Medical School

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.

Match Day and how each medical school celebrates

Kevin

Medical Education

March 18, 2010

by Brian Eule

While the debate continues to rage over the health care reform bill in Washington D.C., today at Noon Eastern time, the newest class of 15,000-plus graduating medical students will get their marching orders, beginning their lives working in medicine.

It’s called Match Day and each year, on the third Thursday of March, the nation’s graduating medical school students gather with their classmates and wait for an envelope with their …

Forcing residents to nap may not improve patient care

Kevin

Medical Education

February 21, 2010

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing — or rejecting — the IOM’s controversial recommendation has yet to make a decision.

The Accreditation Council for Graduate Medical Education (ACGME), which has …

ACP: Resident work hours – Managing a precarious balance

American College of Physicians

Medical Education

February 18, 2010

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,” in which it proposed a number of changes to the current regulations developed and enforced by the …

Why there are so few leaders in medicine and how to fix it

Kevin

Health Policy

February 3, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

A quick look at a newspaper will tell any doc just how important physician leadership has become, and increasingly so, in having a say in our economic futures. But our titular leaders are in a historically weak system complicated by being only one group of voices struggling to be heard in the rush to deal with national health care reform. There are many docs …

How to make your medical grand rounds thrive

Robert Wachter, MD

Medical Education

January 27, 2010

Early last year, my boss Talmadge King and I were at an ABIM meeting (we’re both on the board), and the group was debating a controversial topic. Another participant at the meeting, like Talmadge the chair of a prominent department of medicine, said, “We polled 250 people at our grand rounds last week, and they said ‘X’.” The audience gasped – ‘X’ was a completely unexpected …

Primary care needs a face lift, and a better agent

Jennifer Adaeze Anyaegbunam

Physician

January 21, 2010

General medicine is not sexy. Less than a fourth of the doctors in the United States are currently primary care providers like Pediatricians, Ob/Gyns, and Internists. According to a recent study published by the Journal of the American Medical Association, only 2% of medical students intend on pursuing a career in general internal medicine. So when health-care reform becomes a reality, and the 46 million uninsured men, women, and children …

ACP: 10 major challenges that confront medical education over the next decade

American College of Physicians

Medical Education

January 19, 2010

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past …

How doctors can look for the right non-clinical medical job

Joseph Kim, MD, MPH

Physician

January 17, 2010

How many physicians do you know who have chosen to leave their clinical practice?

There’s no doubt that physicians are getting burned out. Many are tired of fighting insurance companies and even more physicians are getting discouraged about reductions in reimbursement. This has caused some physicians to drop Medicare and Medicaid. Others have switched to cash-only or concierge/boutique practice models. Then you have your group of physicians who have simply decided …

The story behind a whistleblower doctor license reinstatement hearing

David K. Cundiff, MD

Physician

January 6, 2010

After the LA County + USC Medical Center closed my Pain and Palliative Care Service because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.

For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the hospital lost about …

How doctors can stay up to date with current medical information

Kevin

Patient

December 14, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

With the amount of research being published in medical journals and presented at meetings, it should not be surprising when a new finding slips by a busy physician.

Nor should it be surprising, then, that some decisions about patient care might be made without benefit of the most recent evidence.

Although experts …

Should body mass index (BMI) be used as a college graduation requirement?

Amy Tuteur, MD

Conditions and Diseases

December 10, 2009

It’s official. America hates fat people.

Human beings are constantly searching for socially sanctioned reasons to feel superior to others and in 2009, those who are thin feel mighty superior to those who are not. How else could a college dare to make body mass index (BMI) a graduation requirement?

According to James DeBoy, the chair of Lincoln’s Department of Health, Physical Education, and Recreation, the point of the new policy is …

Medical student needlestick injuries

Kevin

Medical Education

December 1, 2009

Originally posted in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Medical students are frequently stuck by needles, and few report their accidents, researchers say.

In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …

Read more…

Medical student needlestick injuries

How training to become a doctor in France differs from the United States

Yann Meunier, MD

Medical Education

November 22, 2009

Among the many differences between the U.S. and the French health-care systems is the approach to medical training. While U.S. medical school graduates in 2008 had an average debt of $154,000, French medical students receive their training virtually for free. For example, first-year medical students at the Faculte de Medecine Pierre et Marie Curie in Paris have only one mandatory cost for this year: an enrollment fee of $264.

The amount …

Are doctors getting enough skin cancer exam training?

Kevin

Conditions and Diseases

October 30, 2009

Originally published in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Opportunities to learn how to perform skin cancer examinations during medical training are inadequate, a survey of residents found.

More than half (55.3%) of residents said that they had never observed a skin cancer examination, 75.8% said they’d never been taught to perform one, and 57.4% had never practiced doing …

What does bias when analyzing data have to do with slow lines?

Paul Levy

Medical Education

September 20, 2009

Here’s an excerpt from a lovely little book by John D. Barrow called One Hundred Essential Things You Didn’t Know You Didn’t Know; Math Explains the World. This selection has a great lesson about statistical inference. The chapter is entitled, “Why does the other queue always move faster?”

You will have noticed that when you join a queue at the airport or the post office, the other queues always seem to …

ACP: Embracing a culture of cost-effective health care

American College of Physicians

Health Policy

June 25, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

In his column in the June 1 issue of The New Yorker, Dr. Atul Gawande used the example of McAllen, Texas, to illustrate the widely disparate spending on health care around the country. This oft cited article captured the attention of President Obama, who reportedly has made it required …

My reaction to President Obama’s speech to the AMA

Kevin

Health Policy

June 15, 2009

I was seeing patients during the actual speech, so I had to rely on the transcript.

The points that interested me the most were any language pertaining to malpractice, addressing the AMA’s recent concerns about the public plan option, and reforming the physician payment system.

I think he did pretty well.

Regarding the physician payment system, he again addressed McAllen, Texas, which is fast becoming the symbol of what’s wrong with American …

Abraham Verghese on the KevinMD Live Q&A: Monday, May 4th at 10:30pm Eastern

Kevin

Patient

May 4, 2009

Abraham Verghese will be answering your questions at my next live Q&A.

Dr. Verghese, a Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine, is one of the most accomplished and admired physician educators today. His pieces have appeared in The New York Times and The Wall Street Journal, and one of his recent articles, entitled Culture Shock, …

6 top medical comments, May 3rd, 2009

Kevin

Medications

May 3, 2009

Here are some of the more interesting comments readers have left recently.

1. Carla Kakutani on the lack of primary care access in Massachusetts:
So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment …

Read more…

6 top medical comments, May 3rd, 2009