On February 12, 2020, the National Board of Medical Examiners (NBME) announced that the USMLE Step 1 will transition to a pass/fail exam in January 2022 at the earliest. This move comes amidst increasing pressure on the NBME regarding its financial conflicts of interest, as well as the tangible sense among medical school deans that students were neglecting ...

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Growing up in a Korean household meant that I had very little experience with the type of baking that most Americans are used to; My grandma made rice cakes, not birthday cakes. But during my third year of medical school, an intern recommended a show called The Great British Bake Off. After watching a few episodes and seeing what devoted home bakers could do, I was smitten and resolved to bake a ...

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acp new logo A guest column by the American College of Physicians, exclusive to KevinMD. Engaging personally with our health care system either as a patient or family member is usually an eye-opening experience for most physicians.  It provides a glimpse of what those under our care likely deal with on a daily basis while attempting to manage ...

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“How did you like it there?” I ask, sitting down next to a new fellow (between bites of a plump sandwich, hoping there is no spinach in my teeth). I expect to hear the standard resident talking points — long hours, frequent call, and ballooning student loans. Instead, she surprises me. “Do you know how much they charged us to park there every month?” I frequently text friends who are residents at her previous program. It is a ...

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I have gotten to the stage where I take a more philosophical approach to the issue of physician burnout and job dissatisfaction. I see it all around me, and it’s impossible to miss some of the sobering statistics just browsing online any medical publication or social media feed. There’s definitely a very real issue that’s been compounded by changes to health care delivery and the nature of the job itself (i.e., ...

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My wife and I had a baby a few months ago. Or, more accurately, she birthed a child while I sat in the corner, contemplating the miracle of reproductive physiology in a vasovagal fugue. In the months leading up to and following that wondrous moment, we found ourselves navigating the labyrinthine complexity of parental leave in graduate medical education. To start with the positive, we are both residents in the same ...

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I just watched the movie 1917 at the theatre. Shot in a unique way giving an immersive experience, showing the frontline reality of war through an unforgettable human story, it has to be one of the greatest war movies ever made. I’d encourage everyone to go watch it. I learned a fair bit about the First World while I was in high school in the United Kingdom. Its stories are ...

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Today my clinic patient lost his wallet, including his cash, government ID, and his credit cards. He drove more than 130 miles to the clinic.  Still, somehow, he sat in front of me in the exam chair as patient as ever through all my history questions. When I asked about his day as I was washing my hands just prior to the exam, he told me his wallet story. I ...

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As a rising fourth-year med student, these are my words of wisdom for all students who are on their clinical rotations. Your mental health is paramount; do not neglect how you are feeling! There is not one med student that I know of who hasn’t felt anxiety, paranoia, or depression. Some of your peers may even be diagnosed with psychiatric disorders and take medications. And that is OK! As a mentor of ...

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What if I told you just a few years ago that Amazon — a budding e-commerce startup — would come to disrupt the multi-billion dollar retail industry. I seriously doubt that anyone could have given it a serious thought. At least not in the magnitude that will force a slew of big-box retailers to shut their doors for good. I am sure the same response would have been elicited about Uber and ...

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"Compassion fatigue" is a phrase thrown around easily when talking about the health care professions. It is often spoken in the same breath as "burnout" and "turnover" while discussing the crisis of a diminishing workforce and increasing demand in health care. The phrase brings to mind the burnt-out nurse who doesn't have the emotional energy to care anymore. I can see her: deep frown lines, flat facial expression, dimmed eyes. The light ...

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“Oh, you’re here to take me to my test.”  I have heard this too many times to count, and I have come to perfect my response. “No, I am not patient transport, your social worker, or your nurse. I am your doctor.” After a moment of confusion, I usually see a facial expression signaling that the patient is reframing his or her initial thoughts. Maybe I am misidentified because I am young, or ...

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Kahlil Gibran writes, "In friendship or in love, the two side by side raise hands together to find what one cannot reach alone." What types of outcomes can physicians and patients achieve in healing, living, and life when Gibran's message is incorporated into the physician-patient relationship? Can humanism in medicine become even more humanistic? "Humanism in medicine" is characterized by the Arnold P. Gold Foundation as respectful ...

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If you asked me five years ago what my career goals were, I may have said something about getting more grant funding and writing more manuscripts so I could eventually become an independently funded physician-scientist. But honestly, at that time, I had no concept of the nitty-gritty details and emotional support that it would take to accomplish those goals. My primary research mentor was a notable figure in our field ...

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Of the nation’s 3.5 trillion in annual health care spending, 90 percent is for people with chronic and mental health conditions. How long can this continue? Can health care institutes afford not to engage in the 2020 wave of preventative care health care disruption? For those riding the disruption wave, the answer is simple. CMS alone is providing more than 80 billion in ...

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A spirited discussion erupted over The Joint Commission’s role in prohibiting food in patient care areas: "Taking food and drink away from doctors and nurses is just cruel." The rumor that The Joint Commission is the enforcer of food and drink policies meant to starve clinicians has been around since I was working as a nurse in direct patient care capacities in the ‘80s and ‘90s. I’ve devoted plenty of time to clarifying my ...

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I admitted an elderly woman to the hospital recently.  The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath.  For some unknown reason, a urinalysis was obtained and was found to be abnormal.  The patient left the hospital with a prescription for cephalexin, in addition to unexplained chest pain and shortness of breath.  The patient presented to the hospital this time with, ...

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I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the ...

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"What do you want to be when you grow up?" It's a question I frequently hear from physicians on my clinical rotations. Phrased somewhat tongue-in-cheek, the wording allows me to answer either in jest or in earnest. "An astronaut," I sometimes say, hoping for laughs and no follow-up. Other times, I try out different responses like Halloween costumes: a critical care specialist, an emergency physician, a surgeon. If I want the questioner's ...

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"I should explain to you, Socrates, that our friend Cratylus has been arguing about names; he says they are natural and not conventional; […] that there is a truth or correctness in them." - Plato I once heard that the sound of one’s name is the most beautiful thing in the universe, which is probably an overstatement. But one’s name is one of the first words one hears from birth, as parents ...

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