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.
I entered medical school with an intense desire to take care of others. A naturally — sometimes overbearingly — caring person with a penchant for science, becoming a physician was my dream since middle school.
My naiveté was quickly slapped by reality when I realized people enter medicine for many other reasons: prestige, job stability, income or a genius fascination of science that sometimes overlooks the suffering human. This crushed my …
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Doctors: It is never too late to step up and fulfill the true potential of your voice
Doctors are all the same: A sea of uniform “white coats without a face” caring for “patients without a face.”
They heal the sick. They save lives.
And they drive their fancy sports cars to their expensive homes and cushy lives.
Not.
I am embarrassed to admit, as a pre-med/medical school hopeful, this was my perception of physicians and patient care before completing two summer internships at a doctor’s office.
A problem that the majority …
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Doctors aren’t just white coats without a face
“I don’t teach IMGs.”
It was such a simple and concise statement. Four words. But it felt like a bullet that was heated in the depths of hell had pierced through my heart when I heard those words. My ears burned and I felt physically ill. I wondered to myself, “Am I really that bad at medicine? Am I even going to make it? Should I just quit?” I felt lesser …
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If you don’t teach IMGs, maybe you should start
As a first-year medical student, I have the privilege of observing medical practice from two perspectives: as a patient and as a student learning how to think like a doctor. I interview patients with deliberation and overthink every part of the physical exam and every detail of the patient’s history. I attempt to convey the patient’s condition, feelings, and pain as I present to my attending. I also marvel at …
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Here’s what it’s like to be a student on a health care team
Greetings from the library. I’m writing to you through caffeine jitters, wrapped in a scarf that doubles as a blanket. I’ve marked my territory with my things: several Apple products, remnants of oatmeal in a mason jar, a sketchbook exhibiting my best attempt drawing the inside of a skull, and the most-essential item: my planner, detailing all the tasks I now avoid.
I’m in the midst of my first round of …
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Pass-fail in medical school. But the stress remains.
More than 15 percent of last year’s new crop of first-year medical students completed a post-baccalaureate program. These programs exist in two flavors: one type helps students who want to improve their undergraduate academic record, and the other helps those who want to redirect their careers toward medicine, like me. Both are growing rapidly in number.
With so many future doctors launching …
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What it’s really like in a post-baccalaureate program
There’s currently an image in heavy circulation making its way around the internet of a hospital patient’s chest tattooed with the words “Do **not** resuscitate,” accompanied by what is assumed to be the man’s signature. This 70-year-old patient arrived at an emergency department unconscious with elevated blood alcohol levels. He did not have any form of identification on him, and his health care providers did not have an identifiable means …
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Going skin deep: Is a tattoo ethically binding?
I am an Olympian. I am a retired All-American student-athlete. I am a resident. I am burned out.
Let me be clear: I love medicine and the opportunity to have privileged relationships with patients and their families. I thrive on the fast-paced environment, growing to-do lists, and the chance to work in a field with endless learning. I love working in team environments to provide optimal care for patients and their …
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This physician is burned out. But not for the reason you think.
The familiarity that health care professionals develop with complex medical procedures and topics is the result of years upon years of hard work, and over time we become accustomed to the jargon. We use phrases like “lap chole” and “appy” without much thought when talking to each other and (if we have a momentary lapse) with patients. We take the fantastic array of medical specialties, procedures, and knowledge in our …
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It’s important to give patients an idea of what to expect
‘Tis the season.
Thanksgiving? Sure. Christmas? That too. But for thousands of fourth-year medical students and foreign medical graduates all over the United States, fall through early winter is a time of job hunting — interviewing for residencies. This is a critical step in our training, where we specialize in the individual fields of medicine that will carry …
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The residency hunt is no small task: Here’s some advice for medical students
My alarm went off at 4:15 a.m. I lay in bed dreading the day ahead of me. By 4:50 a.m., I arrive at the nursing home where I was doing a geriatric rotation. A stack of charts and a patient complaint list was awaiting me. On the list were the usual suspects: a follow up for lab results, a fall, abdominal pain. And at the bottom was a note on …
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Why aren’t doctors allowed to grieve?
For the month of September, I embarked on the experience of a lifetime, living and working on the largest Native American reservation in the United States. Sprawled across the four corners region of Utah, Arizona, New Mexico and Colorado, the Navajo Reservation in Chinle, Arizona, encompasses an area as large as the entire state of West Virginia. Its population, however, is only about 300,000, making it extremely rural. To leave …
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An eye-opening rotation at the Indian Health Service
Medical residents take on a variety of responsibilities. Some are clear, upfront, and obvious: the responsibilities they have been training for since entering medical school. Coming up with a treatment plan and carrying it out is first and foremost their raison d’etre, and they put an enormous amount of effort into it. However, they also acquire a host of other duties. They run interference for attendings. They coordinate with nursing. …
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Teaching residents to teach will improve medical education
I was born in Shanghai, China. In September 2000, my parents and I left behind our family and friends, a language and culture dear to our hearts and social and financial stability to immigrate to the United States. I was six at the time. Although I don’t claim to have fully understood the weight of their decision to start a new life, I knew that my parents were making a …
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How being an immigrant shaped the way I treat patients
I distinctly remember the excitement I felt during my first year of medical school when exposed to the breadth of general and specialty fields that seemed all so equally rewarding and medically influential. I envisioned myself holistically understanding my patient, seeing the problem in the context of her other medical issues, her personality, her family and her environment — an approach I considered at the heart of the oath we …
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How to inspire medical students to pursue primary care
Four o’clock on a Friday afternoon is an anxiety-inducing time to be running behind in clinic as patients and staff both begin to show signs of wanting to leave. After finishing with a particularly complicated case involving chronic pain with multiple spinal and abdominal surgeries, I rushed into the room of the patient scheduled for 3 p.m. frazzled. The patient was an elderly man, seated with arms folded, looking sternly …
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We must ask patients obvious questions
In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors — particularly young doctors in their residency programs — do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ …
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The hidden threat of the 80-hour resident workweek
“I know you think your organization is patient-centered … but it really isn’t.”
The statement from a rare disease foundation president to a room full of industry partners stung as we observed a candid but cordial exchange about what “patient-centered” has come to mean in today’s health industry world. Everyone knew what they were hearing was right.
Rewind a few days to the CBI Independent Medical Education and Grants Breakthrough Summit, where …
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Medical education must be patient-centered
Politics are divisive. That should not be a shock to anyone. However, the political climate in the USA at the moment is more than just divisive. Lately, I have noticed that there is an underlying disdain for those we disagree with in a way that even my grandparents say they have never seen in this country. The current political climate pervades nearly every aspect of our society, from pop culture …
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Today’s divisive political climate and our ability to treat our patients without bias
In 1968, Rosenthal and Jacobsen introduced the concept that expectations in the classroom can positively or negatively affect students. This phenomenon was dubbed, “The Pygmalion Effect.” Since then, there has been controversy surrounding the topic. Other authors have argued that the data was insignificant or inconclusive. From my own personal experience, having been in school for over ten years, I believe that the concept carries validity. Furthermore, I believe that …
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Attending physicians should not pass down their impressions of trainees
