A physician aces his USMLE and ABIM board exams. Here are his tips for success.

Education
February 21, 2016

In this article, I’ll discuss a medicine-specific strategy that many of my physician colleagues and I have used over the years to learn dense, complicated information quickly and effectively, and to do well on board exams.

These are the two most important tenets of studying for a medical board examination:

1. Find the highest-yield information and memorize it cold.  With active methods such as mnemonics, teaching others, lecturing “to the wall,” writing notes …

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The questionable competency of today’s medical and surgical residents

Education
February 21, 2016

What does it mean to be competent at something? Competency may be defined as the ability to do something successfully or efficiently. When it comes to determining if a physician is competent in his profession, no one, board, no organization, no government, no residency training program or hospital actually will state that an individual is competent. There are significant legal ramifications to declaring someone as competent to practice medicine, and …

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Who is responsible for OR delays? And what can we do about them?

Physician
February 17, 2016

Every two or three years, someone, usually a hospital administrator, decides that delays in operating room turnover time need to be looked into. A committee of 20 or 30 stakeholders (love that term) is appointed and assigns someone the job of measuring the time between cases and identifying reasons for delays. In years when turnover time is not being studied, first case starting delays are on the agenda.

In my nearly …

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This is what I’m wearing instead of a white coat

Physician
February 16, 2016

Hospitals are places of long-standing hierarchies where some people are made to feel important and others … not so much. A long time ago, I was told nurses used to stand when a white coat walked into a room. (Imagine that now. Laugh. Snort. Choke. Cough.) In those days, in the patient care setting, white coats were synonymous with importance.

These days, non-clinical hospital administrators, various technicians, and Clinique make-up counter …

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Dr. Mona Hanna-Attisha is a hero. Here’s why.

Physician
February 16, 2016

I have a new hero. Her name is Mona Hanna-Attisha, MD, MPH.

Dr. Hanna-Attisha is a pediatrician in Flint, Michigan. She grew up in a suburb of Detroit. She graduated from the University of Michigan before attending medical school at Michigan State University. During her clinical years (the 3rd and 4th years of medical school), she spent many months at Hurley Medical Center in Flint, which serves as a clinical training site …

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We want access to safe and effective Avastin. Here’s a solution.

Conditions
February 15, 2016

Recently, two states in India halted all use of Avastin for the treatment of eye disease following the report of 15 patients who underwent emergency surgery for potentially blinding infections at the C.H. Nagri Municipal Eye Hospital in Ahmedabad.  Though further investigations are ongoing, there is worry that the cluster of infections centered around a tainted lot of compounded Avastin. This most recent event serves as a reminder of …

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Maybe God made teenagers difficult so we can let them go

Physician
February 15, 2016

It happens each time one of my children enters the teenage years (sometimes a little bit before). I go from having a lovely child and feeling like a reasonably pleasant parent to having a moody houseguest and becoming a shrew.

You’d think, having gone through this now four times, that I’d figure out how to avoid it. Or that I’d expect it. Or not let it bother me so much. Nope. …

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The games drug companies play can dramatically raise costs for patients

Physician
February 14, 2016

I had a patient last week who was a real pain in the ass.  Wait.  No.  He was actually a really nice guy.  He wasn’t a pain in the ass; he had a real pain in the ass.  Literally.

I was initially concerned about a pilonidal cyst, given the unfortunate fact that he was previously afflicted with this condition (which I consider to be incontrovertible proof of Satan).  But, fortunately to …

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A psychiatrist shares her 5 secrets to love

Conditions
February 14, 2016

As a mother of three daughters, I frequently find myself singing along to the catchy tunes of Taylor Swift.  Singer, songwriter, and overall superstar Taylor Swift is famous for penning undeniably captivating love songs. She is popular not only because she has the voice of an angel, a cutting edge look, and a fierce attitude, but also because she is honest and real. Taylor has an uncanny ability to put …

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I left medical school for a startup. Here’s why I went back.

Education
February 13, 2016

Last May, I reflected on my path from medical school to starting a health tech company in San Francisco. In an environment which fetishizes the “dropout founder,” I always met perplexment when I said I planned on returning to medical school. Now that graduation day is around the corner, I thought I’d shed light on my choice for clinical practice and what I learned on the other side.

Medical …

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Can we truly heal another if we can’t heal ourselves?

Physician
February 12, 2016

“Liver Transplant Surgeon Addicted to Alcohol” — reads like a headline from a tabloid paper selling sensationalism.

How could it be?

How could a liver transplant surgeon, someone who sees up close and personal the devastating effects of alcohol on the body, be addicted to alcohol? Surely the diseased, fibrosed, hard, shrunken cirrhotic livers with dilated and engorged veins that can rupture and bleed catastrophically; the yellow eyes and skin of the …

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Is there any hope for physician-only anesthesia groups?

Physician
February 12, 2016

Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology.

Why would I do that?

There are many positive reasons. I believe in the teaching mission of academic medicine:  to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years …

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Vaginal marijuana for menstrual cramps. Does it really work?

Meds
February 11, 2016

Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD.

Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?

THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to …

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A quantitative analysis of the first year of internal medicine residency

Education
February 11, 2016

In a few weeks, thousands of medical students find out where they have matched for residency. I still remember the excitement and anxiety of peeling back that envelope and hoping I would see my top choice. My medical school had a tradition of putting each 4th year’s name in an old doctor’s bag. One by one, our dean would pull out a name, the student would contribute $1 to the …

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Listen to this doctor’s advice to medical students

Education
February 9, 2016

It’s been six years since I graduated from internal medicine residency. Enough time to give me some perspective, but short enough to still remember the highs and lows vividly. I recently had the opportunity to talk with a bright and energetic group of medical students. (Really, though, is there any other kind?)

The conversation turned to any advice that I had or maybe I felt obligated to give some as part …

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10 ways to become a physician entrepreneur

Physician
February 9, 2016

I find myself standing in front of six first-year medical students. They’re waiting for me to tell them something about how to become a physician entrepreneur.

These students are now elite amongst their peers. They’re the ones who’ve had the courage to sign up for my course. And, perhaps unbeknownst to themselves, they’re also among the 1 percent of early adopters to lead the way for health care change.

How do I …

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The end can be sudden in advanced cancer

Conditions
February 8, 2016

It was after shoveling winter snow that Brett began to cough. It was a dry cough, a morning cough, a “smoker’s cough.” It persisted, grew deeper. Several weeks later, there was a particularly harsh cough and in the sink was a crimson blob. Frightened, he called his doctor.

For 71 years old, Brett looked healthy. His lung exam was clear and the cough was gone. A case of bronchitis?   The chest …

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Surgery for your child is scary. This pediatric anesthesiologist is here to help.

Physician
February 8, 2016

The parental drive to protect your child is passionate, and learning that your child needs surgery is jarring at best and terrifying at worst.  As her guardian and provider, your instinct is to prevent harm to her at all costs, and even if you know that surgery is ultimately in your child’s best interest, the thought of her going through an invasive procedure, combined with the presence of illness or …

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5 simple strategies to get the residency you want

Education
February 7, 2016

All medical students start out as the best of the best: You had to be to get into medical school.  So now that you’re in, what are some of the things you can do to attain the specialty you really want? How do you set yourself apart from your peers?

1. Get out of your head. Telling yourself you can’t achieve a competitive residency is your first barrier.  If you can’t even …

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A Muslim-American doctor on the racism in our hospitals

Physician
February 7, 2016

Recently, the wife of a prominent Boston businessman — one of my many wealthy, white patients at Massachusetts General Hospital — greeted me this way: “So what foreign medical school did you go to anyway?”

For background, I’m a petite, Middle Eastern young woman with a headscarf, and I’m guessing I do not resemble her vision of what a doctor “should” look like. That image is probably taller, whiter, male and …

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