Education

Structure case conferences as a primary way to teach and learn

Education
August 14, 2018

When we studied ward attending rounds, the thought process represented the top attribute that learners valued.  Learners can learn facts from textbooks, but using those facts requires experience and role modeling.

I have given many lectures on clinical reasoning, and I have attended many lectures on clinical reasoning.  These lectures can entertain, but one lecture does little to help our colleagues and our learners.

We must structure case conferences as a primary …

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New interns: Get ready to be fleeced

Education
August 11, 2018

This one’s for the new interns.

You’re excited, you’re about to start residency. You’re a doctor. No more short white coat. You’ve got the long white coat that you’ve been waiting for. You’ve arrived.

But actually, there’s one more thing you need before you really feel like you look like a doctor. It might be a few months. There’s going to be a long process. Someone in your program, maybe the chief …

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How to write a medical school diversity essay

Education
August 10, 2018

Now that you’ve turned in your AMCAS (phew!), you’re probably wondering how to tackle the monster of secondaries coming your way. One of the most common questions asked in one form or another is the diversity essay for medical school. Have you ever wondered why diversity is such an important component of the medical school admission process? I’ve heard a lot of pre-med students eager to write this off …

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Tips for fellowship applicants from a program administrator

Education
July 27, 2018

The season has opened, and panic has spread among senior year residents, chief residents, and hospitalists out in the community. Fellowship applications are live and being viewed by the programs applicants think they want to rank one, two, and three. These incredibly intelligent physicians are refreshing student document network daily now and soon to be hourly as the weeks go on. The anxiety is building as people are waiting to …

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Medical students: Welcome to the wards

Education
July 19, 2018

Dear third-year medical students,

Welcome to the wards.

I remember this stage — basking in the glory of completing pre-clinicals, in the excitement of finally switching heavy textbooks for living, breathing people, in the realization that medical education now lies in the hands of those I wanted to heal. I would be sleeping less, but living more, because this was my purpose.

Remember this moment because this will be the most difficult year …

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When attendings come to work rounds

Education
July 18, 2018

Learners value efficiency.  As I recall my residency, nothing caused more angst than unnecessarily long rounds.  In the 1970s just like in the 2010s, I had much to do after rounds ended.

As an attending physician, my responsibilities involve patient care and aiding learning.  I have always worked hard to do that within a time constraint.  The time constraint requires that rounds run efficiently.

Like many things in medicine, efficiency only works …

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What’s better: mentorship or sponsorship?

Education
July 11, 2018

Literature coming from business and human resource management suggests that women are over-mentored and under-sponsored. However, if you have been reading reports about women in medicine, then you likely have heard that women are both over-mentored and under-mentored. Where does the truth lie? That depends on various factors including the definitions of these terms.

What exactly do these words mean? In the business sector, mentorship is …

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Becoming a doctor is the epitome of delayed gratification

Education
June 19, 2018

Recently, I had the honor of standing by one of my childhood best friends as she promised the love of her life that she’d stand by him forever. The wedding was beautiful, and at the reception, I played with another close friend’s 3-year-old daughter and talked with other friends about their work promotions and apartment searches. All I have to contribute to these conversations are anecdotes about medical school and …

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Medical students: You are more than your grades

Education
June 15, 2018

Recently, I entered an essay contest on advice you would give to future medical students. I sincerely believe that the best person to write an article offering advice to younger medical students should come from a person who didn’t match. Also known as me. Why, you say? Well, for everyone else, Match Day is a culmination of four years of mentally, physically, and emotionally taxing work. They might even forget …

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Being idealistic is a necessary component in achieving your goals

Education
June 10, 2018

I am a first-year medical student, and just like some of you once did, the primary reason I am becoming a physician is to really make a difference for my patients by [insert x, y or z].

“Wow, that’s really great, but we’ll see how you feel about it in a few years.”

“That’s not how it works once you’re actually out there.”

“Trust me, medicine isn’t what it used to be, get …

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What you need to hear at your medical school graduation

Education
June 5, 2018

Well done! Strong work! You’ve done it!

Four years (often more) of perspiration have earned you two extra letters (often more) in your name. You should be proud. Nothing should get between you and a gigantic glass of bubbly today. The world feels different. You feel different. But are you?

The thing about ceremonies that feature costumes, protocols and rituals is that they confer upon participants a sense of change. Just look …

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It’s time to recognize the rights of medical students and residents

Education
June 1, 2018

Goodbyes were confusing during my third and fourth years of medical school. Even on my way to a 28-hour labor and delivery call, I tended to say, “I’m leaving for school.” Rather quickly, my wife trained me to say, “I’m leaving for work.” I was never quite reconciled to this, as I couldn’t forget the upcoming exams and tuition costs around $30,000 per year.

For the uninitiated, “work” as a medical …

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We are sorry, you did not match to any position

Education
May 27, 2018

When I was in fourth grade, I won our school’s spelling bee. This meant that I went on to the next tier of the local spelling world — the sort of prestigious competition that takes place in a gymnasium somewhere with a makeshift stage and a bunch of flags.

I was the first kid disqualified. I misspelled veterinarian “veterenarian” and battlement “battlemint.” I remember feeling, in the moment the announcer said, …

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How to ask for a great letter of recommendation for residency

Education
May 25, 2018

Strong letters of recommendation are essential for supporting your residency application and matching well. This article details how to ensure you get great letters of recommendation.

Knowing what constitutes a great letter of recommendation is crucial to obtaining outstanding letters. A strong letter of recommendation clearly conveys knowledge of the medical student, how that student performed and qualities that predict excellent performance in residency. Strong letters of recommendation include the following:

How to deal with devastating criticism

Education
May 24, 2018

“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!”

I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the …

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Don’t be mean: Treat your team members with respect

Education
May 23, 2018

“Those emergency room residents are f**king retarded!” This was the comment that rang through the workroom.  I had only been on this hospital service for three days, and I was having a discussion about a patient with my attending when the on-call resident had burst into the workroom and sat down next to me. He was fuming.

“Why the f*** would they think I need to be consulted for this? Only …

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Medical residents and academic due process: Know your rights

Education
May 20, 2018

I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …

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I was accidentally accepted to an Ivy League medical school at 17

Education
May 20, 2018

Want to hear a crazy story?

Typical medical school students can relate tales of a college experience that includes summer research or hours spent reviewing for the MCAT. I didn’t even take the MCAT. Read on for the oddest medical school acceptance story you’ve ever heard.

I was driven in high school. I’d heard for years about smart kids going off to the Ivy League, and I wanted that experience — to …

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How to match into a fellowship

Education
April 27, 2018

Residency training is an opportunity to get a good feeling of the specialty that interested you when thinking about what to pursue in the future. You may think that after applying for premed college, medical school and residency, applying for fellowship would be a piece of cake for you. Let me tell you: applying for fellowship is probably the hardest one among all other applications you went through so far. …

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My first objective structured clinical examination

Education
April 20, 2018

After a semester of studying and taking written exams, we had our first OSCE in medical school. An OSCE — or an objective structured clinical examination — is the real deal. Instead of filling out multiple choice boxes, we instead work with a real human being, which for me is a welcome change.

The actor is given a script with their unique condition and story — it’s a simulation of what …

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