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Most of what you learned in medical school is wrong. And that’s OK.

Education

September 10, 2019

“90 percent of what you will learn over the next four years will be wrong in a couple of decades from now.”

Speaking to a lecture hall of 120 first-year medical students, our professor’s prophecy seemed to fall on deaf ears. Looking around, I saw no concerned students, no diminishment of our collective enthusiasm. For me, however, his words of caution struck a chord on that first day of medical school.

As …

Medical schools cause burnout. Here’s how to fix that.

Augustine M. K. Cho, MD

Education

September 9, 2019

Students’ time in medical school should help them grow and become insightful, caring doctors. Instead, medical education is somehow turning smart, gifted, enthusiastic applicants into exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout.

I’m no stranger to the demands of medical school. My father and father-in-law were both …

Does the House of God stand the test of time?

David B. Nash, MD, MBA

Physician

September 9, 2019

As media coverage of the 50th anniversary of Woodstock shifted into high gear earlier this month, two articles in the “Arts and Medicine” section of JAMA called attention to another anniversary that transported me back in time.

It has been 40 years since the publication of The House of God — an unabashedly irreverent (some would say “borderline pathological”) fictionalized account of author Stephen Bergman’s …

Meet the orthopedic surgeon who became a rapper

Kamran Hamid, MD

Physician

September 9, 2019

“Jeff, turn my headphones up.”

There is a peace and tranquility to the recording booth before the beat drops. A heavy bass and drum kick in, signaling me to bark gravelly lyrics into a state-of-the-art microphone with hopes that it sounds passable. Over the past year, my rhymes have gone from clunky to less clunky, and for a few moments, they weave between melodic insightfulness and relatable humor. Embedded within these …

Why should you belong to a medical professional society?

Philip A. Masters, MD

Policy

September 8, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Because I work for a medical specialty society, I’m frequently asked by non-members why I believe they should belong to a medical professional society. This is a particularly relevant question these days given the rapidly changing landscape of medicine and with physicians becoming …

How can we address retention in the era of physician burnout?

Fred N. Pelzman, MD

Physician

September 6, 2019

As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients.

From prior authorizations, to clicking in the electronic medical record, to endless streams of regulatory requirements, to the continuous onslaught created by …

Physician coaching: the new normal?

Kristi H. Angevine, MD

Physician

September 6, 2019

What is coaching? It’s a conscious effort to notice and evaluate how our thinking impacts our experiences, how perspective shows up in the results of our life.

Coaching has been integral to fields other than medicine for many years. Yet, many physicians don’t know much about it — much less anything about its potential to radically transform the culture of medical training and our experiences in health care.

It’s time we caught …

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Physician coaching: the new normal?

The problem of overdiagnosis: What can patients do?

Christopher Johnson, MD

Conditions

September 5, 2019

An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come from it, harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything.

Overdiagnosis is the term the authors use to describe …

A thank you from doctors to nurses

Joe Bocka, MD

Physician

September 5, 2019

Earlier this year, I asked a group of nurses what gifts doctors could give that would help them know they are appreciated. There were hundreds of comments that included many I expected: Food (pizza, chocolate, cake, tacos, bourbon, Starbucks, healthy snacks), pens, cash, and/or gift cards for all shifts.

There were some interesting “high end” ideas: Massages or a massage chair. Trips. Cars. Stethoscopes.

Some still make me shake my head and …

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A thank you from doctors to nurses

Is overachieving a sign of past trauma?

Jyoti Patel, MD

Physician

September 5, 2019

Ever feel like you are always on the go, not feeling comfortable slowing down? All through school, college, medical school, residency, and then practicing medicine, the one thing that I got really good at was staying busy. Planning projects, test-taking, solving cases, treating patients, emails, meetings, joining boards, organizations, getting more certifications, a world of task lists, and checkboxes. What was often sacrificed was being a mom, wife, domestic duties, …

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Is overachieving a sign of past trauma?

Sharing mental health issues on social media

Tarena Lofton

Social media

September 4, 2019

Susanna Harris was sitting in her lab class for her graduate program at the University of North Carolina at Chapel Hill when she received an email that told her she had failed what she describes as “the most important exam in grad school,” the doctoral qualifying exam. She took the rest of the day off, went home, and baked cookies.

Harris continued with her regular schedule: lab, work, home, repeat. Everything …

Want to crush USMLE Step 1? Here are some evidence-based study tips.

David Griffin, MD

Education

September 4, 2019

Interleveling strategy

Interleveling is the process of studying/learning multiple unrelated concepts across different subjects during the same study session.
This can make studying appear difficult and more disjointed. However, research shows it yields better exam results. This is attributed to better simulation of the exam environment as questions are presented in random order, and concepts are scattered throughout the test.
A literature review rated interleveling as having …
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Want to crush USMLE Step 1? Here are some evidence-based study tips.

If a doctor has a bad day, someone dies. Remember that.

Sarah Reck, MD

Physician

September 4, 2019

For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her just as fast, the surgeons drowning in blood in their attempt to sew the new …

Explaining Peter Fonda’s lung cancer

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions

September 3, 2019

Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best Original Screenplay for that film as …

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Explaining Peter Fonda’s lung cancer

We are anesthesiologists. We got you.

Sasha K. Shillcutt, MD

Physician

September 2, 2019

I am a cardiac anesthesiologist. I want to explain what anesthesiologists do, who we are, and why it is important for the public to know.

Anesthesiologists are physicians.

Anesthesiologists are the guardians of the operating room.

Anesthesiologists are leaders.

If you get in a car accident, we are there.

If you develop an infection and can’t breathe, we are there.

If you are having a heart attack, we are there.

If you need a new knee or …

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We are anesthesiologists. We got you.

In defense of pimping in medical education

Zachary Fredman, MD

Education

September 2, 2019

The definition of pimping in the medical field is different than the colloquial usage by artists like Jay-Z, Snoop, and Kendrick Lamar. Although most people are aware of pimping in the vernacular language (which will not be discussed further, I would suggest avoiding most rappers terminology if you desire to research), the medical use of the word is a little more nuanced and opinions on the practice are split.

Pimping in …

An interview with a medical student who failed the boards

Anonymous

Education

September 2, 2019

The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way.

However, some students don’t receive the same good news. …

A nurse’s powerful ER exit letter

Jessica Nandino, RN

Policy

September 1, 2019

Dear hospital,

The last three years, I have had the pleasure of working in our state’s renowned emergency department and level-1 trauma center. My departure closes out a decade of my nursing career as an emergency room and flight nurse. This department — the staff, in particular — will forever hold a very special place in my heart. I leave with a great amount of respect and thanks for this exceptional …

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A nurse’s powerful ER exit letter

How nurse practitioners can expand abortion access

Vanessa Shields-Haas, RN

Policy

September 1, 2019

It has been a savage few months for reproductive rights, with 12 states passing 26 bills to ban abortion, including measures that ban abortion as early as six weeks into pregnancy, as well as attempting to outlaw safe methods of abortion. In the face of this extreme, unprecedented wave of attacks, several states pursued an alternative route, passing laws that expand the scope of abortion providers …

Do physicians feel guilt and embarrassment more often than they admit?

Bobak Akhavan, MD

Physician

August 31, 2019

I was an intern, doing a rotation in the coronary care unit (CCU) of a large urban hospital. It was very challenging: The patients had complex medical issues, and my fellow residents and I were given lots of responsibility for their care. Still, I felt I was finally getting the hang of residency.

One of the first patients I saw was Mrs. Smith, a middle-aged woman who had come to the …