Fellow Physician Contributing Writer
Emory University School of Medicine
Dr. Miller is a pathologist, epidemiologist, and fellow in transfusion medicine at Emory University School of Medicine. She will be entering the CDC Epidemic Intelligence Service.
On St. Patrick’s Day 2014, New York’s coldest in a decade, I was a grass snake banished from the fair isle of pediatrics. In the National Residency Matching Program, just half of one percent of approximately 2,500 pediatrics slots across 194 programs remained unmatched, something like four total positions nationwide.
In the 1950s, my grandmother wanted to be a doctor. She asked her father for her dowry money, wanting to use it instead to get her medical degree to become the first female doctor in her hometown. She married another doctor and practiced from an office below her home, accepting vegetables and dry-cleaning services as pay.
My partner Evan’s third year of residency completed his trajectory toward what is commonly called “burnout.” Two out of the 10 residents in his class left the program. In an already understaffed department, the remaining residents picked up the slack, taking extra call and working longer days. The general misery index among his cohort skyrocketed.
On March 11, an invitation-only meeting will determine the future of the United States Medical Licensing Exam (USMLE) Step 1 exam. The results will profoundly affect how all future American doctors are taught.
The faint glow that is the light at the end of the tunnel hits my face as I realize that intern year is almost over. One would think that having been through the personal loss I have — losing two beloved older brothers at a young age — that intern year would be more than manageable. Yet this past year has been, for me, a chaotic roller coaster ride.
Originally, I wasn’t going to enter the fellowship match. I had started my psychiatry residency fully intending to do the four years, then maybe a fellowship. Then, in my second year while sharing dinner with friends who had just certified lists for the general residency match, my plans to go into child and adolescent psychiatry came up.
I met Julian six months ago. He was the first patient I watched go through a buprenorphine/naloxone induction. My preceptor carefully guided him through a series of deeply personal questions: How old were you when you first started using? What is your drug of choice? Have you ever injected? How much? Have you ever traded sex for drugs? When did you last use?
The first time I saw her on the ward, I was instantly curious. There was something so innocent about her; she looked younger than her age, like a little girl. She was barefoot and had uncut, unkempt hair, as if she had accidentally wandered in from a different time period.
“Code Blue, lobby bathroom,” the loudspeaker goes off. For a second we all look up from our workroom computer screens. A seasoned resident shrugs his shoulders and we share a knowing look.
The recent confirmation of Brett Kavanaugh to the United States Supreme Court raises concern about the future of reproductive health, particularly access to abortion and affordable contraception. Although his impact on reproductive rights is to be determined, those who will be disproportionately impacted by further compromise of reproductive rights will always be the most vulnerable women among us. This includes the uninsured, poor, and incarcerated.
The baby’s hat is bright orange, knit with vertical ribbing to mimic a pumpkin’s ridges, and topped with a tiny green stem. The cheeks below it bulge in perfect crescents. I turn to the mother to ask if she made the hat herself. Her eyes don’t leave the muted cartoons bouncing across the television screen as she mumbles, “The nurse or someone gave it to her.”
The recent ruminations of Drs. Katsufrakis and Chaudhry in the form of an invited commentary in Academic Medicine, entitled “Improving Residency Selection Requires Close Study and Better Understanding of Stakeholder Needs,” has garnered a significant amount of attention on Twitter. Drs. Katsufrakis and Chaudhry’s commentary was in response to a well-written and well-reasoned article by a group of medical students published in the same journal recommending the USMLE Step 1 transition from a numeric score to pass/fail.
Medical Student Guest Writer
Cleveland Clinic Lerner College of Medicine
Joshua D. Niforatos, MTS is in his last year of medical school in Cleveland, Ohio. He aspires to be an emergency medicine physician actively involved in clinical research and all things social emergency medicine and advocacy. Joshua also watches a lot of HGTV.
