Amid the buzz about whether medical students should be sued and the bill currently debated in Arizona (a state which finds itself in the spotlight more than usual these days), I noticed some commentary from several people who do not think they would like a medical student on their case. Sometimes patients do refuse to be cared for by medical students, often due to overestimating the involvement they will ...
Vineet Arora, MD
Should medical students be introduced as Doctor?
I recently saw a post in Yahoo questions entitled, "Is it illegal for a medical student to introduce themselves as 'Doctor' before they have received their MD?"One of the answers that was rated highly was "I think it is more unethical than illegal." Clearly, if a student is deliberately misrepresenting themselves as a ‘doctor’, it is grounds for disciplinary action. More often than not, this misrepresentation is not ...
Social workers can reduce preventable readmissions
I just finished another 2 weeks on service. This time, I had also had a shadower, but one of a different kind. As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students. Achieving true interprofessional learning is challenging for schools like ours without a pharmacy ...
How medical students should present patients to their attendings
I just finished another inpatient service stretch at our community hospital with some great cases and lots of good medicine. While attending rounds may have changed a lot in the last 40 years as highlighted in a recent Annals of Internal Medicine article, some things have not changed – the focus on medical student presentations during attending rounds.Students spend hours through their call nights preparing for the visit ...
Medical school and medical training in Ireland
I recently spent a week in Ireland, taking in the sights and spirits.I was actually there for work too – visiting the University College of Dublin and the Mater Miserecordia Hospital – or the original Mercy Hospital as they refer to it. As the future of primary care, residency work hours, and the healthcare insurance system continue to cause angst in the US, we often find ourselves referencing what our European ...
Case reports continue to be an important part of journal publication
I am teaching a new course entitled “Turning your Clinical Cases into Scholarly Work.”I hope to draw on my own experiences through the years mentoring students and residents in writing up several clinical cases, but also in making diagnoses. In preparing for this course, I have also learned quite a bit about the controversy surrounding case reports and the challenges that they face in today’s healthcare system.Unfortunately, case reports have ...
Powerful examples of using the iPad on the wards
I recently completed a two week tour of duty on the wards in July with new residents, interns, and students.Attending (serving as the supervising doctor for the team of residents, interns and students) in July can be challenging, but also one of the most rewarding clinical experiences as a faculty member. The interns and residents are eager to learn and your teaching may have a more lasting impact as the residents ...
Stop calling doctors fleas and teaching professionalism
At the recent AAMC meeting on how to integrate quality into teaching hospitals, the question that kept popping up from speaker after speaker was how to address the fact that doctors in teaching hospitals don’t get along.Unfortunately, all the specialty bashing that takes place prevents the adoption of a team based culture necessary to advance quality and safety. As one speaker highlighted, how can we really start to address this ...
Tips for students who want to shadow doctors
On a recent Saturday, I rounded in the hospital. I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me. While she was doing research at the hospital, she had not ever rounded in the hospital before. It was Saturday so our team was mostly off so it was just me and my very capable resident who is about ...
Hospitalists are killing primary care, and other myths debunked
Those who hate hospitalists believe that students and residents are choosing hospital medicine over primary care so hospitalists are to be blamed for the primary care shortage. They also believe that the rise of hospital medicine has made primary care less attractive. Then, there is the salient argument that care transitions are more inherent and vulnerable due to hospitalists.Of course this hatred is not new. As a ...
China medical school and residency training
My husband and I recently traveled to Wuhan Medical School in the Hubei Province in central China.Our medical school has partnered with Wuhan to help inform their curricular reform efforts. We spent 4 days touring the hospitals and teaching facilities, meeting students and faculty, going on rounds, and giving talks. Although the language barrier was challenging, we had incredible translators who worked to translate every slide we spoke ...
Medical conditions as seen in the movies
I recently went to see Alice in Wonderland in 3D.This epic creation by part genius–part disturbed director Tim Burton features the wickedly talented method actor Johnny Depp as the ‘Mad Hatter.’ As I was watching Johnny Depp’s orange hair and freakish eyes, it occurred to me that some of the most popular fiction movies over the last several years have featured some notable legends and their medical ...
Residency training is like James Cameron’s Avatar
Dr. Carolyn Clancy, head of the Agency of Healthcare Research and Quality, recently highlighted the definite need for enhanced patient safety and training on healthcare IT for residents who will be the practicing docs of the future.At the very end, she compared the future of residency training to James Cameron's Avatar – an epic battle followed by enlightenment.Because I am a huge science fiction fan and working in graduate medical ...
Medicare doc fix questions and answers
A 21% cut for Medicare physician fees is set to go into place soon. This year, fixing physician payment has been overshadowed by all the talk about health insurance reform.In fact, I remember being invited to talk about healthcare reform on a panel for medical students this past fall. As part of my remarks, I mentioned the 21% pending cut in physician payment and recall the questions and ...
Patient handoffs limit residents work hour cap gains
Anyone affiliated with a teaching hospital knows that the controversy regarding resident work hours is heating up again. It's been over 5 years since the ACGME limited resident hours to 80 hours per week with a maximum of 30 consecutive hours. While this may not sound like 'reform', as someone who trained prior to these rules, it is definitely a change.More recently, the Institute of Medicine issued a ...
Can doctors learn medicine from physician lounges?
I just finished rotating at a community hospital where one of the most interesting things I’ve enjoyed is stopping by the Doctor’s Lounge. I can always count on a getting coffee there and hearing some good conversation – doctors asking for input on interesting cases, laughing, sharing stories, both personal and professional, and catching up on each other’s busy lives. In fact, I ran into an old friend of mine ...
