I’m on my family medicine rotation right now. One of my preceptors is about 80 years old and went through medical school in the 1960s. He is still sharp as a tack; he used to do C-sections, hernia repairs, appendectomies, fracture repairs and get this — emergency burr holes for subdural hematomas (a.k.a. neurosurgery). He stopped around 1997, mostly because he …
Family medicine residencies should be 7 years. Here’s why.
As part of the second-year clinical skills course, each member of my class is required to complete two 8-hour emergency department (ED) shifts. I had my first ED shift last week, and when I walked in, I introduced myself as a second-year medical student who needed to practice IV placements, EKGs, and any other procedures that happened to come my way. Three hours later, when I walked out of the …
From medical student to patient, in a matter of minutes
My department had a problem that harmed patients on at least a weekly basis. It was well-known, but it seemed there was no viable solution.
My supervising attending was in his seventies and highly regarded at my hospital, having held powerful administrative positions for decades. About ten or so years ago, he stepped down from running the hospital, and …
An attending threatens patient safety. A resident blows the whistle.
Almost every practicing doctor remembers the grueling hours and intense workload of residency. I recall overnight calls when I ran around from floor to floor, my beeper never stopping. I would collapse at home the next morning exhausted, drained and a little depressed. I would never want to relive residency, but I do look back at it with a sense of accomplishment. In some ways, it is a badge of …
Is there any benefit of duty hour reforms?
Why are we shortening medical degrees?
The four-year medical degree has been the mainstay of U.S. medical schools for more than a century, following the publication of the Flexner report in 1910. Prior to this, there was little standardization about what a medical degree could or should look like. Medical school education was subsequently standardized to two years of academic study, followed …
Shortening medical school: Is that a good idea?
I admittedly spent a good portion of the fourth year of medical school dreading internship. A year where I was expected to suddenly be a doctor and to have all the answers. A year where I would work long hours and carry several pagers at one time. I come to you in blog form to inform you of some of the …
Don’t dread internship: 5 truths from a first-year intern
She was absolutely perfect. She had ten perfect fingers and ten perfect toes. Her eyes were wide and curious and drew you in fondly. She was absolutely perfect everywhere — everywhere except for her nose and mouth. She was born in 1959 with a unilateral complete cheiloschisis and palatoschisis, more commonly known as a cleft lip and palate. Where her perfect, beautiful nose should have been was an empty, gaping …
When it comes to health care, I finally understand how beautiful banality can be
In just the past six months we, the medical community, have been challenged by questions regarding the torture report, #ICantBreathe and #WhiteCoatsForBlackLives hashtags, Ebola research and treatment, the ALS ice bucket challenge, deaths of Brittany Maynard and Joan Rivers, and the Hobby Lobby case. What these events have in common are not their scientific or molecular underpinnings, but rather their push for us to reflect on the current state of …
Ethics: The six-letter word of medical practice
I was checking my email when it happened. My boyfriend had texted me saying that he was late arriving to the airport. So I stood outside with my suitcase behind me and clicked to an email from my mother.
I didn’t notice until too late that someone had approached me, and I screamed when I saw a black man reach out to …
She screamed when her boyfriend hugged her. Why?
“So this is Christmas, and what have you done?” John Lennon sang from my nightstand, waking me out of a deep slumber.
Bleary-eyed, I pondered his question: What have I been doing all year?
A decade ago, my conversations with my younger brother, went something like this: “Do anything but medicine for God’s sake, save your soul, man!”
He’s now an emergency room doc. …
What I learned from the next generation of doctors
I recently wrote about the pressure that comes with the scrutiny of residency applications and the interview process. Adding to this, many applicants apply alongside their significant other, making use of the “couples match” option. Let’s think about that: No longer do you have to stress for yourself, but now you worry for your partner too. And while your primary …
Medical students in the couples match: One student’s story
The competition to get into medical school is fierce. The Association of American Medical Colleges just announced that this year, nearly 50,000 students applied for just over 20,000 positions at the nation’s 141 MD-granting schools — a record. But medical schools do not have a monopoly on selectivity. The average student applies to approximately 15 schools, and many are accepted by more …
How to choose a good medical school: A look behind the scenes
Background
Under the 1997 Death with Dignity Act, Oregon was the first of the now-handful of states to allow physicians to write a prescription that, when filled and administered, would cause intentional death.
Let me be clear: Death with dignity is not offered to Oregonians en masse or even on a whim. To legally qualify, a patient must be 18 years or older, a resident of Oregon, capable of making and communicating …
Death with dignity: Perspectives from a medical student
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Before starting third year, we had a week-long course that taught basic skills not learned in our first two years of medical school: suturing, knot tying, injections, note writing, etc. One critical skill they left out was how to use a fax machine and how to deal with medical record offices.
To outsiders, it probably seems pointless to learn how to operate an archaic communication tool like a fax machine in …
Learn to use a fax machine, and other medical student tips
As a graduating senior resident I’m scared to practice outpatient medicine. In a community of patients and physicians crying out for primary care doctors, what are we doing at a training level to foster and promote confidence and independence at doing this?
Many bright eyed freshly graduated medical school students enter residency understanding the need and embodying the hope of pursing outpatient …
After residency: I’m scared to practice outpatient medicine
“There was one time when I wasn’t here for seven months in a row,” ”Pam” told me.
I sat with Pam in her third floor hospital room — the floor on which she always stays when admitted to the inpatient medicine service — as nurses, doctors, and janitors poked their heads in the door to say friendly hellos and “Nice to see you again, Pam!” A dining facility staff member entered …
Hotspotting: The power of storytelling cannot be underestimated
Each year, over 20,000 U.S. students begin medical school. They routinely pay $50,000 or more per year for the privilege, and the average medical student graduates with a debt of over $170,000. That’s a lot of money. But for some who pursue careers in medicine, the financial cost has been considerably greater. Melissa Chen, 35, a final-year radiology resident at the …
$2.6 million: Is the cost of becoming a doctor worth it?
“So, is this the sickest list you’ve ever had?” the resident asked me at 2 AM, after I finally finished checking off all my boxes for the night. I nodded. I agreed.
I was also shaking.
I had been covering nine patients that night. Almost none were stable. In the span of one shift, we called three rapid responses. One person went into cardiogenic shock right in front of me was transferred to …
Sick or not sick? Handling the reality of inpatient medicine.
I recently began a rotation at the hospital as one of the night float interns. As part of this responsibility, I manage the care for approximately fifty patients each night. Day after day, I perform the same routine in preparation for the night ahead: Grab my stethoscope and pager, claim one of the code pagers, pick up a time sheet to fill in the nightly team to-do’s and mentally prepare …
How to survive a night float rotation
Since the first day of medical school, I was in breathless anticipation of my third year. I came to Harvard with a background in creative writing and the big draw of medicine for me lay in its compendium of human stories.
In college, I volunteered at local hospitals where my primary responsibility was to go knock on patients’ doors and keep them company for a little while. This was awesome. Few …
I will honor my patients by hearing them out
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