Students, residents, and educators writing on KevinMD about how physicians are made: medical school, the match, residency, duty hours, supervision, assessment, board exams and recertification, 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. For what physicians have said about board certification and maintenance of certification since 2008, see Board certification: what physicians say about the boards and MOC, in their own words.
I was a fellow physician, and my contract was recently not renewed for my three-year fellowship at the end of the first year. My experience highlights the examples that, at times, physicians are treated in a disposable manner. COVID-19 is certainly taking a toll on health care workers. So, too, are oppressive practices and unfair treatment of trainees.
The reasons my contract was not renewed concern mentorship and PPE, and I …
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Residents are not disposable. They deserve better.
Whether or not you’re a health care provider, chances are you’ve spent the year thinking, talking, and reading about health care. We’ve had national conversations about everything from the global pandemic to rising health care costs to rationing resources to the politicization of medicine.
Much less discussed—but very much affected by all of this—is the unintended consequences the pandemic has had on our medical students and residents. In March, …
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Resilience is the vaccine med students need right now. Coaching can help.
A year ago, if you had asked me if most doctors respected their patients’ wishes, I would have answered with a resounding yes. If you had asked me if medicine had divorced its paternalistic roots when physicians trampled over ideals like patient autonomy and non-malfeasance, I would have said yes. But that was last year, and in this new world of COVID, panic, hysteria, and ever-present claims of just “following …
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COVID, paternalism, and the death of patient autonomy
It’s this simple: The medical school admissions system is bloated and reinforces implicit and systemic biases leading to further social inequity.
Medical schools across the country are going through thousands of applications and making literal life-changing choices for these students. Introducing randomization into the admission process would simplify and address the built-in issues in this process.
Admissions tests do not determine the quality of a doctor’s …
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Lottery docs? Randomize medical school admissions for fairness
I came from Malaysia dreaming of completing my residency in the U.S. and becoming a nephrologist. Luckily, I interviewed for programs before COVID-19 shook the world, and I began my residency at Yale University Bridgeport Hospital in June 2020.
Having just reached my target score for the United States Medical Licensing Exam (USMLE) after graduating from UCSI University in Malaysia, I empathize with current students struggling to study for their USMLE. …
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Preparing for the USMLE despite 2020’s obstacles
When the COVID-19 pandemic came to the United States, it required drastic changes in medical education curricula across the nation, with the majority of learning opportunities transitioning to the virtual setting. As our nation enters the ninth month of this public health crisis, it is necessary to reevaluate the current system and curate the innovative strategies that have been implemented. It is essential that the next generation of physician-scientists …
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From online education to frontline medicine
For applicants seeking to match into a competitive specialty, it can be challenging. In fact, it’s not uncommon for programs to receive over 100 applications for a single residency position. To sort through that many applications, many programs use filters. One type of filter is a USMLE “cut-off” score: applicants who don’t score above a certain minimum won’t be considered further.
That’s why, for applicants with lower-than-average USMLE scores, my advice …
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3 strategies for matching into a competitive specialty, even with a lower USMLE score
It’s 8 a.m. on a Saturday morning in September of my second year of medical school. My brother, father, and I are chucking the used wood from our construction site into a U-Haul, prepping the wood for its ill fate of an indoor dumpster. Hundreds of miles away, many of my classmates are either still sleeping, enjoying the early morning LA sun, or perhaps even getting through their Anki cards …
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Rusty nails and first aid: silver linings of COVID-19
The other day I was in the main hallway outside of our radiology reading rooms, which is lined with picture frames of all the residency senior classes dating back to the 1980s. I’m new to the institution, so it was nice to see all the prior residents. I found myself wondering what they were up to now after graduating and what fellowship or jobs they landed into. As I kept …
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When your institution has a less than 1% hiring rate for Black residents
Over and over again, I find myself repeating the same words to myself as I watch the sunset over the Sacramento River on my dreary commute back from my job in clinical research: hope over fear.
It was with hope that 2020 began—a catalyst year in which we had the wind at our backs and the promise of a better future just over the horizon. 2020 promised the inevitability of change, …
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In the face of uncertainty, choose hope over fear
COVID-19 has revealed once again how short our nation is of doctors.
Early in the pandemic, several governors called on retired physicians to return to the workforce. Medical schools allowed students to graduate ahead of schedule and begin working and training in hospitals. States loosened licensing restrictions to allow physicians from other locales to practice within their borders.
These temporary measures helped battle the pandemic in the short term. But they’re not …
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We need more doctors. International medical schools can provide them.
For students studying at Caribbean medical schools, success in the residency match is a major concern. And it should be, because Caribbean medical students have unique challenges. At the same time, strategizing early in your medical school career can significantly impact your ultimate success.
Here are five rules that are critical in residency match success:
1. Yes, your exam score matters. The reality of the current day residency match is that programs …
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What Caribbean medical students need to know about the residency match
Lulu was a force of nature. She didn’t believe in expiration dates. Her version of attending church was driving her pumped-up (to manage ranch terrain) golf cart out to the pasture to watch the sunset. She always had dogs underfoot who often ate better than humans. She often would write her birthday card messages on a piece of paper inside the card and then ask me for the …
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We are human and all in this together
The Prussian pathologist, Rudolf Virchow, who gave us Virchow’s triad: hypercoagulability, endothelial injury, blood flow stasis also gave us the foundations of social medicine, claiming that “physicians are the natural attorneys of the poor” and should be equipped to solve the pressing social problems of their time. In addition, he argued that politics was indeed “medicine on a grand scale,” assertions that are all the more prescient during a global …
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Reimagining medical education from within a pandemic
First of all, congratulations on making it this far in your journey towards becoming a physician. It truly is a privilege to be in the position of a third-year medical student because unlike the previous two years, we are now able to address the needs of actual patients, and in many cases, their family members and caregivers, whether they be emotional, mental, physical, or socioeconomic.
I admit that it sounds trite …
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To the third-year medical students who feel like they aren’t learning anything
The symptoms of systemic discrimination and sweeping organizational problems are ubiquitous in the news and health care literature. Yet, medical students’ curricula focus on codes of professionalism, setting these issues, and the historical forces that created them to the side. While professionalism is undoubtedly an important aspect of being a physician, it is simply not enough to give students the background they need to recognize the historical contextualization of ethical …
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Medical ethics and medical school: a student’s perspective
Medical schools are increasingly emphasizing early clinical exposure for their medical students. While the traditional medical education format — in which the basic sciences are taught during the first two years, and clinical rotations are stressed during the latter two — are still generally followed, many schools provide their students with exposures to the hospital or clinical settings much earlier in their medical education. For example, just two months into …
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The benefits of early clinical exposure in medical education
Though many say freedom of speech has never been more prevalent with the creation of social media, moral relativism and shaming have taken a toll. Evident today, cyberbullying in the name of justice polarizes attitudes while placing some opinions as martial law and others as bigotry. This polarization of America marginalizes majorities and attempts to silence them into submission. Concurrently, it diminishes the “moral” side’s own goal to gain support …
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Polarizing medical students do not foster discussion and education
The transition from resident to doctor is overwhelming and can impact your personal life deeply, particularly within the context of your relationship. It is important to sit down and discuss with your partner or spouse and discuss your excitement and fear during this odd phase of life. Although the transition can make or break a relationship, if both you and your partner put forth the effort, you will surely be …
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Moving forward in medicine with your significant other
