My residency, split between a public hospital and private hospital in NYC, just blocks apart, has been as much an education in American inequality as it’s been about the “core curriculum” of internal medicine.
When this is the foundation of your training, you implicitly learn who looks like a “public” patient and who looks like a “private” patient. (Except insert hospital names.) It ends up being exactly as racist as you would expect.
After you realize this, you then quickly realize that these institutions do not want you saying this out loud, even though it’s painfully obvious. You’re instead supposed to praise the private institution for sending some resources to the public one.
And we usually fall in line and don’t say anything because we need jobs at these places and we are trained in medicine to be very, very careful before you upset anyone above you in the hierarchy.
PS - I’m describing my residency, which has had wonderful training in internal medicine and many other things. Your residency may also be an education in American inequality if you look around. It’s everywhere in our health system 👀
PPS - many other programs have "resident clinic" and "faculty clinic." Patients without insurance or with medicaid are seen by inexperienced resident trainees, while privately insured patients see more experienced attending physicians
You can follow @colleenmfarrell.
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