How Your Surgeons Got Their First Jobs
After four tough years of medical school and student loans, facing down seven more grueling years of training, aspiring neurosurgeons enter a residency interview process that is as bizarre as it is effective.
From the Wards
Contributing Writer Emeritus
Columbia University's College of Physicians & Surgeons
Michael Cloney is a recent graduate of an MD/MPH dual-degree program at Columbia University's College of Physicians & Surgeons and Mailman School of Public Health. He writes as a Communication in Health and Epidemiology Fellow for The 2x2 Project, and a health columnist for Impakter Magazine. After 10 years in New York, he is excited to have moved home to join Northwestern University’s Department of Neurological Surgery this summer.
Match Day Spotlight 2016: Family Medicine
Farrah Fong, a recent fourth-year medical student who matched to Rutgers-Robert Wood Johnson University Hospital for family medicine, gives us her expert advice on succeeding in medical school and beyond.
Match Day Spotlight 2016: Pathology, Round 2
Diane Brackett, a recent fourth-year medical student who matched to Massachusetts General Hospital for pathology, gives us her expert advice on succeeding in medical school and beyond.
Match Day Spotlight 2016: OB/GYN, Round 1
Samantha Margulies, a recent fourth-year medical student who matched to Yale-New Haven Hospital for obstetrics and gynecology, gives us her expert advice on succeeding in medical school and beyond.
The Silver Lining
We stood in the shadows, a staggered line of nurses, students and surgeons in matching blue scrubs and masks. It was the middle of the night. Our tired bodies sagged against the walls, our bloodshot eyes dancing between the clock above and the gasping life below. A young man was dying in the operating room. He lay on the cutting table with his arms splayed wide, like a martyred saint stretched upon the cross.
Racial Discrimination as an African-American Medical Student
My recent psychiatry clerkship inspired me to examine racial relations during third-year rotations. This reflection originated from a physician submitting a particularly disturbing evaluation of me. She wrote: “[The student does not] recognize and address personal limitations or behaviors that might affect their effectiveness as a physician … [The student is] defensive, rigid, intense and intrusive; unable to see nuances in human behavior that is necessary for analyses of the human psyche; lower emotional quotient than peers.” Her response left me with an open-jawed, stuporous gaze. I could not believe that she had made this kind of assessment after interacting with me in only two patient encounters for less than half a day!
After the Autopsy
I went through medical school without experiencing the death of a patient I had personally cared for. In contrast to what may be seen on the trauma service, my surgery clerkship was full of routine procedures: appendectomies and cholecystectomies, port placements, excisions of pilonidal cysts, and miscellaneous “ditzels,” as pathologists may refer to them as. Sure, I have had patients who were quite sick and did not have much time left to live. For example, I once performed a neurologic exam on a comatose teenager in the ICU, whose arteriovenous malformation had bled wildly out of control despite prior neurosurgery. But with the constant shuffling of rotations that medical students must endure, I was always in and out of patients’ lives before they had a chance to leave mine.
Occupational Physicians as Goaltenders
I recently had the opportunity to shadow a local occupational medicine physician over spring break. I arrived at his office Monday morning expecting a brief day of clinic, maybe some conversation over lunch; maybe I get lucky and he pays for my sandwich. Within minutes of meeting him, though, the physician offered to host me for the entire week on a “mini-rotation.”
Poker Face: When Patients Are Dealt Terrible Hands (2016)
Like poker, medicine has certain rules — patterns of clinical symptoms and lab findings each correlating with a specific spectrum of prognoses that vary in likelihood, the differential diagnosis. Physicians are like seasoned card players, trained to maintain composure and incorporate numerous variables into logical, calculated decisions at what seems like a “dealer’s table” of outcomes. Sometimes, we hedge our bets that the patient will self-resolve, so we elect not to treat; other times, we act conservatively with a battery of tests and pre-emptive therapy.
Managing Chronic Illness: Three Lessons Learned in Training
While I could list close to 100 lessons, I believe focusing on three of the most important ones would aid other future health professionals in managing and ultimately treating the chronic illnesses that will become even more prevalent in many of our future patients. As a disclaimer, I do not claim to be an expert on this topic, but these ideas spring from my own personal reflections.
Microcosm: A Routine Visit in Primary Care
The old woman with long silver hair sat in her wheelchair, feet propped slightly up, smiling toothless among her layers of wrinkles. She waited for me to speak, deferring her decades of matriarchy and adulthood to the stethoscope I wore so casually after just months of earnest experience. Indeed, it sat lightly on my neck today but heavily on my heart. A few more seconds passed, as I contemplated how exactly I wanted to discuss her test results and how exactly I would ask her to proceed.
Looking Back from the Wards: A Lesson from Anatomy
The other day, while scouring my computer for a lost document, I stumbled upon a speech I had given for my medical school’s anatomy donor recognition ceremony. It was an event held every fall, right after anatomy, during which our school’s first-year students showed their appreciation to the friends and families whose loved ones donated their bodies to science so that we could better learn the anatomy of the body. It has been a couple years since, so I decided to take another look at it.
Contributing Writer
Saint Louis University School of Medicine
Michael Tarkey is a member of the class of the 2017 at Saint Louis University School of Medicine. He graduated from Saint Louis University in 2013 with a degree in Biology with minors in Theology and Urban Social Analysis. His interests include healthcare ethics, social justice, and long walks on the beach.