An excerpt from The Three Stages of a Physician’s Career: Navigating from Training to Beyond Retirement.
The practical aspects of making a medical career transition can be divided into three phases or stages: waking up, taking stock, and taking the leap of faith. Note that this process is the same whether the physician is anticipating a transition out of full-time practice, planning a transition …
The 3 phases of a physician’s career transition
There was more than one tooth missing, maybe three or four from what he could tell. He held one in his scraped hand as I searched for the others, not sure what I would do with them if I found them. My little sister’s bike laid on top of him, a paperweight on his frail frame. Blood pooled in his mouth and dripped onto his shirt when it ran out …
It’s Friday morning in any operating room, USA. Nurses and techs are scrambling to get everything in place before the surgeon arrives because if not, there will be hell to pay. The first patient arrives late, the second patient needs to use the bathroom, the third patient needs blankets before the IV is started … and here he comes … and we’re not ready. The fear is palpable.
Down the street, …
Trauma in the OR. From doctors’ bullying.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old woman is evaluated for mosquito bites on her arms and legs that she received 1 week ago that she has been scratching regularly. One of the bites on her left thigh is now painful with a small amount of drainage. She otherwise feels well, has no significant medical history, and …
MKSAP: 21-year-old woman with mosquito bites
It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I walk in, I grab my patient’s hand, smile and say, “Hello. My name is Dr. Shillcutt. I am a cardiac anesthesiologist, and I am going to take care of you …
I’m your anesthesiologist. Let me explain what that means.
The first thing I remember as I regained consciousness, lying in a hospital emergency room, was hearing a nurse ask my mom if I was allergic to any foods. With my eyes still closed, I said, “asparagus,” thinking this might reduce the chances of anyone serving me what was then a dreaded vegetable.
“Asparagus,” repeated the nurse, making a note on my admission form.
And then, with a chuckle and what must …
Expanding our definition of spiritual competence
So, you’re a physician with a love of travel — awesome! One week of your salary allows you to travel anywhere in the world (coach, at least) — double awesome! But, as you are acutely aware, there is a catch … a big one. As a full time doc, how do you possibly get the time off to explore new cultures, hike/bike amazing trails and eat/drink around the globe?
As physicians …
11 ways to be an doctor and still live your travel dreams
Two hours of administrative tasks for every hour with patients. A proliferation of non-physician administrators deciding how the day is going to run. Little in our training about how to cope with uncertainty and change. It’s no surprise that burnout rates are approaching 60 percent. Despite being so common, when we see a colleague struggling with physician burnout, we may not know what to say. Responding appropriately can bring someone …
How to respond to physician burnout in a colleague
Once during my TV news days, I was feeling pretty good about myself during a three-hour drive to the Mayo Clinic. “I am so glad I don’t practice!” I crowed to my photographer. “Practicing physicians are so sad. They’ve lost their income, their autonomy, and the public’s respect.”
My photographer didn’t miss a beat. “Yeah,” he replied. “They sound just like you.”
By which he meant that as a journalist, I’d lost …
The striking parallels between doctors and journalists
In my last year of training, I came to realize the difference between doctors who felt successful and those who didn’t. From the beginning, I had always been hard on myself. I always thought about the decisions I made for every patient in detail, played them over and over in my head, and wondered what I could have done differently for each one. Whether or not their outcome was satisfactory, …
How to maintain a sense of accomplishment as a physician
My grandmother’s room is silent, save for the plucks of sitar strings and Pixar movie soundtracks I try to stimulate her with. Instead of books, we fill the shelves around her bed with mouth swabs, drab hospital gowns and vials of baby powder. My grandmother — who walked an hour every day, who thrashed me in gin rummy, who rose before sunrise every morning to read — now lies bedridden …
How do we fix the apathy in nursing home staffs?
I remember one sunny day in Chicago, in June 2011, when my husband and I packed up our two young children, aged 2 and 5 months. Professional movers had collected our belongings and had driven off a day prior. We were headed out of state, to my first job at an academic hospital. It had been a rather hectic few months for me, having just had a baby 5 months …
Before my first job, I wish someone had told me a few things
Every time I walk into a bookstore, I pass Paul Kalanithi’s When Breath Becomes Air and am reminded of a specific anecdote he shared.
Kalanithi, MD, was a seventh-year neurosurgery resident and his lung cancer had metastasized – a process which was only being controlled by a new drug his oncologist had decided to try. But one day, Kalanithi had severe nausea and had to be hospitalized to stay hydrated. A …
Doctors will inevitably make mistakes because they are also human
Dr. Leon Pedell discusses how to transition from memorizing physical exam techniques to applying them with real patients to find real abnormalities. Many students have a misconception that they can forget much of what they learned in first and second year as, “low yield.” This is not the case. More than anyone else on a care team, medical students have time to perform thorough physical exams and you …
Transition from memorizing physical exam techniques to real patients
A recent Medical Economics article asked “Is the DPC model at risk of failing?”
The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing health care services to patients and excluding …
Is direct primary care doomed to fail?
Here’s a question that has been debated for several years: Should radiologists talk to patients about their imaging results?
Citing several issues, I came down solidly on the “no” side in a 2014 blog post.
Two major radiology organizations have committees looking into the concept, and New York Times article said, “they hope to make their case [for it] by demonstrating how some radiologists …
Radiologists have an image problem
High-stakes standardized testing is an enduring facet of medical education, and the standardized test that is on every medical student’s mind is the USMLE Step 1. The paramount importance of this test for getting into residency creates a demand for high-quality test preparation materials. Established test prep names like Pathoma, Sketchy Medical, First Aid and UWorld fill that demand in a market consisting of more than 40,000 test takers worldwide …
Test prep companies are more powerful than medical school
I receive a significant amount of email in response to my blog posts about locum tenens work. Curious colleagues (from surgeons to internists and emergency medicine physicians) ask for insider insight into this “mysterious business” of being a part-time or traveling physician. I am always happy to respond individually, but suddenly realized that I should probably post these conversations on my blog so that all can benefit.
The most common question …
Interested in being a locum tenens physician? Read this first.
3 a.m. The alarm blares. Get up, make food, study. Maximize caffeine intake, maximize studying efficiency.
4:12 am. Take the last sip of water, pray. Maximize studying with residual caffeine power.
7 a.m. Get dressed, go to work. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information. Produce saliva, clear dry throat. Study during lunch break. Stay awake, stay alert, see patients, present well, regurgitate answers, retain information.
6 p.m. …
Observing Ramadan as a medical student
Dear future medical student:
It’s graduation week. I’m running into people I haven’t seen in a long time. There are a few things on my mind currently, and in four years, you’ll have the same conversations.
“Did you have so much fun in med school? Did you love it?”
“No.”
“Wow! Those four just FLEW by, didn’t they?”
“No. They absolutely did not.”
“Well just WAIT ‘til you get to residency. THAT was hard. What you …
Medical school is miserable. Here’s the secret to surviving it.
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