Despite the changes around us, the training of physicians has stayed much the same. Sure, there are new work hour limitations and a push to move towards competency-based assessments, but the overall structure of our training remains largely untouched. We spend the vast majority of our time training in hospitals, with the remaining time spent practicing in traditional outpatient clinics. However, health care is being increasingly delivered outside these two arenas. ...

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The issues around race and how it plays out in modern day American society are numerous, deeply personal to many and utterly complex to most. The incidents in Ferguson, Mo., which began in August and erupted late November in nationwide protests, are an example of the many problems with race relations that persist in our country. While I believe we have made significant progress since the civil rights movement began, ...

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“All of you want to help people and save the world now. But, by the end of medical school, only two of you -- if we’re lucky -- will remain idealistic.” Within the first three days of medical school, I had heard three different lecturers tell me that I would lose my compassion and empathy. By the end of the first three weeks, that number had grown to six. During the ...

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shutterstock_112847326 I'm on my family medicine rotation right now.  One of my preceptors is about 80 years old and went through medical school in the 1960s.  He is still sharp as a tack; he used to do C-sections, hernia repairs, appendectomies, fracture repairs and get this -- emergency burr holes for subdural hematomas (a.k.a. neurosurgery).  He stopped around 1997, mostly because he ...

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As part of the second-year clinical skills course, each member of my class is required to complete two 8-hour emergency department (ED) shifts. I had my first ED shift last week, and when I walked in, I introduced myself as a second-year medical student who needed to practice IV placements, EKGs, and any other procedures that happened to come my way. Three hours later, when I walked out of the ...

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My department had a problem that harmed patients on at least a weekly basis. It was well-known, but it seemed there was no viable solution.

My supervising attending was in his seventies and highly regarded at my hospital, having held powerful administrative positions for decades. About ten or so years ago, he stepped down from running the hospital, and ...

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Almost every practicing doctor remembers the grueling hours and intense workload of residency.  I recall overnight calls when I ran around from floor to floor, my beeper never stopping. I would collapse at home the next morning exhausted, drained and a little depressed.  I would never want to relive residency, but I do look back at it with a sense of accomplishment.  In some ways, it is a badge of ...

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shutterstock_190503113 Why are we shortening medical degrees? The four-year medical degree has been the mainstay of U.S. medical schools for more than a century, following the publication of the Flexner report in 1910. Prior to this, there was little standardization about what a medical degree could or should look like. Medical school education was subsequently standardized to two years of academic study, followed ...

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shutterstock_173979863 I admittedly spent a good portion of the fourth year of medical school dreading internship. A year where I was expected to suddenly be a doctor and to have all the answers. A year where I would work long hours and carry several pagers at one time. I come to you in blog form to inform you of some of the ...

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She was absolutely perfect.  She had ten perfect fingers and ten perfect toes.  Her eyes were wide and curious and drew you in fondly. She was absolutely perfect everywhere -- everywhere except for her nose and mouth. She was born in 1959 with a unilateral complete cheiloschisis and palatoschisis, more commonly known as a cleft lip and palate.  Where her perfect, beautiful nose should have been was an empty, gaping ...

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