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Q. Do medical schools take into consideration your institution while looking at your undergraduate GPA? Will going to a grade-deflated school hurt my chances of getting into medical school?A. In general, medical school acceptance hinges on how high your MCAT score and undergraduate GPA are. High GPA is valued, regardless of your school or your major. Passing the first hurdle, other qualities make a difference of your gaining admission into a top tier medical school.If your GPA is in the lower range, allowance is made for the prestige of your undergraduate institution, the challenge of your major and whether there is known grade “deflation.” Even Princeton University reversed course. In 2014, the university made the decision to end grade deflation which had hindered the prospect of many graduates in past years.What can you do if you happen to be an engineering major in a school with serious grade deflation? Score extremely well on the MCAT!What is different about medical school admission compared to law school, business school and undergraduate admissions?Medical school ranking matters little in the medical field. US News Rankings do not make or break a school’s reputation. There is no consensus as to the actual order of the top schools. There is vague reputation as being the top 25, but no order. Schools do not have to worry about having the highest GPA, highest MCAT, lowest acceptance rate, highest yield so that the rank moves up a few notches. There is not even a recognized ranking of top schools. There is a ranking of schools with the highest NIH research funding, and a ranking of best schools in primary care. Both lists matter little in the opinion of those in medicine.Does the reputation of the medical schools matter in the career of graduates, like in law where graduates from Yale or Harvard dominate court clerkships and the Supreme Court bench? Medicine is a bit more complicated. The goal of every physician is to become board certified in a specialty of his/her own choosing. Schools are not strong across all disciplines. The Department of Surgery may be top tier, but the Department of Medicine may not be. The Department of Anesthesiology may be on probation, in part because of the supremacy of the Department of Surgery, causing difficulty in recruiting top quality Anesthesiology Staff. And even in the Department of Surgery, the Division of Plastic Surgery may be top tier, but the Division of Cardiothoracic Surgery may not be. The loss of several stars in a Division may change the fortune of that Division overnight.How do you pick the right school that has a top tier residency program in your chosen medical specialty when only 20–40% of students actually specialize in the specialty that made them want to become a physician in the first place?Does attending a less renowned medical school affect your career? The equalizing factors are successes on the USMLE exams and class rank (or membership in Alpha Omega Alpha Honor Medical Society, medicine’s equivalent of Law Review). With those credentials, a graduate of any medical school can enter any coveted specialty (currently Dermatology, Orthopedic Surgery, ENT etc.) Graduates of prestigious medical schools do dominate matching into the top tier residency programs in the top medical specialties upon review of recent match cycles. Pedigree does matter if you choose an academic career, where attending the best residency program, the best fellowship program and the connections lead to faculty appointments at prestigious institutions. Successes then may lead to leadership at institution, national and international levels in medical and specialty organizations.Back to the question of acceptance into any medical school, the process is “holistic”. The following are what medical college admission committees look for in candidates. First article is from the American Association of Medical Colleges. The second from the University of Minnesota. At the end is a short Kaplan discussion regarding GPA and MCAT in the application process.How Medical Schools Review Applications (AAMC)What are admissions officers looking for?While expectations, missions, policies, and requirements are unique to each medical school, many schools look for students who demonstrate an ability to handle challenging coursework and have the personal attributes needed to work with people. It’s important for applicants to show that they’ve done well in upper-level science courses, and “doing well on the MCAT® exam shows that you can handle medical school coursework,” says Irene Tise, admissions officer in the Office of Medical Student Admissions at Wake Forest School of Medicine.Lori Nicolaysen, assistant dean of admissions at Weill Cornell Medical College, adds that they “seek students who have also demonstrated exceptional personal initiative. Such initiative may take the form of leadership, creativity, research, community service, motivation, or other life experiences.”Mickey Foxwell, M.D., associate dean for admissions at University of Maryland School of Medicine says, “Each applicant needs to be as sure as possible that this is what they want to do with their life. That motivation can be demonstrated through academic achievement and also through exposure to clinical medicine and community service. Does the applicant know what it’s like to take care of someone? Does the applicant have an idea about the advantages and disadvantages of a career in medicine?”Schools also look for evidence that an applicant has demonstrated good judgment, compassion, and selflessness— qualities every physician should embody. Applicants can show evidence through their involvement in extracurricular activities, letters of evaluation, and their personal statement.What happens when my application is received?Each medical school has its own nuanced process for reviewing applications. For example, “Weill Cornell invites all applicants to complete the secondary application,” Ms. Nicolaysen shares. “Once the file is complete (including secondary application, letters of evaluation, and MCAT scores), the application is moved to screening. A number of experienced admissions committee members serve as screeners. Although Weill Cornell has fourth-year medical students on the admissions committee, the students do not screen applications.”Dr. Raquel D. Arias, associate dean of admissions at Keck School of Medicine of the University of Southern California, explains, “In order to give every candidate a fair review of their personal qualities and accomplishments, a single screener evaluates all candidates with a particular MCAT score at our school. This controls for the inevitable influence that this important test has on the process. An admissions officer reads every application submitted to the school.” (There is no automated filter.)At Wake Forest School of Medicine, Ms. Tise explains, “Because of the large number of applications we receive, we use a formula that separates and groups applicants based on their AMCAS® primary application. The groups are: 1) Proceed and send a secondary application, (2) Hold for MCAT score or other extenuating circumstances and notify candidates, and (3) Risk, based on academics.Those candidates in the “risk” category are reviewed individually by the associate dean and an executive committee of five faculty and admissions committee members. From there, a decision is made to either proceed with the application process or reject the application.” Typically, after secondary applications are submitted, the associate dean and a committee review the applications and place candidates into interview pools. Because of the large number of applicants, only a small percentage is asked to interview.How do reviewers decide whom to interview?Medical schools consider each applicant’s academic proficiency, whether they are likely to thrive in the culture of the institution, and if their experiences, attributes, and goals are in line with the school’s mission and goals. Inevitably, medical schools receive many more qualified applicants than they can interview and matriculate. The decision to interview one student over another can be very difficult to say the least.“It is incredibly challenging because there are so many admirable candidates,” Ms. Nicolaysen explains. “Ultimately, the committee screeners attempt to identify the best qualified applicants from diverse academic and personal backgrounds whom we deem most likely to build a dynamic learning environment at Weill Cornell and to become leaders in medicine.”Dr. Foxwell adds, “At University of Maryland, outstanding grades and MCAT scores do not guarantee that an applicant will be invited to interview. Just as important are extracurricular activities and life experiences, essays and personal comments in AMCAS, and letters of recommendation.”Dr. Arias says, “The path to becoming a physician is unique to each applicant; therefore, we do not mandate any particular course of study. We have no preference for a particular major (or minor). Evidence of the personal attributes of integrity, adaptability, language skills, collaboration, and a commitment to service are evaluated with an eye toward the development of physician scientists. We infer the desired applicant qualities from both the content of the application and the care with which it is delivered. Every aspect of the application is important. Applicants who speak in their own voice, without “spin,” is especially valued.”Additionally, some public medical schools also may consider an out-of-state applicant’s ties to the state or institution if non-state residents are not typically considered for matriculation. (For more information, check with individual medical school websites or consult the AAMC's Medical School Admission Requirements.)What are some common mistakes applicants make?The same tips you might have received for undergraduate or job applications hold true for medical school applications. Always tell the truth and be sure to mention activities and volunteer, research, or work experiences that are most important, and if possible, occurred within the last few years. “Take your AMCAS essay questions seriously,” counsels Ms. Tise. “These essays are not creative writing exercises. You may start off with a descriptive experience, but, move quickly into how and why you want to become a physician and how this experience helped determine that. Also, proofread carefully. There are no excuses for punctuation and grammatical errors. We know you are applying to several schools, but be careful to include the correct name in secondary materials.“Redundant information is a waste of space. Inconsistencies can call an applicant’s authenticity into question,” cautions Ms. Nicolaysen. “We advise not including high school activities or activities in which your participation was minimal. Also, try to avoid boasting or exaggerating.”Dr. Foxwell advises that “Applicants must begin to think like professionals. If a photograph is requested in a secondary application, make it a good one, not one that may call your professionalism into question.”What advice does the review committee have?“Do your homework. Know what schools are looking for, and work closely with your advisor,” cautions Dr. Foxwell.Your application needs to be complete and truthful. When it comes to your personal statement, Ms. Tise recommends, “There is no secret checklist or formula. Remember, you are the applicant, and we want to know why you think you are a good one.”Furthermore, Ms. Nicolaysen advises applicants, “Before submitting your application, ask some trusted mentors, friends, or family members to give you feedback about your experiences and essays. You might ask them questions like, ‘How would you describe me based on what you read? Did my essay hold your attention? Was anything confusing? Did you notice any typos?’”Most importantly, relax. Most applicants have one or two items that they wish they’d changed or perhaps a mistake they think they might have made. If you have further concerns or anxiety over the application process, check out the Aspiring Docs fact sheet on helpful tips for dealing with application anxiety.Essential and Desired Qualities of medical school candidates:Strong academicsHigh GPA and MCAT scores. See AAMC MCAT site for students.A commitment to improving the human conditionEssential:Sustained and meaningful commitment to human service demonstrated through volunteer activities, scholarly pursuits, employment, academic endeavors, or other experiencesUnderstanding of medicineSubstantial independent research experience(s) (MD/PhD applicants)Desired:Commitment to care of the underservedCommitment to community and global patient careProfessional conductHonesty and integrity, particularly regarding instances of personal failings or mistakes (essential)Compassion, evident through evaluations, prior employment, or experience in other roles that require compassion (essential)Self-awareness, evident in a student’s knowledge of their own strengths, weaknesses, and when to ask for help (essential)Ethical behavior (essential)Outstanding interpersonal skillsOral and written communication skills must be excellent, both to share knowledge and to convey empathy (essential)Teamwork skills require acknowledging other team members’ expertise, accurate self-assessment, assuming leadership when appropriate, and subsuming individual interests to the work of the team (essential)Cultural humility and inclusivity (essential)Leadership & diversity experiences (desired)A dedication to lifelong learningIntellectual curiosity (essential)Demonstrated scientific aptitude—a fundamental appreciation of how the scientific method is applied to the discovery of medical knowledge and to medical practice (essential)Potential for academic success (essential)Psychological resilience as demonstrated through emotional stability, skills to cope with stress, an ability to deal with sacrifice and hardship, maturity, good judgment, and an ability to defer gratification (essential)Creativity (desired)What’s the Average GPA for Medical School | Kaplan Test PrepNOVEMBER 30, 2016EMILY HAUSEAdmissions officials receive three different GPAs when reviewing applicants.A previous version of this article was originally published by Alex MacNow.While we’ve tackled the topic of medical school admissions by the numbers in the past, we turn our attention today to the average GPA for medical school. It’s stressful to think that a few bad grades in your undergraduate career can impact your chances of getting into medical school; however, it’s important to know that a low GPA can be overcome.Remember, the AAMC keeps GPA information public through their FACTS tables. In addition to what we’ve covered here, there is a lot more information you can glean from these resources. In the world of medical school admissions, knowledge is power!Breaking down the average GPA for medical schoolMedical schools are actually given three GPAs when they look at your application. Your science and math courses are considered according to what is called the BPCM (Biology, Physics, Chemistry, Math) GPA, and your non-science courses (humanities, social sciences, language, etc.) are considered as a separate GPA. The third GPA that schools see is the overall aggregate.While each medical school has its own average GPA for the incoming class (information for MD programs can be easily found in the Medical School Admission Requirements guidebook), the national averages for 2015–2016 were as follows:BPCM GPA: applicants 3.45, matriculants 3.64Non-science GPA: applicants 3.68, matriculants 3.77Overall GPA: applicants 3.55, matriculants 3.70What can I do if I have a below average GPA?Unlike the MCAT, for which many of you still have a clean slate, GPA is set during your college career. So what can you do if you’re applying and your GPA isn’t quite in the range above?1. Explain the GPA tactfullyYou have the opportunity to bring up any blips in your GPA on both the primary application (as part of the Personal Statement) and your secondary applications (in one of the essays or as an addendum to the application). Some secondary applicationseven provide a space for pieces of your application that you’d like to explain.When talking about a problem in your GPA, explain the reason behind the drop, but don’t make excuses! Medical schools want mature applicants who can take ownership of the problem, and—perhaps more importantly—can explain how it served as a learning experience. Did getting a not-so-great grade in Organic Chemistry I teach you how to study better, utilize office hours, or find new ways to learn so that you knocked Organic Chemistry II out of the park? These skills will help you become a better medical student. Explain that to the medical schools.2. Become an MCAT rockstarAccording to Kaplan’s latest medical school admissions officer survey, two of the most important factors in admission are the GPA and MCAT score. Thus, falling below the average GPA for medical school matriculants can be significantly abated with a stellar MCAT score. Prepare wisely and work towards your target MCAT score.3. Retake courses or consider post-bacc workThere are a number of post-baccalaureate programs in the country that can be optimal for a student who needs to boost their GPA (especially the BPCM GPA). Masters and post-bacc programs may also afford you opportunities to become involved in research or shadowing, thus helping your application portfolio that much more.

Let’s look at actions and forget its words:Note: In its 200 year history, the USA has intervened in, invaded or militarily occupied the following Western Hemisphere nations:Canada, Confederate States of America, Mexico, Cuba, Haiti, Dominican Republic, Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica, Colombia, Panama, Venezuela, Surinam, Brazil, Ecuador, Peru, Bolivia, Paraguay, Uruguay, Chile, Argentina, Puerto Rico, Grenada.While the dates most associated with the Central Intelligence Agency are the 1953 coup against Iran’s Mohammed Mossadeq and the following year against Guatemalan President Jacobo Arbenz, the world’s most notorious–and possibly ignoble–spy agency actually was chartered on this day, 18 September, in 1947.Since then, the CIA has played a role in hundreds of assassinations, military coups, and rebellions around the globe, from Argentina to Zaire.Despite it’s championing of freedom, the CIA’s true objective has always been imperialist in nature. Whether oil in Iran or bananas in Guatemala, the U.S. has a material interest in every country in whose affairs it has meddled.In order to meet its goals, the CIA recruits influential, intellectual and charismatic personalities. The agency also resorts to threats, kidnappings, torture, enforced disappearances and assassinations. The organization incites violence, uprisings and military rebellion, and causes economic chaos and misery to the people through scarcity of basic foods, etc..The CIA has been exposed on a number of occasions through documented evidence, leaks of information and whistleblowing by active and former agents.Che Guevera, the revolutionary face of resistance against U.S. homicidal interventions. Two years after leading a rebellion against Washington’s intervention in Bolivia, Che was murdered.1. 1954 – GuatemalaIn 1944, the violent U.S.-backed dictatorship of Jorge Ubico was overthrown by a popular uprising. The people of Guatemala were sick and tired of the brutal injustices of his regime, although in reality Ubico was merely a puppet of The United Fruit Company, which obeyed Washington’s orders. They basically enslaved the population. They stripped campesinos and Indigenous people of their lands and forced them to work their own parcels and paid them bread crumbs. Those who dared to disobey were brutally punished by a police force working for the U.S. fruit company.The victory of the uprising brought peace to the country but it only took 10 years for U S President Dwight Eisenhower (and two of Ike’s cabinet members [who were also United Fruit Company insiders] Secretary of State John Foster Dulles and CIA Chief Allen Dulles) to implement a plan to overthrow the government.In 1954, (US President Dwight Eisenhower’s) CIA launched the so-called Operation PBSuccess. The country’s capital, Guatemala City, was bombed by U.S. warplanes. The young Ernesto “Che” Guevara was there and witnessed the ordeal first hand. Hundreds of campesino leaders were executed and many campesino and Mayan Indigenous communities were completely wiped out. The brutal CIA intervention wasn’t complete until 200,000 had been killed. U.S. companies were again enjoying huge profits in the Central American country and Washington was happy.U.S.-backed and financed military tyrants of Guatemala 19542. 1959 – HaitiHaiti is equally strategic to the United States as are the Dominican Republic and Cuba. So, Washington doesn’t hesitate when their brutal control appears to wane in the Caribbean. Under no circumstance, would the U.S. allow governments in the region to lean to the left, and if they dare to, (US President Dwight Eisenhower’) CIA steps in to push them back to the right. Of course, Cuba is a rare example of resilience to U.S. efforts to achieve hegemony in the area. Since 1959, the Cuban revolution of Fidel Castro has repealed the relentless U.S. attacks.But in Haiti, the story is different. In 1959 as well, popular discontent rose against the brutal puppet of the U.S., Francois Duvalier. The CIA stepped in and stopped it immediately. With the help of the intelligence agency, Duvalier wasted no time and created an army to violently repress all those who rose up against him. He and his heir to the regime, Jean Claude Duvalier, ordered massacres that were so horrendous they defy words. Over 100,000 people were murdered. And in 1986, when a new but uncontrollable rebellion took over, a U.S. Air Force plane rescued Jean Claude and took him to France so he could live in peaceful luxury.U.S. puppet Francois “Papa Doc” Duvalier—a CIA murderer3. 1964 – BrazilThe year of 1964 was one of incredible transformation in Brazil. Democratically-elected President Joao Goulart implemented his “Plan of Basic Reforms.” Even though the U.S. had exerted much of its power through ensuring people weren’t lifted from ignorance and illiteracy, Brazil implemented real changes that made Washington very uncomfortable. Firstly, a tax reform was put in place that would hugely carve into the profits of the multinational corporations of the United States and its allies. Washington was also very unhappy with a reform by which land would be given back to their legitimate owners and would redistribute other lands to poor people.It was now time to send in (US President Lyndon Johnson’s) CIA to take action against the government of Goulart, which they did in 1964. They put in power a brutal dictatorship that lasted 19 years. During this regime, thousands were tortured and hundreds executed. The CIA also made sure all those leaders who had leftist tendencies were eliminated, particularly Marxists.4. 1969 – UruguayDuring the sixties, revolutionary movements spread through Latin America. Uruguay was drowned in crises. United States saw influential socialist leaders emerge in this South American nation. For example, the urban revolutionary guerrilla known as the Tupamaros. Jose “Pepe” Mujica was part of it, and so was his wife Lucia Topolansky. Washington became obsessed with eliminating them, fearing the influence and power they were achieving.Nelson Rockefeller went to Uruguay to observe first-hand how they were, generating a growing anti-Yankee sentiment. He returned to Washington to alert authorities that something needed to be done urgently.Of course, (US President Richard Nixon’s) CIA responded immediately. They sent their special agent Dan Mitrione. He trained security forces in the art of torture and other highly macabre practices that are indescribable in nature. And then the CIA put in power Juan Maria Bordaberry and his military dictatorship. He ruled under direct order from Washington the next 12 years, during which he killed hundreds of people and tortured tens of thousands more. Repression was so brutal and Uruguayans were so traumatized and fearful they no longer carried out their traditional dances, which symbolize happiness and victory.5. 1971 – BoliviaThe vast Latin American natural resources are the envy of the greedy and powerful politicians of the United States, who resort to any means to control them for their own benefit, and never for the people and countries they brutally exploit. During decades, U.S. multinational corporations enslaved people in vast regions of Chile, Bolivia and Peru. When those living under slavery conditions dared to rebel against their oppressors, they were annihilated in bulk. Che Guevara felt compelled to go to Bolivia and help the people rise in revolution.This was 1967. By then, U.S. mining companies had enslaved entire communities, including children, who they banned from school. Two years later, Che Guevara was murdered by (US President Richard Nixon’s) CIA. Once out of their way, CIA officials established a military regime.However, the people again turned on Washington. General Juan Jose Torres took power and implemented reforms to benefit workers and those living in poverty. Hope returned to Bolivia and its people, but the CIA would not allow this to continue. The agency recruited General Hugo Banzer. He led the coup against Torres and in 1971, he kicked off his violent dictatorship. He ordered the torture of a number of opposition leaders and the execution of hundreds of influential political leaders. He sent about 8,000 other leaders to jail. Washington was happy.6. 1973 – ChileChilean President Salvador Allende was just another of the many victims of the many coups on democracy carried out by the United States (Note the date: 9/11/73)Chile was another country brutally exploited by U.S. corporations.Washington (US President Richard Nixon and Secretary of State Henry Kissinger) made sure the people lived in utter misery. The CIA used different tactics but the results were the same. The agency led a smear campaign against the government of Chile, as it is currently doing in Venezuela. They used national and international media to demonize President Salvador Allende. They made sure people who had once been loyal to him because of his benevolent way of governing turned on him.How you ask? The same way they’re doing it in Venezuela. By causing scarcity through extortion, through torture, imprisonment, enforced disappearances and by assassinating all those who refused to bow to them. Washington was irritated beyond control after Allende nationalized natural resources. They were also annoyed because Allende built houses for those who couldn’t afford homes. He made sure his people had access to education. When Allende’s popularity was successfully undermined, the next step was to plan a coup against him. It would now be easy. And on September. 11, 1973, Gen. Augusto Pinochet led the military all the way to the presidential palace with the backing of the CIA, who provided him with all the necessary weapons and armored vehicles.War planes dropped bombs on the palace. Before he died, Allende told his people: “I will not give up! Placed in a historic transition, I will pay for the loyalty of the people with my life. And I tell you with certainty that that which we have planted in the good conscience of thousands and thousands of Chileans will not be shriveled forever. They are strong and they may be able to dominate us, but the social processes cannot be halted nor with crime nor by force.”Pinochet ruled for 17 years. He jailed 80,000 people, tortured 30,000 and murdered 3,200.7. 1976 – ArgentinaThe Argentine people endured arguably the bloodiest dictatorship of South America. It was so terrible that reading about it can be traumatic. Concentration camps, torture centers, massacres, massive rape of women and children, the beating of pregnant women, and the execution of boys and girls. In total, 30,000 people were executed. Behind it all: the CIA.In 1973, Argentina was going through a political crisis so grave that President Juan Peron collapsed and ultimately died of a heart attack in 1974. His wife, Eva Peron, took power only to confront conflicts everywhere, even within her own Peronist party.The CIA waited like a cat hunting its prey until 1976, when the situation they themselves provoked was so bad their intervention would be a walk in the park. Of course, as usual, a key recruitment was in order. The right-wing military dictator-to-be was Gen. Jorge Rafael Videla. The next step – a coup d’etat in yet another Latin American nation, and again another dictatorship at the service of the United States.This time, (US President Richard Nixon’s) nefarious Henry Kissinger would be in charge of supervising the brutal regime. The rest is history: genocide, massive human rights violations, enforced disappearances, child theft, among other heinous crimes. All this, with the approval of the hypocritical and shameless owners of power in Washington.8. 1980 – El SalvadorSalvadoran Archbishop Oscar Romero broke with Catholic tradition by caring for the poor. He paid for it with his life.The people of this Central American country suffered no less than Argentina under the U.S. intervention that was carried out by you know who: the CIA. Washington had already backed a brutal dictatorship that lasted 50 years from 1931 to 1981. Campesinos and Indigenous were smashed without mercy. More than 40,000 were massacred.Things were so bad a rare incident occurred. The Catholic church tried to intervene in favor of the poor and oppressed. At this point in time, El Salvador was controlled by 13 mafia-style families who had expropriated about half of the national territory. The 13 families were closely linked to Washington. And (US President Jimmy Carter’s and later US President Ronald Reagan’s) CIA, just in case, made sure the military was very well trained in everything horrific.They were provided with all the right lethal equipment. And when the CIA found out that Jesuits were helping out the masses, they made sure they were killed. They also asked Pope John Paul II to speak to Archbishop Óscar Romero to try to persuade him to desist. Romero refused to comply and so they murdered him when he was officiating mass in 1980. When the U.S. intervention was over, 75,000 people were reported murdered, but the U.S. was at peace.9. 1989 – PanamaCIA agent and Washington-backed drug trafficker Manuel Noriega enraged the U.S. when he refused to obey their orders, prompting an invasion that left 3,500 innocent civilians dead.Another unprecedented incident occurs in this Central American country. A (US President George H. W. Bush’s) CIA agent rises to power as a dictator in the form of Manuel “Pineapple Face” Noriega. Washington’s interest here, among others, is the inter-oceanic canal.When President Omar Torrijos tried to take over control of the Panama Canal, the CIA planted a bomb on his plane and that was the end of that.In 1983, Noriega took power. He was a drug trafficker for the CIA. He had been for some 30 years. That was fine with Washington. He was of huge service to them. In fact, he was instrumental in the Iran-Contra affair, by which the CIA circumvented Congress’ prohibition to provide the Nicaraguan contras with weapons to be used against the leftist Sandinista movement.Noriega helped with cocaine to be sent mainly to Los Angeles, California, where it was sold in form of crack and served to poison vast Black communities, another of the devious objectives of the CIA. The money was used to buy arms in Iran to provide the contras with them.Money and power transforms the weak and devious. Noriega wasn’t exempt. It went to his head. He now believed he was untouchable and felt he could ignore Washington’s orders and instead of helping the U.S. place Guillermo Endara in power in Nicaragua, he decided he would impose a president of his own choosing: Francisco Rodriguez. Noriega also began harassing U.S. military bases in Panama. The U.S. was not about to put up his unruly behavior. Washington deployed troops to invade Panama in December 1989.They captured Noriega and locked him up in a Miami jail, but before that, they killed 3,500 innocent civilians and displaced 20,000 more… (The CIA called the operation against Panama « Operation Just Cause.”)10. 1990 – PeruFinally, we arrive at Peru (and US President George H. W. Bush’s CIA). First we need to understand that this list by no means represents the end of U.S. interventions worldwide. The CIA continues to cause havoc across Latin America and the rest of the world. However, these 10 cases may enlighten those who refuse to believe that the United States is responsible for death and destruction. It also serves to show how they operate and can be easily detected in places where there is instability, hunger and chaos. Instability, hunger and chaos is their specialty.In Peru another CIA agent rose to power. Alberto Fujimori was elected president in 1990. The reason why his election is highly suspicious is because he was a mediocre person with no education and no charisma. He had no political influence, and he was known to nobody but his family.But he did show some intelligence when he asked Vladimiro Montesinos to be his associate. Montesinos was a lawyer and a very intelligent person with above average strategic thinking. He was also a CIA man.Fujimori named him National Intelligence Service director. A paramilitary group was created only to murder leftist and Marxist leaders. Fujimori dissolved Congress and locked up all the members of the Supreme Court of Justice. The CIA helped him with his plan, they financed him and supervised all his atrocities. Today, Fujimori is in jail.Note: The 10 sovereign Latin American nations that were discussed in some detail above were just the Ten Most Lethal CIA-led Coups. The article did not include the militarily-invaded Latin American nations of Mexico, Cuba, Dominican Republic, Colombia, Honduras, Nicaragua, Costa Rica, Ecuador, Venezuela, Surinam, Paraguay, Puerto Rico and Grenada. – GGK[1]Elliot Abrams, a convicted war criminal who was hired by the Reagan administration to help support the death squads which terrorized and murdered people who resisted the right wing factions in Latin American nations, including El Salvador and Nicaragua. Abrams is now responsible for trying to overthrow the democratically elected government of Venezuela so U.S. oil companies can plunder the massive oil reserves for profit.The liberal American elites love the war criminal Elliot AbramsPractically the entire American political establishment and corporate press are repeating the Trump administration’s claims to have humanitarian motives in Venezuela. As that administration inches closer to full-blown military invasion, whether direct or by proxy, it behooves us to look into the track record of the officials steering this so-called “humanitarian policy.” None other are more deserving of scrutiny than Elliott Abrams, whose crimes have spanned the globe, from El Salvador to Nicaragua to Iraq.Before this month, Elliott Abrams was likely glad to have been largely forgotten by the U.S. public. When the Trump administration announced Abrams’ appointment as U.S. Special Representative in Venezuela in late January, the news caused some ripples on the Left, but across mainstream media outlets, the reaction was mostly sedate.Politico described Abrams as “a somewhat controversial figure,” while Bloomberg focused on his criticisms of Trump. In the wild world of Trump appointees, this was hardly exciting stuff. While Abrams has been associated with some of the darkest moments in American foreign policy over the last 40 years—from death squads in Central America to the Iran-Contra affair to the invasion of Iraq—his appointment failed to resonate with the media obsessions of the moment. This history was simply too long ago to generate much controversy today. A relic from another era, Abrams was on the verge of ascending to the coveted position of “elder statesman.”All of that changed February 13, when Rep. Ilhan Omar subjected Abrams to a withering interrogation. Citing his conviction in 1991 of withholding information from Congress concerning the Iran-Contra affair, Omar declared “I fail to understand why members of this committee or the American people should find any testimony that you give today to be truthful.” When Abrams, incensed, replied, “If I could respond to that,” Omar casually informed him “It wasn’t a question.”She went on to question Abrams about his record, from supporting U.S.-backed military dictatorships in Central America in the 1980s to his recent role in promoting right-wing coup-plotters in Venezuela. Throughout, Abrams protested again and again about the unfairness of her line of questioning. This was simply not how things were done in polite society.Immediately following this exchange, Abrams and his record began attracting significantly more attention than they had when his appointment was first announced. Prodded by Omar, media outlets across the country suddenly remembered the El Mozote massacre in El Salvador, committed by the right-wing military forces that Abrams and the Reagan administration were backing.Yet even this rude intrusion of history into the public sphere only hinted at the full extent of the blood on Abrams’ hands. In her five minutes of questioning, Omar could merely reference his record in shorthand. Yet Abrams’ full career, and its memory in public life, are worth considering in further detail, as they reveal important truths about how foreign policy is made in America.Despite his bloody history, in the aftermath of Omar’s interrogation, a number of mainstream liberal commentators such as the Center for American Progress’s Kelly Magsamen and prominent Joe Biden ally Dave Harden jumped to Abrams’ defense. This exculpation by a sector of the liberal intelligentsia also reveals the continuity of U.S. foreign policy across political parties, and the threat posed to this consensus by Omar’s inquiry.A young counter-revolutionaryThough the famous novelist Thomas Pynchon once made reference to “Schachtmanite [sic] goons like Elliott Abrams,” Abrams, like most neoconservatives, had actually never been on the Left. His career as a counter-revolutionary began in college, when, as an undergraduate at Harvard, he openly opposed Students for a Democratic Society (SDS) and other campus leftists, whom he despised as spoiled children of the elite. When SDS members shut down Harvard in the student strike of 1969, Abrams helped found (with fellow student Daniel Pipes, son of Harvard reactionary Richard Pipes, and later an Islamophobe of some note in his own right) the Ad Hoc Committee to Keep Harvard Open. On the furthest right flank of cold war liberalism, Abrams backed Democratic presidential nominee Hubert Humphrey, who was running on the platform of continuing the Vietnam War, in 1968, and worked closely with AFL-CIO operatives to combat the left-wing insurgency developing in the Democratic primaries.At Harvard, Abrams received his law degree and in 1975 he briefly worked for the Senate Permanent Subcommittee on Investigations, the same committee from which Joseph McCarthy prosecuted his anti-communist crusade in the 1950s. When Abrams got there, the committee was headed by Henry “Scoop” Jackson, also known as “the Senator from Boeing” for his service to the defense industry. Jackson formed a pole in the 1970s around which the most bellicose and bloodthirsty voices in the Democratic Party gathered, figures who were obsessed with not “losing” Vietnam, no matter the price in lives. When Jackson ran for president in 1976, Abrams worked on his campaign.The Reagan yearsAbrams first came to major prominence in the Reagan administration, where, in late 1981, he was appointed Assistant Secretary of State for Human Rights and Humanitarian Affairs. However, Abrams was not the administration’s first choice. Reagan had previously nominated the conservative political thinker Ernest W. Lefever, but his nomination had not gone smoothly. In 1979, Lefever had testified before the House that all human rights standards should be repealed. Questioned about this statement in 1981, he admitted that he had “goofed.” His nomination was finally sunk, however, when two of his brothers claimed that Lefever believed black people to be genetically inferior. This was too big a goof even for the Reagan administration, and in October, Abrams’ nomination was announced.Abrams started his career at the State Department with a lot to do. The day before he came on board, U.S.-trained forces had committed a massacre in the town of El Mozote, El Salvador, torturing, raping and slaughtering over 800 civilians. The killing was performed by the Altacatl Battalion, assembled and trained at Fort Bragg, and later described by the New York Times as having been “the pride of the United States military team in San Salvador.”The El Mozote massacre was but one moment in the Central American civil wars of the 1980s, when in country after country, poor peasants confronted their countries’ traditional military and economic elites, who responded with savage, American-backed violence. Abrams played a key role in directing American support for these regimes as well as running interference when evidence of their atrocities became too obvious for the corporate media to ignore. The main sites of action were as follows:El SalvadorIn 1979, amid mounting protests against an undemocratic government, El Salvador’s military leaders dispensed with the fig leaf of civilian rule and installed a military junta to crush the rising left-wing insurgency. The result was a civil war in which some 80,000 people died in a country with a population of less than 5 million. Later, a United Nations investigation estimated that 85 percent of civilian killings in the war were perpetrated by the military and its death squads. Atrocities such as El Mozote were commonplace. Less than a year later, the military killed over 200 civilians at El Calabozo.One of Elliott Abrams’ main jobs was to deny, distract from, or excuse these atrocities. When news of El Mozote reached the United States, Abrams testified before the Senate Foreign Relations Committee that there was reason for doubt, claiming “We find … that it is an event that happened in mid-December [but it] is then publicized when the certification comes forward to the committee.” Even a decade later, after irrefutable evidence had accumulated about the scale of the horror in El Mozote, Abrams still tried to obfuscate the truth, protesting, “If it had really been a massacre and not a firefight, why didn't we hear about it right off from the F.M.L.N.? I mean, we didn't start hearing about it until a month later.”When questioned by Rep. Omar last week, Abrams defended his record in El Salvador, proclaiming, “From the day that President Duarte was elected in a free election to this day, El Salvador has been a democracy. That’s a fabulous achievement.” Indeed, in 1984, José Napoleón Duarte became president after elections in which parties of the left could not campaign for fear of assassination. He defeated death squad leader Roberto d’Aubuisson. Though Washington supported Duarte in that election, Abrams had previously defended D’Aubuisson, contending that he was not an extremist and claiming that “anybody who thinks you’re going to find a cable that says Roberto d’Aubuisson murdered the archbishop [Oscar Romero] is a fool,” when in fact, cables showing precisely that had arrived in Washington from the U.S. embassy almost immediately after the assassination.Nonetheless, d’Aubuisson was indeed an embarrassment to the United States as it attempted to defend Salvadoran oligarchs. Along with his extravagant brutality in El Salvador, he was also far too undisciplined in talking to the press, telling some European reporters, “You Germans were very intelligent. You realized that the Jews were responsible for the spread of communism, and you began to kill them.” This kind of language was an embarrassment, and so Washington judged that Duarte would be a more effective point man for coordinating the war on the Salvadoran peasantry. Duarte’s verbal promises to restrain the excesses of the military, for Abrams and company, counted as a win for human rights, even as his “moderation” provided a fig leaf that would allow the U.S. government to continue backing the Salvadoran military until the Left had been sufficiently exterminated that “normal” politics could resume.Despite Abrams’ theatrics, the truth of the American intervention in El Salvador was told in rather plainer terms by the liberal New Republic in 1984, which explained that “there are higher American priorities than Salvadoran human rights,” and that “military aid must go forth regardless of how many are murdered, lest the Marxist-Leninist guerrillas win.”NicaraguaTo El Salvador’s southeast, Nicaragua was also going through a political transformation in the early 1980s. In 1979, the Sandinista National Liberation Front overthrew the notoriously corrupt U.S.-backed dictator Anastasio Somoza. The coalition government the Sandinistas created immediately undertook vigorous campaigns in the areas of literacy and healthcare, expanding social service access to the Nicaraguan poor to an unprecedented degree. The government also provided aid to the peasant revolutionaries in El Salvador, and quickly established a close alliance with the Soviet Union and Cuba.This the Reagan administration could not abide. Shortly after coming into office, Reagan officials invited anti-Sandinista exiles to a meeting in Honduras, where the administration forced anti-Somoza opponents of the government to submit to the leadership of elements of the dictator’s hated National Guard. Troops were immediately assembled across the border in Honduras, with U.S. aid helping to put everything in motion. The anti-Sandinista army, popularly known as the Contras, soon accosted government targets, with special attention reserved for government social service locations, like schools and hospitals. Soon, evidence of Contra atrocities began to accumulate.In 1982, this evidence was so abundant that the U.S. Congress become convinced that funding for the Contras needed to be cut off. Abrams, fulminating over the tying of the United States’ hands in its battle against communism, immediately began looking for ways to overcome the ban on funding. One avenue came through soliciting funds from the Sultan of Brunei, whom Abrams convinced to donate $10 million to stopping communism in Nicaragua. But Oliver North’s secretary at the time fudged the transaction by copying the wrong numbers for the Swiss bank account to which the funds would be transferred, and the money ended up in the hands of an unusually virtuous Swiss businessman, who returned it, with interest.For the rest of the 1980s, Abrams essentially ran interference for Oliver North and the other Iran-Contra spooks. For this role, he was eventually indicted, and plead guilty to withholding information from Congress in 1991. At a time when the drug war was in full swing, and draconian sentences were all the rage, Abrams was sentenced to 100 hours of community service. President George H.W. Bush then pardoned him, completing Abrams’ official redemption.After the fallBy the time Abrams was pardoned, the world had changed considerably from the one in which he had been a leading cold warrior. The Soviet Union was no more, and Bill Clinton’s election had ended 12 years of Republican rule. Abrams needed a home in this new wilderness, and found one, ironically, in Ernest Lefever’s Ethics and Public Policy Center, which provided him with a comfortable sinecure. If Lefever’s views on racial fitness ever troubled Abrams, he didn’t comment on it.As the locus of American geopolitics shifted from Central America to the Middle East, Abrams reoriented his concerns accordingly. He was a signatory (along with assorted neocons from Paul Wolfowitz to Francis Fukuyama) to the Project for the New American Century’s infamous 1998 letter to Bill Clinton urging regime change in Iraq. The letter helped inspire the Iraq Liberation Act, which Clinton signed that same year and helped initiate the bipartisan consensus for the eventual war on Iraq.When George W. Bush was elevated to the presidency, Abrams found himself back on the inside. He was appointed to the National Security Council, and helped shape the administration’s Middle East strategy. He reportedly “lost” an Iranian peace proposal in 2003, and in 2006, helped shape the Fatah putsch against the democratically elected Hamas government in Palestine that helped lead to the current division between Gaza and the West Bank.During Trump’s rise, in 2015 and 2016, Abrams was a reliable “never-Trumper,” backing Marco Rubio’s doomed candidacy. In early 2017, Abrams was under consideration to be number two in the State Department under Rex Tillerson. However, the Trump team, under Steve Bannon, reportedly got Elliott Abrams confused with Eliot Cohen, a different hardcore neoconservative, and blocked his appointment.Now, thanks to Mike Pompeo’s appointment of Abrams as point person for the U.S. intervention in Venezuela, he’s back.Liberal enablersAs Rep. Omar dragged Abrams’ ugly past into the spotlight, millions of Americans were alerted to the country’s bloody footprints in Latin America. The El Mozote massacre in particular received renewed attention. Yet even as Americans heard about this record for the first time, a number of voices spoke up to defend Abrams’ honor.Some of these, like the neocon-turned-“resistance” member Max Boot, or the radical-turned-neocon Ronald Radosh, were predictable and uninspiring. Boot warned that Omar showcased the dangers of the “uber-progressive wing” of the Democratic Party, while Radosh compared her to white supremacist Rep. Steve King. National Review’s Jay Nordlinger put a bit more effort in, tweeting that “I’ve come back to my phone to find about 5,000 tweets libeling the great Elliott Abrams as a war criminal….I feel like I’m back in the dorm, listening to stoned undergrads repeat what they recently read in In These Times.” (Any stoned undergraduates reading this are invited to subscribe here).More surprisingly, Abrams also found a number of liberal defenders. Kelly Magsamen, Vice President for National Security and International Policy at the Center for American Progress, called Abrams “a fierce advocate for human rights and democracy” who had made “serious professional mistakes.” Dave Harden, a former USAID administrator (and Biden 2020 supporter), agreed, describing Abrams as “a kind, thoughtful, non partisan mentor” and exhorting his followers to “see the best—rather than the worst—in people.” R. Nicholas Burns, a diplomat and Trump critic, also chimed in, declaring “It’s time to build bridges in America and not tear people down.” Edward Luce, the British liberal journalist and author of The Retreat of Western Liberalism, offered his support for poor beleaguered Abrams as well.Abrams’ liberal defenders were, thankfully, met with a tidal wave of condemnation on Twitter, as hundreds of thousands of tweets denouncing Abrams filled their mentions. Harden petulantly told “the 170k twitter responders who pillared [sic] me as a war criminal in the last 24 hrs” that he’s “doubling down.” The impact Omar’s questioning had in galvanizing opposition to the bloody track record of American imperialism could hardly be clearer.But why were there liberals defending Abrams in the first place? And not merely any liberals, but highly-credentialed figures in the liberal foreign policy establishment. The answer to this question reveals no small amount about the American foreign policy intelligentsia.As several of Abrams’ defenders stated, they had worked directly with him. Whether at the State Department or the National Security Council, they had been part of the same body making and carrying out American foreign policy. But even outside of government, Abrams rubbed shoulders with establishment liberals in plenty of capacities. At the Council on Foreign Relations, a premier centrist foreign policy think tank, Abrams is an accredited CFR “expert” along with Clinton Administration officials Martin Indyk and Robert Rubin. On the U.S. Holocaust Memorial Museum’s Committee on Conscience, he serves with liberal academics like Deborah Lipstadt and Timothy Snyder (as well as Nicholas Burns).This latter appointment is particularly ironic, given Abrams’ lies on behalf of an outright fascist like d'Aubuisson. But Abrams made a habit of associating with truly despicable racists. As mentioned above, he worked for Ernest Lefever after his Iran-Contra disgrace. Abrams even married a particularly unhinged racist, the stepdaughter of neocon Norman Podhoretz. Rachel Abrams, who died in 2013, maintained a blog, “Bad Rachel,” where she offered reflections on the War on Terror such as the following:[T]his is where I have begun to wonder whether it is possible to help these benighted forgeries of humanity save themselves from themselves—for after all, isn’t that the point, once we’ve beaten our enemy, of continuing the fight?—and, more to the point…whether the attempting to do so has been worth the lives…of all those great, valiant, heroic, wonderful, Americans who’ve given them for that cause.Abrams’ links to disreputable characters like these, however, weren’t enough to disqualify him from association in the eyes of elite liberals. Once he made it inside the clubhouse gates, he established himself as a Serious Person, deserving of respect from the plebs. Foreign policy has always been the most mandarin wing of the U.S. state, and when elite liberals saw a properly credentialed and accomplished fellow of theirs under attack from the plebeians, they reacted quickly.Analysts like Noam Chomsky have long insisted that there is more continuity than discontinuity when it comes to foreign policy in the United States. The bonhomie liberal elites exhibit towards Abrams is what this continuity means on the level of personnel. It’s the same people, working together, who carry out American foreign policy. This placid continuity, the disruption of which by Trump is a chief reason for the enmity he has earned from this camp, helps ensure that the ship of state remains on a steady course.But Ilhan Omar’s refusal to let Abrams’ bloody past rest threatened that continuity. It suggested that the new generation of progressives and socialists will not be content to let their revolution stop at the nation’s borders. Much like Bernie Sanders’ declaration in a 2016 presidential debate that he was proud Henry Kissinger was not his friend, Omar’s questioning of Abrams signaled a radical break with the traditional etiquette of deference in foreign policy.If this is the type of direct challenge to U.S. foreign policy that left-wing elected officials like Omar, Rashida Tlaib, Alexandria Ocasio-Cortez and Sanders have planned, establishment liberals are right to be nervous.[2]During Operation Condor the CIA supported right wing dictators who brutally killed tens of thousands of people, for the alleged purpose of “defeating communism.”[3] In actuality the purpose of Operation Condor was all about money. Right wing dictators were open to the neoliberal capitalist model the U.S. wanted so large U.S. corporations could make money exploiting new markets, cheap labor, and cheap natural resources.Alexander Finnegan's answer to What was the most overlooked event of the Cold War?Footnotes[1] The Ten Most Lethal CIA Interventions in Latin America[2] The War Criminal Elliott Abrams and the Liberals Who Love Him[3] Operation Condor - Wikipedia

This may be one of the biggest social problems that is quietly evolving in an American background of physician secrecy, burnout and stress. Today, I work with young physicians, residents and medical students to teach them basic financial literacy, proper income protection and offer life-coaching for the physicians I have as clients. If they were to become disabled, I offer advocacy through that process, so the doctor does not have to be alone… and trust me, as a disabled physician in America, you feel very alone. I was a trauma and cardiac anesthesiologist until 2010. As a disabled doctor who has also attended law school and business school my life has been very interesting educationally and full of many of the greatest instants a medical career has to offer, as well as some of the career’s worst moments.Physician suicide is at an all-time high currently. More than one doctor per day is choosing suicide and physicians are the #1 professional to both attempt and succeed at suicide. Physician early retirement is a growing phenomenon due to stress, burnout and a horrid sense of hopelessness on the part of our physicians towards their careers.In 2018 the number of medical students choosing “any surgical specialty” has fallen 50% since just 2010. That will create a debacle for our society 10-15 years from now… the coming shortage of talented surgical technicians will make the 2001-2005 shortage of anesthesiologists look like it was a just a cloudy day for hospital staffers to deal with and overcome. Physician Assistants and Nurse Practitioners will not be able to fill the surgical needs of America in that timeframe. Something will give, or something will break.Physicians first feel the stress of near inhuman perfection in medical school where the pressure to perform and outperform colleagues begins with exams, then the first steps of Boards and finally with The Match each and every March. In 2018 over 1,000 medical students went unmatched into the fields of their choice and had to compete for unmatched transitional Intern years (think grunt for a hospital) and the number of individuals on their 3rd year consecutive unmatched year has reached a new record in the USA. Why? Residency program accreditation to increase slots takes longer than expanding the number of medical students in the overall system. There exists the widest gap between the number of graduating medical students and number of available training positions even in the United States.The problem is not just big, it is small and personal. Dr. Robert Chu wrote a letter to both national medical officials and government leaders explaining the flawed system of the Match that undercut his career before it even started. Dr. Robert Chu went unmatched to residency. He committed suicide. That’s a loss for tens of thousands of his would-have-been patients. That was before training even began, some doctor’s suicide notes reveal a fear of harming a patient so much from extreme sleep deprivation or other despondent work-environment issues. Instead, utterly hopeless, they choose to kill themselves.Why do they regret their careers?Because they were lied to, that’s why. The entrepreneurial spirit of the American Doctor has been subverted by the 21st Century efficient ‘business’ of medicine. Factory-work medical assembly kills doctors’ dreams first and then their bodies and finally, their souls. In a last act of self-punishment, they die by their own learned hand. Highly intelligent, compassionate and expertly educated individuals cannot properly care for suffering people in 7.5 minutes in order to stay on-track for the business inventory- flow numbers that day. With milestones competitive in the business-practice of medicine; “inefficiency” or “low productivity” labels sometimes push doctors to continuously ‘feel’ like a failure in their own practices. Government mandates create soul-crushing environments for brilliant talented doctors with increasing pressure from insurance companies beating the doctor’s reimbursement into submission along the way. All they really want to do is take care of people!Many suicide letters and notes form doctors point to working conditions with simply inhuman expectations. One big universal complaint is the paperwork/electronic record time to patient time ratio that has, by some measures, completely ruined the practice of medical care from the physician’s perspective. And ‘physician suicide’ as an issue is not just an American problem or a gender problem. Male doctors shoot themselves, female doctors’ overdose, New York docs jump and docs in India and China hang themselves by ceiling fans. Educated in how the body works for over a decade credentials doctors to have a suicidal proficiency seldom seen in any other group of individuals.I did not escape this phenomenon, myself. After my disability, it took six years for me to hit bottom. I was treated for suicidal ideation after learning I could not, no matter how hard I tried, no matter what legal methods I utilized… I simply could not learn how my group disability policy worked. I had to live knowing any ‘mistakes’ I made in returning to gainful employment would or could devastate my family’s finances. That just ‘killed’ me.Point in fact, male anesthesiologists are the highest number of physician suicides in America… and I was a male anesthesiologist. There was a study of ‘suicide attempts’ looking specifically at male anesthesiologists and the time it took between them deciding to try to kill themselves and their initiation of the suicide attempt… the answer was just minutes. They are found in their call rooms, in the operating rooms or they jump from the hospital parking lots… they have been found dead from overdose in their hospital chapels. They are showing those left behind where they were injured, hurt and let down.The secrecy surrounding physician suicide often leads to more doctors to think about or choose suicide as a method out of the mess of modern medical practice. We, physicians, are taught in medical school and residency to bury our emotional responses in order to be better diagnosticians and more efficient practitioners. We mask our emotions even to ourselves and so you get outwardly happy and content doctors returning from vacations killing themselves their next clinical day.The divorce rate is higher among doctors than the normal population. Child custody and care battles for more than a decade can erupt into nasty financial bouts between two emotional and psychologically injured people both using a physician’s income to sustain old wounds that won’t heal. No one enters medicine or a medical marriage thinking ‘I’m going to have to fight this highly educated, highly intelligent person for years over the kids.’ Infidelity is a known issue among doctors, as is the ‘skipping out’ on family issues including the death of family members or parenting duties to disabled children. You can hide a lot of your own pain and misery from yourself and your family by working 80-100 hours per week. Perversely, that incredible ‘work ethic’ leads to personal relationship dysfunction, infidelity, divorce, self- loathing and even suicide.In 11 years of treating patients in operating rooms… only one time did I lose my composure and let my feelings show in front of a patient’s family. Only once in more than 15,000 anesthetics. Thankfully, I was with an older doctor, the chairman of cardiothoracic surgery when it occurred, and he was kind in that moment, reminding me to never lose that compassion. When we lose patients under our care, we hurt…. and we hide that hurt from the outside world, we hide it from our colleagues, our families and ourselves. We practice this self-emotional-secrecy so many times it becomes habitual. Even in my own one-time case of emotional showing, I had done everything correct that day… I do not know why I lost my self-emotional-control. Yet, I still, to this day, sometimes wonder if I could have done more… like forgiving my-physician-self for doing my best is simply an impossibility.As I attended law school, I have assisted in many medical-legal situations generating a few dozen opinion letters both for plaintiffs and for the defenses of physician’s actions. I did this to be balanced and remove myself from leaning one direction or another on medical-legal issues. Yet, humans are mistake-machines during our lives no matter how much precaution is taken… especially unconscious mistakes. One of the last medical-legal cases I was involved with led to the discovery that the number and type of procedures being performed had shifted dramatically right after the previous employment contract had been completed between hospital and their little ‘factory workers’ called doctors. These physicians had ‘shifted’ their procedure numbers to maintain their incomes… consciously or unconsciously, doesn’t really matter because the expected number of errors rose dramatically… and in the particular case I was involved with, the changes had led to the death of a woman in her 30’s.Anything and everything a doctor screws up ends up a public story. The higher more-perfect standard one is held to in society, i.e. U.S. Doctors, the better the story of their collapse and public shaming is for society’s appetite to be entertained, enthralled and sickened by the actions of others. Sex, insurance fraud, DUIs, Medicare scams, greed, stupidity and loneliness all lead to poor decision making and the inevitable highly visible public shaming… all on a backdrop of the habitual inability to confront one’s own emotional state. Now with the Internet… these ‘human’ mistakes and the accompanying shame are forever for the American doctor.One big ‘advance’ was supposed to be the 80-hour work week! Begun on July 1, 2002, all medical trainees were prevented from working more than 80-hours in a given week or more than 28 hours in a row. I graduated in the late 1990’s. I was present for the 2002 switch-over… what happened in reality since the work still had to be completed is that all the residents went home at 5pm or 7pm depending on assigned hours restrictions and the attending physicians (me) just stayed until whenever to complete the work in the operating rooms. I recall working 100 hours per week as a resident and then, in late 2002, I was working 110 hours, even some 120-hour work weeks as an attending physician! Do I need to go into what sleep deprivation does to the human psyche?No one made me do it. That’s right, I chose to work 110 hours in a week. I could have just thrown my hands up and complained… but that’s just the problem, you can’t do that as a doctor in America.One bright spot pertaining that the work week reduction was the increased scrutiny concerning the maltreatment and hazing of younger residents by older ones in the pecking order of training programs… however this was coupled with necessary increased secrecy about lying about work hours so as to not get the training program in trouble with their accreditation bodies with violations on resident and intern time cards. I guess the bright spot was shoved back into the darkened corners of medical education and training. Worse, some resident and intern violators are then ‘outed’ semi-publicly within their residency program with ‘inefficiency’ or ‘low-productivity’ labels and are given the worst call schedules.Let’s back up for one moment. Doctors chose this career, right? They get paid great, right? They should just suck it up? Right? Unfortunately, that is exactly what they do, blaming and shaming go hand in hand pushing doctors to early career burnout. In the land of physician disability insurance, which I now inhabit, the greatest percent increase in claims illnesses are for mental/nervous conditions among doctors. The hopelessness and desperateness expressed by some doctors sounds almost incredulous unless you have walked in their shoes, which I have.My wife, a thoracic anesthesiologist, is a caring, compassionate and intelligent doctor. Sometimes the mercilessness medical system’s impositions and requirements and its accompanying political infrastructures seem unsympathetic towards the reality of physically practicing medicine properly. She works for what I consider one of the leading large medical institution in America. I know personally this system puts tremendous money and time into physician wellness… but they often miss the mark when it comes to application of those resources for their stated goals. Physicians just need to grin and bear the abuse, right?Normal people would scream by this point, “If you just can’t stand it anymore… get help… see a therapist… right?” Wrong. The confidentiality afforded regular Americans for psychological services does not exist for physicians. Even leaving town, paying cash and using a fake name sometimes cannot hide the treatment from the overall medical system, or your own colleagues. Your hospital, your own insurance carriers and even the medical board finds out you’ve sought therapy and then you are doubly screwed for trying to hide that fact from them. Confiding in colleagues does not work out well either, we are notoriously bad with ourselves as patients and even more so with colleagues because we believe we all have to just, ‘put up with it.’ Things are downplayed, rationalized away and any substantive discussion of true psychiatric issues are disregarded as weakness.Why do they regret their careers?Imagine knowing you have mental health issues and having nowhere to go and no one to talk to without making things worse for yourself, your patients, your family and your colleagues and friends… and left untreated and ignored, mental health deteriorates, and doctors choose suicide to escape the pain and the internal suffering. Do you know how humiliating it is for intelligent, compassionate, forthright and duty-bound individual who has championed for their patients to not use drugs and alcohol for years to be forced into random drug screening because the business of medicine wants cover from liability? For those suffering from emotional and psychological issues, coping with it via substances occurs very late in the disease state. If you think doctors do not know to avoid ‘testing positive’ then you are hopelessly naïve.Now some career specialties have more psychiatric issue than others; Emergency Department physicians and Anesthesiologists have higher rates of PTSD than other physicians. Whether as a soldier on the battle field or a doctor in the trauma bay or operating room… seeing human bodies apart unnaturally is a psychic-trauma for the caregivers. The cleaner the environment, think about a modern trauma bay, the starker the contrast of human misery are the traumatic gruesome moments in one’s medical career.What does society do after a physician suicide? Its hidden from the public and from other community physicians or explained in the newspapers as accidental death. Do you know what it is like to know your colleague hung themselves at home and have the community and newspapers all claim, ‘accidental death of this happy doctor’? Imagine answering questions for months about the loss to the community and having to lie about it. Medical schools cover up the suicide of its students because it hurts admissions. The obituaries claim ‘some accident’ or ‘passed away suddenly while asleep’ or worse, the newspaper mentions absolutely nothing about the cause of death… they just write about the happiness and accomplishments of the doctor, not the person.Are there solutions to the off-course nature of the 21st Century physician-career? Yes. They are complex and will take decades to categorically bring to the training and work environments of American physicians.I can’t fix the system. I start with the very simple idea of taking care of yourself first, before you take care of others. I try to assist each of my clients in the ways they need help. What I’ve noticed among young physicians and residents is that they are not taking care of the very basics of financial planning nor are they laying those foundational protections for their incomes. This is something I did very well myself and learned even more about how well I planned my life advocating on my own after disability. That is how I am doing my part to help others in this world, providing physician-to-physician education one doc at a time.~ChrisDr. Christopher YeringtonColumbus, OhioBio: Retired from clinical anesthesiology by a disability in 2010, Dr. Yerington has turned his love of teaching and service to others to his family, colleagues and community. He speaks and educates medical groups and residency programs about the importance of great disability insurance. Having attended law and business schools, Chris is a perpetual student, currently working on his financial certifications.