A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.
My fellow first-year medical students and I have begun our official training in clinical reasoning, …
Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done.
I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, …
Last year the American Association of Nurse Practitioners announced a $2 million campaign to further expand independent practice, which they already have in 22 states. The relatively new doctorate of nursing (DNP) has led to a confusing scenario where nurses are indeed doctors, just not the kind you think of when you see a white coat. The profession (well, its money-making institutions) has fought hard to keep people confused.
Doctors are …
Despite more than a dozen years in medical school admissions consulting, I still clearly recall a bright advisee who had improved her grades considerably throughout her college career. But I, unfortunately, had a less than stellar freshman transcript. After calculating her AMCAS GPA with me, she lamented, “I feel like my grades are a criminal record.” In a twisted way, she was right — she couldn’t erase the grades.
But she …
The Medical College Admission Test (MCAT) should be abolished. This single test — which ranks students by the science they’ve learned before going to medical school — prevents the physician population in the U.S. from looking like the population it serves. Underrepresented minority students have lower scores on all standardized tests. And the MCAT is no exception. When medical school admission committees use the MCAT as a screening tool to …
“90 percent of what you will learn over the next four years will be wrong in a couple of decades from now.”
Speaking to a lecture hall of 120 first-year medical students, our professor’s prophecy seemed to fall on deaf ears. Looking around, I saw no concerned students, no diminishment of our collective enthusiasm. For me, however, his words of caution struck a chord on that first day of medical school.
As …
Students’ time in medical school should help them grow and become insightful, caring doctors. Instead, medical education is somehow turning smart, gifted, enthusiastic applicants into exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout.
I’m no stranger to the demands of medical school. My father and father-in-law were both …
Interleveling strategy
The definition of pimping in the medical field is different than the colloquial usage by artists like Jay-Z, Snoop, and Kendrick Lamar. Although most people are aware of pimping in the vernacular language (which will not be discussed further, I would suggest avoiding most rappers terminology if you desire to research), the medical use of the word is a little more nuanced and opinions on the practice are split.
Pimping in …
The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way.
However, some students don’t receive the same good news. …
“You’re 27-and-a-half weeks pregnant.”
As I lay on the exam table, time froze.
How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?
I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a 27-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they’d been …
I was a 22-year-old intern, just about to finish my public health internship. I had an ambitious career ahead of me. I was trained as a public health educator. I was doing wellness fairs, writing newsletters, and excited to get to the next stage of my life. I wasn’t yet certified, however, so when all of a sudden a job opportunity presented itself to me and gave me a chance …
On March 11th and 12th, representatives from the NBME, AMA, AAMC, Federation of State Medical Boards and the Educational Commission for Foreign Medical Graduates gathered in Philadelphia for InCUS — the Invitational Conference on USMLE Scoring — to discuss potential changes regarding how Step 1 is scored. InCUS came about as a result of a wave of student frustrations over the pressure from the increasing importance of this exam in …
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Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck …
I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior …
Recently, thousands of new residency and fellowship graduates have earned their wings and will be, mostly metaphorically, hanging out their shingles. Sadly, though, as the excitement of finally finishing training after decades of schooling wears off, even great work can become routine.
There is a parable about three men laying bricks. When asked what they were doing, the first man said, “Laying bricks.” The second man said, “Building a church.” And …
At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice.
If you ask a medical student what they have had to sacrifice to study medicine, the list could go on for days. It could be small things like watching their favorite teams play or being caught up on current events. But more than likely we will list …
One of the most common experiences faced by a medical student is being asked for health care advice from a friend or family member. My initial reaction to these questions is usually something along the lines of, “Are you sure you want to be asking me that? I’m not even a doctor yet!” This is especially true when the question is about something that I’m not particularly experienced in (which, …
I’ve finally stopped thinking about the process of getting into medical school. But with friends going through the application cycle, waiting on and making decisions, I’ve been reflecting on my process and remembering just how terrible the whole thing felt. To offer some support to those going through it, I wanted to confess a few things. These confessions feel silly and small in retrospect, but I hope they’ll help at least one …
It is honorable to fight a battle in the face of an inevitable ending while not knowing when that end may come.
First day of third year — the year most medical students take a sigh of relief as they put their Step 1 book on the shelf and prepare to face the wards:
I happened to draw the short straw by having my surgical rotation first, one that often brings an …
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