When I was in medical school in the 1990s, students were given a bleak picture of the life of a subspecialist. We were told that there would be few job opportunities and that the only way to ensure a job was to pursue a career in primary care. Many of my classmates did go into primary care but the majority of us accepted residency positions in surgery, neurosurgery and other ...

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"Doctor, could we have a copy of your most recent CV." "Sure," I said, realizing it hadn't been updated recently. It is interesting how I approach my academic pursuits now.  It used to be that it was "publish or perish" in the world of academic medicine.  Of course, even now the only "publishing" that counts to the academic world is that of conventional peer-reviewed journals with high impact factors (or grant applications that ...

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A technical standard is a formal document establishing requirements in several aspects of medical care which all physicians-in-training candidates must possess. Most medical schools require that all candidates meet these requirements in order to receive their doctor of medicine (MD) degree. Some schools require students to sign that document when applying to a program or as a condition to matriculate into medical school. I took a closer look at different technical ...

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There is a strong relationship comparing sports to the military, business, and also to medicine.  Young athletes, in their late teens and early 20s, are mostly brawn and use their strength and speed to achieve success early in their professional careers.  As the athlete matures in their late 20s and early 30s, the physiologic processes slowly decrease and efficiency and maturity and other cerebral skills emerge. There are 2 rainbow arcs ...

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Spring season is still many months away, but residency programs are in early heat as selection committees across the country buckle down to nominate the next batch of interns for the upcoming academic year. Spread across these institutions' tables one may find headshots, board scores, recommendations and interviewer comments of top candidates interested in training at their respective programs. Often, faculty members of esteemed medical centers will have only a few ...

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When listening with a stethoscope to a patient's heart, one sometimes hears a deviation from the typical "lub-dub" rhythm. Sometimes the "dub" is too loud, or the "lub" too soft. There might be a rubbing sound, or a harsh blowing sound. By interpreting subtle characteristics such as the location, pitch, and timing of these sounds, one can sometimes diagnose things like a diseased heart valve or congestive heart failure.
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I recently had the opportunity to read Daniel Pink’s Drive.  I read it partly to understand why pay-for-performance often fails to accomplish its goals for complex tasks, such as patient care.  However, the thing I found most interesting about this book was the way in which creativity is deliberately inspired and cultivated by industry. I could not help but think about why we don’t deliberately nurture creativity in medical trainees.  Why ...

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Mexican medical residents have been submerged in a bygone system for decades. More than 100 work hours a week, scanty pay and psychological warfare are the everyday burden for residents in our country. You can read more about the working conditions of Mexican residents in my guest post, "The life of a medical resident in Mexico." Gradual progress is being made thanks to 30 years of pushing towards a ...

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When I was in medical school in the 1990s, students were given a bleak picture of the life of a subspecialist. We were told that there would be few job opportunities and that the only way to ensure a job was to pursue a career in primary care. Many of my classmates did go into primary care but the majority of us accepted residency positions in surgery, neurosurgery and other ...

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My mom wrote me the following letter during my first semester in medical school. She has been a patient, and a mother/wife/sister/daughter of patients. She has been around countless doctors. Here is her take on what makes a great one. Dear Son, I am so very proud that you are becoming a physician and that you chose this profession, not for the prestige or the financial advantages, but because you want to ...

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