Residency training is often considered to be one of the most daunting experiences in a physician’s career. Each day comes with its own package of highs and lows. Every year is a new challenge, and a young physician has to adapt significantly as the journey unfolds. Having gone through this process over the past three years as an internal medicine resident, I thought it would be useful for me to …
7 pearls of residency training
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 …
MKSAP: 63-year-old woman after right hemicolectomy for colon cancer
We care for girls and women, pregnant or not.
If you are two years old and put something in your girl parts and it disappears, we get it out.
We care for two patients at once. We balance how pregnancy impacts you and how you impact your pregnancy.
We watch over you and your baby throughout labor and delivery, so you can focus on creating a human.
We care for older women whose laughter …
We are OB/GYNs: What you need to know
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 …
A trauma surgeon reflects on the Yale System, 20 years later
In the U.S., we now have an outbreak of measles where the cases number more than it has in decades. Most of the people being infected are unvaccinated, and we’ve all seen the media reports of the growing tide of anti-vaxxers. While the CDC, WHO, and pretty much every medical and scientific authority across the globe stand by the efficacy and safety of vaccines, those opposed rather rely on the …
Death threats won’t stop this doctor from advocating for vaccines
Did you feel that? That little jolt in your stomach as you clicked on the headline? Perhaps, your muscles tensed for just a moment? Maybe your heart skipped a beat. What was that? An insignificant flutter? A meaningless moment to shrug off in your busy day?
Perhaps that fleeting feeling is explained by the stigma known all too well to sufferers of chronic mental illnesses. Stigma is fuelled by our fears …
This physician has a mental illness. And one day, he might be your doctor.
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 …
The ethics behind the world’s most expensive medication
“I’ll put my cell phone away when you put your computer away,” said the patient.
These were the very words I heard upon opening the door and stepping into the exam room. As I stood waiting for him to look up, I was already looking at my computer for his name. Needless to say, I was aghast that a patient would say this to me. My first instinct was to defend …
“I’ll put my cell phone away when you put your computer away.”
With the announcement of CVS Health HUBs, the synergy of data and business is rapidly coming to the health sector; health systems will become havens only for the severely acutely ill, the more complex, the expensive. In the same way that urgent care centers catered to low acuity, high financial margin problems that both financially supported and congested emergency departments, HealthHUBs will take similar problems away from primary …
How pharmacy-based primary care takes the low-hanging fruit
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 …
This physician takes the time to be humbled and amazed by the stories patients share
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 …
How failing Step 1 helped me pass the boards. Twice.
Eli Lilly and Co. recently announced with some fanfare that it was manufacturing a generic version of its own best-selling insulin brand, Humalog, which it would sell for half off — $137.35 versus about $275.
David Ricks, the chief executive of Lilly, said the company was making this seemingly beneficent gesture because “many patients are struggling to afford their insulin.”
But they’re struggling, in large part, …
Why you shouldn’t be happy with $137 insulin
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, …
OB/GYNs are getting old and tired. Who’s going to be left to deliver your children?
ADVERTISEMENT
After my term as a lieutenant colonel in the United States Air Force, I could join the Air Force Reserves, go back to school or work as a pediatrician. I chose school and work.
I had no specific “why,” since I earned the VA educational funds, it was more like “why not?” My friends and family had mixed reactions. Never one to dwell on a thought, I jumped in before I …
Getting my MBA 30 years after my MD
Physicians leave training with expectations of earning a generous income and dreams of an extravagant lifestyle. They go from years as a struggling resident to a working individual with a stable income. Once they become attendings, their salaries skyrocket, in some cases from $55,000 annually to $550,000 annually.
A $550,000 income requires extensive financial planning, of which the average physician has no experience or exposure. They are building a practice or …
Are you a physician living paycheck to paycheck?
Recently, I was called to task — and probably rightly so — for signing something I know I didn’t read.
This was several months ago, when one of my partners was out on family medical leave, and we divided up all of the coverage of her patients while she was away, making sure that forms for home health aides were signed so …
All doctors sign forms they haven’t read. Is there a better way?
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 …
After nearly 40 years as an internist, Dr. Ron Naito knew what the sky-high results of his blood test meant. And it wasn’t good.
But when he turned to his doctors last summer to confirm the dire diagnosis — stage 4 pancreatic cancer — he learned the news in a way no patient should.
The first physician, a specialist Naito had known for 10 years, refused to acknowledge the results of the …
Why so many doctors won’t break bad news to patients
I was cleaning out the top shelf of my closet — a location where, hypothetically, treasures can be found. I came upon something that was wrapped in a nondescript brown paper bag that smelled oddly of mothballs. I cautiously reached inside and found an heirloom quilt that apparently had been passed down through generations. I had discovered it an estate sale, and now it had finally come to rest in …
The patchwork quilt of my medical care
“Let’s start the powwow,” a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the meeting, and it was almost completely drained. I hung the stethoscope around my neck, knowing I wouldn’t use it as anything but a prop to signify my training and …
A family meeting in Navajo Nation
Get free updates delivered free to your inbox.
