Viewpoint #1. Training programs might say: we are headed for a major league collision in the training of women physicians. Soon 50% of all trainees will be women, and in some specialties, such as OB/GYN, they will be 80-90% of the residents in any particular program. Training years coincide with prime child bearing years. Imagine if even only half the residents in a program were pregnant at once. What would happen …
Are pregnancy and residency compatible?
Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). Switching residencies? Not recommended. But entirely doable.
I spent most of my first half of internship being really, really miserable. I remember sitting in the call room during my ICU month, talking to my mother about how badly I wanted to quit and what my options would be if …
Why I quit internal medicine for physiatry
Virtually every medical school graduate immediately enters at least three years of post-graduate medical training (internship-residency). The exceptions are those who:
1. combine the MD with a JD or PhD;
2. leverage the not-yet-dry diploma into a post as health policy advisor to a state or federal legislator, usually one of Dad’s chums;
3. are named Michael Crichton.
Commencement is in late spring, so post-graduate training begins on July 1. Every year my surgery …
My first day as a surgery intern
Would you rather your physician be an astute diagnostician or a compassionate and empathic practitioner? Of course, we want our physicians to be blends of these qualities. We want it all. We want them to be chimeras of Drs. House and Welby. But, is this possible?
I can’t say. I suspect that it is easier to cultivate soft bedside manners than it is to teach medical acumen, although the latter was …
Choose your doctor: Astute diagnostician or empathic practitioner?
“Dr. Fisher, can you teach our residents EKG lecture series?”
Naively, I said “Sure!”
What I didn’t realize is how hard this is to do today.
Much of this is not residents’ fault. They only have so many hours in so many days to attend lectures while caring for patients. Thanks to residency work-hour restrictions, those hours have become even fewer. To make matters much worse, through the year residents are torn to …
EKG reading: It’s shocking what medical residents don’t know
Across the country, newly minted doctors have started their internships. The first night on call there won’t be an intern – anywhere in the country – who will sleep. Every new intern is absolutely convinced that the beeper is going to go off and they won’t know what to do. (You get over this by about the 2nd or 3rd call night, by the way).
Graduating from medical school …
Tips to be the best intern you can be
June in the United States heralds the month when residencies end and new ones begin. While much will be written soon about the dangers of entering hospitals this time of year (this story never seems to tire with mainstream media), I would like to step back and reflect on why doctors should consider attending residency graduations. I had the pleasure of doing so recently.
Excitement. With all of the dreary news of …
Why doctors should attend residency graduations
“What about combined psychiatry-family medicine-neurology-internal medicine programs? Should I try to do a triple board program in psychiatry-child psychiatry and pediatrics?”
Every April, I field such questions from a slew of rising fourth year students who have become, to their surprise (and sometimes dismay), passionately interested in psychiatry. Psychiatry is a shortage specialty and psychiatric issues rank high among the challenges facing medical care systems here and around the world. For …
Should medical students consider a combined psychiatry residency?
The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.
I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …
Medical school and residency aren’t places for human growth
The more I talk to new physicians who are transitioning into practice, the more I realize how many substantial life and career shifts occur post-residency.
I experienced these changes myself several years ago, but it’s taken me a while to fully process them and realize how they’ve affected my life.
In fact, it would be safe to say that I experienced a complete 180 after graduating from residency. I know other new …
Tips for adjusting to life after residency
Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …
Medical residents are abused more than Chinese factory workers
Some people critique Continuing Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic …
CME limitations and how we can improve Continuing Medical Education
Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.
As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …
Tips to fight depression during medical residency
Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …
Heed the 4th year medical student spoils
I never realized before how much work goes on behind the scenes to prepare and conduct these interview days, but I sure do now. As a Chief Resident, I schedule residents to attend the applicant dinners, lunches, and tours, and to spend time with the applicants our lounge. This makes the actual interview days go by much smoother, because two of us are present at all times to speak to applicants and answer any …
Residency interview tips from a Chief Resident
Like many of my colleagues, I teach and supervise students, residents, nurses, and respiratory therapists. I’m also the medical director of a PICU. Overall, I’ve been teaching and doing administration for over 30 years. And, like most of my colleagues, I never received any formal instruction at all in how to do these things. To some extent I got help from my own mentors, primarily by watching what they did, …
Reward or punishment in medical training
I don’t like selecting colleagues through the Match. The process was established to allow students to get the best opportunity available and I feel that our program (and our patients who rely on our trainees to provide care) is in jeopardy every year. It always turns out better than I anticipate, so I shouldn’t complain. However, we have to interview 60 prospective residents to fill our six slots so …
Advice to prospective family medicine residents
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 …
The 3 types of residents that medical students will encounter
I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.
What kind of shoes should you wear in the hospital?
There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …
What kind of shoes should you wear in the hospital?
The average week for a medical resident training in Mexico can easily exceed 90 work hours. Mexico is a country that takes pride in offering full health coverage for 100 million citizens. This is a new policy and free public medical care is being pushed to the limit. The situation is simple, the work load in outpatient clinics, operating rooms, the wards and emergency rooms across the country is …
The life of a medical resident in Mexico
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