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Words of wisdom to a residency’s graduating class

Physician

June 21, 2019

To my residency class:

The clock is ticking, its hands spinning around its face faster and faster until I feel dizzy and disoriented. The remainder of the academic year can be measured in days, even hours for some. The carousel is slowing down to let some off, some on. Some, like me, will remain in the saddles of their brightly painted ponies. The cheerful calliope melody becomes distorted with the change …

Fasting for Ramadan and being the on-call orthopedic trauma resident

Adil Shahzad Ahmed, MD

Physician

June 20, 2019

A patient groans in agony lying atop a rigid spine board, carried by paramedics into the ER, his neck in a protective collar. The paramedics shout a summary of the accident. Monitors are attached to the man, flashing and beeping the cadence of vital signs. Nurses and physicians swarm. Gloved hands comb through brown hair for bumps or lacerations. They remove his clothes, feeling for pulses in the neck and …

How is Alex Trebek doing with his pancreatic cancer treatment?

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

Conditions

June 20, 2019

In a recent People article, Jeopardy! host Alex Trebek shared some good news. Diagnosed with stage 4 pancreatic cancer in March, Trebek said he was told that he has been responding very well to his chemotherapy regimen, and that he’s in “near remission.”

He went on to say, “It’s kind of mind-boggling. … The doctors said they hadn’t seen this kind of positive …

A medical student’s reflection of “firsts”

Grant Wallenfelsz

Education

June 20, 2019

It is honorable to fight a battle in the face of an inevitable ending while not knowing when that end may come.

First day of third year — the year most medical students take a sigh of relief as they put their Step 1 book on the shelf and prepare to face the wards:

I happened to draw the short straw by having my surgical rotation first, one that often brings an …

What happens when doctors discriminate against patients?

Sheila Ramanathan, DO

Physician

June 19, 2019

Physicians have a long history of discriminating against patients, and racial discrimination only scratches the surface of current problems facing patients who seek access to care. The Tuskegee Syphilis trials demonstrated how the medical community exploited and compromised the trust of African American patients. Recent research indicates that out of a study of 222 residents and medical students, about half demonstrated false beliefs concerning biological differences between white and black …

Should we change resident duty hours?

Michael Grzeskowiak, MD

Physician

June 19, 2019

As I listened to my attending explain how during her residency training she was on call every third night, I realized how the definition of “call” had significantly changed since that time. For her, it meant her shift started at 6 a.m. and ended at 8 p.m. the next day, totaling the shift to upwards of 36 hours. My call, on the other hand, was a mere 6 a.m. to …

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Should we change resident duty hours?

Maximize locum tenens income: 4 tips to make more and work less

The LocumGuy

Physician

June 17, 2019

Every hospitalist heard that locum tenens work pays better than permanent. Of course, I did, too, when I first started practicing. This was one of the reasons why I switched to the full-time locum tenens years ago.

Now, things have changed since then, and employed hospitalist salaries have been rising steadily over the years. It became obvious, then, that $150 per hour for locum tenens work doesn’t cut it …

Career or the egg? Is it time to put pregnancy first?

Ellen Wood, DO

Physician

June 17, 2019

Whether to have a child before becoming an attending physician is a personal choice, but as a fertility specialist, I’m concerned that many people — including physicians — overestimate the effectiveness of today’s fertility treatments.

In the U.S., the average age at which women have their first child went from 21.4 years in 1970 to 26.6 in 2016. Experts attribute that in part to more people seeking advanced education and taking …

The inflammatory myopathies rap video you didn’t know you needed

Jorge Muniz, PA-C and Neil Bobenhouse

Video

June 17, 2019

Learn about the differences between polymyositis and dermatomyositis the Medcomic way.

Illustrated by Jorge Muniz and music by Neil Bobenhouse.

Image credit: Medcomic.com

The inflammatory myopathies rap video you didn’t know you needed

Working in the ER taught this doctor what evil really means

Edwin Leap, MD

Physician

June 17, 2019

If you ask people if there is evil in the world, a lot of them will smile politely at such an obviously Medieval (or Neanderthal) view of the world. Which, of course, is a bit of an insult to both groups who were from all evidence quite intelligent folks.

Some might rattle off some examples of evil. Things like intolerance, racism, sexism, homophobia, transphobia, Islamophobia, and assorted others. Disregard for the imminent …

The power of advocacy: How doctors can be empowered physicians

Amaryllis Sánchez Wohlever, MD

Policy

June 16, 2019

An excerpt from Recapturing Joy in Medicine,

During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers. I trusted their judgment and insight, so when they encouraged …

How a patient saved this physician from losing her passion for medicine

Christine M. Khandelwal, DO

Physician

June 16, 2019

I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me …

MKSAP: 63-year-old woman after right hemicolectomy for colon cancer

mksap

Conditions

June 15, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 63-year-old woman is evaluated at a follow-up appointment after undergoing right hemicolectomy for colon cancer 1 year earlier. Her paternal grandfather had colon cancer diagnosed at age 75 years. She reports that she has been feeling well and takes no medication.

All physical examination findings, including vital signs, are …

A trauma surgeon reflects on the Yale System, 20 years later

Ara Feinstein, MD, MPH

Education

June 14, 2019

The best lens for reflection is to be immersed in the places and people that spawned those memories. Why else would reunions matter? Twenty years after we graduated the Yale School of Medicine, I found myself on campus embracing my classmates again. But it didn’t take long before I felt something creeping up behind the celebratory mood. Amid storytelling and laughter, I couldn’t help reflecting on some of the more …

The ethics behind the world’s most expensive medication

Robert Pearl, MD

Meds

June 14, 2019

With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center of an intensifying debate over the rising price of medications.

Industry watchdogs are outraged. They say Zolgensma is merely the …

This physician takes the time to be humbled and amazed by the stories patients share

Zachary G. Jacobs, MD

Physician

June 13, 2019

What if I told you that, as your doctor, I’d rather listen to your memoir than to your lungs? Or that while I find the sound of a beating heart a marvel to behold, I’m more interested in hearing the jazz song that you wrote or talking about the words tattooed on your left wrist. What if …

How failing Step 1 helped me pass the boards. Twice.

Erica Howe, MD

Physician

June 13, 2019

I remember the day well. The dean of my medical school called me directly. As soon as she announced herself on the other end of the line, I knew it was bad news. Deans don’t tend to make social calls, and I was right. She was calling to tell me that I had failed the USMLE Step 1, the first in a long series of standardized national exams to complete …

OB/GYNs are getting old and tired. Who’s going to be left to deliver your children?

Christina Adams, MD

Physician

June 13, 2019

I’m a 46-year-old OB/GYN. I’ve been on call at least as often as every fourth night for my entire career.

Let that sink in for a minute.

How many people get up and answer phone calls, remove ectopic pregnancies, deliver babies, and do C-sections every fourth night for an entire career? Probably not many.

It’s 4:15 a.m. I just got a call from the hospital about a patient of mine who is term, …

My caffeine-free residency

Rebekah Fenton, MD

Physician

June 12, 2019

A kind resident or attending asks me, “I’m going for a coffee run. Can I get you anything?” I politely decline. “You sure?” “Yeah, I’m actually doing a caffeine-free residency.” A mix of utter disbelief and disgust crosses their faces, probably yours too. With skepticism, people ask: “Why?” I actually hate the taste of coffee. (That is absurd in Seattle, where I’m doing my residency training.) Whenever I try a …

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My caffeine-free residency

Speaking out about practicing medicine in Ethiopia

Dr. Yohannes Mengistu

Physician

June 11, 2019

I am a young physician practicing medicine in the “motherland” of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country.

I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite …

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