When a doctor finishes medical school, he or she then faces what is truly the most difficult part of their journey into becoming a physician: graduate medical education.  The goal of internship, residency, and fellowship training programs -- what is collectively called graduate medical education, or GME -- is to take newly minted doctors, just out of medical school, and turn them into competent physicians, able to practice in their specialty independently.   And ...

Read more...

“Well I don’t know why I came here tonight, I got the feeling that something ain’t right,” the song hummed through the speakers of the DC medical examiner’s office. Something definitely is not right, I thought as I watched the pathologist and his assistant begin the first autopsy of the morning. With rough strokes, the assistant dissembled the body before us. Unlike the cadavers we had dissected one year previously, this ...

Read more...

While my career has included patient care, research and administration, I have always considered medical education my primary purpose. Having had the great opportunity to know many students and residents, having had the great opportunity to visit many medical schools, and having had wonderful colleagues, I have great concerns about the bureaucracy craze that has engulfed medical education. This morning I spent a few minutes reading tweets, and came across a ...

Read more...

The culture of medicine has changed and a new generation of medical students has noticed this insidious path to disgruntlement. Reimbursement rates dominate conversations among health care professionals. Physicians are slowly burning out while younger faces are tempted away from humanitarianism by lucrative lifestyle specialties. Bureaucrats, technology, and increasing health-care costs have transformed the doctor-patient relationship, and students pick up on the increasing frustration in the profession. The few oases of ...

Read more...

As an educator, I've come across some recent news stories that call to mind Dorothy's observation, "we're not in Kansas anymore." Consider the following two. 1. Sara Volz, a high school student from Colorado, won the top prize ($100,000) in the 2013 Intel Science Talent Search for her research of algae biofuels. She accomplished this outside of school in a home lab under her loft bed, sleeping on the same light cycle as ...

Read more...

“What is the one best test?” A test-taker's frustration boils over as they read this prompt and think, “in real life we would do all of the above.”  And for the most part, they are correct.  In the United States, medical trainees are taught for exam purposes to answer the one best test for diagnosis or the one best procedure for management. However, in practice the same trainees watch our role-models take ...

Read more...

Let’s talk for a moment about medical education.  I went to a work-related party recently and rode in the elevator with a dear friend who is my contemporary, and a more senior and highly regarded faculty member known for her work in medical education.  Both were afraid for the future of medical education in different ways. My contemporary was concerned that the emphasis on the use of advanced technologies like ultrasound ...

Read more...

Nothing puts more fear into the heart of an internist than a dermatologic chief complaint. And for good reason: we have very little exposure to the breadth of the field. To us, all rashes seem to be maculopapular, all bumps are pustules … or was that nodules? It’s not that we internists don’t care about the skin or don’t appreciate its complexity. Rather, we simply haven’t seen enough bumps, rashes, and ...

Read more...

Despite recent buzz about shifting resident education to community health centers, hospital based education is here to stay. The model of education, though outmoded, is simple. Get residents exposed to as much disease as possible, in the shortest amount of time. The future of American health care is not in acute management of tertiary care; but in integrated, team-based care. To get there involves focusing not only on educational content, ...

Read more...

Imagine you, like most traditional medical students, went to college for four years to earn an undergraduate degree. Like many, you might also have obtained a graduate degree or worked for a period of time. You then spend time and money fulfilling extracurricular activities, taking the Medical College Admission Test (MCAT), applying to schools and traveling for interviews. If you are part of the lucky minority -- roughly 40 percent ...

Read more...

Most Popular