Blog Archives

Sleep As a Vital Sign

“Without enough sleep, we all become tall two-year-olds.” — JoJo Jensen, Dirt Farmer Wisdom

As a resident, I spent one horrible 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.

I recently heard an interesting AMA Journal of Ethics podcast called “Sleep as a Vital Sign” with Dr. Lauren Hale from Stony Brook University. In her interview, she clarifies the distinction between sleep medicine and the study of sleep as a public health issue, the latter of which is her academic interest. She offers policy recommendations to decrease morbidity and mortality from sleep deprivation, like eliminating daylight savings time and making school start times later. She also touches on how the lack of sleep adversely affects medical professionals. 

The podcast episode is brief and interesting. Plus, you can get CME credit for listening :-).

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Suicide Rates are Significantly Higher for Female Physicians

The British Medical Journal published a meta-analysis last month by lead author Claudia Zimmermann looking at studies published between 1960 and March 2024 that found physicians were more likely to die by suicide than the general population and that female doctors suffered from a rate that was higher than their male counterparts. While male doctors had a suicide rate ratio of 1.05 across all studies, female physicians faced a rate ratio of 1.76. The findings suggest that female physicians have unique challenges and need targeted interventions.

A few months back I read about a nonprofit organization that offers free and confidential counseling for physicians and medical students, using volunteer psychiatrists. The organization is called Physician Support Line and their number is 1-888-409-0141.

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Medical Student and Resident Mistreatment is Pervasive

When I was in my second year of medical school, a third-year student (who later also went into emergency medicine, as I did) came to speak to our class about being on the wards. He gave an animated talk about how important it was to recognize that when residents, attendings, or nurses hollered at us on our clinical rotations, 99% of the time, it wasn’t something we were truly being targeted for: He likened the situation to Boston traffic – how drivers lean on their horns for little cause because they are simply frustrated about their days.

It’s not personal, he said.

When I got to my clerkships, I was dismayed to find that I had underestimated how often I would experience the mistreatment the well-meaning third-year had warned us about. As a medical student, I was berated on numerous occasions for absolutely no logical reason. Residency was worse. The sexism and cruelty was hard to manage, and yet, I had little recourse. 

In a recent piece, AAMC staff writer Stacy Weiner highlighted that, in 2023, at least 38% of US medical students reported having suffered mistreatment and that residents described similar rates. According to the piece, 75% of students and residents don’t report their mistreatment, at least in part because of concerns about retribution. 

The good news is that there are some institutions that are implementing systems to decrease mistreatment, including the University of Colorado School of Medicine and Penn State College of Medicine in Hershey. To its credit, Icahn School of Medicine at Mount Sinai created an online form to report mistreatment with access from every hospital computer.

Here is the AAMC article with more details about this ubiquitous, critical issue.

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Great Things About Being a Physician

Years ago my physician dad told me that it was important to select a specialty whose bread-and-butter you could still enjoy. For orthopedists, it’s back pain. Interestingly, it’s probably back pain for us emergency physicians as well!

Along those lines, I devote a reasonable fraction of my blog entries to the downsides of being a physician because I want to ensure that those who are considering a career in medicine understand and can tolerate the more mundane – even negative – aspects of their planned profession before they can’t turn back.

I’m very happy, then, in contrast, to use today’s blog entry to showcase Medscape’s Best Things About Being a Doctor piece. It’s interesting how many of the physicians interviewed mention having a “tangible” effect on their patients’ lives.

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After You Get In

The AAMC recently published a piece called “Congratulations, you got into medical school! Now what?” in which staff writer Bridget Balch lists seven tips for rising first-year medical students. You can see the article here.

The author makes several suggestions, including leveraging the orientation and embracing the academic challenge, but I would highlight her recommendations to find mentors and prioritize your health.

Identifying strong mentors not only affords you the potential for good letters of recommendation and little-known opportunities, but also doing so can support you when medical school is a terrible grind. Mentors can be especially important role models for women and those in traditionally underrepresented groups. The key is to assert yourself and overcome feelings of insignificance. Many faculty are eager to meet and guide students.

With regard to physical and emotional health, I’ve written recently and many times in the past about clinician burnout and depression. Medical school can be a time of significant contraction in your life. Make sure to care for yourself physically and seek mental help when needed.

In the meantime, before school starts, take a well-deserved break!

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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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Listen to Dr. Finkel’s interview on the White Coat Investor podcast:

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