Doctor’s Orders is our section for residents and physicians to give wisdom and advice to medical students.
Physician Guest Writer
Stanford University School of Medicine
Daniel Orlovich, MD, PharmD is a resident physician in the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University. He attended medical school at the University of California Irvine. He has written for the American Society of Anesthesiology, California Society of Anesthesiology, Anesthesia Patient Safety Foundation and Anesthesiology News.
You see, when starting your anesthesiology clerkship it feels as if you are learning a completely new skillset and knowledge base. Of course you are drawing on common principles in physiology, pharmacology, and anatomy. But how they play out, and how you apply those concepts, are fresh. Here are some tips to maximize your learning, assist your resident and really start to appreciate the field.
The start of medical school is an exciting point in every student’s path toward finally becoming a physician. While you should be spending the majority of your day learning and part of each day marveling in the uniqueness of human anatomy and physiology, it is important for us to remain aware of the barriers to care that exist within the systems we train, and eventually practice in. But now more than ever, being a medical student with a penchant for innovation and entrepreneurship can lead to opportunities to create real change and impact real patients.
Last week marked my first week as a doctor. Like thousands of my colleagues, I began intern year with a combination of enthusiasm and dread. On my first day of clinic, I woke well before dawn, full of nervous energy. I collected my precious intern paraphernalia — my stethoscope, my Pocket Medicine guide, and my crisp long white coat. I filled the pockets of my new uniform, smoothed the hems, and, as a finishing touch, began applying the pins I wore throughout medical school to the collar.
The road to medical school mostly requires good grades in the hard sciences, high entrance exam scores, volunteering, and other quality extracurricular experiences. Once in medical school, the curriculum is a rollercoaster ride of learning anatomy, physiology, pathology, diagnosis, and treatment. At first glance, the journey seems to leave little room for anything else. Along the way, we also often hear about cultivating behavioral decorum and social intelligence as soon as our third year clinical rotations begin, or possibly even sooner.
As I reach the conclusion of an over decade-long training process to become an internal medicine physician I find myself facing a dilemma I really did not expect. Yet while my training has prepared me to care for the sickest patients, I really don’t understand how to get paid for my work. The long and complicated medical training process does little to prepare young physicians for real world practice where a plethora of insurance, billing, documentation, and pharmaceutical companies prey on naive young physicians.
On the journey to become a physician, your education will take you to a lot of different places, both geographically and developmentally. Throughout this process, the cost of transportation is an important and worthwhile factor to monitor. Transportation can become a large a part of your budget; however, there are several things you can do and steps you can take to keep it well within your budget during the time spent in medical school and beyond.
Every medical student dreams of having that “Aha!” moment where you instinctively realize your future specialty. Unfortunately, it never seems to be as simple. That moment is often insidious and occasionally tainted with self-doubt.
As an “underrepresented minority” in medicine, my personal experiences of mistreatment while navigating the challenges of pursuing this career are mostly invisible to the rest of society, but I know that they are far from mythical or unique. In fact, my experiences harmonize perfectly with the tales of so many African-American physicians before me and even in the accounts of the students I currently mentor. Everyone asks, “Aren’t things different now for African-Americans?” Yes. But, are they better? Sadly, not exactly.
I am honored by this opportunity to offer you some advice on how to prepare for your professional career in what has become a treacherous health care system. I will not elaborate on why I think the health care system is “treacherous.” I will assume — and even hope — that you have at least some inkling that things are not rosy in the world of medicine.
Stephanie Marango, MD, RYT is a physician-educator, yoga teacher trainer and author of The Wisdom of Your Body. In this interview, she tells us what led her down the path into integrative medicine.
In case you were wondering: robots won’t replace anesthesiologists any time soon, regardless of what The Washington Post may have to say. There’s definitely a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans. I’ve been practicing anesthesiology for 30 years now, in the operating rooms of major hospitals. Since 1999 I’ve worked at Cedars-Sinai Medical Center, a large tertiary care private hospital in Los Angeles. So what do I want to tell you, the next generation of physicians, about my field?
At 8 a.m. every morning of the work week, I show up to class and make every bit of a dramatic entrance — slapping high fives to people in the front row, cracking a joke at He-Man’s (the class ‘buff guy’) expense, taking a moment to survey the classroom for an empty seat (next to people I haven’t sat with yet), throwing long distance secret handshakes to anyone from my lab table that’s paying attention … and smiling as big as I can stand it. And though this behavior is admittedly odd and seemingly manic, it is actually a completely honest expression of everything that my smile represents. Some of my classmates have noticed and asked me about it. At 2 p.m. on October 10, one of Dr. Rudy’s former patients reminds me of the substantial and universally relevant answer to why I am the way I am.
Editor Emeritus: Former Medical Student Editor (2013-2015)
Morsani College of Medicine at the University of South Florida
Sasha is thrilled for the opportunity to combine her interests in writing and medicine. She has been writing since she got her first journal in second grade, and editing since she ran her high school newspaper. Her interest in medicine evolved through travel, studying the brain through the lens of social science as undergraduate at Boston University, and together with her interest in yoga and dance. Sasha gets inspired on long runs and looks forward to few things more than hiking with her mom.
