Mrs. B was washing dishes in the kitchen when she heard a thump where her twelve-month-old son was asleep. She ran to him and found her son had fallen from a chair (code: e884.2). He was crying (code: 780.92) and visibly shaken, but did not have overt signs of bleeding, bruising, or trauma. She picked him up and immediately brought him to the emergency room.
There, he was triaged by the …
Every doctor can learn from a medical coder
At a recent faculty meeting, we learned that the first year residents in anesthesia will now have to take and pass a written exam at the end of their first year. They will have a certain number of tries and if a resident can’t pass it by the third try they’re either out of the program or held back in some way.
Now, it used to be when I was a baby …
No anesthesia resident left behind
The summer before starting medical school I had the fortune of traveling to both Southeast Asia and Central America on humanitarian medical relief mission trips. I was initially exhilarated by the idea that I soon too will acquire the skills honed by the doctors, nurses, and other health care providers I was working with. The idea of mastering the science of healing had inspired me for so long, yet the …
Can the fight against healthcare disparities be won?
As part of the first-year curriculum, medical students at the David Geffen School of Medicine at UCLA are required to attend chaplain rounds at local hospitals during which they accompany chaplains to offer spiritual care to patients. This is designed to encourage students to empathize with patients who are enduring difficult end-of-life issues and is part of a ubiquitous and important theme that inundates almost every medical student across the …
The reality of medicine’s inherently unequal power dynamic
Medical education today requires students to assimilate lots of facts and amass an incredible fund of knowledge quickly. As medical science advances, more material must be mastered. Medical students must be able to organize facts and apply them to patient care. Medical care today is becoming more of a team effort. Successful physicians must be adept at both leadership roles and in the role of a team member (worker bee). …
A good business school student makes for a good medical student
A guest column by the American Medical Association, exclusive to KevinMD.com.
To close the gaps between how medical students are educated and how health care is delivered now and in the future, the American Medical Association (AMA) has awarded $11 million to 11 U.S. medical schools to fund their bold proposals that support a significant redesign of undergraduate medical education. This is just …
AMA: A significant redesign of undergraduate medical education
Dr. Sam Ko says resident work hours should be limited to 40 per week. Via Twitter, I warned him that I would rebut his assertion.
Without any data or references except a tangential one, he bases his opinion on four premises.
1. Residents will be happier and nicer to patients because they will be less stressed. There is no proof that this is so. In fact, a recent Read more…
Should medical resident training be limited to 40 hours per week?
I’m two weeks into my psychiatry clerkship, sitting quietly in the back of a crowded Alcoholics Anonymous meeting and watching a middle-aged man discuss his past struggles with alcoholism. He starts with his difficult childhood, describing his abusive father. When he was eleven years old, his parents divorced. Soon after, he resorted to alcohol as an escape from his loneliness, drinking to “fit in” and impress his friends at social gatherings. As …
Reflection after attending an Alcoholics Anonymous meeting
I’d prepared as much as I could: I had a huge coffee, a water and every kind of snack imaginable stuffed into my bag. In my head I carried as much information about dilation and curettage as I’d been able to absorb during a study session at Starbucks the night before.
I was a third-year medical student doing my obstetrics and gynecology clerkship, and I was about to spend a day …
First day at a family planning clinic
Recent research suggests that medical students lose empathy during the third (the main clinical year) of school.
Talking with end of the year third year students might make you think differently. Understanding the psychological changes that likely occur during the third year should make you think differently.
Medicine seems easy during the pre-clinical years. You get smokers to stop and prevent COPD and coronary artery disease. Patients just need to listen to …
How to stop medical students from becoming jaded
Over the last couple months, I have often been asked what I plan to do as a recent college graduate. My response has been that I will be attending medical school in Chicago.
“Oh! Medical school!” many exclaim as their eyes light up, “So you’re going to be a rich doctor.”
This response as well as most others I have received seemed to imply that medicine is an ideal profession if one …
Is medicine a choice or a calling?
During my ambulatory care rotation, I got the opportunity to tag along with my attending on a house call to a geriatric couple. The husband, “Joe,” had recently been in the hospital for severe respiratory illness. His wife, “Sally,” had recently fallen and broken her hip and was recovering from a hip replacement.
While my attending checked on Sally, he advised me to talk to Joe. We chatted a while about …
Why medical residents should do house calls
Students wishing to go to medical school — premedical students — have gone through pretty much the same process for nearly a century. The requirements have some variability according to the whims of particular medical schools, but in general a person wishing to go to medical school needs a four year collage degree, during which he or she has completed two years of chemistry (including organic chemistry), a year of …
Let’s change the way we select medical students
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Try your hand at a question from one of our anatomy exams.
What nerve supplies the obturator internus muscle (a muscle in the pelvis)?
The correct answer is the “nerve to obturator internus.” It’s like answering who is buried in Grant’s Tomb.
As a time-strapped medical student, it feels like a godsend when a medical term is named in an obvious way. Even a lay person can intuit the meaning of medical terms …
Medical nomenclature is needlessly complex
When I was a fourth-year medical student in 2002, I signed up for an intense sub-internship rotation in family medicine. My goals for this rotation were two-fold: first, I wanted to make sure that I was ready for intern year and, second, I needed a good letter of recommendation to match into a good family medicine residency program.
On this rotation, I was essentially treated like the other interns. I had …
Limiting resident work hours: Patients remain our utmost priority
I knew from the beginning that residency would be one of the biggest challenges in a career in medicine and reading Dr. Pauline Chen’s article, “The Impossible Workload for Doctors in Training,” put into mathematical terms what I had been sensing all along.
In what other profession do you go through four years of undergrad and four years of $60k/year medical school, only to end up working 100 hour weeks for …
Address the disease of residency work hours
Jennifer was one of my first patients as a new doctor, and she came to see me about an unintended pregnancy. A single mom to a rambunctious 5-year-old girl, Jennifer was struggling economically and battling depression. We talked about the options available to her: continuing the pregnancy and preparing to parent another child, offering the baby for adoption or having an abortion. She chose to continue with the pregnancy, and …
Family medicine residents need to learn reproductive healthcare
One Saturday morning at the Salt Lake City Veterans Affairs Medical Center, I got out of a call room bed and realized I had done it. The year everyone dreads, the year everyone says, “you just need to get through” was finally over. I had completed my write-ups on all the patients I admitted overnight. My emergency room consultation requests had been seen. I checked my pager for missed pages: …
One morning I woke up and I wasn’t an intern anymore
After six weeks in the accelerated bachelor of science in nursing program at the University of Rochester, I was already on clinical rotations in the hospital. I was learning clinical functions that my second-year medical school friends had no idea how to perform: catheterizations, wound dressing changes, how to calculate and administer medications. There’s just not enough time in the first two years.
On the other hand, in the nursing program, …
I am wrong to think of myself as just a nurse
If you’ve read my reviews of the new medical TV show Monday Mornings, you’ll know I’ve been critical of many things about it. I was particularly disappointed with the way the show handled one of its central themes: the morbidity and mortality (M&M) conference.
I thought it might be useful to tell you how most real M&M conferences are run. M&M conferences generally take place at hospitals with residency training …
What really happens in a morbidity and mortality conference
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