Education

ACP: 10 major challenges that confront medical education over the next decade

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

At times of calendar transitions, e.g., at the onset of a new year or a new decade, the popular press often takes a broad view in looking retrospectively at the outstanding or defining events and people of the past …

Read more…

Why simply adding more doctors won’t save our health system

It’s no secret that without a stronger primary care foundation, the current reform efforts are unlikely to be successful. If anything, it will only delay the inevitable.

I wrote last month that one discussed solution, adding more residency slots, won’t help: it would simply perpetuate the disproportionate specialist:primary care ratio.

A recent op-ed in The New York Times expands on that theme. The authors suggest that not only does …

Read more…

Medical student needlestick injuries

Originally posted in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Medical students are frequently stuck by needles, and few report their accidents, researchers say.

In a survey, about 60% of surgery residents reported being stuck with a needle while they were in medical school, Martin A. Makary, MD, MPH, of Johns Hopkins, and colleagues reported in the December issue of …

Read more…

Medical students post inappropriate content online

Originally published in Insidermedicine

The posting of unprofessional and inappropriate content online by medical students is a relatively common occurrence that medical schools are going to have to learn to deal with, according to research published in the Journal of the American Medical Association.

id=”play_continuous_flvs” classid=”clsid:d27cdb6e-ae6d-11cf-96b8-444553540000″ width=”385″ height=”239″ codebase=”http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0″>Read more…

Surgeons don’t receive enough training when resident work-hours are capped

by Crystal Phend, MedPage Today Senior Staff Writer

Limiting surgical residents’ work hours has compromised both surgical education and patient safety, according to an analysis concluding that an 80-hour work week isn’t enough.

The maximum 80-work week imposed in the U.S. for residents is too little to provide mastery in surgery, Gretchen Purcell Jackson, MD, PhD, and John L. Tarpley, MD, …

Read more…

Is the hospital July phenomenon a myth?

“Don’t go to the hospital in July.”

That’s the prevailing public perception, since that’s when new resident-physicians begin their hospital training. And indeed, there have been studies from Australia and England showing a higher rate of death and adverse events during this time.

But what about in the United States?

Recent data isn’t so conclusive. A piece from American Medical News points to a recent study from the Journal of the American …

Read more…

Doctors lose a part of their training when resident work-hours are capped

The restrictions on resident work-hours arguably most impacts the field of surgery.

I understand that fatigue increases the risk of medical errors, but in this excellent post, Jeffrey Parks notes some benefits of being immersed in the hospital. Something is lost as doctors are scuttled out of the hospital when the 81st hour starts.

Dr. Parks notes that “there’s more to being a doctor/surgeon than just learning how to fix a …

Read more…

How emotional stress affects physician training

Much has been made of fatigue increasing the number of medical errors doctors make.

But what about other factors, like emotional stress?

That’s a little-reported issue that Pauline Chen addresses in her recent New York Times column. In residency, some doctors-in-training have to care for small children, among other life issues. As Dr. Chen notes, “whenever one of us experienced additional stress apart from our work, the house of …

Read more…

How work-hour restrictions harms resident surgeon training

Controversy persists about limiting the work hours of resident physicians.

No where is it more prevalent than in surgery, where proficiency depends on the number of times a trainee physician performs a procedure. In a recent study from the Journal of the American College of Surgeons, 43 percent of surgical residents want to work more than the allotted 80 hours per week, and 41 percent felt the work-hour restrictions “were …

Read more…

Are cardiologists going to take their reimbursement frustrations out on primary care residents?

It’s no secret that, in an attempt to increase the pay of primary care doctors, Medicare is going to run in serious resistance from the specialists. In this article from Bloomberg, for example, we’re seeing backlash from cardiologists.

What caught my attention was how cardiologists in residency programs may now harbor resentment against primary care doctors in training. Consider what Ted Epperly, president of the American Academy of Family …

Read more…

Do resident work-hour restrictions increase surgical complications?

by Chris Emery, Contributing Writer, MedPage Today

Reductions in resident physician work-hours at teaching hospitals in 2003 were associated with an increase in complications related to surgery to repair hip fractures, a new study found.

medpage-today The rates of pneumonia, hematoma, renal complications, and blood transfusions associated with hip surgery rose disproportionally at teaching hospitals compared to other hospitals after resident …

Read more…

How to make industry influence transparent in continuing medical education

by Larry Husten, Ph.D.

A recent hearing of the Senate Aging Committee on continuing medical education (CME) should scare anyone who might need to see a doctor in the next few years. But you don’t need to be a Washington policy wonk to discover that there’s a huge problem with CME.

Just walk into the lobby of any major downtown hotel when a large medical conference is in town and you will …

Read more…

Should the informed consent discussion be formally taught?

Most medical students don’t take classes on how to discuss informed consent, that is, talking about the risks and benefits of a medical procedure with a patient.

Pauline Chen remembers such conversations, where she “bumbled through each consent on [her] own, picking up certain phrases and dropping others through a sometimes painful and often awkward process of trial and error.”

That’s often the case, as “young doctors rarely have formal mentorship …

Read more…

Medical students want to become primary care doctors, until reality hits

According to the Journal of the American Medical Association, only 2 percent of medical students are entering primary care internal medicine.

A fourth year medical student gives some reasons why in a Baltimore Sun op-ed:

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform.

Then, a little later, reality …

Read more…

Should health policy be mandatory for medical students?

With health reform upon us, it would be helpful if future doctors knew a bit more about health policy.

Although some schools give some token courses on the subject, the majority don’t. For instance, everything I learned about health policy was from reading medical and policy-related blogs over the past few years.

This piece from Slate gives one reason: medical students are too busy. Indeed, “Faced with a choice …

Read more…

Should geriatrics be mandatory in medical school?

Generally, all third-year American medical students rotate in medicine, surgery, OB/GYN, pediatrics, and psychiatry.

Should geriatrics be added to that list?

After all, patients aged 65 years and older make up more than 40 percent in medical specialty care, and over 30 percent in surgical care. For instance, heart attacks present differently in the elderly, and confusion can be due to infection or a drug reaction.

Most doctors do not receive …

Read more…

Using Wikipedia for online health information, my USA Today column

Both doctors and patients are increasingly turning to Wikipedia to look up medical information.

usa_today_logo See what I think of the phenomenon in my latest op-ed in the USA Today, Wikipedia isn’t really the patient’s friend. Here’s an excerpt:

The ability to research diseases and drugs on the web has empowered patients in managing their health. More than 160 million adults in the …

Read more…

94
pages

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories