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.
As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country. That was my Sputnik Moment.
Since graduating …
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Shorten medical training by 30% without sacrificing quality
The more I talk to new physicians who are transitioning into practice, the more I realize how many substantial life and career shifts occur post-residency.
I experienced these changes myself several years ago, but it’s taken me a while to fully process them and realize how they’ve affected my life.
In fact, it would be safe to say that I experienced a complete 180 after graduating from residency. I know other new …
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Tips for adjusting to life after residency
I have participated in two transitions in care with my mother. The first was when she was released from the hospital after undergoing neurosurgery for a malignant brain tumor. Immediately after surgery of her brain tumor, she went through two weeks of intensive physical, occupational, and speech therapy. At the end of this period, the recommendation was clear. She required around the clock supervision. The plan was to send her …
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Poor transitions in care result in unsafe patient care
Only a generation ago, medical students thought about what specialty to choose simply in terms of what interested them most. All doctors made a comfortable income; money wasn’t a primary motivator. There was a sense that cardiac surgeons or neurosurgeons could make more than most other physicians, but in fairness their training was much harder and longer. Internal medicine was held up to us as the most prestigious and intellectually …
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Why the physician shortage is worse than you think
Medical residents have fewer labor protections than Chinese factory workers. While labor abuses at Apple’s factories make headlines, few people are as concerned about the lack of protections for doctors and medical students here in the United States. As a resident, I was subject to some of the worst abuses – intentionally misreported time sheets and gender-based discrimination – and after I complained, I was fired, so I sued the …
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Medical residents are abused more than Chinese factory workers
The United States of America is an immigrant country. It is a melting pot of many peoples and has basically been so since before the Mayflower passengers laid foot on New England soil. Promise of equality, success, quality of life and freedom have drawn multitudes of professionals from all over the world to try to make it in the US. Some of these professionals are doctors.
A doctor that wants to …
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What should be the threshold for allowing doctors to work in the US?
We finally broke down and bought floaties. The kids played for a few days in the shallows, but since neither of them are yet proficient swimmers, they dared not wander into deeper waters. Each day they watched as younger kids scooted around the pool wearing wing like contraptions colored with cartoon characters.
I never liked the idea of floaties. Much better, I thought, to let them struggle and build on the …
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Are the doctors of tomorrow going to sink or swim?
Every career has that one question that is notoriously hated by all. For nurses, that question is, “So, why didn’t you want to be a doctor?” For teachers, it’s questions about the age-old adage, “Those who can’t do, teach.” For medical students, that question is, “So, do you know what you want to do?”
It’s not that people who ask medical students about their career plans are ill-intentioned or nosy; in …
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The residency journey is just getting started
Some people critique Continuing Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic …
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CME limitations and how we can improve Continuing Medical Education
Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.
As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …
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Tips to fight depression during medical residency
I had a chance to “moonlight” in the internal medicine “drop-in” clinic at the Kaiser Medical Center in San Francisco while I was finishing my residency and endocrinology fellowship at UCSF. I was superbly trained in in-patient care and there was no IV or PA line that I couldn’t put in with my eyes closed. I was comfortable taking care of really sick people and thrived on complex, acute cases. I knew …
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Fixing health care includes reforming medical education
By 2015, according to the American Association of Medical Colleges, the U.S. health care system will be short approximately 30,000 primary care doctors. Yet, everything we read says that primary care physicians are the linchpins of the new (really rediscovered) coordinated care models being talked about by health care policy cognoscenti. What gives?
Since the mid-1990s the number of medical students pursuing a career in primary care has been on a steady, sinking decline, …
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Skills primary care doctors of the future will need
If Dr. Ezekiel Emanuel gets his wish, tomorrow’s physicians won’t deserve to be paid as well as physicians today because they won’t be as well trained.
Dr. Emanuel, a brother of Chicago Mayor Rahm Emanuel and a chief apologist for the Affordable Care Act, is the lead author of a startling opinion column in the March 21 Journal of the American Medical Association. He argues that there is “substantial waste” in …
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Reducing training will diminish the status of physicians
As Match Day for the Class of 2012 quickly fades into the background and residency applications for my class begin to appear on the horizon, I find my classmates starting to disappear from Facebook and other socially-oriented websites.
“Are you taking your blog down for application and interview season?” someone innocently asked, “I mean, some program directors just may not appreciate the social media involvement as much as you do.”
The question, …
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Why I’m not hiding social media from residency interviews
Residency directors have a challenging job. They are entrusted with selecting young doctors and training them over the course of several years. Newly graduated medical students are thereby turned into internists, surgeons, radiologists, pathologists and the like. Fellowship directors build upon this foundation with extra training, setting the stage for these graduates to become clinical experts in their respective fields.
The Maintenance of Certification (MOC) process adds an additional and continued …
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Residency directors and board certification can work together
We are sorry, you did not match to any position. – NRMP Staff
Despite more than one-quarter-million dollars in tuition and expenses at a top-notch medical school, several of my classmates received that stark e-mail on Monday. Most quickly began the SOAP (the new “scramble”) to find an unfilled position. Although many factors influence whether a medical student finds success in The Match, this week’s results suggest to me that the …
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Reflections on the Match: Improving the interview process
Looking back on the first three years of medical school, it’s hard to imagine living through the endless days of studying again. Weekends were spent cooped up in the library and there were countless holidays that I wasn’t able to spend with my family. Instead, they were spent memorizing indecent aspects of the human anatomy and performing DREs on strangers. There are better ways to get to know a person …
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Heed the 4th year medical student spoils
We specialists in infectious diseases love case conferences — especially those where the case is presented as an “unknown,” and we try to figure out the diagnosis from the history.
I suppose this isn’t very surprising, since ID cases in general are already among the most interesting in all of medicine. Those that are case-conference-worthy are particularly prime.
“Funny bug in a funny place,” was how one of my colleagues characterized these …
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What is your case conference personality?
I never realized before how much work goes on behind the scenes to prepare and conduct these interview days, but I sure do now. As a Chief Resident, I schedule residents to attend the applicant dinners, lunches, and tours, and to spend time with the applicants our lounge. This makes the actual interview days go by much smoother, because two of us are present at all times to speak to applicants and answer any …
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Residency interview tips from a Chief Resident
