Blog Archives

Sleep Deprivation is a Form of Torture

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.

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Writing Your Own Residency or Medical School Letter of Recommendation: Is it Ethical?

medical school application and residency applicationIt’s not infrequent that an applicant tells me that a letter of recommendation (LOR) writer has asked the candidate to draft his/her own letter because the writer is “too busy.” I notice that medical school and residency applicants are a bit sheepish as they tell me about this arrangement. Have no fear: You are not doing anything unethical. (Here is a piece by the New York Times ethicist Ariel Kaminer regarding this exact topic.)

If a faculty member asks you to write your own letter, not only should you do it, but you should do it with zeal. Make sure you showcase the accomplishments that distinguish you from other candidates and highlight traits that are important for your future career path. Use honest – but bold – adjectives to describe your best qualities.

Remember that the letter writer has final say, so even a busy faculty member might modify the letter. Keeping this fact in mind might alleviate your (unnecessary) guilt and should encourage you to write the strongest letter you can. (It’s harder to go from outstanding to mediocre than from outstanding to excellent.)

 

Contact me for Strategy Sessions and Complete Packages. The latter are very popular this season.

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ROAD to Nowhere?

This New York Times article, “Job Prospects are Dimming for Radiology Trainees” is worth reading. It’s interesting how seemingly outside forces (overused emergency departments) can lead to job losses in another specialty. It’s also worth noting (and troubling to see) that despite declining job openings for radiologists, there is even more competition for many residency slots because the number of medical school graduates continues to grow. This relative dearth of residency positions represents the so-called bottle neck in the physician supply problem.

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When Your Debt Affects Your Dates Part 2

 

 

The New York Times recently ran Perfect 10? Never Mind That. Ask Her for Her Credit Score, an article that might worry some single pre-meds.

Along those lines, here’s an interesting piece by guest blogger David Z. Presser MD MPH that specifically addresses medical school debt and romance.

Be afraid. Be very afraid.

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Interview Tips from an Entrepreneur

This article is currently at the top of the New York Times’ most emailed list. It’s written for those entering the work force, but it is very pertinent for applicants to medical school, residency, fellowship, and post bacc programs.

I hope everyone has a happy holiday season!

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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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