The greatest good you can do for another is not just to share your riches but to reveal to him his own.
– Benjamin Disraeli
In 2009, when I was president-designate of the American College of Chest Physicians, a prominent physician, educator and outstanding mentor, who had recently died was honored by her colleagues. One of her junior colleagues, who had never met …
Medical societies’ role in improving leadership in medicine
What does a modern internal medicine intern do all day (and night)? It turns out they spend 40% of their time at work using a computer, another 20% on other aspects of patient care that is not in the presence of the patient, 15% in educational activities, 5% on basic needs like walking around and eating, and only 12% in direct patient care. Direct patient care includes interviewing patients, examining …
What does a modern medicine intern do all day?
Three-year program residents graduating in June 2013 like me represented a unique cohort in medicine. As interns we experienced the 2003 ACGME duty-hour restrictions and the 2011 ACGME changes as residents. For example, I took thirty-hour call with a resident my intern year and ended residency with a dizzying iteration of a mixed call/shift system composed of multiple handoffs, residents, and interns. But this story is a call to more …
Redesigning residency training: The evidence is lacking
Flowers and bees.
By no means is that very telling of my current life. On the contrary, I get glimpses of different times of the day when I go into patients’ rooms and look out the window or if by chance the anesthesiologist decides to open the curtains in the OR (yes, this hospital has windows in its ORs!).
So this topic of flowers and bees is very random. But it just …
For medical students, learning to keep their emotions aside
Undoubtedly, those pursuing a career in academic medicine have a tough time line. In most medical schools, somewhere between the 7th and 10th year, depending on whether the academic clock was stopped for pregnancy, the fate of the academic physician is decided. During these years when women have the biologic clock ticking, they also have the “up or out” academic clock ticking.
This rush to create academic contributors is pure insanity, …
Women physicians in academia: The academic versus the biological clock
We had our first human dissection recently. We gloved up, scrubbed up, and wielded a scalpel – the key to opening the secrets hidden below our skin.
Our donor, an older gentleman who died of cancer and gave his body to the advancement of medical education, lay on his back. He was abnormally frigid and unnaturally rigid – cold and stiff to the touch. His face remained shrouded with a white …
Dissection is as much exploration as it is self-evaluation
Now in my final year of residency in pediatrics, there will be a lot of “lasts.” Since the time we are kids, we often remember our different “lasts,” especially when it comes to school.
During the back-to-school rush at our primary care clinic, I had the opportunity to talk with several rising senior high school students who will be starting their “last first-day of high school” this week. I vividly remember …
Reflecting on the final year of pediatrics residency
In July 2011, I made the decision to defer matriculation to medical school for a year. While I was hoping to relax in Philadelphia before entering a lifelong journey in medical training, what I got instead was one of the most emotionally tiring and challenging years of my life.
3 months after I decided to defer medical school, my aunt was diagnosed with acute myeloid leukemia. She was immediately hospitalized and …
Why are there so few women physician leaders?
I am a fourth year medical student that attends an institution that does not have a department of family medicine.
Currently there are only 10 such allopathic institutions in the country. When I tell colleagues and friends that I intend to enter family medicine they say, “oh primary care?” While yes, it is true that family physicians obviously practice primary care, I am disheartened that my colleagues do not know or …
I am an orphan: A medical school without a family medicine department
An attending once told me, “You can’t please ‘em all.” And it’s true. Sometimes in medicine, you just have to keep your head up and remember the bigger picture of why you are in this field.
A few months ago I did my internal medicine sub-I, which is a rotation medical students take in their fourth year when they are expected to perform on the same level as an intern. I’ve …
You have to develop thick skin in medicine
A few months ago I read an essay by Dr. Herbert Fred of Houston, Texas. After reading his essay, “Medical Education on the Brink,” I was inspired to start a revolution in surgical education.
His essay ends with the following recommendation:
“…raise the bar of performance in all training programs to a distinctly higher level, with excellence as the perpetual goal.”
As the Fourth of July approached, I began to …
We need to start a revolution in surgical education
The presence of strong, independent women has been a constant throughout my life. Friends, teachers, mentors, aunts, cousins, and grandmothers have all helped shape my firm belief that gender need not be a hindrance and can indeed become a source of pride. Yet the most influential and compelling woman will always be my mom, and for me, no story of admirable females can go without mention of her.
On a rainy …
A medical student’s lesson in cultural understanding
Edward arrived at the hospital following a stroke; a standard work-up failed to reveal an obvious cause. His physician explained that a previously diagnosed patent foramen ovale (PFO), a hole in between the chambers of his heart, may have led to his stroke. He presented three possible treatment options to Edward: (1) medical management with drugs; (2) open surgery to correct the defect; or (3) interventional catheterization to correct the …
Teaching medical students to provide high value care
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As we enter the fall, we welcome a new class of bright-eyed medical students. To such students, you are about to embark on a life-transforming journey. My first year on the said journey has been full of highs and lows. There was the morning I woke up before 6 and got upset with myself for sleeping in. There was the day I received my first exam score and realized I …
Get the most out of your first year of medical school
In early December 2012, I experienced two life-altering events. First, on December 5, Sadie, my first grandchild, was born. Second, on December 8, I suffered a myocardial infarction. All things considered, I was extremely fortunate. Because I received outstanding care almost immediately, I survived the heart attack. But that night, as I lay in bed in the coronary care unit after undergoing an angioplasty and the placement of a drug-eluting …
Many physicians view retirement as a kind of failure
I remember when we dragged ourselves to the large lecture hall every morning, backpacks slung over our shoulders and cups of coffee in our hands. Six to eight hours of lectures awaited us.
I remember where we all sat in that lecture hall. I remember the future ophthalmologist who sat behind me and made snarky comments while certain professors gave their lectures facing the chalkboard. I remember students sitting six rows …
My classmates now look mature, which means I must look that way too
One of the things I enjoy as an academic oncologist is the opportunity to teach. I like having students, residents, and fellows in my clinic and the opportunity for them to see what oncology is and what we do; how we “marry” the art and science of medicine in our routine care of patients with cancer.
For several years, I’ve co-directed an …
Inspiring a new generation of oncologists
A concept that has been percolating in the medical literature boiled over into the mainstream as the New York Times published this story, “Chicago’s Intern ‘Boot Camp’ is a rehearsal for life or death medical issues.”
The article describes a new internal medicine intern having to deal with a simulated patient who is critically ill and has alarms going off.
Another intern had to tell a “patient” played by an actor …
Should intern boot camps be mandatory after medical school?
You may not remember me, but when I asked how you were, you said, “alive.”
A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone who was grateful for life the way you expressed to me that day.
You may not remember …
You may not remember me, but you changed me
“I don’t want a tube down my nose. I’ve been through it before and I don’t want it again.” Charlie turned his head away from the team and crossed his arms in defiance. “I’d rather be sick.”
I looked at the intern, who looked at the resident, who just said, “Well, think about it. We’ll be back in the afternoon.”
“I’m also hungry and haven’t eaten in days,” Charlie added.
“Maybe some food …
Each patient is still human and deserves to be treated as such
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