It was only as a medical student at Johns Hopkins that I became aware that the private practice of medicine—any specialty, thoracic surgery in my case—was a possible career choice. By far the greater number of physicians at that time and now are in private practice. There have been changes Read More
Category: Academic Medicine
July 1 marks the beginning of the medical school academic year in Medicine. Newly minted medical graduates begin their residency, those in the midst of their program advance one year in seniority, and those who have completed their program move on to practice or further training in a specialized field. Read More
How to teach. Surgeons that are either full-time or part-time academic faculty are the teachers and mentors of surgical residents. Although there is the occasional lecture and/or presentation at Grand Rounds or elsewhere, most teaching and learning takes place in a clinical setting, with patients in the hospital or in Read More
How and who to teach. I taught medical students for about 40 years. Most of that interaction took place while making rounds with them and residents and in the operating room. There were some classroom sessions but most activity was in the clinical setting oriented around actual patients. What is Read More
Explaining Medical Residencies After my previous blog on financing medical residencies, it was brought to my attention that medical residencies, their functional details (why and how) may not be well understood. Let’s start at the beginning for those who want to be a doctor. First you attend college where Read More
Politics get in the way. Hospitals that have medical residency training programs (this includes trainees in internal medicine, surgery, and all other specialties) are responsible for paying the salary and benefits of their residents. In turn the hospitals bill and are reimbursed by Medicare which is where the government housed Read More
Medical schools provide safety nets. The safety net idea is to “catch” patients that fall through the system that catches and cares for the insured. Those that slip through are uninsured or have insurance that is insufficient to give them a foothold in the world of for profit hospitals and Read More
Can you experiment on patients? The answer is yes. As an academic thoracic surgeon many of lung and esophageal cancer patients were in clinical studies. If you are considering participation in a study or are simply curious, this blog should be helpful. There is supervision of and tight controls on Read More
What two surgeons did not do dramatically changed the course of American Surgery. I have discussed the contributions of two influential pioneer surgeons Macewen and Graham. They also changed the course of Surgery in the USA by something they did not do. Both men were offered the position of Chairman Read More
This won’t be as bad as making laws or sausage but there will be details. In the 1980’s the relationship between medical schools and their hospital changed. Until then the school’s parent university owned and the medical school managed the hospital. The advent of managed care programs and shrinking hospital Read More
