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Should USMLE Step 1 be pass-fail?

Ryan Okonski

Education

August 14, 2019

On March 11th and 12th, representatives from the NBME, AMA, AAMC, Federation of State Medical Boards and the Educational Commission for Foreign Medical Graduates gathered in Philadelphia for InCUS — the Invitational Conference on USMLE Scoring — to discuss potential changes regarding how Step 1 is scored. InCUS came about as a result of a wave of student frustrations over the pressure from the increasing importance of this exam in …

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Should USMLE Step 1 be pass-fail?

The questions surgeons need to ask their seniors before surgery

Judith Graham

Conditions

August 13, 2019

The decision seemed straightforward. Bob McHenry’s heart was failing, and doctors recommended two high-risk surgeries to restore blood flow. Without the procedures, McHenry, 82, would die.

The surgeon at a Boston teaching hospital ticked off the possible complications. Karen McHenry, the patient’s daughter, remembers feeling there was no choice but to say “go ahead.”

It’s a scene she’s replayed in her mind hundreds of times since, with regret.

On the operating table, Bob …

How to save money when moving for residency

Arun Ganti, MD

Finance

August 13, 2019

Here are some specific ways for medical trainees to save on their move.

Timing is everything

When is the exact timing of your move? Are you flexible? Think about your situation: you graduate medical school, pack up, and then move for residency. Right?

Most moving companies are busiest (read: most expensive) between May and September when they know you are likely to move. With Match Day in mid-to-late March, getting an early start …

The doctor trap: What it is and how to escape it

Mark Leeds, DO

Physician

August 12, 2019

There is a trap used to capture monkeys that uses a tree with a hollowed-out trunk. The opening is just large enough for the monkey to put its hand inside. While the monkey can easily pull its empty hand out at any time, inside the hole is a larger space containing delicious nuts that the monkey craves. When the monkey grabs a large handful of nuts, it is unable to …

Becoming a doctor in India can be life-threatening

Dr. Saurabh Jha

Education

August 12, 2019

Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck …

Doctors: Step boldly into your calling

Stephanie Wellington, MD

Physician

August 12, 2019

We often associate our calling with our career. That’s what I did from the very moment I decided to become a doctor. That’s all I focused on. I studied for it. I invested time and money into it. Like many doctors, my identity was intimately woven into what it means to be a doctor. It’s who I became to the exclusion of everything else.

From the outside looking in, I was …

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Doctors: Step boldly into your calling

Stop nickel and diming doctors

Fred N. Pelzman, MD

Physician

August 11, 2019

So, who doesn’t want a better health care system?

We are barraged with stories in the medical literature and in the public press about the terrible state of our health care system, what poor outcomes we have, the inefficiencies in care, complaints about the electronic medical record, inflated costs, lives ruined by medical bankruptcy, and massive social inequities in terms of access …

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Stop nickel and diming doctors

What are patients’ responsibilities for their health?

Anonymous

Conditions

August 11, 2019

I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process.

My experiences as a patient have made me understand how difficult it can be to maintain a sense of responsibility. I often yearn for clarity and a “gameplan,” but instead find myself confronted with medical guideline gray areas and conflicting treatment …

A doctor survived a day without a computer. Here’s how he did it.

Hans Duvefelt, MD

Physician

August 9, 2019

It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no internet.

For my part, the day went pretty smoothly, mostly because of some of my own work habits. It also helped that it was a warm, sunny day, and my schedule was on the light side. Others have frowned at my old-fashioned work habits, …

Why doctors make bad patients

Rada Jones, MD

Physician

August 8, 2019

I’m a doctor. And, like most medical professionals, I’m a bad patient.

Two years after my last appointment, I got a CTJ, “Come to Jesus” from my doctor.

I called his office for a form. I needed proof that I don’t have tertiary syphilis. For my Thai visa.

Why tertiary syphilis, as opposed to HIV, cholera, lepers or bubonic plague? I don’t know. That’s the power of bureaucracies. They don’t have to make sense. …

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Why doctors make bad patients

Elon Musk’s girlfriend had eye surgery for depression. Is there science behind that?

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

Conditions

August 7, 2019

Claire Elise Boucher, 31, known professionally as Grimes, is a Canadian singer, songwriter, record producer, and visual artist. Her music incorporates elements of varied styles, including dream pop, R&B, electronic music, and hip hop. Since 2018, Boucher has been in a relationship with technology entrepreneur Elon Musk.

Grimes recently became the star of a new Adidas advertising campaign. In announcing this new …

Pro tips for residency or fellowship relocation

Arun Ganti, MD

Finance

August 7, 2019

Each spring, thousands of students and residents will relocate for their next career stages facing the same question: How am I supposed to move my stuff? The answer is varied and can be surprisingly complex.

Relocation is part of any industry, but medical trainees, in particular, relocate during a narrow time frame often without any employer reimbursement.

How does your move fit in with other major life events such as a wedding …

How to make $5 million from investing in real estate

Passive Income, MD

Finance

August 6, 2019

When I first started working on this blog post, the working title was “Different Ways to Make $1 Million in Real Estate.”

However, I realized that if you’re reading this, you’re likely looking for a similar type of life that I’m interested in: a life of financial freedom where I’m also able to make huge contributions to society as well.

Unfortunately, $1 million may not be enough these days to make that …

White coats should no longer be worn by physicians

Frederick Gandolfo, MD

Physician

August 6, 2019

Did you know that the traditional doctor’s white coat that you probably associate with your physician actually was a look that doctors “borrowed” from another profession? Back in the early days of doctoring, to add some perceived legitimacy to the title physician, the white coat look was adopted from our colleagues in the hard sciences who did actual experiments in the lab. If you recall, what we doctors call a “white …

Who are the best educators for medical students?

Kunal Shetty

Education

August 6, 2019

I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior …

The importance of patient education before surgery

Steven Young, MD and Joseph Answine, MD

Conditions

August 6, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

For years, research and common belief have supported the concept that patient education alters patient behavior and improves patient outcomes. For instance, lifestyle changes, implemented after improved physician-patient engagement and education, have demonstrated clinical benefits in a wide range of chronic illnesses, …

How to prevent patients from falling through the cracks

Fred N. Pelzman, MD

Physician

August 5, 2019

Falling through the cracks, when it comes to health care, is a bad thing, but the way things are going, it’s getting harder and harder to avoid.

Providers in every setting are bombarded on all sides with data, results, messages, and things crying out — screaming — for our attention. Take, for instance, the conundrum that appears when a patient is …

UpToDate? Information my cardiologists didn’t have.

Anonymous

Conditions

August 4, 2019

I have always felt lucky and relieved when a cardiologist told me I seemed to be fine despite my heart condition. My condition, referred to as congenital, complete AV block, is estimated to affect between 1 in 15,000 to 22,000 live-born infants. The electrical block is more commonly seen among older, adult patients where it presents an acute pacemaker indication.

Researchers do not know very much about what causes the condition …

A critical discussion is needed about planned death

Tom Schaaf, MD and Hope Wechkin, MD

Conditions

August 4, 2019

“Planned death.”

When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.

When necessary, we prognosticate. But …

Physicians need better PR

Rebekah Bernard, MD

Physician

August 3, 2019

On July 8, 2019, the American Academy of Emergency Medicine wrote a letter to the American Medical Association, asking the organization to create a public campaign to support physician-led care.

Noting concerns over the recent media crusade to promote nurse practitioner care to patients, including the American Association of Nurse Practitioners “We Choose NPs” campaign, the letter asks the American Medical Association to combat the …

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Physicians need better PR

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