Students & Residents

Here you will find blog posts by medical students, residents and their advisors exploring a career in hospital medicine. To learn more about what SHM offers students and residents, visit: www.hospitalmedicine.org/students or www.hospitalmedicine.org/residents.

VISTA: The Future of Hospital Medicine Is in Healthcare Delivery Sciences

Eleven years ago, I remember being a junior faculty member attending the first “Quality Fair” at the University of Chicago, and presenting my work among roughly 20 posters on how to measure quality for hospitalized older patients. While I am proud to say this poster actually won an award, I am also embarrassed to say that I did not improve anything. That is perhaps where the state of the science was; we were still talking about how to measure quality and where the safety problems were as opposed to the science of actually improving it. Fast forward, this past week, I attended the 11th annual University of Chicago Medicine’s Quality and Safety Symposium. Over 120 posters were presented on a wide range of innovations, including how to improve patient transport times, predict the next heart attack in the community, as well as proactively screen patients before they develop hospital-acquired infections.…

Reflections on Palliative Care: Clinging to Life

by Dr. Allison Schneider
By Dr. Allison Schneider My first day on the Palliative Care service ended with me in a heap on my couch sobbing into my husband’s shoulder. That day I attended family meetings for two patients in their 40s dying of cancer and leaving young kids behind. I also sat at the bedside with the mother of a young man dying of AIDS. As a fourth year medical student, I had experienced hard days; that day was one of the hardest. Yet, it was also beautiful. The interdisciplinary palliative care team navigated each conversation with inspiring empathy and grace. They worked together seamlessly to support and honor the goals of each patient and their families. The team also made it a priority to support each other. Through frequent check-ins, debriefs and formal talks about self-care, the rotation created a truly safe space to express and work through the raw emotion that…
Dr. Allison Schneider grew up in Washington, D.C., and received a BA in Public Policy and American Institutions from Brown University. She then worked for the Kaiser Family Foundation Commission on Medicaid and the Uninsured prior to entering medical school at the University of California, San Francisco. She graduated this month and will be starting her residency training in Obstetrics and Gynecology at Kaiser Oakland Medical Center in July.

Getting Permission to Die

by Rachel Deming
by Rachel Deming When I first met Ms. G. she told me she was in such pain that she wanted to die. She had a nice life, a full life, and her pain was just unbearable, she told me. "I have to stay strong for my children, however," she said. "They want to see me, so I have to keep fighting, keep bearing this pain for them." Over the next week, I saw Ms. G. many more times. Sometimes she was in good spirits, and other times she would cry in pain, pleading to make it stop. One afternoon when she was feeling better, she asked if she could tell me her story. She told me that she had a great story, a story that was worth sharing. She grew up in the Philippines; as a young woman she worked at the U.S. air force base as a cleaner. While…
Rachel Deming is a fourth year medical student at University of California, San Francisco School of Medicine. She has a B.A. in Human Biology from Stanford University. Before applying to medical school, she taught high school science in Oakland, CA. Rachel is currently applying for pediatric residency programs  for next year, and has a special interest in palliative care, as well as medical education.

Single Payer Healthcare in the US? What?

by Dr. Douglas Mitchell MD, MBA
by Dr. Douglas Mitchell MD, MBA  On January 10, 2014 the state of Maryland announced a new approach to hospital payments that would radically alter how healthcare is delivered in the state. Hospitals would no longer be incentivized to generate more volume but would instead be rewarded for keeping people out the hospital. Uwe Reinhardt, a health care economist at Princeton University said "This is without any question the boldest proposal in the United States in the last half century to grab the problem of cost growth by the horns." Understanding healthcare reform efforts in Maryland requires a little bit of wonkiness but components of the Maryland plan will likely become part of national healthcare reform efforts. Like all change there are opportunities for people to excel in the new system, and in order to excel hospitalists need to adapt intelligently to the new environment. A Little History for Context:…
Dr. Douglas Mitchell MD, MBA is CEO and a founding partner of Physicians Inpatient Care Specialists (MDICS). He began working as a hospitalist in 1998 at Anne Arundel Medical Center in Annapolis, Maryland. While at AAMC he became the lead hospitalist and grew the program from four FTEs to over twenty FTEs, started a surgical hospitalist program, and became president of the medical staff. In 2007 he started at private hospitalist group at Anne Arundel Medical Center – Physicians Inpatient Care Specialists or MDICS. Since 2007 MDICS has grown to over 300 providers contracted to provide hospitalist services in sixteen hospitals and to provide geriatric services in over 45 skilled nursing facilities. He spends free time gardening, growing berries, and keeping bees. He also enjoys puttering around the house and trying not to hurt himself with power tools.

Student Resolutions for the New Year

by Dr. Hyung (Harry) Cho
by Dr. Harry Cho As we ring in the New Year, the medical students in our new Student High Value Care Committee (sHVC) have three wishes. They spent quite a bit of time doing research, reviewing evidence and guidelines like Choosing Wisely and our own, Things We Do For No Reason. [caption id="attachment_14088" align="alignleft" width="300"] The Student High Value Care Pitch Day.[/caption] The amazing thing about students is that they haven’t yet conformed to our standards of medicine. They are learning more about what could be, and not what is. An air of innocence surrounds them, as they attend lectures, read textbooks and examine literature with the purest of intentions. If anything doesn’t make sense, they speak out with honesty. So in the spirit of #ThingsWeDoForNoReason, they showcased their honesty with these three wishes in front of our faculty, staff, and fellow classmates during our sHVC “Pitch Day” at Icahn…
Dr. Hyung (Harry) Cho is the Director of Quality and Patient Safety for the Division of Hospital Medicine at Mount Sinai Hospital. He is also the Chair of the High Value Care Committee where he develops innovations to decrease unnecessary medical testing and treatment. His primary research focus is in the relationship of overuse and patient harm, as well as in high value care education and implementation. Since 2011 he has been an academic hospitalist at Icahn School of Medicine, Mount Sinai Hospital. He was selected as the Clinical Quality Fellow for the Greater New York Hospital Association and United Hospital Fund, and as the Senior Fellow for the Lown Institute. His efforts in value improvement have received many awards and recognition, including the Choosing Wisely Case Study Award from Society of Hospital Medicine. You can follow Dr. Cho on Twitter @HyungChoMD.
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