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.
There is a strong relationship comparing sports to the military, business, and also to medicine. Young athletes, in their late teens and early 20s, are mostly brawn and use their strength and speed to achieve success early in their professional careers. As the athlete matures in their late 20s and early 30s, the physiologic processes slowly decrease and efficiency and maturity and other cerebral skills emerge.
Spring season is still many months away, but residency programs are in early heat as selection committees across the country buckle down to nominate the next batch of interns for the upcoming academic year.
Spread across these institutions’ tables one may find headshots, board scores, recommendations and interviewer comments of top candidates interested in training at their respective programs. Often, faculty members of esteemed medical centers will have only a few …
I recently had the opportunity to read Daniel Pink’s Drive. I read it partly to understand why pay-for-performance often fails to accomplish its goals for complex tasks, such as patient care. However, the thing I found most interesting about this book was the way in which creativity is deliberately inspired and cultivated by industry.
I could not help but think about why we don’t deliberately nurture creativity in medical trainees. Why …
Mexican medical residents have been submerged in a bygone system for decades. More than 100 work hours a week, scanty pay and psychological warfare are the everyday burden for residents in our country. You can read more about the working conditions of Mexican residents in my guest post, “The life of a medical resident in Mexico.”
Gradual progress is being made thanks to 30 years of pushing …
Protected naptime is a luxury usually reserved for the under-five-year-old set. Might it also be a tool to combat our country’s astoundingly high rates of medical errors?
Trainee fatigue has been a major focus of patient safety efforts since the mid 1980’s, after 18-year-old Libby Zion died tragically from a drug interaction that may have been precipitated by residents working long hours. In 2003, the Accreditation Council for Graduate …
As far back as I can remember, I’ve deliberately spent my life on the high road. I was the seventh-grader who was told by adults that she was very serious. I was the college student who majored in chemistry because it was the strongest premed major. I became a doctor.
Before becoming a doctor, I imagined that I would be the epitome of compassion. I envisioned pausing for a moment before …
Back in the day, legend has it that when space programs were just developed, NASA soon discovered that ball-point pens will not write in zero-gravity. Unfazed, NASA spent a large amount of money developing pens that will work in space, while the Russians simply used pencils.
It turns out that this legend is only half true, but the lesson remains – sometimes, we get bogged down trying to solve …
We are in the last steps of getting surgery arranged; the counseling is complete and the consent is on the clipboard. Just as the patient is putting pen to paper, she asks, “When I’m asleep, you’re not going to let some trainee practice on me, are you? I mean, I wouldn’t let the brand …
Fourth year medical students are starting the interview process to match into a residency program – their next and potentially final stage of training.
Over the next few months, these students will rank the programs they visit based on features such as geography, research funding, and hospital affiliations. But there’s another factor to consider – one that gets little attention but that probably matters more for the kind of doctors they’ll become. …
“I want to be just like Dr. Smith. He has a sweet practice.”“I want to make a ton of money.”
“I want to make a ton of money.”
These are some bad reasons why medical students choose a specialty. Most medical students decide what specialty to pursue when they are in their mid to late 20s. While we all think …
The patient had arrived for a urology procedure with a blood glucose in the 400’s. He suffered from a recent stomach bug and had gotten off schedule with administration of his meds. While his GI symptoms had subsided, he was feeling crappy overall. I decided to cancel his case and went about initiating treatment to get his blood sugar under control. When I informed the urologist of my findings and …
Accepting a promotion in the workplace is never easy task. One must take on a higher level of responsibility, carry out new job objectives, and must quickly form new working relationships with colleagues at the office.
Taking on the role as a newly-branded doctor after years of being a medical student is no different in this aspect from becoming a junior partner …
I want to tell you a story about dying that ended up being a story about living.
A few years ago, I was an eager-beaver third-year medical student, and relished the opportunity to finally work on the wards. One of my patients was Mr. Taylor, a middle-aged man with pancreatic cancer—a disease that, of course, carries a bleak prognosis. He was emaciated, …
The crowded emergency department (ED): It has become a symbol for our fragmented, inefficient health care system.
In the wake of Hurricane Sandy, the visual has become more familiar than we’d like – the young and the old slumped forward on rigid plastic chairs in the waiting room, occupied stretchers lined up in tandem in the hallway. Some of these patients are sick enough to warrant a hospital admission but languish …
I’m not that surprised. My girls have been vomiting all weekend. Not just vomiting, epic vomits. Like the kind where they vomit a lot and you think, “Wow.” Then they vomit again. And then a third time. And now it’s on the couch, the carpet, the TV, basically everywhere in a 50 foot radius. And then just when you think this may never end, …
I learned a lot of medicine during residency, but perhaps I actually learned even more about how to just get things done in a hospital. If you wanted a right-upper-quadrant ultrasound done for our patient, I was your man. I had a complicated series of unwritten algorithmic flow diagrams in my head that included handwriting an order, making sure that it was faxed to the right number, calling the appropriate …
By now, it’s common knowledge that people should be careful about what they post to social media sites — especially job seekers. But if you’re a resident or physician, you need to be especially careful because of HIPAA.
Again, this seems like common sense. But the more popular social media becomes, the more the lines are blurred. For most people, Facebook, Twitter, Linkedin and other sites are a part of day-to-day life. It’s easy …
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 …
Since medical school, I’ve gone through an additional 6 years of training, read countless volumes of medical literature, and had the fortune of having some great teachers. Through it all, experience has been the greatest teacher, which I suppose is what training is about. I’ve watched with interest as advice has been hashed out on the web around this time of year to new trainees on all matter of subjects. …
Questions such as this from proactive, increasingly knowledgeable patients place a physician on the horns of an ethical dilemma. Although fellows are closely supervised and trained under a gradually increasing responsibility principle (based upon subjective evaluation), a time will come when there is no one available to back you up in the catheterization lab.
Fact: Someone has to be a physician’s first case of any given type. However, no one really …
