“Philosophically committed to the objectives of the facility,” read the original job posting for a physician by The GEO Group in the prestigious Journal of the American Medical Association (JAMA). The GEO Group is a for-profit company that runs correctional facilities not just in the United States, but also in the United Kingdom, South Africa and Australia. It also operates several Immigration and Customs Enforcement (ICE) processing centers in the United States.
After reading the title of this article, you may think that I am one of those hospital higher-ups trying to peddle “social hour” as a miraculous cure for burnout rather than an ineffective band-aid on a broken system. I can assure you, I am not. I am one of the residents on the front lines.
My wife and I were preparing to move overseas so I could begin medical school in Israel. We both wanted children young. I grew up as one of five siblings, and we looked forward to a big family. I knew that having kids would change my medical education experience, but I had no idea how grateful I would be for the advice I received that sunny spring day in Alabama.
In 2019, sexual harassment and discrimination in medicine prevent patients from receiving the best possible care. We all deserve better. Not only do all who practice medicine and care for patients deserve an equitable workplace, patients deserve optimal care provided by medical teams in which all members are respected and valued. This is why I’m proud to be a founding member of TIME’S UP Healthcare.
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.
The sky angry. The waters murky. The fear that at any moment a sudden undertow may drag you deeper into violent waters. A creature brushes your leg, friend or foe unknown. You become paralyzed by fear, anxiety and hypervigilance. You hear someone shouting to you from somewhere far into the distance, “Get out of the water!” But you cannot see the shore. Women live in a world of fear.
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.
I am an intern physician currently enrolled in a residency program, writing anonymously for fear of of retribution. I am also chronically injured and disabled. In my time off from work, I’ve had the chance to reflect on being injured in residency, and one particular incident comes to mind.
“I spent the first semester in France where I studied the language.” I was about to say that I spent the second semester in my home country in South America doing research on Chagas disease when he interrupted by saying, “What a waste of time. What did learning French ever help you with?”
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.