physician

Managing Bipolar Disorder in Medical School

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Two days before interviewing at the medical school I now attend, I couldn’t get out of bed. At the nadir of my eighth major depressive episode in eight years, I seriously considered whether I could make the trip. Thankfully, I did. And thankfully, six days after that interview I met the psychiatrist who would finally piece together my long and steadily worsening psychiatric history.

I sat in his office, quiet and dulled compared to my spring and summer self, and began recounting my story – the weightiness of my current depression, the semester in college marked by a mere two to four hours of sleep a night (“insomnia” according to my doctor then), and the clockwork nature of my mood changes each year. Within ten minutes, he stopped me mid-sentence and said, almost casually, “You know, you show a lot of signs of bipolar disorder.”

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How My Research Degree Taught Me I’m Not a Surgeon

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Recognizing the connection between lab work and surgery
What surprised me the most during my medical school journey was that it was primarily lab work, not my surgery rotation, that taught me I was not a surgeon. The type of experience my lab work entailed had absolutely nothing to do with surgery or clinical medicine, so it was a peculiar and fortuitous realization. I do not believe when entering medical school that I had ever thought about doing research, but our program strongly advocated it. I met with various advisors in first year and decided I was going to transition into the combined PhD program.

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How Nontraditional Students Can Best Position Themselves When Applying to Med School

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A friend of mine studied film in college and subsequently found himself working as a cameraman for a documentary television program about the lives of EMTs and ER physicians. He experienced some very tense situations, and from his work decided that he wanted to do more than document how people received medical care—his desire was to participate in the action of helping others as a doctor.
Unfortunately, his film education was the furthest possible undergrad experience he could have from pre-med. He had no applicable science credits, no anatomy or physiology, and the only shadowing he had done of physicians had been with a camera in hand. In short, his path would be an arduous one, and he was soon going to turn 31.

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A Portrait of Obstetrics & Gynecology

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Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
Having finished my first rotation, Women’s Health Clerkship, I’d like to offer a short look into the specialty, sharing some of my observations the last few weeks. As I have said often over the past two months, I believe this was the perfect rotation to kick off third year. OB/GYNs have a wide scope of practice, and their field contains elements of many other specialties. During this rotation I was exposed to clinical medicine, by which I mean the art of seeing patients in a clinical setting, spending a few minutes with each, and using history and physical exam skills to offer a diagnosis and treatment plan. I was also exposed to surgery. I hadn’t realized just how surgical of a specialty it is, or at least can be, depending on how a doctor chooses to practice. (More on that later.) I also saw some inpatient medicine, managing patients in a hospital setting and consulting with other specialties as needed. And of course, OB/GYNs have a very unique aspect of medicine that is theirs alone: the labor & delivery floor. This breadth of practice settings was an excellent introduction to many aspects of medicine that I’m only beginning to understand.

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Physician Burnout: What It Is and Its Impact on Future Doctors

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Physician burnout is a widely discussed topic among practicing physicians and public health researchers. Many studies have been done showing the implications of burnout on patient satisfaction, career satisfaction, and care outcomes. A few studies even try to measure the dollar cost of burnout to society. However, very few articles appear to address the impact of physician burnout on one very important demographic in medicine: future physicians. Future physicians, such as residents and medical students, are molded by the doctors who come before them. The prevalence of physician burnout is likely to affect the outlook future physicians have regarding their own careers and the possibility of them experiencing their own burnout as well.
Background
Physician burnout in the United States is becoming more common. According to one recent study, roughly 45% of physicians reported feeling signs of burnout, an increase from 39% in a study conducted in 2013. Put another way, nearly 1 out of every 2 physicians has experienced burnout or will in the future.

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Sleep Deprivation and Residents: Are We on the Right Track?

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sleep deprivation

The tradition of long hours on the floor is an old one in American medical training. And criticism of this tradition is of long standing too. The controversy over the grueling residency schedules is not a new one, but neither is it one that has been successfully resolved. It can still spark off strong feelings in both the proponents and opponents of cutting back on the length of residency shifts and/or the time off between shifts for professionals engaged in this important stage in their medical education. What’s more, it is a topic which has pitted respected healthcare institutions such as the Harvard School for Public Health and the American Academy of Family Physicians against one another, so much so that this issue is not likely to be resolved anytime soon.

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Choosing a Residency That’s Right for You

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choosing a residency

If you are in medical school, you have been making choices for a long time now, from what to major in as an undergraduate to what volunteer work during your gap year will give you the best chances at getting a coveted med school slot. But now that you are in medical school, one of the most important decisions still lies ahead: what kind of residency should you choose? This is an incredibly important choice that will shape the rest of your career. A good decision now will make it more likely that you will be satisfied with your professional life down the road.
The choice can be a difficult one. What things should you consider before you decide? Read on to find out more about the steps you should take in order to match to a residency that will leave you both personally and professionally satisfied.

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Physician Employment Contracts Part II: The Story Continues

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physician employment contract

Make sure to check out Part I here!
Today’s article takes a closer look at several key terms in employment contracts that can have a significant impact on a new physician – compensation methods, incentive compensation and outside work or “moonlighting”. Building on our first article that examined termination provisions, non-compete clauses, professional liability insurance and indemnification, we will identify key issues in evaluating compensation models and moonlighting and outline some of the questions to consider before signing on the dotted line. 

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Junior Doctor Stress and What Can be Done about It

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junior doctor stress

Junior doctors [and residents in the US] do a valuable and sometimes life-saving job for patients. They are the future in medicine and can bring enthusiasm and fresh ideas into the profession. Despite the importance of their role to society, junior doctors have sky rocketing stress levels and many have an appalling state of mental health.
The Shocking Suicide Rate Among Doctors
It is totally shocking that in the 21st century, so many bright young doctors fall prey to depression and around 400 US physicians intentionally end their own lives annually. This means that every year in America, a million patients lose their doctor to suicide. The chance of dying by suicide is greatly increased for those in the medical profession compared with ‘lay’ people. For instance, male doctors have a 70% increased risk of dying as a result of suicide, when comparing the death rates with men from the general population. One of the reasons there are more completed suicides – ironically – may be as a result of doctor training. Doctors know the human body intimately. They know about drug dosages, they know more about the effects of drugs on the body. They know how to save a life and because of this, how to take one. A determined doctor can calculate a fatal drug dose expertly or know where to cut that would be catastrophic. They also have access to powerful, death dealing drugs that are only available on prescription to the rest of the population. This may be why there are so many successful doctor suicides each year.

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Increasing Access to Healthcare in America

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The advent of the Affordable Care Act was meant, in part, to help to increase the access that all Americans have to healthcare providers. However, while this has meant that a larger number of families now have health insurance, there is still a long ways to go before equitable access to healthcare is achieved.For medical students who will be coming into practice in the near future, an understanding of this issue and why it is important is a critical beginning to producing new physicians that are aware of the problem and are willing to be both proactive and creative when it comes to finding solutions to it. This article covers health care disparity and why it is important, as well as practical solutions to help close the gap of access to medical care in America.

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Love and Happiness… And Medicine? Our Experience in the Couples Match

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couples match

We were in the same class in medical school. It was your typical story. Boy meets girl, girl doesn’t like boy’s buzz cut, they waste a year, eventually end up as anatomy TAs working on the same dissection together, and fall in love. Standard. I knew that I was going to be a surgeon, he was thinking about ER. We moved in together. We talked about getting married. Then he went out for third year rotations and I started the Anatomy Fellowship at our school. He did Surgery mid-way through the year. To my concern, though not to my surprise, he loved it. He loved it the way I loved it. We talked seriously about what this would mean for us, both for our relationship and for our careers. We had always assumed that when the Match rolled around that we would participate in the Couples Match. Couples matching into Surgery seemed like a long shot, but we both knew we couldn’t be satisfied in another field, that we were surgeons at heart. So we decided we had to try.

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What You Should Know: Talking to Your Patients About Their Mental Health

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mental health

Even student doctors who have not yet completed all of their medical training have probably realized that awkward, difficult or delicate conversations are part and parcel of a physician’s practice, and for a number of different reasons. Few conversations you will likely to have with your patients can feel more uncomfortable–for patient and doctor both–than those involving a patient’s mental health. Despite energetic advocacy for the mentally ill in recent decades, the stigma of mental illness remains and many patients may feel embarrassed, upset, or ashamed to discuss these issues with their healthcare providers. A doctor who is comfortable with this topic and can put their patient as ease, however, can more easily screen patients for mental health disorders and, more importantly, get them referrals and contact with community resources that many of them so desperately need.
But how do you start this conversation?

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