job options for a MD without residency?

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VA Hopeful Dr said:
But see, that's not always the case. Imagine single coverage ED and no one is willing to step up to cover the shift. My first partner out of residency worked at a hospital with a single OB/GYN. If dude wasn't available, you couldn't do certain things - and emergent c-sections can't be rescheduled and generally can't be transferred.
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This is the reality. When my young daughter was emergently hospitalized, no one volunteered to take my ICU service days and I continued to work. People have their own lives and issues and it is unrealistic that their lives stop for yours. Likewise, the patients you treat don't just stop being sick. That being said, I had one colleague who offered to take a call so I could be there for my daughter one night (because I could give them a little heads up and payback the shift), but the reality is, I could have just as easily had to work and she could have been there by herself (though I would have checked on her frequently since she was in the same hospital I work). Do I wish that medicine allowed for more flexibility for emergent issues? Sure. But me and my family know that that isn't reality and if we run into problems, we each do what we have to to make it through. You just have to prioritize what is necessary versus what is desired.
 
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VA Hopeful Dr said:
But see, that's not always the case. Imagine single coverage ED and no one is willing to step up to cover the shift. My first partner out of residency worked at a hospital with a single OB/GYN. If dude wasn't available, you couldn't do certain things - and emergent c-sections can't be rescheduled and generally can't be transferred.
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Theoretically these things could happen, but they don't actually happen. Your ED group COULD refuse to switch your shifts for your personal crisis, but actually they won't, because you would give your 1 month notice and leave them scrambling for coverage for ALL of your shifts. An attending COULD take a single coverage job that doesn't have any backup coverage for emergencies, but actually less than 1% of physicians will take a job like that, and most of them are making twice the market rate or their time and knew exactly what they were getting into.

When academic attendings want to abuse the next generation of physicians for fun and profit, they generally justify it by talking about scenarios that could happen, but actually don't.
 
SurfingDoctor said:
This is the reality. When my young daughter was emergently hospitalized, no one volunteered to take my ICU service days and I continued to work. People have their own lives and issues and it is unrealistic that their lives stop for yours. Likewise, the patients you treat don't just stop being sick. That being said, I had one colleague who offered to take a call so I could be there for my daughter one night (because I could give them a little heads up and payback the shift), but the reality is, I could have just as easily had to work and she could have been there by herself (though I would have checked on her frequently since she was in the same hospital I work). Do I wish that medicine allowed for more flexibility for emergent issues? Sure. But me and my family know that that isn't reality and if we run into problems, we each pull our weight to make it through, you just to prioritize what is necessary versus what is desired.
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The key difference is that you are needed and no alternative was available. In that case you do what you have to do.

OP's case is not similar to this. He is not needed, no alternative was looked for (like a make up day).
 
sliceofbread136 said:
The key difference is that you are needed and no alternative was available. In that case you do what you have to do.

OP's case is not similar to this. He is not needed, no alternative was looked for (like a make up day).
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That is true. But someday they will be needed. They should realize when that happens, the expectations will change. I suspect that is was what the clerkship director was trying to instill, though I wasn't there so I don't know.
 
sliceofbread136 said:
The key difference is that you are needed and no alternative was available. In that case you do what you have to do.

OP's case is not similar to this. He is not needed, no alternative was looked for (like a make up day).
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Oh yeah, the OPs case really sucked and I hope said attending is disciplined for it. Mine (and my pediatric colleague here) are going after the idea that there is always back up which is not true.
 
Perrotfish said:
Theoretically these things could happen, but they don't actually happen. Your ED group COULD refuse to switch your shifts for your personal crisis, but actually they won't, because you would give your 1 month notice and leave them scrambling for coverage for ALL of your shifts. An attending COULD take a single coverage job that doesn't have any backup coverage for emergencies, but actually less than 1% of physicians will take a job like that, and most of them are making twice the market rate or their time and knew exactly what they were getting into.

When academic attendings want to abuse the next generation of physicians for fun and profit, they generally justify it by talking about scenarios that could happen, but actually don't.
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If that's all it took to make doctors quit and find better jobs, none of the jobs out there would suck because people wouldn't stay. Plus, I've never seen shorter than a 90-day out clause.

I had a job I absolutely hated, but my wife had just had our twins so we couldn't afford to move. I've seen doctors stick with awful jobs because their kids are in the good schools and have friends.

As for the scenarios that never happen, a real life example was literally just posted above yours.

I'm not saying this is ideal, and certainly med students should be cut a decent bit of slack since they are so very unneeded - but to say that you'll always be able to find coverage is naive at best.
 
VA Hopeful Dr said:
But see, that's not always the case. Imagine single coverage ED and no one is willing to step up to cover the shift. My first partner out of residency worked at a hospital with a single OB/GYN. If dude wasn't available, you couldn't do certain things - and emergent c-sections can't be rescheduled and generally can't be transferred.
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There are absolutely times when physicians make extraordinary sacrifices in order to do their duty to patients.

A third year medical student does not hold that degree of ultimate responsibility. Forcing them into it in order to prove a point about how they should behave in extreme situations that they might hypothetically face in their future does not help build their character. It just breaks their spirits, makes them bitter, and if they survive it, makes them more likely to abuse others in turn. There are other ways to impart virtue... such as modeling it and being someone whose behavior is worth emulating.

But you aren't wrong that there are places where resources are limited and having back up for emergencies is a luxury, and that it shouldn't be assumed that everyone can just call off and have someone cover them.

Edited to add: I see from your recent post that we agree that med students deserve a little slack. And that physicians don't always have back up coverage. It is always nice to find oneself in agreement with those that one respects. I hope you understand that the majority of my comment above is more speaking to the overall thread, and not suggesting that you had made any particular statement about whether the OP should have been granted leave.
 
Perrotfish said:
Theoretically these things could happen, but they don't actually happen. Your ED group COULD refuse to switch your shifts for your personal crisis, but actually they won't, because you would give your 1 month notice and leave them scrambling for coverage for ALL of your shifts. An attending COULD take a single coverage job that doesn't have any backup coverage for emergencies, but actually less than 1% of physicians will take a job like that, and most of them are making twice the market rate or their time and knew exactly what they were getting into.

When academic attendings want to abuse the next generation of physicians for fun and profit, they generally justify it by talking about scenarios that could happen, but actually don't.
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Not everyone is plug and play in a group and there are not a lot of redundancies in specialist or subspecialist groups. You can't always have a backup person twiddling their thumbs just in case.
 
DrBowtie said:
Not everyone is plug and play in a group and there are not a lot of redundancies in specialist or subspecialist groups. You can't always have a backup person twiddling their thumbs just in case.
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True, for most places I've been at, the model is it is better to be understaffed and have people do more shifts than to be overstaffed and pay people to sit around and doing nothing. I don't know if that is true for private practice but I know that is true for academics. It doesn't leave much room for flexibility, but then again, one should know what they are getting into before signing a contract.
 
SurfingDoctor said:
True, for most places I've been at, the model is it is better to be understaffed and have people do more shifts than to be overstaffed and pay people to sit around and doing nothing. I don't know if that is true for private practice but I know that is true for academics. It doesn't leave much room for flexibility, but then again, one should know what they are getting into before signing a contract.
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Interestingly, my wife's hospitalist group is the only example I've ever seen of the latter. Their staffing level is appropriate during the winter months (16ish patients/day), but during summer they will often be down to 8-10 patients/day each. Before that got staffed up, during the winter most of them were pulling 14-16 hour shifts instead of the usual 12.

Apparently having 1/3rd of your doctors threaten to quit will make the admin folks find a way to pay for a little over-staffing during half the year.
 
VA Hopeful Dr said:
Interestingly, my wife's hospitalist group is the only example I've ever seen of the latter. Their staffing level is appropriate during the winter months (16ish patients/day), but during summer they will often be down to 8-10 patients/day each. Before that got staffed up, during the winter most of them were pulling 14-16 hour shifts instead of the usual 12.

Apparently having 1/3rd of your doctors threaten to quit will make the admin folks find a way to pay for a little over-staffing during half the year.
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I sometimes wonder if doctors should have unions for this very reason. Not sure where I stand on it, as I'm not well versed on unions and I'm sure there would be other repercussions to it. Though it's an interesting thought one of my attendings once brought up.

Regardless, glad it worked out for your wife's hospitalist group. I've heard life style and flexibility can vary a lot between practice settings.
 
zeppelinpage4 said:
I sometimes wonder if doctors should have unions for this very reason. Not sure where I stand on it, as I'm not well versed on unions and I'm sure there would be other repercussions to it. Though it's an interesting thought one of my attendings once brought up.

Regardless, glad it worked out for your wife's hospitalist group. I've heard life style and flexibility can vary a lot between practice settings.
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Its complicated. First, you have to deal with doctors being independently minded. "Herding cats" being a fairly accurate representation. My wife's group didn't decide this together, it really was just 4 of them each going to the director in a 2 week span saying some variation of "if this doesn't get better I'm going to quit, haven't seen my kids in 3 days and its getting old".

Second, despite what you'll read most people still do respect doctors and actually think we still care about our patients. A union would likely damage that reputation. The public doesn't understand why 200k/year isn't as much as it sounds like nor are they going to like the idea of their surgeries/appointments/tests getting delayed because we're not happy about something.

Third, unions have a tendency to cause trouble in the long run. They get more expensive as time goes on, it complicates matters, and you just don't see them in highly skilled fields (us, law, Silicon Valley).
 
zeppelinpage4 said:
:smack: No one here is saying one shouldn't pull their weight. We're saying that taking a day off for a family emergency/unexpected event (as long as you notify your staff and make arrangements to return the favor) =\= not pulling your weight.
It's called being flexible with your schedule and understanding when others on the team or yourself needs time off. Sometimes we won't have a choice and will need to suck it up, but that shouldn't be the case every single time.

Either there's some miscommunication here, or you're just trolling to push people's buttons dude.
Anyways I'm done arguing. I really hope you're not this stubborn and judgemental in real life with your fellow residents. I want to believe you're not. Personally for me, dealing with antagonistic personalities is far worse than dealing with someone who doesn't pull their weight.
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There are no arrangements at that late time. Everyone is very busy as well already
 
OP,

Don't let one doc or even your schools administration ruin it for you. As you go through 3rd year you see different environments. Most are decent and even enjoyable. About 1/3 of my rotations felt the need to haze the students. They were coincidentally generally the most incompetent doctors. Just don't end up in a training environment like that after medical school. So far in 4th year its been great btw, attendings buying lunch, staff joking around together, praise for good work and constructive criticism when I can improve. Good residencies want good candidates and good candidates don't want to deal with that garbage either.
 
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Really? In my medical school, medical students had 6 to 8 patients each themselves on the regular wards. They saw them and reported to the residents. Residents were swamped. This was before these new rules came out
 
GroverPsychMD said:
Really? In my medical school, medical students had 6 to 8 patients each themselves on the regular wards. They saw them and reported to the residents. Residents were swamped. This was before these new rules came out
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Even at the VA where we had the most freedom, my residents when I was a student still had to see every patient. They could co-sign my notes but as actually writing a note takes maybe 5 minutes then my 4-5 patients saved at most 20 or so minutes. It helped sure, but the hospital would get along just fine without a single medical student.
 
Then we trained at very different places. Med students are valuable. If I wasn't there the other med students would have to divide my work. And who knows in this case if a resident wasn't there as well
 
....is anyone going to actually answer the op's question, which was the whole purpose of this thread??? It's turned into a pissing contest of "who's more correct". Christ.
 
Leo_45 said:
....is anyone going to actually answer the op's question, which was the whole purpose of this thread??? It's turned into a pissing contest of "who's more correct". Christ.
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A search will bring up dozens of threads that have already answered this question.

The short version is, without a medical license there are very few jobs open to MDs that aren't open to anyone with a science background.
 
GroverPsychMD said:
Really? In my medical school, medical students had 6 to 8 patients each themselves on the regular wards. They saw them and reported to the residents. Residents were swamped. This was before these new rules came out
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If you mean that the patient's care was being provided primarily by someone who was not yet a physician with only the most cursory oversight by a resident, let alone an attending, then yeah, I have also seen that happen.

That isn't a system that anyone should be in favor of.

The disservice to the patients is obvious, as they are not receiving the legal or ethical standard of care to which they are entitled. It does not benefit the students, who are not actually being trained through being able to observe the practice of fully trained physicians. Rather, they are being used as dray labor and expected to teach themselves whatever they can along the way. And the regular staff physicians and residents are also clearly being asked to do more than they are capable of doing well, without resorting to such measures.
 
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chipwhitley said:
Yes, because it makes sense that a hospital wouldn't be able to run without the help of people who are actually paying to work there (med students).
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Why be a true teaching hospital when you can just use them for free labor, or even make them pay you for the privilege of exploiting them?
 
Promethean said:
Why be a true teaching hospital when you can just use them for free labor, or even make them pay you for the privilege of exploiting them?
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You'd think if someone makes you pay them to let them exploit your labor, the least they could do is let you go to your grandma's funeral.
 
GroverPsychMD said:
Then we trained at very different places. Med students are valuable. If I wasn't there the other med students would have to divide my work. And who knows in this case if a resident wasn't there as well
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I have had a different experience. Since neither are on the hook from a medicolegal prespective, I essentially do all the work (or at the minimum double check it) myself and let them get what educational opportunities they want from it. If a student or a resident orders an improper medicine or doesn't check a lab and there is a adverse outcome associated with it, they aren't the ones going to court.
 
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Perrotfish said:
Theoretically these things could happen, but they don't actually happen. Your ED group COULD refuse to switch your shifts for your personal crisis, but actually they won't, because you would give your 1 month notice and leave them scrambling for coverage for ALL of your shifts. An attending COULD take a single coverage job that doesn't have any backup coverage for emergencies, but actually less than 1% of physicians will take a job like that, and most of them are making twice the market rate or their time and knew exactly what they were getting into.

When academic attendings want to abuse the next generation of physicians for fun and profit, they generally justify it by talking about scenarios that could happen, but actually don't.
Click to expand...
You keep throwing out percentages, 96% of which you've made up on the spot based off of the environment you perceive the 0.01% of doctors you've been exposed to have to work in...and realize there are more situations than single coverage where it would be difficult to get someone to take shifts for you, or that a hospital wouldn't have to go in divergence because of lack of coverage, or patients with aggressive diseases wouldn't have to delay treatment.
 
I don't know if anyone else has offered this, but you could always move to a medical marijuana state and become a pot doc.
 
SurfingDoctor said:
I have had a different experience. Since neither are on the hook from a medicolegal prespective, I essentially do all the work (or at the minimum double check it) myself and let them get what educational opportunities they want from it. If a student or a resident orders an improper medicine or doesn't check a lab and there is a adverse outcome associated with it, they aren't the ones going to court.
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I'm not talking about court. I'm talking about how much work we did as students. And I've seen residents named in suits.

Back to op, we don't have all the info. The higher ups he appealed to aren't backing him.
 
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chipwhitley said:
You'd think if someone makes you pay them to let them exploit your labor, the least they could do is let you go to your grandma's funeral.
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Promethean said:
Why be a true teaching hospital when you can just use them for free labor, or even make them pay you for the privilege of exploiting them?
Click to expand...
For whatever reason, they wanted him to stay. We don't know the factors
 
VA Hopeful Dr said:
Its complicated. First, you have to deal with doctors being independently minded. "Herding cats" being a fairly accurate representation. My wife's group didn't decide this together, it really was just 4 of them each going to the director in a 2 week span saying some variation of "if this doesn't get better I'm going to quit, haven't seen my kids in 3 days and its getting old".

Second, despite what you'll read most people still do respect doctors and actually think we still care about our patients. A union would likely damage that reputation. The public doesn't understand why 200k/year isn't as much as it sounds like nor are they going to like the idea of their surgeries/appointments/tests getting delayed because we're not happy about something.

Third, unions have a tendency to cause trouble in the long run. They get more expensive as time goes on, it complicates matters, and you just don't see them in highly skilled fields (us, law, Silicon Valley).
Click to expand...
Thank you for clarifying it for me. The idea of physician unions peaked my interest when I first heard about it, but I definitely understand the set backs and hurdles you mentioned. It sounded good in idea, but probably not so practical or beneficial in practice.
GroverPsychMD said:
There are no arrangements at that late time. Everyone is very busy as well already
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I don't know what you mean by late time...I didn't mention time in my post.
Regardless yes, if no one can cover, you hunker down and do the job. It sucks, but you do what you have to do. The main point of my post was to explain that if arrangements can be made, I see no issue with taking time off. In OP's case, there was no useful role to be filled and other arrangements like making up the day weren't even considered by the attending in charge.

And in regard to your later post on medical students serving a purpose. That's actually quite amazing that students have such independence at your program. That's not the case at many other programs. Where I did one rotation, 4th year SubI's had a max patient load of 5, and most times the third years shadowed their resident and afterwards wrote 1-3 notes which the resident signed off on. The third years purpose is to learn and practice, not fill a dire functional need in the team. In the best case scenario it's one in the same, where a student contributes to the team and learns in the process...however I'd say that's uncommon in most places.
 
zeppelinpage4 said:
Thank you for clarifying it for me. The idea of physician unions peaked my interest when I first heard about it, but I definitely understand the set backs and hurdles you mentioned. It sounded good in idea, but probably not so practical or beneficial in practice.

I don't know what you mean by late time...I didn't mention time in my post.
Regardless yes, if no one can cover, you hunker down and do the job. It sucks, but you do what you have to do. The main point of my post was to explain that if arrangements can be made, I see no issue with taking time off. In OP's case, there was no useful role to be filled and other arrangements like making up the day weren't even considered by the attending in charge.

And in regard to your later post on medical students serving a purpose. That's actually quite amazing that students have such independence at your program. That's not the case at many other programs. Where I did one rotation, 4th year SubI's had a max patient load of 5, and most times the third years shadowed their resident and afterwards wrote 1-3 notes which the resident signed off on. The third years purpose is to learn and practice, not fill a dire functional need in the team. In the best case scenario it's one in the same, where a student contributes to the team and learns in the process...however I'd say that's uncommon in most places.
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I now understand everyone's confusion. I chose my medical school because I knew I would get a lot of experience 3rd and 4th year med school.

As for op, I have nothing else to say he has not contributed any new information to the thread.
 
Psai said:
I don't know how anyone will survive residency with someone like you. There's really not much worse than having to pick up someone's slack because they suck.
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In all honesty, just based off of your responses in this thread, I'll happily take sliceofbread on my team over working with you.
I have no idea where you get the idea that sliceofbread or any of us are slackers from our posts here.
And regardless of who is or isn't a slacker, amenable team players who try to understand their teammates trumps all else for me in terms of qualities I want in my teammates. Someone who lacks that, and decides to be judgemental, or put down other team members is worse than a slacker to me.
I don't expect everyone on a team to see eye to eye, but I expect people to get along and maintain a sense of respect. If you can't do that, then I don't care how much extra weight you pull on the team.
 
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GroverPsychMD said:
There are Dental residencies where the dentists pay for residency. Ortho, perio, endodontics, etc. Only 3 are paid by government
http://forums.studentdoctor.net/threads/specializing-and-700k-debt.1221226/
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Dental residencies are not required in order to practice.

Besides, in IM residency, my cheap labor has been exploited to fill in a wide variety of gaps/insufficiencies in hospital staffing. I'd be really pissed if I had to pay money so that the hospital could use me to save money.
 
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They are not required, but if a dentist wants to specialize in a field they need residency. If I want to do a child psych fellowship, the government will cover it
 
GroverPsychMD said:
They are not required, but if a dentist wants to specialize in a field they need residency. If I want to do a child psych fellowship, the government will cover it
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Dental residency is a lot more like an extension of dental school, so it makes some sense. That being said, no one should be paying for residency. Even undergrads get paid for summer internships, so the idea of a dental or medical school graduate paying to work under supervision is absurd.
 
Psai said:
That's a pretty crappy thing to say and you should feel bad about yourself. Also, I already have except I made the prudent choice.
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Well, that's great for you. I actually admire the insane lack of sympathy you have. I hope to be as insensitive as you someday so that I'll be able to give up my entire life to medicine. "Doctor to death"
 
Syndicate said:
I am in my 3rd year of medical school and I'm realizing that I can't do medicine. I don't want to go into specifics but I am fairly confident I do not want to pursue this career any longer. I do however, want to graduate and get my MD degree since I've already paid 3.5 years worth of tuition and passed everything so far.

What are some options in healthcare insurance, consulting, or other fields that are available to those who only have an MD degree with no residency? I'm search these forums but there haven't really been any solid advice thus far.
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It seems like this thread got pretty off topic but to answer your question. I interned at a big three management consulting firm and they love hiring MDs. You just will need to practice the case-based interviewing format but if you prepare hard and have good standardized test scores you have a fairly likely chance of getting hired (helps if your MD/undergrad comes from prestigious school)
 
GroverPsychMD said:
have you ever run a business?
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Have you? Being a fair boss that treats employees like human beings usually results in your employees being more productive and your company retaining and attracting top talent. Working your employees like slaves and showing no leniency only works in a developing world sweatshop.
 
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