Match Day: It’s among the most memorable moments of medical school, a time when students, friends, family and faculty gather to open those coveted white envelopes. It’s the symbolic first step out of medical school and into residency, and a tradition that is beloved by many. Yet the matching process is viewed by those outside of the medical profession (and to some within it) as a very odd way to ...

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"Old school" is difficult, but doable for teaching attendings.  While prioritization is the key, having a basic framework will help. Here are my personal keys: 1. Sit at the bedside and retake the history of present illness on those patients in whom taking the history is clearly a key.  For example, someone admitted with presumed community acquired pneumonia should have a short history including fever and perhaps night sweats and possible rigors.  ...

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A hospital is not the homiest of establishments. The bright neon lights, strange smells and piercing high-pitched beeps that radiate from the rooms of dormant patients fill the halls in a symphony of annoying sensory stimulation. But to someone recovering from a relationship that just ended, hospitals are heavenly. When the lonely silence of your one bedroom apartment is overwhelmingly loud, beeping IV lines and incoherent mumbles are surprisingly therapeutic. As ...

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Poverty is a significant public health concern affecting 10-15% of individuals living in Canada and the United States. Recommendations to eliminate poverty have focused on areas of income, housing, food security, and early childhood development. Calls for government action and provision of resources to healthcare professionals have been issued. Notably, educating medical trainees to address poverty has been absent from the discussion. Low socioeconomic status (SES) is a ...

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More than a century of American medical history was turned on its ear recently by the announcement that the groups that accredit medical residencies will unify their standards. Don’t be too hard on yourself if you failed to understand the significance (or notice at all). But this should be viewed as good news across the land. As someone who trains doctors from both traditions, I certainly welcome a more level playing field. First, ...

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Since becoming a full-time medical school faculty member again, I've volunteered to interview about two applicants each month from September through March. When I first started doing this, I was surprised that the admissions office did not provide me with a copy of the applicant's resume and essay until the time of the interview, carried in a manila folder by the applicant. But I quickly realized that it wasn't necessary to ...

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On Twitter a while ago, a medical student asked me how surgical program directors select new residents. Then a discussion arose among some academic surgeons on the same topic. Someone suggested that medical school grades were the best way to tell whether an applicant would be a successful resident. The fact is that we aren't really sure what the best way to choose residents is. First, here's what we really do. A 2011 
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Whither the white coat and why As a philosophical coda to the 2013 cacophony over Obamacare, health care reform and the notion that doctors and their skills will be needed less in some indeterminate future, this last month saw a media frenzy about the fate of the doctor’s white coat. It started with an article by Gonzalo Bearman and his colleagues in Infection Control and Epidemiology that asked the ...

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There was a very large lesion in his left frontal lobe, and no one knew what it was. He had been admitted earlier that day, after a neighbor found him in the hallway, confused and covered in urine.  Now he sat in his bed quietly, while we stared at his brain and the bright spot that didn’t quite resemble something. It can’t be tissue death from a stroke, insisted one resident. It ...

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The past few months I have joined thousands of individuals hoping to match into a residency program in 2014. I have had interviews all over the country and spent way too much time living out of a suitcase. For many students, residency interview season is exciting. For others, it’s stressful and exhausting. But for me, more than anything else, the interview trail was inspiring. I am currently applying to internal medicine-primary care ...

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