You don’t have to spend too much time on Twitter to find ideas about what people think medical students need to know. From health economics and climate change to value-based care and informatics, it seems there’s no shortage of new competencies. And every person with a new suggestion about what doctors need to master believes their idea would be transformative. ... Continue Reading about What Medical Students Need to Know – The Zero-Sum Curriculum
Medical life in the future will be a series of real-time upgrades. We will all be endless newbies. That bears repeating. All of us—every one of us—will be endless newbies in the future simply trying to keep up. Here’s why: First, most of the important technologies that will dominate life 30 years from now have not yet been invented, so naturally you’ll be a newbie to ... Continue Reading about Medicine’s Endless Newbies
When I was a medical student I had an attending who would fail medical students who failed to universally perform the rectal examination. He would gloat on rounds when reviewing admissions with the trainees. Stopping dramatically during the middle of the presentation of the physical exam, he would smile broadly, look around at the team and ask, “So what did the ... Continue Reading about What Did the Rectal Examination Show?
I hear this a lot from young and mid-career physicians in the face of new information, “But I was trained to...” 'I was trained’ suggests knowledge and standards are static. The way things were done is the way things are done. It fuels the myth that our mentors could do no wrong and they knew everything. 'I was trained’ is a dangerous way to think. It closes us ... Continue Reading about The Danger of What Doctors Were Trained to Do
This brief essay from the British Medical Journal is worth thinking about. Here’s the quote about overutilization that pulled me in: There is a hidden curriculum in medicine that encourages trainees to do extensive workups to demonstrate their knowledge and curiosity. As a resident I rotated through one consult service where I was encouraged to strive for 10 ... Continue Reading about Overutilization and Clinical Exhibitionism
When candidates for the Navy SEALS enlist they go through a punishing trial involving midnight runs, sleep deprivation and carrying logs. When trainees have had enough, they are invited to ring a bell which absolves them of any further obligation. But Navy special forces operatives aren't called to go behind enemy lines to carry logs. Their training is a test for ... Continue Reading about Doctors, Training and the Test of Will