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. The board exams that follow training, and the fight over maintenance of certification, are on Board certification: what physicians say about the boards and MOC, in their own words. Medical school itself is a separate record.
In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the…
In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the lack of correlation between fastball speed and the quality of a pitcher. As it turns out, the most important factor in a pitcher is deception, not a high-velocity fastball. The …
On a normal Tuesday, one of my fellow residents did the same things we all do. She woke up before sunrise, put her best face forward, came to work, saw patients quickly, wrote notes, said "good morning" to everyone at…
On a normal Tuesday, one of my fellow residents did the same things we all do. She woke up before sunrise, put her best face forward, came to work, saw patients quickly, wrote notes, said “good morning” to everyone at morning conference, saw more patients, wrote more notes, then went home. She said “good night” to her loved ones — her parents and siblings at home — and went to …
To me, five years ago: Right now you are 28, seated at the top of everything: chief resident of the entire pediatric department. You are in charge of 19 other interns and residents. You are resilient, kind, funny and determined.…
To me, five years ago:
Right now you are 28, seated at the top of everything: chief resident of the entire pediatric department. You are in charge of 19 other interns and residents. You are resilient, kind, funny and determined. You seem to have the solution for everything, yet you don’t actually have the answer to anything. At least that’s how you’ll feel on most days in your new leadership role. …
The other day I was sitting at home looking out the window at an achingly crisp, clear blue sky. A slight, cool breeze was wafting through that open window, and faint birdsong accented a view of tree tops in blooms…
The other day I was sitting at home looking out the window at an achingly crisp, clear blue sky. A slight, cool breeze was wafting through that open window, and faint birdsong accented a view of tree tops in blooms of pink, red, and white. The blue-tinged mountains were hovering in the distance, proud and majestic.
Only, no. I was actually at work. Underground. In front of a computer screen, whose …
Fireworks, champagne toasts, sparkly hats, and the ball drop are all items that we conger up in our minds as we think of the New Year. For the majority of the world, January 1st represents the transition from one year…
Fireworks, champagne toasts, sparkly hats, and the ball drop are all items that we conger up in our minds as we think of the New Year. For the majority of the world, January 1st represents the transition from one year to another on the calendar. New resolutions are made, and there is a global fresh start. However, for those of us in the medical field, there is another new year …
Every July, recently graduated doctors from medical school transition into hospitals, clinics, and surgical rotations. Doctors completing their internship year welcome the second year with additional leadership roles. This period of transition is coupled with the pressure of doing well,…
Every July, recently graduated doctors from medical school transition into hospitals, clinics, and surgical rotations. Doctors completing their internship year welcome the second year with additional leadership roles. This period of transition is coupled with the pressure of doing well, the stress of proving your competency on attending rounds, and the desire to receive respect from your team.
It is easy to become confused and frustrated as you learn to navigate …
My wife and I were in a unique situation after graduating medical school. We had met in the first year of medical school in and became friends. During our second year we started dating, and by end of third year,…
My wife and I were in a unique situation after graduating medical school. We had met in the first year of medical school in and became friends. During our second year we started dating, and by end of third year, we were married. By the beginning of fourth year, we were proudly expecting. By June 1st, 2016 we were fortunate enough to share our graduation from medical school with our …
They say you never forget your first crush. Or your first date. Or your first kiss. And you don't. Just as we have landmarks events that shape us in the adolescence of our personal lives, physicians also have landmark events…
They say you never forget your first crush. Or your first date. Or your first kiss.
And you don’t.
Just as we have landmarks events that shape us in the adolescence of our personal lives, physicians also have landmark events that shape them in the adolescence of medical training: residency.
No longer a child of medical school, needing constant supervision and clinical babysitting by elders, resident physicians start with a refreshingly nascent view …
I knew that residency would be indentured servitude for (in my case) three years. I knew it. I prepared for the fear, the shaming, and the isolation as best I could. And I have for the past 11 months done…
I knew that residency would be indentured servitude for (in my case) three years.
I knew it. I prepared for the fear, the shaming, and the isolation as best I could.
And I have for the past 11 months done OK. I am not the smartest or fastest. But I am told that I am passionate about my patients and have an “adequate fund of knowledge.”
Dear intern, It will be the best of times, and it will be the worst of times. But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine —…
Dear intern,
It will be the best of times, and it will be the worst of times.
But what a special time this will be. It will be a time of learning the details and nuances of clinical medicine — the diagnostic features of sarcoidosis and the second, third and fourth line treatments for community-acquired pneumonia. You will learn how to learn, and you will forget what you learned, only to learn …
When I started my intern year, I was told that I was going to be sleep deprived and it was going to be the worst years of my life. Yes, there were times I racked up a sleep debt, but…
When I started my intern year, I was told that I was going to be sleep deprived and it was going to be the worst years of my life.
Yes, there were times I racked up a sleep debt, but it was for patient care. And because of the camaraderie and relationships I formed (both inside and outside the hospital), I will forever remember residency with a smile.
Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many…
Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many of us are quite literally surrounded by the four white walls of an exam room most of our lives.
Physicians work hard to treat each patient individually, but this feeling of …
I will walk into the hospital with a clean, ironed white coat buttoned to the top, dress shoes polished, a tie neatly knotted under my collar, my maroon stethoscope rearing to go -- and I will be largely unprepared for…
I will walk into the hospital with a clean, ironed white coat buttoned to the top, dress shoes polished, a tie neatly knotted under my collar, my maroon stethoscope rearing to go — and I will be largely unprepared for what lies ahead. Along with countless others across the country, I will begin my medical internship, a year considered by many to be the most important in a physician’s working …
In my last year of training, I came to realize the difference between doctors who felt successful and those who didn’t. From the beginning, I had always been hard on myself. I always thought about the decisions I made for…
In my last year of training, I came to realize the difference between doctors who felt successful and those who didn’t. From the beginning, I had always been hard on myself. I always thought about the decisions I made for every patient in detail, played them over and over in my head, and wondered what I could have done differently for each one. Whether or not their outcome was satisfactory, …
The Match. The happiest time of any medical student's life. Years of hard work culminating into one moment of affirmation. It's enough to bring any student, proud family and friends to tears. That is unless you find the daunting words…
The Match. The happiest time of any medical student’s life. Years of hard work culminating into one moment of affirmation. It’s enough to bring any student, proud family and friends to tears. That is unless you find the daunting words pictured below:
Match Results: We are sorry, you did not match to any position.
Though I wish and hope that no one else has to see this screen, reality is in 2016 …
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. What is the best way to approach a struggling learner?…
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.
What is the best way to approach a struggling learner?
What is the best way to give guidance and feedback without being perceived as a tyrant or overbearing?
How can I maximize the potential of my team members and the trainees
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…
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 …
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,…
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 …
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…
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 …
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,…
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 …
