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Yeah, no. That will cause just as many problems as it is supposed to solve.
Yeah, no. That will cause just as many problems as it is supposed to solve.
Agree completely. Not that being a clinical med student is 100% fun and joy, but you get to have most of the pros of playing like you're a doctor while having no responsibility whatsoever. You can spend an hour talking to a patient, and no one cares that you're not being efficient. You can decide not to come in when you're sick (or if you just plain don't feel like coming in), and it doesn't inconvenience anyone else or leave your patients in the lurch because there's no one to cover for you. You get every major holiday off, including two weeks at Christmas/New Years. You get pulled in to see all the cool cases, and unless your residents are jacka**es, you get shielded from most of the BS scut. I never send my students in to see the borderline personality disorder patients who are allergic to everything except IV dilaudid, and are here yet again for their chronic back pain. When one of my seniors was being a jerk and making our student stay late every night for no good reason, I shamed him into sending the student "to the library to study" by mid-afternoon.If I could be an MS3 all over again, yeah, I'd do it. MS3 was awesome. You show up, you learn a ton, you see a bunch of cool things that most people will never see...it was great.
Being a "real doctor" took some of the fun out of things.
This I do agree with. The biggest upside of being a resident is that you *are* a doctor, and you're not just playing at being one any more. You actually do have some ability to help other people beyond sitting with them and talking for an hour.And put some real fun into other things. I find residency so much more rewarding, challenging, interesting than student years.
Agree with this too.I think if the time comes where I feel so dispassionate about bad news, about patients dying unexpectedly, that is the time to hang it up and retire. When I stop caring it's time to stop practicing.
And this.But dang, some of the bs administrative garbage makes the practice of medicine so stinkin hard.
And this.If I could just take care of patients all day, then I would definitely do it all again, no question. Taking care of patients who truly need your help is awesome.
you get to have most of the pros of playing like you're a doctor while having no responsibility whatsoever.
I think if the time comes where I feel so dispassionate about bad news, about patients dying unexpectedly, that is the time to hang it up and retire. When I stop caring it's time to stop practicing.
You have a job, and you can get fired. If that happens, you have no recourse, and your MD/DO is basically useless. Those of you who haven't done so yet should go to the Gen Res forum and read some of the threads by terminated residents. It will be a real eye-opener for you.
http://www.medscape.com/viewarticle/756561"The greatest myth of human life is the belief that I'll be happy if I just get what I want," says O'Connor. "All the research shows that as soon as we get what we want, we'll just want something else."
http://www.medscape.com/viewarticle/756561_3
How frequently does this happen? I was told that in med school it's more dependent on one's attitude and willingness to work hard. Are you on more shakey ground as a resident? Is it much easier to slip and screw up and lose everything you've worked for? Or is it still a matter of attitude, hard work, and playing nice with your team? Thanks.
That resident didn't take the warning seriously and refused to "play by the rules". He almost killed a second patient and was fired from residency.
Disagree completely.Agree completely.
Not that being a resident is 100% fun and joy, but you're actually getting paid for doing real work that needs to be done, instead of getting endlessly pimped on topics you couldn't care less about, never being sure what your role is, switching to a new rotation as soon as you start to get the hang of how things work on the current one, feeling like an idiot as your resident sends you off on some task to deal with other hospital staff and you know they're thinking "oh, great, they only sent the medical student... can we get someone who actually knows what's going on?"Not that being a clinical med student is 100% fun and joy, but you get to have most of the pros of playing like you're a doctor while having no responsibility whatsoever.
You have a legitimate excuse to cut off patients who'd talk indefinitely, because you've got work to do.You can spend an hour talking to a patient, and no one cares that you're not being efficient.
Cue Law2Doc coming in here to say that your school must have been a rarity, and you shouldn't go into medical school counting on any of the above being true, at most hospitals a medical student will catch hell for calling out sick, you'll be working most major holidays and not having 2 weeks at Christmas/New Years off, you'll be doing scut because you're the low man on the totem pole and "that's just the culture" in 3... 2... 1...You can decide not to come in when you're sick (or if you just plain don't feel like coming in), and it doesn't inconvenience anyone else or leave your patients in the lurch because there's no one to cover for you. You get every major holiday off, including two weeks at Christmas/New Years. You get pulled in to see all the cool cases, and unless your residents are jacka**es, you get shielded from most of the BS scut.
Welcome to psych residency.I never send my students in to see the borderline personality disorder patients who are allergic to everything except IV dilaudid, and are here yet again for their chronic back pain.
But again, you're doing important work that needs to be done and getting paid, and you can just do your work and GFTO, rather than being expected to show up bright-eyed and bushy-tailed, kissing butt and asking displaying your knowledge and asking insightful questions about something you don't have the least bit of interest in.Once you're an intern, all of a sudden you "don't need" anyone to look out for you. It's ok to scut you out. There's no problem with having you work every single holiday in the calendar.
Screw that. I'm no longer a medical student who has to suppress my stomach grumbles and clench my sphincters extra-tight all day in the hopes of making a good impression and getting that coveted honors. I'm there to work, and I'm eating my damn lunch and using the damn bathroom. What are they going to do, fire me? These academic hospitals are staffed by lazy attendings, and residents do all the work. They need us. They fire us, they have a gaping hole in their staffing, and that's a prospect too terrible for them to contemplate.You somehow cease to have human needs like eating lunch or using the bathroom.
Haven't been over there in a while, but I recall stories of people getting fired for endangering patients, not for eating and using the bathroom.You have a job, and you can get fired. If that happens, you have no recourse, and your MD/DO is basically useless. Those of you who haven't done so yet should go to the Gen Res forum and read some of the threads by terminated residents. It will be a real eye-opener for you.
I don't think I ever said that I don't feel it's worth it, nor that other people shouldn't do it. I said that *I* wouldn't do it again if I had it to do over. And I wouldn't. I would have gone to pharmacy school instead.Q, it's interesting that our positions have switched; when we were in med school, I was the one saying I wouldn't do it over, whereas now, in residency, while that's still true, I'm much more content, and you're posting in the non-trad forums saying you don't feel it's worth it.
Here's my reply, but in paragraphs.Anyway, I like you, but I'm going to have to do a line-by-line...
I don't think I ever said that I don't feel it's worth it, nor that other people shouldn't do it. I said that *I* wouldn't do it again if I had it to do over. And I wouldn't. I would have gone to pharmacy school instead.
That's what matters the most to me. As long as the process is not arbitrary and I have control over my own performance, I think there is still hope for making the most of it and being happy.(However, knowing this individual, I can't say that their termination wasn't warranted.)
and working as a pharmacist is all painless? .
As long as the process is not arbitrary and I have control over my own performance, I think there is still hope for making the most of it and being happy.
Correct. I have no desire to be a retail pharmacist, any more than I have a desire to be a community physician. However, there is a lot more that can be done with a PharmD than work in retail. Academic pharmacists often do residencies and specialize, analogous to what academic physicians do. For example, it is possible for a pharmacist to specialize in cards drugs, or GI drugs, and work in those departments. Likewise, they can work in critical care areas of the hospital such as ICUs or the ED. At my current hospital, we have pharmacists rounding with us in the ICUs, and coordinating the drug administration during codes. The ER even has specialized emergency pharmacists who work solely in that capacity to advise the ER physicians.I definitely didn't get the impression that she thinks it's all painless. I also suspect she'd do something a bit different with a pharmd than work in retail pharmacy...
I'd argue that it's basically akin to how third year of medical school is graded: you have the objective part (exam grades), and you have the subjective part (evaluations). The objective part is easy to evaluate. No one can argue over whether a resident scored well enough on, say, an in-service exam, or whether or not they passed Step 3 if that is required for eligibility to continue their training. (It is for us.)There have been a number of stories in the gen res forum where it seems to be about miscommunication and misunderstanding, getting off on the wrong foot with a supervising resident/physician, and never getting back on track, so your evals are always subpar and then, well...
I can see how that would easily happen, but who knows for sure exactly what happened in each of those stories.
It really depends on the culture at the program. At some programs, with some attendings, there IS a fair degree of "arbitrariness" to the process, and it's not completely in your control. It's hard to tell which programs are like this, and which are not. So there's a fair degree of luck in that, too.
The difference is that in most industries, you can still get some LORs from people who do like you and use them to get a job somewhere else. It's not generally possible for a resident to join another program without their PD's blessing. The consequence of not being able to finish a residency program is that you cannot practice medicine. Or, if you have at least finished your intern year and gotten a full license, the consequence is that your clinical job options are severely limited, as most jobs and hospitals require you to be board-eligible at minimum. (You cannot be BE in any specialty without completing an entire residency in that specialty.)so if you're a clinical or academic pharmacist, won't you get evaluated and judged by the corresponding faculty, program directors, and department chairs? if you're an assistant professor, don't you have to "publish or perish"? What if you rub the department chair the wrong way, or you don't bring in enough grant money, and you don't get tenure? what if you work for a pharmaceutical company, and your boss gives you a "doses not meet expectations" rating cause she doesn't like you? not only that, you don't get to do research on what you want, but on what the company wants.
same things you describe in medicine can happen in any field or on any job. that's part of being a working adult, isn't it? to have to navigate the mine fields of work, and survive under conditions where it's not just your objectively measurable skills which determine your success.
I suppose you must have married the very first person you ever dated after only going out once or twice. I mean, no one ever puts on a good show for your benefit the first time you meet them, right?also, I don't think that residency PD's and attendings are "out to get" the residents. if they were, they would have a reputation for it, which you should've been able to find out about and not chosen to go there.
I don't think I ever said that I don't feel it's worth it, nor that other people shouldn't do it. I said that *I* wouldn't do it again if I had it to do over. And I wouldn't. I would have gone to pharmacy school instead.
Yeah, but contrasted with being a medical student, when someone rolls their eyes at you, you can just punch them in the face. OK, not really, but you don't have to care. Maybe our experiences are different because you cared less as a medical student, or care more now. But after the gut-wrenching torture that was the clinical years of medical school, I find it almost exhilarating that, on off-service rotations, all I have to do is survive (and not harm patients, of course.) Yeah, I got pimped a little on medicine, but I just did the best I could, and rested easy in the knowledge that it would all be over soon. I know, I was probably fortunate to have pretty non-malignant attendings and seniors. Actually, the worst attending I have encountered so far was an ER attending during my ED month--awkward, poor social skills, a curt, abrasive personality and sardonic, condescending tone; everybody in the hospital disliked her, and yeah, she gave me a hard time, but I still felt that as a resident I just didn't have to care as much as I did as a medical student, and taht made all the difference.Yes, you get paid for the work, but a lot of that filling out forms and making phone calls could be done by someone with a high school education. Also, for the number of hours worked, the pay sucks. At least in my program, interns do still get pimped. And being an intern doesn't shield you from getting an eye roll when you deal with other people, because you really don't know much of anything, especially when you're starting out. You still have to do off-service rotations and try to adjust to a new system for most months of your intern year, so that's not an improvement over med school either.
No, I agree with you, I just thought I'd channel Law2Doc for fun.Ok, did you seriously ever "catch hell" for calling in sick as a med student? We had three automatic sick days off per rotation. We had vacation every Christmas/New Years. Our school specifically did not allow us to be scutted out.
I like talking to patients in general, but manic patients need to be cut off or they would never stop, and with psychotic patients with bizarre delusions, you don't get anything useful out of them after the first 5 or so minutes.What I find ironic is that you're in psych, a specialty that basically hangs up the stethoscope entirely and places a lot more focus on talking to patients, while the more clinical specialties are the exact opposite. People who don't like talking to patients don't generally choose psych as a specialty! And seeing as many clinical rotations do not realistically have a way to schedule time for lunch, sometimes I don't get lunch. Or it's at 3 PM even though I got there at 7 AM.
I suppose the lesson is, do your homework during interviews, and if you're a laid-back person, go into a laid-back field. I have sympathy for people in malignant programs, but not for jackasses who can't get along with others.FWIW, it's not true that you're irreplaceable. If you disappeared tomorrow; if your entire intern class disappeared, you'd simply be replaced by people who failed to match somewhere this year. Most of the Gen Res descriptions of firings are because of the resident having interpersonal conflicts with attendings and faculty, not because they're endangering patients or eating/using the bathrooms. I know one terminated resident IRL, and that is the exact reason why this person was terminated. (However, knowing this individual, I can't say that their termination wasn't warranted.)
No, I agree with you, I just thought I'd channel Law2Doc for fun.
I'm not quite sure though why you'd want to do the extra 5 years of med school + internship and then get the MPH and work in public health. what's the added benefit vs just getting a MPH without the MD? seems like a waste of time to go to med school if you're never gonna touch patients. maybe someone can explain that to me....
by the way, there are fields in medicine which have much less patient contact, if any, and so for those who don't want to deal with the fear of "killing someone", there's always options like ....
I like patient contact. That's the main thing that makes medicine worth doing, IMO. Like you pointed out, I could have done public health with an MPH. That being said, having an MD does give you a perspective that those with grad school only experience do not have. It's all well and good to discuss pharmaceuticals as a chemist (i.e., theoretically), but real practice often doesn't follow theory. To the point that, when applicants tell me that they're applying to med school because they "love science," I tell them that if they *really* love science (like, actually doing science), they won't love medicine. The way we make decisions at the bedside would never fly at the bench.by the way, there are fields in medicine which have much less patient contact, if any, and so for those who don't want to deal with the fear of "killing someone", there's always options like preventive/occupational med etc. for preventive you just have to do a 1 year internship/transition year, so you just have to survive that. and you're not likely to get fired for almost killing anyone cause as an intern you don't have as much independence as a resident. then after that you get your mph and then you can work in public health. so starting out as a pre-med or 1st year med student, you don't have to be so scared of not ever having a job in medicine. I'm not quite sure though why you'd want to do the extra 5 years of med school + internship and then get the MPH and work in public health. what's the added benefit vs just getting a MPH without the MD? seems like a waste of time to go to med school if you're never gonna touch patients. maybe someone can explain that to me....
Tri, I didn't find medical school rotations to be torture, and that's probably the biggest difference in our perspectives. (There was one exception, which was OB, but then, I don't know all that many people who really loved their OB rotation.) I don't find residency rotations to be torture either; that's a pretty strong word. I just don't like that my reason for existence has come in large part to be doing ridiculous amounts of paperwork. We have forms here that need to be filled out to get more forms. It's ridiculous.Trismegistus4 said:Yeah, but contrasted with being a medical student, when someone rolls their eyes at you, you can just punch them in the face. OK, not really, but you don't have to care. Maybe our experiences are different because you cared less as a medical student, or care more now. But after the gut-wrenching torture that was the clinical years of medical school, I find it almost exhilarating that, on off-service rotations, all I have to do is survive (and not harm patients, of course.) Yeah, I got pimped a little on medicine, but I just did the best I could, and rested easy in the knowledge that it would all be over soon. I know, I was probably fortunate to have pretty non-malignant attendings and seniors. Actually, the worst attending I have encountered so far was an ER attending during my ED month--awkward, poor social skills, a curt, abrasive personality and sardonic, condescending tone; everybody in the hospital disliked her, and yeah, she gave me a hard time, but I still felt that as a resident I just didn't have to care as much as I did as a medical student, and taht made all the difference.
As for channeling L2D, he's still around. What you need is a bat-signal, not a medium.
Yes, it's called pathology or the coroner. The patients are already dead!!
What are "laid-back fields"?? I'm looking at FM, I *hope* it's laid-back!!!! Am I basically going to have to be a kiss-ass for 5yrs (med school + residency) so that I am always perceived as "getting along"?? I can do that, I think... I'm generally well-liked, but as with any person I'm sure there will be people who don't like me, as I am strong-willed, how do you deal with that?
I was thinking 3rd/4th year + residency, not years 1 & 2....
When do you cross the line from "stand your ground/idea" to "argumentative"?? Or is it basically, if they say jump you do it regardless of your thoughts?
Read it two years ago. Huge fan of Dr. Fischer. (For those of you who are preclinical med students, Conrad Fischer is to Step 2 what Goljan is to Step 1, only funnier and much less pompous.) Great book. Not a cure for the disillusioned trainee, I'm afraid, but well worth reading anyway. Did I mention that I'm a huge fan of his??I just started reading this. cure for med student and resident disillusionment.
http://www.amazon.com/Routine-Mirac...=sr_1_3?s=books&ie=UTF8&qid=1335143534&sr=1-3
Read it two years ago. Huge fan of Dr. Fischer. (For those of you who are preclinical med students, Conrad Fischer is to Step 2 what Goljan is to Step 1, only funnier and much less pompous.) Great book. Not a cure for the disillusioned trainee, I'm afraid, but well worth reading anyway. Did I mention that I'm a huge fan of his??
I'm a Conrad fan myself. But i just watched the interview series on youtube.
Who the f@ck has time to read a book. I watch stuff. While I'm eating. Or listen to it while I'm studying. Books...are like some old school ****...like, horses and buggies.
Cabinbuilder, what an inspiration you are! The only dissimilarity is that my children are a lot older, maturer and independent, and I'm starting pretty late in the game. Medicine has always been my passion for as long as I can remember. With the love and support of my husband and children, I have come to the decision that "here and now" is the time to make my dreams of being a doctor come true. I know it won't be easy, but doing what you love be nothing but extremely well worth it!!
I am asking this question at the beginning of my journey. I'm a M0 at this point. I start in the fall in Oregon. I've seen these types of questions posted on the general doctor forums but not specifically toward non-trads who deal with different life scenarios due to age and other complications when starting the process. So I am wondering not that you have or are in the process:
1) What expectations were met?
2) What expectations were not met?
3) If you have a family, how did they cope with your decision and then the application of that decision?]
4) Do you love what you do?
Thanks for your time.