It’s fascinating — the strange clarity that a little panic brings. I remember thinking this in the days after, startled at the level of detail in my memories of the first time I watched a patient die. “Just got a call, transport’s bringing in a code. You good to standby for compressions?” I nodded as I felt my stomach free fall ten-thousand feet, managing a, “Yeah, totally,” that sounded more confident than I ...

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A professor recently romanticized my idea of clinical reasoning as he began our session by saying, "When you're a physician, you're a detective." He elaborated: "Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis." As he said this, my eyes narrowed, and I sat up a little taller. My fellow first-year medical students and I have begun our official training in clinical reasoning, ...

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Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done. I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, ...

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The sun rises in the distance. The finish line beckons. A wave of adrenaline propels me forward. Finally, after almost 24 hours of running, 100 miles were in my rearview mirror. Years of training prepared me for this moment, and I was particularly proud I accomplished this despite being in medical school. While the preparation was time-consuming and the miles were physically draining, running 100 miles unequivocally made me a ...

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The University of Kansas School of Medicine-Salina opened in 2011 — a one-building campus in the heart of wheat country dedicated to producing the rural doctors the country needs. Now, eight years later, the school’s first graduates are settling into their chosen practices — and locales. And those choices are cause for both hope and despair. Of the eight graduates, just three chose to go where the shortages are most evident. Two ...

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In the recent book, Range: Why Generalists Triumph in a Specialized World, David Epstein makes a strong argument for exploring or sampling different interests and jobs before settling on a career of choice, a process that leads to “match quality,” which describes the degree of fit between one’s work and who they are. This idea flies in the face of our strongly held belief that early specialization, or ...

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Duty hours have been the focus of a lot of research recently. If you are just joining this discussion, the iCOMPARE trial randomized 63 internal medicine residency programs to either flexible (interns could work more than 16 hours) or standard (interns had to work within the 16-hour limit) work hours. The results so far have shown no significant difference in the time interns spend on patient care ...

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Last year the American Association of Nurse Practitioners announced a $2 million campaign to further expand independent practice, which they already have in 22 states. The relatively new doctorate of nursing (DNP) has led to a confusing scenario where nurses are indeed doctors, just not the kind you think of when you see a white coat. The profession (well, its money-making institutions) has fought hard to keep people confused. Doctors are ...

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Despite more than a dozen years in medical school admissions consulting, I still clearly recall a bright advisee who had improved her grades considerably throughout her college career. But I, unfortunately, had a less than stellar freshman transcript. After calculating her AMCAS GPA with me, she lamented, "I feel like my grades are a criminal record." In a twisted way, she was right — she couldn't erase the grades. But she ...

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Dear Alex, As you realize your destiny, I want to share the lessons I have learned in my 45 years on the front lines of health care. I am hoping they will serve you well on your journey. First and foremost, love what you do. Have fun with the people who surround you. Know that in medicine, as in life, you will have the chance to make a difference in others’ lives, ...

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