The Blog

Posts tagged medical school

All these stories are Emergency Medicine Department (ER) stories borrowed (and cleaned up) from the forums over at studentdoctor.net. They’re just too good to pass up..

1) Never, ever leave flashlights, beer bottles or any other long, circular object on the floor because someday you will fall on it… and it will somehow impale its way up your rectum.

2) Always do woodwork with your skillsaw before using meth.

3) White latex paint, despite being luxuriously thick and creamy, does not coat your stomach and provide relief like pepto bismol does.

4) If you have taken 7 home pregnancy tests, and they’re all positive, when you come into the emergency department… chances are our test will come back positive too.

5) If you are given a prescription for narcotics, at least have the courtesy of leaving the lobby before you try to sell the pillz.

Read More

Dear Patients,

Please do not get sick in July. Why you ask? Well, you might die. No, we’re not suffering from heat strokes..

In a recent study published by the Journal of General Internal Medicine, there was a 10% spike in teaching hospital deaths during the month of July due to medical errors.

This spike, is referred to as “The July Effect” and it’s attributed to well, us — from the influx of all of us starting our residency training (internship).

The reason behind it? As a medical student, you typically graduate from medical school in June and end up beginning your first year of residency in July. To be honest, as eager as we are to invade the hospital, to care for our patients, and to make real medical decisions, there is just one problem. We don’t quite know what we’re doing all the time.

After at least four years of undergraduate education, another four years of medical school, and the letters M.D. after our name.. we arrive in the hospital (at our first job) with virtually no practical knowledge of medicine. At least we have our ‘peripheral brains’ made up of condensed medical manuals to make up for the lack of knowledge in our actual brains.

Everyone — even doctors, especially doctors — have to learn and train in order to become proficient. Interns start out as rookies, not seasoned veterans. Experience takes time. 

So if you have to go to a hospital in July, please treat the interns with patience and respect — then perhaps check with your nurse to make sure we know what we’re doing.

This is the age of intellectual democracy. In a frightening departure from millennia of human tradition, everyone is now an expert in everything. Turn on the television or surf the Internet. We somehow believe that polls of individuals are useful for guiding policy, in everything from international politics to morals and religion. Legislators and marketing experts trust this information, as if masses of humans had extensive experience in diplomacy and warfare, in economics and federal tax structures, rather than what so many do have expertise in; video games and the accumulated out-takes from American Idol.

It’s especially odious in the world of medicine. How many times do we argue with patients that they don’t need an antibiotic or x-ray, admission or laboratory test? A family once skeptically asked me to show them the x-ray I had taken of their child, who swallowed a coin. Once they saw it, they were satisfied that I hadn’t missed anything. They weren’t radiologists, but they were experts. Because any idiot can be a physician, right?

Read More

We’ve become a nation of hypochondriacs. Every sneeze is swine flu, every headache a tumor. And at great expense, we deliver fantastically prompt, thorough and largely unnecessary care. There is tremendous financial pressure on physicians to keep patients happy. But unlike business, in medicine the customer isn’t always right. Sometimes a doctor needs to show tough love and deny patients the quick fix. A good physician needs to have the guts to stand up to people and tell them that their baby gets ear infections because they smoke cigarettes. That it’s time to admit they are alcoholics. That they need to suck it up and deal with discomfort because narcotics will just make everything worse. That what’s really wrong with them is that they are just too damned fat. Unfortunately, this type of advice rarely leads to high patient satisfaction scores.

I couldn’t have said it better myself. What a fabulous paragraph, even if the article is a couple of years old. Click on the link below to read the rest of the article by Dr. Thomas A. Doyle. No, I don’t know who he is or anything about him either, except for the bit of blurb at the end of the article. But he has some very interesting things to say, don’t you think? 

Read More via Emergency Physicians Monthly

Have you ever heard, or seen something funny in medicine that just cracks you up? 

Here’s some actual unedited notes written by fellow physicians, on patients medical charts. 

• Both breasts are equal and reactive to light and accommodation.
• Exam of genitalia reveals that he is circus sized.
• The patient stated that she had been constipated for most of her life until she got a divorce.
• I saw your patient today; who is still under our car for physical therapy.
• The lab test indicated abnormal lover function.
• The pelvic examination will be done later on the floor.
• Large brown stool ambulating in the hall.

Medical students are used to being at the bottom of the totem pole. However, there is one area in which they surpass residents and attending physicians: the art of communication.

Unfortunately, as you gain training and experience in medicine, your communication skills may worsen. Although there are obvious reasons why this occurs (eg, time constraints curtail communication), the trend can be stopped.

The ability to communicate well is not innate. Think of communication as another procedure you must learn in medical school, perhaps one of the most important in the long run — given that most of what you do is talk to patients.

Research shows that the patients of physicians who communicate well are more adherent to therapies, more satisfied with care, and less likely to file malpractice suits. Just like you need to learn how to diagnose strep throat, you need to learn how to communicate effectively.

How well we learn communication depends on how it’s taught. Few of us learn well when we sit in lecture halls and listen to didactic presentations. “And before you tell the patient the bad news, ask the patient what she knows first…” The main problem with this format is that none of the information is individualized to the learner. It is easy for the learner to see the technique and think, “I already do that, so I don’t need to improve,” or “I don’t do that with my patients, so this is not relevant to me.”

Read More

(Source: medscape.com)

Physician income overall has declined since 2010, yet there are tiny glimmers of hope in some specialties. Frustration is mounting, however, and doctors in every specialty are bracing for what they expect to be further income declines as healthcare elements are implemented, such as accountable care organizations and required treatment and quality guidelines.

Who earns the most, and who is the happiest? Despite a decrease in mean income, radiologists and orthopedists were the top earners at a mean of $315,000, slightly besting cardiologists and anesthesiologists. Urologists and gastroenterologists were also among the top earners. As in Medscape’s 2011 compensation survey, pediatricians earn the least, at a mean income of $156,000, up from $148,000 the previous year. More internists and family physicians saw a slight increase in income than saw a decline.

Some of the major findings from Medscape’s 2012 report:

1. Dissatisfaction with medicine is intensifying, although a majority of physicians would again choose the same career path. In 2012, just over half of all physicians (54%) would choose medicine again as a career, far less than in the previous year’s report, where 69% of physicians would choose medicine again.
2. The top-earning specialties in 2012 were the same as in the previous year, even though their incomes declined in general. In 2012, radiologists and orthopedic surgeons again topped the list at a mean income of $315,000, followed by cardiologists ($314,000) and anesthesiologists ($309,000). The same 4 specialties were in the leading positions in last year’s survey. The bottom-earning specialties also remained similar: pediatrics ($156,000), family medicine ($158,000), and internal medicine ($165,000).
3. Who’s up, who’s down since 2010? “Decreased reimbursement” is the overall buzz-phrase, yet a minority of specialties saw modest gains. The biggest income increases were in ophthalmology (+9%), pediatrics (+5%), nephrology (+4%), oncology (+4%), and rheumatology (+4%). The largest declines were in general surgery (-12%), orthopedic surgery (-10%), radiology (-10%), and neurology (-8%).
4. Do men or women earn more? Overall, male physicians earn 40% more than female physicians, although that difference is only 23% in primary care. Experts say that the difference is related to choice of specialties and lifestyle preferences that women choose.
5. Don’t write off private practice! Although physicians are rushing toward employment, partners in private practice far outearn physicians in other work environments. Overall, partners in private practice earn significantly more than solo practice owners and employed physicians, who earn less than either group.
6. The “rich doctor” myth may be just that, although “rich” is relative. Overall, only 11% of physicians say they consider themselves rich, while about 45% say their incomes are no better than that of many nonphysicians, and another about 45% say, “My income probably qualifies me as rich, but I have so many debts and expenses that I don’t feel rich.” The specialties with the highest percentage of physicians who felt rich were pathology (15%), radiology, oncology, and gastroenterology (14% each).
7. Doctors in all specialties are swamped with paperwork. A third of physicians (33%) spend more than 10 hours per week on paperwork and administration.
8. One healthcare reform goal of reducing “unnecessary care” garners negative response. The vast majority (67%) of physicians said they won’t reduce the amount of tests, procedures, and treatments they perform (in order to comply with insurer treatment guidelines) either because the guidelines aren’t in their patients’ best interests or because doctors still need to practice defensive medicine.

Those are some of the insights from Medscape’s Physician Compensation Survey Report: 2012 Results. The report is based on a survey that garnered responses from more than 24,000 US physicians representing 25 specialties.

This video made by some fellow medical students is clever and entertaining. Medical school can drive you crazy, but thankfully while working our way through the process, we can find ways to escape and claim our sanity back. 

A simple technique dramatically improved the memory recall of Harvard Medical School students. Try it for yourself!

Turning a medical student into a doctor takes a whole lot of knowledge. B. Price Kerfoot, an associate professor of surgery at Harvard Medical School, was frustrated at how much knowledge his students seemed to forget over the course of their education. He suspected this was because they engaged in what he calls “binge and purge” learning: They stuffed themselves full of facts and then spewed them out at test time. Research in cognitive science shows that this is a very poor way to retain information, as Kerfoot discovered when he went looking in the academic literature for answers. But he also stumbled upon a method that really is effective, called spaced repetition. Kerfoot devised a simple digital tool to make engaging in spaced repetition almost effortless. In more than two dozen studies published over the past five years, he has demonstrated that spaced repetition works, increasing knowledge retention by up to 50 percent. And Kerfoot’s method is easily adapted by anyone who needs to learn and remember, not just those pursuing MDs.

Read More