Medicine offers you a front-row seat on life. Meaning is all around you. When you can see it, it gives you a sense of gratitude for the opportunity to do this work. -Rachel Naomi Remen The first-year medical student cried openly during the session. Not hard, but enough to be embarrassed. “I’m really sorry,” she said, “but this is one of the things that scares me most about going into medicine. I cry ...

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Discussions of resident duty hour reforms reached the point of ad nauseam a few years ago.  Everyone had their say -- program directors (“In 2003 we instituted an 80 hour work week, in 2011 we switched to 16 hour shifts, what’s next – online residencies!?”), senior residents (“What? I have to write H&Ps again? I don’t even know my computer password!”), interns (“I thought I was done with cross-covering after this ...

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I don’t have time for this, I thought as I attempted to walk the twenty minutes from home to my Mind-Body Medicine class at a ten minute pace. I felt a sharp cramp in my abdomen, reminding me that I had just wolfed down dinner without taking a break for enjoyment or digestion. By the time I reached the medical school building the sky was dark, my face glistened with ...

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My introduction to internship was during my hooding ceremony at graduation when the revered Dr. David Wagner hooded me and told me that internship was a time to become “intimate with disease and the suffering caused.” “You will live with it so that it becomes so much a part of you that you instinctively know what to do, what to expect, even without sleep, food or outside contact.” Filled up with this ...

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After getting off a 15 hour call day, all I want to do is write. These past 2 weeks death has been on my mind a lot, more than it ever has been. I have always known that physicians counsel patients and families on dying, but actually being the one to do it is entirely different. How do you tell someone that their best medical option, the best thing you can offer ...

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An op-ed piece this past summer by Verlyn Klinkenborg in the New York Times decried “The Decline and Fall of the English Major." As I read it, I reflected on my own experience in medical school and beyond, and I think that Mr. Klinkenborg’s message is one that medical school admissions committees should be hearing loud and clear. Despite the fact that doctors are faced with increasing mounds of paperwork ...

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It was a quarter past six in the evening. The day team had just completed their signout to us. As we sat quietly along the periphery of the trauma bay getting oriented to our list of patients, a small army of hospital personnel started trickling in. We were expecting company. He was rolled into the first slot. From behind the desk, I tried assessing how serious the injuries were, but the ...

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Three years ago, in the midst of all that was happening with health care reform, I thought about if I'd ever recommend medicine to my daughter.  I thought and thought about that issue and looked deep inside myself for reasons one might still choose this profession, then penned "The Top Ten Reasons to Be a Doctor."  It is, by far, the most popular post on my blog, having been ...

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Recently in NEJM Journal Watch General MedicineAbigail Zuger reviewed an article from the Journal of General Internal Medicine in which researchers examined how medical interns spend their time. The results from this time motion study might be concerning but are not unexpected. The investigators found that interns on inpatient rotations spend only 12% of their time in direct patient care and spend only 8 minutes daily with each patient on their inpatient services. Dr. Zuger notes this ...

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You have to love the blogosphere.  The latest big issue concerns lower ABIM pass rates.  Here are a series of blog posts worth considering. Dumber Doctors?

One concern that has a ring of truth to it is that young doctors have become great “looker-uppers,” and have lost the sense of what it’s like to actually read and study medicine. While doctors enter the profession with a commitment to lifelong learning, ...

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