In the 2014 Forbes article “How A Nobel Economist Ruined The Residency Matching System For Newly Minted MD’s,” Amy Ho argues the way we place new medical school graduates into residency positions needs to be reassessed. She calculated the cost of applying to residency to be greater than $7,500 when taking into account loans and interest. If you have not participated in the U.S. medical educational industrial complex, ...

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There’s no doubt physicians entering practice today leave their residency programs with a tremendous amount of medical education and training; what seems like a lifetime’s worth of knowledge crammed into just a few, intense years of instruction. Unfortunately, all the time residents spend on rotations, lecture, journal club, and myriad other obligations leaves little opportunity for getting oriented to the more mundane, yet absolutely critical components of practice. As a result, ...

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A letter to my nephew, who is just starting residency. There will be days ahead when patients will bring you their most prized and flawed possessions -- their broken bodies, their flagging spirits, their waning hope.  They will wonder: "Can I get back to my loved ones, my life, my dreams?  Will you help me? Do you care?" You will not have all the answers, though you will have read a forest ...

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July is back, and clinical faculty at teaching hospitals have again braced for the annual deluge of new residents just beginning their specialty training. Unfortunately, our new doctors may be more unprepared than ever. The gap between medical school (the four years leading to the MD degree) and residency (advanced training in a particular field) has widened over the past several years. Changes in the health care system, shifting patient expectations, ...

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Much is made of the date July 1st in the medical profession.  Freshly graduated physicians begin their training career in medicine as interns.  Although technically physicians, these interns are new to the clinical practice of medicine and all that comes with that.  Much has been made of the experience of the new intern.  Samuel Shem's House of God is a renowned novel about medical training.  Countless television series, chronicle the ...

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Residency is a time of immense learning. You learn from your attendings, your patients, and your colleagues. Of all the teaching moments during my residency, one that frequently stands out in my mind now is the day when one of my co-residents told me about the “post-training phenomenon.” He had previously completed a different residency and practiced in that field for a decade prior to switching to our specialty. “Once you ...

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For many people in medical training, one period of time that they look forward to is the elective period. Most of the time, these periods are available for people to explore potential career opportunities, whether it is a certain subspecialty or a research opportunity. Usually, people are not on call and weekends are free, luxuries that are often sparse during the rigors of medical training. Most of the time, one ...

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On May 11, 2016, we lost another bright, young soul to suicide. Sean Petro was in his third year at the USC Keck School of Medicine and is the third tragedy at his school in the last two years. On April 23, 2015, we lost Kevin Dietl to suicide just weeks before he was to graduate medical school. Kevin's parents were so excited to attend their son's graduation. Instead, they attended ...

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asco-logo A recent AMA Wire article highlighted the resident depression endemic and identified some strategies for improvement. The upshot: Too many trainees are unhappy with their jobs. The most important tool used to gauge trainees’ satisfaction with their training programs is the ACGME survey. Since the ACGME is the organization that formally accredits training programs, ...

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On my recent tour of residency programs, I had the pleasure of meeting many foreign medical graduates (a.k.a. FMGs; not to be confused with international medical graduates, who are U.S. citizens who go abroad for medical school). Almost uniformly, they struck me as confident, mature and articulate. Many were older than me, some by as much as 10 or 15 years. Most had extensive research experience, and a few had even ...

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