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.
Every medical student is a bit apprehensive when he/she knows they will be assigned a new resident. The same questions always come up. Will the resident be nice? Will they understand my busy schedule? Will they make me do a ton of scutwork? Will they make me write all of his/her progress notes? And maybe most importantly, will they let me leave early to study for boards or enjoy the …
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The 3 types of residents that medical students will encounter
Science, technology, engineering, and mathematics (aka STEM) represent the fields in which the U.S. continues slip in their ranking worldwide. These fields are crucial for the U.S. to remain competitive in an increasingly global market. Workers in these fields spur innovation, have very stable job security. Students in these fields earn more money than non-STEM graduates. Indeed, improved STEM education is a priority of the Obama administration.
Despite the benefits of pursuing study in these areas, …
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The lack of underrepresented minorities in STEM
During my first week on a pediatric outpatient clinic as a third year medical student, I spent an average of 140 minutes caring for each patient. Looking back at that first week, the amount of time I spent with each patient ranged from a “brief” 79-minute visit to one whopper 188-minute visit where I reviewed several journals in the workroom and sought two attending physician opinions to be completely sure. …
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The value of continuity of care is priceless
The practice of medicine is changing structurally, technology, and financially at an unprecedented rate. Scientific advances in genomics, electronic medical records, an increased focus on quality improvement, and changes in the health insurance structure are a few of the areas in which the landscape of medicine is changing. However, in many of these processes physicians seem to be bystanders. Medicine requires innovative physicians to be part of this change. At …
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Be an innovator in medical school
The third year of medical school is definitely an interesting one. You leave the classroom and enter the big bad world of medicine, and you quickly realize that much of what you’ve learned is for naught. You also realize that the medical student next to you could become your best friend, or the bane of your existence — or fall anywhere along that spectrum. Here is a list of the …
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The 7 types of medical students you’ll meet
While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding ourselves standing a table away from Don Berwick in a relatively empty conference room. As MD/PhD in Health Policy students, we were interested in asking him a question about ACOs, so we approached him and introduced ourselves, hastily adding, “We know you’re busy, so we just have …
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A medical student meets Donald Berwick
I’ve heard applying to medical schools can be a soul crushing process, but I didn’t really quite get it until I got hurled into the process myself. Although I still wouldn’t describe this as “soul crushing,” it has certainly brought out a lot of insecurities in me and my accomplishments. Do they not like my stated reasons for pursuing medicine? Do my extracurricular activities seem phony and under-whelming? Is this …
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Lessons from applying to medical school
A popular teacher at our school recently gave a lovely talk about “emotional intelligence.” I was at once proud of my school for offering such a lecture and disturbed that it was necessary. Our schedules are flooded with lectures devoted to issues such as professionalism and emotional awareness. We’ve all heard stories about insensitive doctors with terrible bedside manner and outrageous faux pas by medical students, transmitted in whispers, and …
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Why emotional intelligence matters for doctors and medical students
I never thought I would call cancer “cool.”
It was the last day of anatomy lab. Finally, we had dissected through everything: starting with the back, moving through arms and legs, hands and feet, chest cavity with lungs and heart, abdominal cavity with gastrointestinal organs, pelvis, and ending with head and neck.
Looking at our cadaver was disorienting. There were insides where outsides should be. Organs completely removed. The head literally sawed …
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Care about people as people, not just as hosts of disease
The study of medicine can be overwhelming. We’ve simply discovered too much for one person to master completely. This is the challenge medical educators are tasked with – what’s so important that it must be allotted time in the brief 2 years of dedicated book learning doctors-to-be receive?
Students face a similar time-management challenge – first, we must decide what’s important enough to focus on, but the real question I think …
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Nutrition needs to be taught in medical school
Some medical schools have altered their admissions process by replacing the traditional applicant interview with the Multiple-Mini Interview (MMI). MMI resembles speed-dating: applicants rotate through numerous interview stations, where they act out scenarios and solve puzzles, sometimes alone and sometimes in groups. A July New York Times article presented a good overview of MMI, as implemented by Virginia Tech Carillon.
As you might expect, schools that have adopted MMI (UCLA and …
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Problems with the Multiple-Mini Interview for medical school
His face was four inches away from mine. I tried not to blink as he shined the ophthalmoscope’s light into my left eye and stared into my pupil as though it were the most interesting thing in the world. He frowned, placed his hand on my head, and used his thumb to pry my eyelid higher. He maneuvered for about 45 more seconds while I sat stone still, and then, suddenly, …
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Medical school is a fragmented, intimate experience
Today, during my psychiatry rotation, a very grateful patient confronted my attending and thanked him profusely for saving him. The patient had been severely depressed and was at his wit’s end before they met. The doctor listened to him, analyzed his situation, and came up with a plan to help which included involving the patient’ family as well as using proper medication. The patient had a great response to this …
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The hesitation before shaking a patient’s hand in the hospital
As a current fourth year medical student, one of the main things I look forward to after I graduate is trading in my white coat. For medical students everywhere, it’s a huge sign of accomplishment to shed the short coat and don the long one. It means you are now a real doctor.
Medical students are required to wear short white coats that might reach to their fingertips, if they’re lucky. …
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It is natural for medical students to feel long white coat envy
When the patient jokingly touched my nose, I knew I had muddied the boundaries between us too much and it was too late to go back.
(Note: Except for the aforementioned sentence, all of the patient’s details and quotations have been fabricated. Events from the interview and exam have been drawn from a conglomeration of patients and scrambled to illustrate a general theme.)
It didn’t happen until the end of the interview, …
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When easy familiarity blurs the boundaries
We heard from a patient during our dermatology week, who worked as a medical laboratory technician, running hundreds of blood samples every day, and frequently using her own blood as the negative control. Then she began to notice that the numbers stopped making sense. Her ANA had shot through the roof and her white blood cells started dropping.
“I couldn’t use my blood as the negative control anymore,” she said, shrugging …
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The unspoken assumption that doctors are well
Harvard University’s Edmond J. Safra Foundation Center for Ethics has conducted a lecture series focused on Institutional Corruption. In December, Marcia Angell-Relman, M.D., the first woman to serve as acting editor-in-chief of the New England Journal of Medicine (NEJM), gave an hour lecture which focused on conflicts of interest (COI) in academic medical centers (AMCs), and continuing medical education (CME). After the lecture, …
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The benefits of academia-industry relationships
Last year I was assigned to complete a history and physical on a patient in the hospital. Stifling my excitement to be doing this on a weekend night, I walked to the operator’s desk and paged the on-call intern, who — I’d been assured — knew I was coming. “You’re who now for what?” she stared blankly back at me after I’d explained my task.
My patient (we’ll call her Betty) …
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A nurse offers a medical student sage advice
Recently, our whole class was asked to “become” a diabetic to try and really understand what it is we’re diagnosing people with. Fantastic idea. Fantastic opportunity.
Not so fantastic to carry out. I opted for the insulin-dependent, type I option, which meant I had to keep a diary of what I ate (including counting carbohydrates), regularly check my glucose level, and inject myself before meals. (We didn’t actually inject insulin or saline, …
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A medical student becomes a diabetic and finds public disapproval
