His eyes were as wide open as his mouth as he slowly placed his beer on the bar without looking away from me. Making no effort to wipe the thick foam from his upper lip, the man continued to stare in disbelief, “That’s the coolest thing I’ve ever heard.”
The thirty-something C-something-O was blown away by what I did for work. By this time a small crowd had gathered, standing in …
Stop telling younger generations not to become doctors
As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues.
As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers …
How duty hour restrictions are hurting residency training
When I first seriously began discussing the possibility of applying to medical school with my family and close friends, I received mixed reactions. Although medicine seemed like a great fit for me in many ways, I also heard sad stories about relationships and even entire families that had struggled to survive the strenuous period of medical training (particularly residency). As somebody who values family and close relationships highly, I was …
The mantra of “more work is better” has to stop in medical education
In the hour after I heard the news, I experienced the full spectrum of typical reactions to a physician suicide.
One end of the spectrum came from the attending in a clinic, who when asked if the residents could go home and mourn their friend who just committed suicide, proceeded to tell me a story of how when her grandpa died before a final exam in medical school. She decided to …
A medical resident commits suicide. Here’s how one colleague mourns.
On February 3, 2016, many physicians on social media took a moment to celebrate the first ever National Women Physician, timed to coincide with the 195th anniversary of the birthday of pioneer, Dr. Elizabeth Blackwell.
I began the day with a Facebook post wishing all my fellow women physician friends and colleagues a happy #nwpd and adding, “May today be the last day someone says to any of us ‘you look …
The gender gap persists in medicine. What can we do about it?
A few years ago, the hospital where I work started new residency programs in internal medicine and family practice. Many of the residents do rotations in anesthesiology and surgery where I have an opportunity to meet and talk with them. They are eager to learn medicine of course, but they are also interested in the perspective that many of us who have been practicing medicine for many years have to …
New doctors should listen to this advice if they want to last
When I was finishing my fifth year of studies as clinical psychology doctoral student, I fell in love with a second-year medical resident; a wanderer at heart with the softest smile and a way of listening that made me feel like the whole world stopped when I spoke. Whenever possible, we found ourselves in the forest exploring the world on foot or, if the weather was bad, on long drives …
The heartbreak of dating an exhausted medical resident
It was a concept intimately familiar to me long before anyone gave it a name. From my earliest days in college, I felt surrounded by people who packed their days with meetings, activities, sports practices or competitions; classes, study groups, and research; for whom every moment had been spoken for and each day didn’t so much end as spill over into the next. The standard was clear: to do any …
Time macho: Why I’m part of the problem
In this article, I’ll discuss a medicine-specific strategy that many of my physician colleagues and I have used over the years to learn dense, complicated information quickly and effectively, and to do well on board exams.
These are the two most important tenets of studying for a medical board examination:
1. Find the highest-yield information and memorize it cold. With active methods such as mnemonics, teaching others, lecturing “to the wall,” writing notes …
A physician aces his USMLE and ABIM board exams. Here are his tips for success.
What does it mean to be competent at something? Competency may be defined as the ability to do something successfully or efficiently. When it comes to determining if a physician is competent in his profession, no one, board, no organization, no government, no residency training program or hospital actually will state that an individual is competent. There are significant legal ramifications to declaring someone as competent to practice medicine, and …
The questionable competency of today’s medical and surgical residents
In a few weeks, thousands of medical students find out where they have matched for residency. I still remember the excitement and anxiety of peeling back that envelope and hoping I would see my top choice. My medical school had a tradition of putting each 4th year’s name in an old doctor’s bag. One by one, our dean would pull out a name, the student would contribute $1 to the …
A quantitative analysis of the first year of internal medicine residency
It’s been six years since I graduated from internal medicine residency. Enough time to give me some perspective, but short enough to still remember the highs and lows vividly. I recently had the opportunity to talk with a bright and energetic group of medical students. (Really, though, is there any other kind?)
The conversation turned to any advice that I had or maybe I felt obligated to give some as part …
Listen to this doctor’s advice to medical students
All medical students start out as the best of the best: You had to be to get into medical school. So now that you’re in, what are some of the things you can do to attain the specialty you really want? How do you set yourself apart from your peers?
1. Get out of your head. Telling yourself you can’t achieve a competitive residency is your first barrier. If you can’t even …
5 simple strategies to get the residency you want
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Last week I, like many around me, came down with a horrible cold. My husband got sick the week before and was in bed all weekend sleeping and trying to recover, and lo and behold, come Monday, I started having the same symptoms.
I knew the approximate course of the cold since I’m a doctor, and I saw my husband go through it, but I thought I could be strong and push through. I continued …
You’re a doctor and you’re sick. Make your health a priority.
This past month has been a particularly difficult one for me because I’ve been on our float rotation. I have worked only night and swing shifts throughout our hospitals; this means my work hours are primarily from 8 p.m. to 10 a.m.
There are certainly other rotations during which I worked longer hours and had more emotionally draining conversations, but I have never felt as burned out as I have this …
The unintended consequences of the night float rotation
There’s been a bit of kerfuffle over resident duty hours lately.
For those unfamiliar with the topic, physicians in training in the United States have traditionally lived in the hospital — hence why they were called residents — and available to patients 24/7. Over time, concerns about patient safety led to limits on how many hours could be worked consecutively in the hospital. In 2003, the maximum number of …
Why resident work-hour restrictions should be individualized
“She is not yours to grieve.”
That statement, from another physician, hours after Ava died and as pent up tears rolled down my face, left me embarrassed and ashamed.
The message: She was my patient, not my child.
Never mind the amount of time and tenderness I had poured into her care during the month she spent in the pediatric ICU. I had no right to mourn her death. I am a doctor.
As …
Doctors grieve too: A lesson I did not learn in medical school
As a second year resident, I often do not feel like an expert in anything. Every day I learn more about medicine and realize how much more I still want to learn. In spite of the emotional, physical and mental challenges that being a young doctor entails, I have remained positive and have grown stronger throughout residency. As I reflect on the past year and a half, I appreciate the …
10 tips to make residency more enjoyable
Up to a third of resident physicians suffer from clinical depression or its symptoms. This was the finding of a large review of 54 studies involving 17,560 resident physicians, published in JAMA recently. In some of the studies reviewed, up to 40 percent of resident physicians reported depressive symptoms. The study found these physicians were 4.5 times more likely to suffer from depressive symptoms following beginning …
The key to preventing depression in residents? Value young physicians.
Readers are slowly learning about my admiration for the Farnam Street Blog. The about page describes the blog in this way:
My goal is to help you go to bed each night smarter than when you woke up. I’ll do this by giving you tools, ideas, and frameworks for thinking.
I’m not smart enough to figure all of this out myself. I try to master the best of what other …
These are the words medical educators should think about
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