I have fond memories of my first class in the anatomy laboratory. It was the Monday of my first week at medical school. I’d spent the last night pouring over my newly purchased anatomy textbooks. I wondered how I would ever appreciate the countless anatomical details of the human body. But as I stood around the benches with a body donor, everything changed. Suddenly all the organs, vessels and tissues …
Donors are a medical student’s first teacher
This May, I will graduate from medical school. I will also be part of the first group of medical students to graduate from its new Literature and Medicine track. To me and the other participants, this has been one of the most important components of our medical education. In many ways, it has kept us grounded, serving as a constant reminder that there are experiences different from our own.
We know …
What medical school fails to teach
Dear Dr. Wible,
We’ve talked before. To catch you up, I’m in my clinical years now and I keep waiting to feel the same starry-eyed excitement I felt during the first months of med school, when I thought that becoming a doctor would finally give me a tangible purpose and make me a better person by helping me do right by others in …
“I hate myself. I don’t deserve to be a doctor.”
I’ve been told that one of the hardest things that a physician endures is the passing of her first patient. However, what I imagine to be even more challenging than this is pronouncing the death to the patient’s family for the first time. Although I find myself in a similarly intimidating and burdensome position of addressing the loved ones of our gracious donors tonight, for my first time, I feel …
The hardest thing to do as a physician
Dear Me, MD:
Now that you have opened this letter, you may have graduated or maybe you just matched into residency — somewhere, anywhere, hopefully?! As you read this, it should be some time during spring 2017. But, you never know, sometimes the train derails, and it takes a little longer than expected, so forgive yourself if that is the case. You learned a while back that the fast lane is …
A letter from my med student self to me now
Most doctors are very bright people. I believe that what often sets apart those who perform well on the job and on exams isn’t raw intelligence but rather the ability to learn effectively.
In the MCAT and USMLE steps 1, 2, and 3, I did poorly and barely passed. In 2009, I took my family medicine in-training exam and fell below the minimum passing score. After taking almost five years away from residency …
How I went from the bottom to the top 1 percentile on board exams
Welcome to planet medicine, where four rides around the sun earns you a golden ticket to study more, to train more, and to enjoy splicing two sacred letters onto the end of your title. The days are long, the weeks go fast, and sleep is optional. In this world, all-star draftees leave their immaculate collegiate careers as masters of memorization and intellectual puzzle solvers only to still be no more …
“Ya mero llegamos?”
Are we almost there? These become one of the most dreaded words I have to hear every weekend, when I pick you up from the long commute that is from Sacramento to the bay area to spend time with you. Oftentimes I am just as inpatient as you my love. This has been our sacrifice these last few years, being physically away from one another. I take a deep …
We made it! An open letter to my son.
My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one.
As a neophyte in the operating room, I still relish …
Learning surgery one stitch at a time
As graduation nears, I recall an away rotation that concerns me for the future of medicine. I remember eagerly boarding my plane, ready to work hard, learn as much as possible, and explore the unknown. My first day in clinic, I was excited to befriend the student I would rotate with. After seeing our first patient together, she asked me to share my clinical reasoning for the case. I happily …
The gunner culture hurts the future of medicine
It’s 4:00 p.m. on a Thursday: time to present at teaching attending rounds. I have prepared my presentation and know about the patient’s pathology, but I can never help myself from being incredibly anxious for these moments. I gather my papers and begin:
“This is a 49-year-old undomiciled male with a past medical history significant for alcoholism, insulin dependent diabetes mellitus and chronic pancreatitis who presents with hematemesis.”
I take a breath. …
This one question changed how I thought about medicine
I was sitting on hold in the resident room gearing up to beg the IT person that would soon come on the other line for enough authorization to be able to view the residents’ patient problem list, and I found myself thinking about what some of the old docs must think of us third-year students now. Talk to some of these older physicians and they’ll tell you their stories of …
The infantilization of medical students
Like many of my peers, I started medical school with idealistic dreams of providing compassionate care for poor patients. I thought being a physician was a noble profession and even discussing money, much less changing my career choices based on it seemed antithetical to that. A visit to the financial aid office quickly cured me of my naiveté. I was facing over $300,000 in debt and would be forgoing millions of …
Why this medical student joined the National Health Service Corps
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When the U.S. health care system began, physicians were largely autonomous in selection of medical treatments and their delivery. Patients were treated under a fee for service model. However, over time we began to notice an alarming incline in medical spending which ultimately lead to the development of health maintenance organizations (HMOs). At their inception, HMOs were intended to standardize medical treatment, reduce unnecessary use of resources, and encourage the …
We should teach medical residents health policy. Here’s why.
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so.
However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” …
The little-known ACGME guideline change every resident should know
Just before the holidays, I was treating a woman with severe pneumonia. As I examined her, day after day, she told me about her family, their plans for Thanksgiving, and how much she missed her children. I liked her. I cared about her. I even used the promise of free Wi-Fi to convince her teenage daughter to come see her.
The day …
Practicing humanistic, patient-centered medicine requires doctors to stifle their humanity
Every summer medical school seniors are faced with the daunting task of completing applications for residency programs. This requires completion of the “common application” through the Electronic Residency Application Service (ERAS), among other things. This ultimately becomes a compilation of medical school and USMLE transcripts, letters of recommendation, personal and biographic information, a personal statement, and a resume composed of work, volunteering, and research experiences.
Countless hours are spent on its …
The Match is broken. Can it be fixed?
Virtually every med school hopeful writes a personal statement with some variation of “I want to help people.” Three years into medical school, helping people seems to be the last thing on any medical students’ mind. At every stage of medical training, there seems to be a competition designed to consume us. Just getting into medical school can feel like an obstacle course with barriers at every step. First-year medical …
Medical students are more than test scores
“Can you make Moana sing,” my four-year-old daughter begs as she widens her dark brown eyes. (My husband insists those are my eyes.)
Apparently, the Disney toy was involved in an accident. A button on the wrist that makes the doll loudly blurt out “See the line where the sky meets the sea!” has become separated from her plastic body. Pink wires stick out instead of forearm bones. I’m a doctor. …
This is what foreign doctors have to deal with
Spoiler alert: I am biased. I graduated from St. George’s University, a medical school in Grenada that graduates more physicians annually than any other medical school in the world. It is a school comprised of people who are so determined to become doctors that they are willing to move to a different country — some taking their families with them, some leaving everything behind — to study medicine. My peers …
5 reasons why IMGs will save U.S. health care
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