Ask the resident (previously ask the 4th year)

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Mattinthehat250 said:
How do you feel that your education has differed from the education at an MD school (of course, unless you've ever been to both it will be impossible to know for sure)? Do you feel that the "holistic approach" was emphasized more? Were there any negative ways in which it differed?
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I feel the old guard likes to remind us we're "holistic" and our MD counterparts aren't which is obviously bull crap. I would say our education is nothing different except we get more hands on touchy feely.
 
Bacchus said:
I feel the old guard likes to remind us we're "holistic" and our MD counterparts aren't which is obviously bull crap. I would say our education is nothing different except we get more hands on touchy feely.
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1) Does/can it help you become a more confident physician to help understand what's going wrong with your patients before the lab, MRI/CT-Scan results were received?

2) Can you help your patients feel better pre-op and/or post-op using OMM?


P.S.: Fixed it.. typo. Sorry. What is CT Scan? Read from here http://www.mayoclinic.com/health/ct-scan/MY00309

There's, however, CAT Scan (computed axial tomography).. Same thing, different naming, though... Kindly, read it from this link, as well. http://en.wikipedia.org/wiki/X-ray_computed_tomography
 
Last edited:
DrBumblebee said:
1) Does/can it help you become a more confident physician to help understand what's going wrong with your patients before the lab, MRI/CATScan results were received?

2) Can you help your patients feel better pre-op and/or post-op using OMM?
Click to expand...

What's a CATScan?

Sent from my SGH-T999 using SDN Mobile
 
MedPR said:
What's a CATScan?

Sent from my SGH-T999 using SDN Mobile
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002.JPG
 
NontradCA said:
http://3.bp.blogspot.com/-wtDPIaUbDug/TW6secapD2I/AAAAAAAAESM/A6CYaWXfay8/s1600/002.JPG
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:laugh:

I think the poor guy means CT scan. But it sounds like he's asking if OMM can replace imaging? lol
 
coolingglasses said:
once upon a time, it was a website where a video game programmer used to stick cats in his flatbed scanner
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How cool it is, right. Woohoo... Anyway, it was a typo in the post. Sorry, if it was not up to the taste of your medical terminology awareness..

What's a CT-scan? Kindly read from this link, if you want to learn http://www.mayoclinic.com/health/ct-scan/MY00309

There's, however, CAT Scan (computed axial tomography).. Same thing, different naming, though... Kindly, read it from this link, as well. http://en.wikipedia.org/wiki/X-ray_computed_tomography
 
Hey Bacchus,

For FM, are you thinking about working as an Internist or in a clinic within the hospital or something? Or do you want to open your own practice? I've been thinking about pursuing IM or FM because I like the lifestyle of 7 on and 7 off, but I wanted to hear what future Residents, such as yourself, want to do once they're done.

Also, what is the job market like in urban areas for FM?
 
darklabel said:
Hey Bacchus,

For FM, are you thinking about working as an Internist or in a clinic within the hospital or something? Or do you want to open your own practice? I've been thinking about pursuing IM or FM because I like the lifestyle of 7 on and 7 off, but I wanted to hear what future Residents, such as yourself, want to do once they're done.

Also, what is the job market like in urban areas for FM?
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Well, if he is going into family medicine, he won't be working as an internist any time soon.
 
darklabel said:
Hey Bacchus,

For FM, are you thinking about working as an Internist or in a clinic within the hospital or something? Or do you want to open your own practice? I've been thinking about pursuing IM or FM because I like the lifestyle of 7 on and 7 off, but I wanted to hear what future Residents, such as yourself, want to do once they're done.

Also, what is the job market like in urban areas for FM?
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I have no desire to work as a solo practitioner. Ideally I want to work for a hospital organization or practice that will pay off my loans for me. I thought about doing a hospitalist gig, but I think I'll miss the outpatient population too much.

FM docs who do hospitalist work should go to a residency that has a strong inpatient education. Some residencies are known for this.

As a FM doc, there is no reason you can't be a hospitalist, but I've not seen FM hospitalists at larger institutions.
 
Thanks for doing this. I was surprised by how much I liked FM in the little exposure I had to it (~50 hours).

Do you feel any sort of pressure with the somewhat of an intrusion mid-levels and allied health professionals are attempting to make? I feel that there will without question always be a place for FM physicians, but also fear that with the compensation being sub par along with other specialties being more "prestigious" it is becoming too easy for midlevels to gain practice rights outside of the scope of their training.

Thoughts?

edit: I was actually wondering if you had an opinion on this especially in regards to rural primary care.
edit#2: I'm not sure of your experience with this, but how do you feel about FM docs working in EDs? I like EM a lot, but also like FM quite a bit. I can't see myself working in an ED later on in my life, but the dual residency is an extra year or two. In rural settings, it seems fairly easy to land an ED job as a FM, with competitive pay to an EM trained doc. Do you see this changing?
 
Mehd School said:
Thanks for doing this. I was surprised by how much I liked FM in the little exposure I had to it (~50 hours).

Do you feel any sort of pressure with the somewhat of an intrusion mid-levels and allied health professionals are attempting to make? I feel that there will without question always be a place for FM physicians, but also fear that with the compensation being sub par along with other specialties being more "prestigious" it is becoming too easy for midlevels to gain practice rights outside of the scope of their training.

Thoughts?

edit: I was actually wondering if you had an opinion on this especially in regards to rural primary care.
edit#2: I'm not sure of your experience with this, but how do you feel about FM docs working in EDs? I like EM a lot, but also like FM quite a bit. I can't see myself working in an ED later on in my life, but the dual residency is an extra year or two. In rural settings, it seems fairly easy to land an ED job as a FM, with competitive pay to an EM trained doc. Do you see this changing?
Click to expand...

Regarding practice rights:

I'm a big proponent of the mindset in which there will always be a need for the PCP who is residency trained. I see this especially holding true with the ACA and the drive towards ACOs and PCMHs. The training we receive is superior than the midlevels, but unfortunately there hasn't been enough studies done to show if outcomes are equivalent or different. We think differently. We are able to respond to situations appropriately even if we need to walk away from the algorithm. The nursing model of care follows algorithms. Our brains will never be replaced. I do feel better about PAs since they're under the control of state medical boards so there is appropriate oversight. PAs also get much better clinical training. As far as rural America, everyone needs a PCP(rovider) regardless of degree. Despite the inherent risk of more complications by not seeing a physician, it still allows improved management and health, keeping patients on track for a healthy life. I think you'd find this thread interesting over in the Allopathic forum: http://forums.studentdoctor.net/showthread.php?t=985512


Regarding FM docs in the ED:

I do think its going to change. I remember reading on SDN somewhere that the change was already starting to occur where hospital organizations are looking for board certified emergency physicians. I think this is a good move. An FM doc, who does no extra time in EM has an EM rotation in medical school and during intern year. That's not enough time to learn emergency medicine for truly emergent issues. If you would want to work in the ED and still do family medicine, then I'd recommend a dual residency.
 
I've had a number of conversations with various surgeons...Ortho, Plastics, General and they all really didn't have a great outlook on the future of medicine. I don't mean to imply they were peeing vinegar, but they made it a point to emphasize that going into medicine during this stage of the game was more about the desire to serve people versus a large paycheck.

They also said they would go into FM or EM if they had it all to do again.

Thought it would be an interesting anecdote for this thread.
 
What in your opinion is the best approach to preparing for boards? Is the mentality of just doing as well as you can in the preclinical classes good preparation for boards, or would it be wise to incorporate some kind of board prep material into studying for classes, even if it might result in lower preclinical grades?
 
Back 5 said:
I've had a number of conversations with various surgeons...Ortho, Plastics, General and they all really didn't have a great outlook on the future of medicine. I don't mean to imply they were peeing vinegar, but they made it a point to emphasize that going into medicine during this stage of the game was more about the desire to serve people versus a large paycheck.

They also said they would go into FM or EM if they had it all to do again.

Thought it would be an interesting anecdote for this thread.
Click to expand...

Plastic and Ortho surgeons wanna do FM instead?

Hmmm, my B.S. radar just went off. The average ortho doc makes at least twice as much as an FM doc. Same goes for plastic.

I don't think they were being honest with you. Yes, FM is a very rewarding field in the sense that you get to maintain the health well-being of the entire family and be able to form a long relationship with your patients. However, both plastic and ortho are also rewarding, intrinsically and extrinsically.
 
Back 5 said:
I've had a number of conversations with various surgeons...Ortho, Plastics, General and they all really didn't have a great outlook on the future of medicine. I don't mean to imply they were peeing vinegar, but they made it a point to emphasize that going into medicine during this stage of the game was more about the desire to serve people versus a large paycheck.

They also said they would go into FM or EM if they had it all to do again.

Thought it would be an interesting anecdote for this thread.
Click to expand...

I shadowed a doctor who said they told him that when he was a pre-med.

I'm not trying to be a "starry eyed" premed, but I hate hearing stuff like this when they still take home easily 250k+ a year.

Besides look at it this way, with the Patient Protection and Affordable Care Act, there will be way more people insured, thus more "customers" for PCPs and from there, if there is something wrong that was caught early or something, they can be referred to specialists without fear of paying out the nose (thus delaying treatment).
 
darklabel said:
I shadowed a doctor who said they told him that when he was a pre-med.

I'm not trying to be a "starry eyed" premed, but I hate hearing stuff like this when they still take home easily 250k+ a year.

Besides look at it this way, with the Patient Protection and Affordable Care Act, there will be way more people insured, thus more "customers" for PCPs and from there, if there is something wrong that was caught early or something, they can be referred to specialists without fear of paying out the nose (thus delaying treatment).
Click to expand...

More like 350+, bro. Both specialties make a tad under neurosurgery, but have a much more sane hours.
 
Bacchus said:
Regarding practice rights:

I'm a big proponent of the mindset in which there will always be a need for the PCP who is residency trained. I see this especially holding true with the ACA and the drive towards ACOs and PCMHs. The training we receive is superior than the midlevels, but unfortunately there hasn't been enough studies done to show if outcomes are equivalent or different. We think differently. We are able to respond to situations appropriately even if we need to walk away from the algorithm. The nursing model of care follows algorithms. Our brains will never be replaced. I do feel better about PAs since they're under the control of state medical boards so there is appropriate oversight. PAs also get much better clinical training. As far as rural America, everyone needs a PCP(rovider) regardless of degree. Despite the inherent risk of more complications by not seeing a physician, it still allows improved management and health, keeping patients on track for a healthy life. I think you'd find this thread interesting over in the Allopathic forum: http://forums.studentdoctor.net/showthread.php?t=985512


Regarding FM docs in the ED:

I do think its going to change. I remember reading on SDN somewhere that the change was already starting to occur where hospital organizations are looking for board certified emergency physicians. I think this is a good move. An FM doc, who does no extra time in EM has an EM rotation in medical school and during intern year. That's not enough time to learn emergency medicine for truly emergent issues. If you would want to work in the ED and still do family medicine, then I'd recommend a dual residency.
Click to expand...

Bacchus,

Likewise, there're IM-hospitalist ACGME programs now. How do you think, in the near future, hospitals would employ only board certified hospitalists?
 
I can't pretent to know exactly what they meant, I just thought it was an interesting perspective coming from highly sought after specialties.

Figured Bacchus might have a perspective on it.
 
Thanks again Bacchus. What's the diversity like at PCOM as far as student population?
 
I'm surprised there are more Blacks and Hispanics than Asians. In most med schools, those numbers are switched. Usually Asians are over-represented, and Blacks/Hispanics are under-represented.
 
113 said:
I'm surprised there are more Blacks and Hispanics than Asians. In most med schools, those numbers are switched. Usually Asians are over-represented, and Blacks/Hispanics are under-represented.
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All the Asians are in MD schools :naughty:






































notsrs. don't get your jimmies rustled people.
 
PCOM never interviewed me so it looks like I'm about to contribute to the statistic lol
 
coolingglasses said:
My stepfather is black, does that count?
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Did you see the thread in preallo about the white kid who had Hispanic foster parents? He wanted to know if he was urm. Srs too.

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MedPR said:
Did you see the thread in preallo about the white kid who had Hispanic foster parents? He wanted to know if he was urm. Srs too.

Sent from my SGH-T999 using SDN Mobile
Click to expand...

LOL I remember that
 
How do you think the future of Family medicine looks, reimbursement-wise? There was talk that the ACA is going to increase the salary of doctors in primary care, but i did not know if that is a reality at this point.

What minor surgeries can Family med do? When I shadowed, I saw the PCP doc remove a cyst from the skin. What are the boundaries? Can They dabble in derm care, such as removing wart and tags or preform lazer removal?
 
Hi Bacchus, thanks for doing this.

I'm just curious what was your least favorite rotation and why??
 
surgeryDO said:
Thanks, didn't see that. My browser said there is something malicious on page 3 so I skipped that page.
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What browser are you using? Nothing malicious on sdn unless you click a link to another page.

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Did you move to go to PCOM? Realistically how much can one expect to travel from Med School on?
 
NontradCA said:
Did you move to go to PCOM? Realistically how much can one expect to travel from Med School on?
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Bumping since I have even more free time now and we're further into the cycle.

To answer your question, yes I did move but it was at the beginning of undergrad to Philadelphia. I've had multiple apartments within the city limits but no big moves since coming down here after high school.

I'd say its possible to travel the most during fourth year since you'll have a ton more free time and you'll know which rotations are lax. A lot of my classmates put their vacation month as the last rotation of med school so they're done at the end of April until residency begins. If you budget wisely or live with a roommate you should have some money left over to travel. I went to two conferences this year. One was as a networking event the other was more fun.

Just be careful borrowing because there is always interest accruing. With that said, a bunch of people are using (some) leftover loan money to go on post-grad trips because realistically there won't be a lot of time after this.
 
Bacchus said:
Bumping since I have even more free time now and we're further into the cycle.

To answer your question, yes I did move but it was at the beginning of undergrad to Philadelphia. I've had multiple apartments within the city limits but no big moves since coming down here after high school.

I'd say its possible to travel the most during fourth year since you'll have a ton more free time and you'll know which rotations are lax. A lot of my classmates put their vacation month as the last rotation of med school so they're done at the end of April until residency begins. If you budget wisely or live with a roommate you should have some money left over to travel. I went to two conferences this year. One was as a networking event the other was more fun.

Just be careful borrowing because there is always interest accruing. With that said, a bunch of people are using (some) leftover loan money to go on post-grad trips because realistically there won't be a lot of time after this.
Click to expand...


What should be my gameplan for the first week of med school in August?

What things would you look for in a living situation (proximity to school, roommates, etc) that would make life easier for a med student?

Best way to find research opportunities at a DO school without its own hospital?
 
Bacchus said:
Bumping since I have even more free time now and we're further into the cycle.

To answer your question, yes I did move but it was at the beginning of undergrad to Philadelphia. I've had multiple apartments within the city limits but no big moves since coming down here after high school.

I'd say its possible to travel the most during fourth year since you'll have a ton more free time and you'll know which rotations are lax. A lot of my classmates put their vacation month as the last rotation of med school so they're done at the end of April until residency begins. If you budget wisely or live with a roommate you should have some money left over to travel. I went to two conferences this year. One was as a networking event the other was more fun.

Just be careful borrowing because there is always interest accruing. With that said, a bunch of people are using (some) leftover loan money to go on post-grad trips because realistically there won't be a lot of time after this.
Click to expand...

So for your 3rd and 4th years you were able to stay in the Philly area? When do you start having patient contact in years 1-2? It's easy for me to say I want to be a Physician now and it's kinda hard to know what to expect in Medical School. Most physicians and students say they were surprised by the sheer amount of information and studying required. How do you not get "lost" in all this and know you're going to be a FM doc soon(or EM doc at the time)? Is it apparent what is absolutely essential to learn and disseminate from material what does not apply? Or is there a pressure to know and retain everything (besides for testing purposes)
 
Mattinthehat250 said:
1.What should be my gameplan for the first week of med school in August?

2.What things would you look for in a living situation (proximity to school, roommates, etc) that would make life easier for a med student?

3.Best way to find research opportunities at a DO school without its own hospital?
Click to expand...

1. Relax beforehand. Get into your new place a week or two to get everything settled so you don't have to do that. If your first week is orientation... then orient yourself. Have fun, make friends, go to events and hang out with people when given the chance. If you mean first week as in classes, prepare to be unprepared. I never took anatomy and that's the majority of what our first trimester was. I felt behind after the first week. I felt like I didn't know how to study. With that said, get your heels dug in and try to keep on top of things. Start to figure out what works for you. You'll know this at the end of the first test. Don't be discouraged by the first week of classes. You deserve to be there.

2. I'd try to live within a short, commutable distance of school if possible. Going to PCOM, there were 5+ apartment complexes within walking distance of the school and plenty of craigslist advertisements for places in the surrounding area. Living with roommates (who are med students or will respect your schedule if not med students) will save you a lot of money, potentially 500-600 a month because of split rent. You can always get your own place after first year. If you know people going to your school and you've lived with them before or feel you can live with them, I'd try it. I say this as a 4th year who has a roommate after not having one for 2 years. It has saved me a ton of money this year and after all, that equals less loans. I also found it good to live within a short distance of the school because it provided more sleep during 1st and 2nd year and let me do electives/rotations on campus without having to commute a far distance.

3. Research was "abundant" here. It seemed for those who wanted to do it it was available by asking a basic science professor. I know other classmates have done research because of the amount of hospitals in the area. I assume they contacted those hospital departments on their own.
 
NontradCA said:
So for your 3rd and 4th years you were able to stay in the Philly area? When do you start having patient contact in years 1-2? It's easy for me to say I want to be a Physician now and it's kinda hard to know what to expect in Medical School. Most physicians and students say they were surprised by the sheer amount of information and studying required. How do you not get "lost" in all this and know you're going to be a FM doc soon(or EM doc at the time)? Is it apparent what is absolutely essential to learn and disseminate from material what does not apply? Or is there a pressure to know and retain everything (besides for testing purposes)
Click to expand...

I would have been able to stay in Philadelphia if I chose to. There is a rural rotation requirement at PCOM that will send you into the wilderness; however, some of the sites on the list are commutable from Philadelphia. It's basically your luck of the draw with picking rotations, but you have a good chance of being in Philadelphia the entire time.

You'll start having patient contact a few weeks in through standardized patients. You'll realize the beginning of third year how much those encounters didn't prepare you when attendings ask you for information you would have never thought of asking.

You study to know the material. The better you know it the better and easier your prep for the COMLEX will be. That said, I don't remember the majority of 1st or 2nd year anymore beyond the clinical information we received. As a fourth year, I feel my clinical competence is fairly good to handle a lot of noncomplicated issues coming through the outpatient office. I did a lot of FM electives so I've been exposed over and over again to those complaints.
 
NontradCA said:
So for your 3rd and 4th years you were able to stay in the Philly area? When do you start having patient contact in years 1-2? It's easy for me to say I want to be a Physician now and it's kinda hard to know what to expect in Medical School. Most physicians and students say they were surprised by the sheer amount of information and studying required. How do you not get "lost" in all this and know you're going to be a FM doc soon(or EM doc at the time)? Is it apparent what is absolutely essential to learn and disseminate from material what does not apply? Or is there a pressure to know and retain everything (besides for testing purposes)
Click to expand...

I'm a fellow 4th year. For my 3rd and 4th year rotations I mostly had away rotations. I did this to save money, plus I was never interested in staying in the Philly area. Yes, I did live in a suitcase in hospital housing, but I save about 10k a year in rent/utilities/food and got to see all the different areas and hospitals.

The thing is, my sister lives in Philly, so when I had to return for an exam or even the required rotation, I stayed with her. But you can always stay with a friend or get a temp place.
 
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