Are the allopathic forums more mature/less troll-ridden than the pre-allopathic forums?

[Psai]

They may know something that basic. But they often lack some very basic knowledge about other areas of our healthcare system.

I had a group interview at one school where we were asked what CMS was. Everyone else at the table looked dumbfounded. When I answered appropriately, our interviewer noted that I was the only person to have actually answered the question correctly all year. While he certainly doesn't interview all candidates, that so many potential medical students are clueless about the organization that administers health care to more Americans than any other (and the one that will likely affect their own income the most via its policies) seemed ridiculous to me. Payments and legislation are, like it or not, a huge part of medicine. For someone to claim they want to be a doctor while knowing little to nothing about the non-patient care side of things seems almost ridiculous in this day and age.

People's perception of what a doctor does and what they actually do are very different. You come in thinking that you're going to save lives and people are going to thank you from the bottom of their hearts. What actually happens is that another doctor tells you what happened at night. Then you see the patients and spend a bunch of time on the computer doing mindless electronic paperwork. Then you talk about the patients with the other doctors on your team. Then you go around and see patients with the other doctors. Then you go and write more stuff in the computer while you make phone calls to people who don't want to do what you want them to do. Maybe you spend a few minutes for lunch. You do that for a few more hours and then it's time to tell another doctor what you did and what they should do that night while you go home so you can sleep early to get up and do it again tomorrow.

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[Mad Jack]

People's perception of what a doctor does and what they actually do are very different.

Embarrassingly different, imo.

 

[DermViser]

People's perception of what a doctor does and what they actually do are very different.
You come in thinking that you're going to save lives and people are going to thank you from the bottom of their hearts. What actually happens is that another doctor tells you what happened at night. Then you see the patients and spend a bunch of time on the computer doing mindless electronic paperwork. Then you talk about the patients with your boss doctor. Then you go around and see patients with the boss doctor. Then you go and write more stuff in the computer while you make phone calls to people who don't want to do what you want them to do.

All the more reason why as a premed you're SUPPOSED to look for opportunities that actually show you what REAL medicine is like - not just do it bc it's "fun" or easy to rack volunteer hours. Same for only volunteering in certain specialties but not others. I guarantee you, I could put 20 year olds on MS-3 rotations and by the end of the week, half would be gone. Don't blame your medical school or others bc you got a very tilted way of what medicine is like bc your did ****** ECs that gave you a very lopsided view.

http://www.pandabearmd.com/category/a-day-in-the-life-of/ There was one story of a high school/college? volunteer - one of many good stories.

Edit: By the way I love Panda Bear, MD

 

[demayette]

They may know something that basic. But they often lack some very basic knowledge about other areas of our healthcare system.

I had a group interview at one school where we were asked what CMS was. Everyone else at the table looked dumbfounded. When I answered appropriately, our interviewer noted that I was the only person to have actually answered the question correctly all year. While he certainly doesn't interview all candidates, that so many potential medical students are clueless about the organization that administers health care to more Americans than any other (and the one that will likely affect their own income the most via its policies) seemed ridiculous to me. Payments and legislation are, like it or not, a huge part of medicine. For someone to claim they want to be a doctor while knowing little to nothing about the non-patient care side of things seems almost ridiculous in this day and age.

I know some (or many) premeds do not know much about US healthcare delivery... I guess that is one reason more schools are gearing toward the non trad applicants... Many in the healthcare industry don't know what CMS is... So it is not a premed 'thing'...

 

[DermViser]

I know some (or many) premeds do not know much about US healthcare delivery... I guess that is one reason more schools are gearing toward the non trad applicants... Many in the healthcare industry don't know what CMS is...

You can bet if you work in the healthcare industry -- you DEFINITELY know what CMS is bc it brings home the bacon.

 

[Mad Jack]

I know some (or many) premeds do not know much about US healthcare delivery... I guess that is one reason more schools are gearing toward the non trad applicants... Many in the healthcare industry don't know what CMS is... So it is not a premed 'thing'...

If you spend more than a year in a place, you'll have to prep for one CMS audit or another. Trust me, you know who they are if you want to keep the reimbursements flowing.

 

[demayette]

You can bet if you work in the healthcare industry -- you DEFINITELY know what CMS is bc it brings home the bacon.

I met a few that did not know what it was... They were nurses who thought 'their **** does not stink'

 

[demayette]

If you spend more than a year in a place, you'll have to prep for one CMS audit or another. Trust me, you know who they are if you want to keep the reimbursements flowing.

Some places (like nursing homes) don't call it 'CMS audit'... They call it 'state audit'.

 

[PL198]

To be fair, aren't you in a combined BS/MD program, which means the average age of matriculants is younger? There is a pretty big difference between an average 22-year-old going straight in to medical school and an average 25-year-old who has lived outside of school for several years.

yeah but we have traditionals too, and I'd wager a decent amount of them don't know either. As a whole, the knowledge of medical students in non-textbook issues never ceases to disappoint me.

 

[Mad Jack]

Some places (like nursing homes) don't call it 'CMS audit'... They call it 'state audit'.

CMS and state DPHs are entirely different but equally annoying entities. Nothing beats the aptly named Joint Commission though.

 

[OCDEMS]

I think the above posts are a good argument for restructuring the medical school process, specifically the pathway students take into medicine. Sometimes I can’t help but wonder if there should be some integrated undergraduate admissions process where, like nursing, students obtain progressively more experience in medicine until they get their MD/DO. I can’t help but see the tremendous difference between those students in my class with previous healthcare experience and those who are coming in without any idea what medicine actually entails. The naivety is astounding. You shouldn’t hear a room full of medical students suddenly quiet or gasp when they hear stories of uncooperative patients or provider abuse. They shouldn’t be surprised to find out that family practice doctors make less than specialist. Their entire concept of how medicine works in America is a fairy tale.

I really think this is what has made the nurse practitioner route so popular for so many up and coming students. The process has stopping points throughout, allowing a student to stop their educational investment when they’ve had their “fill” of that particular healthcare pathway. The problem with the “medical model” is that we essentially have two, maybe three, stopping points on the way to being a physician. The physician assistant is at least a Master’s Degree requiring 6 years postsecondary educational attainment. EMS, which is to say prehospital medicine, is hardly at a point in its development as a profession where we could say that it is a reliable entry point into higher medicine. Furthermore, it’s too specialized. We don’t have such a generalist low-tier entry point. What we do have is the Hunger Games of academia: an extremely competitive process that attracts competitive people with a general interest in science, not necessarily medicine.

I wonder if the profession would be better served by working long-term to create a progressive entry pathway. Perhaps we need an undergraduate linkage to graduate level medical school and then finally to residency? Something, no matter how small, that would forcibly expose applicants to clinical medicine in a more meaningful way than what shadowing accomplishes today. Just a thought. If we don't do it, nursing eventually will. I predict that it's a matter of time until the nursing profession decides to make the argument that DNPs should be considered full-fledged physicians.

 

[Ismet]

Moving to pre-allo, as OP is pre-med.

 

[deleted407021]

Okay...Thanks. Now we have to deal with it.

 

[Ace Khalifa]

I think the above posts are a good argument for restructuring the medical school process, specifically the pathway students take into medicine. Sometimes I can’t help but wonder if there should be some integrated undergraduate admissions process where, like nursing, students obtain progressively more experience in medicine until they get their MD/DO. I can’t help but see the tremendous difference between those students in my class with previous healthcare experience and those who are coming in without any idea what medicine actually entails. The naivety is astounding. You shouldn’t hear a room full of medical students suddenly quite or gasp when they hear stories of uncooperative patients or provider abuse. They shouldn’t be surprised to find out that family practice doctors make less than specialist. Their entire concept of how medicine works in America is a fairy tale.

I really think this is what has made the nurse practitioner route so popular for so many up and coming students. The process has stopping points throughout, allowing a student to stop their educational investment when they’ve had their “fill” of that particular healthcare pathway. The problem with the “medical model” is that we essentially have two, maybe three, stopping points on the way to being a physician. The physician assistant is at least a Master’s Degree requiring 6 years postsecondary educational attainment. EMS, which is to say prehospital medicine, is hardly at a point in its development as a profession where we could say that it is a reliable entry point into higher medicine. Furthermore, it’s too specialized. We don’t have such a generalist low-tier entry point. What we do have is the Hunger Games of academia: an extremely competitive process that attracts competitive people with a general interest in science, not necessarily medicine.

I wonder if the profession would be better served by working long-term to create a progressive entry pathway. Perhaps we need an undergraduate linkage to graduate level medical school and then finally to residency? Something, no matter how small, that would forcibly expose applicants to clinical medicine in a more meaningful way than what shadowing accomplishes today. Just a thought. If we don't do it, nursing eventually will. I predict that it's a matter of time until the nursing profession decides to make the argument that DNPs should be considered full-fledged physicians.

I like your idea. I work as an ER scribe now while applying to MD schools. I know that the reality of medicine is NOT a fairy tale, and I agree that it is incredibly naive to go into this field, either as a premed applicant or a matriculated medical student, without knowing what the reality of medicine looks like. Also, now I know what to spend my free time learning about (CMS, physician compensation models, the non-medical side of healthcare, etc.), so thanks, everyone who is not pre-allo!

 

[DermViser]

Moving to pre-allo, as OP is pre-med.

 

[DermViser]

yeah but we have traditionals too, and I'd wager a decent amount of them don't know either. As a whole, the knowledge of medical students in non-textbook issues never ceases to disappoint me.

But they're able to regurgitate Guyton, Robbins, etc. like Olympic athletes.

 

[DermViser]

I hope this thread gets moved to preallo.

Wish granted.

 

[Cyberdyne 101]

All the more reason why as a premed you're SUPPOSED to look for opportunities that actually show you what REAL medicine is like - not just do it bc it's "fun" or easy to rack volunteer hours. Same for only volunteering in certain specialties but not others. I guarantee you, I could put 20 year olds on MS-3 rotations and by the end of the week, half would be gone. Don't blame your medical school or others bc you got a very tilted way of what medicine is like bc your did ****** ECs that gave you a very lopsided view.

http://www.pandabearmd.com/category/a-day-in-the-life-of/ There was one story of a high school/college? volunteer - one of many good stories.

Edit: By the way I love Panda Bear, MD

It'd be nice if the bolded were a requirement (although it doesn't seem to be logistically possible).

 

[Lawpy]

I'm surprised pre-osteo is way more mature than preallo will ever be

 

[DermViser]

It'd be nice if the bolded were a requirement (although it doesn't seem to be logistically possible).

True, probably not logistically possible. Definitely save a lot of people time and loan money.

 

[Cyberdyne 101]

True, probably not logistically possible. Definitely save a lot of people time and loan money.

It would also save admission committees
a lot of time and energy as well.

 

[DermViser]

People's perception of what a doctor does and what they actually do are very different. You come in thinking that you're going to save lives and people are going to thank you from the bottom of their hearts. What actually happens is that another doctor tells you what happened at night. Then you see the patients and spend a bunch of time on the computer doing mindless electronic paperwork. Then you talk about the patients with the other doctors on your team. Then you go around and see patients with the other doctors. Then you go and write more stuff in the computer while you make phone calls to people who don't want to do what you want them to do. Maybe you spend a few minutes for lunch. You do that for a few more hours and then it's time to tell another doctor what you did and what they should do that night while you go home so you can sleep early to get up and do it again tomorrow.

And don't forget you, as the doctor, get blamed for: high healthcare costs, not spending enough time with patients, always looking at your computer screen, etc.

If you're going into medicine and expect to receive a "thank you from the bottom of their hearts" from all your patients, then you are in for a very RUDE awakening when reality doesn't comport with that.

 

[DermViser]

It would also save admission committees
a lot of time and energy as well.

Yup, applications would be ridiculously low. They'd be begging for people to attend medical school. They could still do medicine but it would much more likelier thru another route.

 

[RJGOP]

And don't forget you, as the doctor, get blamed for: high healthcare costs, not spending enough time with patients, always looking at your computer screen, etc.

If you're going into medicine and expect to receive a "thank you from the bottom of their hearts" from all your patients, then you are in for a very RUDE awakening when reality doesn't comport with that.

That's especially true for certain specialties. It'd probably be more realistic to expect a long middle finger and a cuss out for telling your patient they need to stop eating McDonalds for every meal and smoking three packs of cigarettes a day.

 

[moisne]

I think the more you learn, the more you realize you actually know nothing (in comparison to all there is to know) so you talk less ****... :/

and the higher you go... the more incompetent you realize you are....

 

[DermViser]

That's especially true for certain specialties. It'd probably be more realistic to expect a long middle finger and a cuss out for telling your patient they need to stop eating McDonalds for every meal and smoking three packs of cigarettes a day.

Pretty much: http://jezebel.com/5959682/doctors-are-****ty-to-fat-patients

You're ****** either way.

 

[Ismet]

And don't forget you, as the doctor, get blamed for: high healthcare costs, not spending enough time with patients, always looking at your computer screen, etc.

Yup. Before 3rd year, we had a clinical experience course throughout M1 and M2, part of which was shadowing. One of the docs I shadowed would chart while talking to the patient and her back was essentially turned to the patient during the entire history. I remember thinking that was horrible and that I would try to never do that (ha!).

Fast forward to now, and I realized very quickly, at least for the high-volume clinic I was in, that if you don't chart during the visit, you end up staying 2 hours after the last patient finishing up your notes, turning what should be an 8 hour day into a 10 hour day. And I usually saw less than half of the patients that were scheduled for the day, can't imagine if I was seeing and charting all 20+. Also doesn't help that patients are scheduled for a 15 minute followup and come in with a list of 8 cc's.

 

[DermViser]

Yup. Before 3rd year, we had a clinical experience course throughout M1 and M2, part of which was shadowing. One of the docs I shadowed would chart while talking to the patient and her back was essentially turned to the patient during the entire history. I remember thinking that was horrible and that I would try to never do that (ha!).

Fast forward to now, and I realized very quickly, at least for the high-volume clinic I was in, that if you don't chart during the visit, you end up staying 2 hours after the last patient finishing up your notes, turning what should be an 8 hour day into a 10 hour day. And I usually saw less than half of the patients that were scheduled for the day, can't imagine if I was seeing and charting all 20+. Also doesn't help that patients are scheduled for a 15 minute followup and come in with a list of 8 cc's.

I've never understood M1/M2 shadowing much (mainly bc you don't have any medical knowledge or basic science down). I thought the whole point was to get you to LIKE and enjoy clinical medicine. If anything you see the realities: ridiculous level of checking off boxes, EMR documentation, etc. You can't actually spend time with patients and get out at a reasonable hour if you aren't documenting on the computer inside the room. I think Skeptical Scalpel has the best idea: http://skepticalscalpel.blogspot.com/2010/07/shortage-of-primary-care-physicians.html

There's just no way you can do a thorough job on someone with >3 medical problems in a 15 min. visit.

 

[Cyberdyne 101]

Yup, applications would be ridiculously low. They'd be begging for people to attend medical school. They could still do medicine but it would much more likelier thru another route.

And it seems that med schools, residencies, and possibly society as a whole benefit from the typical young and "not very aware" overachiever (and I'm not saying that all younger pre-meds fall into this category, but some do). They're not gonna drop out after MS-3. And who's gonna leave a residency program after PGY-2? Maybe just a few.
But in the end, doctors (even if some are reluctant) emerge from this process. And I guess that's what matters most.

(n=3 or 4) But a few have told me that aside from the financial commitment it's immensely difficult to turn away from this path because sick ppl need your help.

 

[Goro]

What my young colleague is saying is the he doesn't suffer fools lightly. I can sympathize.

No, just people who remark on topics they know nothing about: i.e. the wonder and fulfillment of single-payer healthcare while being a Medical student (accepted) and not knowing anything about how medical services economics and transactions work now. If you're going to remark on specific payment methods, you should know basic things about how health insurance works, what copays are, what a deductible is, etc. I'm not even expecting you to know the more complex stuff like what are bundled payments, capitation, ACOs, etc. are.

Actual questions are fine and are encouraged.

 

[DermViser]

And it seems that med schools, residencies, and possibly society as a whole benefit from the typical young and "not very aware" overachiever (and I'm not saying that all younger pre-meds fall into this category, but some do). They're not gonna drop out after MS-3. And who's gonna leave a residency program after PGY-2? Maybe just a few.
But in the end, doctors (even if some are reluctant) emerge from this process. And I guess that's what matters most.

(n=3 or 4) But a few have told me that aside from the financial commitment it's immensely difficult to turn away from this path because sick ppl need your help.

It's pretty much financially impossible to turn away no matter how bad things get, the further you go in. I think of it as the merry-go-round that never stops once you hop on.

 

[DermViser]

What my young colleague is saying is the he doesn't suffer fools lightly. I can sympathize.

I'm ok with the ones that wish to be educated and are open to changing their minds (there are some like that here). It's not 100% black and white. It's the ones that hold onto an idealistic belief regardless of evidence to the contrary (some even upholding that since they are a non-traditional, that somehow this means something tangible, and gives them a leg up over the traditional premed) which is nauseating.

That's what happens when you get a bunch of overachievers whose main strengths are academic (i.e. GPA) - regurgitating information from textbooks and doing well on multiple choice exams, who don't know anything about how our healthcare system works and believe that medicine is somehow in some protected bubble and that no outside forces can greatly alter it.

 

[Great White Buffalo]

It's not a gaming term, it's an HBO series

And for the more literate types, a book series by George R. R. Martin. Excellent books (well, at least first three were, the latest 2 were meh). Looking forward to book six if the guy ever gets it written. Beware, these run 600 to 700 pages each. Enjoy.

 

[alpinism]

People's perception of what a doctor does and what they actually do are very different. You come in thinking that you're going to save lives and people are going to thank you from the bottom of their hearts. What actually happens is that another doctor tells you what happened at night. Then you see the patients and spend a bunch of time on the computer doing mindless electronic paperwork. Then you talk about the patients with the other doctors on your team. Then you go around and see patients with the other doctors. Then you go and write more stuff in the computer while you make phone calls to people who don't want to do what you want them to do. Maybe you spend a few minutes for lunch. You do that for a few more hours and then it's time to tell another doctor what you did and what they should do that night while you go home so you can sleep early to get up and do it again tomorrow.

Embarrassingly different, imo.

All the more reason why as a premed you're SUPPOSED to look for opportunities that actually show you what REAL medicine is like - not just do it bc it's "fun" or easy to rack volunteer hours. Same for only volunteering in certain specialties but not others. I guarantee you, I could put 20 year olds on MS-3 rotations and by the end of the week, half would be gone. Don't blame your medical school or others bc you got a very tilted way of what medicine is like bc your did ****** ECs that gave you a very lopsided view.

http://www.pandabearmd.com/category/a-day-in-the-life-of/ There was one story of a high school/college? volunteer - one of many good stories.

Edit: By the way I love Panda Bear, MD

This is why I can't help but laugh a little inside whenever I hear M1/M2s talking about how they "can't wait for 3rd year" or even better when I hear premeds talking about how they "can't wait for med school and being able to help people every day."

PB is awesome. His article on M3 year is probably the best I've ever read and nearly spot on with my experience:

http://www.studentdoctor.net/pandabearmd/2006/11/14/tomorrow-will-suck/

To be fair, general surgery and vascular surgery are probably the worst offenders, however, each rotation has its fair share of ridiculous BS.

 

[Mad Jack]

http://www.studentdoctor.net/pandabearmd/2012/07/06/satisfaction/

This is the real world.

 

[Cyberdyne 101]

So in conclusion, if you're looking for daily gratitude, a lower risk of burnout, and ppl not giving you **** on a daily basis, find another career.

 

[Tri4thlete]

To OP, yes.

I rarely go on the pre-med forums because I generally don't trust anything a pre-med has to say about anything related to post-undergraduate topics. "Bro, I'm a freshman in college, but trust me, I watched Gray's Anatomy and surgery is way better than any other specialty, don't do XXX specialty" -- Hasn't worked one day inside a hospital.

I only say this because I used to be the naive undergrad that thought I knew everything about medicine. Cheers bros

 

[TooMuchResearch]

Browsing through the first page of thread topics alone in enough to see that Allo >>>> Pre-allo but I don't think it has anything to do with ADCOMS. Troll posts seemed to be entertained for far longer in pre-allo. New users that haven't been around long enough fall for it, plus sheer volume of users in pre-allo means more people respond.

Not to mention in Allo we have @DermViser calling out anyone less than an MS-3 who has an opinion or a stupid question.

DermViser does this in Allo, too.

 

[NickNaylor]

The allo forums are substantially better in all regards to pre-allo. The quality:quantity ratio is much higher, and the people that post there are generally more intelligent.

 

[Cyberdyne 101]

Yeah, but med students, residents, etc cannot deny the sheer entertainment of the pre-Allo forum. Otherwise, you wouldn't keep coming back

 

[DermViser]

This is why I can't help but laugh a little inside whenever I hear M1/M2s talking about how they "can't wait for 3rd year" or even better when I hear premeds talking about how they "can't wait for med school and being able to help people every day."

PB is awesome. His article on M3 year is probably the best I've ever read and nearly spot on with my experience:

http://www.studentdoctor.net/pandabearmd/2006/11/14/tomorrow-will-suck/

To be fair, general surgery and vascular surgery are probably the worst offenders, however, each rotation has its fair share of ridiculous BS.

Is this a different blog? http://www.pandabearmd.com/2007/01/25/clinical-evaluations/, it's also Panda Bear MD.

 

[ZaneKaiser]

And for the more literate types, a book series by George R. R. Martin. Excellent books (well, at least first three were, the latest 2 were meh). Looking forward to book six if the guy ever gets it written. Beware, these run 600 to 700 pages each. Enjoy.

I disagree, the fourth book is the most literary of the series so far. It has some of the most beautiful prose and what it lacks in plot development, it makes up for with a strong sense of theme that beautifully conveyed the decay of the war. I think you will enjoy it a lot if you re-read it.

 

[Ismet]

Is this a different blog? http://www.pandabearmd.com/2007/01/25/clinical-evaluations/, it's also Panda Bear MD.

That post is gold.

 

[xffan624]

Yeah, but med students, residents, etc cannot deny the sheer entertainment of the pre-Allo forum. Otherwise, you wouldn't keep coming back

For information and tips to help me navigate medical school, I go to Allo. To watch a train wreck as its happening, I go to pre-Allo.

 

[DermViser]

That post is gold.

Yes, it's my favorite blog post of Panda Bear MD's so far. I want to meet him and shake his hand. Apparently he was a poster on SDN?

 

[Ismet]

Yes, it's my favorite blog post of Panda Bear MD's so far. I want to meet him and shake his hand. Apparently he was a poster on SDN?

He was, long ago. He deleted his account.

 

[Ismet]

For information and tips to help me navigate medical school, I go to Allo. To watch a train wreck as its happening, I go to pre-Allo.

Allo has its own share of train wrecks occasionally though

 

[DermViser]

He was, long ago. He deleted his account.

So if he deleted his account, his posts get deleted, too? If he posted in the way his blog posts are, he would have gotten the ban hammer early on, I'm sure.

 

[Winged Scapula]

So if he deleted his account, his posts get deleted, too? If he posted in the way his blog posts are, he would have gotten the ban hammer early on, I'm sure.

It depends on how his account was handled.

Some were just changed to a random "member xxxxrandom number" and still exists in archival form. Others were actually deleted, with all the attendant posts. The latter caused the servers to hang up and staff was discouraged from doing a full stop delete for that reason.

He stopped posting here after his wife came on and ranted about how SDN was ruining their marriage because he spent all his hours at home here. It was actually very sad.

 

[xffan624]

Allo has its own share of train wrecks occasionally though

True, Arky's always there in the clutch.