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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 …

Is medicine really a model family-friendly profession?

Kristina Fiore

Policy

August 30, 2019

An article in the New York Times touting medicine as a family-friendly profession has stirred up critics who say it denies the reality of career sacrifice and gaps in leadership and pay that female physicians face.

Writer Claire Cain Miller profiled female doctors whose specialties afford them flexible work hours that make it easier to balance their professional and caregiving responsibilities. Britni …

Should hospital systems post physician salaries?

Smart Money, MD

Finance

August 30, 2019

One of my coworkers who grew up in India told me that their teachers in grade school would post everyone’s scores in the hallway after every exam. This comparison of grades and objective testing further extended to cities and even regions in the country. There are people going through the hierarchical ranks with “gold medals” in science or engineering. Throughout this process, it was relatively transparent who the smartest or …

Will separating obstetrics from gynecology help specialist burnout?

Robert Pearl, MD

Physician

August 30, 2019

At the end of a long table covered with hors d’oeuvres and a birthday cake, I struck up a conversation with three primary care physicians.

I was hungry for their opinions.

Inside the crowded apartment, we spoke for some 20 minutes about the systemic and cultural causes of burnout in primary care—a conversation that informed the first article in this series.

As I was about to leave, I …

The sensitive topic of physical contact during exams

Hans Duvefelt, MD

Physician

August 29, 2019

Touch is a sensitive thing. No pun is intended here, but whether and how we touch our patients deserves our careful thought and deliberation.

So much interpersonal contact these days is virtual, with emojis, abbreviations and whole words thrown around as substitutes for human contact. Think XOXO and, “hugs and kisses.” And when people do touch in our health care environment, it is often with gloves, even for simple fingerstick blood …

Just because EMRs can document everything doesn’t mean they should

Fred N. Pelzman, MD

Tech

August 29, 2019

It’s always kind of a surprise when you read a patient’s chart, and you see an examination of a body part they just don’t have.

Just the other day, I was reading a consult note on a patient of mine who had been seen by a subspecialist for evaluation of a serious issue, and I received back a long detailed office …

The story of a hospital collapse and how small towns were devastated

Barbara Feder Ostrov and Lauren Weber

Policy

August 28, 2019

The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family, and business partners.

It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring …

A surprise pregnancy in medical school

Christine Loftis

Education

August 28, 2019

“You’re 27-and-a-half weeks pregnant.”

As I lay on the exam table, time froze.

How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?

I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a 27-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they’d been …

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A surprise pregnancy in medical school

The decision to undergo robotic surgery is a more than just about the length of the scar

Anonymous

Conditions

August 27, 2019

Over the last three decades, surgery has slowly but steadily evolved towards a minimally invasive technique. The standard of care for appendicitis now involves creating three half-inch incisions and using a laparoscopic technique to remove the appendix. This technique uses a camera to see inside the body via a large screen. Instruments that are over a foot long are used. Sufficient research has shown that this minimally invasive technique leads …

What role does the science of complexity play in medicine?

Robert Trent

Conditions

August 27, 2019

The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. These systems (animals, plants, ecosystems, etc.) are the most productive and functionally effective systems known to man.

Unfortunately, our …

Considering CBD oil? This psychiatrist suggests these questions to ask first.

Greg Smith, MD

Meds

August 26, 2019

One question I get asked a lot lately is this: “Is it OK for me to use CBD oil?”

First of all, CBD oil and associated preparations are types of alternative medications, medicines that might not be mainstream or readily prescribed by doctors, but are nevertheless used by many people on their own. Alcohol and marijuana are two substances that are often used as “medicines” by those that think they function …

Should physicians yearn for the nostalgic ideals of their predecessors?

Ioana Baiu, MD

Physician

August 26, 2019

What has the medical community, once thought of as the “ultimate team,” finally come down to in 2019? The “back in my day” sigh I often hear from more senior physicians has inspired me to read several books about the history of medicine. As I devoured them from cover to cover, the excitement of medical discovery, the anticipation of the near-miracles that were about to be revealed, and most importantly, …

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