As I finished my 24-hour call recently, I was reminded of a 2009 study revealing a decline in empathy as medical students transition from their mostly-didactic second year to third year, which is essentially an apprenticeship in the hospital with lecture as an afterthought.  I began my third year with what most would argue is the most difficult rotation, surgery, and my experiences over ...

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I'm starting to understand why graphic pictures on cigarette packs are so effective. We are studying pathology, which is the human body gone wrong.  The photos--taken from autopsies--are gross, meaning their structures can be seen with the naked eye.  Cirrhotic livers are littered with bumps and scars, the heart dies and leaves a band of black tissue behind, the lungs are stretched so far that they can't pull in the ...

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Debates over resident autonomy are nothing new. Informed patients are sometimes reasonably concerned about just how much responsibility for their care will be delegated to their doctor's trainees. Care within academic medicine, especially acute inpatient care in a public system, can and does sometimes mean going a whole admission without meeting the attending physician presumably responsible for your care as a patient. At least in my limited experience. This as ...

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She whispered to me with bulging eyes of urgency, "something is not right, I’ve been in pain all night." Her chief complaint was chest pain.  She had a routine work-up and some care with little relief.  The news came that all of her test results were normal.  Her body appeared tense, she looked panicked and afraid.  At bedside, the attending suggested endoscopy offering that her pain ...

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I do my clinical training at the VA. It is an interesting population because the people are all pretty similar (this will likely change as the army changes, but for now, its just a lot of old guys, and a lot of heart problems). In our last few weeks, we finally switched to doing histories and physicals on patients (this really just means that we ...

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Recently, Dr. Philip Baker, Dean of the University of Alberta's Faculty of Medicine, gave a speech to the graduating class at the convocation banquet held in Edmonton.   Now, there are accusations that Dean Baker lifted much of his June 10 speech from a commencement address given by famed physician and essayist Dr. Atul Gawande at Stanford's School of Medicine in June 2010. As Baker gave his address last Friday, medical students ...

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When Professional Responsibility class began, I was most excited at the idea of not having to sit through another lecture on proteins and cell transport. I was also looking forward to the class where we would be using clickers from the Library to poll audience responses during the lecture, as doing something while listening to someone talking has a much higher success rate in getting ...

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Recently, the Harvard class of 2014 took its last exam of the year. We filled our usual amphitheater, took a 60 multiple choice question test on viruses, parasites and fungi, and went to go see X-men in the afternoon. I told my mom last night that I expected people to exit the lecture hall in hysterics, falling to their knees on our marble floors and weeping at being 25% closer to ...

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Recently, I was in a meeting organized by the American Academy of Family Physicians in an effort to understand the lack of student interest in family medicine as well as to encourage brainstorming among those of us charged with facilitating interest on ideas that might work and be transportable. I was with Bill Coleman from Alabama (among others) and was pleased to discover that we were ahead of the region. ...

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For the first time since I have been in medical training, I got sick. Not just the kind of sick where its a cold, or you know that its stress, but the kind of sick that does not go away and randomly comes up just to make you mad when you just want to have fun (like ...

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