Students, educators, and physicians writing on KevinMD about medical school: admissions and what they select for, the cost of tuition and the debt it leaves, the curriculum and what students say it does and does not teach, Step 1 and the test-prep industry, pass/fail, mistreatment and depression in training, the match, Caribbean schools, and what should change. Most contributors are students writing while still in school, many of them anonymously. For what physicians have said about paying off that debt and the money decisions that follow, see Physician personal finance: what physicians say about their own money, in their own words. For a maintained record of what students and physicians have said about medical school on KevinMD since 2004, see Medical school: what students and physicians say, in their own words. For what physicians and deans have said for and against affirmative action and diversity in admissions, see Race and medicine: what physicians say, in their own words. For what international and Caribbean graduates have said about the Match and visas, see Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words.
Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life.
We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted …
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The medical education system hates families
Recently, a brilliant, caring and warm-hearted friend of mine approached me asking if I would help her with MCAT studying. She’d be a non-traditional medical school applicant due to a few gap years. Thus, she needed to prove to herself and prospective schools she still had the academic chops.
Immediately, I froze.
Over the years, I have served as mentor to medical students, interns, and residents. To be there at someone’s aha …
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Should we encourage people to go into medicine?
“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles” — a.k.a. how did you manage training for a marathon while in medical school? The simple truth: I decided to run a marathon, so I did. Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.
Training for and …
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What this medical student learned from running a marathon
In medicine, there is a key group of people we seem to be excluding: introverts.
I noticed this twice at the recent AMSA convention. It made me realize how often our culture in medicine rewards the boldness, loudness, and confidence so often associated with extroversion.
The first instance was after my talk. I was answering questions from a group of people when someone came up, handed me a note, thanked me, then walked …
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How do we honor the introverts in medicine?
I’m a default crier. I happy-cry, stress-cry, romantic-comedy-cry, regular-comedy-cry and, apparently, I even doctor-in-training-cry.
Crying is a tough response, especially for someone who wants to take care of sick patients. My default reaction poses challenges for my future career. I had my first taste of this when a patient actor brought me to tears. An actor? That’s ridiculous, you might think. It was all pretend and yet, I broke down. I’m …
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The medical student who cries
Once a minor hurdle on the road to Match Day, the USMLE Step 2 CK is now required by many residency programs before ranking applicants. For those with low Step 1 scores, Step 2 CK is even more critical, as it represents a student’s only opportunity to compensate for Step 1 performance. I was happy with my Step 1 score but planned to take Step 2 CK well before applying …
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This medical student scored a 281 on the USMLE Step 2 CK. You can, too
In the mid-1800s, Ignaz Semmelweis, then a professor at Johns Hopkins, proposed something outrageous: Doctors and medical students working in the maternity ward should wash their hands before delivering babies because doing so could reduce infant mortality. For proof, he performed a rigorous experiment that showed babies delivered by midwives, who traditionally did wash their hands prior to deliveries, had rate of death that was five-fold lower than those delivered by doctors.
He …
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Science and medicine are seemingly at constant odds
The first week of medical school you became a new person. Assigned a cadaver and some partners in your first anatomy lab, the gravity of the endeavor struck you to your core as you slowly unzipped the cadaver bag for the first time and met “Ernie” (as you later named him) and wondered how he died. You looked to the table beside you where blue nail polish could still be …
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Match Day: the perfect ending to the medical school experience
Medical students and residents become accustomed to living life in year increments. Four years for medical school, three to five years for residency, a couple years for fellowship, research, and so on. While many of us like to think we are putting our life on “pause” as we complete our medical training this just isn’t possible. Life is happening all around us every day. Many physicians look back on their …
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How to have a life in residency
During my third year of medical school, I received a harrowing phone call, “Can you please go over to Steve’s place? I am worried about him. He might want to hurt himself.” The person requesting this was the mother of one of my best friends in medical school. I was a third-year medical student on my surgical rotation. Steve’s mom was concerned he might commit suicide. Sleep deprived as I …
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Physician, know thyself
There is no glory in defense. Fans don’t notice it. The most perfectly-executed defensive play results in a non-event; that is, the other team doesn’t score. Then everyone forgets about it, and the game moves on.
But there is an art to defense. It is reactionary in nature: You must read the offense and anticipate what’s coming. You have to study the opposing players one-by-one, so you know their strengths and …
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Why medical school is like playing defense
“Why are you in seminary?”
As a “non-traditional applicant,” I was asked this question on every medical school interview four years ago.
I’ve come to learn that seminary training engenders stereotypes and mythopoeia. My mentors knew this, and advised me to have examples ready related to the importance of being trained in fields that both study the human condition and provide the skill set necessary to critically assess paradigms.
Some interviewers appreciated the …
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Why seminary? Or, why are you non-traditional?
One of the definitions of “academic” is the following: Not of practical relevance; of only theoretical interest.
When we look at the term academic medicine, sadly the descriptor “academic” increasingly falls under this definition.
To be fair, there have been some wonderful scholars in the field of medicine: Semmelweis, Fleming, Salk, Sabine, Starzl, and Marshall to name a few. And these few were not readily embraced by their peers in medicine. Barry Marshall was ridiculed …
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If academic medicine is to avoid becoming academic, it must prioritize patient care
In medical school, the lessons and stories have a unifying theme that connects the threads of humanity. In medicine, I could find these stories, the feelings of loss and fear and hope and love. In the face of illness, suffering, and death, we often see the unvarnished sides of the human condition — the more raw sides of our nature hidden behind the decorum of everyday living, behind the curations …
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Medicine isn’t about mechanics. It’s about the soul.
I had the honor and privilege of rotating for three weeks on the transplant service where I experienced a lot of great medicine, surgery and the ethics that intertwines them. One late night on service I had the opportunity to travel to a different hospital and help the team harvest a liver and kidneys from a donor. Never had I seen anything more amazing than what I witnessed that night …
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When you learn about a person’s story, you can’t ignore it
I’m about two-thirds of the way through my 3rd year of medical school, and I have hit my wall. I have become so fed up with the set up of medical school. I think a decent amount of this comes from the fact I am on my 6th week of an eight-week surgery clerkship (an area of medicine that I literally have zero interest in). I’m tired of waking up …
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Is apathy needed to survive medical school?
The contrast between the first two years and last two years of medical school are unparalleled to any other graduate field of study. You progress through a period of relentless studying through case-based, team-based, and lecture-based curriculums for two years with very little, if any, patient interaction. Afterwards, the script flips and you’re staring nervously at your first patient trying to channel interpersonal skills that sat on the backburner during …
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How to unite medical students in the preclinical and clinical years
When my classmates and I returned to Boston to continue our first year of medical school early last month, we returned to a very different type, of course, called “Essentials of the Profession.” In it, we explored health policy, social medicine, ethics, and other topics outside the realm of traditional physiology and disease but just as important to our roles as physicians. In the health policy class, we learned about …
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This is what’s missing from medical education today
During the first week of medical school classes, we visited the anatomy lab. As far as I can remember, I had extremely mixed feelings on that day. I felt the thrill of taking my first baby steps towards my medical journey blending with a certain feeling of fear. Was I afraid of the pure existence of cadavers in that gloomy, long and hall-like room? Or was it the fear of embarking …
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A medical student’s first day in anatomy lab
Remarkable improvements in advanced life-saving therapies have brought chronic disease management to the forefront of American health care. Today, we see more patients that have complicated conditions. Often, these patients are admitted to the hospital with acute symptoms related to chronically managed conditions such as heart failure, lung diseases or cancer.
These patients can end up in the intensive care units and require critical care such as ventilators, dialysis and other …
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Chronic disease is making medical education worse
