Please take a look at my recent guest entry on the KevinMD blog exploring the disconnect between emergency medicine’s immense popularity in the Match and an Archives of Internal Medicine study documenting severe burnout among emergency physicians. (According to the research, emergency physicians experience burnout at a rate of more than three times that of the average doctor and more than anyone else inside or outside of the medical field.) Pre-meds and medical students will find useful information in my guest blog entry, as they consider their future fields and lifestyles.
As a resident, I spent one horrific week on my surgical rotation clocking 138 hours in the hospital…and I slept only 6 1/2 of those. By the end of the week, I had decided to quit residency. Fortunately, a good night’s sleep helped me turn that decision around.
Pauline Chen MD recently wrote a piece in the New York Times called “The Impossible Workload for Doctors in Training” in which she argued that the ACGME’s (Accreditation Council for Graduate Medical Education) work hour improvements over the last decade have not been effective. After the Libby Zion case, the ACGME started mandating fewer work hours for residents for their safety and the safety of their patients. The most recent (2011) rules do not allow interns to work more than 16 consecutive hours.
Dr. Chen’s point is that because the volume of work has increased, limiting the number of hours has not been an adequate way to address the problem of over-tired residents. In other words, even if someone is working fewer hours, if she’s managing many more patients in a shorter time period, safety is still a major concern. There are studies and anecdotes to support her assertion that are cited within the article.
Of course, the solution is not to go back to the previous work hours – nor to continue as is. More funding needs to be allotted to residency positions. Not only would this alleviate the workload problem, it would mitigate the physician shortage crisis. We have a lot of medical students; the bottle neck comes in residency positions. If we had more training spots, we could train more doctors and consequently, offer more primary and preventive care, while providing increased safety to residents and their patients. It would be a win-win-win.
That week on my surgical rotation was particularly bad, but I had many, many others that were also minimally human. We would not accept heavy or dangerous work loads for pilots or police officers. We need to reject them for doctors-in-training as well.
Last month I was an invited exhibitor at Student Doctor Network’s Test Prep Week 2013. As an exhibitor, I received several good questions. Because I am always impressed with someone who thinks ahead, one of my favorites was
The below was my response:
Good question. The simple answer is to start working on a personal statement and ERAS activities draft around March of the year you are planning to apply. Assume it will take multiple drafts to get your written materials into good shape. Once you’ve done your best, find someone with residency admissions experience (like me) to help you get your documents into outstanding shape.
In terms of your comprehensive residency candidacy, you should start planning a strategy toward the beginning of your first year of medical school. If you are applying in a very competitive field (derm, plastic surgery), you should get started on your first day of med school. (No joke.) Consider hiring me for a Strategy Session early.
I hope this helps current first-, second-, and third-year medical students who are thinking ahead!
Pre-meds and 2014 ERAS applicants: Who says you can’t have it all?
Every winter applicants contact me asking if I can work with them throughout the medical school and residency admissions processes. In the past, my help has been through a la carte services, but now I’ve created two packages (each with a $430 discount) for those applicants seeking my assistance from the beginning to the end of the admissions process.
The Complete Package for medical students covers a one-on-one Medical School Strategy Session, Editing Services (including the Medical School Personal Statement, AMCAS®, Medical School Secondary Essays, and a Letter of Intent) and Medical School Mock Interviews. Check it out here on my website!
The Complete Package for residency applicants (including IMGs) includes a one-on-one Residency Strategy Session, Editing Services (including the Residency Personal Statement, ERAS®, Curriculum Vitae, and a Letter of Intent) and Residency Mock Interviews. Check it out here on my website!
As always, feel free to email me with questions: email@example.com
Check me out at www.InsiderMedicalAdmissions.com
I greeted this news with both encouragement and concern. On the one hand, it’s reassuring that low- and medium-income students who cannot afford the exorbitant costs of a medical education will have the option to pursue their career dreams with less (although still significant) financial burden. Shaving off $20 to $50,000 of tuition and living costs can mean opening up the medical career to those who are understandably terrified of decades of loan repayment.
On the other hand, the NYU accelerated medical students will need to choose their specialties when they apply to medical school. In return, they will be guaranteed a residency slot when they graduate, but presumably, these applicants would have matched successfully to a residency position if they had been in a traditional program. After all, they are being accepted to a strong medical school and are competitive applicants. (NYU expects these students to stay in the top half of their class academically in order to continue in the accelerated program.)
Asking students to pick a specialty prior to even completing one day of clinical rotations begs the question of whether these future physicians will be satisfied in their fields. Studies have shown that doctors who are more dissatisfied provide lesser patient care and are more likely to leave medicine, which will worsen the accelerating doctor dearth.
Take a look here to read the NYT’s article regarding NYU’s new program, and make your own conclusions.