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.
I grew up with a harsh awareness of my own mortality. Though due in part to my drivers’ ed teacher, who spent most classes telling gruesome tales of the horrors that befall high schoolers who don’t pay attention while driving (you got your money’s worth, Mom and Dad!), I think the reality of cancer was what really struck me. It took my grandfather in his 70’s, and I miss him …
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Life somehow leads us exactly to where we are supposed to be
Across the country, newly minted doctors have started their internships. The first night on call there won’t be an intern – anywhere in the country – who will sleep. Every new intern is absolutely convinced that the beeper is going to go off and they won’t know what to do. (You get over this by about the 2nd or 3rd call night, by the way).
Graduating from medical school …
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Tips to be the best intern you can be
There’s an intersection in Boston outside one of my favorite places to eat. At the corner of two bustling streets is a white bike, chained in place, surrounded by flowers. In loving memory.
***
One evening earlier this month, I was riding the ‘T,’ Boston’s streetcar system, when our train suddenly stopped.
There were the usual sights and sounds of delayed passengers: people fiddled with cell phones, glanced at watches, tapped feet impatiently. …
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The functional and professional necessity of detachment
One of the most intense moments of my third-year of medical school was during my internal medicine clerkship when a code blue was called.
It was our responsibility as medical students on the inpatient service to report to every code blue while we were on our calls every 4th night. This time was no different, and my call partner and I ran to the code. When we arrived, I recognized the …
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The moments that define the job of a physician
As the nation, physicians, hospitals, and political pundits await the Supreme Court’s decision on the Affordable Care Act, I find myself waiting for something else: to begin medical school. I will be hitting the books, studying vigorously, and desperately trying to remember the myriad of information being thrown at me well after the justices decide the fate of President Obama’s landmark legislation. So what does this mean for me, or …
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Become not just a physician, but a great physician
“What about combined psychiatry-family medicine-neurology-internal medicine programs? Should I try to do a triple board program in psychiatry-child psychiatry and pediatrics?”
Every April, I field such questions from a slew of rising fourth year students who have become, to their surprise (and sometimes dismay), passionately interested in psychiatry. Psychiatry is a shortage specialty and psychiatric issues rank high among the challenges facing medical care systems here and around the world. For …
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Should medical students consider a combined psychiatry residency?
I figured it out! I realized what the basic, underlying, fundamental problem is with medical care in this country.
The problem is that it’s too expensive and often isn’t very good, but that’s clear.
The reason medical care in this country is fragmented and overly expensive is that there is a perverse inversion of the correct ratio between primary care and specialty physicians (should be significantly greater than one, instead of significantly …
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Most medical students don’t have what it takes for primary care
Before I started medical school I thought it would be phenomenal to become a doctor. What could be more amazing than to possess a thorough, complete and intimate understanding of the human mechanism? I came to medical school to learn physiology and pathology in their entirety. I could not imagine a more valuable understanding than to fully know the secrets of the human body, what befalls it and how to …
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Medical students need guides during their clinical years
Take a look around you. What do you see? Babies playing with gadgets, four year olds playing with cell phones, and teenagers and adults playing with iPads or typing away on their personal computers. With the exponential increases in technology, specifically the digitalization of communication, in the past decade, our citizens have moved to the point of paying more attention to our devices than to each other.
As we begin to …
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Communication skills are lacking in health care today
It’s been two days now since I basked in the glory. I still find myself floating above the ground. I can still feel the weight of the heavy gown and the velvet tam. I can feel the tickle of the tassel on my ear. My eyes fill with tears at the thought of my classmates – those who toiled alongside me – experiencing the same emotions. The reminders of our …
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The selfless people in medicine are the people a patient never sees
Why would anyone want to become a doctor? Seriously. Think about it, because this is a very important question for the future of healthcare in our country.
The future of medicine is somewhat unclear in this age of healthcare reform, but we do know a few things. Physician compensation is currently falling while lawsuits and malpractice premiums are rising. Doctors must see many more patients in a day to maintain their …
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The reasons our future doctors are choosing medicine have changed
One of the most memorable discussions regarding the cost of care was at 4:45AM during surgical morning rounds.
As usual, the interns would present the overnight events of their patients to the chief resident and a plan for the day would be agreed upon. These morning rounds were particularly intense: in addition to the 30 patients that an intern had to manage solo over night, the brutal hours that the surgical …
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Is the daily blood draw in the hospital truly necessary?
I am four months into my third year of medical school. The third year is the first clinical year, when students spend most of their time in the hospital, interacting with patients and working as part of the medical team.
Our deans told us at the beginning of the year that we would be talking with patients more than anyone else on the medical team; we would serve as advocates for our …
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As I progress through my medical career, I must make time to listen
Hard time is here
And ev’rywhere you go
Hard times is harder
Than th’ever been befo’
The opening lines of a century-old Delta blues song rings out among the stars and the dark of a rural Virginia night. I sit tenuously awake atop an old wooden stump in front of a farmhouse, where four minds sleep peacefully inside. It is 3:00 am. From the window, I hear the sound of the needle dragging …
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Listening is what a patient needs most
My psych final was this morning, which I am 90% confident I did well enough on to pass the class (which is all I need to be satisfied). Considering I counted watching “Girl, Interrupted” as studying, I say that’s not too bad.
I felt like there were many necessary topics left out of our behavioral medicine and psychiatry course. One of the many: sexual assault.
For the past eight years I have …
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How we treat sexual assault matters more than we will ever know
“Um—Hi there, I’m a, uh, you know. Medical student. First year. For, you know, the Patient-Doctor—err, Patient-Physician course—”
The nurse smiled and turned to a woman of shorter stature with bony, scrunched- up shoulders. “Mary, do you want this first year to interview you?”
Mary was about to set foot in the lounge when she heard this. She let out a sigh and faced me. Her eyes looked worn; I could tell …
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A medical student’s first patient interview
I have been thinking a lot over the last few weeks about all the many ways that the experience of medical school has changed me.
The most obvious is knowledge. I’ve drunk from the proverbial “firehose” of information that we experience in medical school, and apparently enough of the facts stuck with me to pass all my exams, and secure myself a residency program back in my home state of California. …
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How medical school changed me
The lines of text on my laptop screen blurred together as I lost focus. I knew there was at least one error on my medical school re-application I would regret later on. My eyes scanned the familiar body of words but failed to connect the information to my brain. Frustrated, I closed the application and shut my computer off.
My bedroom door abruptly swung open, revealing my mother with the phone …
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Struggling with the idea of leaving for medical school
I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way …
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Medicine involves a tension between isolation and connection
The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.
I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …
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Medical school and residency aren’t places for human growth
