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.
The human experience is an exercise in connection. Nothing is seen, heard, or felt in isolation. This is what can make womanhood in a large urban city so challenging. A catcall is not a single comment, heard on a single morning about the tightness of your jeans or the way your hair falls; but instead carries with it every unsolicited thing you’ve ever heard about your body, a shadow of …
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A medical student resents having to make smart choices. Here’s why.
It’s 2 a.m., and the patient’s blood pressure is beginning to rapidly decrease. Every IV line is occupied by an antibiotic or IV fluids, and we are in need of a vasoactive medication. The nurse comes to my computer and sternly states, “We can no longer avoid it. I think the patient needs a central line.” I quickly say “OK,” but I don’t move. I am momentarily frozen by my …
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Doctors are growing uncomfortable with procedures. Is training to blame?
It is the fourth year of medical school, and I have been dreaming in the language of ERAS (electronic residency application service). In less than one month, I will put my name into the sorting hat of applications as part of the match’s algorithm to interview, and hopefully I’ll be matched to a pediatric residency position.
Based on 2014 program director survey data published by the National Residency Matching Program (NRMP) …
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When applying for residency, should medical students be quantified?
In August of 2002, as a spry young adult, I stepped foot onto the University of Missouri’s campus. Eight years later, I was a double alumnus of my wonderful alma mater, and today, my heart still bleeds black and gold. Although I was happy to begin a new phase in life, Mizzou was not my first choice for college.
After graduating high school, I had spent a summer at Xavier University in …
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What academic medicine can learn from #ConcernedStudents1950
Most people who apply to a graduate school and/or graduate medical programs apply to get accepted the first time of applying. No one wants to have to apply a second time and definitely not a third time. After a second rejection, a lot of people would probably recommended someone picking another field to enter or even giving up altogether. For me, both of my rejections were taken hard and still …
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I got rejected from medical school twice. It was the best thing that happened to me.
I have the privilege of being a first-year medical student. Awkwardly learning how to perform the physical exam, repeating the same questions to collect an HPI from standardized patients, unsure of how all of my mediocre skills will translate to the precision of the physicians I attempt to emulate. I have settled into the pace of lectures, and the rush of experiencing the human body has left me as I …
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A medical student learns from the power of the bystander effect
Any Stanford student knows all too well that the immense campus, with its seemingly eternal sunshine and endless rows of palm trees, can make it difficult to want to get outside and experience the real world. When it comes to medical education, this creates a very real concern: Is it possible to experience the full diversity of our health care system when you are living in the so-called “Stanford bubble” …
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What medicine is really like isn’t seen in some medical schools
As the last line of defense in soccer, the goalkeeper holds a privileged position. She’s the one who can see the whole field unfolding in front of her, and she’s the one who must come up with big plays when the game is on the line. When I was a goalkeeper, I lived for the pressure, drama and chance to be the one to make the big plays for my …
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High quality health care shouldn’t require big saves
I did some pretty crazy things to get into medical school (don’t worry, Mom, nothing illegal). For several years before applying, I became a medicine groupie. I read books about being a doctor, watched documentaries about medicine, and shadowed physicians for hours on end so I could imagine what it might be like. I watched many a friend go off to med school and graduate … and I waited, I …
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Maybe medical school applications should come with a warning label
As a native New Yorker, I was thrilled when Governor Cuomo announced plans for an executive order that prohibits discrimination against transgender people in areas such as employment and housing. Specifically, this executive order would expand existing anti-discrimination protections to include gender identity, transgender status, and gender dysphoria. There have also been advancements regarding the protection of transgender people from discrimination in health care.
Recently, the Department of Health and Human …
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Transgender discrimination: Physicians must not lag behind
Have you ever had that experience when you think what you’re doing is futile, and that thought goes through your mind:
“Why am I doing this?”
“I’m torturing him.”
“This feels wrong.”
For those of us that are physicians, think back to your internship and residency training. I think we can all remember at least one of these situations, if not more.
I remember being in the ICU as a third-year internal medicine resident, being sent …
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We are morally scarring our future physicians
I started medical school recently. Before it started, I told myself (and everybody else) that I would feel like a kid in a candy shop when I was here. I’d get to try different specialties and figure out which one I want to do out of everything that excited me. It really is kind of like that, don’t get me wrong. But I’m also confused and disheartened.
I had a different …
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If you don’t advocate for women, I don’t trust you with patients
I wonder how I would’ve felt if Ben Carson had run for president back when I was a kid. At that age, I was wholly inspired (and terribly intimidated) by doctors. They knew everything! They were the coolest people ever! Nowadays, I’m in medical school where I’ve learned that doctors definitely learn a lot, but we’re not the coolest ever, and we are certainly not filled with innate knowledge on …
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What a Muslim medical student thinks of Dr. Ben Carson’s words
To be a third year medical student is to enter a world that few understand. The pressure of constant evaluation, the stress of doing well in the field which you want to enter, and the fear of making a mistake often haunt the very long days and night which characterize the most physically exhausting year of medical school.
Yet quite frequently as I move through this year I find myself feeling …
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A heartfelt thank you to my patients
“She has a pneumothorax. You ever placed one of these before?”
The senior resident handed me a chest tube. An intern who had been standing nearby smiled and quipped, “It’s your lucky day.”
Three weeks into my surgery rotation — my first rotation of third year — I was taking a night shift in the emergency room when paramedics wheeled Ms. P into the trauma bay, frail and bruised, hardly breathing. Oftentimes, …
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The unsettling incongruity of a medical student’s “lucky” day
Lately, there seems to be a lot of negativity surrounding the practice of medicine. From the staggering student debt, to the grueling hours as a resident, to the high rate of burn out, it sometimes feels as though this profession is constantly under attack. To be honest, I’ve threatened to quit medicine so many times over the last decade that it’s become somewhat of a family joke. I even went …
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My patients have shown me that medicine is a universally spoken language
In May 2014, I gave my Grandma Lou a call to say goodbye before heading to Guatemala for two months of research. She took the opportunity to tell me her cancer had relapsed, and she didn’t think she wanted treatment. I was so anxious the entire trip that that phone call would be my final goodbye to Grammy but she conceded to my family’s pleading to receive treatment that was …
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A rotation in Uganda provides perspective to this medical student
I have a skeleton in the closet. I really do. It is a human skeleton that I acquired when as a first-year medical student at the University of Sydney in 1981.
Back then, just about every medical student would own a half or full skeleton. They had to be real human bones as the quality of plastic models at that time were as good as useless as they often lacked many …
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Is it time to take out your skeleton in the closet?
A few weekends ago, I saw a patient with bloated shins at our school’s free clinic, and I marked in my notes that she exhibited “peripheral edema,” an esoteric phrase that means little to those outside of the medical community. That experience only highlighted the tendency in medicine to inflate common bodily functions into opaque medical jargon. Its use can be frustrating for patients who are trying to understand their …
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The core of the scientific process is how we ultimately serve our patients
“You work here?!”
I nodded, a hint of a smile revealing my bemusement at his incredulity.
“Well … probably not after this.”
The other patients in the psych waiting area of the ER nodded in agreement. In my newly issued brown scrubs, stripped of my belongings, I was no longer a research coordinator at a top hospital, but rather one of them. And sadly, they believed being one of them meant you couldn’t …
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A medical student’s psychiatric hospitalization
