Residents, attendings, and the physicians who remember training writing on KevinMD about residency: intern year, duty hours, supervision and autonomy, pay and unions, having a family during training, mistreatment, the Match for international medical graduates, and what physicians say should change about how residents are trained. Many contributors write anonymously, and many write while still in training. For a maintained record of what residents and attendings have said about residency itself on KevinMD since 2004, from intern year through the end of training, attributed by author and date and organized by question, see Residency: what residents and attendings say, in their own words. For what international medical graduates have said about the Match, visas, and being foreign in American medicine, see Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words. Medical school itself is a separate record.
This summer, new resident physicians begin their training all across the United States. Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a sideline) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school. Anxiety-filled and debt-ridden, they will embark on four …
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Nurses are always right. And 28 other tips for new residents.
The season has opened, and panic has spread among senior year residents, chief residents, and hospitalists out in the community. Fellowship applications are live and being viewed by the programs applicants think they want to rank one, two, and three. These incredibly intelligent physicians are refreshing student document network daily now and soon to be hourly as the weeks go on. The anxiety is building as people are waiting to …
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Tips for fellowship applicants from a program administrator
Even though my own internship was a decade ago, I vividly remember the transition from student to resident. Residency was monumental in my path to becoming a physician. There were obvious changes: People now called me “doctor,” my misshapen short white coat was upgraded to a more comforting full length one, and I was often the first one paged to respond to patient problems. Coupled with the positive aspects though, …
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How to thrive during your residency
Literature coming from business and human resource management suggests that women are over-mentored and under-sponsored. However, if you have been reading reports about women in medicine, then you likely have heard that women are both over-mentored and under-mentored. Where does the truth lie? That depends on various factors including the definitions of these terms.
What exactly do these words mean? In the business sector, mentorship is …
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What’s better: mentorship or sponsorship?
I sometimes get messages from people who have lost physician colleagues and loved ones to suicide. It’s the specifics of these stories that wound me: a note left for an unexpected person; an insignificant fight at sign-out that in retrospect is full of meaning; the white coat that a woman wore when she jumped to her death. Each of these lives is complex, and each of these deaths …
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What I wish my family had known about medical residency
Young, aspiring doctors are the Iron Youth of this generation. In Erich Maria Remarque’s All Quiet on the Western Front, young German soldiers are called the Iron Youth as part of a campaign to generate enthusiasm for fighting in the war; these soldiers soon realize the true horrors of war and its lasting impact on the psyche. The analogy is not necessarily to compare residency to war but to highlight …
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8 things I would tell my younger self
There are 168 hours in a week and 8,736 hours in a year. There are 10,080 minutes in a week, and 524,160 minutes in a year. Residents and fellows working in an academic environment often work close to, if not in large part, more than 80 hours a week, or 4,160 hours a year. They work 4,800 minutes a week, and a staggering 249,600 minutes a year. In medicine, it’s …
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Where has the loyalty in medicine gone?
Summer is upon us, and with it comes the end of the academic year, graduations and the arrival of the newest crop of interns. Soon these fresh-faced physicians will enter into one of the most remarkable educational experiences of their medical careers: residency. Many of these soon-to-be-interns are looking to attendings now for advice on how to excel during (or survive through) the arduous first year of training. Suggestions like …
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Welcome to your intern year breakdown
Congratulations! You made it through medical school, got your MD/DO degree, and can officially be called doctor! One day, you’re a student. The next, you’re a doctor and with that come the responsibility, trust, compassion, and professionalism associated with our career. But how do you transition?
It starts with your mindset and then deciding to be the best doctor you can be. Your thoughts inspire your words, which direct your actions.
I …
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The new doc on the block: 7 lessons from my first year of being a doctor
The third year of medical school is met with a newfound sense of freedom. Freedom to rediscover yourself and rekindle your love for all things forgotten. It’s about the thrill of seeing your textbook knowledge come to life or connecting deeply with a stranger. It’s about the humbling moments in medicine that force you to hide tears in the exam room. Allergies, you say.
You can tackle anyone’s drug list now, …
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Medical students: Here’s to becoming the best version of ourselves yet
When I was in fourth grade, I won our school’s spelling bee. This meant that I went on to the next tier of the local spelling world — the sort of prestigious competition that takes place in a gymnasium somewhere with a makeshift stage and a bunch of flags.
I was the first kid disqualified. I misspelled veterinarian “veterenarian” and battlement “battlemint.” I remember feeling, in the moment the announcer said, …
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We are sorry, you did not match to any position
Strong letters of recommendation are essential for supporting your residency application and matching well. This article details how to ensure you get great letters of recommendation.
Knowing what constitutes a great letter of recommendation is crucial to obtaining outstanding letters. A strong letter of recommendation clearly conveys knowledge of the medical student, how that student performed and qualities that predict excellent performance in residency. Strong letters of recommendation include the following:
How to ask for a great letter of recommendation for residency
I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …
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Medical residents and academic due process: Know your rights
The words were like bitter candies that I had been sucking on, hoping to come to a sweet center. I had walked the hallways of the hospital holding them in the silky pocket of my cheek for weeks. Finally, afraid I would choke, I spit them out into the middle of the dinner table.
“I think I’m depressed.”
I stared down at the tablecloth, moisture collecting on the base of my water …
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Fight depression during residency by fostering connections
The first week of residency of any program is usually comprised of several orientation sessions in which the new interns are introduced to various important aspects of the residency program. My orientation week was no different with a river of new information flowing towards me. Needless to say, I felt a bit overwhelmed and struggled to keep track of everything that was being introduced. Later on, I found out that …
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Has patient-centered care gone too far?
The tendency to look back and impose self-criticism for the past is an all too common human tendency. A more robust strategy involves looking far ahead — not just dreaming, but making a detailed plan after careful analysis of goals, hopes, and reality. What follows are some thoughts and wishes applied through the filter of the retrospectoscope.
Father time
The bravado of youth often overlooks critical developments that alter the landscape of …
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What I wish I knew as a young doctor
A 76-year-old gentleman with a history of kidney failure, myasthenia gravis and recently diagnosed with esophageal cancer presented for evaluation of melena and hypotension.
The patient was my first admission to the medicine team as an intern, and he was as near to an ICU admission without actually being admitted to the ICU as one could come. After examining the patient, I briefly staffed with the busy attending physician, placed the …
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A medical intern’s 3 greatest fears
Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life.
We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted …
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The medical education system hates families
Medical students and residents become accustomed to living life in year increments. Four years for medical school, three to five years for residency, a couple years for fellowship, research, and so on. While many of us like to think we are putting our life on “pause” as we complete our medical training this just isn’t possible. Life is happening all around us every day. Many physicians look back on their …
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How to have a life in residency
A single error oft inters the good that doctors do. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS convicted for homicide for the death of a child from sepsis and hounded by the General Medical Council is every junior doctor’s primal fear.
A boy in shock
Friday, February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had recently returned from a 13-month …
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To err is homicide in Britain
