Medical Education

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.

Is it justifiable to judge a paper by its author or funding source?

Ilana Yurkiewicz

Medical Education

January 13, 2013

Doctors use different standards to judge scientific research depending on who funded it. They judge research funded by industry as less rigorous, have less confidence in the results, and are less likely to prescribe new drugs than when the funding source is either the NIH or unknown – even when the apparent quality of the research is the same.

Those were the results of a study published by Harvard …

Holding doctors accountable: The role of teaching hospitals

Ishani Ganguli, MD

Medical Education

January 7, 2013

Fourth year medical students are starting the interview process to match into a residency program – their next and potentially final stage of training.

Over the next few months, these students will rank the programs they visit based on features such as geography, research funding, and hospital affiliations. But there’s another factor to consider – one that gets little attention but that probably matters more for the kind of doctors they’ll become. …

Incremental improvement in medical education is not enough

Michael Moore

Medical Education

January 5, 2013

Going to a new medical school working its way through the accreditation process is, by design, a bit of an experiment. A school wants to establish itself as distinctive, but in the end, it seems that doing anything radical is out of the question. The drive to conform to professional standards and expectations is a good thing. It generally prevents schools from bilking students of grand amounts of money while …

Medical schools don’t care about the primary care shortage

Reflex Hammer

Medical Education

December 28, 2012

I attended a talk by the Dean of Admissions of one of the most competitive medical schools nationwide. The topic was primary care and community health. He talked at length about how not enough medical students were entering primary care. He put up some graphs showing that the most lucrative specialties tend to be the most competitive ones, with primary care among the lowest-paying and least-competitive. He said that medical …

4 bad reasons why medical students choose a specialty

Jessica Freedman, MD

Medical Education

December 27, 2012

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“I love the hours.”

“I want to be just like Dr. Smith. He has a sweet practice.”“I want to make a ton of money.”

“I want to make a ton of money.”

These are some bad reasons why medical students choose a specialty. Most medical students decide what specialty to pursue when they are in their mid to late 20s. While we all think …

The transition from resident to attending physician

Dawn Baker, MD

Medical Education

December 19, 2012

The patient had arrived for a urology procedure with a blood glucose in the 400’s. He suffered from a recent stomach bug and had gotten off schedule with administration of his meds. While his GI symptoms had subsided, he was feeling crappy overall. I decided to cancel his case and went about initiating treatment to get his blood sugar under control. When I informed the urologist of my findings and …

Medical eponyms and their connection with Nazi crimes

Ilana Yurkiewicz

Medical Education

December 17, 2012

In 1977, a group of doctors began a campaign to change the name of an inflammatory arthritis after discovering it was named after a Nazi doctor who planned and performed gruesome forced human experimentation that killed thousands. In one of these experiments, for example, Hans Conrad Julius Reiter inoculated Buchenwald concentration camp inmates with the microbe causing typhus, resulting in the deaths of over 250 people. The …

How my ER rotation turned me into a primary care doctor

Stella Safo, MD, MPH

Medical Education

December 14, 2012

It’s Saturday night at an emergency department (ED) in Boston, MA, and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke? That is exactly what I adored about emergency medicine as a …

To the health professionals during hurricane Sandy: Thank you

Jessica Gold

Medical Education

December 12, 2012

It’s 3:30 am and my clock alarm is singing some song that I used to like. I roll over to turn it off all the while thinking to myself: “I am waking up to stand for the next 12 hours straight holding a retractor. No one is going to care that I am there, and if I am even acknowledged …

When comparing teaching hospitals, context matters

Joanne Conroy, MD

Medical Education

November 24, 2012

The Dartmouth Atlas Project released a study on October 30, 2012, entitled, “What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training.” The data, and the conclusions of the report’s authors, bear closer examination.

The data set focuses on the differences in the intensity of services that Medicare patients receive, and highlights the academic medical centers rated by U.S. News and World Report as …

On the inpatient psychiatry ward, a new code governs

Shara Yurkiewicz

Medical Education

November 16, 2012

“By the way,” my chief resident told me on the first day of my inpatient psychiatry rotation, “don’t lick your lips in front of him.”

“Wait, what happens if–”

I fell silent as the patient walked into the interview room. The resident wanted to discuss his paranoid delusions; the patient wanted to discuss his discharge.

The patient wasn’t ready to leave because the medications that made the demons stay away were also making his …

Death is not supposed to be a comfortable subject

Eve Purdy

Medical Education

November 3, 2012

A palpable tension was present in our cab as we drove west. The taxi driver taking us to the retirement home of our patient filled the air with stories of the local prisons and the beauty of this area in the summer time. I am sure that I laughed at his light-hearted anecdotes but all I really could focus on was my heartbeat, its obvious crescendo as we drew kilometer …

Why medical students need to begin in the classroom

Lucy Hornstein, MD

Medical Education

October 29, 2012

My esteemed colleague Dr. Bob Centor is enamored of an interesting essay from which he quotes:”Only you can educate you—and you can’t do it by memorizing. You have to find out who you are by experience and by risk-taking, then pursue your own nature intensely. School routines are set up to discourage you from self-discovery. People who know who they are make trouble for schools.”

Personally, I found it more of …

The rewards of family practice in a rural town

Haley Adams

Medical Education

October 28, 2012

Although McAlester, Oklahoma, is a relatively small, rural town, it’s the largest town in southeastern Oklahoma. Well over 100,000 people come through for a number of goods and services, including health care. Growing up 30 minutes outside of town, I understood rural Oklahoma from a patient’s perspective, and I looked forward to seeing it from the provider’s perspective. During a summer rural externship, I spent three weeks shadowing Carol Gambrill, …

Rural medicine in India: What American health care can learn

Roheet Kakaday

Medical Education

October 27, 2012

Many premeds take time during their undergraduate careers to volunteer abroad. Popular destinations include Mexico, various Central and Southern American countries, and Africa. These are great opportunities to discover more about underserved care and, more importantly, what you are made of. I just thought I would share my reflections on volunteering abroad during college. Hopefully, you can glean something from them.

In the backcountry of India, in the state of Maharashtra, …

How to steel myself against this profession I have chosen

Shara Yurkiewicz

Medical Education

October 25, 2012

An elderly man startles awake after a man in a white coat touches his shoulder. He looks around and sees three other white-coated people standing around his bed.

“Sir? Good afternoon, sir. How are you?” says the man who touched the patient’s shoulder.

“Oh, I’m fine.” He’s perfectly calm.

“I know this is a silly question,” continues the man, “but do you know where you are right now?”

“Of course, of course. I’m at …

My feelings of superiority were replaced by a sense of kinship

Shumon Dhar

Medical Education

October 25, 2012

In the summer of my first year of college, I did an internship as a nursing attendant in a rehab hospital’s stroke unit.

As a premed student, I had little idea of what it meant to be a physician. But that didn’t stop me from feeling slightly superior to others who weren’t on the same path. Although I didn’t know how to take someone’s blood pressure, I often treated friends to …

How gross anatomy changes you forever

Anonymous

Medical Education

October 21, 2012

After a week of medical school orientation, followed by two weeks in the classroom studying cellular organelles and biochemical pathways, our class was finally going to start the centuries-old rite of passage that is human gross anatomy. For many students, it will be first time seeing a dead body. The anatomy lab is where future surgeons will make their first cut with a scalpel, without the pressure of life and …

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How gross anatomy changes you forever

Are pregnancy and residency compatible?

Linda Brodsky, MD

Medical Education

October 16, 2012

Viewpoint #1. Training programs might say: we are headed for a major league collision in the training of women physicians. Soon 50% of all trainees will be women, and in some specialties, such as OB/GYN, they will be 80-90% of the residents in any particular program. Training years coincide with prime child bearing years. Imagine if even only half the residents in a program were pregnant at once. What would happen …

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Are pregnancy and residency compatible?

5 pieces of advice nobody tells you before starting residency

Deep Ramachandran, MD

Medical Education

October 11, 2012

Since medical school, I’ve gone through an additional 6 years of training, read countless volumes of medical literature, and had the fortune of having some great teachers. Through it all, experience has been the greatest teacher, which I suppose is what training is about. I’ve watched with interest as advice has been hashed out on the web around this time of year to new trainees on all matter of subjects. …

Medical Education

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