Residency and Medical Training

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.

Residency applications during COVID-19: a rain cloud with a silver lining for some

Karolina Woroniecka, MD, PhD

Physician

September 6, 2020

Like everything in life, applying for residency this year is going to be radically different. There won’t be any long cross-country plane flights, no driving across state lines, no crashing at friend’s places to save money on hotel nights. Residency interviews are going virtual. Medical students that need help with the residency applications virtually, can use this helpful tool to make better decisions.

For some students, this …

Residency recruitment in the era of COVID-19: Why it’s more important than ever for programs to have an online persona

Kevin Zhang, MD

Physician

August 23, 2020

More than six months into the COVID-19 pandemic and with social distancing measures in full swing, virtually every facet of life in America has been affected, with medical education being no exception. Medical students have been forced to reschedule USMLE/COMLEX board exams and cancel entire rotations. Residents have been re-deployed to work in COVID-19 ICUs. And of course, the annual residency application and recruitment season have …

It’s time to rename resident burnout

Daniel Orlovich, MD, PharmD

Physician

August 20, 2020

It is time we stopped framing resident burnout in a certain way. Let’s be honest, the current descriptions give us nothing to build on.

How is burnout currently framed?

In a strict academic sense, we are guided by clear, globally accepted definitions. We are familiar with Maslow’s Hierarchy of Needs, depersonalization, emotional exhaustion, and reduced personal accomplishment, as well as the various questionnaires and indexes.

However, in the real world, in the hospital and clinics, …

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It’s time to rename resident burnout

A letter to 2020 interns

Wendy Peltier, MD

Medical Education

August 16, 2020

Congratulations on becoming PGY-1s! Truthfully, most memories of the times around my internship at Rush Medical College in 1991 are a blur. For example, I cannot recall the popular songs, who won the Super Bowl, or even the model of car I drove. However, as clear and crisp as if it was yesterday, I remember the faces and stories of many of the patients and families for whom I cared.

1991 …

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A letter to 2020 interns

This will be an interview season for the ages

Steven Rose, MD

Medical Education

August 14, 2020

The interview season has again arrived. The circle of life repeats, the wheel of time rolls on as the new residents who were interviewees last year meet the next group of interviewees, and our senior residents again themselves become interviewees in their quest for jobs and fellowships. However, something is different this time. The presence of a life-changing global pandemic second only in impact to the zombie apocalypse yet to …

6 tips for success in residency training

Adam Bitterman, DO and Randy M. Cohn, DO

Physician

July 8, 2020

Recently, a few colleagues and I sat down with our six incoming interns during a welcoming round-table discussion. Being the closest member of the faculty to these residents in age and time from residency, I was best able to relate to them and their current feelings.

I, too, sat in those chairs in a conference room that was last used for graduating our outgoing chief residents. I, too, remember the feelings …

How the United States depends on doctors trained in other countries

Tania M. Jenkins, PhD

Medical Education

July 1, 2020

I met Trevor on his very first day of residency, at the start of three years of practical, …

Dear interns: We have your backs

Mercy Hylton, MD

Physician

June 29, 2020

Every July, the same tired “new interns: be scared to go to the hospital” memes and jokes appear. I disagree. I believe that July is as safe as any other month to go to the hospital.

July should be celebrated. Medical students and resident physicians are the lifeblood of our profession. Clinical physicians have never felt more exhausted, harassed, commoditized, and defeated by the “health care machine.” We need your eagerness, …

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Dear interns: We have your backs

IMGs are abandoned during COVID

Dr. Michelle Warncke and Dr. Wahab Khan

Medical Education

June 23, 2020

The Match is a stressful time during any physician’s life. Applicants study for, arrange for, and lose sleep over their USMLE steps, their letters of recommendation, and their personal statements. The matching process is particularly difficult during a global pandemic.

As COVID-19 spread in March 2020, all USMLE testing was suspended. Applicants were reassured that tests would either be rescheduled, or that an alternative testing format would be proposed. The National …

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IMGs are abandoned during COVID

Take yourself as you know you can be: a message from residency educator

Christina Shenvi, MD, PhD

Medical Education

June 22, 2020

To the residents graduating in 2020 and joining us in the ranks as physicians, from a residency educator:

Victor Frankl was an Austrian psychiatrist and holocaust survivor. He was paraphrasing Goethe when he said: “If you take a man as he is, you make him worse. If you take him as he should be, you make him capable of becoming what he can be.”

When you started as interns, we, your educators, …

Understand your resident contract: What you don’t know may hurt you

Todd Rice, MD, MBA

Physician

June 17, 2020

When I matched into anesthesiology residency in 2002, I assumed that the entire four years of training were guaranteed to me, barring any gross failure on my part. A package deal, essentially. I hadn’t heard of anyone not finishing.

For me, residency was exhaustingly tolerable, yet gratefully formative – interspersed with warm camaraderie, the occasional difficult patient or frustrating attending, satisfying progress, and finite episodes of survivable misery. I had a …

The medical education question that needs to be changed

Bo Cheng, DO, PharmD

Medical Education

May 18, 2020

“What do you want to be when you grow up?”

That is a common question you hear in the setting of medical education. I think I heard it for the first time on my first clinical rotation. A little background, I was a non-traditional medical student. I worked as a clinical pharmacist for ten years prior to starting medical school. When the resident asked me that question, I was initially a …

The crisis of rotation availability during a pandemic: a medical student’s ethical conundrum

Amit M. Khan, Javaid Afghani, Taner B. Celebi, and Zachary Scheid

Medical Education

May 17, 2020

With COVID-19 still consistently creating setbacks in the health care community, we see yet another issue for medical students because of this pandemic. In prior years, the traditional medical student would be expected to be part of a team assisting medical professionals in the field, developing relationships with future mentors, and gaining the experience necessary to take on the difficulties presented in that given field. COVID-19 has been altering the …

To the AAMC: Recommend an interview limit or else this year’s residency match may be a disaster

Jordan Hughes, MD

Medical Education

May 16, 2020

The COVID-19 pandemic has turned medical education upside-down. There has been massive disruption from exclusively virtual pre-clerkship courses to delayed clerkships to canceled graduation proceedings. After weeks of speculation, we’ve learned how the pandemic will disrupt the 2020-2021 residency application cycle. The Association of American Medical Colleges (AAMC) now recommends that all residency interviews be conducted virtually. While this is a wise recommendation, out of concern for public safety, I …

The shift from a junior to a senior resident

Justin Dubin, MD

Physician

April 15, 2020

For physicians, residency is the most critical time for growth in clinical and surgical skills, professionalism, and medical knowledge. Your residency training — for better or worse — shapes your future career as a physician. Your surgical technique, clinical decision making, and bedside manner are all, to some degree, a reflection of where you trained.

Interestingly enough, there are only two residency years with formal titles — the intern and chief …

Entitlement, arrogance, and isolation in modern-day medical practice

Cristina Carballo-Perelman, MD

Physician

March 10, 2020

I recently read a medical school commencement, delivered by a physician, that was both inspiring and sadly reminiscent of what physicians should aspire to throughout their careers.

This physician relayed how patients throughout her training and career had provided her with moments of clarity, helping her identify the “why” she chose a career in medicine. She went so far as to describe how a group of patients saved her from choosing …

The new USMLE Step 1: How your medical school and residency will change

Kevin Zhang, MD

Medical Education

February 20, 2020

With the advent of countless resources and study aids over the years to help medical students prepare for the USMLE Step 1 exam, ranging from the venerable First Aid review book and Anki flashcard decks, to online tools such as UWorld, Pathoma, SketchyMicro, Firecracker, Amboss, and countless more, the entire process of studying for Step 1 has become an arms race. At the same time, Step 1 scores have established …

How minor fixes can help with resident burnout

Daniel Orlovich, MD, PharmD

Medical Education

February 11, 2020

“How did you like it there?” I ask, sitting down next to a new fellow (between bites of a plump sandwich, hoping there is no spinach in my teeth).

I expect to hear the standard resident talking points — long hours, frequent call, and ballooning student loans. Instead, she surprises me.

“Do you know how much they charged us to park there every month?”

I frequently text friends who are residents at her previous program. It is a …

Medical residents need parental leave

Eric Bressman, MD

Physician

February 10, 2020

My wife and I had a baby a few months ago. Or, more accurately, she birthed a child while I sat in the corner, contemplating the miracle of reproductive physiology in a vasovagal fugue. In the months leading up to and following that wondrous moment, we found ourselves navigating the labyrinthine complexity of parental leave in graduate medical education.

To start with the positive, we are both residents in the same …

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Medical residents need parental leave

A paradoxical fix to physician burnout: more patients, less supervision

William O. Collins, MD

Physician

December 20, 2019

Most physicians recall the rigors of their residency training through a mixed lens. In prior generations, a single-duty shift could stretch to 36 or more consecutive hours, but the exhaustion was buoyed by the camaraderie of sleepless on-call nights in the hospital. Despite the exhaustion, resident well-being received scant attention. Beginning with the 1984 Libby Zion case, and later the Accreditation Council on Graduate Medical Education (ACGME) duty hour restrictions …

Residency and Medical Training

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