I had just started my first clerkship of third year at a nearby hospital when the news broke. Hahnemann Hospital, the main teaching hospital of my medical school, was closing. More accurately, the hedge fund manager who purchased the hospital a year earlier was filing for bankruptcy. He separated the valuable Center City real estate from the hospital itself to ensure a tidy profit for investors at the expense of patients and staff.
Over the last year, our collective minds have been captivated by stories about child and family separation, detainment of citizens and immigrants, and the quality of the health care within detention facilities. These stories have been jarring and traumatic, and have also awoken an important level of national consciousness about the nature of detention. What has not received as much coverage in recent discourse is the ongoing nature of solitary confinement in our justice system.
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.”