The Real WebbMD Profile picture
Feb 7 6 tweets 2 min read
I don't know who on #MedStudentTwitter needs to hear this, but Step 1 is not the High Jump. A high score doesn't win, and a low score doesn't eliminate you from contention; it doesn't determine how good of a doctor you will be, and it certainly doesn't determine your worth.
It's not really a competition at all, but if you need a track and field analogy it's more like that weird water obstacle in the Steeplechase.

You might leap right over it. You might stumble. You might fall face first with an embarrassing splash and get trampled a bit like I did.
But all that matters is that you get over it somehow; and then you can keep running. If you really stumble it might mean you have some catching up to do, but the nice thing about this- compared to the real Steeplechase- is that finishing is the goal, not beating anybody else.
At best, it's a proxy for your medical knowledge; in reality, it's measure of how much you studied for that test, how good you are at test taking, and all sorts of other privileges and advantages that go along with succeeding at standardized testing.
What it can't measure is your clinical reasoning, your empathy, your dedication to your patients, your cultural, professional, and personal humility- all the things that will make you a great doctor.
You have to get past it; there's no way around that, just like in the Steeplechase. So by all means study hard during your dedicated prep time.

But I'm begging you; please don't attach ANY of your self-worth, as a person or as a physician, to that score.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with The Real WebbMD

The Real WebbMD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @tjwebbmd

Feb 7
"Live like a resident for a few years so you can pay off your debt" appears to be a bit of a controversy right now.

I finished college with $0 in debt and about $1,000 in savings. By the end of residency in 2016, my med school loans had grown to $470,000.
2/ My living like a resident included a lot of awesome factors. I was married; we had 2 children and an awesome dog we had adopted in med school. We had a reliable baby sitter and went on dates semi-regularly. We had a little rent house that was fairly priced. We had two cars.
3/ If we had continued on my resident salary- or given ourselves a 50% raise- and used the rest of my new income to pay loans, we would have been able to pay off my med school debt in about 5-6 years.

That does sound really nice, but I don't think it would have been sustainable.
Read 24 tweets
Feb 6
There's this theory that "capitalism breeds innovation," so our healthcare system must be improved and advanced by the competition of private insurers.

It fails because it doesn't account for the fact that all innovation of insurance companies is directed at increasing profits.
2/ Under our current model, there is no incentive- none at all- for insurance companies to innovate in the direction of improving peoples' health; not the health of their clients, and certainly not the health of others in our society.
3/ In most industries, if you get poor service or have deeply negative experiences with one company, you try a competitor. You can typically do it right away, even with other forms of insurance; I can switch from Geico to Allstate tomorrow if I want to.
Read 14 tweets
Feb 5
Thinking about the attending physician that once told me I was taking too long on informed consent with patients. "It's good to be thorough, but sometimes you just need to get the form signed and go."

Miss me with that for a million years.

#MedTwitter #MedEd
2/ A robust informed consent process prior to a treatment or procedure is not a "stretch goal" if we have enough time. It's not even the highest ideal of patient autonomy; it's the barest essential, the last line of defense that keeps medical care from becoming medical violence.
3/ In ideal patient care, everything is informed consent; just with other things tacked on to it. The goal of an office visit is to listen well, diagnose, explain, and reach a shared plan; it's just informed consent with a differential diagnosis and branching treatment paths.
Read 8 tweets
Jan 22
A 🧵 on white privilege, and the way it operates on your behalf without you ever even needing to think about it.

We travelled to a small family gathering for Christmas; it was about a 13 hour drive. On the way home, our youngest, 2, began to feel sick and then to run a fever.
2/ (He's fine, by the way. It wasn't COVID; more likely RSV).

We still had 7 hours left and it was late, so we decided to get a hotel for the night. We looked at the map and booked a hotel room in the next town on our route; a random town in rural Missouri we had never visited.
3/ We arrived around 9 PM and got everyone settled in (we have 4 kids; it takes a while). The 2 yo's fever began to climb despite the tylenol we had given him earlier, and he's our child that spikes VERY high fevers when he gets sick. Like a dummy I hadn't packed ibuprofen.
Read 15 tweets
Jan 20
About 6 years ago a patient told me they picked up their medication after our last visit, even though it cost over $200 and they had to borrow money from family to afford it.

The medicine was extended-release Nifedipine. It should have cost about $14.
The patient told me, with some hesitation or reluctance, "I'd like to switch to something less expensive if possible. I know you have to make your money somehow, but I just can't afford this medicine."
I'm not sure how it happened. I probably selected the brand name instead of the generic in the EHR by mistake. And then the pharmacy, by design or just not catching the error, failed to offer a cheaper generic equivalent.
Read 9 tweets
Dec 14, 2021
@kidney_boy I'm the resident you're talking about here, sir; the very one. The one who stayed late, blew by duty hours, volunteered for the admission or the procedure; the one who covered his peers' shifts.

The thing you are missing is that I didn't make those choices, I had those choices.
@kidney_boy My spouse is an RN; we had talked this through together and had decided that's how those 3 years of residency were going to be for us. It was what we wanted, because we knew it was temporary and because I wanted every last ounce of training I could get out of those years.
@kidney_boy It was hard, but she chose to stay home so that I could do that, and I couldn't have if she hadn't been paying the bills, managing our meager finances, caring for our children, fixing our house, and creating insane amounts of margin for me to be able to be that kind of resident.
Read 12 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

:(