Resident Lounge Insights on Residency

A harsh reality I am coming to terms with, as a newly minted “pre-tending,” is that we don’t know the cost of the care we provide. There are recommendations for things like High Value Care, from organizations like the ACP. But how much do things actually cost?

As physicians, we generally attempt to separate our personal lives from our work. Some of this comes from modeling behavior of others during training, some comes with further experiences in coping with the patients we encounter...

It’s that time again — time to dust off your nicest suit and prepare for either residency or fellowship interviews. Being knee-deep in interview season for Infectious Diseases fellowships, my interview days...

I began one of my PGY2 medical oncology rotations alongside my co-resident: an MD/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were “Harvard kids.” Needless to say...

This basic lifesaving medication is cheap to produce. It should not be a way to make a billion dollar profit. Should EpiPens be inexpensive and available? I say yes, and here are my reasons...

Last month, as I was adjusting to my new role as a newly minted attending (affectionately referred to by many as a “pre-tending”), I had the opportunity to precept some of our strong upper levels in our ambulatory clinic. Luckily for me...

You are currently on inpatient wards and notice your chief medical resident has been demonstrating erratic behavior, frequently muttering about MEN syndromes and antibodies associated with rheumatologic diseases and has been reciting gene translocations. What is the most likely cause of her symptoms...

“Medicine Purple is now rounding at Room 202.” The announcement rang throughout the hallways on the lower pavilion. It was an announcement I had heard many times before, but this time it was quite different. As I glanced in the upper right hand corner of the electronic medical record of my first patient...

I will never forget Sunday morning, June 12. I was off that day. I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before. I was still half asleep when I picked up my cell phone to see what time it was...

At the beginning of the year, I wrote about the rude awakening I was experiencing with regard to my own finances. I heard from more than a few other imminent or recent resident graduates who expressed some degree of similar feelings of being inadequately prepared in the financial realm.

I still remember the day I got the welcome letter from my medical school. I was super excited and proud. My dreams of becoming a physician were now a reality. So, I pushed myself during my two basic science years and awaited my clinical years...

Here are some questions that are still on my mind as I approach the tail end of my chief year. I’m thinking about the best ways to offer constructive feedback...

Living in Orlando, one cannot escape Disney. Disney movies are a delight, because one subconsciously anticipates that the happy ending is going to make up for the rest of the characters’ struggles. It works for me! Be it Simba, Cinderella, Snow White, Belle, or  Elsa...

I took my dog to the vet today. You’d think this would be a straightforward sort of thing for a medical professional. You’d be wrong.

When I woke my dog up at 5:15am (my new daily start time, as it’s apparently the only way I can find time to do board questions, and is also the excuse I use when I miss the majority of said questions), he seemed sleepy...

“May I never see in the patient anything but a fellow creature in pain.”- The Oath of Maimonides I am not immune to the post-election frenzy. Never in my relatively short life, nor in my even shorter existence on social media, have I seen people so divided. Shortly after the president-elect was named, I found myself […]

Questions for young physicians: Do you remember and recall the series of events that inspired you to become a healthcare provider? Are you satisfied with the field of medicine? Have you ever thought about your perceptions of healthcare before and after becoming a physician? Have you ever been a patient yourself? 

We had known Ms. B. for weeks. She was a “bounce-back” to the unit. Every day, an intern would enter the ICU room and ask, “How do you feel?” “OK.” Do you have any pain?” “No.” “Any trouble breathing?” “No.” “Tightness in your chest?” “No.” “No? OK.” I was the senior resident following the case, 1 […]

“Please don’t spoil the movie with your own soundtrack.” Remember hearing this message before the beginning of a movie in a theater and how most people turn their devices on silent to watch the movie? The cost of the movie ticket is considerably less than the cost of medical education, but I wonder if learners […]

I’m April, and I’m the incoming PGY-5 Chief for the Internal Medicine and Pediatrics Residency in Chapel Hill, North Carolina. Just last month, I had my 4th graduation from something since I finished high school. Residency, it turns out, is long and hard. I’ve spent tons of hours practicing the art of sphincter control each time that […]

NEJM Journal Watch is happy to welcome a new panel of Chief Resident bloggers for the 2016-2017 academic year. Here’s a sample of what our new bloggers will be discussing, starting on August 1! “Resilience” is defined as the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress. […]

“Oh no, she’s calling again.” I look at the caller ID in the Chiefs’ office where I sit with one of my co-Chiefs.  It is the Documentation Lady. Her call is as regular as BMs with C. diff: Profuse, excessive, associated with a lot of hot air and a bunch of crap, but inevitable. We play […]

Reflections and observations from my last day in Greece as part of the SAMS (Syrian American Medical Society) medical mission for Syrian refugees: 1) It rained during clinic hours. It was a bit inconvenient for the team. For the refugees, it was catastrophic. Their tents, already damaged, allow the drops of precipitation to find their ways in and soak […]

1) At one point today in the Idomini refugee camp, I was playing catch with a beautiful baby girl in between some of the tents. She could not have been much older than my own daughter and, like my daughter, would throw the ball backwards over her head instead of towards me and then would […]

1) The following are real conversations the team has had with patients/refugees in our short time here: Young lady who came in with urinary symptoms: “How old are you?” “I am 27 years old… I hope this is the last year of my life.”   Teenage male: “I have to get out of here. I’ve spent 3 months of my […]

I am participating in the SAMS (Syrian American Medical Society) medical mission in Greece. 1) Loneliness is truly the darkest consequence of this crisis. The Syrian people haven’t just been kicked out of their homes. They were stripped away from their neighborhoods, friends, and family via death, destruction, sickness, and tough decisions that they had to make about splitting […]

Note from the NEJM Journal Watch staff — Ahmad Yousaf is currently on a trip to help care for refugees in Greece. He is sending daily updates to share his thoughts; we will be posting them here daily.   The discomforts of travel are real. Stress, related to the unknown: flight times, traffic to the airport, crying babies, […]

“Be careful. He’s violent.” That was the way sign out began for Mr. T. The intern continued, “He has been in the hospital forever because he was kicked out of his nursing home. Good luck. And, oh yeah… he’s blind.” Puzzled, I looked at my list of patients and, not sure whether I should write […]

“Is he dead?” I stepped up closer. He was yellow. Bright yellow. Steve had been admitted to the hospital for altered mental status when his last PET Scan revealed that the pancreatic cancer had spread from the tail of his pancreas into his liver where it now blocked the ducts that carried the bile out of […]

The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER: 1AM: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s good, he’ll  get a cut.” 1:40AM: Patient is making inappropriate sexual comments and is verbally aggressive with medical staff. He […]

Notes from chief residents in family and internal medicine.

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from 5 chief residents in family and internal medicine.

Notes from 5 chief residents in family and internal medicine.

Notes from 5 chief residents in family and internal medicine.