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.
In his commencement address at Sarah Lawrence College, international affairs journalist and author Fareed Zakaria defended the value of a liberal arts education. “At its essence,” explained Zakaria, “a liberal education is an education to free the mind from dogma, from controls, from constraints. It is an exercise in freedom.” His speech, I imagine, was well received and much appreciated by the over 400 graduates earning liberal arts degrees that day …
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Why premedical students need the liberal arts
As I walked home last night I glanced up at the evening sky of Dominica. Twinkling down at me was what seemed like a surprisingly bright star compared to all the rest. It couldn’t be a plane because planes very rarely fly over this Caribbean island. It seemed to be stationary so it couldn’t be a meteor. Confused, I pulled out the sky map on my iPhone and discovered it was …
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Rekindling a medical student’s passion for medicine
If you pay close attention to medical education and training, you have surely read something like this as an goal or learning objective: “Manage inflammatory bowel disease and its complications.”
However, this is not exactly what our goals should be. One push in the patient-centered care community has been changing the focus from managing the disease to managing the patient who has (or might have) the disease. The difference in wording is subtle, but it gets more …
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Medical educators: A subtle difference in wording makes a difference
We recently took our last exam as first-year medical students. Sitting in the same library that I used to as a pre-medical student, I thought about what it was, exactly, that changed this year. For me, the point of transition from pre-med to med student really happened over last Thanksgiving break.
I had come home from my first term of medical school more …
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A 4-year-old taught me the most important lesson in medical school
I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live: Ideally someplace cheap, not too far from school.
There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a …
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The night when I entered the cult of medicine
I’ve been a practicing oncologist for all of seven months, and so was surprised when my chief asked that I take part in our quality review panel. The quality review panel is an internal group that is tasked with the responsibility of looking into allegations that a patient’s care was not in keeping with best practice or what is generally considered the standard of care. Cases (often in the form …
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The importance of professional evolution in medicine
This quarter of medical school has by far been my favorite, because almost everything we do has an explicit clinical correlation. Each week we work in small groups of 10 or so students to go over patient cases, practice respiratory and cardiovascular (our two organ blocks this quarter) physical exam skills, and interface with real patients in the hospital. These experiences have been both exciting and humbling, and two in …
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A passion for family-centered care
A few months ago, we had an opportunity for one-on-one time with standardized patients (SPs): the trained actors that are well-versed in how us medical school fledglings should and shouldn’t be performing physical exams. It was a laid-back, non-graded session wherein we could ask for advice and even have the SPs walk us through exactly what we should do. So, when it came time for the abdominal exam, I asked my …
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Choosing words wisely: Can healing get lost in translation?
“Ultimately, I am convinced that in my future lies not simply a profession performed ably, but a vocation performed lovingly and devotedly.”
Soon, after the coming pomp and circumstance fade into fond memories and well-framed photographs, I will be in the hospital. Soon, I will have my own patients in the clinic. With these occasions, life will be what I hoped it once would be some years ago – being a …
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A medical school graduate’s retrospective
Recently, I began to think of death as a friend. My grandfather was hospitalized on Mother’s Day, and by the time my parents called me on Monday morning they couldn’t tell me anything more than, “He’s in the ICU with multiple seizures. They’re taking him off ventilation tomorrow.” Reaching for the knowledge I’ve spent all year chipping away at textbooks to acquire, I asked about neurologic exams, autonomic drugs and …
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A parting gift from my grandfather
I remember opening that email. The overwhelming weight of nervous emotion that collapsed into a wave of ecstasy as I read, then re-read, then read again those words: “Congratulations. You have been accepted.”
That moment marked the end of so much. The destination had been reached. The long nights of studying made worthwhile, the pre-requisites taken and survived. Trying to compile an accurate reflection of one’s life wading through resumes, CVs, …
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Reflecting on the journey to the clinical years
Whatever we learn to do, we learn by actually doing it; men come to be builders, for instance, by building, and harp players by playing the harp.
-Aristotle
I groaned. “Don’t make me operate with him again! I assisted him in surgery just last week!”
I was low man on the totem pole and there was no point arguing. All of the residents and fellows kept track of the rotation and I knew …
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A surgeon hopelessly disinterested in teaching
I argue with my father a lot. He works as an intensivist at a community hospital in Indianapolis while I am about to graduate from a highly academic internal medicine program in Chicago. Needless to say, we have very different perspectives.
He sometimes expresses views similar to those written in an article, “When I Was a Resident: How Duty Hour Rules Are Creating a Lost Generation of Physicians.” I started residency the …
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Duty-hour regulations do not define me as a doctor
He was my first patient — ever. I had seen only a few patients before at my school’s student-run clinics, but never had I conducted a full visit. He was my first patient since starting the second semester of my first year, which meant more independence on my part (theoretically), and that, for the first time, I would be holding the office visit from beginning to end. Without guidance. Of …
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My first patient: I felt humbled by his patience
When I graduated from my residency, far from my current professional home, I wanted to write a book called How Not to Get Yelled At in the Operating Room. Or How to Clear the Fear from Your OR.
I had these titles in mind because I struggled so much during my intern year. It was a tough year, full of intense patient care and sleep deprivation, but the challenge that I most wanted help …
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Reducing the stress of teaching surgical residents
I recently served as a preceptor for first year students at our Hofstra-North Shore LIJ School of Medicine who were doing one of their RIA (reflection, integration and assessment) sessions. The students do these sessions every 12 weeks, and are generally scheduled with the same preceptor over time. It may be routine for the students, but I found it absolutely remarkable.
Each student is responsible for doing a complete history and …
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Medical students today are getting richer clinical training
Change causes distress for most people. In medicine we have a hierarchy that disdains most change. Medical students, residents, attending physicians all seemingly reject change. Practicing physicians dislike change. Yet change occurs and is necessary. I learned a great deal about change from my mother. This anecdote may help put change into perspective.
Many years ago, we lived in a 3 bedroom house. In the evening we all sat in the …
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Physicians must be part of the change process
