Closing the Door on the “Closing Doors” Metaphor: Reframing our Step 1 Advice

By Emily Green

Anyone who advises medical students about USMLE Step 1 will be familiar with the metaphor of “closing doors”.  Upon receiving their Step 1 score, worried students wonder if the sound they are hearing is the slamming shut of gateways to particular specialties.  The problem with the pervasive “closing doors” metaphor is that it presents career options as being either available or unavailable, with little in-between.  In a student’s mind, a score of 240 might mean that the door to a particular career is open, but a 239 means that it is closed.  Convincing students the wrongness of this thinking is a challenge.Read More »

In My Panic Zone: Teaching Feedback Seeking

By J.M. Monica van de Ridder

Teaching is something that I have been doing for over 20 years. So, in general, I don’t worry about it. I think I know what works and does not work.

Things were very different for me this time. I was worried, and I felt very much out of my ‘comfort zone’ almost in my ‘panic zone’ (Brown, 2008; Palethorpe & Wilson, 2011). I had developed an intersession for M1 and M2 medical students on how to optimize their learning processes in the clinical setting through goal setting, self-regulation, receiving and seeking feedback. The content on feedback I am familiar with, from goal-setting and self-regulation, -I assume- I know more than average.

I tried to discover my fears. What is worrying me?Read More »

Extension

By Tim Lahey

Every March I run the last required course at our medical school. It’s a three-week-long, 47-hour sprint – a sort of boot camp for professional formation. We polish clinical skills, revisit foundational sciences, let students pick from a menu of interesting tutorials, and discuss professional formation.

Students grapple with hypothetical gastrointestinal crises on scatalogically-named student teams. They resuscitate rubbery patients with various flavors of hypotension. I don a sparkly red bowtie to MC a game show called Antibiotic Jeopardy.

Throughout, we discuss the evolution of their professional identities. I ask how their idealism has changed during medical school, and every year over 60% say it has waned. We share the stories that shape us, and how they can stay true to the values that brought them to medical school in the first place. Then they hand in a tall stack of confidential essays that I reply to on nights and weekends right up until the day they speak the Hippocratic Oath. Read More »

From Marjory Stoneman Douglas to Medical School: A Call to Action

by Zarna Patel

I cannot find the right words to describe how it felt when I read news: “School shooting at High School in Southeastern Florida.”  Despite the 239 school shootings since Sandy Hook, nothing can prepare you for the numbness of having it happen in your hometown.  The way your heart leaps into your throat, the way all sound is muted, the way debilitating fear takes hold from your head to your toes.

“Are you OK?  Tell me you’re OK?!  Please answer me!”  Never in a million years did I think I would have to send a text like that to my 16-year-old cousin, whose biggest worry last weekend was her upcoming SAT test.

Knowing how many innocent children would never return to their parent’s arms that night was paralyzing.  I couldn’t close my eyes for more than a few minutes before flashes of my old high school haunted my dreams.  The large courtyard we ate lunch in, smeared in blood.  The freshman building we loved to hate, filled with kids running away, hand raised. The large auditorium where I spent four years performing, now filled with the cries of distraught children.

Read More »

Power, Diversity and Medical Regulation: State Medical Boards Move Beyond the Old Boys’ Club

By David Johnson

Recently, the Association of American Medical Colleges announced that for the first time ever women comprised the majority of matriculants into US medical school programs.  This triggered a few thoughts of my own.

In 2017, I debuted my Twitter account focusing on the history of medical regulation.  In the fall of that year, I shared several historical snippets focusing on women in medical regulation.  In one I focused on a regulatory trailblazer: Adele Hutchinson, MD, a graduate of Boston University who appears to have been the first woman to serve on a state medical board anywhere in the United States.  This occurred surprisingly early–in Minnesota in the 1890s.  The fact that two other women (Margaret Koch; Hannah Hurd) succeeded her on the Minnesota medical board struck me as all the more remarkable considering the male domination of medical boards individually and collectively throughout the majority of their history.Read More »

Overcoming Uncertainty through Experience

By Michelle Sergi

Coming out of my first year of medical school I struggled with my sense of confidence.  After endless nights of studying, a multitude of experiences at our Clinical Training and Assessment Center, and specialized clinical experiences, I felt that I could take on the challenge of counseling patients.  On the other hand, when I thought about being on my own to take care of patients, I was terrified.  My pharmacology knowledge was insufficient, and even though I knew how to conduct a full physical exam, did I really know what was normal compared to abnormal?  These questions proved to me that I lacked the clinical experience necessary to become a good physician.

When I heard of the opportunity to apply for the Leroy Rogers Preceptorship, I immediately knew that it could help bridge the gap between my medical textbooks and clinical knowledge.  This program gives preclinical students the opportunity to choose a preceptor for a four week, hands-on family medicine clinical experience.  I had shadowed a family physician, Dr. Andrews, in my hometown several times before so I knew he would be the perfect preceptor.  I also felt that I would learn from his patients, especially because many are medically underserved.Read More »

The Physician’s Role in the Rising Cost of Prescription Drugs

By Angira Patel

When I started my medical training, my pediatrics residency program banned all pharmaceutical sponsorship of activities.  No free lunch in the middle of the day, no fancy dinners at expensive restaurants, or trips to conferences paid for by a pharmaceutical company.  Even my lab coat was unadorned by the colorful pens given by various drug representatives.  At the time, I remember thinking a pen or a free lunch would never influence how and what I prescribe to my patients.

As a young trainee, I did not appreciate why my residency program took this stance, but I do now.   Read More »