Jetpearl Number 10

[jetproppilot]

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http://forums.studentdoctor.net/showthread.php?t=543134

Resident colleagues,

The name of this thread is ADDRESSING COCKY SURGEONS.

My objective in posting this thread is for you to know that at some point you gotta step up to the mike with Micatin when you reach your private practice pinnacle.

Concentrate on the initial post....it kinda wanders after that.

Oh, and ignore my GF references.

She's history. (chuckle)

Hope you enjoy reading it.

 

[sevoflurane]

👍 Good one. And soooo true. We are a service specialty. That is the bottom line. Three points:

• Be nice and do your job well.
  
• IF you let your surgeons walk all over you... they will.
  
• IF you stop it in it's tracks the first time by showing some backbone... chances are you're good from then on.

 

[IlDestriero]

👍 Good one. And soooo true. We are a service specialty. That is the bottom line. Three points:

• Be nice and do your job well.
• IF you let your surgeons walk all over you... they will.
• IF you stop it in it's tracks the first time by showing some backbone... chances are you're good from then on.

X2!👍
They smell weakness and love to walk all over the weak.
BTW, if you really suck, they will ask not to work with you anymore. If you tell them to STFU, cut the BS and lets get the job done, they will request to work with you.👍
Unfortunately my group has a couple of outliers that make some of the surgeons cringe when they see their names on the schedule in their room.🙄 As a result they frequently get easier rooms, like routine urology and ortho, thereby being rewarded for their mediocrity.👎

 

[Noyac]

Unfortunately my group has a couple of outliers that make some of the surgeons cringe when they see their names on the schedule in their room.🙄 As a result they frequently get easier rooms, like routine urology and ortho, thereby being rewarded for their mediocrity.👎

Funny how that works.

We can't put locums in anything but the easiest rooms b/c they are not capable of doing difficult cases. So we bring these guys in, pay them more per day than we make and they get all the easy cases. To top that off, they only take call on weekends.

So we reward their mediocrity.

But this will soon end for my group thanks to our new hires coming this summer. Dre' 👍

 

[IlDestriero]

Funny how that works.

We can't put locums in anything but the easiest rooms b/c they are not capable of doing difficult cases. So we bring these guys in, pay them more per day than we make and they get all the easy cases. To top that off, they only take call on weekends.

So we reward their mediocrity.

But this will soon end for my group thanks to our new hires coming this summer. Dre' 👍

Let me know if you need someone to come out for a week before he starts. Sounds great!
I promise to pretend to be really useless, I'll even complain about working "too late" and ask for OT. Hmmm, sounds like some other people I know...

 

[DrDre']

Thanks for the shout out.

I am so excited to start. Loving the end of residency. I think we have sold our house. 68 days to the end (48 excluding post call and weekends!)

Got back to the OR 20 mins early for first case start. ET, AL, Subclavian in about 12 minutes. Then wait one hour for prepping. 10 hour head and neck case....


Coming to Durango in two weeks to look for a house.

Hope we can get a few beers or a Macallan together!

Loving the Jet pearls (it sure does sound like a sex toy!)


I remember all these posts from years ago.


NOY, what cases are so difficult the LTs cant do them?

Funny how that works.

We can't put locums in anything but the easiest rooms b/c they are not capable of doing difficult cases. So we bring these guys in, pay them more per day than we make and they get all the easy cases. To top that off, they only take call on weekends.

So we reward their mediocrity.

But this will soon end for my group thanks to our new hires coming this summer. Dre' 👍

 

[DrDre']

I am still learning and working on my surgeon management skills.

I , as always in life, find that humor helps a lot. You can broadcast exactly what you need and do it in a less painful way. This goes particularly well because I am a firm believer in self-deprecation ! 😀


The other ninja weapon is what is best for the patient. YOu will always win.


We have a senior orthopedic surgeon who wants the room frigid. He's about 100 paygrades above me.

One day when I am a CA-1. He starts complaining about how hot it is. "Can we get the temp down?", he whimpers/orders.

I say, "the patient is 34.9. I'll let you decide."

Can't argue that.

Of course, my pts usually arent cold, but in this case, I could use it against him. No surgeon want intraop bleeding or decreased postop wound healing from intraop hypothermia

 

[GoodmanBrown]

Funny how that works.

We can't put locums in anything but the easiest rooms b/c they are not capable of doing difficult cases. So we bring these guys in, pay them more per day than we make and they get all the easy cases. To top that off, they only take call on weekends.

So we reward their mediocrity.

But this will soon end for my group thanks to our new hires coming this summer. Dre' 👍

If you does locums for awhile, does that give you a stigma in PP land? Like, "This guy's not good enough to get a full-time job, so he's gotta go locums."

 

[Noyac]

NOY, what cases are so difficult the LTs cant do them?

Hernias 😱

 

[sevoflurane]

Hernias 😱

Ummm...... How do you mess up a hernia? Tube, Sux, Prop?

 

[sevoflurane]

Coming to Durango in two weeks to look for a house.

That is a great sentence to be able to write. 👍

Ya gonna love it up there. How many days to freedom? 68 days.... You are already there.

 

[Apollyon]

But this will soon end for my group thanks to our new hires coming this summer. Dre' 👍

The kid is sharp. Treat him right!

 

[Noyac]

Ummm...... How do you mess up a hernia? Tube, Sux, Prop?

Well, actually we try to place them in all the hernias and similar cases. But we still get complaints from surgeons. Yes, it could be partly a surgeon problem but all I can say is that they are accustomed to pretty good anesthesia.

 

[cfdavid]

I am still learning and working on my surgeon management skills.

I , as always in life, find that humor helps a lot. You can broadcast exactly what you need and do it in a less painful way. This goes particularly well because I am a firm believer in self-deprecation ! 😀


The other ninja weapon is what is best for the patient. YOu will always win.


We have a senior orthopedic surgeon who wants the room frigid. He's about 100 paygrades above me.

One day when I am a CA-1. He starts complaining about how hot it is. "Can we get the temp down?", he whimpers/orders.

I say, "the patient is 34.9. I'll let you decide."

Can't argue that.

Of course, my pts usually arent cold, but in this case, I could use it against him. No surgeon want intraop bleeding or decreased postop wound healing from intraop hypothermia

yup, pretty tough to argue that one!

i too appreciate these threads a great deal. one of the best is the "let it roll off your back" thread (can't remember the exact title, but many of you guys will remember".

some great lessons in that one.

cf

 

[cfdavid]

Well, actually we try to place them in all the hernias and similar cases. But we still get complaints from surgeons. Yes, it could be partly a surgeon problem but all I can say is that they are accustomed to pretty good anesthesia.

Noy, are these grads from reputable US institutions?? I'm assuming they are since FMG's must, generally, complete a US residency, so it's disappointing to hear that people are slipping through the cracks.

Can you elaborate on their backgrouds?? I know it's often a work ethic/personality/speed issue gap, and not necessarily a theoretical knowledge gap.


cf

 

[sevoflurane]

Noy, are these grads from reputable US institutions?? I'm assuming they are since FMG's must, generally, complete a US residency, so it's disappointing to hear that people are slipping through the cracks.

Can you elaborate on their backgrouds?? I know it's often a work ethic/personality/speed issue gap, and not necessarily a theoretical knowledge gap.


cf

Although in theory that makes sense, it is not the necessarily the case. I have met some excellent US and non-US FMG's. I have also met some terrible US residents/anesthesiologists.

That being said, our group uses LT from time to time and we have indeed picked up a couple of scary FMG individuals. One refuses to do prone MAC cases 😱
We did pick up a US trained anesthesiologist LT that intubates on the floor with a midazolam and a 6.5 ETT. 😱 Hard to watch....
We prefer NOT to put LT on call as we don't want any adverse outcomes regardless of who is providing anesthesia. At least during the day we can bail them out if they get into trouble (which I have had to do on numerous occasions with both FMG and US grads LT). This minimizes risk to our patients as a whole.

During my residency, we had some strong US-FMG's. These people have to jump a lot higher to get into a competative anesthesia program than their US trained counterpart.

I am a US-FMG. My wife and I are the only ones that got into anesthesia out of 150 people in our class. Plastic, Ortho, Peds surgeons request us all the freggn' time. Annoys our OR scheduler as it makes scheduling cases more complicated. We brought USG regional anesthesia to our group and we do about 50 hearts ea. a year right out of residency. The way I see it, if our patients are requesting us, we are doing something right.

I don't think you can generalize. Some people are just not as good as others regardless of their background. Clearly, I'm biased. 🙄

 

[Noyac]

Noy, are these grads from reputable US institutions?? I'm assuming they are since FMG's must, generally, complete a US residency, so it's disappointing to hear that people are slipping through the cracks.

Can you elaborate on their backgrouds?? I know it's often a work ethic/personality/speed issue gap, and not necessarily a theoretical knowledge gap.


cf

Yes, they are from reputable programs. We do a detailed background search and reference followup. To date not one has been an FMG.

 

[Planktonmd]

Being a locum is challenging and although I never did it I can just imagine how stressful it is to come to a place where you know no one and be expected to perform at the same level of the local guys from day one!
It takes courage and confidence to do that and no matter how good you are you will look inferior to the guys who have been there for years even if you are Paul Barash himself!
This is the simple fact that Noyac appears unable to understand: These guys can not look as good as you, not because you are better but because they are at a huge disadvantage by definition.
And the surgeons will naturally want a familiar face not the new guy, that does not mean that you are a genius, it simply highlights that people like to deal with people they know as opposed to strangers.
If you are better than a locum in the eyes of a surgeon or an OR nurse this simply emphasizes the fact that people prefer dealing with familiar people, it does not mean you are better.

 

[cfdavid]

Thanks for the responses Noy and Sevo. BTW, that was definitely not a slam against FMG's, US-FMG or otherwise. I was just currious to see if the quality coming out of these places was so variable. Apparently it is.

cf

 

[sevoflurane]

Being a locum is challenging and although I never did it I can just imagine how stressful it is to come to a place where you know no one and be expected to perform at the same level of the local guys from day one!
It takes courage and confidence to do that and no matter how good you are you will look inferior to the guys who have been there for years even if you are Paul Barash himself!
This is the simple fact that Noyac appears unable to understand: These guys can not look as good as you, not because you are better but because they are at a huge disadvantage by definition.
And the surgeons will naturally want a familiar face not the new guy, that does not mean that you are a genius, it simply highlights that people like to deal with people they know as opposed to strangers.
If you are better than a locum in the eyes of a surgeon or an OR nurse this simply emphasizes the fact that people prefer dealing with familiar people, it does not mean you are better.

I agree with everything you said and maybe I've been a bit unfair 👍.
I have met a couple good LT out of about 6. I have seen some interesting anesthesia from 2-3 of the others that I would never employ on any of my patients. From my population size of 6, I do see the difference. Not because of what the surgeon says, but because of what I have heard from nursing staff and what I have seen with my own eyes. Maybe they don't care as much as they are only there for 5 or so days. Maybe I've just seen some outliers.

I kid you not... one of my partners picked up a PCo2 of >150 (too high to measure) in the PACU about 3 months ago. Guess who did the case?

Inadequate reversal (confirmed by TOF) and narcotic hypoventilation. Just giving my experience Plank.

 

[ProRealDoc]

Being a locum is challenging and although I never did it I can just imagine how stressful it is to come to a place where you know no one and be expected to perform at the same level of the local guys from day one!
It takes courage and confidence to do that and no matter how good you are you will look inferior to the guys who have been there for years even if you are Paul Barash himself!
This is the simple fact that Noyac appears unable to understand: These guys can not look as good as you, not because you are better but because they are at a huge disadvantage by definition.
And the surgeons will naturally want a familiar face not the new guy, that does not mean that you are a genius, it simply highlights that people like to deal with people they know as opposed to strangers.
If you are better than a locum in the eyes of a surgeon or an OR nurse this simply emphasizes the fact that people prefer dealing with familiar people, it does not mean you are better.

I could not have said it better myself. 👍

 

[Noyac]

Being a locum is challenging and although I never did it I can just imagine how stressful it is to come to a place where you know no one and be expected to perform at the same level of the local guys from day one!
It takes courage and confidence to do that and no matter how good you are you will look inferior to the guys who have been there for years even if you are Paul Barash himself!
This is the simple fact that Noyac appears unable to understand: These guys can not look as good as you, not because you are better but because they are at a huge disadvantage by definition.
And the surgeons will naturally want a familiar face not the new guy, that does not mean that you are a genius, it simply highlights that people like to deal with people they know as opposed to strangers.
If you are better than a locum in the eyes of a surgeon or an OR nurse this simply emphasizes the fact that people prefer dealing with familiar people, it does not mean you are better.

Dude, let's get one f*cking thing straight here. I don't know you and you sure as hell don't know me. You can try to play all high and mighty but you aren't fooling anyone. Your statement is exactly what I have been preaching to our administrators and surgeons for a few years now. My group and I have gone to bat for these guys on more occasions than I can remember. But if a LT can't intubate, extubate or perform a simple regional anesthetic then I really can't help him. Our current guy can't chart or keep track of his narcotics. Now pharmacy is on our asse s.

Let me ask you two questions, do you guys use LT's and are you saying that you couldn't do any better? And try to just answer the questions and not make this into a pissing match. We all know your history here.

 

[Licoricestick]

Confused here - US FMGs vs non-US FMGs

Is a US FMG someone from the US who did med school somewhere else (eg: Caribbean, Australia, wherever) and has returned to the US to work? Ie the Americans who studied at my med school and then went back for residency.
Is a non-US FMG someone who isn't originally from the US, did med school overseas and then went to the US to work? Ie me if I went to work in the US.

What about someone from outside the US who does med school in the US?

 

[Planktonmd]

I am not turning anything into a pissing match, I just highlighted that your continuous attack on locums (known from your history) is getting old and is unfounded.
You are operating in your environment, you know the people, you know the hospital, you are in your comfort zone.
It does not make sense to compare your performance to that of a guy on his first day.
Answering your questions:
1- We do use locums sometimes
2- Some of them are not good some are good and some are excellent clinicians.

When we use them we try to figure out each one's level initially and give them the appropriate support and we try to use the same ones so they get more familiar with our system and more comfortable.

Dude, let's get one f*cking thing straight here. I don't know you and you sure as hell don't know me. You can try to play all high and mighty but you aren't fooling anyone. Your statement is exactly what I have been preaching to our administrators and surgeons for a few years now. My group and I have gone to bat for these guys on more occasions than I can remember. But if a LT can't intubate, extubate or perform a simple regional anesthetic then I really can't help him. Our current guy can't chart or keep track of his narcotics. Now pharmacy is on our asse s.

Let me ask you two questions, do you guys use LT's and are you saying that you couldn't do any better? And try to just answer the questions and not make this into a pissing match. We all know your history here.

 

[Gimlet]

Confused here - US FMGs vs non-US FMGs

Is a US FMG someone from the US who did med school somewhere else (eg: Caribbean, Australia, wherever) and has returned to the US to work? Ie the Americans who studied at my med school and then went back for residency.
Is a non-US FMG someone who isn't originally from the US, did med school overseas and then went to the US to work? Ie me if I went to work in the US.
What about someone from outside the US who does med school in the US?

You got it right. I think generally the term US-FMG is assumed to be a Caribbean med school graduate, although it would apply to Australian grad, German grad, etc, as long as they are US citizens.

Not sure what you would call a non-citizen graduate of a US medical school. It's all just semantics anyway.

 

[IN2B8R]

Confused here - US FMGs vs non-US FMGs

Is a US FMG someone from the US who did med school somewhere else (eg: Caribbean, Australia, wherever) and has returned to the US to work? Ie the Americans who studied at my med school and then went back for residency.
Is a non-US FMG someone who isn't originally from the US, did med school overseas and then went to the US to work? Ie me if I went to work in the US.

What about someone from outside the US who does med school in the US?

It's simple, dude: these are U.S. undergraduates who either had a bad GPA/MCAT score or simply could not interview well when it came to the admission process for a U.S. medical school. So later on in life, they have to work a little harder to prove that they can hack it in a U.S. residency. Some can hack it, others cannot.

 

[IN2B8R]

Thanks for the shout out.

I am so excited to start. Loving the end of residency. I think we have sold our house. 68 days to the end (48 excluding post call and weekends!)

Got back to the OR 20 mins early for first case start. ET, AL, Subclavian in about 12 minutes. Then wait one hour for prepping. 10 hour head and neck case....


Coming to Durango in two weeks to look for a house.

Hope we can get a few beers or a Macallan together!

Loving the Jet pearls (it sure does sound like a sex toy!)


I remember all these posts from years ago.


NOY, what cases are so difficult the LTs cant do them?

Right off the bat you're going to buy a house?!😱 Don't you wanna give it a year before buying, just to see if the practice/group/hospital/area is right for you? What happens if the group falls apart and everyone has to go their merry way? A new hospital CEO walks in and decides to "cut costs." What are you going to do with that house mortgage? Ain't trying to talk you out of anything, but damn, staright out of residency looking for a house is a very gutsy, un-wise move. Unless Noyac puts a disclaimer into the mortgage that says he is willing to take over the mortgage if the group falls apart or if the hospital kicks everyone out. Would like to hear your feedback on this one: if judgemental and premature (which I doubt it will be), then you gots lots of learning to do....

 

[Planktonmd]

Agree with everything you said.
But in some places there is simply no rentals and the only way to get a decent place is to buy, Durango might be one of these places.

Right off the bat you're going to buy a house?!😱 Don't you wanna give it a year before buying, just to see if the practice/group/hospital/area is right for you? What happens if the group falls apart and everyone has to go their merry way? A new hospital CEO walks in and decides to "cut costs." What are you going to do with that house mortgage? Ain't trying to talk you out of anything, but damn, staright out of residency looking for a house is a very gutsy, un-wise move. Unless Noyac puts a disclaimer into the mortgage that says he is willing to take over the mortgage if the group falls apart or if the hospital kicks everyone out. Would like to hear your feedback on this one: if judgemental and premature (which I doubt it will be), then you gots lots of learning to do....

 

[IN2B8R]

Agree with everything you said.
But in some places there is simply no rentals and the only way to get a decent place is to buy, Durango might be one of these places.

There's gotta be something out there, LOL. F*ck it, rent a winnabago...

 

[Noyac]

Being a locum is challenging and although I never did it I can just imagine how stressful it is to come to a place where you know no one and be expected to perform at the same level of the local guys from day one!
It takes courage and confidence to do that and no matter how good you are you will look inferior to the guys who have been there for years even if you are Paul Barash himself!
This is the simple fact that Noyac appears unable to understand: These guys can not look as good as you, not because you are better but because they are at a huge disadvantage by definition.
And the surgeons will naturally want a familiar face not the new guy, that does not mean that you are a genius, it simply highlights that people like to deal with people they know as opposed to strangers.
If you are better than a locum in the eyes of a surgeon or an OR nurse this simply emphasizes the fact that people prefer dealing with familiar people, it does not mean you are better.

Here is a quote from me just over 1 year ago.

"Military or otherwise, walking into a strange environment and expecting to perform as those that routinely work there is difficult. Everything is less familiar to you including surgeons, staff, instruments/supplies, administration, consultants, and on and on. You may be a solid provider but you are at a disadvantage. If it is a place with many locums then you will likely shine but if its just you and the regulars you will struggle at times."

You can see it on this thread: http://forums.studentdoctor.net/showthread.php?t=610548

So how in the world do you get the idea that I don't understand locums? You are just picking fights, again. Get your facts straight son.

 

[Noyac]

Right off the bat you're going to buy a house?!😱 Don't you wanna give it a year before buying, just to see if the practice/group/hospital/area is right for you? What happens if the group falls apart and everyone has to go their merry way? A new hospital CEO walks in and decides to "cut costs." What are you going to do with that house mortgage? Ain't trying to talk you out of anything, but damn, staright out of residency looking for a house is a very gutsy, un-wise move. Unless Noyac puts a disclaimer into the mortgage that says he is willing to take over the mortgage if the group falls apart or if the hospital kicks everyone out. Would like to hear your feedback on this one: if judgemental and premature (which I doubt it will be), then you gots lots of learning to do....

I have recommended renting to most of our new associates for a different reason. This is a dynamic town. There are many different areas. You can't figure out where to live right away.

IN2B8R, has a point but I'd buy in this town if I found what i liked. Houses are moving well enough. Just last month 3 sold on my street and there are only about 16 total.

I think some of you guys are underestimating Dre'. He is a very bright guy with his **** together. He will make the right decision. He has already proven that.😉

 

[fastosprintini]

I have recommended renting to most of our new associates for a different reason. This is a dynamic town. There are many different areas. You can't figure out where to live right away.

IN2B8R, has a point but I'd buy in this town if I found what i liked. Houses are moving well enough. Just last month 3 sold on my street and there are only about 16 total.

I think some of you guys are underestimating Dre'. He is a very bright guy with his **** together. He will make the right decision. He has already proven that.😉

i think the key concept is to differentiate between a house (small, definition is market dependent) which is easy to move
versus "too much house" as in expensive , difficult to sell and an a reason why you hesitate to walk if the need arises...
buying a smallish house right out of residency is a smart move especially in this market.
i did it back in the day and it worked out well.
just remember the famous robert de niro quote from "heat".

good luck, fasto

 

[lfesiam]

Giving a shout out to Dre'. Good luck bro! Hopefully our path will meet again one day at some random places! 👍

 

[Planktonmd]

Great!
Maybe you understand that locums are at disadvantage but this does not seem to stop you from constantly describing them as inferior physicians at every occasion.
I am not going to dig out your posts where you make fun of locums and accuse all of them of incompetence but I am sure everyone here knows what I am talking about.
I am not "picking fights" with you unless you consider any opinion different than yours a fight!
And "son" maybe you need to tone down the arrogance a bit!

Anyway, I really don't think it is helpful to continue this discussion with you since no matter what I say you will attribute that to me trying to fight with you.
I already stated what I think of your annoying endless anti locum rhetoric and I will let you have the final word here if you like.

So how in the world do you get the idea that I don't understand locums? You are just picking fights, again. Get your facts straight son.

 

[IN2B8R]

I have recommended renting to most of our new associates for a different reason. This is a dynamic town. There are many different areas. You can't figure out where to live right away.

IN2B8R, has a point but I'd buy in this town if I found what i liked. Houses are moving well enough. Just last month 3 sold on my street and there are only about 16 total.

I think some of you guys are underestimating Dre'. He is a very bright guy with his **** together. He will make the right decision. He has already proven that.😉

I'm sure things will work out. Best of luck to all of you guys out there, I'm sure it's a solid practice (with the obvious and only weakness being you, Noyac (j/k, lol)). Enjoy the house, but don't go spending happy! G'Luck.

 

[cfdavid]

It's simple, dude: these are U.S. undergraduates who either had a bad GPA/MCAT score or simply could not interview well when it came to the admission process for a U.S. medical school. So later on in life, they have to work a little harder to prove that they can hack it in a U.S. residency. Some can hack it, others cannot.

I'm a US medical grad, from an MD program, but I think this is a bit harsh.

I know a lot of US-FMG's that had better credentials than at least a few in my class. Remember that folks like Indian/Asian Americans are often seen as "overrepresented" and thus may be overlooked based upon that fact.

If you look at the "demographic" of Carribean schools, they're packed with Indian/Asian Americans. I think there's a reason for this. Frankly, it's discriminatory and against the ideal of a merit based system...

cf

 

[sevoflurane]

I'm a US medical grad, from an MD program, but I think this is a bit harsh.

I know a lot of US-FMG's that had better credentials than at least a few in my class. Remember that folks like Indian/Asian Americans are often seen as "overrepresented" and thus may be overlooked based upon that fact.

If you look at the "demographic" of Carribean schools, they're packed with Indian/Asian Americans. I think there's a reason for this. Frankly, it's discriminatory and against the ideal of a merit based system...

cf

Agree CF. There are a lot of different reasons why people go to offshore medical schools. I was accepted to a midwest medical school with average MCAT (31) and GPA (3.75). I was not ready for it. Took 4 years off. Lived in South America and then in the Colorado Rockies. Best decision I ever made. When I went back to school, most med schools wanted me to take my MCATs again- looked at organic chemistry and calculus for about 10 min. and said no way. Sn1, Sn2, E1 and E2 equations = HELL.

Went off to the Caribbean for 2 years. Then to Ireland for a year and then rounded up my clinicals in Miami, Fl and Riverside, CA. I graduated in 3.5 years and met my wife during my 1st semester of med school.

No doubt there are some slackers out there. Most of them get weeded out by the end of the first semester as your debt quickly accumulates. There are many reasons why people end up going through non-traditional pathways and your decison needs to be carefully thought out as it is much more difficult to secure a good residency in a competative field coming from abroad.

Now... if I could start up one of those caribbean med schools.... Those guys make BANK!! You do the math. 150 students x 14k a semester x 3 semesters a year. x 3.5 years = $22,050,000 😱

 

[IN2B8R]

I'm a US medical grad, from an MD program, but I think this is a bit harsh.

I know a lot of US-FMG's that had better credentials than at least a few in my class. Remember that folks like Indian/Asian Americans are often seen as "overrepresented" and thus may be overlooked based upon that fact.

If you look at the "demographic" of Carribean schools, they're packed with Indian/Asian Americans. I think there's a reason for this. Frankly, it's discriminatory and against the ideal of a merit based system...

cf

Yes.... Yes...<Slap!> cf, I just bitch slapt ya! I never said that all Carribean grads ain't worth a thing, just that many (if not most) ended up going to the Carribean because they either had low GPA's or so so MCATS. I doubt that many Indians/Asians were turned back because of "discriminatory reasons;" but then again, **** happens and for whatever reason, they didn't get into U.S. medical schools--I'd wager that this didn't happen for the majority of Indians/Asians in Carribean medical schools, i.e., they didn't get into U.S. medical schools because they either had bad grades or just had lowsy interviews.... Many Carribean grads are good physicians, take Sevo, for example, he's worth a whole $3.00.

 

[sevoflurane]

Don't make me bring out another one of your pictures in action!! 😛

 

[cfdavid]

Yes.... Yes...<Slap!> cf, I just bitch slapt ya! I never said that all Carribean grads ain't worth a thing, just that many (if not most) ended up going to the Carribean because they either had low GPA's or so so MCATS. I doubt that many Indians/Asians were turned back because of "discriminatory reasons;" but then again, **** happens and for whatever reason, they didn't get into U.S. medical schools--I'd wager that this didn't happen for the majority of Indians/Asians in Carribean medical schools, i.e., they didn't get into U.S. medical schools because they either had bad grades or just had lowsy interviews.... Many Carribean grads are good physicians, take Sevo, for example, he's worth a whole $3.00.

please tell my you were being light hearted with that comment and not trying to be a tough guy on an annonymous internet forum. nevertheless, i never said you said that about ALL US-FMGs. i was just making a counter-point.

cf

 

[IN2B8R]

please tell my you were being light hearted with that comment and not trying to be a tough guy on an annonymous internet forum. nevertheless, i never said you said that about ALL US-FMGs. i was just making a counter-point.

cf

I was messing wid ya, bro'. your counterpoint was more than valid...

 

[cfdavid]

I was messing wid ya, bro'. your counterpoint was more than valid...

no problem man. i thought so, and didn't mean to come off like an a.shole. but, we've all had the token chump try asserting his penis size on this forum, so one tends to be on "alert". i should have known better, though, with your track record. my bad.

peace,

cf

 

[sevoflurane]

Don't make me bring out another one of your pictures in action!! 😛

Ooopps....

http://piratevitamins.files.wordpress.com/2009/03/******_ninja.jpg

 

[hoyden]

Confused here - US FMGs vs non-US FMGs

Is a US FMG someone from the US who did med school somewhere else (eg: Caribbean, Australia, wherever) and has returned to the US to work? Ie the Americans who studied at my med school and then went back for residency.
Is a non-US FMG someone who isn't originally from the US, did med school overseas and then went to the US to work? Ie me if I went to work in the US.

What about someone from outside the US who does med school in the US?

US FMGs are Carribean, etc grads, who went to study abroad on purpose, but originally are Americans.
Non-US FMGs or IMGs are graduates from foreign medschools who never have planned initially to immigrate to the US ( except Indian and Pakistani kids who start preparing for USMLEs from kindergarten) and were practicing physicians in their home countries. Their citizenship could be different - US or their country of origin.

 

[Noyac]

Great!
Maybe you understand that locums are at disadvantage but this does not seem to stop you from constantly describing them as inferior physicians at every occasion.
I am not going to dig out your posts where you make fun of locums and accuse all of them of incompetence but I am sure everyone here knows what I am talking about.
I am not "picking fights" with you unless you consider any opinion different than yours a fight!
And "son" maybe you need to tone down the arrogance a bit!

Anyway, I really don't think it is helpful to continue this discussion with you since no matter what I say you will attribute that to me trying to fight with you.
I already stated what I think of your annoying endless anti locum rhetoric and I will let you have the final word here if you like.

Well before you go making comments like you did, I would suggest you do some homework which includes digging up old posts if you can't remember what someone actually stated. You think you look like a fool here, just imagine if you were in a court of law.

You are picking fights when you insult someone in your post. Don't act innocent on this matter. Every time you disagree with someone you start the debate with an insult. I'm pretty sure you are one of the main people CF is talking about here: "we've all had the token chump try asserting his penis size on this forum, so one tends to be on "alert"." You can have a difference of opinion and still be a friend or at least a decent guy but when you attack people every time you disagree with them then you are just picking a fight.

Then you finish your last comment with "your annoying endless anti locum rhetoric" and you aren't trying to keep this fight going? Really?

And of all things you say that you will leave the last word to me. You just wrote paragraphs with insults and then say this ****. What is wrong with you? The chip on your shoulder is immeasurable.

 

[jetproppilot]

Well before you go making comments like you did, I would suggest you do some homework which includes digging up old posts if you can't remember what someone actually stated. You think you look like a fool here, just imagine if you were in a court of law.

You are picking fights when you insult someone in your post. Don't act innocent on this matter. Every time you disagree with someone you start the debate with an insult. I'm pretty sure you are one of the main people CF is talking about here: "we've all had the token chump try asserting his penis size on this forum, so one tends to be on "alert"." You can have a difference of opinion and still be a friend or at least a decent guy but when you attack people every time you disagree with them then you are just picking a fight.

Then you finish your last comment with "your annoying endless anti locum rhetoric" and you aren't trying to keep this fight going? Really?

And of all things you say that you will leave the last word to me. You just wrote paragraphs with insults and then say this ****. What is wrong with you? The chip on your shoulder is immeasurable.

WORD OF ADVICE: DON'T FU C K WITH NOY. SEEN THE DUDE. HE'S TOMMY LEE. WITH MUSCLES.😱

 

[Planktonmd]

WORD OF ADVICE: DON'T FU C K WITH NOY. SEEN THE DUDE. HE'S TOMMY LEE. WITH MUSCLES.😱

Don't worry, I am done.

 

[sevoflurane]

Well before you go making comments like you did, I would suggest you do some homework which includes digging up old posts if you can't remember what someone actually stated. You think you look like a fool here, just imagine if you were in a court of law.

You are picking fights when you insult someone in your post. Don't act innocent on this matter. Every time you disagree with someone you start the debate with an insult. I'm pretty sure you are one of the main people CF is talking about here: "we've all had the token chump try asserting his penis size on this forum, so one tends to be on "alert"." You can have a difference of opinion and still be a friend or at least a decent guy but when you attack people every time you disagree with them then you are just picking a fight.

Then you finish your last comment with "your annoying endless anti locum rhetoric" and you aren't trying to keep this fight going? Really?

And of all things you say that you will leave the last word to me. You just wrote paragraphs with insults and then say this ****. What is wrong with you? The chip on your shoulder is immeasurable.

👍

 

[Eta Carinae]

Dude, let's get one f*cking thing straight here. I don't know you and you sure as hell don't know me. You can try to play all high and mighty but you aren't fooling anyone. Your statement is exactly what I have been preaching to our administrators and surgeons for a few years now. My group and I have gone to bat for these guys on more occasions than I can remember. But if a LT can't intubate, extubate or perform a simple regional anesthetic then I really can't help him. Our current guy can't chart or keep track of his narcotics. Now pharmacy is on our asse s.

Well before you go making comments like you did, I would suggest you do some homework which includes digging up old posts if you can't remember what someone actually stated. You think you look like a fool here, just imagine if you were in a court of law.

You are picking fights when you insult someone in your post. Don't act innocent on this matter. Every time you disagree with someone you start the debate with an insult. I'm pretty sure you are one of the main people CF is talking about here: "we've all had the token chump try asserting his penis size on this forum, so one tends to be on "alert"." You can have a difference of opinion and still be a friend or at least a decent guy but when you attack people every time you disagree with them then you are just picking a fight.

Then you finish your last comment with "your annoying endless anti locum rhetoric" and you aren't trying to keep this fight going? Really?

And of all things you say that you will leave the last word to me. You just wrote paragraphs with insults and then say this ****. What is wrong with you? The chip on your shoulder is immeasurable.

WORD OF ADVICE: DON'T FU C K WITH NOY. SEEN THE DUDE. HE'S TOMMY LEE. WITH MUSCLES.😱

Don't worry, I am done.

BEEN PATIENTLY WAITING TO USE THIS ANIM...

And ladies and gentlemen, that's THE definition of getting owned.

To be clear, Plank is the guy who gets knocked out- like big time.

😀

 

[Planktonmd]

BEEN PATIENTLY WAITING TO USE THIS ANIM..
😀

How old did you say you are?
Your status says post doc... WTF does that mean?
Did you finish high school?