I recently read some statistics that shocked me, but not really. In the U.S., 60% of medical students come from families with incomes in the top 20% of the nation. Meanwhile, only 3% come from families with incomes in the lowest 20%. Not much socioeconomic diversity in the house of medicine. Now, I realized early on that I didn’t have a lot of company in this respect, but I didn’t think ...

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My father who was a junior doctor in Britain’s National Health Service (NHS) in the seventies would have been grateful for the match scheme, an algorithm that places medical students in residency programs in the U.S. The training in the NHS was unstructured. Physicians carved their own training by joining a patchwork of hospital positions in disparate places. Over a few years we lived in Yorkshire, East Anglia, Wales, East London ...

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Physician and best-selling author Abraham Verghese is a professor of medicine at Stanford University and has given presentations worldwide, focusing on the human side of medicine.  In his terrific TED talk, he passionately argues that in the midst of overwhelming data and technology, we must never lose sight of the patient. "When we shortcut the physical exam, we not only overlook simple diagnoses, but we're losing much more than that."

A PubMed query of the phrase "social media" yields 8,747 unique peer-reviewed articles.  When the search is refined to "social media medical education" there are 578 articles.  When “professionalism” is also added to the search string, there are only 31 article results.  This suggests that very few authors are writing about the topic: Approximately 0.4% of the available peer-reviewed literature about social media pertains to how we doctors should use and ...

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I argue with my father a lot. He works as an intensivist at a community hospital in Indianapolis while I am about to graduate from a highly academic internal medicine program in Chicago. Needless to say, we have very different perspectives. He sometimes expresses views similar to those written in an article, “When I Was a Resident: How Duty Hour Rules Are Creating a Lost Generation of Physicians." I started ...

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When I graduated from my residency, far from my current professional home, I wanted to write a book called How Not to Get Yelled At in the Operating Room. Or How to Clear the Fear from Your OR. I had these titles in mind because I struggled so much during my intern year. It was a tough year, full of intense patient care and sleep deprivation, but the challenge that I most wanted help ...

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Change causes distress for most people. In medicine we have a hierarchy that disdains most change. Medical students, residents, attending physicians all seemingly reject change. Practicing physicians dislike change. Yet change occurs and is necessary. I learned a great deal about change from my mother. This anecdote may help put change into perspective. Many years ago, we lived in a 3 bedroom house. In the evening we all sat in the ...

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KevinMD.com recently published the article "It’s time to make the Match disappear" written by medical student Amy Ho. I firmly agree with her that the current match system is wildly inefficient and needs fixing. However, she is throwing the baby out with the bath water in abandoning the algorithm which yields an extremely effective system. Firstly, when one examines her data, which in itself is correct, one also needs ...

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“Are you more or less cynical than when you started residency?” This was the question my program director asked our senior internal medicine residents at a recent dinner with Dr. Bob Wachter. If you aren’t familiar with Dr. Wachter, he is widely acclaimed as the “father of hospital medicine” and a renowned champion of patient safety and quality. His blog, Wachter’s World, is chock full of insightful commentary on the American ...

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As everyone knows, residents are now restricted to working 80 hours per week. One of the lesser known side effects of this work hours limitation is the drastic loss of educational conference time. Since at least one third of the residents must now go home after morning rounds, afternoon conferences are no longer possible. Most residency programs now devote part of at least one morning per week to dedicated educational time. JAMA ...

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