When the first pandemic lockdowns swept through hospitals, our hallways went silent. The absence of visitors felt practical at first, a necessary shield against viral spread. But weeks turned into months, and that silence began to echo with something deeper: distrust.
I remember walking into a patient’s room to find her eyes fixed on the door. She wasn’t waiting for the nurse. She was waiting for her daughter, the daughter she …
The practice of medicine is fundamentally different from the study of medicine. Right now, you’re being rewarded for memorizing and test-taking. But being a good doctor is about communication, clinical judgment under uncertainty, and treating whole humans in context. The skills that get you through preclinical years aren’t the ones that make you excellent at the bedside. Start developing those now: learn to really listen, to tolerate ambiguity, and to …
Patients once traveled on foot from Afghanistan to see my father, a Cleveland Clinic-trained doctor who practiced in Peshawar, Pakistan. It is easy to attribute such health care to a developing country. But California’s economy outperforms whole nations, and patients in the Central Valley still drive for hours to get life-saving treatment. I have lived and studied in both of these “doctor deserts,” one arid and one fertile. Both are …
The unpaid backbone of a billion-dollar scientific publishing industry
Not long ago, I received yet another “urgent” peer review request from a major medical journal. The email hit all the familiar notes: “We value your expertise. Your contribution is essential to scholarly excellence. Please respond within 72 hours.”
I glanced at the journal’s website. Their open-access fee? $3,800. Reviewer compensation? Zero.
This is the quiet hypocrisy we’ve all come to accept: Journals charge …
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Internal medicine physician Robert C. Smith discusses his article “Why medicine needs a second Flexner Report.” In this episode, Robert explores how modern medical education has fallen behind the science it was …
The most powerful lesson I am learning in medicine whispers against the roar of constant intervention. It is the art of “”unmedicine”: the wisdom that the best care can often mean doing less. I entered medical school envisioning a future of decisive action. Yet, my clinical experiences have painted a more complex picture. I’ve seen a physician spend a full consultation gently steering a patient away from an unnecessary MRI, …
Ten years. That’s how long I carried around this idea I just couldn’t seem to put into action. I wanted to speak openly about this tension I felt as both an academician and an ordained minister. Yes, this false notion that my academic life and my spiritual life had to run on separate tracks. Not only did I want to openly discuss this tension; I wanted to do something about …
There is an old parable about a farmer whose horse runs away.
The neighbors cry, “Such bad luck!”
The farmer only replies, “Maybe so, maybe not. We will see.”
The next day, the horse returns with two wild horses. “Such good fortune!” they cheer.
Again, the farmer answers, “Maybe so, maybe not. We will see.”
Soon after, the farmer’s son breaks his leg taming one of the horses. “Such misfortune!”
The farmer answers, “Maybe so, maybe …
When we began medical school, we had dreams and plans for what the next four years would look like. After all, we had the privilege of being siblings on the same medical training journey. The truth we have realized over these past years is that nothing truly prepares you for how medical school will change your time, priorities, and even your sense of self. Therefore, the decisions you make (or …
If you have grown up under the realities of western medicine, you likely have general grievances about the financial cost of care, the inconvenience of scheduling and attending appointments, and the long wait times at the emergency room or to see a specialist. As a medical student and an occasional patient, the majority of my experiences have been in this philosophy of health care where everyone is entitled to quality …
“Do you have a key?” my grandma asks me. I hesitate and she repeats herself, “Do you have a key to this place?” She is sitting in a hospital chair behind one of those hospital tables with a tray full of hospital food in front of her. She is practically skin and bones; her shirt and pajama pants are hanging off of her. My mom is sitting on the bed, …
The weight of a number
Three years ago, I sat in my car during a work break, hands trembling as I opened my MCAT score report. The number stared back at me: 494. My heart sank. As a husband and father of two young girls, I had poured five months into prep courses, question banks, and late-night study sessions, all while balancing family and work. I walked out of that eight-hour …
I had heard about night float: a daunting rotation for interns as they cared for patients they often were not well acquainted with, putting out fires until their usual team could take over in the morning. Given this reputation, I was surprised to find a night float week on my schedule as part of my internal medicine clerkship, a core rotation as a third-year medical student.
My first patient was a …
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Medical student Devin Behjatnia discusses his article “The case for a standard pre-med major in U.S. universities.” Devin outlines why he believes a unified pre-medical studies major would better prepare students for …
In medical school, we are taught how to recognize the signs of depression, how to assess for suicidal ideation, and how to document risk. We memorize screening tools, safety plans, and algorithms. But what we rarely learn, if at all, is how to hold the emotional weight of these encounters. We are not formally taught emotional literacy. Some may argue that emotional literacy can be learned informally over time, but …
The U.S. primary care system is unraveling. Fewer graduates are choosing it, and patients are struggling to find someone who stays. But in the background, one group continues to step up: international medical graduates (IMGs).
Quietly and steadily, they are filling the spaces others have left behind.
They are physicians who trained abroad, adapted to new systems, passed more hurdles than most of their U.S.-trained peers, and still chose to serve.
And yet, …
For the last several years, burnout (a syndrome typically defined as emotional exhaustion, cynicism, and poor efficacy) has been a hot topic in the world of health care. But as a bit of good news, the AMA recently released that the rates of physician burnout are at the lowest they have been since the beginning of the COVID-19 pandemic. However, I would argue that if 43 percent …
In medical training, there are moments when the question quietly shows up. It might be during a night shift, after a long stretch without sleep, or while catching up on charting. The thought is simple, but heavy: What if I had chosen something else? What if I had gone into engineering, or business, or any path that didn’t ask quite so much?
This reflection started as an assignment for a medical …
“Did I get dumber?” This poignant question from a medical student, asked in frustration after receiving a lower-than-expected grade, became the focus of a forty-five-minute academic coaching session. Simply put, my role as a learning specialist was to foster a mindset shift: from “my grade determines my self-worth” to “my grade reflects where I am in my learning right now and guides my next steps.” Helping the student build this …
Leadership training in medicine is often framed around titles and administrative skills, preparing students to one day manage teams or step into academic or hospital leadership roles. While these skills are important, they miss the deeper, more urgent need in medical education: helping future physicians understand themselves, navigate complex health care systems, and make intentional career decisions aligned with their values.
Why traditional leadership training falls short
Countless physicians enter practice only …
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