented by Virginia Tech Carillon.
As you might expect, schools that have adopted MMI (UCLA and …
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Problems with the Multiple-Mini Interview for medical school
His face was four inches away from mine. I tried not to blink as he shined the ophthalmoscope’s light into my left eye and stared into my pupil as though it were the most interesting thing in the world. He frowned, placed his hand on my head, and used his thumb to pry my eyelid higher. He maneuvered for about 45 more seconds while I sat stone still, and then, suddenly, …
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Medical school is a fragmented, intimate experience
As a current fourth year medical student, one of the main things I look forward to after I graduate is trading in my white coat. For medical students everywhere, it’s a huge sign of accomplishment to shed the short coat and don the long one. It means you are now a real doctor.
Medical students are required to wear short white coats that might reach to their fingertips, if they’re lucky. …
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It is natural for medical students to feel long white coat envy
When the patient jokingly touched my nose, I knew I had muddied the boundaries between us too much and it was too late to go back.
(Note: Except for the aforementioned sentence, all of the patient’s details and quotations have been fabricated. Events from the interview and exam have been drawn from a conglomeration of patients and scrambled to illustrate a general theme.)
It didn’t happen until the end of the interview, …
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When easy familiarity blurs the boundaries
Harvard University’s Edmond J. Safra Foundation Center for Ethics has conducted a lecture series focused on Institutional Corruption. In December, Marcia Angell-Relman, M.D., the first woman to serve as acting editor-in-chief of the New England Journal of Medicine (NEJM), gave an hour lecture which focused on conflicts of interest (COI) in academic medical centers (AMCs), and continuing medical education (CME). After the lecture, …
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The benefits of academia-industry relationships
Last year I was assigned to complete a history and physical on a patient in the hospital. Stifling my excitement to be doing this on a weekend night, I walked to the operator’s desk and paged the on-call intern, who — I’d been assured — knew I was coming. “You’re who now for what?” she stared blankly back at me after I’d explained my task.
My patient (we’ll call her Betty) …
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A nurse offers a medical student sage advice
Today I went to Middle of Nowhere, Ireland for a rural lumps and bumps clinic. I really enjoy the outings to the country, hanging around the little hospitals, and seeing the old farmers who drive in on their tractors (true story).
I had the chance to see a nice variety of patients: from swallowing difficulties to sebaceous cysts, urinary retention to infected toe nails. For me the real fun is with …
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A Canadian medical student training in Ireland
“How are residents supposed to prepare for real life as a surgeon if they can’t even work twenty-four hours straight now?”
I hear this complaint about once a month from a someone trained in the Golden Age of hazing. Outside of anecdote, we’ll never know if surgeons are better trained now or twenty years ago, or fifty. But it’s too painful to imagine every-other-night-call wasn’t of critical importance.
Residency resembles the …
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Can I do residency again in a better rested environment?
The average week for a medical resident training in Mexico can easily exceed 90 work hours. Mexico is a country that takes pride in offering full health coverage for 100 million citizens. This is a new policy and free public medical care is being pushed to the limit. The situation is simple, the work load in outpatient clinics, operating rooms, the wards and emergency rooms across the country is …
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The life of a medical resident in Mexico
As you all know, the personal statement is one of the most important components of the medical school application process. It is one of the first opportunities you have to explain to an admissions committee exactly who you are and what you bring to the table. Don’t show up empty handed.
Here are some tips I learned while writing my personal statement.
1. The personal statement on the AMCAS does not have …
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Personal statement tips for medical school
Urban myths come in all shapes and sizes. Recent medical scares include a rogue politician claiming that a vaccine is no good, based on someone they met in the audience who was not trained in medicine or science. How many physicians know patients who are scared of taking a medication or getting a needed procedure based on an Internet story or a friend of a friend?
Recently, there has been controversy …
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Elimination of industry support for CME is an urban myth
I grew up playing a variety of different organized sports. Looking back now, I notice that no matter what the sport my best performances were always on teams which were led by inspiring coaches. The same could be said about my education, with teachers replacing the coaches. Whether I knew it at the time or not, throughout my life I have had a number of mentors who have brought the …
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The value of a mentor during medical training
