I recently came across a Medscape-sponsored discussion called “How can we make medical training less toxic?” The video is visible here, and you can log into Medscape to read the transcript. The participants – two emergency physicians and one surgeon – discuss sexism in the workplace, corrosive and inaccurate narratives about women residents, the importance of strong mentorship, and diversity training. This topic is additionally important because toxic work environments can lead to depression, burnout, and suboptimal patient care. My experience in residency was marred by sexism and sexual harassment. It saddens me that these problems are still present, but I’m pleased the issues are starting to be addressed.
Blog Archives
Match Results 2023: Why Did Emergency Medicine Do So Badly?
Emergency medicine has had its ups and downs over the years with regard to desirability. Soon after the show “ER” became popular, emergency medicine programs also were suddenly in vogue. Over the interim years, the field’s cachet has declined and increased, but up until recent years, emergency medicine programs routinely filled 99% of their available spots in the Match.
The fact that 554 emergency spots went unfilled in this past Match was particularly distasteful to many emergency physicians, accordingly.
The reasons for this plummeting interest in the field is well described in a recent piece in ACEP Now. (ACEP stands for the American College of Emergency Physicians.) The authors note multiple issues, including burnout, decreasing remuneration, and systemic problems in the emergency healthcare system that frustrate clinicians.
Of note, these issues have driven out many middle-aged emergency physicians, as well.
Even if you are not interested in becoming an emergency doctor, take a look at the piece here, keeping in mind that certain factors may soon adversely affect other specialties as well.
(I’d like to give a shout out to my old friend Jonathan Fisher MD MPH who was one of the reporters on this article.)
BS/MD Programs
Here is an AAMC piece about BS/MD programs. While these curricula do provide some benefits to students with an early interest in medicine, I am generally not a proponent of the BS/MD option, as it really precludes most participants’ ability to take full advantage of the college experience; the caveat may be 8-year programs (like Brown or Tufts) that don’t accelerate students, as much as give them early assurance of admission to medical school (assuming individuals maintain their grades).
My bias is that taking more time – for example, a gap year – is a way to enjoy the school experience and approach medical training with maturity and career choice confidence.
USMLE Performance Data 2022
The National Board of Medical Examiners (NBME) publishes USMLE performance data year after year, and the most recent information regarding the 2022 testing cycle is particularly interesting. Frankly, I’m not sure what to make of it, but performance on Step 1 is notably worse than years prior (e.g. 2021 compared to 2020; 2020 compared to 2019). I’m not sure if this is related to the pandemic, changes in the test itself, or some other factor. Here is the data.
Tags: Medical Careers, residency, Step 1 and 2 scores, Usmle
How Race and Gender Affect Medical Specialty
The AAMC published an interesting piece recently showcasing the results of their Physician Specialty Data Report on the interplay of race, gender, and specialty.
It’s worth combing through the data yourself, but here are a few takeaways:
Doctors from underrepresented groups are more concentrated in primary care fields. These specialties are extremely needed and noble, but since primary care is less well remunerated than surgical specialties, it’s worth thinking about the disproportionate density of minority physicians.
Women make up the majority of medical school students for the fourth year in a row.
Women represent a significant minority in surgical specialties like orthopedic surgery (5.9%), thoracic surgery (8.3%) and neurosurgery (9.6%). Ouch.
Focusing on another demographic, the doctor workforce has grown older. Over 46% of active U.S. doctors are 55+. That number was ~38% in 2007.
For more details, read the report here.
Tags: Aamc, choosing a specialty, Diversity, Medical Careers
Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more
