What are you looking forward to in medical school?

[mdambitions]

To add to my answer...never having to request transcripts again. As a nontrad with 10 prior schools, definitely looking forward to never dealing with that hassle again.

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[bakedbeans18]

Haha. I didn't intend that to be hugely negative, just realistic. I think medical school >>> undergrad in terms of the work in spite of all of its negatives.


Sent from my iPhone using Tapatalk

Yeah, I'm not coming in from undergrad. I doubt I'll be that jaded about things come Step I.

 

[WhippleWhileWeWork]

Of course the pre-clinical years of medical school turned out to have little to no relevance to my practice of medicine, but that is a separate issue. What I have enjoyed a lot is working my butt off and learning things and then applying them in the hospital. Certainly more so as a resident than in medical school, but being able to help provide good health care and improve people's lives IS rewarding. Seeing a tangible product from your hard work IS rewarding.

Maybe the NPs are right.

 

[circulus vitios]

Making it through MS3/4 without administering any rectal or pelvic exams.

 

[tiedyeddog]

To add to my answer...never having to request transcripts again. As a nontrad with 10 prior schools, definitely looking forward to never dealing with that hassle again.

lol, if you do sub-I's you'll have to do this for your school. Won't be too difficult but transcripts nonetheless.

 

[tiedyeddog]

Making it through MS3/4 without administering any rectal or pelvic exams.

eh, they aren't that bad unless you're receiving one.

 

[tiedyeddog]

Try ED thoracotomies...

http://en.wikipedia.org/wiki/Resuscitative_thoracotomy

The numbers are generous. The survival numbers at even the best centers are about 10%. Forget breaking 2-3 ribs. We are cracking the patient's chest in the ED. I've done 3 and assisted on 4 others. Had two survive to the ICU and one leave the hospital alive. Still nothing more gratifying than putting your hands on someone and saving a life, I'd say an order of magnitude higher when you stick your finger in their pulmonary artery to plug a bullet hole and get wheeled up to the OR while on top of the patient. Not a single one of those experiences were terrible. And while I would never wish ill on others, it is something that I look forward to on trauma call. I don't want people to get hurt, but I want to be there when they do.

Yes, I am jaded. When you constantly deal with death, it happens. A bad night, you might have 3-4 deaths on trauma call. CVICU? I lost 4-5 this week. To be honest, if it is the natural course a particular pathology, it really starts to not bother you. It can't. If it did, you couldn't function in that environment. Yes, the young kids or sudden unexpected deaths haunt you, but that is more than made up for by the rest of the experience. At least, for me it is. Not everyone is built the same or enjoys the same aspects of medicine.

If I didn't have to do any endovascular work I would totally apply to vascular surgery residencies because of the instances you mentioned above.... I rotated on vascular surgery and their open surgeries were just... amazing, even run-of-the-mill fem-fems and fem-pops.

Endovascular grafting kills it for me. I wish the field weren't moving in that direction.

 

[bakedbeans18]

Making it through MS3/4 without administering any rectal or pelvic exams.

 

[TheRobin]

I'm looking forward to a new routine, whatever that will be.

 

[mdambitions]

lol, if you do sub-I's you'll have to do this for your school. Won't be too difficult but transcripts nonetheless.

Wait, what? Undergrad transcripts for sub-i's ?!?!

 

[WillburCobb]

Wait, what? Undergrad transcripts for sub-i's ?!?!

Maybe for away sub-Is? My school doesn't require them.

 

[touchpause13]

Well this thread got depressing

 

[DoctorLacrosse]

What you deal with in the ED isn't the same animal as what happens in an ICU or a witnessed patient going down on the floors. The odds of successful resuscitation are pretty good when you catch a patient early- I don't exactly keep score, but ICU ACLS at my place is probably 50-60% effective, and the patients we get back almost never have deficits. On the floor, if it's witnessed, you probably have very similar odds, but if it's unwitnessed, your odds might be closer to 30% because of the downtime.

In my year as a tech in the ID prior to what I do now, we probably got 1 out of 10 people back- these patients often came in via basic units and thus didn't get the drugs they needed, had minimally qualified bystanders working them for a few minutes, and often had completely unknown causes of arrest, all things that work against us pretty heavily. Don't let the ones that come in from the outside make you think ACLS is ineffective- it can be very effective, but low downtime, promptly starting resuscitation, and quality ACLS are critical to getting them back, and more importantly, getting them back in one piece.

I can agree with that. I was a nursing assistant on the general units for a couple years prior to my ED experience, and I certainly saw more success in rapids of all kinds compared to in the ER. definitely helps to have professionals on site when it hits the fan. no downtime helps tremendously. I clearly suddenly take everything to mean it's coming through the ED, so forgive that bias haha

 

[tiedyeddog]

Wait, what? Undergrad transcripts for sub-i's ?!?!

Medical school transcripts.

 

[mdambitions]

whew...

 

[WillburCobb]

Well this thread got depressing

Well we all know the given trajectory of a thread once it passes so many pages.

 

[Gregor Wiesmann]

Well we all know the given trajectory of a thread once it passes so many pages.

True dat.

 

[DermViser]

Doing CPR on someone is a terrible experience and not something to look forward to. Enjoy that 30% success rate and breaking 2-3 ribs as you watch someone die in front of you. Sent from my iPhone using Tapatalk

I think it's a true failure of our medical education system, when even incoming medical students, esp. those of the SDN variety, think that CPR is this lifesaving tool with a gigantic success rate. It tells me that the volunteering experiences med students undertake aren't really to gain a true appreciation for what the reality of medicine is. I would even peg that 30% number as much higher than the real success rate.

 

[DermViser]

Yeah, I'm not coming in from undergrad. I doubt I'll be that jaded about things come Step I.

Basic sciences is a cakewalk compared to MS-3 rotations, when you no longer have the protection of the classroom, when it comes to disillusionment and being "jaded". Your previous life experience is not antidote to being jaded during medical school.

 

[alpinism]

What you deal with in the ED isn't the same animal as what happens in an ICU or a witnessed patient going down on the floors. The odds of successful resuscitation are pretty good when you catch a patient early- I don't exactly keep score, but ICU ACLS at my place is probably 50-60% effective, and the patients we get back almost never have deficits. On the floor, if it's witnessed, you probably have very similar odds, but if it's unwitnessed, your odds might be closer to 30% because of the downtime.

In my year as a tech in the ID prior to what I do now, we probably got 1 out of 10 people back- these patients often came in via basic units and thus didn't get the drugs they needed, had minimally qualified bystanders working them for a few minutes, and often had completely unknown causes of arrest, all things that work against us pretty heavily. Don't let the ones that come in from the outside make you think ACLS is ineffective- it can be very effective, but low downtime, promptly starting resuscitation, and quality ACLS are critical to getting them back, and more importantly, getting them back in one piece.

Unfortunately, there has never been a quality study that shows ACLS provides any mortality benefit. In fact, more and more studies have shown that it may do more harm than good, and that's not even taking into account the opportunity cost of performing an unproven treatment.

http://www.thennt.com/nnt/acls-medications-for-cardiac-arrest/
http://forums.studentdoctor.net/threads/questionable-practices.743558/

I have to go through the inpatient census where I work everyday and anytime I come across a patient who had CPR either in the field or the hospital I keep an eye on them to see the outcome. IIRC in the past 2 years 4 have had a somewhat successful outcome. One, who prior to procedure was completely independent, crashed post-op ended-up having a 3 month long stay (for what generally is a 1-2 day hospitalization). Since discharge 5 months ago he's been bouncing back and forth between the hospital and nursing home 2-3 times/month. Now that's what I call quality of life!

That's been my experience as well.

I've done CPR probably well over 200 times between the ED and ambulance and I can count on 1 hand the number of patients who've made it out of the hospital alive with no brain damage and who've gone on live productive lives for at least another year. The sad fact of the matter is that even in those patients you get back, most end up wasting away in an ICU or nursing home for months until they eventually die or are right back in the ED within another week or so because of another MI/CHF exacerbation/COPD decompensation etc...

CPR is only really effective in young healthy patients (under 50 w/ no chronic diseases) who've had a witnessed arrest in the hospital or field. In both cases they need quality compressions and defibrillation within 10min. If you take those patients out of the picture, the success rate of CPR is likely well under 10%. Furthermore, if you were to then look at the percentage of those patients who made it out of the hospital neurologically intact with a good quality of life, the success rate would likely be under 1%.

 

[WillburCobb]

Unfortunately, there has never been a quality study that shows ACLS provides any mortality benefit. In fact, more and more studies have shown that it may do more harm than good, and that's not even taking into account the opportunity cost of performing an unproven treatment.

http://www.thennt.com/nnt/acls-medications-for-cardiac-arrest/
http://forums.studentdoctor.net/threads/questionable-practices.743558/



That's been my experience as well.

I've done CPR probably well over 200 times between the ED and ambulance and I can count on 1 hand the number of patients who've made it out of the hospital alive with no brain damage and who've gone on live productive lives for at least another year. The sad fact of the matter is that even in those patients you get back, most end up wasting away in an ICU or nursing home for months until they eventually die or are right back in the ED within another week or so because of another MI/CHF exacerbation/COPD decompensation etc...

CPR is only really effective in young healthy patients (under 50 w/ no chronic diseases) who've had a witnessed arrest in the hospital or field. In both cases they need quality compressions and defibrillation within 10min. If you take those patients out of the picture, the success rate of CPR is likely well under 10%. Furthermore, if you were to then look at the percentage of those patients who made it out of the hospital neurologically intact with a good quality of life, the success rate would likely be under 1%.

Depressing but, 3 codes today. 2 in the cath lab and 1 in the cardiac ICU - all are now on the organ harvest list.

 

[bakedbeans18]

Basic sciences is a cakewalk compared to MS-3 rotations, when you no longer have the protection of the classroom, when it comes to disillusionment and being "jaded". Your previous life experience is not antidote to being jaded during medical school.

Whatever you say. Everyone said the same thing before I went to graduate school....I'm graduating in a week and not a day has gone by where I've felt jaded. Some of us have more mental toughness than others...and I don't think I've given anyone on this forum a reason to question mine, so please don't invite yourself to do so, thanks.

 

[DermViser]

Whatever you say. Everyone said the same thing before I went to graduate school....I'm graduating in a week and not a day has gone by where I've felt jaded. Some of us have more mental toughness than others...and I don't think I've given anyone on this forum a reason to question mine, so please don't invite yourself to do so, thanks.

Graduate school (PhD) education is NOTHING like medical school education (esp. MS-3), residency training, or the practice of clinical medicine in general. It shows how academically sheltered you are that you believe your experiences in grad school somehow gives you a leg up when it comes to handling med school.

Your response to @NickNaylor that "Yeah, I'm not coming in from undergrad. I doubt I'll be that jaded about things come Step I" has nothing to do with "mental toughness" and reveals your utter lack of experience and insight on your part. The fact that you think, he wasn't being "very, erm, 'inspiring'", when he's actually seen and experienced the firsthand reality of medical school education (and before you deflect - he went to a top tier medical school) with how it's implemented and structured in MS-1/MS-2, Step Exams, and MS-3, shows how truly "mentally tough" you are, when you would much rather be "inspired" than be told the truth.

 

[DermViser]

No offense, but this just sounds flat-out weird.
1. there's a difference when you're the one with the responsibility
2. there's a difference between 'being there for people in their last moments' and physically assaulting the pretty-much-dead body of someone who won't ever truly be 'back', even if you do succeed, against the odds, in resuscitating them enough for the ICU.
3. Why are you being patronizing to one of the most helpful med student posters on pre-allo?

You forget she's the Cardiology Princess. It's different when she does CPR. After all, she's special - can't you see that with her selfie avatar?

 

[DermViser]

True dat.

As demonstrated by your performance in the "Doctor's Houses" thread.

 

[Mad Jack]

Unfortunately, there has never been a quality study that shows ACLS provides any mortality benefit. In fact, more and more studies have shown that it may do more harm than good, and that's not even taking into account the opportunity cost of performing an unproven treatment.

http://www.thennt.com/nnt/acls-medications-for-cardiac-arrest/
http://forums.studentdoctor.net/threads/questionable-practices.743558/



That's been my experience as well.

I've done CPR probably well over 200 times between the ED and ambulance and I can count on 1 hand the number of patients who've made it out of the hospital alive with no brain damage and who've gone on live productive lives for at least another year. The sad fact of the matter is that even in those patients you get back, most end up wasting away in an ICU or nursing home for months until they eventually die or are right back in the ED within another week or so because of another MI/CHF exacerbation/COPD decompensation etc...

CPR is only really effective in young healthy patients (under 50 w/ no chronic diseases) who've had a witnessed arrest in the hospital or field. In both cases they need quality compressions and defibrillation within 10min. If you take those patients out of the picture, the success rate of CPR is likely well under 10%. Furthermore, if you were to then look at the percentage of those patients who made it out of the hospital neurologically intact with a good quality of life, the success rate would likely be under 1%.

That just sounds crazy low to me. We've got a 36 bed MICU split over 2 floors, in which we probably code a patient a day at least. Surgical we have fewer codes, but the patients are often younger and healthier. Outcomes for the ones we get back in-unit and witnessed are extremely good- I can't even remember the last witnessed one we got back that was completely neurologically devastated. Maybe we should do a study of some sort, as our results sound like they are way outside the norm. Prehospital codes that are brought in and successfully brought back have results are as poor as anywhere else though- wouldn't be surprised if our completely intact patients were in the single digit percentage range.

 

[Cinclus]

Basic sciences is a cakewalk compared to MS-3 rotations, when you no longer have the protection of the classroom, when it comes to disillusionment and being "jaded". Your previous life experience is not antidote to being jaded during medical school.

Rotations are sooo much better than basic science. Basic science was a comparatively miserable experience (extremely miserable at times). I'm actually enjoying myself now. Things just don't seem so difficult when you enjoy what you're doing.

 

[bakedbeans18]

Graduate school (PhD) education is NOTHING like medical school education (esp. MS-3), residency training, or the practice of clinical medicine in general. It shows how academically sheltered you are that you believe your experiences in grad school somehow gives you a leg up when it comes to handling med school.

Your response to @NickNaylor that "Yeah, I'm not coming in from undergrad. I doubt I'll be that jaded about things come Step I" has nothing to do with "mental toughness" and reveals your utter lack of experience and insight on your part. The fact that you think, he wasn't being "very, erm, 'inspiring'", when he's actually seen and experienced the firsthand reality of medical school education (and before you deflect - he went to a top tier medical school) with how it's implemented and structured in MS-1/MS-2, Step Exams, and MS-3, shows how truly "mentally tough" you are, when you would much rather be "inspired" than be told the truth.

The word 'inspired' wasn't a very deliberate word choice. I was really commenting on the s#itty attitude that was thrown my way out of nowhere. By all means, continue thinking what you will about me, it makes no difference in the end, frankly. If you want to make an assertion that I am 'utterly inexperienced', that's your perogative, but you have one or two comments made in passing to make that judgement....not really substantial backing for any argument you've made. Peace out hombre.

 

[DermViser]

The word 'inspired' wasn't a very deliberate word choice. I was really commenting on the s#itty attitude that was thrown my way out of nowhere. By all means, continue thinking what you will about me, it makes no difference in the end, frankly. If you want to make an assertion that I am 'utterly inexperienced', that's your perogative, but you have one or two comments made in passing to make that judgement....not really substantial backing for any argument you've made. Peace out hombre.

I doubt @NickNaylor was throwing a s#**ty attitude your way. He was clearly explaining the reality of medical school, and you interpreted him as throwing a bad attitude, just bc it doesn't fit your narrowly defined worldview on something you have yet to experience. Also, no, it's not just 1 or 2 comments to pass judgment on you. You have several gems to base your naiveté on.

I'm looking forward to studying in a curriculum where each grade actually matters. Perhaps one of the most infuriating thing for many of my undergrad and grad classes was that the goal was to achieve mastery of a subject, only to do a memory dump 5 months later. It will be nice that everything will build on the previous thing in medical school, and that my exam studying and grades will actually have implications for the future - it's no longer just a big bag of BS. Also, stethoscopes.

With comments like the above, it's pretty obvious you don't know what you're getting into if you truly think that medical school, especially in the first 2 years, doesn't 1) have a huge memory dump component, 2) that your exam studying and grades have "implications" for the future, and 3) that you won't be learning a lot of BS.

 

[DermViser]

Rotations are sooo much better than basic science. Basic science was a comparatively miserable experience (extremely miserable at times). I'm actually enjoying myself now. Things just don't seem so difficult when you enjoy what you're doing.

Remember to read this when you're working with residents and attendings in General Surgery and OB-Gyn. Hopefully your school's rotations are realistic when it comes to exposing their students to the number of hours on those rotations as a resident, and not sheltering you. Of course you'll have a better idea of which specialties are actually open to you once you've finished taking Step 1, since Baylor students take Step 1 AFTER finishing their clinical rotations, and not before rotations, like most other medical schools.

 

[bakedbeans18]

I doubt @NickNaylor was throwing a s#itty attitude your way. He was clearly explaining the reality of medical school, and you interpreted him as throwing a bad attitude, just bc it doesn't fit your narrowly defined worldview on something you have yet to experience. Also, no, it's not just 1 or 2 comments to pass judgment on you. You have several gems to base your naiveté on.


With comments like the above, it's pretty obvious you don't know what you're getting into if you truly think that medical school, especially in the first 2 years, doesn't 1) have a huge memory dump component, 2) that your exam studying and grades have "implications" for the future, and 3) that you won't be learning a lot of BS.

Yeah, you're right. I'm just flippantly going into medicine because I like the idea of being a doctor. I don't know what I'm getting myself into at all. You really hit the nail on the head with this one bub. [ignore]

 

[AndyQC]

FWIW - my wife enjoyed medical school for the most part. The preclinical years were manageable and she enjoyed spending time with her classmates. The clinical years, on the other hand, varied between being almost fun (psych) to a nightmare (surgery). She had two preceptors during third year that made her want to quit medicine. Several of my friends had similar experiences but each of them stuck it out.

From what I've observed, there's a ton of variability between medical schools. One's experience at UTSW, for example, is going to be completely different from Drexel or Tufts or OHSU. Different preceptors, different culture, different expectations. But even at the most challenging programs, the attrition rate is incredibly low. Why? I suspect that students tend to rise to the occasion when they're $100K in debt and have no other options.

 

[DermViser]

Yeah, you're right. I'm just flippantly going into medicine because I like the idea of being a doctor. I don't know what I'm getting myself into at all. You really hit the nail on the head with this one bub. [ignore]

I didn't say your decision to go into medicine was flippant. My point was that what you said about medical school shows that you TRULY don't know what it is when you believe that bc people said grad school was difficult and it wasn't, that this somehow means people are lying about medical school.

If you think that:

• medical school esp. in MS-1/MS-2 doesn't require mastery and then memory dumping
• that somehow each year of med school seamlessly builds on the prior year
• and that exam studying and grades, esp. in MS-1/MS-2, some how have such great implications

Then you are truly misguided with delusions of grandeur. Edit: Thanks for making this your avatar tagline. It fits you well.

 

[DermViser]

FWIW - my wife enjoyed medical school for the most part. The preclinical years were manageable and she enjoyed spending time with her classmates. The clinical years, on the other hand, varied between being almost fun (psych) to a nightmare (surgery). She had two preceptors during third year that made her want to quit medicine. Several of my friends had similar experiences but each of them stuck it out.

From what I've observed, there's a ton of variability between medical schools. One's experience at UTSW, for example, is going to be completely different from Drexel or Tufts or OHSU. Different preceptors, different culture, different expectations. But even at the most challenging programs, the attrition rate is incredibly low. Why? I suspect that students tend to rise to the occasion when they're $100K in debt and have no other options.

Very true - the cultures at different medical schools across the country are very different. For example, as you mentioned UT-Southwestern vs. OHSU vs. UCSF vs. WashU vs. Tufts -- the overall ambient culture will be vastly different. This is esp. hard to tease out during interview season when everything is heavily choreographed, and things are only presented in the best light. That being said as far as the attrition rate, medical schools up to this point, try as best to "pass" you even after failing multiple times. Now with increasing unmatch rates, this is very much being called into question.

https://www.aamc.org/newsroom/reporter/april2014/378174/viewpoint.html
As a result, medical schools are re-examining promotion guidelines to determine if the relatively low attrition rate, typically less than 3 percent for most schools, makes sense in this increasingly competitive Match environment. How much time and energy should be invested in remediation for students who are unlikely to match into a residency? Are we setting students up for failure by promoting them once competencies are eventually achieved, especially in light of the additional student debt accumulated by such remediation? How do we tighten requirements for graduation while balancing the need for developmental, competency-based curriculum models and making the academic environment safe for failure, practice, and measured remediation?

 

[breakintheroof]

Very true - the cultures at different medical schools across the country are very different. For example, as you mentioned UT-Southwestern vs. OHSU vs. UCSF vs. WashU vs. Tufts -- the overall ambient culture will be vastly different. This is esp. hard to tease out during interview season when everything is heavily choreographed, and things are only presented in the best light. That being said as far as the attrition rate, medical schools up to this point, try as best to "pass" you even after failing multiple times. Now with increasing unmatch rates, this is very much being called into question.

https://www.aamc.org/newsroom/reporter/april2014/378174/viewpoint.html
As a result, medical schools are re-examining promotion guidelines to determine if the relatively low attrition rate, typically less than 3 percent for most schools, makes sense in this increasingly competitive Match environment. How much time and energy should be invested in remediation for students who are unlikely to match into a residency? Are we setting students up for failure by promoting them once competencies are eventually achieved, especially in light of the additional student debt accumulated by such remediation? How do we tighten requirements for graduation while balancing the need for developmental, competency-based curriculum models and making the academic environment safe for failure, practice, and measured remediation?

It seems perverse for the takeaway from rising unmatch rates to be encouraging more people to wash out of medical school.

 

[EMDO2018]

Also for me, NEVER HAVING TO WRITE ANOTHER LAB REPORT!!!!!

 

[DermViser]

It seems perverse for the takeaway from rising unmatch rates to be encouraging more people to wash out of medical school.

I very much agree with you and then we wonder why medical students tend to have overly perfectionist tendencies to where they're afraid to make any mistake at all.

 

[niblet]

I'm looking forward to finally be doing the thing immediately relevant to what I'll actually be doing the rest of my life.

No longer will it merely be education or some medically related activity, but real actual medical education. It'll be the first time where the purpose of whatever it is I'm doing will have becoming a doctor front and center. No more slogging through crap for the chance of slogging through more crap to become a doctor; just slogging through crap to become a doctor, which sounds much nicer.

 

[mehc012]

Some of us have more mental toughness than others...and I don't think I've given anyone on this forum a reason to question mine, so please don't invite yourself to do so, thanks.

 

[xffan624]

Also for me, NEVER HAVING TO WRITE ANOTHER LAB REPORT!!!!!

We have to do that every week at my school.....




as the kids say these days, j/k, j//k ... I did have to do a two page summary of the objectives of an anatomy lab, but that was because I had missed a lab for a medical mission trip.

 

[Gregor Wiesmann]

As demonstrated by your performance in the "Doctor's Houses" thread.

Go away........

 

[DermViser]

Go away........

 

[Gregor Wiesmann]

 

[touchpause13]

You two should just make out already

 

[DermViser]

You two should just make out already

I would but he's working hard on getting in to Yale Med with CC courses.

 

[Gregor Wiesmann]

I would but he's working hard on getting in to Yale Med with CC courses.

Not applying to Yale........, transferring to Uni next month.

 

[DermViser]

Not applying to Yale........, transferring to Uni next month.

 

[Gregor Wiesmann]

Get a life......

 

[acceptmeplease]

I'm looking forward to not being a nurse anymore. 33 remaining shifts feel like an eternity.

As for the CPR discussion, I don't get thrills from feeling ribs crunch. ACLS seems to be the best option in practice because it's supposedly better than nothing. Living in the south has probably jaded me because EVERYONE wants everything done their 93 year-old grandma.

Maybe it's just my facility, but it seems like renal patients can't die and survive every code, but previously "healthy" patients almost never make it.

 

[Lets Get Free]

I'm looking forward to living close to the beach, working hard, meeting new friends and colleagues, and being expose to the wide variety of possibilities for a career after med school.

I'm also interested in seeing how science and medicine, as well as healthcare policy, evolves over the next several years, and being in a position to gain a deeper understanding of it all.