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.”
For children who have been reunited with their parents, though, the damage may have already been done. Let’s discuss some of the key consequences associated with parental-child separation in detail, starting with the notion of toxic stress.
A quiet, frail, emaciated gentleman in his 60s who was dying of cancer. What made him different was that he was shackled to the bed, one arm and one leg bound to the bed of a barren room, lit only by the pale blue light from the window that cast the silhouette of bars on the floor. This was the prison unit.
In order for the country to make meaningful progress in tackling the opioid epidemic, we need a cultural shift in the way patients and providers think about pain.
Pharmaceutical companies and physicians are being demonized for their manufacturing and dispensing of opioid analgesics. Money-hungry executives from Big Pharma caused the crisis by brainwashing doctors to prescribe these medications left and right. Greedy doctors want patients dependent upon them for years, ensuring a steady stream of paying patients in their waiting room. Drugs drive the market. Drugs lead to big profits for everyone involved. The more drugs, the better.
For most of our childhoods growing up in the Midwest, the Iowa we called home was a swing state proud of its investments in education, was welcoming to refugees from around the world, and was the third US state to legalize marriage equality.