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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A year ago in a post about law school applications decreasing, I speculated about whether a similar phenomenon would occur with medical schools. In that post, I commented on the impending problem of too many medical school graduates and not enough residency training positions. I cited an article that appeared in the New England Journal of Medicine in 2011 in which the CEO of the Accreditation Council for Graduate Medical Education ...

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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 ...

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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 ...

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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 ...

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