“You will have 15 minutes to take a full medical history,” the moderator says in a plain, mechanical voice. We stand at our assigned exam room doors ready to embark on a mission that will be recorded, reviewed, and graded as part of an OSCE (objective structured clinical examination). “You may begin!” I knock, enter, and make a b-line to the soap dispenser -- check. I take the history in record time ...

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Congratulations, student doctor, you studied hard and scored well on your exams -- not only on your MCAT but in your organic chemistry classes as well.  You mastered anatomy as well as pharmacology, neurology and more “ologies” than you care to remember.  Now it is time to get hands-on learning experience, without being able to hide in the library, while preparing for your clerkship shelf exams or showcasing your talents ...

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I am an imposter in a white coat. I’m not sure if anyone knows yet, I hope I am good at hiding it. It’s a well-kept secret amongst all medical students. In the hospital, I am at the bottom. I know the least and have the least power. Most patients don’t realize this and look up to me like I’m an all-knowing, wise muse or something of that nature. Sometimes, ...

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As a medical student seeking to learn the principles of entrepreneurship, I have found Steve Blank’s insight to be a great guide and resource. His Harvard Business Review article, entitled “Why the Lean Start-Up Changes Everything,” was my first exposure to the idea of customer discovery. The idea of customer discovery is a simple practice -- listening intimately to multiple customers’ needs and pain points and using it to inform ...

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In the 2012 National Residency Match Program survey, which is sent out to residency program directors around the country by the NRMP, the factor that was ranked highest with regards to criteria considered for receiving an interview -- higher than honors in clinical clerkships, higher than extracurricular experiences or AOA election, and even higher than evidence of professionalism, interpersonal skills, and humanistic qualities -- was the USMLE Step 1 score. When ...

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As physicians-in-training, medical students suppress feelings and mask them under the veil of professionalism. Sometimes however, medical training requires us to manufacture emotions. During the third year of medical school, the majority of student grades are derived from the subjective evaluations of the residents and attendings that work with us. To achieve the highest marks, students must appear to be "engaged" and "excited" at all times. While most of us ...

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A loyal reader, who agrees with me that we may be teaching and testing medical students and residents the wrong way, asks why aren't all board recertification examinations given orally. She correctly asserts that oral examinations are better because they assess how people think rather than how much they have memorized. Here's why it would be difficult to do. The initial surgery board exam is given in two parts. First a written ...

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Perhaps one of our greatest assets and strongest detriments in medicine is our ability to look at a patient and make a quick, thorough assessment of his or her condition and state of distress. Certainly, a good clinician is able to triage and provide greater quality of care in the emergency room if he or she can use the intangibles of a patient’s presentation to provide them better quality of ...

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Like any other industry, in health care, the books and schooling don’t always match the “real world.” Patients everywhere have the same complaints about physicians and their bedside manner. “I feel like she’s talking at me, not to me.” “He said I had cancer like it was just another sentence.” “He walked in, looked at my meds, and walked right out of the room without saying a word.” Those training tomorrow’s ...

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Becoming a doctor takes time, but those outside of medicine do not always realize how convoluted the process can be. Central to the perversion is the National Resident Matching Program (or “the Match”). After college and the two years of classroom-based training in medical school, students are ushered into clinical training through third year core rotations in predetermined specialties. In the spring of their third year, students must decide on their ...

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