The Physician in the 21st Century

From Hippocrates to Osler, the sacrosanct physician-patient relationship has been paramount. Hippocrates is best remembered for the Oath that bears his name(1), often recited at medical school graduations, which places the patient first and foremost in the physician encounter. More than two thousand years later, William Osler, the renowned professor of medicine at Johns Hopkins Hospital and Oxford, wrote that the premier quality of a good physician is “aequanimitas”, meaning calmness and patience(2). The foundational idea of the personal, caring relationship between physicians and patients has clearly withstood the test of time. Perhaps it can serve as a guidepost for the enormous changes coming in medical care in the 21st century. Indeed, across the ages of advances in scientific discovery, the special nature of the physician-patient relationship, exemplified by compassion, has been the mainstay of medicine.[...

Reimagining Medical Education in the Age of AI

Available medical knowledge exceeds the organizing capacity of the human mind, yet medical education remains based on information acquisition and application. Complicating this information overload crisis among learners is the fact that physicians\u27 skill sets now must include collaborating with and managing artificial intelligence (AI) applications that aggregate big data, generate diagnostic and treatment recommendations, and assign confidence ratings to those recommendations. Thus, an overhaul of medical school curricula is due and should focus on knowledge management (rather than information acquisition), effective use of AI, improved communication, and empathy cultivation

An analysis of medical students' residency and specialty choices

The contemporary geographic maldistribution of physicians and shortages in some specialty areas is a persistent problem facing United States federal and state wide health planners. This paper attempts to illustrate some of the formal and informal processes of the selection of specialties and recidency programs based on a survey of senior students of 37 selected American medical schools at the time of the National Residency Matching Program in 1982. Results of a factor analysis on influences on specialty choice produced two major clusters of medical students; those predominantly influenced in specialty choice by the faculty and other senior physicians (sponsorship), and those predominantly influenced by the social dimension of the physicians' role (social responsibility). These medical specialty choice orientations were also systematically related to either choice of specialty vs primary care medicine, to a life-style or status related choice of residency program, and to students' perceptions regarding a program's evaluation of a candidate. The results of the survey suggested that students who chose primary care were more apt to be influenced by sources outside of the medical school. These findings raise questions regarding the efficacy of medical school curriculum in motivating career choices in primary care. This is particularly important in view of the stated need to increase the proportion of medical school graduates choosing primary care careers.medical education postgraduate training specialty choice residency choice

Debt, Moonlighting, and Career Decisions Among Internal Medicine Residents.

In the study reported here, medical residents were surveyed to determine their patterns of educational indebtedness, the effects of debt on their decisions about training and career, the frequency with which they begin making loan payments during training, the extent to which they moonlight and the reasons for doing so, and their opinions about the effects of moonlighting on house staff training. A total of 223 residents from four residency programs were surveyed; 181 responded. Most (86 percent) had educational debt (mean = $20,500), and more than half of those with debt were making loan payments. Forty percent of the residents moonlighted, and moonlighting was related to the presence of educational debt, monthly loan payments, and number of dependents