My family has always expressed that they’re proud of what I’m doing -- the funny thing is, they go on to say that they’re unsure of exactly what I do. My parents know I’m studying medicine and that this means I’ll be a doctor. What they don’t get is where in the process I am, what specializing means or what I’m talking about most of the time when I share stories ...

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“Are you more or less cynical than when you started residency?” This was the question my program director asked our senior internal medicine residents at a recent dinner with Dr. Bob Wachter. If you aren’t familiar with Dr. Wachter, he is widely acclaimed as the “father of hospital medicine” and a renowned champion of patient safety and quality. His blog, Wachter’s World, is chock full of insightful commentary on the American ...

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Before the 1980s, drug testing was uncommon. It was widely viewed as an invasion of privacy and an infringement on fourth amendment rights. Today, a medical student is likely to be drug tested before entering medical school, before clinical rotations, and/or before residency. If preventing drug use among medical students is the goal of these tests, they have failed miserably. Urinalysis drug tests are ineffective. But more importantly, ...

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An American poet and political activist, Muriel Rukeyser, said the universe is made of stories, not of atoms.  I believe her. As a seasoned storywriter and storyteller, I walked gingerly into the adult emergency services for my first shift as a volunteer at a legendary New York City public hospital. I sported a crisply ironed red polo with “emergency department volunteer” embroidered in white stitch. Armed with a pocket notebook and a ...

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As everyone knows, residents are now restricted to working 80 hours per week. One of the lesser known side effects of this work hours limitation is the drastic loss of educational conference time. Since at least one third of the residents must now go home after morning rounds, afternoon conferences are no longer possible. Most residency programs now devote part of at least one morning per week to dedicated educational time. JAMA ...

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A newly minted physician, one who has just graduated from medical school, is not yet ready (or licensed) to practice medicine. The next phase in medical training is called residency, a 3 to 5 year span of time during which the new doctor is given teaching, supervision, and increasingly allowed to function independently in his or her chosen specialty. Since 2003 residents have been limited to working 80 hours per week, averaged over ...

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“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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