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…
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 …
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…
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 …
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…
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 …
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…
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 …
“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…
“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 …
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…
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 …
“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…
“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 …
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…
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 …
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…
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 …
“To help other people overcome their injuries.” 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…
“To help other people overcome their injuries.”
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…
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…
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…
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…
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…
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,…
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…
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…
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.…
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…
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 — …
