Education

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.

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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, …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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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 …

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Do doctors set themselves up for physician burnout?

It’s no surprise that doctors are prone to burnout, especially during residency training.

But, according to a study cited by Pauline Chen in a recent New York Times column, it’s part of the doctor-in-training culture. In fact, residents “from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects …

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Poll: Is further reducing resident work hours worth the cost?

The Institute of Medicine is recommending “rapid implementation” of its proposed plan to further restrict medical residents’ work hours. The plan includes a 5-hour nap during extended shifts, a strict 16-hour cap on shifts without naps, reduced workload, and more days off.

But at what price?

It seems like common sense that better rested doctors make fewer errors and contribute to better patient care, but data from several large-scale studies does not …

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Grading medical students, pass-fail or letter grades?

Medical schools have traditionally used letter grades for their students, but to decrease the competitive atmosphere between these prospective doctors, some of gone with a simple pass-fail system.

Does it matter?

A recent study suggests the answer is no. When comparing two groups, one who was graded “A-F” and the other pass-fail, there was no difference in absolute test scores, as well as no discrepancy in board scores or getting …

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Death of the medical riddle and why Google is responsible

Stanford’s Abraham Verghese challenges readers to solve his medical riddle, without using Google.

These exercises, when thought through, offer the student the opportunity to “formulate hypotheses, go to the book, research and eliminate possibilities . . . and come to the answer,” and can be a valuable learning experience.

But with the dawn of Google, many arcane answers can simply be looked up, often at the expense of thinking through a problem.

So, …

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Do drug company logos influence medical students?

Many medical schools are in the midst of purging pharmaceutical companies from their halls.

But can subtle marketing tactics can influence perceptions of prescription drugs?

It depends on where you trained.

A recent study looked at fourth-years, some of whom were exposed to pharmaceutical-branded clipboards and pens. At the University of Miami, which has a less restrictive policy towards drug companies, students preferred the brand name cholesterol medication Lipitor over its generic …

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