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.
This mantra was accompanied by flushed faces, hidden trembling hands, and nervous chuckles as the majority of my peers told the class why they decided to pursue physical therapy as a career. Soon thereafter, this adage was lost as we dived into our studies, learning every bone, muscle, and organ. Focusing on the human body is a must for all healthcare professionals, and PTs …
We like to say good things; we try to make normative to our profession to do the things that should be done. Many of us are saying that physicians should be advocates for their patients and communities outside of the clinic.
Sounds good right? Unfortunately, what sounds good is not always a reality on the ground. I think most physicians agree that …
Watching my first below-the-knee amputation on my surgery rotation, I felt a curious mix of revulsion and detachment. The woman on the operating table had a gangrenous infection that had spread across her foot. Her long history of smoking and her delay in seeking medical care meant that she had stiff, black toes by the time a surgeon first saw her. The only treatment was amputation.
Mrs. C was used to my quiet knock every morning at 6 a.m. She smiled as I turned on the overhead lights, but began to grimace when she realized that today was dressing-change day. The rustling packages of bandages in my overstuffed coat pockets had given it away. Mrs. C had stage four metastatic endometrial cancer; a malignancy of her uterus that was not responding well to chemotherapy and had …
Training doctors is no easy task. After medical school, newly minted doctors enroll in residency programs at various hospitals throughout the country for a length of 3 to 8 years, depending on their specialty. Some specialties, like family medicine, are even considering adding another year to the process. Resident physicians spend this time working long, arduous hours under their attending physicians, learning the clinical intricacies of their specialties that could not …
Students undergo a conversion in the third year of medical school: not “pre-clinical” to “clinical,” but “pre-cynical” to “cynical.”
— Abraham Verghese, MD
The scalpel hovered over the swollen, red and inflamed mass peeking through the opening in the sterile drapes. The patient lay on her side facing away from us, clutching the stiff emergency room pillow against her face and moaning as she rocked back-and-forth. Whenever the surgeon manipulated the mass, …
Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.
– Susan Sontag, Illness as a Metaphor
I have spent many blog hours bemoaning the inadequate communication going on in hospitals today. Thanks to authors of a new study published in the New England Journal of Medicine, I have more objective data for my ranting. A prospective intervention study conducted at 9 academic children’s hospitals (and involving 10,740 patients over 18 months) revealed that requiring resident physicians to adopt a formal handoff process at shift change resulted in a 30 percent …
Pamela sits on the examining-room stool, looking at me expectantly.
I am in my first year of medical school. I do as I’ve been told to do in medical skills class: I observe my patient — without judgment or assumptions — and try to figure out what questions to ask, based on the information I am given.
Pamela has curly, strawberry-blonde hair and looks to be thirty, just a few years older …
Life is full of choices and each choice has the potential to open certain doors and close others. I choose medicine. It is a demanding career, but even as a 7th grader, I knew what I was signing up for.
What I didn’t know was how much this profession could influence the trajectory of my personal life and the types of relationships I’m able to maintain. I grew up genuinely thinking …
Like most second-year medical students, I have the MP3 files of Goljan’s high yield pathology review lectures on my phone. Unlike most medical students, I rarely bring myself to listen to them, always opting for their Motown or punk counterparts instead. I often feel guilty about this — listening to them would make for more efficient car rides and walks home — …
Ironically, we had just finished our endocrine unit when I noticed a lump in my neck. Perhaps school had made me more vigilant, or perhaps I merely fell into the realm of hypochondriac medical student, but I couldn’t ignore this lump.
I set up an appointment with my doctor fully expecting a diagnosis of medical student neuroticism. Instead she agreed that it was …
Recently, Dr. Peter Kramer published an intriguing, well-written, but poorly reasoned and potentially dangerous “thought piece” in the New York Times. His article, “Why Doctors Need Stories,” contains several logical flaws and erroneous arguments, but the overarching concept is a classic straw man argument.
He creates a false and highly misleading notion of what …
In September, Doximity, a closed online community of over 300,000 physicians, released its ratings of residency programs in nearly every specialty. Many, including me, took issue with the methodology. Emergency medicine societies met with Doximity’s co-founder over the issue and echoed some of the comments I had made about the lack of objectivity and emphasis on reputation.
I wonder if it is even possible to develop a set of valid …
One of the hardest parts about medical school for me has been the constant pursuit of approval. Having a pass/fail system during pre-clinical years helped ease things some, but there remains a personal desire to prove myself. In front of attendings, all I can focus on is performing my physical exam just right, presenting in the perfect manner, and nailing the assessment and plan. Unfortunately, my strong desire to look …
I don’t talk about it much, and that’s on purpose. Here’s why: My life is wonderful. I really love it. Is it perfect? No. Is anyone’s life perfect? Definitely not. I would never wish to portray my life in a negative fashion and certainly not to wish for sympathy. I would talk about it in an informative way, but even …
If I had to choose one theme that has stood out in the first weeks of medical school, it would be this: questions, questions, and more questions. In the first class on our first day of medical school, our professor set the tone by laying down the requirement that we ask a minimum of ten questions before the lecture was over. Based on my experience in large undergraduate lectures, where …
Medical students are brilliantly frugal. And it’s no surprise — according to the AAMC, the average U.S. medical student incurs $170,000 of debt from medical education. We are a resourceful, smart, and cost-conscious group — so why is the medical school curriculum practically silent on the cost of medicine?
During medical school, we are taught to be excellent diagnosticians. The third and fourth years of training provide 60 to 80 hours a week of …
As of October 2013, the average medical student graduated with $169,901 of debt with nearly 80 percent of all graduates owing at least $100,000. Although these numbers are daunting, medical school educational debt is part and parcel of our profession. Truth be told, at the end of our training (which can range from three to ten years post-medical school), almost all of us will make at least $150,000 and likely be …
The present time has one advantage over every other – it is our own.
– Charles Caleb Colton
The cherubic young man smiles from the black-and-white class photo. His open, relaxed appearance captures my attention. He sits on a wooden bench at the far right end of the front row, his sharp white shirt and patterned tie cinched tightly beneath his three-piece wool suit with the stylishly wide lapels. He looks directly at the camera …
