Class of 2020 Starting Early?

[salmonellaisafish]

Do you think the class of 2020 who have matched to programs in high burden areas will have to start residency early, prior to July 1?

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[Dr. Doctor MD]

Do you think the class of 2020 who have matched to programs in high burden areas will have to start residency early, prior to July 1?

I don't see how this would be possible and more importantly legal. Maybe if a program asked and a resident was willing to do this, it could be a possibility, but I don't think there would be any recourse if the incoming resident said "no, I'll see you in July"

 

[mehc012]

Programs would need to come up with a good amount of money to pay residents if they started early.

They would also need to move orientation and all our pre-residency training back to May. Everyone would need to submit all their HR paperwork within the next two weeks for it to be processed in time to start. Plus, MS4s would need to find a drug testing location that is still open even though many cities shutdown.

I don’t think it could happen

I'm having a hard enough time figuring out how to get 2 TB tests, a physical exam, and an in-person ACLS course by June!

 

[Ducant]

My school seems to have no intentions of moving up graduation.
Some people still have required rotations to fulfill and that runs until the end of April.

 

[Sleepingdoc]

Do you think the class of 2020 who have matched to programs in high burden areas will have to start residency early, prior to July 1?

Interns that are coming in does not really benefit the residency until they have gone through at least 1-2 months into the year... there is a training period so I am not sure if it would be advantageous to have residents come in early.

 

[Mass Effect]

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus | CNN

Thousands of medical students across Europe are being fast-tracked into early service in an attempt to boost health systems across the continent that are struggling to cope with the coronavirus outbreak.

www.cnn.com

 

[njtrimed]

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus

Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus | CNN

Thousands of medical students across Europe are being fast-tracked into early service in an attempt to boost health systems across the continent that are struggling to cope with the coronavirus outbreak.

www.cnn.com

Not in the U.S. Even now.

 

[Oedipa Maas]

It’s here...

 

[Coupd'Cat]

It’s here...
View attachment 299691

My gut reaction is that this is leading sheep to slaughter. NYC hospitals barely have enough PPE for their residents. At my friend's institution N95s are locked up and symptomatic healthcare workers currently can't get tested while they're awaiting the roll-out of new tests. This is putting students at risk and preying on their sense of mission and duty during a public health crisis that has been mismanaged and further exacerbated by existing weaknesses in our healthcare system.

I say you have plenty of time to be noble and self-sacrificing in the future, if you haven't already. Go be with your family and loved ones. If you want to be helpful, there are plenty of local advocacy and mutual aid efforts. In the end, do what you want, but this is what I am telling my friends still in medical school and what I would tell my own family.

 

[Mass Effect]

That isn’t starting residency early. It is for the MS4s already at the school, so they don’t have to go through the HR process. It’s not for just NYU MS4s who matched at NYU for residency and it’s not for non NYU MS4s who matched there

The point is that they're allowing MS 4s to graduate early and work as an intern because the manpower is needed. It's the first step. I expect more schools will follow suit.

 

[RaginMD]

They are graduating us a basically a month early and ending all of our graduation requirement by April 9th here in Louisiana. However I'm not sure if this early graduation (sad face my family will not be able to see me graduate and I'm 1st generation) translates into starting work early. I for one do not plan on starting until July 1st when I have to. I think throwing us newly minted doctors into that **** show is just asking for more problems than we can solve. I still have to find a place to live, move and I have a wedding in May. If offered to start early I'll have to politely decline unless they offer a substantial pay increase.

 

[Ducant]

They are graduating us a basically a month early and ending all of our graduation requirement by April 9th here in Louisiana. However I'm not sure if this early graduation (sad face my family will not be able to see me graduate and I'm 1st generation) translates into starting work early. I for one do not plan on starting until July 1st when I have to. I think throwing us newly minted doctors into that **** show is just asking for more problems than we can solve. I still have to find a place to live, move and I have a wedding in May. If offered to start early I'll have to politely decline unless they offer a substantial pay increase.

Id decline too, tbh.

I got my orientation info today anyway, nothing until June. Normal timeframe.

 

[ludgate]

My program is offering for us to start residency early as well. Makes you feel guilty and selfish for not wanting to jump in and help but I just don’t know that I’m willing to give up the only year of my life I have a large block of vacation time...we already lost match day and graduation so I’d like to keep at least one perk of 4th year.

 

[CyrilFiggis]

A little bit of knowledge is a dangerous thing.... anyone else do an away in July and see interns on their first month just trying to orient themselves? Now do that early with no formal orientation, probably rushed to move to their new city and in the middle of a pandemic that is short of protective equipment. We were all drawn with a sense to help, but running into the fire without a helmet or gun isn’t noble, it’s foolish.

 

[mehc012]

A little bit of knowledge is a dangerous thing.... anyone else do an away in July and see interns on their first month just trying to orient themselves? Now do that early with no formal orientation, probably rushed to move to their new city and in the middle of a pandemic that is short of protective equipment. We were all drawn with a sense to help, but running into the fire without a helmet or gun isn’t noble, it’s foolish.

It can be if you're the medic.
My take is, by the time they ask for my sorry αss, they need whatever help they can get. They KNOW how useless I am. So I'm not rushing or pushing for anything early, but if it gets to that point, I'm not going to say no, either. Plus...I could use the money. CA is expensive. And frankly, if the hospitals are that short on PPE, I'm about to get COVID-19 anyway...and I'd rather get it now than in June. I can take a month of sick leave and quarantine now. But during that crucial June-Sept period during a prelim intern year? Nope. I can't afford it. I cannot deal with another unsuccessful Match.

 

[IntheClouds4ever]

It’s here.. Personally, I’d do it. Not from a sense of duty or altruism BS. I just hate sitting around for the last month and have three more months of just sitting. I’d rather get started and make better use of my time. Just me though..

Osteopathic medical students may be graduating early to fight COVID-19 - The DO

Accrediting body approves steps for colleges of osteopathic medicine to allow fourth-year students to enter the health care workforce early.

thedo.osteopathic.org

 

[CyrilFiggis]

It can be if you're the medic.
My take is, by the time they ask for my sorry αss, they need whatever help they can get. They KNOW how useless I am. So I'm not rushing or pushing for anything early, but if it gets to that point, I'm not going to say no, either. Plus...I could use the money. CA is expensive. And frankly, if the hospitals are that short on PPE, I'm about to get COVID-19 anyway...and I'd rather get it now than in June. I can take a month of sick leave and quarantine now. But during that crucial June-Sept period during a prelim intern year? Nope. I can't afford it. I cannot deal with another unsuccessful Match.

You seem to have a very specific scenario. I’m speaking more generally.

 

[sanfran256]

My program is offering for us to start residency early as well. Makes you feel guilty and selfish for not wanting to jump in and help but I just don’t know that I’m willing to give up the only year of my life I have a large block of vacation time...we already lost match day and graduation so I’d like to keep at least one perk of 4th year.

Which state are you in?

 

[mehc012]

You seem to have a very specific scenario. I’m speaking more generally.

My specifics exacerbate the situation, but the general idea stands.

M4s are all about to start residency (aka not staying home safe) in June, aka will be at risk anyway. Nobody is better served getting this during intern year rather than before. Plenty of people are moving and facing immediate expenses. Plenty of people want to help, especially if it gets bad enough that we're considered at all with how green we are.

 

[njtrimed]

My specifics exacerbate the situation, but the general idea stands.

M4s are all about to start residency (aka not staying home safe) in June, aka will be at risk anyway. Nobody is better served getting this during intern year rather than before. Plenty of people are moving and facing immediate expenses. Plenty of people want to help, especially if it gets bad enough that we're considered at all with how green we are.

People younger than me have died from this in my area. The longer I’m around to take care of my children, the better. If I’m guaranteed to get it when I start working, I’d rather have the time with my family now. If someone else would rather start now than later, more power to them, but I am happy to stay at home safe while I can.

 

[mehc012]

People younger than me have died from this in my area. The longer I’m around to take care of my children, the better. If I’m guaranteed to get it when I start working, I’d rather have the time with my family now. If someone else would rather start now than later, more power to them, but I am happy to stay at home safe while I can.

And I think that's perfectly legitimate and reasonable... but so is the other. There's not one right answer. That's why I was careful to leave my statement at "plenty of people ".

 

[sanfran256]

,,

 

[sanfran256]

Does anyone think there is something terribly wrong with the medical education system if new interns are considered useless after completing four years of medical school ?

 

[mehc012]

Does anyone think there is something terribly wrong with the medical education system if new interns are considered useless after completing four years of medical school ?

I think that I can keep the day to day orders going, and tell 'sick or not sick' most of the time, with a strong tendency to err on the side of 'sick' if I'm uncertain because the risk is greater that way. I will make mistakes in both of those, and those mistakes will negatively impact patients.

That is useful. We think it's not because our system strives for perfection, and so interns are closely supervised to avoid those inevitable mistakes.
In a situation where the choice is between "someone who will largely get it right (and most patients have the same issues so the learning curve is quicker)" and "nobody"...that's a world of difference. This is not a situation where we can strive for perfection. It's one where we strive for as much benefit as we can get.*

*'This' being 'the situation where MS4s are actually called in to help

 

[ludgate]

Which state are you in?

Louisiana. They’re graduating us early with the option to start in May or June.

 

[ACSurgeon]

Do you think the class of 2020 who have matched to programs in high burden areas will have to start residency early, prior to July 1?

it’s hard enough for experienced physicians to medical staff to navigate this chaos. Do we think it’s a good idea to have a bunch of beginners starting now? I would think not.

 

[Candidate2017]

Do you think the class of 2020 who have matched to programs in high burden areas will have to start residency early, prior to July 1?

Most definitely if things worsen, especially in NYC. Residency is a whole new world of hurt. They've got you guys by the balls. Never underestimate hospital admin's and your residency's willingness to step up and sacrifice you while they run away. You are expendable in the name of PR for the government and hospital, as well as a barrier between the faculty and frontlines.

If you haven't seen the news, the CEO/Dr/psychiatrist of one the worst hit NYC hospitals is holed away out of state in one of his 3 mansions while staff lack ppe and have died.

 

[CyrilFiggis]

The blunt truth is medicine comes with inherent risks and you can't choose to only practice in safe times if you are a doctor.
Also, i think you are overestimating your risks with COVID . While it is true that young healthy people do tragically die, if you are <40 you still have only a 0.16% chance of dying

It’s obvious you don’t have a spouse or children.

 

[CyrilFiggis]

Does anyone think there is something terribly wrong with the medical education system if new interns are considered useless after completing four years of medical school ?

Not every 5 star football recruit starts as a freshman. The speed of the game is faster. You had to carry 1-3 patients as an M3-4, now you’re expected to do more, in a new environment, possibly new EMR, where you don’t know anyone. There’s a reason residency exists.

 

[mehc012]

Not every 5 star football recruit starts as a freshman. The speed of the game is faster. You had to carry 1-3 patients as an M3-4, now you’re expected to do more, in a new environment, possibly new EMR, where you don’t know anyone. There’s a reason residency exists.

I mean, the new environment, EMR, and not knowing anyone is true of your first attending gig, too.
There's a lot that's learned in residency, but those three things seem the least of it.

Also...you don't need to know how to handle everything with no support to help in these circumstances. You need to learn how to handle one thing, at high volume, while surrounded by people also learning and handling that same thing. The goals of residency are different than the goals of pandemic care.

 

[Mass Effect]

That's fine. Others see medicine as a calling and feel the need to start helping (if needed at their program) right away
The blunt truth is medicine comes with inherent risks and you can't choose to only practice in safe times if you are a doctor

Of course you can. Until there's a full-on draft, people can choose to only practice in safe times if that's what they want. No one took an oath to harm themselves for others.

Regarding the percentage of folks under 40 who die, that's what they say now, but who knows what the final numbers will show.

 

[Mass Effect]

And by the way, before there is a full-on draft, I hope they arrest all the clowns participating in big gatherings.

 

[Mass Effect]

I mean, the new environment, EMR, and not knowing anyone is true of your first attending gig, too.
There's a lot that's learned in residency, but those three things seem the least of it.

Also...you don't need to know how to handle everything with no support to help in these circumstances. You need to learn how to handle one thing, at high volume, while surrounded by people also learning and handling that same thing. The goals of residency are different than the goals of pandemic care.

There's a learning curve in attendinghood as well. That's why they say that anyone who goes into solo practice after residency/fellowship is a fool. As a junior attending, you still need the support. As an intern, you need a hell of a lot more. Never underestimate the workload. I went from carrying 3 minimally complicated patients (5 at the ultimate most) as an MS-4 to carrying 10 - 12 patients daily as an intern, all of whom were VERY sick. I tackled over a dozen nursing pages a day, many of which I had to scramble to find a computer to log in to Up To Date and look up what to do for various acute problems and if I couldn't find it, I'd rely on what I did know to tell the nurse, then I'd frantically page my senior to make sure I did the right thing. I thought it was just me, but it wasn't. This is what many interns do because holding a person's life in your hands is terrifying.

During a pandemic, it's going to be much, much harder.

 

[mehc012]

There's a learning curve in attendinghood as well. That's why they say that anyone who goes into solo practice after residency/fellowship is a fool. As a junior attending, you still need the support. As an intern, you need a hell of a lot more. Never underestimate the workload. I went from carrying 3 minimally complicated patients (5 at the ultimate most) as an MS-4 to carrying 10 - 12 patients daily as an intern, all of whom were VERY sick. I tackled over a dozen nursing pages a day, many of which I had to scramble to find a computer to log in to Up To Date and look up what to do for various acute problems and if I couldn't find it, I'd rely on what I did know to tell the nurse, then I'd frantically page my senior to make sure I did the right thing. I thought it was just me, but it wasn't. This is what many interns do because holding a person's life in your hands is terrifying.

During a pandemic, it's going to be much, much harder.

Never did I say that it would be easy. The question at hand was whether a green intern adds any value to the overloaded system.
My point is: not if your goal is ideal care and producing a doctor who can eventually function independently in a variety of situations. If your goal is "better than no provider" after a crash course and high volume in a very specific situation...probably.

My hope would be that they would not ask less-qualified individuals to contribute unless they'd gotten to the point where they were struggling to meet even the latter goal, and I would volunteer because if they're asking, I presume they're at that stage.

 

[njtrimed]

Of course you can. Until there's a full-on draft, people can choose to only practice in safe times if that's what they want. No one took an oath to harm themselves for others.

Regarding the percentage of folks under 40 who die, that's what they say now, but who knows what the final numbers will show.

Exactly. The residents and attendings I have talked to about this agree that in my situation, the responsible thing to do is take care of my family and start as scheduled in July. I made it clear that if I was actually needed, I would be happy to jump in. But it was made pretty clear to me that this is not the case.

That's fine. Others see medicine as a calling and feel the need to start helping (if needed at their program) right away
The blunt truth is medicine comes with inherent risks and you can't choose to only practice in safe times if you are a doctor.
Also, i think you are overestimating your risks with COVID . While it is true that young healthy people do tragically die, if you are <40 you still have only a 0.16% chance of dying

Your judgment is irrelevant to me, and only demonstrates how little you understand parenting or...well, adulthood. Also, I’m not sure why you assume anything about my age.

 

[njtrimed]

it’s hard enough for experienced physicians to medical staff to navigate this chaos. Do we think it’s a good idea to have a bunch of beginners starting now? I would think not.

That was kind of my feeling as well. While it’s noble to want to help, the reality is that there’s a steep learning curve at the beginning of residency, and asking physicians to navigate the first weeks of this pandemic while orienting interns seems like a bit much.