When an attending doctor recently took me aside after a particularly hard clinical case with a first-year resident, she made pains to point out to me that the resident felt she wasn’t being treated fairly by nurses, because she was a woman. The physician went on to describe the difficulty of being a woman in a professional world where male colleagues are taken more seriously and treated with more respect, …
The physician-nurse hierarchy in medicine
“When people with ADHD are able to get the treatment that they need as soon as they’re diagnosed as children, it gives them the best chance to realize their full potential.” These were the words that hit me like a ton of bricks one day as my preceptor was talking about his experiences treating adult patients with ADHD. I was soaking up every bit of information as he was teaching …
My late ADHD diagnosis in med school
When the first pandemic lockdowns swept through hospitals, our hallways went silent. The absence of visitors felt practical at first, a necessary shield against viral spread. But weeks turned into months, and that silence began to echo with something deeper: distrust.
I remember walking into a patient’s room to find her eyes fixed on the door. She wasn’t waiting for the nurse. She was waiting for her daughter, the daughter she …
Why visitor bans hurt patient care
When I began PA school, I faced an unexpected financial hurdle: I no longer qualified for employer-sponsored health insurance, and although at the time, I didn’t meet the requirements for Medicaid, I did qualify for subsidized health coverage through the marketplace. However, even with subsidies, the monthly premiums and out-of-pocket costs were still a financial strain. To afford health care and cover basic living expenses, I had to continue working …
Why we need to expand Medicaid
The practice of medicine is fundamentally different from the study of medicine. Right now, you’re being rewarded for memorizing and test-taking. But being a good doctor is about communication, clinical judgment under uncertainty, and treating whole humans in context. The skills that get you through preclinical years aren’t the ones that make you excellent at the bedside. Start developing those now: learn to really listen, to tolerate ambiguity, and to …
How to succeed in your medical training
Patients once traveled on foot from Afghanistan to see my father, a Cleveland Clinic-trained doctor who practiced in Peshawar, Pakistan. It is easy to attribute such health care to a developing country. But California’s economy outperforms whole nations, and patients in the Central Valley still drive for hours to get life-saving treatment. I have lived and studied in both of these “doctor deserts,” one arid and one fertile. Both are …
The crisis of physician shortages globally
The unpaid backbone of a billion-dollar scientific publishing industry
Not long ago, I received yet another “urgent” peer review request from a major medical journal. The email hit all the familiar notes: “We value your expertise. Your contribution is essential to scholarly excellence. Please respond within 72 hours.”
I glanced at the journal’s website. Their open-access fee? $3,800. Reviewer compensation? Zero.
This is the quiet hypocrisy we’ve all come to accept: Journals charge …
Stop doing peer reviews for free
When I started medical school, I imagined long nights memorizing anatomy, shadowing physicians, and, eventually, walking hospital hallways in a white coat, trying to solve the intricate puzzles that patients carry in their bodies.
What I didn’t expect was that some of the most important lessons wouldn’t come from a professor or a textbook but from conversations about algorithms, data, and machines that learn.
Artificial intelligence felt distant at first, something for …
How AI is changing medical education
The most powerful lesson I am learning in medicine whispers against the roar of constant intervention. It is the art of “”unmedicine”: the wisdom that the best care can often mean doing less. I entered medical school envisioning a future of decisive action. Yet, my clinical experiences have painted a more complex picture. I’ve seen a physician spend a full consultation gently steering a patient away from an unnecessary MRI, …
The courage to choose restraint in medicine
Students have been sharing with me their reasons for deciding to pursue a career in internal medicine, a fitting topic for this year’s upcoming Internal Medicine Day. The most moving stories are those describing them seeing the person behind …
Celebrating internal medicine through our human connections with patients
“It is, I think, not easy to exaggerate the importance of the informal social element in the promotion of science and learning.”
– Abraham Flexner, 1930
As stated by Mr. Flexner, the importance of the informal social element of science and learning is one of the key fundamentals of the hidden curriculum, a well-understood but unspoken rule in medical education and training. The hidden curriculum consists of the unspoken or implicit …
Confronting the hidden curriculum in surgery
Ten years. That’s how long I carried around this idea I just couldn’t seem to put into action. I wanted to speak openly about this tension I felt as both an academician and an ordained minister. Yes, this false notion that my academic life and my spiritual life had to run on separate tracks. Not only did I want to openly discuss this tension; I wanted to do something about …
Why faith and academia must work together
There is an old parable about a farmer whose horse runs away.
The neighbors cry, “Such bad luck!”
The farmer only replies, “Maybe so, maybe not. We will see.”
The next day, the horse returns with two wild horses. “Such good fortune!” they cheer.
Again, the farmer answers, “Maybe so, maybe not. We will see.”
Soon after, the farmer’s son breaks his leg taming one of the horses. “Such misfortune!”
The farmer answers, “Maybe so, maybe …
What psychiatry teaches us about professionalism, loss, and becoming human
When we began medical school, we had dreams and plans for what the next four years would look like. After all, we had the privilege of being siblings on the same medical training journey. The truth we have realized over these past years is that nothing truly prepares you for how medical school will change your time, priorities, and even your sense of self. Therefore, the decisions you make (or …
A sibling’s guide to surviving medical school
In the world of global surgery, progress is a word we love to repeat. Since 2015, we have celebrated the drafting of National Surgical, Obstetric, and Anaesthesia Plans (NSOAPs), applauded World Health Assembly resolutions, and cited countless academic papers. But walk into a district hospital in a low- or middle-income country, and the patient waiting for a life-saving operation will not feel that progress. For them, the promises of global …
Global surgery needs advocates, not just evidence
If you have grown up under the realities of western medicine, you likely have general grievances about the financial cost of care, the inconvenience of scheduling and attending appointments, and the long wait times at the emergency room or to see a specialist. As a medical student and an occasional patient, the majority of my experiences have been in this philosophy of health care where everyone is entitled to quality …
A medical student’s journey to Tanzania
“Do you have a key?” my grandma asks me. I hesitate and she repeats herself, “Do you have a key to this place?” She is sitting in a hospital chair behind one of those hospital tables with a tray full of hospital food in front of her. She is practically skin and bones; her shirt and pajama pants are hanging off of her. My mom is sitting on the bed, …
The art of pretending in medicine and family
The weight of a number
Three years ago, I sat in my car during a work break, hands trembling as I opened my MCAT score report. The number stared back at me: 494. My heart sank. As a husband and father of two young girls, I had poured five months into prep courses, question banks, and late-night study sessions, all while balancing family and work. I walked out of that eight-hour …
From a 494 MCAT to medical school success
I had heard about night float: a daunting rotation for interns as they cared for patients they often were not well acquainted with, putting out fires until their usual team could take over in the morning. Given this reputation, I was surprised to find a night float week on my schedule as part of my internal medicine clerkship, a core rotation as a third-year medical student.
My first patient was a …
My first week on night float as a medical student
In medical school, we are taught how to recognize the signs of depression, how to assess for suicidal ideation, and how to document risk. We memorize screening tools, safety plans, and algorithms. But what we rarely learn, if at all, is how to hold the emotional weight of these encounters. We are not formally taught emotional literacy. Some may argue that emotional literacy can be learned informally over time, but …
Why doctors need emotional literacy training
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