I don't speak spanish and I'm worried about residency

[Richard Cypher]

Starting as IM intern next month at a place with significant spanish speaking population and I don't speak it. There are translators available but it takes forever to get them. As a student I got by because I could just wait for a translator because students don't have a heavy load and can afford to wait. I'm worried I won't do well - be efficient. Is this a common problem among residents or am I going to be suffer because of it? Will I pick up enough as I go along to make it work? History is 80% of dx and I just worry. Thank you for your advice - as intern time approaches, I seem to find new things to worry about day after day.

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[mickey1t]

I am not sure where ur located, but I too am in a Spanish heavy hosipital. I wouldnt stress it too much. Obviously, you will strugggle a bit initially but I can assure you u will be surprised how quickly u will pick up "medical" spanish. Before u know ull be able to conduct the interview and communicate with patients.

My local medical school would offer basic medical spanish classes for those interested as a way to jump start the process. I dont know if that is availabe in ur area.

 

[glade]

I usually just ignore what the Spanish-only population has to say. Trust me, you go to Mexico and only speak English and nobody is lecturing the physicians about the ethics of providing translators or forcing everyone there to learn English to accomodate you. Just talk loudly and slowly and keep repeating what you said, then leave after five minutes, regardless of what information has been exchanged. 😎

 

[glade]

Hey, maybe your local medical school should offer English classes to the general population, rather than offering Spanish classes to the medical students.

 

[NYRN]

Starting as IM intern next month at a place with significant spanish speaking population and I don't speak it. There are translators available but it takes forever to get them. As a student I got by because I could just wait for a translator because students don't have a heavy load and can afford to wait. I'm worried I won't do well - be efficient. Is this a common problem among residents or am I going to be suffer because of it? Will I pick up enough as I go along to make it work? History is 80% of dx and I just worry. Thank you for your advice - as intern time approaches, I seem to find new things to worry about day after day.

I work in a hosptial where a big percentage of the patient population does not speak English. You will learn a lot of words and phrases over time that will help you. Some people carry around a card with different phrases on it that can be answered with yes or no in English and Spanish. It is annoying to have to wait for a translator, but if thats what you need to do get get an accurate history, you have to do it.

Remember, getting consent from someone who doesn't speak English without expert translation is pretty much a guaranteed lawsuit if the patient has a bad outcome and then goes crying to a lawyer that he/she didn't understand the risks explained to them before signing. When the Joint Commission was at my hospital for survey, they were questioning the people who were providing translation to make sure not only did they speak the language fluently, but that they understand and know how to explain medical terminology.

 

[glade]

Hey, if you can't get consent from them for something, then you can't have gotten consent from them for accepting hospital care (which also requires consent). So if they didn't consent to that, put them out on the street.

 

[NYRN]

Hey, if you can't get consent from them for something, then you can't have gotten consent from them for accepting hospital care (which also requires consent). So if they didn't consent to that, put them out on the street.

In many places hospital admission papers are printed in multiple languages. If not, you can get any employee who speaks the language to translate for that since its written in layman's terms. Getting consent for surgery/blood transfusion/invasive procedures/CT scan with contrast is a whole 'nother ball game. If your patient does not speak English, you get someone in there who is qualified to translate. This means you cannot use the patient's 12 year old daughter or the housekeeper. You get another doctor or nurse or use the language line to get consent.

 

[glade]

Yeah, don't get me started on the silliness of "multiple language" documents in the hospital. 🙄

Like I said, go to Mexico and see if you can get a Japanese translator. Whereas in America, it's like "you speak Mawali? Here you go!! I'm so culturally sensitive!! Want your yak to stay in the room with you???"

 

[dragonfly99]

When you are getting consent for an invasive procedure, you will need a translator of some sort (either a nurse, other physician, language line, or the hospital translator). This isn't as bad as you think, as getting a Spanish translator at these type hospitals usually isn't that time consuming...getting one for some of the less common languages can take longer.

If you want to start learning Spanish, you could buy one of those language learning CD's or books, or just check out something from the library. Also, there were some other suggestions mentioned above. I have also found that for getting a basic history, a lot of the Spanish speaking patients speak some English, and/or they brought a lot of supportive family members with them. Usually if someone doesn't speak English, they have family members who do and these people often know it can be a problem in the hospital and they want to be helpful. If I know a patient needs a procedure the next day and doesn't speak English, I usually try to get the consent the day before @the end of the day,or set up something so the translator will be around at a certain time.

 

[notinkansas]

I would hazard a guess that the vast majority of US medical grads don't speak spanish. You will muddle through. And you will learn to cope.

While Spanish is the most handy second language for Americans, as glade points out, there are a lot of people in this country who don't speak English but who speak some other unusual language. So Spanish alone won't solve all your problems.

That said, i am currently in an interesting program. It's a self paced program that also offers sessions by telephone. Total cost of going though it isn't any more than the total cost of the full Spanish program at my local community college.

http://www.bilingualamerica.com/

 

[sideways]

Yeah, don't get me started on the silliness of "multiple language" documents in the hospital. 🙄

Like I said, go to Mexico and see if you can get a Japanese translator. Whereas in America, it's like "you speak Mawali? Here you go!! I'm so culturally sensitive!! Want your yak to stay in the room with you???"

 

[Rendar5]

Hey, if you can't get consent from them for something, then you can't have gotten consent from them for accepting hospital care (which also requires consent). So if they didn't consent to that, put them out on the street.

I speak decent spanish and I won't even attempt to consent anyone for anything remotely dangerous that I can't fully and completely explain all the risks and benefits of. I will consent them for stuff that is basics of medical care without a problem and basic procedures that I know how to explain fully.

And if I were in Mexico, I wouldn't let anyone do **** for me unless they speak my language. If they can't provide it sucks to be me.

 

[glade]

And if I were in Mexico, I wouldn't let anyone do **** for me unless they speak my language. If they can't provide it sucks to be me.

Right, I totally agree with that. But see the difference? You say "if they can't provide it, it sucks to be me." You don't go "if they can't provide it ...then it's a violation of my human rights, WAAAAAAAHHHH!!!" The burden is on each individual to be able to speak the language. The fact that I have to use some translator phone (which I refuse to do, BTW, and have never used) is ridiculous. I'll just assume they get the gist of it. Hey, they're lucky enough, getting free medical care.

 

[DrJosephKim]

Pick up a pocket guide for medical Spanish. Even if you don't achieve fluency, your patients will appreciate the fact that you understand some of the basics. You may find yourself fluent before you know it.

 

[glade]

Pick up a pocket guide for English and helpfully give it to your patients. Smile encouragingly at them.

 

[NYRN]

The burden is on each individual to be able to speak the language. The fact that I have to use some translator phone (which I refuse to do, BTW, and have never used) is ridiculous. I'll just assume they get the gist of it. Hey, they're lucky enough, getting free medical care.

http://www.physiciansnews.com/law/404roediger.html

the Doctrine of Informed Consent is the sole responsibility of the physician. In most jurisdictions as a matter of law, a hospital or other health care facility lacks the control over the manner in which the physician performs his duty to obtain informed consent so as to render the facility directly or vicariously liable. This, in turn, leaves the physician as the sole target in a case involving failure to obtain informed consent.

http://journals.lww.com/neurotodayo...igations_to_Patients_Who_Speak_Limited.9.aspx

In 1984, the misinterpretation of a single word led to a patient's delayed care and quadriplegia that was considered preventable. When 18-year-old William Ramirez was transported by ambulance into the emergency room, his mother and girlfriend told the doctors, paramedics, and emergency room staff that he was intoxicado - Spanish slang for dizzy and nauseated. The office staff spoke no Spanish and assumed the man was inebriated or on drugs. Still undiagnosed two days later, the patient went into respiratory arrest and was found to have a cerebellar hematoma with brainstem compression as well as a subdural hematoma. The hospital, paramedics, and physicians involved in his case were all sued, and the Miami hospital ended up paying a $71 million malpractice settlement.

http://www.cornealaw.com/can_you_sue.htm

PLEASE NOTE: The mere fact that you have signed a consent form does NOT mean that you cannot sue for malpractice. A consent form does not give the health care provider a license to commit malpractice. If English isn't your first language the document should have been translated for you, line by line, not paraphrased by an employee of the surgeon or the center and it should not be left to a friend or family member who may have come with you as they may well be no more familiar with the terms they are reading than you are. The surgeon or other members of the health care team, should have been available to review the document and to clarify information and answer all the questions you may have regarding the information presented in order for you to make an informed decision about the contemplated surgery.

 

[glade]

Thanks for the update, it doesn't bother me in the slightest. Like I said, if I can't get "informed consent" by talking to them in English, I just write that they didn't consent and am like "peace out, biatch!" on my way out the door. 👍

 

[glade]

By the way, quoting stuff on me about lawsuits doesn't solidify your position. The fact of the matter is that lawsuits are what drives the cost of our healthcare up so much. The same people who whine about the cost of our healthcare point to countries like Mexico, where if you sue someone they drag you out behind "la hospital" and beat you to death. So pick one or the other.

Oh, and if William Ramirez' family can't speak English, then T.S. for them.

 

[csmittyB]

...
In 1984, the misinterpretation of a single word led to a patient's delayed care and quadriplegia that was considered preventable. When 18-year-old William Ramirez was transported by ambulance into the emergency room, his mother and girlfriend told the doctors, paramedics, and emergency room staff that he was intoxicado - Spanish slang for dizzy and nauseated. The office staff spoke no Spanish and assumed the man was inebriated or on drugs. Still undiagnosed two days later, the patient went into respiratory arrest and was found to have a cerebellar hematoma with brainstem compression as well as a subdural hematoma. The hospital, paramedics, and physicians involved in his case were all sued, and the Miami hospital ended up paying a $71 million malpractice settlement....

If it was slang, then it is possible that even if there was someone who spoke some Spanish, he still could have ended up undiagnosed.

I tend to agree with glade here. It sucks that the guy ended up a quad, but if his g/f or mom hadn't used slang and instead said he was dizzy and nausiated, things may have been different. If either of them had decided to learn English, it would have been even better (I know that is asking for too much). If I walked into a foreign hospital and said I've been tossing cookies they'd look at me like WTF😕

 

[NYRN]

If it was slang, then it is possible that even if there was someone who spoke some Spanish, he still could have ended up undiagnosed.

I tend to agree with glade here. It sucks that the guy ended up a quad, but if his g/f or mom hadn't used slang and instead said he was dizzy and nausiated, things may have been different. If either of them had decided to learn English, it would have been even better (I know that is asking for too much). If I walked into a foreign hospital and said I've been tossing cookies they'd look at me like WTF😕

People that speak Spanish fluently would have understood what he meant, or they could have asked more questions to clarify what they meant by "intoxicated". Agree with it or not, the law requires the hospital to provide an interpreter to any patient who requests it, AND you are held liable if anything bad happens because you didn't understand the patient or the patient didn't understand you. Next time you are at the hospital, speak with someone from risk management and ask them if they will defend you in court when you cause them to be named in a lawsuit due to not obtaining proper translation. See what they tell you.

If you are willing to bet your patient's life and/or your medical license? If you are not getting an accurate history or obtaining consent from a patient who doesn't understand you, you are.

 

[NYRN]

Thanks for the update, it doesn't bother me in the slightest. Like I said, if I can't get "informed consent" by talking to them in English, I just write that they didn't consent and am like "peace out, biatch!" on my way out the door. 👍

This is a great example of patient abandonment and false documentation

 

[NYRN]

By the way, quoting stuff on me about lawsuits doesn't solidify your position. The fact of the matter is that lawsuits are what drives the cost of our healthcare up so much. The same people who whine about the cost of our healthcare point to countries like Mexico, where if you sue someone they drag you out behind "la hospital" and beat you to death. So pick one or the other.

Oh, and if William Ramirez' family can't speak English, then T.S. for them.

Previous cases set the standard for what can and cannot be won in court. This is entirely relevant.

What drives up the cost of healthcare is in part due to BS lawsuits, but if you are practicing negligently, than you are the reason why the competent people are paying high premiums.

 

[csmittyB]

People that speak Spanish fluently would have understood what he meant, or they could have asked more questions to clarify what they meant by "intoxicated". Agree with it or not, the law requires the hospital to provide an interpreter to any patient who requests it, AND you are held liable if anything bad happens because you didn't understand the patient or the patient didn't understand you. Next time you are at the hospital, speak with someone from risk management and ask them if they will defend you in court when you cause them to be named in a lawsuit due to not obtaining proper translation. See what they tell you.

If you are willing to bet your patient's life and/or your medical license? If you are not getting an accurate history or obtaining consent from a patient who doesn't understand you, you are.

I get what your saying. I still think giving a patient's family $70 million dollars b/c the family couldn't properly communicate is ludicrous. I wonder if the family ever bothered to take an ESL class with the money they won.

 

[cartoondoc]

During my internship, 50% of the patients spoke Spanish and all I had was my high school Spanish background. I used a translator on my PDA, and since almost everyone had the same 5-6 diagnoses, I got pretty good at taking a history in Spanish. By the end of the year, many of the patients thought I was fluent, amazingly.

I'd always call for a translator too, just to clarify anything I wasn't sure about at the end. But since I usually had to wait around a bit for the translator, it would have been painful not to be able to ask about the basics.

 

[NYRN]

During my internship, 50% of the patients spoke Spanish and all I had was my high school Spanish background. I used a translator on my PDA, and since almost everyone had the same 5-6 diagnoses, I got pretty good at taking a history in Spanish. By the end of the year, many of the patients thought I was fluent, amazingly.

I'd always call for a translator too, just to clarify anything I wasn't sure about at the end. But since I usually had to wait around a bit for the translator, it would have been painful not to be able to ask about the basics.

This is entirely appropriate. In a non-emergency, and you only need basic information, you don't necessarily need a translator if the patient understands what you are talking about and vice versa. My "spanglish" gets me by most days, but if there is anything important that needs to be explained or if a more extensive history is required, I get a translator.

I know a resident (who ironically speaks 3 languages) get some sort of letter/violation from the dept of health because the patient claimed that he did not recieve instructions in his language. The resident documented that the instructions were translated, and who the translator was, so he was not in trouble. Which is the next point, document who is translating for you if you do use a translator.

 

[glade]

This is a great example of patient abandonment and false documentation

Here's a tip from me to you: don't act like you know something you don't. It just makes you sound stupid. You're acting like a typical nurse, where you try to define things based on loose technicalities and then blow it out of proportion in a weak attempt to get your way based on what you perceive as a threat.

 

[NYRN]

Here's a tip from me to you: don't act like you know something you don't. It just makes you sound stupid. You're acting like a typical nurse, where you try to define things based on loose technicalities and then blow it out of proportion in a weak attempt to get your way based on what you perceive as a threat.

I proved you wrong more than once and you look stupid so now you must throw a tantrum like a child. I have my own license that I am responsible for, YOU on the other hand, risk your attending's license if you are actually doing the things you say you do. It's not a threat to me, I know the right thing to do, and more likely than not your senior resident or attending does too, so you will be made a fool of when you think you can circumvent the law and do whatever you want. I stand by everything I have said, and anyone, including you, who thinks it's BS can go right down to risk management and explain to them exactly how you practice medicine and ask how acceptable that is. The passage below shows exactly how you WILL be charged with malpractice and patient abandonment if you actually refuse to operate on patients due to their racial background. Why don't you read the link below, its a plain english version of the patient abandoment law. You don't even know what the definition of informed consent is, so maybe you should read up on that too.

http://www.uoworks.com/articles/patientdismissal.html


While conceivably it’s possible to fire a patient for almost any reason, including something as basic as the fact that the doctor finds the patient’s personality unpleasant and doesn’t want to work with him anymore, the law does outline several exceptions. A physician may not fire a patient on the basis of gender, sexual orientation, race, religion, or disability.

 

[glade]

After you wrote "I proved you wrong ..." I stopped reading because I knew that the entire post would be a joke. I mean, what is this "Make Crap Up And See If It Will Fly Day"?

 

[glade]

Oh, by the way, next time I need a nurse to lecture me on what my responsibilities are, I'll find you and you can cut and paste stuff off the Internet to your heart's desire. 👍

 

[PlutoBoy]

Oh, by the way, next time I need a nurse to lecture me on what my responsibilities are, I'll find you and you can cut and paste stuff off the Internet to your heart's desire. 👍

You are an a.... not very likable person...

 

[Socrates25]

While conceivably it’s possible to fire a patient for almost any reason, including something as basic as the fact that the doctor finds the patient’s personality unpleasant and doesn’t want to work with him anymore, the law does outline several exceptions. .A physician may not fire a patient on the basis of gender, sexual orientation, race, religion, or disability.

I dont see language as one of those criteria. I dont give a flip what the law says, its not my responsibility to provide a translator for everybody who comes in the door. Its their problem, not mine. The only exceptions are emergency room care and hospital settings.

 

[PlutoBoy]

I dont see language as one of those criteria. I dont give a flip what the law says, its not my responsibility to provide a translator for everybody who comes in the door. Its their problem, not mine. The only exceptions are emergency room care and hospital settings.

You might not give a flip about it, but that´s not going to win a case in court for you in case you screw things up in violation of the law...

 

[Socrates25]

This is a great example of patient abandonment and false documentation

Patient abandonment only comes into play if you have a PRIOR ESTABLISHED PATIENT-DOCTOR relationship. Somebody coming into your clinic for the first time who speaks a language you dont understand does not qualify.

As for the false documentation, I would simply write "pt does not speak English, phone number given for ER where they have spanish translators available" should more than suffice. In a private clinic setting, its not my responsibility to make sure everybody has a translator.

 

[glade]

Since everyone (i.e., the nurse) thinks it's the physician responsibility to use translators for all interactions with patients, or else that constitutes "patient abandonment," let's enforce the same standards for everyone. I mean, don't you all think it's just a little funny that the physician evaluating the patient has to EVERY DAY use a translator to talk to a patient (and not a relative or employee!!) and then for the remainder of the day the nurse doesn't? And don't you think that impacts patient care? Do the nurses not care? I bet they do! Let's make them use translators for all interactions with patients. 👍

 

[Socrates25]

You might not give a flip about it, but that´s not going to win a case in court for you in case you screw things up in violation of the law...

I'll become concerned when you can show me cases of doctors losing cases in court of first-time patients who the doc did not evaluate because they were non-english speaking. Note: I'm talking specifically about an outpatient office setting, not an ER/hospital setting.

If you can show me that doctors are being successfully sued for not providing on-site translators in their clinics, then I'll be concerned.

 

[glade]

Actually, using a lawsuit as a measure of anything is a fail. Lawsuits are a reflection of a variety of issues, usually the least of which is "what is right." I'm sure everyone is aware, but just in case they're not, you can level a completely frivolous lawsuit AND WIN MONEY with everyone involved knowing it was a frivolous lawsuit. So to say "oh, yeah, take a look at this lawsuit result, now what?" is utterly pointless, as you can do the completely right thing medically, for example, be sued, and lose. Wow, I guess that proved something!

Moreover, as I stated, the statement that anyone "must" speak to anyone in any language other than English is an artificial contrivance for political correctness. There's no ethical or moral impetus behind it and not doing so doesn't constitute any ethical or moral breach of anything, including your duty as a physician, and anyone who thinks that it does is quite a) incorrect and b) foolish.

 

[NYRN]

I dont see language as one of those criteria. I dont give a flip what the law says, its not my responsibility to provide a translator for everybody who comes in the door. Its their problem, not mine. The only exceptions are emergency room care and hospital settings.

It doesn't specifically say language, but that doesn't mean that the accusation won't be made by some that the discrimination was based on race and not language. In real life however, most patients who have an appointment at a clinic/office will bring someone who speaks English. They have time to plan that out. In prior posts, I was talking about a hospital setting where the patient's issue is urgent/emergent.

 

[NYRN]

Actually, using a lawsuit as a measure of anything is a fail. Lawsuits are a reflection of a variety of issues, usually the least of which is "what is right." I'm sure everyone is aware, but just in case they're not, you can level a completely frivolous lawsuit AND WIN MONEY with everyone involved knowing it was a frivolous lawsuit. So to say "oh, yeah, take a look at this lawsuit result, now what?" is utterly pointless, as you can do the completely right thing medically, for example, be sued, and lose. Wow, I guess that proved something!

Moreover, as I stated, the statement that anyone "must" speak to anyone in any language other than English is an artificial contrivance for political correctness. There's no ethical or moral impetus behind it and not doing so doesn't constitute any ethical or moral breach of anything, including your duty as a physician, and anyone who thinks that it does is quite a) incorrect and b) foolish.

I never said that you must speak their language. Honestly, getting sued would be the least of your problems. Failing to ensure that your patient is able to give INFORMED consent, English speaking or not, is professional misconduct and grounds to lose your license. If you don't want to believe the lawsuits, go to any physician misconduct page online at any of the state licensing boards. Those you can't dispute. You will probably see yourself there one day if you actually practice the way you say that you do.

 

[NYRN]

Since everyone (i.e., the nurse) thinks it's the physician responsibility to use translators for all interactions with patients, or else that constitutes "patient abandonment," let's enforce the same standards for everyone. I mean, don't you all think it's just a little funny that the physician evaluating the patient has to EVERY DAY use a translator to talk to a patient (and not a relative or employee!!) and then for the remainder of the day the nurse doesn't? And don't you think that impacts patient care? Do the nurses not care? I bet they do! Let's make them use translators for all interactions with patients. 👍

You need good translation for important aspects of care such as H&P, informed consent and discharge. If you are asking the patient what they want for lunch you can use the housekeeper or family member. Did it ever occur to you that it would be a HIPPA violation to use the family member as a translator to obtain a history without permission from the patient? I bet you don't give a rats a** about HIPPA either. It's also obvious that you don't know what patient abandonment is.

 

[turquoiseblue]

To the OP,

Been there done that. So no worries. I hardly know spanish and got by just fine and so did many others. Just use the phone translator or a real translator for H and Ps, consents, and other important documents. You don't have to know spanish. In fact, there are sometimes many other languages spoken at hospitals too like russian, swahili, creole , polish, etc. I or many others don't even know those either. Oftentimes, neither do any of the attendings, nurses, or other staff, but the job still gets done just fine.

If you want to learn medical spanish there are great apps on the iphone and other smartphones that actually say phrases, so that may help. There are also med spanish books out there to help you along.

To relate to the patient, the main spanish you need to know are hola, mama, pappi, gracias, dolor, donde, muchos, poco, bueno, no bueno, si, non, kaka, sangri, agua, etc. and you point a lot like use hand gestures.

Just find out your main H and P questions and memorize those and it may help you have an easier time understanding hispanic patients, if they are your majority patients.

In surgery is easier to talk to patients because all you need to know are certain questions dealing with pain and the bowel, but im sure you could get the hang of it sooner or later no matter what specialty you are in.

 

[docbill]

http://www.medicalspanishapp.com/

I like this program and I have it on my iphone. I have not had a chance to use it except to impress the nurses.

In the northern (read cold) regions of the USA, most speak some type of English.. not saying it is understandable... but some type. Actually to think about it, Spanish might be easier then trying to understand this slang.

 

[glade]

You need good translation for important aspects of care such as H&P, informed consent and discharge. If you are asking the patient what they want for lunch you can use the housekeeper or family member. Did it ever occur to you that it would be a HIPPA violation to use the family member as a translator to obtain a history without permission from the patient? I bet you don't give a rats a** about HIPPA either. It's also obvious that you don't know what patient abandonment is.

I actually don't give a rats ass about that, you're quite correct. When a patient is in a room with someone else, I just start talking to them, usually in Dutch or using aboriginal clicks. After all, if nobody can understand what I'm saying, then no HIPPA violation can occur. 👍

P.S. I like how you don't care about translating stuff properly from a nursing perspective because it would inconvenience YOU. I guess you're indirectly admitting that nursing communications with the patient are irrelevant to health care.

 

[notinkansas]

I know a resident (who ironically speaks 3 languages) get some sort of letter/violation from the dept of health because the patient claimed that he did not recieve instructions in his language. The resident documented that the instructions were translated, and who the translator was, so he was not in trouble. Which is the next point, document who is translating for you if you do use a translator.

Good point, thanks!

As far as learning some spanish, the company I mentioned previously, Bilingual America, has just made the announcement that they will be offering their course materials, for free (not tutoring but the materials) to medical personnel.

http://speakspanish.com/

I posted this as a thread on this forum, which the administrator moved to "all students" Not helpful, because, as MD I never look at "all students"

I do think that everyone who chooses to come to this country should make an effort to learn English. I wish we could be more like Australia when it comes to immigration policy. That said, Spanish is a handy second language. And since I travel a bit and plan to travel more, learning it is a good thing. I do plan to learn more languages as well.

 

[glade]

LOL, "Bilingual America." I think I'll start a company called "Everyone In Mexico Should Speak English."

 

[J-Rad]

Everyone is reminded to keep on topic. This thread is not meant to be a referendum on immigrants, immigration, ESL, or nurse vs. physician issues. Thank you to those that have put in some useful input to help the OP.

 

[Winged Scapula]

I posted this as a thread on this forum, which the administrator moved to "all students" Not helpful, because, as MD I never look at "all students"

The thread was moved because it was off topic and not relevant to residency. All Students is read by everyone from students to attendings - you may not not read it, but many others do. It was meant to be of interest to everyone - all of us are students, even attendings (or "MDs" as you put it).