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. Medical school itself is a separate record.
I recently recreated a now-famous business school study on a subset of residents in my internal medicine residency program.
In the original study, researchers asked students to read a case of the real-life venture capitalist Heidi Roizen, who expertly leveraged an extensive professional network to forward her career. Half of the students read the original case; half were given a case in which Heidi’s name was switched to Howard — a …
The afternoon began like any other day in medical school. Students arrived at the lecture hall and took their seats. An individual with long blue-and-white hair and handlebar mustache entered the room wearing oversized fish-print pants, a loose-fitting clown shirt, and a single earing fashioned out of a bent fork. He casually strolled up to the front, introduced himself as Dr. Patch Adams, and told us …
I watch as my almost-2-year-old daughter awkwardly climbs the stairs. I do not hold her hand, but I do not turn my back on her either. She is still clumsy, and her little-bowed legs often miss their targeted landing spots. She holds on to the rail with a vice grip that steadies each monumental step forward and upward.
Every so often she wobbles as she miscalculates the distances and her toes …
It’s 2 a.m., and the patient’s blood pressure is beginning to rapidly decrease. Every IV line is occupied by an antibiotic or IV fluids, and we are in need of a vasoactive medication. The nurse comes to my computer and sternly states, “We can no longer avoid it. I think the patient needs a central line.” I quickly say “OK,” but I don’t move. I am momentarily frozen by my …
It is the fourth year of medical school, and I have been dreaming in the language of ERAS (electronic residency application service). In less than one month, I will put my name into the sorting hat of applications as part of the match’s algorithm to interview, and hopefully I’ll be matched to a pediatric residency position.
Based on 2014 program director survey data published by the National Residency Matching Program (NRMP) …
Three words that many physicians couldn’t ever imagine coming out of their mouth, but for me, I say it all the time, usually with a smile on my face. I was a year and a half into my family medicine residency and decided it was enough. My decision mostly revolved around the birth of my son. My husband (a resident in the same program) and I planned to …
Have you ever had that experience when you think what you’re doing is futile, and that thought goes through your mind:
“Why am I doing this?”
“I’m torturing him.”
“This feels wrong.”
For those of us that are physicians, think back to your internship and residency training. I think we can all remember at least one of these situations, if not more.
I remember being in the ICU as a third-year internal medicine resident, being sent …
Lately, there seems to be a lot of negativity surrounding the practice of medicine. From the staggering student debt, to the grueling hours as a resident, to the high rate of burn out, it sometimes feels as though this profession is constantly under attack. To be honest, I’ve threatened to quit medicine so many times over the last decade that it’s become somewhat of a family joke. I even went …
“Thou must be like a promontory of the sea, against which, though the waves beat continually, yet it both itself stands, and about it are those swelling waves stilled and quieted.”
– Marcus Aurelius
My reaction to this quote, which begins Osler’s Aequanimitas, has changed over the years. When I first heard it, I was filled with a sense of pride and anticipation. I would be that rock, for my patients, for …
Confession time: I despise presentations that involve the use of a PowerPoint Jeopardy! game. To be clear, I get uncomfortable when any game-like activity appears in a medical teaching presentation.
Not that I don’t think games can have an important role in education — far from it. Heck, I once worked on a presentation that turned our residency conference room into a giant Game of Life board with …
An intern pushed open the call room door so that twelve medical students could crowd their eager faces together to see where we might sleep for the next three years. Only a few months away from medical school herself, the intern acted as if sleeping in such quarters were second nature. She gestured to the fluffy quilts the residents had brought from home to adorn their beds and giggled about …
BEEEP BEEEP BEEEP BEEEP … I pressed a button to silence my pager and rose groggily from the bed in the on-call room. I hadn’t truly been asleep, just catching a quick rest between pages. It was 2 a.m. I was 19 hours into my shift and, from the looks of the page, there was a new patient ready for admission to our family medicine inpatient service. I picked up the …
I was once in your shoes. There was a time where I wore a beat up white coat, pockets overflowing with cards and knew every nook and cranny of the hospital. I was the doctor that woke up the patients in the am, gently asking them to roll over so I could listen to their lungs sounds. That was me.
If you’re anything like me, then you are counting the …
When I first applied for medical school, I beamed about exploring not just the science of medicine, but also the art. But what is that art? Some would say it’s clinical experience, combined with being cultured and compassionate and communicating with clarity/conviction. But how would one teach that art?
Journal Watch’s Dr. Allan Brett recently reviewed a multicenter U.S. study following ~300 metastatic cancer patients who had failed initial chemotherapy. The study showed …
Being an intern and resident in today’s day and age of medicine is proving to be more difficult than ever. I’ve written about resident work hours before, but now that I have finished intern year, I have a lot more to say regarding this issue. I recently reread Dr. Pauline Chen’s article “The Impossible Workload for Doctors in Training,” …
We live in a time of great cynicism and skepticism. We seem to see only the mundane and boring in even the most interesting and spectacular things. The electrical rhythm of the heart that pulses through cardiac tissue and results in a coordinated muscle contraction that effectively ejects blood to the rest of the body for appropriate oxygen delivery is just … a …
Blackness covers the paper in its entirety. Hunched over, charcoal stained fingertips splayed out in front of me, I exhale and my saturated breath evokes miniature tornadoes. The fragrance of warm charcoal engulfs my olfactory bulb and my temporal lobe explodes with images of the past. I am transported back to scraped shins guarded by starched, white ruffled socks. My fingertips …
In a field filled with history, data, and very smart people, it can be difficult to do anything with confidence. And yet, this is one of the most desirable traits a doctor can have, that and a light hand when it comes to handing out narcotics. However, I have never been a fan of over-confidence. I feel that if you are going …
By the time you read this, time will have passed with the same explosive inevitability that C. diff diarrhea passes from unfortunate rectums. I’m not sure where life has taken you — you might be a serious senior resident physician, frazzled fellow, or — maybe — living your dream of being an eccentric train conductor with an affinity for shoe …
If you had asked me 15 years ago what I wanted to be when I “grow up,” a doctor was definitely not a thought in my mind. I wasn’t bred at a young age to become a physician by the ancestors that walked before me, nor did I desire to go through that much schooling before I could enter the real …
