For years, I supervised residents. They would come in each week and tell me about a patient in crisis. If no one was in crisis, they’d say all their patients were fine and they didn’t know what to talk about, even though I had told them to pick a patient they saw weekly and either audio-record the sessions or take detailed process notes. Psychotherapy, I would say, is a …
Psychiatry residents need to learn psychotherapy
At lunch recently, a few of us got into the topic of mental health in medical school. The conversation started when someone brought up the fact that a Harvard College senior and a Harvard Law School student had both recently committed suicide.
We all worried that the medical school wasn’t doing an adequate job caring for students who may be suffering from mental illness. To be fair, University Health Services …
Medical schools need to better recognize mental illness in students
It happened on a bus on my way to work. I got on and sat in the only available seat, which I quickly realized was next to a disheveled looking man who smelled faintly of urine and had a dry hacking cough that could be heard throughout the entire bus. He was leaning against the window and did not seem to notice me. I was less than pleased with my …
A medical student’s first day of clinical training started on the bus
I recently saw a post in Yahoo questions entitled, “Is it illegal for a medical student to introduce themselves as ‘Doctor’ before they have received their MD?”
One of the answers that was rated highly was “I think it is more unethical than illegal.” Clearly, if a student is deliberately misrepresenting themselves as a ‘doctor’, it is grounds for disciplinary action. More often than not, this misrepresentation …
Should medical students be introduced as Doctor?
In the New York Times article “18 Stethoscopes, 1 Heart Murmur and Many Missed Connections,” Madeline Drexler tells her story of being a model patient. Not like a model citizen cooperative and pleasant but, a person with a medically interesting finding who is asked to help teach medical students. These “patients” are examined by small hoards of inexperienced medical students who have little knowledge, little skill and varying degrees …
A model patient in physical exam class
If you’re a new intern you are hopefully a little afraid of the new found responsibility in your life. I say “hopefully” because there is nothing more frightening in healthcare than someone who is “unconsciously incompetent.” That is, someone that doesn’t even realizethey have no idea what they are doing.
Before starting medical school I was an emergency nurse. As an RN, I had the opportunity to see many medical …
Advice to new interns from a nurse turned medical student
A strange thing happens on your first day of med school. Yesterday, you may have joked with old friends about upping your Paxil dose, but starting today, you are expected to be professional. And professional is suddenly a word that prevents you from being open with your new friends, a word that hints admitting to any real struggle could be a career-ending mistake.
I want to tell you that it isn’t, but the truth is, I’m …
A medical student with anxiety and depression
Applying to medical school is really annoying, expensive, and hard for no reason. I’d like to share some wisdom I picked up along the interview trail.
Become an expert stalker. You have had plenty of practice stalking your friends on Facebook. Use those skills to find out everything you can about the school. Admissions officers tend to ask you why you would like to attend their institution. In order to …
7 tips for students applying to medical school
As a medical student I have come to appreciate two core goals of health care:
1. Health: The delivery of medical knowledge, assessment or treatment to a patient
2. Care: The compassionate approach to any patient
In my medical training, I have also witnessed clinical medicine practiced across a spectrum of situations. Taking my time to reflect on these experiences, I am not certain we are meeting our goals. Too often …
Are we providing health care, or just delivering health?
For the sake of patient privacy, I am going to tell this story very ambiguously and hope that the insanity of it is not missed with the lack of details.
Because most of us do clinical training with non-pediatrician tutors, we have mandatory pediatric tutorial sessions. While I had already done a little bit of lung and heart listening on some children earlier on in …
The first child patient at a pediatrics rotation
July is the month that new resident physicians begin their training all across the United States.
Our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (ok, not really a specialty, just a side-line) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school.
Anxiety-filled and debt-ridden, they will embark on …
Practical tips for new July resident physicians
Arriving in anatomy lab there was an obvious discontent in the air. People were slower to arrive than usual and then they were even slower to get changed in the locker room. Girls would start casual conversation, or would wait for 15 minutes for others to move from in front of their locker, just in the hopes that they would get 5 more minutes …
The first brain a medical student sees in anatomy lab
I’ve always had a hard time identifying myself as a feminist.
I work for healthcare equality and human rights. Women’s rights seemed to me a part of human rights work (and as Hilary Clinton and others have said, woman’s rights are human rights). Tying myself to the feminist movement then seemed to be looking backwards – clinging to a term that was anachronistic, divisive and too narrowly defined in what activism …
Examining medicine through the lens of women’s rights
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As I finished my 24-hour call recently, I was reminded of a 2009 study revealing a decline in empathy as medical students transition from their mostly-didactic second year to third year, which is essentially an apprenticeship in the hospital with lecture as an afterthought. I began my third year with what most would argue is the most difficult rotation, surgery, and my experiences …
Reasons why medical students burn out and become depressed
Debates over resident autonomy are nothing new. Informed patients are sometimes reasonably concerned about just how much responsibility for their care will be delegated to their doctor’s trainees. Care within academic medicine, especially acute inpatient care in a public system, can and does sometimes mean going a whole admission without meeting the attending physician presumably responsible for your care as a patient. At least in my limited experience. This as …
Resident responsibility at a Level 1 trauma center
She whispered to me with bulging eyes of urgency, “something is not right, I’ve been in pain all night.”
Her chief complaint was chest pain. She had a routine work-up and some care with little relief. The news came that all of her test results were normal. Her body appeared tense, she looked panicked and afraid. At bedside, the attending suggested endoscopy offering that her pain …
I do my clinical training at the VA. It is an interesting population because the people are all pretty similar (this will likely change as the army changes, but for now, its just a lot of old guys, and a lot of heart problems).
In our last few weeks, we finally switched to doing histories and physicals on patients (this really just means that we …
A medical student doing clinical rotations at the VA
Recently, Dr. Philip Baker, Dean of the University of Alberta’s Faculty of Medicine, gave a speech to the graduating class at the convocation banquet held in Edmonton. Now, there are accusations that Dean Baker lifted much of his June 10 speech from a commencement address given by famed physician and essayist Dr. Atul Gawande at Stanford’s School of Medicine in June 2010.
As Baker gave his address last Friday, medical students …
A medical school dean plagiarized Atul Gawande in his commencement speech
When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport.
I was also looking forward to the class where we would be using clickers from the Library to poll audience responses during the lecture, as doing something while listening to someone talking has a much higher success rate in getting …
Is First do no harm really part of the Hippocratic Oath?
Recently, the Harvard class of 2014 took its last exam of the year.
We filled our usual amphitheater, took a 60 multiple choice question test on viruses, parasites and fungi, and went to go see X-men in the afternoon. I told my mom last night that I expected people to exit the lecture hall in hysterics, falling to their knees on our marble floors and weeping at being 25% closer to …
The last exam of a first year medical student
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