Do residents get high?

[NeedToStudy]

This may sound like a strange question but I know that marijuana use is pretty common in college and probably med school as well. I was wondering does this carry over to residency as well or does everyone become responsible married adults by then?

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[Top Gun]

I suspect some may in private, but residents don't exactly broadcast it if they do. Not unless they want to be immediately terminated by their PD. So its difficult to say how many actually do it.

 

[Winged Scapula]

Not everyone is responsible or married during residency but I suspect that random drug testing is a deterrent for almost all.

 

[Law2Doc]

Not everyone is responsible or married during residency but I suspect that random drug testing is a deterrent for almost all.

Agreed. Once they are paying you, and not the other way round, the odds of being drug tested are just much higher. Pretty much all residencies test you when you start, some do it again if you rotate off site, apply for credentialing, work at a VA, moonlight, apply for fellowship, etc. Failing a drug test can get you fired, or make it harder to get or renew a DEA license, etc. There is no "it's not illegal in" eg Colorado, Washingon, wherever, defense for licensure). So It becomes a career impacting decision. Has nothing to do with being a responsible married adult, and more to do with not wanting to screw up a career you have already invested pretty substantial time, money and effort to attain. It's really no different than when you read that some pro athlete screwed up a multi-million dollar career with foolish brushes with the law. Not to mention that during residency you will not have the kind of free time you previously had to hang with your stoner friends, and will be using the few free hours away from the hospital each week to sleep and run errands.

 

[QofQuimica]

I don't know of anyone who uses marijuana in residency. Certainly anyone who wants to keep their license would be wise to avoid broadcasting it if they do.

 

[colbgw02]

I get a high from helping patients. I also have a bridge to sell.

 

[drcrispmd]

You can be responsible and unmarried as well. Don't smoke pot during residency. Not worth future impact on license.

 

[gutonc]

The residents who like not being practicing physicians any longer get high. The rest just drink.

 

[NeedToStudy]

Alright alright I get it. Looks like there will be no fun and partying during residency. I guess one has to grow up sometime.

 

[Winged Scapula]

Alright alright I get it. Looks like there will be no fun and partying during residency. I guess one has to grow up sometime.

I dunno...I had many fun times in residency; lots of camaraderie and parties. If you can't have fun without getting high, that's a problem.

You don't have to "grow up" but most people eventually want to and you do have to obey the law and the restrictions of your chosen profession.

 

[mahasanti]

Where on earth do they give you a urine drug screen in residency. That certainly hasn't been my experience.

 

[colbgw02]

Where on earth do they give you a urine drug screen in residency. That certainly hasn't been my experience.

It's usually in a bathroom.

 

[Winged Scapula]

Where on earth do they give you a urine drug screen in residency. That certainly hasn't been my experience.

The VA; my home program also did it.

 

[Rendar5]

mine did not, but again, not really worth it, and if you do do it, not worth it to let anyone know you partake. Honestly, I'm fine with others pot smoking in moderation, but wouldn't touch the stuff right now because my job isn't worth risking.

 

[Law2Doc]

mine did not, but again, not really worth it, and if you do do it, not worth it to let anyone know you partake. Honestly, I'm fine with others pot smoking in moderation, but wouldn't touch the stuff right now because my job isn't worth risking.

Yeah, It has very little to do with what you or I might think is "fine in moderation". Most hospital employers and the DEA simply aren't "fine" with it showing up in your urine, even microscopically. If you want to be a doctor it's one of the relatively more minor sacrifices you just have to make.

OP, I think if you equate not getting high to being "grown up", or even equate growing up as being a bad thing, you may want to reevaluate your mindset. People who don't do drugs aren't all stiff Joe Friday types who live boring lives and nobody is expecting you to be. If you are needing/equating use of drugs (or alcohol) to have fun though, that ought to be a huge warning sign.

 

[HighPriest]

How about PCP? You guys doing any PCP?

 

[gutonc]

How about PCP? You guys doing any PCP?

Mostly just mushrooms and mescaline.

 

[HighPriest]

Mostly just mushrooms and mescaline.

Niiice.

 

[sacrament]

Some of us at work the other day were wondering how hospitals in Washington and Colorado are going to handle this. Conversations like this are interesting because they tend to reveal that people continue to make a subtle distinction between occasional social drinking and occasional social pot smoking--a distinction that I think is completely arbitrary and will disappear in another generation or so. "Do residents ever get together and have a couple of drinks... or will you get fired if your residency finds out that you had a Coors Lite on Saturday evening?" sounds like paranoid lunacy, but sounds eminently more reasonable if you replace alcohol with marijuana. To a marginal degree that's because one is legal and the other (for the most part) isn't, but I think it's more about some vestigial remnant of outdated, "Reefer Madness"-esque moral judgment. I wouldn't even bat an eye if I knew one of my coworkers smoked a joint on their night off, no more than if they had a glass of sherry.

 

[Law2Doc]

Some of us at work the other day were wondering how hospitals in Washington and Colorado are going to handle this. Conversations like this are interesting because they tend to reveal that people continue to make a subtle distinction between occasional social drinking and occasional social pot smoking--a distinction that I think is completely arbitrary and will disappear in another generation or so. "Do residents ever get together and have a couple of drinks... or will you get fired if your residency finds out that you had a Coors Lite on Saturday evening?" sounds like paranoid lunacy, but sounds eminently more reasonable if you replace alcohol with marijuana. To a marginal degree that's because one is legal and the other (for the most part) isn't, but I think it's more about some vestigial remnant of outdated, "Reefer Madness"-esque moral judgment. I wouldn't even bat an eye if I knew one of my coworkers smoked a joint on their night off, no more than if they had a glass of sherry.

That some states legalize it won't change anything. Your DEA license is federal. You need that to practice.

 

[keindo]

How about PCP? You guys doing any PCP?

I wasn't originally, but then I heard that we need more PCPs in this country... does that count as peer pressure?

 

[HighPriest]

I wasn't originally, but then I heard that we need more PCPs in this country... does that count as peer pressure?

Yeah, it seems like med schools are really pushing the hard stuff

 

[Junge]

I interviewed at 3 places that had a paper that stated that if we tested positive for nicotine our employment would be terminated (also stated we would be reported for a match violation). So it seems that whether or not it is legal doesn't matter.

 

[rokshana]

Some of us at work the other day were wondering how hospitals in Washington and Colorado are going to handle this. Conversations like this are interesting because they tend to reveal that people continue to make a subtle distinction between occasional social drinking and occasional social pot smoking--a distinction that I think is completely arbitrary and will disappear in another generation or so. "Do residents ever get together and have a couple of drinks... or will you get fired if your residency finds out that you had a Coors Lite on Saturday evening?" sounds like paranoid lunacy, but sounds eminently more reasonable if you replace alcohol with marijuana. To a marginal degree that's because one is legal and the other (for the most part) isn't, but I think it's more about some vestigial remnant of outdated, "Reefer Madness"-esque moral judgment. I wouldn't even bat an eye if I knew one of my coworkers smoked a joint on their night off, no more than if they had a glass of sherry.

legal isn't the issue…many programs test for nicotine metabolites and tobacco is legal…programs can state that they have policies that they expect you to follow and if you choose to rank them, you agree to their policies…remember the match is legally binding, so if you are opposed to their policies, don't rank them.

 

[sacrament]

That some states legalize it won't change anything. Your DEA license is federal. You need that to practice.

I am fully aware of this. I am commenting on current perceptions vs. what I personally believe is a very different underlying reality. And I am speculating that the perception and the reality (and the much mentioned law) will become aligned in the not so distant future, and our kids will find discussions like this to be quaint.

BUT: I think you are possibly incorrect in saying that it won't change anything. Those states chose to legalize marijuana despite knowing that it would remain against federal law. They decided to see what happens. Some progressive hospital system in Denver might be emboldened to simply stop all routine testing for marijuana. Probably won't happen, but they could just decide to go with "don't ask don't tell."

 

[sacrament]

legal isn't the issue…many programs test for nicotine metabolites and tobacco is legal…programs can state that they have policies that they expect you to follow and if you choose to rank them, you agree to their policies…remember the match is legally binding, so if you are opposed to their policies, don't rank them.

The interesting question in this case isn't what the federal law is, or what residency programs are allowed to required. These answers are well-established. The interesting question is how things should be. Physicians are so generally so milquetoast by nature that they have no interest in engaging in this question. I haven't smoked pot in over a decade and have no interest in ever smoking pot again, but I get so irritated with shrinking violets who fetishize The Law as though it cannot be questioned that I end up becoming a loud spokesperson for all this crap that I don't even really have any personal investment in. Everybody in my practice must think I'm some kind of fringe liberal hippy. I'm probably going to have to give a piss test after my rant last week. But I just think common sense should rule the land.

 

[Law2Doc]

... Some progressive hospital system in Denver might be emboldened to simply stop all routine testing for marijuana. Probably won't happen, but they could just decide to go with "don't ask don't tell."

Wouldn't work. Without a DEA number you cant function as a doctor. Doesn't matter if the hospital doesn't care about the results of drug tests, they would still have to administer them due to outside requirements, and doctors aren't going to risk their livelihood for a fun Friday night. Doctors don't just answer to one hospital. They answer to every place they are credentialed, plus their insurance companies, the state and the federal government. Lots of masters, lots of bosses. So it doesn't really matter if one or two get lenient on drugs, you still have to comply with all the others. It's a heavily regulated industry and that's not going to ever change. I don't see the federal government changing things any time soon. In fact I suspect if democrats lose in the next election things will tighten back up again at the federal level. Bottom line is there are always tradeoffs and choices in life. This shouldn't be one of the more difficult tradeoffs for most people who have invested so much time and money.

 

[auburnO5]

Wouldn't work. Without a DEA number you cant function as a doctor. Doesn't matter if the hospital doesn't care about the results of drug tests, they would still have to administer them due to outside requirements, and doctors aren't going to risk their livelihood for a fun Friday night. Doctors don't just answer to one hospital. They answer to every place they are credentialed, plus their insurance companies, the state and the federal government. Lots of masters, lots of bosses. So it doesn't really matter if one or two get lenient on drugs, you still have to comply with all the others. It's a heavily regulated industry and that's not going to ever change. I don't see the federal government changing things any time soon. In fact I suspect if democrats lose in the next election things will tighten back up again at the federal level. Bottom line is there are always tradeoffs and choices in life. This shouldn't be one of the more difficult tradeoffs for most people who have invested so much time and money.

I think you're missing his point. He's just posing how things 'should' be. I don't partake, but if programs administer UDS for marijuana then they should do weekly (or daily) alcohol screens as well.

 

[SouthernSurgeon]

The people I knew in med school who smoked pot certainly had no plans of quitting once they hit residency. I'd hazard a guess that the % that use it as residents is remarkably similar to the % who do as med students.

 

[sacrament]

Wouldn't work. Without a DEA number you cant function as a doctor.

I did not need to take a drug test to get my DEA number. And I did not need to take a drug test to get privileges at my current hospital.

 

[Raryn]

I did not need to take a drug test to get my DEA number. And I did not need to take a drug test to get privileges at my current hospital.

Very few hospitals actually drug test their physicians. Exceedingly few. Physician autonomy is still a thing, even though you do have your 1,000,000 masters.

State boards don't usually drug test unless they have reason to. (Of course, if you do get caught for any kind of drug related offense, they will drop the hammer).

That said, more residency programs/medical schools do drug test, and it's better to be safe than sorry.

 

[Mad Jack]

Alright alright I get it. Looks like there will be no fun and partying during residency. I guess one has to grow up sometime.

You want to be a doctor but you are disappointed you have to grow up?

Also pretty sad that you equate getting high with having fun. I haven't known anyone like that since my first year of college- people usually grow out of it and realize either the drugs weren't all that fun to begin with our the people they are with are so awesome that they can have a good time without getting high.

 

[Mad Jack]

Some of us at work the other day were wondering how hospitals in Washington and Colorado are going to handle this. Conversations like this are interesting because they tend to reveal that people continue to make a subtle distinction between occasional social drinking and occasional social pot smoking--a distinction that I think is completely arbitrary and will disappear in another generation or so. "Do residents ever get together and have a couple of drinks... or will you get fired if your residency finds out that you had a Coors Lite on Saturday evening?" sounds like paranoid lunacy, but sounds eminently more reasonable if you replace alcohol with marijuana. To a marginal degree that's because one is legal and the other (for the most part) isn't, but I think it's more about some vestigial remnant of outdated, "Reefer Madness"-esque moral judgment. I wouldn't even bat an eye if I knew one of my coworkers smoked a joint on their night off, no more than if they had a glass of sherry.

It isn't about how people morally feel toward the issue- I don't give a damn if someone is smoking pot, so long as they don't do it on the job. But it's just stupid to smoke if you could lose a career you invested over a decade into because of it.

 

[Cytarabine]

The interesting question in this case isn't what the federal law is, or what residency programs are allowed to required. These answers are well-established. The interesting question is how things should be. Physicians are so generally so milquetoast by nature that they have no interest in engaging in this question. I haven't smoked pot in over a decade and have no interest in ever smoking pot again, but I get so irritated with shrinking violets who fetishize The Law as though it cannot be questioned that I end up becoming a loud spokesperson for all this crap that I don't even really have any personal investment in. Everybody in my practice must think I'm some kind of fringe liberal hippy. I'm probably going to have to give a piss test after my rant last week. But I just think common sense should rule the land.

I don't smoke simply because the risk to reward ratio is too imbalanced, regardless of how unlikely it may be to get caught as a med student, but the attitudes toward pot use, at least among the classmates in my coterie, are neutral to positive. Pretty universally viewed as less harmful than the binge drinking that 90% of the class partakes in

 

[Euthymia]

A lot of the physicians, nurses, and support staff in hospitals I rotated at in California spoke pretty openly about their marijuana use. I would say it depends on what part of the country you're located.

 

[samsoniter]

Good posts, agree with a lot- esp. the risk benefit analysis. BUT this presents an interesting case in WA and CO. Also feel ETOH has more negative effects than THC, and it's sort of unfair that ETOH/METH/COCAINE are short lived and would not show up unless tested within 24 hours after use....THC up to 1 month. Bottom line, if I had to choose bt an alcoholic or coke head doc over the occasional THC user I would take the latter (but I think we all prefer our docs/pilots/train conductors etc. sober).

 

[colbgw02]

Good posts, agree with a lot- esp. the risk benefit analysis. BUT this presents an interesting case in WA and CO. Also feel ETOH has more negative effects than THC, and it's sort of unfair that ETOH/METH/COCAINE are short lived and would not show up unless tested within 24 hours after use....THC up to 1 month. Bottom line, if I had to choose bt an alcoholic or coke head doc over the occasional THC user I would take the latter (but I think we all prefer our docs/pilots/train conductors etc. sober).

I mean, I'm not really an anti-marijuana crusader or anything, but that's pretty much the definition of a false equivalence you've got there. Pretty much everyone would choose to be an occasional THC user over an alcoholic or coke head.

 

[Shikima]

I mean, I'm not really an anti-marijuana crusader or anything, but that's pretty much the definition of a false equivalence you've got there. Pretty much everyone would choose to be an occasional THC user over an alcoholic or coke head.

I was just about to say something when I saw your post. Glad someone caught the logical fallacy.

 

[keindo]

Figure out where you're going first (don't know if they have drug tests before then), know how long the drug test is effective for, and don't abuse THC.

 

[DermViser]

I dunno...I had many fun times in residency; lots of camaraderie and parties. If you can't have fun without getting high, that's a problem.

You don't have to "grow up" but most people eventually want to and you do have to obey the law and the restrictions of your chosen profession.

or any job. I don't know any job that doesn't have the restriction of no drug use.

 

[deuist]

That some states legalize it won't change anything. Your DEA license is federal. You need that to practice.

What if you practice in an environment that does not require prescribing controlled substances? Does a diagnostic radiologist, pathologist, dermatologist, or counseling-heavy psychiatrist really need a DEA?

 

[Trogghunter]

No

 

[Top Gun]

What if you practice in an environment that does not require prescribing controlled substances? Does a diagnostic radiologist, pathologist, dermatologist, or counseling-heavy psychiatrist really need a DEA?

Probably not a diagnostic radiologist or pathologist. Most psychiatrists do not rely on counselling alone. Psychiatrists also rely on drug therapy in addition to psychotherapy, and often patients with panic disorder or anxiety disorder will require benzodiazepines, such as Xanax or Klonopin, for panic attacks or severe anxiety episodes, So psychiatrists definitely need a DEA license.

 

[Arcan57]

The problem with casual THC use is that most hospitals are going to have some mechanism by which you can be tested for drugs if you are suspected of practicing while impaired. Sleep deprivation can look similar to being stoned (especially to a pissed off patient) and that patient complaint is usually enough to get you tested in residency. If you pop positive for THC, it's going to be difficult to build a credible defense that you haven't used in a couple of weeks. Now you're an impaired physician and life is suddenly sucking on all kinds of levels. Also, many people don't consider marijuana use a big deal but given the potential consequences for a doc even occasional use indicates a level of risk taking that is significantly higher than the general population.

 

[IMPD]

What if you practice in an environment that does not require prescribing controlled substances? Does a diagnostic radiologist, pathologist, dermatologist, or counseling-heavy psychiatrist really need a DEA?

Nope.

 

[IMPD]

Nope.

I'll elaborate. I do some consulting work for an insurance company to review physicians who are up for credentialing. Without credentials, you can't bill. (Yes, you can make up a story here about how you're going to be a cash-only doc. Good luck with that.)

At least every month of review we go through the physicians who have tested positive for a substance, usually in relation to some other event. That other event might be an encounter with law enforcement or whatnot. However it happens, when positive toxes come up, we don't usually get much further than discussing what rehab program the doc will get on or whatnot. The reality is that no matter how trivial the drug use seems (or is), if it becomes public that a doc is using (which it would if your actions came before the State board or a hospital exec committee), how is that going to look? Not good.

People certainly do complete whatever rehab they're ordered to and come back to work. And yes, alcohol issues are way more common than others. But the end result is the same. Your reputation and the risk-averse nature of your employers means that behavior that seems like a personal choice has ramifications out of your control.

 

[DermViser]

This may sound like a strange question but I know that marijuana use is pretty common in college and probably med school as well. I was wondering does this carry over to residency as well or does everyone become responsible married adults by then?

Uh, no. Just no.

 

[hiltonty997]

Uh, no. Just no.

You are very naive.

 

[DermViser]

You are very naive.

Yeah and those mj tokers are usually not at the top of the class.

 

[Cytarabine]

Yeah and those mj tokers are usually not at the top of the class.

Yeahhh most people aren't at the top of the classes, that's how distributions work. I know of plenty of smokers in the top quartile in med school, getting engineering phd's at top ranked programs, etc. Do you think successful people don't drink either?