A 76-year-old gentleman with a history of kidney failure, myasthenia gravis and recently diagnosed with esophageal cancer presented for evaluation of melena and hypotension. The patient was my first admission to the medicine team as an intern, and he was as near to an ICU admission without actually being admitted to the ICU as one could come. After examining the patient, I briefly staffed with the busy attending physician, placed the ...

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Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life. We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted ...

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Medical students and residents become accustomed to living life in year increments. Four years for medical school, three to five years for residency, a couple years for fellowship, research, and so on. While many of us like to think we are putting our life on “pause” as we complete our medical training this just isn’t possible. Life is happening all around us every day. Many physicians look back on their ...

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A single error oft inters the good that doctors do. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS convicted for homicide for the death of a child from sepsis and hounded by the General Medical Council is every junior doctor’s primal fear. A boy in shock Friday, February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had recently returned from a 13-month ...

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Performance appraisals are an integral part of an organization's assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require ...

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The exploitation and bullying of medical students and residents can only be meaningfully understood in the broader historical context of the New Deal’s dismantling and the destruction of the middle class that has followed in its wake. Moreover, it is fallacious to look at this inhumane treatment as something that happens only within the confines of the medical profession. For these exploitative working conditions have in fact become the norm ...

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Physician training is an extremely high stakes business, not only for the patients that will be under the care of the eventual independent, fully-trained, board-certified doctor, but for the trainee herself. The financial and time costs of the entire training process are enormous. To become derailed from the board certification path can have significant and permanent career consequences. With so much at stake, what does a resident do when she ...

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“No one can know what you’re doing here.” The resident across the table from me made this clear the moment we sat down. We were in her hospital’s cafeteria, talking discreetly at her request with the union coordinator. In an effort to generate more revenue for the hospital, her already substantial call duties had been increased yet again, leaving less time to spend with each patient with no discernible educational benefit. ...

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Let’s talk about the cycle of abuse. No, I am not referring to the very serious issue of domestic violence. Instead, I am talking about the graduate medical education system. No one is a resident forever: the duration of each residency is predetermined with a wide range of three to nine years. The self-limited nature of this experience decreases the incentive for participants to advocate for changes. And the attitude ...

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STAT_Logo'Tis the season. Thanksgiving? Sure. Christmas? That too. But for thousands of fourth-year medical students and foreign medical graduates all over the United States, fall through early winter is a time of job hunting — interviewing for residencies. This is a critical step in our training, where we specialize in the individual fields of medicine that will carry ...

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