Education

Half MD: How to fix the scramble before Match Day

The following is reader take by Half MD.

The third Thursday of March each year is Match Day for fourth-year medical students. There are many smiles and frowns made on this day when soon-to-be doctors discover where they will obtain their first job to continue their medical training. While Match Day is the most famous day of the week, Monday and Tuesday are the …

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Will gross anatomy soon be rendered irrelevant?

Dissecting a human body is messy, smelly, and expensive.

In fact, more medical schools are resorting to so-called “virtual” gross anatomy, using sophisticated imaging and computer programs.

This is a mistake, says psychiatry resident Christine Montross, in a NY Times op-ed. And she has a point.

“Someday, [doctors] need to keep their cool when a baby is lodged wrong in a mother’s birth …

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Is banning industry-sponsored CME a good idea?

I wrote previously that pharmaceutical industry influence should be removed from physician continuing medical education courses.

The American Psychiatric Association is taking that recommendation to heart, announcing that it will end industry-sponsored seminars at its annual meeting.

Good for them.

But, I’d be interested to see how many of these professional organizations can survive the funding cut. For instance, the APA stands to lose …

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Why is Sweden allowing murderers and rapists to become doctors?

Should a convicted murderer ever be allowed to become a doctor?

Lawrence Altman writes about the strange situation in the NY Times, where, after a convicted murderer was expelled from Sweden’s most prestigious medical school, was admitted to a second medical school.

Dr. Altman also points to another case, where a medical student, convicted of rape, was only expelled after exhaustive court action.

What’s going on …

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Who’s ranked above a full professor at Harvard?

“God.”

So says famed Harvard psychiatrist Joseph Biederman during a deposition investigating whether his drug research results were biased in favor of his funder’s interests. Was his research supporting the use of antipsychotic medications in children with bipolar disorder tainted?

Certainly, in light of recent events, combined with the pressure on academic physicians to produce studies, established research is now being called into question.
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Is loan forgiveness enough to convince students to choose primary care?

I’ve often said that forgiving medical school loans, often exceeding $140,000, can help more students choose primary care.

Students at Harvard Medical School were the lucky recipients of an offer by an anonymous donor, offering $60,000 to students who entered, and completed, a primary care residency.

Salary is one consideration that students have when choosing a specialty. The other is lifestyle. As they train, they observe …

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Should the MCAT grant extra time for students with learning disabilities?

A recent California court denied extra time for aspiring medical students with dyslexia and attention deficit disorder when taking the MCAT.

The body that administers the test has to straddle a delicate line, in granting extra time to a broadening definition of the disabled student versus maintaining the overall fairness and integrity of the high stakes test.

Despite the ruling, three of the four plaintiffs have gone …

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Match Day comes and goes, and did medical students continue to avoid primary care?

Match Day in March often marks the climax of the years of training a medical student endures.

This year, we apparently have more focus from the national media on the issue, thanks to the proliferation of health blogs that every newspaper seems to have.

Pauline Chen writes about her experience with the rite (complete with a photo taken from my alma mater, Boston University), writing how students …

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Medical students lobby Congress for lower medical school tuition

Medical students graduate, on average, with $140,000 in debt, with many having loans in excess of $200,000.

The majority who enter school wishing to practice primary care often change their minds when greeted with this fiscal reality. Combined with the fact that primary care role models are overburdened in a practice environment so toxic towards generalist practice, it is no wonder that most students change their minds, and gravitate …

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Are conflicts of interest with the pharmaceutical industry causing a rift at Harvard Medical School?

Some professors at the Harvard Medical School are the biggest beneficiaries of funding and gifts from the drug industry.

These conflicts of interest are causing some dissension within the student body, with some feeling “violated” when being lectured by professors who are paid consultants to drug makers.

This places the school in a difficult position. On one hand, especially at a school as revered as Harvard, …

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Restricting resident work hours forces doctors to lie, and other unintended consequences of the 80-hour work week

To his credit, Dr. Thomas J. Nasca, chief executive of the Accreditation Council for Graduate Medical Education, is aware of the many problems in trying to limit work hours for physicians in training.

This topic has been frequently discussed on this blog, but some points bear repeating.

The first are the ethical quandaries that the cap often places on residents. In one example, a doctor wanted …

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Did Medscape use CME to illegally promote off-label use of drugs for rheumatoid arthritis?

The controversy surrounding drug industry influence in continuing medical education continues to grow.

Merrill Goozer talks about a recent case where the Medscape, the physician internet portal site, is alleged to have illegally conspired with Amgen to promote the off-label use of Aranesp and Embrel. According the to complaint, “The scheme was to increase market share through the covert commercialization of CME programs.”

I recently cited internal …

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Restricting resident work hours leads to a shortage of surgeons

Surgical residents in the United States are currently restricted to working less than 80 hours per week.

If you think that’s extreme, consider what’s happening the UK, where surgeons are capped at 58 hours per week (via Dr. Wes). Furthermore, that cap is set to go down to 48 hours.

Apparently, these caps are rarely enforced, as “only 25% of surgeons think their human resource …

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Poll: Are the Institute of Medicine’s recommended restrictions on residents’ work hours good for medicine?

The Institute of Medicine recently recommended a requirement that medical and surgical residents have a minimum sleep period of 5 hours in any 24-hour work period, with a maximum shift length of 16 hours. This was a follow-up to the 2003 ruling which limited resident work-hours to 80 hours per week.

That is the focus of this week’s poll. Are the Institute of Medicine’s recommended restrictions on residents’ …

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Is there a place for a part-time medical residency?

Doctors in training often do so in their prime family-rearing years.

A few pediatric residencies are offering part-time residency options, designed for those who also want to raise their own families. Proponents argue that residents can not only get more rest, but also avoid depression, which affected almost a quarter of pediatrics residents.

Combined with the talk of further limiting work hours down to 56 …

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"So you work after you’ve been on call?"

Note to today’s senior residents: The real world doesn’t have work hour restrictions.

Resident work hour restrictions

Boston’s BI-Deaconess’ surgery program was cited for violations of the strict resident work hour restrictions. No doubt, this is happening in hospitals across the country:

“When your 80 hours are up on Friday and someone comes in with a ruptured aneurysm, we don’t have the luxury of saying ‘Sorry, I have to go home,'” said Dr. Scott Johnson, a transplant surgeon who has headed the hospital’s surgery training …

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Work Hours Reform

If I Knew Then – Dr. Meeta Prasad, MD, University of Pennsylvania School of Medicine, on Work Hours Reform
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Work-hour restrictions = scut management

How resident work-hour restrictions is affecting housestaff:

The conversation is shifting. Traditional hierarchical patient management is giving way to the need for “scut management” as work hours, thrown in amongst teaching sessions, draw short. Divide-and-conquer. No time for supervision. Hurry up! We’ve got to get done!

These restrictions have to be accompanied by a sizable bump in ancillary staff to reduce scut. Filling out paperwork and drawing …

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Night float

Frequent NY Times contributer Sandeep Jauhar has a piece in Slate talking about night float, where interns take a 12 to 14 hour shift overnight to cross-cover the entire hospital.

Sometimes the problem of caring for another doctor’s patients can lead to medical errors:

The nightmare of night float raises a central question about work limits for interns: Is it better to be cared for by a tired resident …

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