Whither the white coat and why As a philosophical coda to the 2013 cacophony over Obamacare, health care reform and the notion that doctors and their skills will be needed less in some indeterminate future, this last month saw a media frenzy about the fate of the doctor’s white coat. It started with an article by Gonzalo Bearman and his colleagues in Infection Control and Epidemiology that asked the ...

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There was a very large lesion in his left frontal lobe, and no one knew what it was. He had been admitted earlier that day, after a neighbor found him in the hallway, confused and covered in urine.  Now he sat in his bed quietly, while we stared at his brain and the bright spot that didn’t quite resemble something. It can’t be tissue death from a stroke, insisted one resident. It ...

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The past few months I have joined thousands of individuals hoping to match into a residency program in 2014. I have had interviews all over the country and spent way too much time living out of a suitcase. For many students, residency interview season is exciting. For others, it’s stressful and exhausting. But for me, more than anything else, the interview trail was inspiring. I am currently applying to internal medicine-primary care ...

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I’ll never forget the anxiety of the first day of medical school. I was excited. I was enthusiastic. I was overwhelmed. But all of these emotions were humbly interrupted by my profound, palpable sense of otherness. I was surrounded by one hundred and sixty-seven brilliant peers, many from high-ranking undergraduate schools and each of whom had countless accomplishments in their already rich pasts. They clearly, unquestionably deserved to be here. ...

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"A new roadmap for improving residents’ professional skills was released Tuesday by the Accreditation Council for Graduate Medical Education (ACGME)" begins the press release. As I dove into this announcement a bit further, I discovered the origins of this initiative outlined in this executive summary published by the ACGME on the "CLER Program:"

The Accreditation Council for Graduate Medical Education (ACGME) recognizes the public’s need for a physician workforce capable of meeting the challenges of ...

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How do you ask a person to be the last person to go through an education system that is failing them?  Yet we’re doing just that. Every day tens of thousands of medical student wake up to an education, and an education system, that is failing them.  This is not to say that we are not producing good doctors.  On the contrary, our doctors are likely the most well-educated, and ...

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Education debt nearly is a practical puzzle. For many students, this lending proves crucial and extends enormous utility. Stickiness usually surfaces only after a student graduates and his or her loans enter repayment. While debt dollars or repayment problems may differ across academic majors and college settings, students should be reasonably able to defer their education loans, regardless of lender, while enrolled in school. When borrowing for education, students often draw ...

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Recently, our residency program had the excellent fortune of hosting Dr. Bob Wachter as a visiting speaker. Dr. Wachter is considered a pioneer in the hospitalist movement and has built his career around inpatient quality and safety. During lunch with Dr. Wachter, some of our residents, and hospitalist faculty, we discussed the topic of resident autonomy in the hospital. In the glory days of residency, I imagine that house officers experienced ...

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In the past 84 days, I have traveled to eleven different cities, been left stranded in two unfamiliar airports by cancelled flights, met approximately 124 new people and briefly recited the more interesting parts of my life story far too many times to count -- all for the purpose of matching to a residency program in March. Exhausting doesn't come close to summing it up. And yet, this process has also ...

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New journals are appearing almost every day. Does anyone read them? Journals keep popping up because of the need for faculty to publish. Another reason could be that publishers, particularly those who charge authors fees for publishing, are in the business of making money. Authoring journal articles is not only enhancing to one's CV (the old "publish or perish" cliché), it is required by residency review committees as evidence of "scholarly ...

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