America’s resident physicians have strict limits on how many hours they can work in the hospital. Many break that limit and keep quiet about it. Others lie.
Resident physicians are the doctors-in-training that millions of Americans come into contact with at teaching hospitals across the country. We work for three to seven years (it depends on the medical specialty) …
Your doctors may be lying about how long they worked today
One of the most respected and skilled clinician-educators — of course, he is an infectious diseases specialist — at our institute came into my office, sat down and immediately starting eating pretzels. “Let me know what you think about this,” he said between bites. He went on to recapitulate a recent interaction he had with the members of the internal medicine team (medical students, house staff and the attending physician) …
Are you asking students questions or “pimping?”
It’s not a sprint, it’s a marathon.
You often hear this analogy about the medical training process, but, having run a few marathons myself, I think it’s particularly apt. I’m working my way through my fourth and final year of residency now, and I can attest that running marathons was one of the better things that prepared me mentally for the challenges of med school and beyond.
26.2 miles is no trivial …
How running marathons helped prepare me for medical training
It was 1 a.m. on a Sunday night on call, and we were waiting patiently for admissions in the resident workroom. We were four near-perfect strangers, yet we had one thing in common: our challenges we faced in maintaining relationships. Was it truly because of our shared profession of medicine or because of our similar personalities that led us into the field? We realized we struggled preserving our current relationships …
The difficulty of maintaining relationships throughout medical training
Dear future colleague,
What a tremendous thing it is to know you are becoming a physician! You are devoting your life and talents to the betterment of the health of your future patients, your local community, and our entire society. You have responded to the call to serve in a profession that is hundreds of years old, steeped in tradition but vehemently progressive, always changing, and vowing to remain abreast of …
A young black physician’s letter to future black doctors
Let’s start with the most important part first. Your primary goal while in residency/fellowship is to become a great doctor. The kicker is that you also have to devote some time to your finances and not completely neglect them. We will outline the few financial items you should worry about while in residency.
Student loans
If you don’t have student loans, go ahead and skip to the next item; however, the unfortunate …
A medical resident’s guide to personal finance
I still don’t know how I did it. I don’t know how I got through life as a lower-level neurosurgery resident. I vividly remember the horrific call nights and weekends. There are certain sensations you get when you have gone weeks without more than two or three hours of sleep at a time. It wasn’t the foggy thoughts that bothered me most, or continually feeling cold, or even when I …
The debate over how many hours an intern can work misses the point
What is grit?
In an article in The Guardian, Angela Duckworth, a psychologist often called the guru of grit, defined it as the commitment to finish what you start, to rise from setbacks, to want to improve and succeed, and to undertake sustained and sometimes unpleasant practice in order to do so.
She said in a paper that grit is perseverance and passion for long-term goals.
I think we’d …
One way to train gritty doctors: Don’t allow them to quit
A response to “This resident works 100+ hours per week, but is still a poorly trained surgeon.”
I am truly sorry your experience in a urology residency thus far has been far below your expectations. I am finishing residency in June, and I know how hard it is. There are sleepless nights, thankless tasks, and residency feels like a learning process that crawls forward in inches rather than feet. …
Not all residency programs are bad. Here’s what to do if yours is.
Dear patient,
I may never get to meet you, which is a real shame. I think I would have enjoyed getting to know you and working together with you to overcome whatever particular medical issue with which you had come to meet me. We might have learned about each other. We might have learned about our community. We might even have made some kind of change together.
I myself am a patient, …
Are the new work-hours restrictions pushing people out of medicine?
“I did a weekend of 72 hours in which I only got four hours of sleep. I would also secretly hope to get in a car accident and maybe break a leg so that I would be force to take off from work … just so I could get some rest. Thank God, I never got in an accident, but I have had colleagues fall asleep at the wheel.”
– Dr. …
The American system for training doctors is broken
Sleep deprivation and medical errors are not the only issues that arise from long shifts. Aside from being dangerous, working 28 hours straight can teach new doctors that their health and even their life is not a priority. With extremely high rates of depression and suicide in this field, increasing work hours is not the step we should be taking. When I was interviewed by Public …
A different consequence of 28-hour shifts
Nothing compares to the apprehension of starting residency.
OK, that’s not true, but it’s really high up there on nerve-wracking firsts.
I remember my first day as a resident. In a matter of a few hours, I went from being human furniture to being asked to make life-altering decisions. I was overwhelmed, to say the least. Here are some pieces of advice that I wish senior residents would have emphasized before I started this …
Be prepared mentally, physically, and socially for residency
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“Medicine Purple is now rounding at Room 202.” The announcement rang throughout the hallways on the lower pavilion. It was an announcement I had heard many times before, but this time it was quite different. As I glanced in the upper right-hand corner of the electronic medical record of my first patient, the following glared back at me in all capital letters: “ATTENDING: COOPER, JOSEPH DAVID.” I had imagined the …
The moment my passion for clinical care was reaffirmed
On Friday, November 4, Thomas Nasca, MD, the chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME), released a letter outlining the proposed changes to intern work hour restrictions and other regulations.
Specifically, the proposed update is expanding the previous restrictions to the length of the intern (who is a physician in their very first year out of medical school) work day from 16 to up to 28 …
The new hour restrictions for residents: Stop with the manipulation
Kicking off intern year means BBQs, team dinners, and block parties. Every invitation encourages us to bring our significant others, those people who define our existence outside of the hospital. And yet, hot dog and cold drink in hand, it seems we can’t help but alienate our non-medical partners by talking exclusively about the minutiae of our medical lives: our interesting patients, our frustrations, and our philosophies of medicine. They …
Burgers with a side of glomerulonephritis
Something odd happens in medical school. It affects you as a patient, me as a provider, and state and federal budgets.
For the first two years of medical school, empathy levels stay the same while we bubble in multiple choice questions. Then third year comes. Eagerly, we drop the backpacks and pick up the stethoscope ready to see real life patients. What happens during this long awaited year? Read more…
How medical humanities can help physician burnout
It’s that time again — time to dust off your nicest suit and prepare for either residency or fellowship interviews. Being knee-deep in interview season for infectious diseases fellowships, my interview days bear some resemblance to my residency interviews, yet also are quite different. I have a unique opportunity this year to be a part of the recruitment and decision process for our internal medicine residency program, in addition to being a fellowship applicant.
I was visiting …
Dos and don’ts for your residency interview
It is hard for any physician to advance as a medical researcher. Competition for research funding is fierce; the rigors of publishing in prestigious medical journals are gargantuan. And women pursuing such careers face even bigger challenges, with many having to take on disproportionate burdens at home compared to their male colleagues (caring for kids, attending to chores), while receiving less effective mentorship than equally accomplished men.
Add …
The silent epidemic of sexual harassment in medical schools
I began one of my medical oncology rotations alongside my co-resident: an MD/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were “Harvard kids.” Needless to say, I was intimidated. My colleague and counterpart not only had the entire catalogue of genomic alterations at the tip of his tongue, he knew and understood their implications on disease. I saw my intern having a long conversation …
Being ashamed to acquire knowledge is a tragedy
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