medical students

RECENT POSTS

A Prescription For Better Teaching, Stronger Doctors

The author's stethoscope from medical school stethoscope. (Courtesy)

The author’s stethoscope from medical school. (Courtesy)

By James Morris
Guest Contributor

Medicine, in many ways, is changing. Patient-centered care is all the rage and the old, iconic image of the all-knowing doctor is fading away.

In one concrete example of this shift, a new Medical College Admission Test (MCAT) is just around the corner. Starting in spring 2015 for the class that will enter medical school in the fall of 2016, the new MCAT promises a “better test for tomorrow’s doctors.”

Among other changes, it will have a new section focusing on the social determinants of health — essentially asking students to consider how income and social status, education, home and work environments and other factors shape health outcomes.

Premedical education takes place at the undergraduate level. I went to medical school, but now spend most of my time working with undergraduates in the classroom.  I often think about what I learned in medical school and how it translates — or doesn’t translate — to teaching, and why it matters.

Of course, there are the obvious connections. One of the classes I teach is comparative vertebrate anatomy, and I use what I learned about anatomy in medical school directly in this class.

But there are other lessons that don’t apply. Doctors often use three-letter abbreviations in their notes. HPI is the history of the present illness, the patient’s narrative of what brought them to the doctor’s office or hospital, as heard and interpreted by the physician.

CAD is coronary artery disease. TIA is a transient ischemic attack, a “mini-stroke.”

There is a saying I remember from medical school: Physicians are especially fond of TLA’s … three letter abbreviations.

I don’t use many acronyms in my teaching. But sometimes, it’s helpful: For problem sets, I sometimes use “PS.” However, when I do this, I am inundated with emails and questions asking what they mean.

In medical school, mnemonics are also widely used to help aspiring physicians learn and remember all kinds of information. The 12 cranial nerves can be recalled using the mnemonic “On Old Olympus’ Towering Top, A Finn And German Viewed Some Hops,” where the first letter of each word of the saying is the first letter of each of the cranial nerves: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, auditory, glossopharyngeal, vagus, spinal accessory, and hypoglossal.

Or, for Harry Potter aficionados, there is “Only Owls Observe Them Traveling And Finding Voldemort Guarding Very Ambiguous Horcruxes.”

These are handy, but I learned so many mnemonics in medical school that I often had trouble remembering which mnemonic was used for what kind of information. Is that the mnemonic for the cranial nerves, or the bones in the wrist, or the femoral triangle, or the major branches of the aorta? Continue reading

Latest Data: Average Med School Grad Owes Over $166K


Know a virtuous young person who wants to become a doctor for all the right reasons? Think their soaring idealism might need a bit of ballast from financial reality? Here it is: The latest figures on medical school debt, just out today from the Association of American Medical Colleges.

The mean debt load for students from all medical schools is $166,750, up 3 percent from last year, and the median is $170,000, up 5 percent from last year. And it doesn’t much help if you go to a public medical school — the mean debt is about $156,000, compared to nearly $184,000 for a private school.

Depending on your repayment schedule, the new AAMC data show, your total repayment after graduating could total as much as $476,000. And we wonder why health care is so expensive in this country? Doctors’ salaries are of course only one element of our high price tags, but it’s an element that sets us apart from Europe, where medical education tends to be lower-cost or free.

Amednews.com reported recently here:

Meanwhile, tuition rates continue to increase dramatically. The median cost of attending a private allopathic medical school has grown at 1.8 times the rate of inflation during the last 13 years. At public schools, it has grown more than twice the rate of inflation, the AAMC said.

Public medical schools have been particularly hard hit, as states have reduced funding in a poor economy.

Readers, what is to be done? See the full AAMC data below. One interesting note: 30% of graduates plan to enter loan forgiveness or repayment programs: Continue reading

Study: Costs Keep Med Students From Much-Needed Mental Health Care

By Fran Cronin

CommonHealth intern

Medical students are a challenged lot — sleep-deprived, stressed and driven. With the constant cramming of facts into their overloaded heads, and the constant need to steel themselves against the daily rounds of disease and injury, many medical students are left mentally and emotionally drained. Like their patients, they need a doctor. But many don’t reach out for help.

In a research letter just published in the Journal of the American Medical Association, Drs. Rachel Nardin and J. Wesley Boyd — both from the Harvard-affiliated Cambridge Health Alliance (CHA) — help illuminate the vulnerability of U.S. medical students to untreated and debilitating depression and substance abuse. These at-risk students tend not to seek the mental health services they need, the researchers found, due to the overwhelming cost of appropriate mental health services.

Schools and parents may be mandated to provide health insurance, but the study found that many of the plans offered did not provide affordable or adequate coverage for mental health and substance abuse treatment.

Data culled for this first-time survey of health insurance offered to U.S. medical students was collected from June through December 2010. The findings from 115 of the total 129 public and private medical schools in the U.S. revealed wide variability in annual dollar and visit limitations across the non-uniform plans.

‘Mounting debt from long stints at expensive schools weighs very heavily upon the students.’

For example, mental health dollar limits ran from $1000 – $200,000 for outpatient services; $800 – $200,000 for outpatient substance abuse treatment; and $1000 – $200,000 for inpatient mental health and substance abuse treatment. Continue reading

Med Students Rally For Vermont Single Payer System

Medical students show support for a single payer health system in Vermont

Medical students from Vermont and neighboring states are heading to Montpelier this weekend to rally in support of a publicly-funded, single payer health system for the Green Mountain state.

A press release from the group, Physicians for a National Health Program, quotes Harvard Medical student Jonathan Takahashi on why he supports the plan:

“Through my training in medicine and public health thus far, I have seen firsthand how much the current lack of a unified and equitable health care system is a stumbling block in doing the work I care about. This is why action to improve health care, through measures such as implementing a single-payer financing system, is important to me.”

Sen. Bernie Sanders, I-Vt., and Gov. Peter Shumlin, D-Vt., both of whom have been outspoken advocates of single-payer reform, are scheduled to speak at the 1 pm rally Saturday at the Vermont Statehouse, the physicians group says.

Earlier this week over 200 physicians from around the country, including 13 from Massachusetts, said they would seriously consider relocating to Vermont if it were to implement a single-payer system.

Read our interview here with one of the students planning to attend the rally.