About halfway through the internal medicine residency, there comes a time when a resident must decide on what he or she plans to do after three years of training. We may come across a second-year resident saying: What should I do next? Should I become a hospitalist or plan for a fellowship? But in what? Cardiology and gastroenterology are fascinating careers, but is my resume ready for a competitive match? …
I would like to offer some words of encouragement to what many call the “non-traditional” students pursuing medicine.
The term encompasses people in different aspects in their lives. It may be someone in a different line of work looking at medicine as a second career or another just getting started that didn’t take the traditional path in undergrad.
My own journey
I started medical school at 28 after spending six years as a …
1. Very little revolves around the patient. For a place dedicated to healing, the hospital does a poor job accommodating patients. Labs are drawn in the middle of the night, so the doctor has them early in the morning. There is no standard rounding time, so the patient is constantly awakened throughout the day. Vitals must be measured every few hours. Patients often comment about being happy to be discharged …
I have been a neonatologist for 30-plus years. Throughout my career, nurses and neonatal nurse practitioners (NNPs) have guided me, assisted me and comforted me through difficult patient care issues that arose. Even more importantly, they allowed me to leave the neonatal intensive care unit (NICU) without worrying about how my patients were being taken care of.
I am writing this because our profession (MDs and DOs) continue to devalue these …
How can you work for 24 hours in a row? My friends outside of medicine ask me that often. What is it like? I wondered the same thing the night before my first 24-hour shift or “24.” I lay awake worrying, ironically, that I should have gone to bed earlier to rest up for the ordeal.
When I get to work, full of nervous energy, I am relieved to find out …
Exhausted. Aching. Hungry. Slightly delirious.
Mile twenty-four of a marathon? Or hour twenty-four of a twenty-eight-hour shift?
I am a resident. I am a runner. I am also a rather tired human since, as I type these words, I’m both post-call and post-run. However, this post-call/run state of body and mind is one I have learned to love and embrace during this residency whirlwind.
I’m not myself unless I’m wearing scrubs or running clothes. …
Recently, news broke about a disturbing act of medical battery carried out by doctors at St. Joe’s Medical Center in Syracuse, New York. The case began when police officers conducted a pretext stop and elected to harass their victim about a small amount of marijuana.
As the situation escalated, the cops took the man to St. Joe’s Medical Center for him to be searched for …
Even though physicians do not talk about transferring residencies, it is more common than is often believed. According to the AAMC website, about 30 percent of residents do not finish the initial program they started. Quantifying that number further, the ACGME recently reported 1,044 residents transferring from their program.
There are a variety of reasons for transferring residencies: A spouse being accepted for …
One time, I applied for an emergency department (ED) nurse manager position. I thought I had the job locked up until I was asked during the interview how I would “enforce metrics.”
“Enforce.”
My holistic, qualitative research-based response to this authoritarian-style question was: “I’ll find more organic ways to achieve your metrics without shoving numbers down their throats.”
I didn’t get the job. Someone told me I wasn’t “MBA enough.”
Yet, I stand by …
There has been a profound deterioration in the education of our medical students. I only make this contention after having taught over a hundred medical students across five continents, often one-on-one and for extended periods. Although the majority of those I’ve taught have been students educated at international medical institutions, a substantial number have been those from U.S. medical schools. While I do recognize that those that find their way …
Yes, med-peds is a real residency! It is a real specialty! And it is a practicing profession by many physicians today! It can open doors for so many wonderful professional opportunities. It is a discipline that can provide patients and communities extremely comprehensive medical care. People need to know more about this unique and sometimes under-recognized field. And here is why:
Like many people today, I didn’t even know what med-peds …
It is a known fact, but every generation feels that they had it worst and that other generations have it made.
“When I went to school we had to walk uphill in the snow both ways!” says every grandparent
I identify myself with the Generation X physicians, finishing medical school in 1997 and my radiology residency and fellowship training in 2003.
During this time I have seen quite a change in the medical …
Physicians receive rigorous medical training for the better part of a decade. However, we emerge unprepared for the real-world job application process to which our friends in other professions are accustomed. One of these logistics includes credentialing and verification for hospitals and clinics where your group intends to practice — a process that can take up to three months.
There are a number of items that are requested during the credentialing …
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A lot has been spoken and written about clinical documentation already. In spite of that, many hospitals still struggle in getting the best out of their doctors when it comes to documentation quality. And although we can cite various reasons for this, we can all safely agree that the hospital EMR is the single biggest influence when outcomes to efficiency and quality of documentation — both in terms of compliance …
A wonderful senior resident helped me understand the goal of rounding. Rounds should focus primarily on understanding the key problems and the diagnostic and therapeutic approaches to those problems. She suggested that some rounds spend too much time on “minutia” that the resident could handle, and not enough on understanding the big issues. According to her, rounds work best when we spend our time addressing the problems that the patient …
Our country is at risk of losing an iconic institution that has played a pivotal role in the history of medical education. A school, which has produced some of the boldest pioneers in medicine, could lose accreditation upon the opening of a new hospital that will shunt away 40 percent of their current patients. Scores of our brightest potential medical students will be ripped away from the communities that desperately …
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I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …
I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid of excess fluid. After seeing the patient, I spoke with the nurse, went over the …
First impressions are critical. We are taught early in our careers that first impressions truly matter. Whether interviewing for medical school or a residency program, our goal is to make a positive first impression in hopes of making the cut at each checkpoint in our early careers.
These processes in our academic lives and careers are exhausting. As residencies and medical schools are becoming more competitive, the importance of first impressions …
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In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective, there are only four countries with a GDP more than the amount spent on health care in the United …
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