Here are some questions that are still on my mind as I approach the tail end of my chief year. I’m thinking about the best ways to offer constructive feedback.
How to give constructive criticism as a physician
I was walking home from classes last week when I ran into a few friends from my medical school class sitting outside at a local bar. I was done for the evening, so I pulled up a chair, ordered a beer, and joined the conversation. They were talking about the wards. I’ve been on a year off since we’d all been third-year medical students together, so it was fun to …
Why is there hostility between medical specialties?
The ACGME recently formally increased its work-hour limits for resident physicians, a change that was widely covered in the press.|
This decision has also been significantly misreported. While it may seem like all residents will now work for longer hours, in reality, only first-year interns will be allowed to work longer 24-hour shifts, where the previous maximum was 16 …
Defending the increase in duty hour limits
During medical school, I made it a goal to graduate with a degree in one hand and a baby in another. I had a supportive husband, so we started trying to conceive when I was in my third year of medical school. We didn’t get pregnant as quickly as I thought, and we almost gave up on the idea of having a baby at that time. I was already 28 …
5 things I learned while having 3 kids during medical school
Most doctors are very bright people. I believe that what often sets apart those who perform well on the job and on exams isn’t raw intelligence but rather the ability to learn effectively.
In the MCAT and USMLE steps 1, 2, and 3, I did poorly and barely passed. In 2009, I took my family medicine in-training exam and fell below the minimum passing score. After taking almost five years away from residency …
How I went from the bottom to the top 1 percentile on board exams
Before I started my residency program at Boston Medical Center (BMC), I had no idea that residents were unionized at 60 hospitals across the country. I actually didn’t know much about unions or the labor movement until I got involved in contract negotiations between my own union, the Committee of Interns and Residents (CIR), and Boston Medical Center administration. Through this process, I now know what it is like to …
The importance of a doctors’ union in the age of Gorsuch
From a young age, I knew I wanted to be a physician. There were no physicians in my family, but I had interacted frequently with doctors as a child and felt a strong desire to similarly help others as I grew older.
To this end, I focused on academics. In choosing a university, I chose the one I felt was academically best, despite being a private school in an expensive city …
The far-reaching consequences of medical school debt
Are you a medical resident or fellow? Do you have a family to provide for? Do you feel that your biweekly paycheck is not quite enough to justify the hard work you put in? Luckily for you, your program offers the great benefit of “moonlighting.” Should you take advantage? Here are some of my thoughts on the matter.
What is moonlighting?
Like so many other things we take for granted in medicine, …
The pros and cons of moonlighting for medical trainees
The hold music on the telephone cut off abruptly as the doctor I was trying to reach picked up the line. “Yes?” she said curtly.
“Hi, this is Erin Barnes,” I said. “I’m calling from Temple University Hospital in regard to one of your patients. She was admitted last week with anemia. We were initially concerned …
This physician fights burnout by having a binder of successes
When the U.S. health care system began, physicians were largely autonomous in selection of medical treatments and their delivery. Patients were treated under a fee for service model. However, over time we began to notice an alarming incline in medical spending which ultimately lead to the development of health maintenance organizations (HMOs). At their inception, HMOs were intended to standardize medical treatment, reduce unnecessary use of resources, and encourage the …
We should teach medical residents health policy. Here’s why.
On July 1st, 2017, the updated Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements will take effect. The increase in the maximum continuous work hour shift from 16 to 24 hours has surely received the most attention, and will likely continue to do so.
However, the ACGME did make some significant improvements in this latest guideline update worth noting. Among them was a slight conjunctional switch from an “and/or” …
The little-known ACGME guideline change every resident should know
After thirteen years of duty hours restrictions, it was important for the Accreditation Council for Graduate Medical Education (ACGME) to assess the impact those regulations had had on patient safety and resident training. So last year, on March 16 to 17, 2016, the ACGME convened a congress on resident duty hours in Chicago. It was evident to everyone who attended that the ACGME had made a real commitment to hear …
Defending the change in resident duty hour restrictions
Every summer medical school seniors are faced with the daunting task of completing applications for residency programs. This requires completion of the “common application” through the Electronic Residency Application Service (ERAS), among other things. This ultimately becomes a compilation of medical school and USMLE transcripts, letters of recommendation, personal and biographic information, a personal statement, and a resume composed of work, volunteering, and research experiences.
Countless hours are spent on its …
The Match is broken. Can it be fixed?
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“Can you make Moana sing,” my four-year-old daughter begs as she widens her dark brown eyes. (My husband insists those are my eyes.)
Apparently, the Disney toy was involved in an accident. A button on the wrist that makes the doll loudly blurt out “See the line where the sky meets the sea!” has become separated from her plastic body. Pink wires stick out instead of forearm bones. I’m a doctor. …
This is what foreign doctors have to deal with
Spoiler alert: I am biased. I graduated from St. George’s University, a medical school in Grenada that graduates more physicians annually than any other medical school in the world. It is a school comprised of people who are so determined to become doctors that they are willing to move to a different country — some taking their families with them, some leaving everything behind — to study medicine. My peers …
5 reasons why IMGs will save U.S. health care
The scene at the resident teaching session was all too familiar: Awkward silence with either blank stares or brows furrowed in deep valleys of confusion. As I scanned the room, I recognized the moment many lecturers experience: I had completely lost my audience. And, whatever I had planned for the next 10 minutes, would now be spent “taking a step back.” We weren’t talking about a crazy exam finding or …
It’s time to teach residents money management skills
On Saint Patrick’s Day, my classmates and I will file into a room. Each of us will pick up a small white envelope, and we’ll open them together. Inside those envelopes will be the answer to a question we have wondered for months: Where did I match? Where will I begin my career as an MD, and what kind of doctor will I be? After years of endless studying, hundreds …
I’m afraid of public humiliation on Match Day
Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality):
“I did my internship in internal medicine and residency in neurology before laws existed to regulate resident …
The secret horrors of sleep-deprived doctors
On March 17 at noon, about 18,000 medical students will open envelopes telling them where they will spend the next several years of their lives. It’s residency Match Day, and for many, that letter is one of the most important they will ever receive.
The process is supposed to be straightforward. Medical students, like me, submit applications to hospitals and health systems …
How medical students can game Match Day
It’s Match Day. Standing with my medical school class in the lobby of our medical education center, there is a palpable energy. It had been a long journey. After reluctantly leaving CA for NY I had finally completed four grueling years. The entire time I was laser focused on doing well enough to make it back to California. The four years came and went in a flash, and without hesitation, …
The untold story of Match Day emotion
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