"Each year, medical students across the country prepare to start the long-anticipated core clinical rotations. Suddenly, we’re thrust into a world of constant adaptation and evaluation, with many highs and many lows.

As I finish up the year and new students get ready to start, I’ve been asked time and time again for my advice. I decided to aggregate my key takeaways from the year, and what I wish I had been told."

Netana Markovitz is a medical student.

She shares her story and discusses her KevinMD article, "13 tips for medical students starting their clinical rotations." (https://www.kevinmd.com/blog/2020/09/13-tips-for-medical-students-starting-their-clinical-rotations.html)

"We in medicine are experts in delayed gratification. We’ve been in school for what, about 21 years before residency? Then we finally become an attending.  Then we can splurge a little. But still, we were told to hold back. Live like a resident.

This is a great skill to have as an entrepreneur. Their world is tough. Countless working hours, low pay, myriad emotions, and a light at the end of the tunnel. Sounds just like residency, right?

Now I know the idea of doing another residency doesn’t sound that great, but it’s possible. You’ve already survived one. Many even more than one or a fellowship. You have the power to do another if you wanted."

Pranay Parikh is a hospitalist and can be reached at his self-titled site, Pranay Parikh.

He shares his story and discusses his KevinMD articles, "Doctors make bad entrepreneurs" (https://www.kevinmd.com/blog/2020/09/doctors-make-bad-entrepreneurs.html) and "Doctors make great entrepreneurs." (https://www.kevinmd.com/blog/2020/09/doctors-make-great-entrepreneurs.html)

"What has become of medicine today? What has become of the sacred patient-physician relationship? What has become of medical offices- aren’t they supposed to be healing places? Who goes to a medical clinic (no matter how Big the Name) to be insulted and diminished and hurt? What has become of physicians as stewards of healing?

Why is this happening to us?

How much have we been hurt, as doctors, to not be able to see past our own ego and agenda and use our hard-earned healing potential to harm instead of soothe and heal?"

Corina Fratila is an endocrinologist.

She shares her story and discusses her KevinMD article, "Are physicians the stewards of healing that they are meant to be?" (https://www.kevinmd.com/blog/2020/10/are-physicians-the-stewards-of-healing-that-they-are-meant-to-be.html)

"I plan to reach out to climate organizations and see what I can do to get involved. Whether that means writing more op-eds like this one or writing to legislators, I now recognize that as part of the medical field, especially in regard to mental health, I have a role to play. I invite all of you in the medical field to join me in this effort.

You can hear the rumblings in certain pockets that, just like with gun control, medicine should stay in its lane and not be involved in issues like climate advocacy. That’s simply not a tenable stance. With a warming planet and without action, the human population will simply get sicker. That stands in direct conflict with our oath to “Do no harm.”

So again, get involved with the climate movement in the best way you know how. Our patients’ and future patients’ lives are on the line."

Derek Wolfe is a medical student.

He shares his story and discusses his KevinMD article, "Dear medical community, it’s time to engage in the climate movement." (https://www.kevinmd.com/blog/2020/09/dear-medical-community-its-time-to-engage-in-the-climate-movement.html)

"We must continue to work to create gender equity as here is where we stand today: A significant gender pay gap still exists in medicine where women doctors earn up to 33% less than their male counterparts. Even though women make up 36% of practicing doctors in the country, only 15% of women doctors are department chairs. Among women doctors who are also mothers, 78% felt discrimination. All of this is leading to 48% of women doctors reporting burnout, and 22% of female physicians admitted thoughts of suicide this year right before the pandemic hit our shores.

As a nation, we cannot afford to lose doctors to professional burnout and suicide, especially in the midst of a global pandemic worsening and hitting record numbers throughout our country in recent weeks."

Archana Reddy Shrestha is a physician life coach, author, and co-founder, Women in White Coats. She can be reached on Instagram @womeninwhitecoatsblog.

She shares her story and discusses her KevinMD article, "What Kamala Harris means for women doctors." (https://www.kevinmd.com/blog/2020/11/what-kamala-harris-means-for-women-doctors.html)

"I recently represented a physician in a noteworthy peer review case at an academic medical center. The medical staff president initiated a complaint against a surgeon, who would later become my client. The complaint was that the surgeon inappropriately collected cash payment from an uninsured patient at the hospital’s point of service instead of having his office invoice and collect payment from the patient. The medical staff felt this was unorthodox and highly inappropriate and contra to the medical center’s values. It is important to note that neither the medical staff bylaws nor any hospital rules addressed the collection of payment at the hospital’s point of service. The medical staff president quickly appointed a three-member ad hoc investigation committee, which included one of the surgeon’s competitors, an obvious conflict of interest. The ad hoc investigation committee recommended that the surgeon be disciplined, i.e., lose his medical staff privileges."

Barney Cohen is a health care law attorney.

He shares his story and discusses his KevinMD article, "How this surgeon beat a medical staff disciplinary action." (https://www.kevinmd.com/blog/2020/12/how-this-surgeon-beat-a-medical-staff-disciplinary-action.html)

"The COVID-19 pandemic has exacerbated factors that cause violence in the workplace. At no time in recent history will you find clinical health care workers under this degree of stress. Physicians and nurses are operating under high alert in hospitals and clinics while facing COVID deniers and abusive treatment (name-calling such as “disease spreaders”) in their day-to-day life. Due to social distancing measures, shutdowns, and resultant economic fallout, patients are experiencing significant psychological and financial burdens. The politicization of the pandemic has elevated the level of difficulty for all parties.

This combination of clinical and societal strain increases the likelihood of overly (and overtly) aggressive or unpredictable reactions to day to day encounters."

Mercy Udoji is an anesthesiologist.

She shares her story and discusses her KevinMD article, "When an epidemic of violence against health care workers meets a pandemic." (https://www.kevinmd.com/blog/2020/09/when-an-epidemic-of-violence-against-health-care-workers-meets-a-pandemic.html)

"As soon as I realized we had so few Black residents, I began to ask around to find out if there were reasons why. One person brought up the fact that we happen to be the smaller institution between 3 other larger universities within an hour away and even bigger world-class institutions just 6 hours away. So, there is always a chance that Black residents may be choosing to go to more urban and populous cities for more job opportunities and networking. Another attending explained that the county we are in is in the top ten most populous counties in all of the United States, but Black or African Americans make up only 1.7% of the demographics. There are some odds that black applicants may not have family close enough for support and choose to go elsewhere. But despite these potential reasons, even though our county’s demographic makeup is admittedly small, it’s still better than our institution’s hiring rate."

Karen Tran-Harding is a radiologist who blogs at How the Other Side Thinks.

She shares her story and discusses her KevinMD article, "When your institution has a less than 1% hiring rate for Black residents." (https://www.kevinmd.com/blog/2020/12/when-your-institution-has-a-less-than-1-hiring-rate-for-black-residents.html)

"Researchers should make clinical trials more accessible by providing patients with simple explanations of studies at a variety of locations, including community clinics and medical centers. Increased flexibility regarding transportation and visit timing is essential. Researchers should also allow the participation of people who do not speak English and those living with chronic conditions whenever it is safe to do so. If the treatment will be approved to use on these populations, it is unethical to exclude them. These are considerations that researchers must think about not only when designing COVID-19 studies, but all clinical trials, as this is essential to reducing health care disparities overall. Moving forward, we must put fairness and our patients’ safety above increased cost or administrative burden; perhaps this is how we begin to make amends for the atrocities of the past."

Amelia Trant is a medical student. Andrea Silber is an oncologist.

They share their stories and discuss their KevinMD article, "Medicine must create inclusive clinical trials." (https://www.kevinmd.com/blog/2020/09/medicine-must-create-inclusive-clinical-trials.html)

"I am thankful to you SARS-CoV-2 virus as you allowed me to be human again, to make mistakes, and learn from them. You taught me to slow down so that I could reset and redefine my goals. You allowed me to have time for myself, to dream again, and plan my future. You pushed me out of my comfort zone and re-explore what I thought was possible or impossible. You helped me re-embrace my imperfections and love myself just the way I am! You showed me that this pandemic is a circumstance beyond my control and that there will many more circumstances, such as this one in life. However, what will always remain within my control or reach is my own thoughts about, and reaction to, such times. It is up to me now how I want to re-shape them to get to the results I want to see. Thank you, COVID-19, for being a great teacher. I respect you. I am not afraid of you but will always be cautious of you."

Annie Nawab is a pulmonary and critical care physician.

She shares her story and discusses her KevinMD article, "Beyond the medical lessons learned from COVID." (https://www.kevinmd.com/blog/2020/09/beyond-the-medical-lessons-learned-from-covid.html)