I never understood the loss of empathy during medical training. Until now.

[DermViser]

But derm seems to be the most friendly specialty in term of lifestyle... By the way, I saw in the AAMC 'Careers in Medicine' site that derm physicians make 446k/year working an average of 45hrs/wk... Are these numbers real? If so, I think the 241 average step1 fro derm is still relatively low...

I don't know any general derm who is making 446K coming right out of residency. 1 - I don't know if those numbers include people who also do Mohs or Dermpath also. 2 - That figure is likely people who have built a completely cosmetic practice which is only viable in certain locales - NYC, LA, Miami, etc. where you have the clientele available to support it. Of course those areas are oversaturated as well.

The 45 hrs. a week is probably pretty accurate.

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[BestDoctorEver]

I don't know any general derm who is making 446K coming right out of residency. 1 - I don't know if those numbers include people who also do Mohs or Dermpath also. 2 - That figure is likely people who have built a completely cosmetic practice which is only viable in certain locales - NYC, LA, Miami, etc. where you have the clientele available to support it. Of course those areas are oversaturated as well.

The 45 hrs. a week is probably pretty accurate.

Are you still a resident?

 

[DermViser]

Are you still a resident?

Yes, as is GuyWhoDoesStuff. But Pedi Derm which is what I hope to go into, is not a lucrative subspecialty. In fact, a 100% Pediatric Derm practice makes even less money than a General Derm.

 

[jakeislove]

I actually agree with @jakeislove...

Even a stopped watch is right twice per day.

 

[username456789]

Yes, as is GuyWhoDoesStuff. But Pedi Derm which is what I hope to go into, is not a lucrative subspecialty. In fact, a 100% Pediatric Derm practice makes even less money than a General Derm.

As an aside, I still can't figure out why the derm world insists on referring to pediatric dermatology as "pedi derm" and not "peds derm." It just sounds like nails on a chalkboard to me for some reason. Does any other field do this?

/digression

 

[fancymylotus]

I'll still take teeth over 446k at a 45 hour work week derm. Teeth = $$$$$$

 

[fancymylotus]

Oh right, I care and stuff too

 

[PL198]

As an aside, I still can't figure out why the derm world insists on referring to pediatric dermatology as "pedi derm" and not "peds derm." It just sounds like nails on a chalkboard to me for some reason. Does any other field do this?

/digression

it's because you guys are all so f*cking pretty so they're just so used to mani/pedi that it just fits nicely

 

[DermViser]

As an aside, I still can't figure out why the derm world insists on referring to pediatric dermatology as "pedi derm" and not "peds derm." It just sounds like nails on a chalkboard to me for some reason. Does any other field do this?

/digression

I always wondered that too. Like in med school, the Pediatric clerkship was always called "Peds" by fellow classmates, or Pediatric Gastroenterology was referred to as Peds GI, but yet Pediatric Dermatology is referred to as Pedi Derm. I think it's more a patient moniker that got adopted - parents referring to their child's dermatologist as their child's Pedi Derm. There's even a product called Pedi-Derm Bum Paste.

On another digression, you don't know how much ribbing (in good fun) I've gotten for wanting to go for Pedi Derm rather than go straight into practice as a General Derm or go for the fellowships "worth" going for - Mohs or Dermpath. Geez, it's only like 1 year.

 

[DermViser]

I'll still take teeth over 446k at a 45 hour work week derm. Teeth = $$$$$$

Technically, teeth are part of the integumentary system as is skin.

I guess dentistry allows you to be much more violent when it comes to teeth - pulling teeth, "crushing bone" like you said.

 

[DermViser]

it's because you guys are all so f*cking pretty so they're just so used to mani/pedi that it just fits nicely

Ok, even I have to admit that's pretty funny --- mani/pedi/Pedi Derm. LOL.

 

[PL198]

Ok, even I have to admit that's pretty funny --- mani/pedi/Pedi Derm. LOL.

I would have liked my own comment if that was on facebook

 

[fancymylotus]

Technically, teeth are part of the integumentary system as is skin.

I guess dentistry allows you to be much more violent when it comes to teeth - pulling teeth, "crushing bone" like you said.

Yes let's get nitpicky abt it. What I meant is ill take my salary/hours/lifestyle/age at start point over that

 

[EMDO2018]

If I started a thread about med school girls will it get deleted or locked?

 

[PL198]

If I started a thread about med school girls will it get deleted or locked?

Probably. They're no different than any other girls soooooo

 

[EMDO2018]

Probably. They're no different than any other girls soooooo

True, im starting to notice people in med school are just like the general population, except smart enough to get high MCAT scores. Everybody's here, the frat bros, sorority girls, nerds, jocks, goths, its like middle school all over again

 

[DermViser]

True, im starting to notice people in med school are just like the general population, except smart enough to get high MCAT scores. Everybody's here, the frat bros, sorority girls, nerds, jocks, goths, its like middle school all over again

Medical school is very much like high school on steroids. I would say it's even worse in a way.

 

[PL198]

True, im starting to notice people in med school are just like the general population, except smart enough to get high MCAT scores. Everybody's here, the frat bros, sorority girls, nerds, jocks, goths, its like middle school all over again

yes so treat them like normal people and not some sacred goddess and I bet you'll do better with whatever your problem is. the concept that you wanted to talk about " med schools girls" already implies that you think they're somehow different than avg female, which they really aren't except, just like the guys are no different than avg guys

 

[PL198]

Medical school is very much like high school on steroids. I would say it's even worse in a way.

closer to middle school

 

[DermViser]

closer to middle school

Except the hierarchy is pretty much solidified in high school. Middle school everyone is still prepubescent.

 

[PL198]

Except the hierarchy is pretty much solidified in high school. Middle school everyone is still prepubescent.

Yeah but it somehow drains most people of maturity and rationality, so I'm honestly surprised they aren't sucking their thumbs.

 

[xffan624]

It will just be a job for me! period.

Somehow you're going to be the "BestDoctorEver" with that attitude...?

 

[DermViser]

Somehow you're going to be the "BestDoctorEver" with that attitude...?

LOL!!! Just now saw that. Go figure the "BestDoctorEver" would see medicine as just a job.

 

[seminoma]

I always wondered that too. Like in med school, the Pediatric clerkship was always called "Peds" by fellow classmates, or Pediatric Gastroenterology was referred to as Peds GI, but yet Pediatric Dermatology is referred to as Pedi Derm. I think it's more a patient moniker that got adopted - parents referring to their child's dermatologist as their child's Pedi Derm. There's even a product called Pedi-Derm Bum Paste.

On another digression, you don't know how much ribbing (in good fun) I've gotten for wanting to go for Pedi Derm rather than go straight into practice as a General Derm or go for the fellowships "worth" going for - Mohs or Dermpath. Geez, it's only like 1 year.

Ah Mohs.. Maybe I'll be so lucky.

 

[DermViser]

Ah Mohs.. Maybe I'll be so lucky.

To have it done or to do it?

 

[seminoma]

Wow. I would not have thought dental school would have such a decrease in empathy. Not bc it's "easier" bc it's not, but bc at least in general dentistry, you get a good night's sleep, not on call (that I know of), etc. Specialization in dentistry is more a cherry on top thing, with different procedures but same type of outpatient practice (besides OMFS).


You think coming in already cold and calloused will make things easier to deal with in medical school? I would think that's the perfect recipe for disaster. Or maybe you're more referring to having more realistic expectations?

I came in cold and calloused. Dealing with standardized patients who tend to use their own personal backstory and/or clinic patients has actually improved my level of empathy.

Cold and calloused helps with what most of my classmates feel to be depressing amounts of studying and unfair exams. Having a IDGAF attitude makes the typical "makes you hate yourself" parts of med school less troublesome. Truthfully none of the long hours of studying affects me because on any given day if I don't feel like studying for more than 4 hours I just don't do it. Hasn't hurt my grades and if more people realized the need for half days off they might not be so damn moody all the time. Their schedule is more like binge studying followed by binge drinking followed by hangover followed by stress due to falling behind leading to the cycle repeating itself.

 

[xffan624]

LOL!!! Just now saw that. Go figure the "BestDoctorEver" would see medicine as just a job.

Yeah. In my mind, working at starbucks or kmart is job. Medicine is in my mind is a profession. It requires a bit more sacrifice.

 

[DermViser]

I came in cold and calloused. Dealing with standardized patients who tend to use their own personal backstory and/or clinic patients has actually improved my level of empathy.

Cold and calloused helps with what most of my classmates feel to be depressing amounts of studying and unfair exams. Having a IDGAF attitude makes the typical "makes you hate yourself" parts of med school less troublesome. Truthfully none of the long hours of studying affects me because on any given day if I don't feel like studying for more than 4 hours I just don't do it. Hasn't hurt my grades and if more people realized the need for half days off they might not be so damn moody all the time. Their schedule is more like binge studying followed by binge drinking followed by hangover followed by stress due to falling behind leading to the cycle repeating itself.

Well that's more just self-induced procrastination.

 

[seminoma]

To have it done or to do it?

To do it. I shadowed one before starting med school and kind of fell in love with it. Had never heard of Mohs before then.. Spent 3 weeks with the doc and it was the only time I never got bored shadowing.

 

[DermViser]

Yeah. In my mind, working at starbucks or kmart is job. Medicine is in my mind is a profession. It requires a bit more sacrifice.

Yes. Medicine is more than a job with respect to the level of sacrifice in time, money, and the huge toll it takes on people's relationships with their family, friends, spouses, etc. I'm surprised (or I guess not) how people don't comprehend that. Just talk to any surgical resident.

 

[seminoma]

Well that's more just self-induced procrastination.

Yeah I guess. Everyone wants to have fun and treat med school like college. The reality (my reality) is that you just need to show up and go to work for 8 hours M-F and work a few hours of OT on the weekend. Less than that if you want to be just average.

 

[DermViser]

To do it. I shadowed one before starting med school and kind of fell in love with it. Had never heard of Mohs before then.. Spent 3 weeks with the doc and it was the only time I never got bored shadowing.

You might want to talk to @MOHS_01. He might be a good person to lead you in the right direction to your goal.

 

[DermViser]

Yeah I guess. Everyone wants to have fun and treat med school like college. The reality (my reality) is that you just need to show up and go to work for 8 hours M-F and work a few hours of OT on the weekend. Less than that if you want to be just average.

At least for the first 2 years - yes.

 

[seminoma]

You might want to talk to @MOHS_01. He might be a good person to lead you in the right direction to your goal.

Thanks for the tip. I'll keep an eye on this thread and see if he responds.. Don't want to annoy an attending in such a small field by pming him.

At least for the first 2 years - yes.

Well yeah. I imagine MS3 is just 12+ hour days of getting **** on.

 

[DermViser]

Well yeah. I imagine MS3 is just 12+ hour days of getting **** on.

I don't know about getting **** on. The hours are just less controllable and varies greatly among clerkships.

There is still a standardized exam (the shelf) at the end of each clerkship, but that's only one part of your grade. Schools add other stuff: subjective evals, OSCEs, reflective papers (not my school thank God), turning in H&Ps, oral exams, etc. as they see fit.

 

[seminoma]

I don't know about getting **** on. The hours are just less controllable and varies greatly among clerkships.

There is still a standardized exam (the shelf) at the end of each clerkship, but that's only one part of your grade. Schools add other stuff: subjective evals, OSCEs, reflective papers (not my school thank God), turning in H&Ps, oral exams, etc. as they see fit.

It still comes back to being cold and calloused... or perhaps just realistic like you said. We all have our limits and even though we need to push ourselves to be better, we need to know when enough is enough. So what exactly is it that makes me think I can take half days off whenever I feel like it and still think I can learn everything and prep well for exams/step1? Maybe it's arrogance, maybe it's laziness, maybe it's a fear of burnout/depression. I don't know what it is, but like I said before,I came in cold and really more interested in the science than the patients, but after working with patients and listening to what they have to say (even the annoying ones) I think I'm moving more towards empathy rather than away from it.

 

[DermViser]

It still comes back to being cold and calloused... or perhaps just realistic like you said. We all have our limits and even though we need to push ourselves to be better, we need to know when enough is enough. So what exactly is it that makes me think I can take half days off whenever I feel like it and still think I can learn everything and prep well for exams/step1? Maybe it's arrogance, maybe it's laziness, maybe it's a fear of burnout/depression. I don't know what it is, but like I said before,I came in cold and really more interested in the science than the patients, but after working with patients and listening to what they have to say (even the annoying ones) I think I'm moving more towards empathy rather than away from it.

I think you can easily take a half day off a week and still do well on Step 1. More hours studying doesn't necessarily mean better grades. Most people in your circumstance, don't usually like working with patients. Most of the time I see it in reverse (starting out empathetic and then hating patients).

 

[seminoma]

I think you can easily take a half day off a week and still do well on Step 1. More hours studying doesn't necessarily mean better grades. Most people in your circumstance, don't usually like working with patients. Most of the time I see it in reverse (starting out empathetic and then hating patients).

I think people find patient care to be a waste of precious study time at this stage in the game. Has to contribute at least a little to the loss of empathy.

 

[MOHS_01]

To do it. I shadowed one before starting med school and kind of fell in love with it. Had never heard of Mohs before then.. Spent 3 weeks with the doc and it was the only time I never got bored shadowing.

I used to say that it was the best kept secret in medicine.... because it was. Times are changing; I don't really have the time right now to expound, but there are more dark clouds on our horizon than just the ACA, Medicare cuts, etc. The culture of the WW2 era generation that made this job as great as it was is dying with them; the boomers that follow them are a totally different breed.

 

[DermViser]

I used to say that it was the best kept secret in medicine.... because it was. Times are changing; I don't really have the time right now to expound, but there are more dark clouds on our horizon than just the ACA, Medicare cuts, etc. The culture of the WW2 era generation that made this job as great as it was is dying with them; the boomers that follow them are a totally different breed.

In terms of reimbursement for Mohs? I swear Mohs is like Medicare Central in terms of patients.

From a practice model standpoint, our Mohs guys are very gratified (they do a lot of Procedural Derm too). Too much constant walking and seeing through the microscope for every, single, layer for me, though. lol.

 

[MOHS_01]

In terms of reimbursement for Mohs? I swear Mohs is like Medicare Central in terms of patients.

From a practice model standpoint, our Mohs guys are very gratified (they do a lot of Procedural Derm too). Too much constant walking and seeing through the microscope for every, single, layer for me, though. lol.

Oh, reimbursement -- indeed, coverage -- for Mohs has huge storm clouds coming. For example, the proposed LCD for micrographic surgery in FL now has several objectionable measures in it; first, they use intentionally ambiguous language allowing for complete arbitrary determination of coverage. Second, coverage may be considered "only when the tumor cannot be managed by excision or destruction". (Given that Mohs is, by definition, an excision... maybe someone should draw for these simpletons a Venn diagram or some other Common Core accepted stick figure representation so they can understand the total **** logic they are employing here). Third, they are including hindering language regarding reconstruction in with the Mohs LCD! Major WTF there....

Full draft LCD at the link:

http://www.execinc.com/hosted/emails/acms/file/FCSO Florida Mohs LCD.pdf

 

[Arkangeloid]

My reaction when somebody says they "read it in Robbins."

 

[DermViser]

My reaction when somebody says they "read it in Robbins."

Maybe they're referring to Medium Robbins, not Big Robbins.

 

[PL198]

Maybe they're referring to Medium Robbins, not Big Robbins.

medium robbins isn't even readable. I don't understand people that can do it. I consider myself a pretty fast reader yet it took me like 3 hours to read a chapter. My professor specifically said " this robbins book is so readable, which is great," (our path lectures are mandatory) and I was like wtf are you smoking brah.

 

[DermViser]

medium robbins isn't even readable. I don't understand people that can do it. I consider myself a pretty fast reader yet it took me like 3 hours to read a chapter. My professor specifically said " this robbins book is so readable, which is great," (our path lectures are mandatory) and I was like wtf are you smoking brah.

Are you talking about this book?

Your professor is correct. It is very much readable. Unless you're a lazy sack of ****, and if so, then read Baby Robbins:

 

[PL198]

Are you talking about this book?

Your professor is correct. It is very much readable. Unless you're a lazy sack of ****, and if so, then read Baby Robbins:

Yes

 

[DermViser]

Yes

Well, I agree with your professor. You've likely gotten lazy from having course packs/syllabi handed to you.

 

[Cytarabine]

Well, I agree with your professor. You've likely gotten lazy from having course packs/syllabi handed to you.

It's definitely readable, but it was too perfunctory for tests

 

[BobbyB]

baby robbins + lecture ppts + pathoma crew checking in!

 

[seminoma]

baby robbins + lecture ppts + pathoma crew checking in!

Pathoma + Goljan + ignore school lectures = #winning.