In case you haven't noticed, a hot new topic in education is "grit." In order to reduce the long-standing 20% attrition rate of surgical residents, some say we should select applicants who have more grit or conscientiousness. A recent paper in Surgery reported residents who dropped out of programs had decreased levels of grit as measured by a short-form survey. But due to unexpectedly low attrition rates in the surgical programs ...

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Recently I attended a national academic conference, and while I'll admit that, having brought my husband and son along for the trip, the balance of time spent was skewed more toward pool and beach activities than academic sessions, I did indeed attend several and overall they were of good quality. One left me somewhat disappointed, though, because although it addressed what I would consider an important topic within my field, ...

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She’s 58, but appears maybe three days older than 42. Her eyes are sunken, tearful, worried, anxious.  She tells me about her two grandchildren, and how she just visited them in Michigan.  She came to the hospital, straight from the airport.  She’s worried. She’s worried because her shortness of breath hasn’t gone away for over a month now.  She has had breast cancer, and opted for a more conservative approach: a ...

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Two years ago, I received my first employment contract. Not long after Match Day, I did what 115,000 physicians in training did that year and will do again this year: I signed the contract promptly and returned it. I tried to read the contract carefully, but it didn’t really matter. Unless you no longer want to be a physician, there is no other choice but to sign. Today, as president of my ...

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In a New York Times column, Thomas Friedman recent wrote about what Google values and seeks in its new employees. Striking to me was the fact that overall intelligence ranks lower on their values totem pole than several traditionally more important attributes. So, what can medicine learn from Google and how can we apply it to our admissions process? Here are five key points from the article, adapted to our admissions ...

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No medical resident looks forward to working night float. The initial glamour of doing chest compressions in the rising light comes up against a litany of administrative tasks. As the glamour wanes, the gulf between the objective curriculum and actual practice widens. On paper, residents learn how to manage acute emergencies and learn deeper clinical reasoning. Actual practice, or the “hidden curriculum” of training, can be a different experience, involving ...

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Dear new medical student: Congratulations! You are about to embark upon an exciting, life-altering experience, one you will never forget. You are about to join an elite group of people who will now be your peers going forward. You will be continually fascinated, and not a single day will go by from now until you retire that you aren’t challenged by something you have never encountered before. You will be solving problems ...

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Last August I sat surrounded by 163 other ambitious, new medical students on our “introduction to the profession” week. Anxiety was high with undertones of self-doubt mixed with lofty goals. Another distinguished figure had taken the floor to introduce us to the concept of medical professionalism: commitments to patient-centered care, intellectual honesty, social responsibility and advocacy. The long list of medical virtues we were to develop, cherish, and exemplify in ...

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I thought the most important thing I had learned while working in the emergency department as a first-year medical student was to bop and weave.  The impeccable foot skills I harnessed as a youth lacrosse player were put to great use- to stay out of the way.  The quiet whisper of a nurse trying to slide behind me, and -- BAM -- back against the wall.  I can hear the ...

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I performed my first paracentesis in November of my intern year.  It was 3 a.m., and I was on overnight call in a packed ICU.  The patient, a 45-year-old male with hepatic encephalopathy, was hardly alert enough to remember my name.  He didn’t know I was an intern.  He didn’t know I’d never even attempted a paracentesis before. After I finished, I added the patient’s name to my procedure card.  I hurried to get an ABG ...

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