Despite convincing results for many health care interventions, translating evidence from research into clinical practice is often challenging. Implementation barriers are myriad and complex, but a number may arise from core design issues. While real-world environments are clearly vital to the success of any intervention, many traditional research efforts are structured to remove them from the proverbial equation. In studying the impact of a new medication, for instance, a group might ...

Read more...

Critics have been making the rounds again with a warmed-over complaint: International medical schools that offer U.S. teaching hospitals financial support for clerkship programs are unfairly buying access for their students instead of "more deserving" U.S.-based students. As the proud dean of a Caribbean medical school, I want to set the record straight yet again: This argument is hollow and based on a false dichotomy. In fact, the argument has ...

Read more...

asco-logo “Observe, record, tabulate, communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone you can become expert." – Sir William Osler, “The Father of Modern Medicine” (1849–1919) In this modern era of oncology, the potential extent of malignant spread is staged by high-quality scans. Further, when ...

Read more...

How do you learn to be a good doctor? Sure, you study anatomy, and make flashcards, and memorize nerve pathways, but what makes someone a good doctor is the way they apply all that knowledge to real patients with compassion and diagnostic expertise. Strong “doctoring” skills, like listening carefully, taking a comprehensive history, explaining medication and treatment options clearly and patiently, and writing notes that colleagues can understand, are what ...

Read more...

His eyes were as wide open as his mouth as he slowly placed his beer on the bar without looking away from me.  Making no effort to wipe the thick foam from his upper lip, the man continued to stare in disbelief, “That’s the coolest thing I’ve ever heard.” The thirty-something C-something-O was blown away by what I did for work.  By this time a small crowd had gathered, standing in ...

Read more...

Fidgeting in my seat, I waited nervously in one of the most crowded waiting rooms I had ever been in. Suddenly, I felt like a bucket of ice water had been dumped down my back; my legal name was being called over the dozens of waiting room sniffles. My instinct was to remain glued to my seat, not to let anyone know that I was the person attached to that ...

Read more...

The family medicine fellow set down her pen and inhaled deeply. “So when is it OK to cry with a patient?” she asked the senior attending across the table, a veteran internist in her mid-60s. About a dozen of us -- fellows, physicians, writers -- sat hunched over a paper- and laptop-strewn table in the fellows’ shared office, talking about a poem: Sharon Olds’ “Death of Marilyn Monroe.” In it, Olds ...

Read more...

These are the words that inspired me to begin my journey as a medical student blogger. Four years later and  I'm still at it!  The time has flown since I received my acceptance letter to now, only a few weeks away from my graduation.  And as graduation approaches and I make the transition from student to resident, I can't help but ask myself, how am I doing?  How is my first patient really doing? It's a difficult question ...

Read more...

As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues. As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers ...

Read more...

“Son, just let me die.” Those were the first words Mr. O. told me as I introduced myself. As a 75-year-old stage IV lung cancer patient with brain metastasis, Mr. O knew his time on this planet was limited -- the last place he wanted to be was in a hospital with a newly minted clinical student. Mr. O’s neighbor had found him unconscious on his porch earlier this morning, and ...

Read more...

Most Popular