Medical Education

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.

Residency training is like James Cameron’s Avatar

Vineet Arora, MD

Medical Education

April 1, 2010

Dr. Carolyn Clancy, head of the Agency of Healthcare Research and Quality, recently highlighted the definite need for enhanced patient safety and training on healthcare IT for residents who will be the practicing docs of the future.

At the very end, she compared the future of residency training to James Cameron’s Avatar – an epic battle followed by enlightenment.

Because I am a huge science fiction fan and working in graduate medical …

Diet Coke and the AHA red dress endorsement

Kevin

Medical Education

March 29, 2010

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

A red dress jauntily displayed on cans of Diet Coke has become the latest symbol in the ongoing debate about pharmaceutical company support of research or CME.

But whose dress is it? The American Heart Association says it’s “not our red dress,” even as leading pharma critic Steven Nissen, MD, …

ACP: To whom are physicians accountable?

American College of Physicians

Medical Education

March 22, 2010

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

The New England Journal of Medicine‘s March 11 issue included an interesting “Clinical Decisions” article. Looking at a hypothetical case of an endocrinologist with time-unlimited board certification, the editors posed the question of whether he should voluntarily …

Match Day and how each medical school celebrates

Kevin

Medical Education

March 18, 2010

by Brian Eule

While the debate continues to rage over the health care reform bill in Washington D.C., today at Noon Eastern time, the newest class of 15,000-plus graduating medical students will get their marching orders, beginning their lives working in medicine.

It’s called Match Day and each year, on the third Thursday of March, the nation’s graduating medical school students gather with their classmates and wait for an envelope with their …

Patient handoffs limit residents work hour cap gains

Vineet Arora, MD

Medical Education

March 10, 2010

Anyone affiliated with a teaching hospital knows that the controversy regarding resident work hours is heating up again. It’s been over 5 years since the ACGME limited resident hours to 80 hours per week with a maximum of 30 consecutive hours. While this may not sound like ‘reform’, as someone who trained prior to these rules, it is definitely a change.

More recently, the Institute of Medicine issued a …

Young doctors gathered around the beer machine

Kevin

Medical Education

March 5, 2010

Originally published in MedPage Today

by Charles Bankhead

From time to time, I hear a “mature” person lament the sad state of affairs of the “next generation.” Sometimes I wonder whether the same concern should apply to the next generation of doctors.

I was at a cardiology meeting, and my schedule included a breakfast program. As I headed toward the meeting, I …

Forcing residents to nap may not improve patient care

Kevin

Medical Education

February 21, 2010

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing — or rejecting — the IOM’s controversial recommendation has yet to make a decision.

The Accreditation Council for Graduate Medical Education (ACGME), which has …

ACP: Resident work hours – Managing a precarious balance

American College of Physicians

Medical Education

February 18, 2010

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,” in which it proposed a number of changes to the current regulations developed and enforced by the …

How to make your medical grand rounds thrive

Robert Wachter, MD

Medical Education

January 27, 2010

Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, “We polled 250 people at our grand rounds last week, and they said ‘X’.” The audience gasped – ‘X’ was a completely unexpected …

ACP: 10 major challenges that confront medical education over the next decade

American College of Physicians

Medical Education

January 19, 2010

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past …

Medical student needlestick injuries

Kevin

Medical Education

December 1, 2009

Originally posted in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Medical students are frequently stuck by needles, and few report their accidents, researchers say.

In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …

Read more…

Medical student needlestick injuries

How training to become a doctor in France differs from the United States

Yann Meunier, MD

Medical Education

November 22, 2009

Among the many differences between the U.S. and the French health-care systems is the approach to medical training. While U.S. medical school graduates in 2008 had an average debt of $154,000, French medical students receive their training virtually for free. For example, first-year medical students at the Faculte de Medecine Pierre et Marie Curie in Paris have only one mandatory cost for this year: an enrollment fee of $264.

The amount …

Surgeons don’t receive enough training when resident work-hours are capped

Crystal Phend

Medical Education

November 13, 2009

by Crystal Phend, MedPage Today Senior Staff Writer

Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.

The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, …

What does bias when analyzing data have to do with slow lines?

Paul Levy

Medical Education

September 20, 2009

Here’s an excerpt from a lovely little book by John D. Barrow called One Hundred Essential Things You Didn’t Know You Didn’t Know; Math Explains the World. This selection has a great lesson about statistical inference. The chapter is entitled, “Why does the other queue always move faster?”

You will have noticed that when you join a queue at the airport or the post office, the other queues always seem to …

Do resident work-hour restrictions increase surgical complications?

MedPage Today

Medical Education

September 8, 2009

by Chris Emery, Contributing Writer, MedPage Today

Reductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found.

The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to other hospitals after resident …

How to make industry influence transparent in continuing medical education

Larry Husten, PhD

Medical Education

August 25, 2009

by Larry Husten, Ph.D.

A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.

Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will …

Half MD: How to fix the scramble before Match Day

Kevin

Medical Education

March 31, 2009

The following is reader take by Half MD.

The third Thursday of March each year is Match Day for fourth-year medical students. There are many smiles and frowns made on this day when soon-to-be doctors discover where they will obtain their first job to continue their medical training. While Match Day is the most famous day of the week, Monday and Tuesday are the …

Should the MCAT grant extra time for students with learning disabilities?

Kevin

Medical Education

March 22, 2009

A recent California court denied extra time for aspiring medical students with dyslexia and attention deficit disorder when taking the MCAT.

The body that administers the test has to straddle a delicate line, in granting extra time to a broadening definition of the disabled student versus maintaining the overall fairness and integrity of the high stakes test.

Despite the ruling, three of the four plaintiffs have gone …

Is there a place for a part-time medical residency?

Kevin

Medical Education

November 25, 2008

Doctors in training often do so in their prime family-rearing years.

A few pediatric residencies are offering part-time residency options, designed for those who also want to raise their own families. Proponents argue that residents can not only get more rest, but also avoid depression, which affected almost a quarter of pediatrics residents.

Combined with the talk of further limiting work hours down to 56 …