There were many things I pictured myself doing as I endured four years of medical school: building relationships with my patients and their families, performing complicated procedures, sleeping with my shoes on so I could jump up at any moment when I was on call. One thing I didn’t imagine was that I would be learning about and becoming a part of the labor movement. My experience at UCSF ...

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Adapted from a keynote address given to the graduating medical class at the University of Toronto. When I was asked to give the keynote to graduates of the class of ’14, it was an honor that nevertheless filled me with terror and a bit of wistfulness. My sense of fear in giving advice to these amazing young doctors comes from not being sure I belong in the same company. They are whip smart, ...

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Want to become a doctor? 5 criteria you should consider. While running several times over the past week, I have thought carefully about our profession. I cannot imagine having chosen any other profession than medicine, nor any specialty other than internal medicine. But that is me, is it you? A medical tweeter than everyone should follow @medicalaxioms had these tweets recently:

If you become a doctor for wealth or prestige, you are going ...

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I never understood the loss of empathy during medical training. Until now. It was 4:30 a.m., and I was on the side of the road, drenched in sweat and tears. I had finally slowed my breathing to normal. I was going to be late for rounds. No time to obsess over possible questions. No time to memorize lab values, or practice regurgitating them. I thought of home. My family and friend, who I hadn’t ...

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As I begin another year teaching EKGs to our new residents, I find I am increasingly asking myself, "Where to teach?" I do not mean to imply a geographic sense to the word "where" (although this is difficult, too, as residents move from hospital to hospital in large health care systems like ours as they change rotations), but rather as more of a "level." What level do I teach our residents ...

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Learning in medical school often feels like learning a completely new language. There are numerous acronyms (OPQRST, CAGE) and molecules (IL-1, TGF-beta) and more. But most striking to me are two particularly ubiquitous buzzwords: “high-yield” and “protected time.” I feel like I heard both these terms -- and particularly the former -- thrown around every single week of this past school year. High-yield has been used to refer to, as you ...

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My high school graduation ceremony was your typical Californian high school graduation -- the sun hovering lazily over us, a cool, ocean breeze bringing wafts from the sea. As I listened to my principal deliver his address, my attention waned in and out. The sun was too warm and the wind was too soft. When the student speaker came up to speak, I reclaimed my attention to listen to him ...

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Today, I saved a life. And I wish I could tell you a story about fancy heroics -- about an exploratory laparatomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life.  But I can’t.  But I can tell you that I saved a life. She was 16-years-old, and moved here four years ago from a different ...

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Four adages I learned in medical training that I still speak of today: “Common things are common.” (The alternate version of this that might have more appeal to zoologists: “When you hear hoofbeats, think horses, not zebras.”) This cautions physicians to remember that it is more likely that the patient has a common condition than a rare one. Although it is prudent to consider all the possible diagnoses that might match a given ...

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In case you haven't noticed, a hot new topic in education is "grit." In order to reduce the long-standing 20% attrition rate of surgical residents, some say we should select applicants who have more grit or conscientiousness. A recent paper in Surgery reported residents who dropped out of programs had decreased levels of grit as measured by a short-form survey. But due to unexpectedly low attrition rates in the surgical programs ...

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