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Reflections Of A Clinician-Educator

A version of the following post by Kimberly Manning appeared on the blog Reflections of a Grady Doctor:

May and June mark the end of our academic year in medical education. The medical students either advance to the next level or become sho’ nuff and bonified doctors — albeit uncertified and untrained — but doctors nonetheless. The interns exit the novice stage and become residents — one week asking someone senior what to do, the next telling someone junior what to do. And of course, the senior residents and fellows finally get the stamp of approval that officially releases them from the nest. It’s kind of bittersweet for folks like me — the surrogate mommies and daddies that helped guide them along this path to becoming full-fledged physicians. Read more »

*This blog post was originally published at ACP Hospitalist*

Medical Schools: Why Do Some Do Primary Care Better?

A new study published in the Annals of Internal Medicine, ACP’s flagship journal, finds that medical schools vary greatly in producing more primary care physicians and getting them into underserved communities.

– “Public schools graduate higher proportions of primary care physicians” than private schools.

– “The 3 historically black colleges and universities with medical schools (Morehouse College, Meharry Medical College, and Howard University) score at the top” in training primary care physicians who then go on to practice in underserved communities. (Click here for an interview with two recent graduates of historically black colleges and with Wayne Riley, MD, FACP, who is the president and CEO of Meharry Medical College in Nashville, Tennessee and a regent of the American College of Physicians.)

– “The level of NIH support that medical schools received was inversely associated with their output of primary care physicians and physicians practicing in underserved areas.” Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Musings From A Member Of The Medical Class Of 2010

As a medical student in his last year, I can attest that my classmates and I would like nothing less than a crystal ball. Always a daunting time in a future physician’s career path, the direction we point ourselves as we launch out of medical school this year seems as arbitrary as ever.

As we examine the rolling seas of medicine and try to determine our individual paths, there seem to be more clouds than blue skies, and certainly more shadows than light. This may or may not be a feeling many prospective physicians feel, but for the class of 2010 it comes as a tough pill to swallow. In a profession at the heart of a national policy debate and with a storied history to examine, it’s extremely disconcerting to be faced with so many question marks. Read more »

The Positive Power Of Compulsive Medicine

Most experienced physicians expect uncertainty in caring for real people with average everyday problems. Yet those inexperienced or uninitiated in medicine tend to see the practice of medicine as exact or even absolute.

I remember waiting in vain as a medical student and resident for my instructors to illuminate a path towards certitude. Instead, I was given something far more real and lasting: An acceptance of the indeterminate mixed with the drive to be compulsive on behalf of my patients.

During my internal medicine internship, I remember a more-senior resident during our daily morning report bemoaning her uncertainty by saying, “But I just don’t know what’s wrong with my patient.” Although she was visibly upset, our program director’s reaction to her comment bordered on amusement, culminating with, for me, an unforgettable response: “Well, you certainly have chosen the wrong profession.”

Read more »

Patient Tests, EHRs, And Medical Homes: The Price Isn’t Right

Healthcare reform is forcing medical students to learn about the financial costs of the tests they order, as well as their clinical importance. Once a taboo topic, it’s being openly taught to students to prepare them for practice.

At Harvard, one physician in training duplicated television’s “The Price is Right” to keep his peers guessing at the costs of tests on a patient’s bill. Molly Cooke, FACP, a Regent of the College, encourages doctors to consider the value of the tests they order as they deliver care. (Kaiser Health News, New England Journal of Medicine)

The price isn’t right for electronic medical records. Even $44,000 in stimulus money isn’t enough to make doctors jump into using computers. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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