Blog Archives

Finding – and Redefining – Balance: It’s Not about Better Multitasking

This time of year, when the residency and medical school interview processes are in full swing, many of us feel overwhelmed. Here’s a brief but thoughtful piece regarding balance. As you consider your future career, it’s worth thinking about issues the author covers like clarifying what brings you joy, considering your goals while understanding they will change, and defining balance for yourself. 

In this day and age, one can choose a traditionally tough specialty but work in a practice setting that allows for some autonomy and flexibility. But you need to know what you want, and you need to give yourself the room to explore that in order to guide yourself in the right direction.

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How the Show ER and New Residency Programs Change the Economy of a Specialty

Here’s an interesting piece called “Are There Too Many Emergency Physicians?” by Thomas Cook MD, an emergency medicine program director. Dr. Cook chronicles the growth of emergency medicine residency positions from a total of 1821 in 2015 to 2488 in 2019. This rapid growth in the field may lead to an oversupply of emergency physicians.

The paradox here is that only recently there was a shortage of emergency physicians. And back when I graduated from medical school in the mid-1990s, almost no one was applying for emergency medicine. In my class of around 150 students, there were three of us. As the popularity of the show “ER” waxed, the number of applicants to the field swelled. Then, years later, the field contracted again. 

Other fields have also recently seen a boom in the number of residency spots, including family medicine, psychiatry, and anesthesiology. Of course, opening up more residency positions is a good thing for medical students (especially international medical graduates) and patients, but the growth in certain fields may lead to a change in the economy of those specialties. It will be an interesting experiment.

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The Week I Spent 138 Hours in the Hospital

During my internship, on my surgical rotation, I once spent 138 hours in the hospital in one week. If you think this isn’t mathematically possible, I will tell you that I was on call from Monday morning to Tuesday evening, from Wednesday morning to Thursday evening, in-house on Friday, and then on call from Saturday morning until the next Monday morning. (I had to stay in-house that Monday until evening rounds were over too.) As you can imagine, I was barely human by the end. How this schedule was good for patient care is beyond me.

I thought of that ghastly time recently when reading this article in the New York Times called “How Job Stress Can Age Us” written by Dr. Dhruv Khullar. The author reports on a study, “Physician-Training Stress and Accelerated Cellular Aging” that assessed the DNA of 250 first-year medical residents around the country. Researchers examined the saliva samples of these residents, focusing on their telomeres – the bumpers at chromosome ends that prevent DNA damage – before and after the first year of residency. Researchers found that the DNA of first-year residents aged six times faster than normal.

Six times faster.

I found this both shocking, upsetting, and validating. Residency training is as hard as we think it is. 

What I would strongly recommend is that you compare residency programs’ hours before you create your Match list. Strangely, many applicants don’t even consider this important issue when making decisions about their next three to five years. Also, many residencies support physician wellness programs and night coverage. Especially in the setting of severe burnout among doctors, your happiness should be a primary factor in your career choices. If you’re not sure, consider your shrinking telomeres. 

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Accelerated Medical School Programs

Great Opportunity or Impending Mess?

I’m sure many of you read last week’s news that NYU and other medical schools will be offering a three-year, accelerated medical school program to eligible applicantsmedical school programs

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.

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The Role of Patient Anecdotes in the Personal Statement

Medical School Personal Statement

The temptation is great to include patient anecdotes in the personal statement. When written well, these stories can capture a sense of common human experience that transcends economic and cultural barriers and demonstrates the empathy of the author-applicant and her sincere motives for pursuing a medical career. This can only help the applicant, right? The answer (as with most situations in life) is: it depends. Read more ›

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About Dr. Michelle Finkel

Dr. Michelle Finkel

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

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