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.
Undoubtedly, those pursuing a career in academic medicine have a tough time line. In most medical schools, somewhere between the 7th and 10th year, depending on whether the academic clock was stopped for pregnancy, the fate of the academic physician is decided. During these years when women have the biologic clock ticking, they also have the “up or out” academic clock ticking.
This rush to create academic contributors is pure insanity, …
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Women physicians in academia: The academic versus the biological clock
We had our first human dissection recently. We gloved up, scrubbed up, and wielded a scalpel – the key to opening the secrets hidden below our skin.
Our donor, an older gentleman who died of cancer and gave his body to the advancement of medical education, lay on his back. He was abnormally frigid and unnaturally rigid – cold and stiff to the touch. His face remained shrouded with a white …
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Dissection is as much exploration as it is self-evaluation
In my practice, as in most medical practices, we accommodate patients’ particular needs in all kinds of ways: wheelchair accessible rooms and hallways, interpreters of virtually all languages including American Sign Language, gowns and instruments in a wide range of sizes, information sheets and videos suitable for patients with a variety of educational backgrounds.
No one questions the appropriateness of these accommodations.
But what about when the doctor or nurse requires an …
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Who accommodates a doctor with a disability?
In July 2011, I made the decision to defer matriculation to medical school for a year. While I was hoping to relax in Philadelphia before entering a lifelong journey in medical training, what I got instead was one of the most emotionally tiring and challenging years of my life.
3 months after I decided to defer medical school, my aunt was diagnosed with acute myeloid leukemia. She was immediately hospitalized and …
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Why are there so few women physician leaders?
I am a fourth year medical student that attends an institution that does not have a department of family medicine.
Currently there are only 10 such allopathic institutions in the country. When I tell colleagues and friends that I intend to enter family medicine they say, “oh primary care?” While yes, it is true that family physicians obviously practice primary care, I am disheartened that my colleagues do not know or …
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I am an orphan: A medical school without a family medicine department
An attending once told me, “You can’t please ‘em all.” And it’s true. Sometimes in medicine, you just have to keep your head up and remember the bigger picture of why you are in this field.
A few months ago I did my internal medicine sub-I, which is a rotation medical students take in their fourth year when they are expected to perform on the same level as an intern. I’ve …
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You have to develop thick skin in medicine
The presence of strong, independent women has been a constant throughout my life. Friends, teachers, mentors, aunts, cousins, and grandmothers have all helped shape my firm belief that gender need not be a hindrance and can indeed become a source of pride. Yet the most influential and compelling woman will always be my mom, and for me, no story of admirable females can go without mention of her.
On a rainy …
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A medical student’s lesson in cultural understanding
The first resident who really reamed me out on the wards was having trouble reading my handwriting. My handwriting became doctor-unreadable well before medical school, but how quaint. It was the beginning of my second month of clinical training, and hers of internship. She couldn’t follow our shared patient’s daily progress note. I didn’t tell the story in the right order. The format was wrong. Instead of noting only pertinent …
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Why EMRs will not placate technology-hungry medical students
Edward arrived at the hospital following a stroke; a standard work-up failed to reveal an obvious cause. His physician explained that a previously diagnosed patent foramen ovale (PFO), a hole in between the chambers of his heart, may have led to his stroke. He presented three possible treatment options to Edward: (1) medical management with drugs; (2) open surgery to correct the defect; or (3) interventional catheterization to correct the …
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Teaching medical students to provide high value care
As we enter the fall, we welcome a new class of bright-eyed medical students. To such students, you are about to embark on a life-transforming journey. My first year on the said journey has been full of highs and lows. There was the morning I woke up before 6 and got upset with myself for sleeping in. There was the day I received my first exam score and realized I …
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Get the most out of your first year of medical school
I remember when we dragged ourselves to the large lecture hall every morning, backpacks slung over our shoulders and cups of coffee in our hands. Six to eight hours of lectures awaited us.
I remember where we all sat in that lecture hall. I remember the future ophthalmologist who sat behind me and made snarky comments while certain professors gave their lectures facing the chalkboard. I remember students sitting six rows …
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My classmates now look mature, which means I must look that way too
As a medical educator in a hospital setting, I often tell first-year medical students about disparities in health care and about the vastly different quality of care that hospitals deliver, depending on their resources.
I tell my students how important it is to advocate for patients, to learn to navigate the healthcare system and to work respectfully with health professionals in order to get optimal care for your patients.
When my own …
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With my son hospitalized, an opportunity to apply my teachings
A concept that has been percolating in the medical literature boiled over into the mainstream as the New York Times published this story, “Chicago’s Intern ‘Boot Camp’ is a rehearsal for life or death medical issues.”
The article describes a new internal medicine intern having to deal with a simulated patient who is critically ill and has alarms going off.
Another intern had to tell a “patient” played by an actor …
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Should intern boot camps be mandatory after medical school?
It was spring. My medical school class, two years along in our five-and-a-half year endeavor, had earned the “medicinae kandidat” degree. We were now worthy of leaving the basic sciences and research center on the outskirts of town and starting our preparatory clinical, “propedeutic” semester at the University Hospital. In Sweden, at that time, we used a lot of Latin words and phrases. Crohn’s disease was Morbus Crohn, chart notes …
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Do you worry about the diseases you learn in medical school?
You may not remember me, but when I asked how you were, you said, “alive.”
A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone who was grateful for life the way you expressed to me that day.
You may not remember …
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You may not remember me, but you changed me
“I don’t want a tube down my nose. I’ve been through it before and I don’t want it again.” Charlie turned his head away from the team and crossed his arms in defiance. “I’d rather be sick.”
I looked at the intern, who looked at the resident, who just said, “Well, think about it. We’ll be back in the afternoon.”
“I’m also hungry and haven’t eaten in days,” Charlie added.
“Maybe some food …
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Each patient is still human and deserves to be treated as such
Disruptive technology is a term used to describe new technology that disrupts the status quo. These technologies displace existing technology—dramatically changing the production, delivery, or use of a product or service. For example, 3D printing is an innovative method of producing three dimensional objects using digital prototypes and will change manufacturing as we know it. Although the term is traditionally used in a positive light, this technology, as its name …
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Disruptive technology in medicine has the ability to heal or harm
I have reached a new milestone in my medical training—third year—the year when we transition from the classroom into the hospital, from the preclinical to the clinical curriculum. Those who have come before me understand that this is a major turning point in one’s medical education where the theory and memorizing from the first two years is put into play in order to manage patients with complex conditions.
It is an …
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When the patient represents tedious work
I thought of Peter when I lost my TAB status.
I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess.
But I didn’t expect it would involve a chicken.
I should explain.
I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient …
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Losing my temporarily able-bodied status
As a member of the medical school admissions committee, I’ve interviewed many amazing applicants. Here’s what I wish I could say to them:
1. Your interview performance is critical. As interviewers, we’re amazed by the quality of today’s applicants. In fact, many of us wonder if we would get into med school today. “I can’t believe how much she’s done,” is something I hear time and time again from my colleagues. The sad …
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The medical school interview: Strategies from an admissions officer
