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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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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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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The blonde minority: Sexism is alive in medicine While demographic data may suggest otherwise, I still consider myself a minority, albeit a less common one. I am a young woman in medicine, and I am a natural blonde. I barely qualify for a prescription for eyeglasses, but I have found they give credence to my words and patients seem to take me more seriously. Perhaps three years of residency training ...

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As a fourth-year medical student, it was fairly easy to maintain a healthy lifestyle. When you have much leisure time and are relatively stress free, you can eat healthy, stay physically active and maintain quality mental health. However, as I begin the journey called residency, it is clear that the task of maintaining my own health will be much more difficult. But the importance of this task should not be overlooked. ...

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Two years ago, I received my first employment contract. Not long after Match Day, I did what 115,000 physicians in training did that year and will do again this year: I signed the contract promptly and returned it. I tried to read the contract carefully, but it didn’t really matter. Unless you no longer want to be a physician, there is no other choice but to sign. Today, as president of my ...

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I performed my first paracentesis in November of my intern year.  It was 3 a.m., and I was on overnight call in a packed ICU.  The patient, a 45-year-old male with hepatic encephalopathy, was hardly alert enough to remember my name.  He didn’t know I was an intern.  He didn’t know I’d never even attempted a paracentesis before. After I finished, I added the patient’s name to my procedure card.  I hurried to get an ABG ...

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July as a newly minted intern: It was the best of times, it was the worst of times. The only analogy I can make is you feel like a middle school kid sitting in a PhD course, desperately trying to back-learn everything in a language of acronym alphabet soup you've never heard before. If medical school is drinking from a fire hose, this is trying to sip from Niagara Falls. You have ...

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Working the night shift as a resident physician You’ve changed. No longer do we see you sluggishly walking en route to work every morning with refillable coffee thermos in one hand, robotically scanning some kind of social media feed with the other. We are concerned that the regular and cyclic day time group texts received from you are now occurring at odd hours of the night.  Your persistence to move ...

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