I pulled on my white coat and straightened my tie before walking into the patient room with my supervising physician, Dr. H. Our patient was a teenage boy with autism, and Dr. H let me take the lead. Towards the end of the visit I asked, as I always do, “Do you have any questions for me?” He had not made eye contact with me throughout the visit, which can …
“Are you in ISIS?” my patient asked
I’ll be honest, when I first matriculated into medical school, I didn’t even know what a USMLE Step exam or clinical clerkship was. In fact, the first time I ever heard of them was from another applicant on the interview trail. I have always been a take-it-one-step-at-a-time type of person, but eventually, I would have to succumb to the pressure and ask upperclassmen about the exam. And what did they …
Should we standardize clerkship grades?
Today, I am a 40-year old with type 2 diabetes. I have been on glyburide since I was diagnosed four years ago and am otherwise healthy, although my blood pressure today is 140/96. I don’t check my glucose levels at home because I don’t have a monitor. Typically, I avoid sweets, but my diet is high in natural sugars, carbohydrates and starches. The only exercise I get is walking around …
I’ve seen over 8,000 medical professionals. Here’s what I’ve learned.
I have fond memories of my first class in the anatomy laboratory. It was the Monday of my first week at medical school. I’d spent the last night pouring over my newly purchased anatomy textbooks. I wondered how I would ever appreciate the countless anatomical details of the human body. But as I stood around the benches with a body donor, everything changed. Suddenly all the organs, vessels and tissues …
Donors are a medical student’s first teacher
This May, I will graduate from medical school. I will also be part of the first group of medical students to graduate from its new Literature and Medicine track. To me and the other participants, this has been one of the most important components of our medical education. In many ways, it has kept us grounded, serving as a constant reminder that there are experiences different from our own.
We know …
What medical school fails to teach
Dear Dr. Wible,
We’ve talked before. To catch you up, I’m in my clinical years now and I keep waiting to feel the same starry-eyed excitement I felt during the first months of med school, when I thought that becoming a doctor would finally give me a tangible purpose and make me a better person by helping me do right by others in …
“I hate myself. I don’t deserve to be a doctor.”
I’ve been told that one of the hardest things that a physician endures is the passing of her first patient. However, what I imagine to be even more challenging than this is pronouncing the death to the patient’s family for the first time. Although I find myself in a similarly intimidating and burdensome position of addressing the loved ones of our gracious donors tonight, for my first time, I feel …
The hardest thing to do as a physician
Dear Me, MD:
Now that you have opened this letter, you may have graduated or maybe you just matched into residency — somewhere, anywhere, hopefully?! As you read this, it should be some time during spring 2017. But, you never know, sometimes the train derails, and it takes a little longer than expected, so forgive yourself if that is the case. You learned a while back that the fast lane is …
A letter from my med student self to me now
From a young age, I knew I wanted to be a physician. There were no physicians in my family, but I had interacted frequently with doctors as a child and felt a strong desire to similarly help others as I grew older.
To this end, I focused on academics. In choosing a university, I chose the one I felt was academically best, despite being a private school in an expensive city …
The far-reaching consequences of medical school debt
Welcome to planet medicine, where four rides around the sun earns you a golden ticket to study more, to train more, and to enjoy splicing two sacred letters onto the end of your title. The days are long, the weeks go fast, and sleep is optional. In this world, all-star draftees leave their immaculate collegiate careers as masters of memorization and intellectual puzzle solvers only to still be no more …
“Ya mero llegamos?”
Are we almost there? These become one of the most dreaded words I have to hear every weekend, when I pick you up from the long commute that is from Sacramento to the bay area to spend time with you. Oftentimes I am just as inpatient as you my love. This has been our sacrifice these last few years, being physically away from one another. I take a deep …
We made it! An open letter to my son.
As graduation nears, I recall an away rotation that concerns me for the future of medicine. I remember eagerly boarding my plane, ready to work hard, learn as much as possible, and explore the unknown. My first day in clinic, I was excited to befriend the student I would rotate with. After seeing our first patient together, she asked me to share my clinical reasoning for the case. I happily …
The gunner culture hurts the future of medicine
I was sitting on hold in the resident room gearing up to beg the IT person that would soon come on the other line for enough authorization to be able to view the residents’ patient problem list, and I found myself thinking about what some of the old docs must think of us third-year students now. Talk to some of these older physicians and they’ll tell you their stories of …
The infantilization of medical students
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Like many of my peers, I started medical school with idealistic dreams of providing compassionate care for poor patients. I thought being a physician was a noble profession and even discussing money, much less changing my career choices based on it seemed antithetical to that. A visit to the financial aid office quickly cured me of my naiveté. I was facing over $300,000 in debt and would be forgoing millions of …
Why this medical student joined the National Health Service Corps
Match Day results were announced recently and a record high 35,969 medical students learned the location and specialty of their first job. As these newly indoctrinated physicians chart their next steps, the majority will opt out of academia, creating a potential crisis in medicine and healthcare innovation.
Although 45 percent of graduating medical students aspire to work in an academic setting, only about 16 percent will do so. Of those who do …
Why we need more doctors opting for academic medicine
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so.
However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” …
The little-known ACGME guideline change every resident should know
Just before the holidays, I was treating a woman with severe pneumonia. As I examined her, day after day, she told me about her family, their plans for Thanksgiving, and how much she missed her children. I liked her. I cared about her. I even used the promise of free Wi-Fi to convince her teenage daughter to come see her.
The day …
Practicing humanistic, patient-centered medicine requires doctors to stifle their humanity
Virtually every med school hopeful writes a personal statement with some variation of “I want to help people.” Three years into medical school, helping people seems to be the last thing on any medical students’ mind. At every stage of medical training, there seems to be a competition designed to consume us. Just getting into medical school can feel like an obstacle course with barriers at every step. First-year medical …
Medical students are more than test scores
Imagine while driving into work, you drive through a green light. When you look to the right, you see a car barreling through the intersection, and then everything goes black. You vaguely remember being taken into the emergency room of a prestigious hospital nearby. In the ED, you hear a doctor’s voice yelling at nurses to give you medications, and then everything goes black. You wake up in a hospital …
What should my doctor look like?
There’s absolutely no good reason why Sally should have been in the hospital. Not a day over 60, she had come to the emergency department for severe gastrointestinal pain and was then moved to a bed on the 10th floor of one of the hospital’s two towers.
I met Sally (not her real name) during my first year …
The new generation of physicians will reconcile the patient-provider relationship
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