I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She ...

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Having a mentor leads to a more successful and satisfying career for doctors. So how does one go about finding a mentor mid-training or after training? Many medical schools and residency programs have mentorship requirements for trainees. But those mentorship needs may change if a student or resident (like myself!) changes their mind about what they want to be when they grow up. I have been enthusiastic ...

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“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis. Medical training has ...

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Want to hear a crazy story? Typical medical school students can relate tales of a college experience that includes summer research or hours spent reviewing for the MCAT. I didn't even take the MCAT. Read on for the oddest medical school acceptance story you've ever heard. I was driven in high school. I'd heard for years about smart kids going off to the Ivy League, and I wanted that experience — to ...

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He wasn’t particularly likable upon first encounter. He wasn’t apt to answer questions asked. He had a long pause and a long drawl and a tangential, winded story — and backstory — all of which he was bound and determined to tell to its detailed completion. With an irregular heart rate in the 170s and a respiratory rate in the 30s, I tried to steer him in the direction of ...

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“Put me out of my misery!” I’ve pleaded to anyone within earshot in the throes of a grueling day, a rant from one feeling burnt out. There are days I want to pull my hair out, even the ones that aren’t gray. One night I caught myself grunting, “I hate my life,” while heading out the door at 12 a.m., after an already exhausting day in the OR. No sane ...

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He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection. That was years ago. The opioid epidemic hadn’t yet been declared ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 2-month history of progressive lower-extremity edema, weight loss, and fatigue. Medical history is significant for recreational use of inhaled cocaine; he denies injection drug use. He has no other known medical issues and takes no medications. On physical examination, temperature is 37.2 °C ...

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The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder. Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to painkillers are 40 times more likely to ...

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I’m always intrigued by those who earn millions of dollars per year or even per month. Some manage to blow all that money and then some. Others, like a select few NFL players, choose to spend wisely and save prodigiously. Today’s Saturday Selection highlights the habits of one athlete who was among the highest paid NBA stars for many years. The headlines sadly feature athletes with similar ...

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The ability to lead is not something that comes naturally to everyone. There are some people out there who are wired to lead right from when they are very young -- but these are few and far between. Most of us have to train ourselves, and acquire the necessary leadership skills based on our own learning curve and experiences. The fact is that we are all leaders in one way ...

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When I was a cardiology fellow back in the 1980s, I learned about a variety of early tools for evaluating heart health that had been displaced by the modern standards of electrocardiography (ECG, or EKG for the Deutschephiles) and echocardiography. One such technique – ballistocardiography – stuck with me, and may be making a comeback. Ballistocardiography is based on the observation that the mechanical action of the heart leads to subtle ...

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Just sign here. How many times a day are we asked to do this? "Just sign here." "Just put down your license number." "We need a stamp with your doctor's info on it." "Give us your NPI." "Initial here, here, and here." If we took the time to read all the things we're signing, we wouldn't have time to do any doctoring. The other day I was asked to hand-write the date on ...

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Many doctors don’t want anything to do with investing money. They feel investing is not what they were trained to do and therefore a waste of their valuable time. I think this attitude gets some doctors into trouble. It is true that our time is best spent in our main area of training, but it’s very important for us to also have an adequate knowledge of investing. Being somewhat familiar with ...

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I believe there’s no such thing as work-life balance. I think this every morning when I leave for work, watching my two-year-old son press his face against the front window and wave at me as I back down the driveway. It comes up again at work, as I guiltily feel relieved when a patient cancels and I have an unexpected half hour to work on a behavioral science presentation for ...

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Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports to discover ever new and egregious forms of bias, we will be endlessly reminded, in ...

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One of the best bits of wisdom I’ve ever received is that you can tell a lot about someone by looking at how they spend their time. In medical school, time is our scarcest resource. We’re at this strange and exciting point in our lives, during which we’re responsible for learning an enormous amount of information in hopes that someday we’ll be able to quite literally save lives. Many of my ...

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Doing a simple internet search, you can find a plethora of information about well-being and health. Being happy and well is a goal everyone should aim to achieve. However, I  find many of the tips out there are simply unattainable. It may be that I am just a fail at true inner peace and that my inner tsunami doesn’t let me rest. Or it may be that the tips just ...

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Recently someone asked me how I started my blog, Brave Enough. The person, a physician, wondered how I made the jump from safe, traditional academia into the world of social media and blogging about women empowerment. “Did you have one moment? Did something happen? What was it?” The conversation made me reflect, as I have been, for several weeks. Like most things, my introspection ended up as words in my journal. Then, words in a ...

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The lows don’t mean you are loser.  To the contrary, they mean something else that is completely antithetical.  They mean you are pushing the envelope.  You’re learning from past mistakes.  The lows mean that you are at an inflection point.  The trick is not to see the pit you are currently trapped in as a pit.  Think of it more as a privileged vista in which to view the pathway ...

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