“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 ...

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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 ...

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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 ...

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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, ...

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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 ...

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Recently, I attended the annual AAMC meeting where the question, “What will medical education look like in 2033?” was asked in a session called “Lightyears Beyond Flexner.” After this thought-provoking session, I too pondered academic medicine’s fate. I would like to share my reflections in this forum. Without question, technology stood out as a major theme in this conference. And for good reason: clearly it is already permeating every corner of our ...

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The use of standardized or simulated patients (SPs)  in medical education for the teaching and assessment of clinical skills has enormously expanded the opportunities for medical students and residents to develop and practice their skills in challenging and high-risk clinical situations without any risk to patients. While many use these two terms interchangeably, most medical educators define a simulated patient as an individual who is trained to act as a real patient in order to ...

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Over the past 300 years, the peer review process has played an integral role in scientific publishing. If you don't happen to spend your time injecting laboratory mice with toxic chemicals and submitting your results to the New England Journal of Medicine, here's how it typically works: A manuscript is submitted to a journal using an online manager, after which editors screen the paper and decide whether it merits further consideration. At ...

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After years of pounding the post-baccalaureate pre-med pavement, I did it.  I got accepted to medical school.  And I did it as an out lesbian on my application. Disclosing my sexual identity on my AMCAS personal statement felt like a big risk even though my mentors assured me that it would pay off in the end.  My hesitation to be out on my primary application was due, in part, to a ...

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While interviewing for medical schools last fall, I observed a strange phenomenon: every institution I encountered would underscore its student-run free clinic as a major highlight of the medical education they could offer. First- and second-year students would speak rapturously about the experience they gained from clinic. Working there, they said, reminded them of why they wanted to become doctors in the first place. Today, the majority of all U.S. medical ...

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