I stood right beside them as they slowly slid your head into a plastic bag, looped the coarse twine about your neck and tied it tightly. Like the amateurs they were, they double-knotted it to make sure nothing came loose or dripped out. Then they casually walked away, chatting about what would come next. Within minutes the bag fogged up, and a clear red liquid pooled at the bottom. That was just ...

Read more...

I know where America’s future primary care physicians are, and more importantly, where we are losing them. I am one of them, and I almost got lost. Maybe I was naïve. I’d had no math or science classes as an undergraduate, and I’d never really thought about the mechanics of medical education. Even while jumping through all the prerequisite hoops before applying, it never occurred to me how inadequate my non-traditional ...

Read more...

From an early age, I was encouraged by my family to consider a career in medicine. I was told it was a well-respected profession, offering financial security and community respect. Seeing the white coats, stethoscopes, and grateful patients at my childhood doctors’ visits made the field mysterious and intriguing, and these stuck with me as I grew older. I also developed a love for music at an early age; I ...

Read more...

In my transition from pure learner (i.e., the med student role) to teacher-learner (i.e., the attending), I’ve actually found myself focusing more on the learner than the teacher part of my dual existence.  Strong learning seems to be requisite to strong teaching, and I am realizing that succeeding on the next level requires some extra meta-cognition, that is, learning to learn in new ways. Learning to unlearn In med school, learners amass an ...

Read more...

If you want to understand the world of professional board certification, it is important to understand the business and politics of testing professionals. Such testing is big business. So big in fact, that huge international media and education companies that trade on the New York Stock Exchange have been created to service this need. According to one article on Reuters from 2012, "the entire education sector, including college and mid-career training, represents nearly ...

Read more...

It’s okay that you don’t remember me. My name is Shara, and I’m part of the surgical team. I’m checking to see how you’re doing after your surgery. Do you know where you are right now? Actually, you’re in the hospital. You had surgery a few hours ago, for a broken hip. You used to be able to walk before you broke it, so it was important to fix it as soon ...

Read more...

A recent editorial in the New England Journal of Medicine lauded, albeit cautiously, point-of-care ultrasound that has risen to such an extent that it is now becoming an integral part of medical education. Could the availability of ultrasound revolutionize clinical medicine in much the same way Laennec’s stethoscope broke the acoustic barrier? Certainly this possibility can’t be ruled out. But I am not so sanguine. One thing I’m sure about: Indiscriminate ...

Read more...

With the rollout of Obamacare, we are living in a moment in which there is no dearth of heated debates among friends, family, and co-workers. And often times, these debates degrade to become emotion vs. emotion, or even ad hominem, and so these initially well-meaning conversations morph into heated arguments that lead nowhere. (Even Immanuel Kant advised debaters to out-shout opponents when more civil methods of discourse had failed.) It is far ...

Read more...

There are words in many languages that have no good English equivalent. During my work in Haiti, I’ve noticed my Haitian colleagues on occasion exhaling a phrase -- “tet chaje” -- which literally means “head charged.” More accurately, it describes a sense of being overwhelmed or conveying disbelief or frustration. Based on my limited experiences in the field, I can only begin to imagine the burnout that local providers face ...

Read more...

I had never seen my young cousin sit so still. “What did you do?” my aunt wondered, amazed that her hyperactive 12-year-old had been transfixed for nearly an hour. “Were you two playing video games?” “Actually we were just talking about some of the things I learned in medical school. He’s really interested,” I told her. Indeed, he hadn’t even touched one of the delicious samosas we were eating. Every time he ...

Read more...