I sometimes wonder if we spend too much time talking about professionalism.
It is not that I don’t think we should promote professionalism. Of course we should. But many discussions of professionalism descend into overly academic and scholarly treatises that end up obscuring rather than clarifying the values such discussions hope to promote. It may be a mistake to overly …
Humility in medicine and our academic training environments
I recently finished my second month of internal medicine. I had a different attending physician for each month. It is interesting to see how two different attending physicians will approach similar conditions. There is a lot of flexibility in the standard of care. Neither of them is wrong by any stretch of the imagination. Just different.
It is also amazing how much of a difference a good, well informed resident can …
How two different attending physicians approach similar conditions
When I was a medical student on my first clinical rotation, obstetrics, I was criticized for not using enough medical jargon when I spoke to the patients.
I took that criticism as a compliment and have always attempted to speak clearly and without too much “inflation” of my terms. In my opinion, the more clearly we physicians communicate, the better will be our patients’ understanding of their ailments.
The important topic of doctor-patient communication led a …
How to improve doctor patient communication
Like most everyone else, I took a break from my evening chores the past few nights, and watched Jeopardy!
IBM’s super-computer, Watson, was taking on Jeopardy! phenoms Ken Jennings and Brad Rutter. [SPOILER] The computer won handily.
After watching, I began to study for my upcoming board re-certification exam.
But, then, I wondered. Why?
In the New York Times, applications for Watson are …
Why Watson makes board certification exams obsolete in medicine
I just finished another inpatient service stretch at our community hospital with some great cases and lots of good medicine. While attending rounds may have changed a lot in the last 40 years as highlighted in a recent Annals of Internal Medicine article, some things have not changed – the focus on medical student presentations during attending rounds.
Students spend hours through their call nights preparing for …
How medical students should present patients to their attendings
Adapted from Generation Earn: The Young Professional’s Guide to Spending, Investing, and Giving Back.
by Kimberly Palmer
Young professionals today aren’t exactly known for our financial expertise. Dubbed “generation debt,” we’re stereotyped as over-spending shopaholics, easily enticed by credit cards, lattes, and the latest smartphone. But that reputation, it turns out, isn’t fair.
Yes, we have more student loan debt than previous generations, and average credit card debt among twenty-five- to thirty-four-year-olds …
Smart money tips for young doctors and medical students
“Doctor Pete” was fifty-one when I started my residency in family medicine. “Family practice” we called it then, and I think I liked that name of our specialty better. It implies continued learning and brings to my mind visions of practicing a down-to-earth craft.
I had interviewed with his predecessor the summer before and was really impressed with him and the program. I ranked it as my first choice in the …
Ode to a family practice mentor
by Zakari Tata, MD
Biomedical ethics and bedside communication is currently taught to medical students in a classroom mainly in the first two years. In residency it is not usually given a lot of attention. This is leading to a situation where a very basic part of daily patient interaction is not addressed. This leads to many complex problems in the hospital that lead to moral dilemmas and conflicts.
The idea needs …
Bioethics and bedside communication in daily patient interaction
Dear Dr. Brandt,
Using failure as motivation for medical residents
I recently spent a week in Ireland, taking in the sights and spirits.
I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it. As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European …
Medical school and medical training in Ireland
I’ve made some fairly outrageous claims about the workload of a neurosurgical resident recently. Seems like a reasonable time to lay out exactly what a day on call can be like for me and my fellow residents.
To be fair an average experience may be hard to articulate. Different rotations and different days yield different … adventures. Right now I’m on a service that could hardly be called grueling, but I …
A neurosurgical resident’s typical day
by Jessica Tekla Les, MD
During my third year of medical school I was performing a routine breast exam, more for practice than anything else. I was trying the concentric-circles-around-the-nipple technique, one of several I’d been taught. About halfway through the right breast I found a lima-bean-sized lump, not far from the breastbone. I took liberties with this particular exam. I poked the lump, tried to …
Breast cancer transforms a doctor in training to patient in an instant
by Shawn Vuong
Some time in the years 2002-2005, cardiothoracic surgery hit the wall.
The specialty’s big time claim to fame, the CABG (coronary artery bypass graft), surgery was on a huge decline. The field of cardiothoracic surgery became super saturated with over trained surgeons who were no longer in demand. The interventional cardiologist had come along and started stenting coronary arteries, saving patients from the chest opening …
Cardiothoracic surgery has a shortage of surgeons
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by Tayson DeLengocky, DO
The physician shortage in Texas has commanded an unusual amount of public interest in recent weeks.
The Houston Chronicle (Oct. 17), Star Telegram (Oct. 19) and Fort Worth Business Press (Oct. 27) all devoted space to the growing shortage of physicians in Texas and the steps necessary to correct the problem. The three articles recognized that the availability of residency slots is the determining factor in addressing the …
Addressing the physician shortage in Texas
What happens when you randomly assign medical students to either a mandatory two week rotation in specialized geriatric training or to a traditional non-geriatric clerkship that sees a lot of old people?
Will there be any difference in the knowledge of geriatric conditions, the attitudes toward older adults, or geriatric clinical skills between the two groups? Or does mere exposure to an aging patient population give students the training they need to …
Medical students taking a mandatory rotation in geriatrics
When one is a medical student, pretty much everything one does is directly supervised. Though a student is allowed to assess patients and make recommendations, rarely is a student given the autonomy to make decisions that will affect patients. They practice these decisions, but there is always someone more senior ratifying them.
Once a student becomes a resident, things start to change. As residents are physicians, they have the power to write …
Autonomy versus supervision for residents is a fine line
I spend much time talking with medical students. It is part of my job, but more than that I like medical students.
What should be the goal of medical schools? I believe we have an obligation to help our students grow into great physicians. What philosophical principles should we use?
Perhaps the answer to success is Servant Leadership. As I learn more about this concept, I hope that have become a servant …
Using servant leadership to teach medical students
Doctors: if you’re sick, don’t go to work.
The stereotype of doctors is that they go to work, despite whatever symptoms ail them. Calling in sick places strain on colleagues. Especially in residency, where team members are expected to pick up the slack.
In a recent column, the New York Times’ Pauline Chen discusses the image of self-sacrifice that a sick doctor going to work portrays:
Hacking, febrile or racked with the …
Sick doctors who work are doing more harm to their patients than good
by Ali Khan, MD
“So, why didn’t I take the ROAD again?”
It’s a question that I regularly hear from many of my co-residents in internal medicine – and no, we’re not questioning our travel routes to the hospital.
We all know why we chose internal medicine: the intellectual challenges inherent in treating across organ systems, the excitement of primary scientific investigation and diagnosis and the like. As we …
Will a higher demand for generalist doctors save primary care?
This month of my intern year, I am covering night float for the private hospital. Compared to the massive county hospital teeming with laboring patients, churning at all hours of the day and night, the private practice pace is meant to be a luxury for interns seeking respite. And for the most part, life has been pretty nice.
This week however, has been nothing less than hell. One night, I was …
Medical resident superstition and black clouds
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