This month of my intern year, I am covering night float for the private hospital. Compared to the massive county hospital teeming with laboring patients, churning at all hours of the day and night, the private practice pace is meant to be a luxury for interns seeking respite. And for the most part, life has been pretty nice.
This week however, has been nothing less than hell. One night, I was …
Medical resident superstition and black clouds
by Timothy Dempsey and Pamela Savitz
Last month, the National Football League inducted seven of its all-time great players into its Hall of Fame in a ceremony filled with nostalgia and memories of legendary careers long-finished.
While this was going on, there was another type of induction ceremony taking place around the country. Yet, these celebrations lacked recollections of past achievements by retired legends finally receiving …
The White Coat Ceremony and its effect on medical students
Recent rules issued by the Accreditation Council for Graduate Medical Education (ACGME) for resident work hours have further limited the consecutive and total number of hours that medical trainees may work. These measures, originally created because of safety concerns, are intended to decrease the number of fatigue-related errors made by physicians in training. They have received broad support within the medical community.
A recent story published by Mike Lillis in The …
Should OSHA create work rules for physicians in training?
A rising second year medical student read some of my posts and wrote me a kind note asking if I would write something for students. I taught students and ran surgical clerkships at community teaching hospitals for my entire career until about 19 months ago.
I also was prompted to address this subject after reading a recent New York Times story about a new admissions policy at Mt. Sinai …
Advice for a second year medical student
The Wall Street Journal’s Health Blog carries an interesting piece about a program at Indiana University–Northwest that allows volunteers from the general public to participate in preparing cadavers for first year medical students.
This is a brilliant idea for several reasons:
Should the public participate in preparing cadavers for students?
There’s been considerable buzz on the web recently – on the New York Times website, on Facebook, and on a physicians’ forum called Sermo, at least – over a New York Times article recently entitled, “Getting Into Med School Without Hard Sciences.”
The article describes the Humanities and Medicine Program at Mount Sinai Medical School, a program which each year admits into the medical school 35 undergraduates who major …
Should humanities be the focus of prospective medical students?
by James Gaulte, MD
Should medical student applicants be chosen less for their demonstrated ability to master large amounts of knowledge and solve problems and more for their social consciousness and desire to push forward with social justice?
That appears to be the suggestion of a panel of experts from the AMA in a project called the Initiative to Transform Medicine (ITM) who believe an …
Should social justice matter when choosing medical students?
Even as a medical student, I’m already complicit in exacerbating the problem of the high cost of health care.
It hit me one day, during my medicine rotation. We were working up a patient, and I was ordering tests with my resident. The patient had liver disease and perhaps some ascites.
He came in for another issue, and this wasn’t of primary concern to us, and we really wouldn’t have …
How a medical student can exacerbate the high cost of health care
A guest column by the American Medical Association, exclusive to KevinMD.com.
by J. James Rohack, MD
This year marks the 100th anniversary of the landmark Flexner Report that standardized medical education in North America. Now, during this historic time of health system change, medical education reforms on the scale of those enacted a century ago are needed …
AMA: Ensuring medical education best prepares future physicians
I thought I was an oddball in college. I’ve only recently learned that I was avant garde.
Right before beginning college in 1975, I decided I wanted to be a doctor. Being the first-born son – with decent SATs – of an upwardly mobile Long Island Jewish family, I had relatively little choice in the matter. Notwithstanding this predestiny, I felt confident that medicine was a good fit for my interests …
Social science requirements for pre-medical students
Some reflections on my first semester of medical school.
1. Medical school is hard. Yes, it’s true — medical school is as hard as people who have been through it make it out to be.
I was skeptical when I started mostly because I felt I had challenged myself while doing my undergrad degree and in graduate school. I had taken heavy loads …
Medical school is hard, and other medical student thoughts
According to an article published in the Journal of General Internal Medicine, counties with teaching medical hospitals experienced a 10% increase in fatal medication errors as compared to counties without teaching medical hospitals.
First, what is the July Effect? It represents an entire transition in the hospital, during which medical students become interns, interns become senior residents, and second or third-year residents become chief residents. …
Fix the July Effect for incoming interns and residents
Can the field of family medicine truly become monotonous?
I never thought I’d ever find myself in a repetitive routine when selecting family medicine as my specialty. I spent eleven years after high school studying what I know. How can eleven years of material really become mundane? In a way, it’s a great thing – it means I am feeling comfortable and confident in my job.
And I am fortunate enough to …
Teaching family practice residents is rewarding
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One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations?
Recently, in the New England Journal of Medicine, two of the Biggest Kahunas in the safety and quality worlds – the Joint Commission (TJC) and the Accreditation Council for Graduate Medical Education (ACGME) – announced bold new policies. To their credit, both organizations …
Will the new resident duty hour rules improve patient safety?
How many hours can a doctor work?
The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents finally achieved the vaunted 80-hour workweek. New York State was 15 years ahead on this, having mandated an 80-hour work week in 1989, stemming from the Libby Zion case.
Every patient wants …
The 80 hour resident work week balances fatigue and independence
by Timothy Dempsey
One thing changes everything.
While this may be a poor paraphrase of the cheesy slogan ESPN used for the recently finished World Cup, in my life this statement has revealed itself as a universal truth. For me, one book changed everything. It would lead me into research labs, on a trip to disease-riddled Gaborone, Botswana, and pique my interest into an epidemic whose global …
Fighting AIDS compelled this student to become a doctor
It has been 10 years since the landmark Institute of Medicine report “To Err is Human” uncovered disturbing deficiencies in the quality of our nation’s medical care.
Progress in correcting these deficiencies remains frustratingly slow, and it has become clear that achieving the quality and safety improvements we seek will require us to examine our approach to medical education.
Although today’s newly minted physicians are well prepared in the science of medicine …
Today’s new physicians are unable to improve patient safety
by John Gever
Academic medical centers need comprehensive policies to manage their physicians’ relationships with industry and other commercial interests, according to the Association of American Medical Colleges (AAMC).
Disclosure of such relationships — both to patients and to their institutions — should be more detailed than is currently the case at many medical schools, an AAMC task force recommended in a new report.
In particular, significant potential conflicts should be reported annually …
Academic medical centers need better conflict of interest policies
While the percentage of commercial support for continuing medical education (CME) has continued to drastically drop over the past few years (29% decrease from 2007 to 2009), recent data, which show an epidemic of medication errors in hospitals, make this decrease even more troublesome.
At a time when 30 million more patients will flood our hospitals, do we really need to …
Commercial CME funding and the rise of medical errors
As originally reported in a New York Times article recently, with more coverage in MedPage Today, the University of Michigan School of Medicine has decided to end all industry support of CME as of January 1, 2011.
According to the dean of the medical school, “the decision was based on a review of literature about the influence on clinical faculty of industry-funded CME.” Apparently the decision was made after a …
How essential is industry funding for university CME?
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