Interview season is winding down and budding physicians everywhere are clutching tightly to their hard-fought medical school acceptance letters. I thought now would be an opportune time to reflect on what I wish I had known before starting medical school. Let's boil it down to five essential aspects of medical school that you wouldn't expect or are of such crucial importance you should be reminded of them. 1. You will have time ...

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Giving and receiving feedback is really hard.  When I left training and joined the faculty at a major medical school last year I found many things about my new position daunting.  Fitting into a well established practice; learning a new system; being a teacher; juggling different services and roles; billing appropriately; and last but not least, giving feedback. Psychological and logistical hurdles make it challenging to deliver feedback.  Constructively criticizing the ...

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“That makes no sense!” a friend recently blurted out to me after I finished helping her understand how the vast majority of internal medicine residents are trained in this country. Her incredulousness was less about the "how," and more about the “where.” No doubt. When you consider that the overwhelming majority of practitioners will ultimately be practicing almost exclusively in the outpatient environment, and that cost-conscious healthcare reform efforts are specifically ...

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As the sun rises in hospitals across the nation, medical interns start their age old ritual of rounding and examining patients. While the old guard may feel that paper and pens are being replaced by impersonal interactions of mouse clicks and scrolling through the electronic medical records; the essence of the intern experience remains the same. It is a year filled with a roller coaster of highs and lows which adds ...

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How I weather the yearly residency cycle I've been a family medicine residency faculty member for nearly 5 years, and I've come to observe the yearly cycle of a residency over that time.  Reminding myself of that cycle helps me weather and celebrate the peculiarities of each time of year. July-September: Adjustment Every resident's role changes on July 1.  For the first-years, it's their first day of being called "doctor."  Second- and third-year ...

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Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner.   After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion.  After all, why go into this much debt and spend so much ...

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Watching my grandfather pass away changed my life. It wasn’t sudden and it shouldn’t have been unexpected. Yet it seemed unnatural, mysterious, and incredibly uncomfortable. I can still remember receiving the phone call from the hospital, my mother letting out a distraught cry that my grandfather was no more. My initial reaction was shock and confusion: I just couldn’t understand what had happened. Looking back, he had been under intensive ...

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When I came to medical school, I was certain I wanted to do primary care.  Despite the forces that steer many of us off the path – how many times have we heard, “but you’re too smart to do primary care!”? – after three years of medical school, I was still committed to primary care. But I struggled with which type of program would be best for me. I applied to both ...

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"Aren't those decorations looking nice?" asks a soft voice beside me. Startled, I turn to find a young woman wearing a red-and-white sari. Her head and face are swathed in the folds of the sari, leaving only the large red bindi on her forehead clearly visible. We're sitting on a grassy tuft amid a large campus green. All about us stand buildings with signs in both Hindi and English. Atop the central ...

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Predatory Publishers, Batman! The news out of Gotham City (New York Times) tells a tale of deception and woe. “Pseudo-academia?”  How can open access to information be a bad thing, and why does Nature call some of these journals “The Dark Side of Publishing”? What is Open Access? Open Access is a movement encouraging free and unrestricted access to published material.  The movement takes many forms, from ...

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