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.
During my residency training in plastic surgery, I remember spending time in the offices of some of our community faculty members. These were invaluable opportunities to gain exposure to the field outside of the academic university hospital, where things were quite different.
The university was a large organization where several residency programs and hundreds of trainees were not just seamlessly integrated into the workings of the hospital, but actually required to …
As clinicians, we often forget or become desensitized to the image that society has of medicine and doctors. Alongside teachers and scientists, we are seen to be among the most trustworthy of professionals, yet our morale is low, with almost 50 percent describing it as “low” or “very low.” You can imagine, then, why I often describe medicine as a forest: …
It’s the beginning of February and this year’s residency interviews are wrapping up.
It is widely known, even encouraged, that medical students change their social media profile names or deactivate their accounts while applying and interviewing for medical residencies. David becomes AviD, Jessica is now Jes Sica, and Sarah morphs into Miss S; students are leery of admissions committees stumbling upon their accounts, changing their profile names to something that would …
I will always remember my awkward medical school interviews. Filled with bioethical scenarios and questions to measure my ability to prevent an impaired physician from practicing, the interviewers seemed hardly interested in my prior career achievements or humble beginnings.
Such discussions carried on through the first two years of medical school. They never taught us how health care reimbursement works or why …
Long gone are the purgatory stints of library study, slaving to solve esoteric problems relating to planks and pulleys. Innumerable several-day exams have been conquered and tucked far away in our memories, hopefully never to haunt us again. The last of our forced smiles and faux-eager nods have been displayed toward ambivalent instructors and medical teams during the throes of our student rotations.
It’s that time of year again. Bright-eyed fourth years have begun wandering our hospital in uncomfortable shoes and fancy suits. They look equal parts nervous and excited, ready to embark on the insane adventure that is being an intern. But first, they have to survive interview season and Match Day: a stressful, expensive, hoop-jumping endeavor that culminates with an envelope containing the result of eight years of hard work. Wouldn’t …
It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year:
Start early.
Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat …
When my husband started medical school, we immediately got hooked on getting student loans. After spending years of being broke all through undergrad, we felt like we were getting “magic” checks in the mail. Life was good. We could go out to dinner, buy our son the toys we wanted him to have, go shopping. We were enjoying all the luxuries …
Do physicians in training take better care of patients or perform better on their exams when their work hours are restricted? Two recent studies in the Journal of the American Medical Association suggest that the answer is no. In one, patients of surgery residents showed no difference in morality or postoperative outcomes after duty hour restrictions were implemented. Their test scores …
You’ve made it. Four years of college, four years of medical school, and three years (sometimes four or five) of residency, depending on the specialty you chose. You’ve earned a prestigious title.
You are a doctor.
But wait, you are not done yet.
Want to be a cardiologist, oncologist, or gastroenterologist? Add another three years to the eleven spent to become an independent practitioner. Another three years of interest accruing on that six-figure …
Despite the changes around us, the training of physicians has stayed much the same. Sure, there are new work hour limitations and a push to move towards competency-based assessments, but the overall structure of our training remains largely untouched. We spend the vast majority of our time training in hospitals, with the remaining time spent practicing in traditional outpatient clinics.
However, health care is being increasingly delivered outside these two arenas. …
I’m on my family medicine rotation right now. One of my preceptors is about 80 years old and went through medical school in the 1960s. He is still sharp as a tack; he used to do C-sections, hernia repairs, appendectomies, fracture repairs and get this — emergency burr holes for subdural hematomas (a.k.a. neurosurgery). He stopped around 1997, mostly because he …
My department had a problem that harmed patients on at least a weekly basis. It was well-known, but it seemed there was no viable solution.
My supervising attending was in his seventies and highly regarded at my hospital, having held powerful administrative positions for decades. About ten or so years ago, he stepped down from running the hospital, and …
Almost every practicing doctor remembers the grueling hours and intense workload of residency. I recall overnight calls when I ran around from floor to floor, my beeper never stopping. I would collapse at home the next morning exhausted, drained and a little depressed. I would never want to relive residency, but I do look back at it with a sense of accomplishment. In some ways, it is a badge of …
I admittedly spent a good portion of the fourth year of medical school dreading internship. A year where I was expected to suddenly be a doctor and to have all the answers. A year where I would work long hours and carry several pagers at one time. I come to you in blog form to inform you of some of the …
Mr. B shook my hand as the paramedics got the stretcher ready to send him to a nursing home. His firm grip punctuated the end of a long hospitalization, which had been characterized by several decisions to leave the hospital against medical advice into extremely unsafe situations, leading into complex capacity evaluation decisions.
It was a pleasure to take care of you, I told him. He smirked back at me and …
Are millennial doctors well trained for the 21st century? That was the question posed in NPR’s Millennial Doctors May Be More Tech-Savvy, But Is That Better? I believe how millennial doctors are educated may make them less adequately prepared than previous generations. This isn’t a reflection of medical education, but of education in general.
Do the technological tools available prevent the engagement needed to …
There is controversy about whether or not there will be a doctor shortage in the near future. I wonder why there is so much speculation. The Association of American Medical Colleges estimates that we will be short 90,000 physicians by 2020 and 130,000 physicians by 2025. If things stay as they are now, of course there will be a shortage. The …
I recently wrote about the pressure that comes with the scrutiny of residency applications and the interview process. Adding to this, many applicants apply alongside their significant other, making use of the “couples match” option. Let’s think about that: No longer do you have to stress for yourself, but now you worry for your partner too. And while your primary …
I was a fourth-year surgery resident, on the transplant team. It was a difficult rotation, because the doctor who ran it was sexist and got along better with you if you flirted with him. He made innumerable sexual wisecracks in the OR while we were working, and preferred to round with his arm around me as he made further innuendoes.
