literature

work-life

Learning - 2

Journal clubs are a longstanding tradition in residency training, dating back to William Osler in 1875. The original goal of the journal club in Osler’s day was to share expensive texts and to review literature as a group. Over time, the...

Journal Club: How to Build One and Why

Professional Dev 5

When we become obsessed with finding the right answer, at the risk of oversimplifying the richly iterative and evolutionary nature of clinical reasoning, the result is the very antithesis of humanistic, individualized patient-centered care.

Tolerating Uncertainty — The Next Medical Revolution?

Teaching - 4

Despite the hours spent gaining medical knowledge and skills training, chances are that little time was spent preparing you to teach. Yet, on day one you will be expected to do just that. So, how do you prepare for this role?...

The Resident as Teacher

Student Corner - 2

The moment has arrived…it’s time to leave the lecture hall and learn how to take care of patients. Are you worried that you won’t know enough during teaching rounds or have time to see your friends and family? This article offers advice and practical tips on getting the most out...

Preparing for Clinical Clerkship

Learning

Learning - 1

As an internal medicine resident, your days are filled with morning rounds, daily progress notes, admission order sets, and procedures. So, when do you have time to continue to learn and keep up with medical research? ...

Keeping Up with the Medical Literature

Student Corner

Student Corner - 1

For many medical students, choosing a specialty is one of the most challenging aspects of medical school. Although many medical schools are expanding third-year exposure to different specialties to include more time in clinical rotations and a wider variety of experiences,...

Family Medicine, Rad Onc, or OB? How to Choose a Specialty

Professional Dev 2

Most physicians remember the day they discovered where they would spend the next several years in residency training. Many also remember the moment elation gave way to reality as they began to calculate the cost of living and loans (averaging nearly $200,000) and realize it was more than their future...

Valuing the Resident Physician: Advocating for Change

Student Corner - 5

After many long nights huddled over textbooks, agonizing over the brachial plexus, committing childhood exanthems to memory, and making surgical knots of any loose fiber within arm’s reach, you have finally received the news of a lifetime: You’re accepted to a...

Prepping for PGY-1

Professional Dev 3a

The last time you stepped inside an operating room may have been the third year of medical school, but during residency you will care for many patients who require surgery, either electively or emergently. Calling a surgical consult can be daunting or intimidating, especially if the problem or situation is...

Advice for Calling a Surgical Consult

Student Corner - 4

The medical profession in the U.S. has a remarkable international flair. One in four U.S. physicians is an international medical graduate (IMG), and every year around 12,000 IMGs apply for U.S. residency positions. But the path to practicing in the U.S. is not an easy one when you must navigate...

Applying for Residency as an International Medical Graduate

Professional Dev - 3b

Should residents have end-of-life conversations with patients or should they be left to the attending physician? Columbia University’s Dr. Craig Blinderman provides guidance and resources. 

Residents’ Roles in End-of-Life Care Discussions 

Learning - 4

Figure 1 Applying for fellowships is a stressful process. It not only involves making major decisions that will impact your life but it also requires creating a competitive application and preparing for high-stakes interviews, all while you are still fulfilling your responsibilities as a resident. NEJM Resident 360 hosted a...

Applying for Fellowship: What You Need to Know

Professional Development

<h3>Patient Communication</h3>
Rachel M. Taliercio, DO
Concepts to help you enhance your communication skills and navigate through difficult conversations
The following topics are addressed in this guide:
The Medical Interview and Building Rapport Shared Decision Making Communication Challenges and Health Literacy Delivering Bad News Error Disclosure Communicating with Family Members and Caregivers Communicating with Colleagues and Medical Teams

Professional Dev 1

Teaching - 3

Feedback is defined as information describing an individual’s performance in a given activity that is intended to guide their future performance. Medical trainees are becoming increasingly aware that feedback is a critical component of clinical training. In a two-part series on improving formal feedback exchanges, we will focus on the...

Improving Feedback Exchanges with Residents: Can You Hear Me Now?

Teaching

Teaching - 1

In the first part of this series, Improving Feedback Exchanges with Residents: Can You Hear Me Now? , we reviewed basic knowledge and skills related to feedback exchanges in medical training. We defined the difference between feedback and assessment, highlighted the key components of high-quality feedback, identified barriers to feedback...

How to Receive and Deliver High-Quality Feedback

Teaching - 2

Although every resident develops his or her own style for each of these roles, the following practical strategies were discussed in a NEJM Resident 360 discussion (How to Lead a Team on the Wards: The Art to Being an Effective Resident).

The Art of Leading with the Right Balance as a Senior Resident

Professional Dev 4

Residents who wish to become pregnant often face limited options for adjusting their schedules without interrupting their careers. This status quo reflects a need for structural and cultural change.

Pregnancy and Residency — Overdue for Equity


Research - 2a

All residents have at least one scholarly requirement and it is in your best interest to find out exactly what that requirement is before you are up to your elbows in ICU cases. Nairmeen Haller, PhD, Director of Research at Cleveland Clinic...

Introduction to Research in Residency

Career - 3

Dr. Julie Freischlag from UC Davis offers advice on how to prepare to negotiate that first job contract.

Tips on How to Negotiate a Contract

Personal

Personal - 1

Whether you are a student, resident, or faculty member, no doubt you have attended obligatory talks on well-being and burnout. The attention to high rates of burnout in the U.S. health care workforce, and its unsurprising increase during the pandemic , has been beneficial, but concerns have been raised that...

It’s OK to Not Be OK

Personal - 3

Indiana University Medical School's Jose Rivera Espada provides guidance on how to manage your medical school debt during residency.

Managing Medical School Debt

Career - 2

Perspective

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In this Graphic Perspective, a medical student gets a taste of the life of an oldfashioned country doctor — the simplicity, the deep human connections … and the threat of extinction, as corporate medicine makes inroads into rural areas.

The Catfish King

It’s Dr. C.’s first weekend taking calls at her new hospital, only weeks after graduating from residency. When called in for a patient with laryngeal cancer, she’s suddenly disorientingly aware that she’s in charge now. Does she have what it takes?

Breathe

The debate about changing the scoring system for the USMLE Step 1 exam is both a manifestation of dysfunction in the medical education pathway and an opportunity to address this dysfunction.

A Shared Evaluation Platform for Medical Training

A 32-year-old transgender man, presenting with severe lower abdominal pain and hypertension, is classified as a man who hasn’t taken his blood-pressure medications. When examined several hours later, he’s found to be pregnant, but no fetal heartbeat can be detected.

The Power and Limits of Classification — A 32-Year-Old Man with Abdominal Pain

After a stillbirth, a California woman with an opioid use disorder hears clinicians questioning her fitness for reproduction. During a cesarean delivery, a Romani woman in Czechoslovakia is unwittingly sterilized. What can be done to correct such reproductive injustice?

Reproductive (In)justice

After an uninsured Puerto Rican man with back pain, other chronic conditions, and a history of incarceration admits to a doctor at a free clinic that he’s bought oxycodone illegally, he refrains from filling his prescription or returning to the clinic, fearing rearrest.

The Structural Violence of Hyperincarceration

The parents of a deaf boy in India are advised to get him a cochlear implant so he can live a “normal” life. When they can’t afford to maintain the device, he’s left with little ability to communicate. How can the concept of “multiple normals” improve clinical practice?

Embracing Multiple Normals

A woman on Chicago’s primarily black South Side is seen for a breast lump at a community hospital that lacks the resources for high-quality cancer care. A navigator from the Metropolitan Chicago Breast Cancer Task Force reroutes her to a qualified medical center.

Structural Racism — A 60-Year-Old Black Woman with Breast Cancer

Sent to a psychiatrist because of aggressive behavior and social withdrawal, a Brazilian teenager is empowered by the doctor’s dialogic approach and addresses his anger and anxiety by working on the school council to change the conditions that led to his symptoms.

Dialogic Praxis

Aside from the obvious moral issues associated with mistreatment of and job discrimination against women physicians, such behaviors can ultimately result in a loss of talent in biomedical science and worse clinical outcomes for patients.

Lost Taussigs

The Case Studies in Social Medicine demonstrate that when physicians use only biologic or individual behavioral interventions to treat diseases that stem from or are exacerbated by social factors, we risk harming the patients we seek to serve.

Misdiagnosis, Mistreatment, and Harm — When Medical Care Ignores Social Forces

The full health implications of the climate crisis may be more immense and insidious than we have imagined. Although dedicated climate and health research is needed, this gap can be addressed more rapidly by adding a climatechange lens to existing lines of research.

The Climate Crisis and Clinical Practice

A man with multiple mental health conditions stops attending the clinic where he received wrap-around services. Denied Supplemental Security Income because his psychiatrist had documented his improvement, he had ceased taking his...

Biological Citizenship

By all objective indicators, I should have been unhappy in those grueling months I spent as a medical house officer. But the hospital pub offered an egalitarian escape where I could unload — and learn more medicine than in all the grand rounds I’ve ever attended.

The Den

The “what” questions stressed in medical education are not as absorbing — and their answers not as gratifying — as “why” questions. Tweetorials provide a tool for physicians who aim to rekindle and stimulate curiosity about pathophysiology and mechanisms of disease.

Why Is a Cow?

Before Joe, a psychiatry resident, was killed, distinguishing between work born of love and that born of duty was his life’s theme. His struggle to practice medicine in a way that was meaningful to him may offer one antidote to the spiritual crisis of physician burnout.

All In

A 66-year-old man with PSA-detected prostate cancer undergoes prostatectomy that leaves him impotent — a decision he regrets when new evidence becomes available. How can the largely social processes by which we identify diseases transform diseases themselves?

Contingent Knowledge and Looping Effects

The consequences of climate change directly affect human health, the practice of medicine, and the stability of health care systems. This Interactive Perspective elucidates these effects and some approaches to mitigating them. In this new feature, clinicians will find the...

The Climate Crisis — Health and Care Delivery

Research

Research - 1

Quality improvement (QI) is a disciplined effort to make healthcare delivery safer, more effective, patient-centered, timely, equitable, and efficient (less wasteful). These six domains were established by the National Academy of Medicine in 1999 as the tenets of... ...

What Is Quality Improvement?

Student Corner - 3

Applying to residency can be an arduous process, both emotionally and financially. To best manage this complex endeavor, it is important to be systematic and thoughtful.

Applying to Residency

Personal - 4

Welcome new doctors! Yesterday you were medical students and today you are physicians! What a scary feeling. Remember that everyone shares similar concerns and fears as they start their residency and wants to succeed. Getting into residency is the beginning of an incredible journey. Savor it, relax, enjoy the ride,...

Surviving the First Month as a Doctor: Advice from the Community

Learning - 3

When most people think of librarians, they picture the stereotypical older woman with glasses and a bun who shushes them for talking too loudly. In the past, librarians were the keepers of information but have now evolved to become navigators of...

How to Take Advantage of Your Medical Librarian

Personal - 2

When you dedicate years to studying and practicing medicine, you learn that certain steps are required to maintain good health and prevent illness and disease. However, the concept of systematically and proactively cultivating good habits applies to many aspects of life,...

Five Steps to Improve Your Financial Health in Residency

Career

Career - 1

The New England Journal of Medicine invites applications from physicians at any career stage for a one-year, full-time, paid editorial fellowship beginning in July 2025. Several fellows will be selected for the 2025–26 year; applications are due by August 1, 2024. Learn more about the NEJM editorial fellowship and how...

The NEJM Editorial Fellowship

Research - 2b

For many medical trainees, transitioning from having a question for a research project to taking the next steps is difficult. Finding an appropriate mentor, getting ethics approval, collecting data, performing analyses, and writing up a project for publication are particularly hard when added to the pressures and stresses of medical...

Once You’ve Found the Question: How to Take the Next Steps in Research

Career - 4

Dr. Carol McLaughlin, director of the Global Health Equities Track in the internal medicine residency program at the University of Pennsylvania, writes about what it takes to pursue a career in global health and how can you plan for it during residency.