Much to ponder...

As my MSTP training life comes to an end, in favor of a new chapter training in Ob/Gyn in Philadelphia, there remains unfinished business, unwritten reflections. Here's a list with brief abstracts. I hope to expand on each:

1. USMLE Step 1 - why is it so hard, so feared? In many ways, it's like an intense, fast-paced language immersion program, where you have to learn the language without the why or always the precise "how." It's a way to lay out the foundations needed to start learning medicine as it is practices. It requires one to learn the foundations and science of medicine without any of the art. How frustrating and challenging. Along these lines: how do we *define* the stages of training? Should the learning objectives, and the comparisons and contrasts between and among stages of training be better defined? e.g. should medical students not simply be told to, "understand the pathophysiology, treatment, and prognosis" of a disease, but also being given the caveat that, "you will not be able, nor should you be expected to, manage X disease clinically; in this phase you are to learn to recognize and understand the core principles of the disease."

2. Philadelphia abortion doctor found guilty of murder, having killed neonates after botched late-term abortions. Ugh.

3. Career decisions in medicine: how to separate the forest from the trees, and stop listening to advice from people who shouldn't be giving it.

4. Deeply understanding the role of healthcare providers -- why isn't this better emphasized in medical training?

5. Shout out to my Ph.D. mentor, newly-elected member of the National Academy of Sciences.

6. Deep gratitude for my teachers and mentors at the UCLA David Geffen School of Medicine and the MSTP.

7. Deep gratitude for my undergraduate education at Pomona College, and it's enduring lessons and skills taught.

8. Even while medical schools are emphasizing the success of humanities-majors-turned-physicians, should we be dismissing the value of a rigorous scientific education and how it can play a role in medicine? Has science become the "S" word in medical education? Part of the burden falls on scientists, who need to learn to be more art- and humanity-minded. It's on us, too.