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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“Ms. M,” the resident says, “I saw in your chart that the last time you had surgery you had a pulmonary embolism.” She nods with recognition: “I felt like I couldn’t breathe. It was really scary.” Then: “I sure don’t want that again.” The resident lifts up the covers and sees that the patient’s calves don compression boots. “Make sure you keep the boots on,” he says, pointing. What do boots ...

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In my 3 years of residency, the nearly universal resident response to outpatient continuity clinic was a disturbing, guttural groan. I recognize that many aspects of primary care drag down even the most enduring physicians. But I have also found primary care -- particularly with a panel of high-risk and complex patients -- to be a welcome challenge. I recently spoke with one of my institution’s main advocates for academic primary ...

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In medicine, we pledge: primum non nocere. First, do no harm. But before we can do no harm as doctors, we need to be doctors. And before we can be doctors, we need to be human beings. Being a doctor is a great privilege, but it is a subordinate privilege. Being human comes first. I distinctly recall the time in my medical education when I realized I was becoming ...

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Since the beginning of it all, since that exact moment where I shot up from my friend’s dorm room cot with a revelation to pursue my ancestral calling in medicine, I have been continually questioned by family and friends on exactly where I sit in the totem pole of physicianhood.  And I get it. With terms like sub-intern, intern, senior resident and attending, it must be confusing to ...

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When we die, we die alone. Regardless the number of those who surround our deathbed, we experience our last breath alone. Our last feeling of pain. Our last moment of hope. Our last words, our parting gift to the sentient world as we depart the duress of consciousness. The ethereal message leaves our lips to pierce the very tangible aroma of Clorox and human excrement. The hearts of the healthy, ...

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It’s common knowledge among third year medical students that statistically a lot of us are mentally damaged in some way. Knowing these stats makes us feel better about our ongoing feelings of low self esteem, high anxiety and sometimes outright panic. In the car on the way to rotations, regular starters of conversation are statements like, "Did you know 35% of med students are depressed at any given time?", to ...

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