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Rounds to Residency (from MedSchoolCoach)


Aug 6, 2020

Chase DiMarco chats with Dr. Bradley Block, who is an ear, nose and throat (ENT) specialist based out of New York and host of the Physician’s Guide to Doctoring podcast which covers “everything doctors should have been learning when they were busy learning the Krebs cycle.” Speaking from the perspective of an attending physician who has mentored many residents, Brad breaks down the experience of being an ENT resident, common struggles, and tips to become a better ENT. 

 

[01:21] Brad’s Most Outrageous Observation in Academic Medicine

[04:29] Brad’s Background

[08:41] Common Struggles of ENT residents

[13:13] Tips for Residents

[19:19] Important Learning Experiences for ENT Residents

[22:28] Brad’s Biggest Desired Change in Medicine in the Next 5-10 Years

[28:18] Further Resources

 

In terms of the struggles of ENT residents, the first is that learning how to treat ears is very difficult. It takes considerable skill to learn how to tell the difference between a healthy versus infected eardrum, for example. This is especially difficult when dealing with children, who are a large proportion of patients, because children tend to wriggle, and have very small ears making diagnosing ear infections even more tricky. One tip to overcome this is to practice detecting ear infections in adults first, which will make it easier when you have to treat children. Another struggle is determining where you are in your educational journey. There are three stages to become a successful ENT:

1. Becoming an effective information collector
2. Arriving at diagnoses
3. Making management decisions.

Perfecting the first stage involves learning how to only focus on important information, and leaving out irrelevant facts about the patient. Perfecting the second stage involves learning how to use the facts to arrive at a diagnosis. And the third stage involves thinking about how to further treat the patient. For example, should you perform further tests? Should you prescribe a particular drug? Only by developing an awareness of where you stand amongst the three ENT learning stages can you take steps to move on to the next.

 

Brad's advice for otolaryngology residents in particular, is to dive into surgery, which is often the most difficult set of skills to learn as an ENT. Honing these skills can be key to becoming a successful otolaryngologist. By diving into surgery, the attending physicians become more comfortable with you, you get more skilled, and in turn the attending physicians become even more comfortable with you. A feedback loop. For medical students, those preparing for residency & residents more generally, Brad urges them to improve their soft skills such as how to interact with patients, getting the patient information that is relevant to a diagnosis, cultivating a good relationship with your preceptor etc. Brad also urges humility, and a willingness to listen, learn and improve. He recalls being defensive when people advised and criticized him earlier in his career — and strongly advises against this. 

 

When asked about the biggest change that he would like to see in medicine in the next five to ten years, Brad emphasized that education should be evidence-based. Instead of urging students towards the rote memorization of facts, Brad proposes a different approach: 1. determine the definition of a “good” doctor and 2. develop materials that help students to achieve this definition. For example, teaching them how to interact with patients, how to be aware of their potential biases towards patients from a given socio-economic background, and how to become more effective and efficient learners all around. 


Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do also check out Dr. Bradley Block’s podcast, The Physician’s Guide to Doctoring.