Read on Twitter
People joke about July 1st being a scary day for medical care because you get new students, interns, and attending doctors.
In the words of one of my mentors from training, Paula Rauch, let me complicate your thinking about that. (1/10)
In the words of one of my mentors from training, Paula Rauch, let me complicate your thinking about that. (1/10)
Medical training is intense and lengthy. You learn about how the body works, what can go wrong, and how we can help when something goes wrong.
But above all, you learn the three most important things in medicine:
(2/10)
But above all, you learn the three most important things in medicine:
(2/10)
1) how to develop hypotheses about illness (we call this differential diagnosis, informed by an understanding of pathophysiology).
2) how to situate the patient’s presentation in the context of their history and environment (we call this a biopsychosocial formulation). (3/10)
2) how to situate the patient’s presentation in the context of their history and environment (we call this a biopsychosocial formulation). (3/10)
The third is how to keep reinforcing, refining, and reinvigorating our medical skills and knowledge. We call that lifelong learning, and it’s one of those buzzwords that doesn’t always get the appreciation it deserves. But the best doctors live it every day. (4/10)
Today, I’ve been an attending in child & adolescent psychiatry for a decade. And still this week, I saw a presentation of illness that wise colleagues had described, but I’d never seen in person. A (very new) medication used in 2 patients inspired me to learn about it. (5/10)
I met patients and heard the stories about their lives that helped explain what they are experiencing. And I got to hang out with some brilliant, energetic young doctors who just finished their internship and ascended to their second year of residency. (6/10)
My job is stressful - whose isn’t? - but I am so happy to lean into these aspects of my work.
There are lots of things medicine needs to address. (7/10)
There are lots of things medicine needs to address. (7/10)
The way the healthcare system is financed is a mess. Access to medical and mental healthcare is a travesty. Structural inequality, poverty, and systemic racism that influence the social determinants of health are a deep-seated problem that doctors alone can’t heal. (8/10)
But our trainees and our young doctors are the bones of our medical system, and the bones are strong. Your doctor and their team will take good care of you. Treat them with kindness and respect. (9/10)
Congratulations to all the new and newly advanced doctors out there! You got this! 
