A smear of what I assumed was cat poop obstructed a narrow asphalt path that led to a mobile home. It was raining. I tiptoed around the sopping heap of excrement. Behind me, the wound care attending physician followed.
Last May, Evan matched into a fellowship that will take him across the country for a year, beginning in August. Because he’s a little bit off in the head, he chose subspecialty training that will likely entail even longer hours than residency at the same pay scale.
Nurses in New York City are pushing back against hospital systems that put profits over patients and threaten their efforts to strike for safer staffing ratios. While nurses are fighting, physicians have thus far remained on the sidelines of this struggle.
Career and specialty choice aside, the debt accrued for physicians is very real. Obtaining accessible and accurate advice on what to do with that debt is, at best, disappointing. My goal for this article is to educate, provide adequate resources that can help alleviate stress, set you — the reader and colleague — up to be financially successful, and hopefully make you “money wise” when it comes to your early career.
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.
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?
When I took a job as a residency coordinator in graduate medical education at a local community hospital, I made myself a promise: I will not date a resident. They’re too busy, we work together, and we have nothing in common.
“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.
In 1999, the American Board of Internal Medicine and Association of Program Directors in Internal Medicine defined a “problem resident” as a “trainee who demonstrates a significant enough problem that requires intervention by someone of authority, usually the program director or chief resident.”