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.
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.
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.
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 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.”
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.