LUCOM: Pros and Cons from current students

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I'll wade in: I don't have a big problem with the question. I don't necessarily agree with it, and I don't really understand what the point of asking a question like that is. But the question itself suffers more from clumsy execution than anything else.

Suppose I phrase it like this:

---------------------------------------
A woman struggling with her sexuality comes to your clinic. She is experiencing tension between her deep religious values and her attraction to other women. What would be an appropriate course of action?"

A - ________
B - ________
C - Encourage her to discuss this issue with trusted friends, family members, or clergy
D - ________
--------------------------------------

Anyone really have a problem with answer (c)? The problem with the question at LUCOM was that they referred to this as "direct to holiness" or whatever weirdo Protestant nonsense is vogue in that denomination. But I would argue that what they were getting at was an answer along the lines of, "Encourage the patient to discuss this with a trusted representative of their faith." And that is a perfectly acceptable answer.

I have to completely disagree. It doesn't matter how religious or areligious the patient was before coming to you. Referring a newly out of the closet patient or someone with experimental feelings, to an anti gay organization, is a recipe for disaster and gives a very biased view. And good ol Jerry Falwell and his southern baptists of liberty university are anti gay not neutral. Heck Id have trouble recommending the patient talk with the family right away if the family was very anti gay let alone some religious nut jobs who claim to care what genital(s) you prefer.
 
I have to completely disagree. It doesn't matter how religious or areligious the patient was before coming to you. Referring a newly out of the closet patient or someone with experimental feelings, to an anti gay organization, is a recipe for disaster and gives a very biased view. And good ol Jerry Falwell and his southern baptists of liberty university are anti gay not neutral. Heck Id have trouble recommending the patient talk with the family right away if the family was very anti gay let alone some religious nut jobs who claim to care what genital(s) you prefer.
If I was the doc IRL I would provide them with gay friendly resources including their local PFLAG and a therapist and whatever gay friendly churches are in town as well as encouraging them to talk with their own faith committee. I think what Tired was getting at was that if you have someone who hasn't come out to themselves yet it's kind of a balancing act and you can't just be like "ignore your faith" because then they aren't going to trust you.
 
At my MD school we didnt have any SP during 1st year
Damn, we had four SPs in first year. I found it to be really good experience- the feedback they provided has really helped me nix a few bad habits I acquired in years of clinical practice, little things that aren't really all that detrimental, but could stand to be improved. SPs are great, IMO.
 
I love how everyone insisted that LUCOM would be like every other medical school, and would be secular in all but name, despite the warnings myself and others did our best to provide.

LUCOM is shaping up to be exactly what I expected- a completely nutty neocon evangelical medical school that disregards diversity in religion and opinion and rules over its students with an iron fist.
 
I have to completely disagree. It doesn't matter how religious or areligious the patient was before coming to you. Referring a newly out of the closet patient or someone with experimental feelings, to an anti gay organization, is a recipe for disaster and gives a very biased view. And good ol Jerry Falwell and his southern baptists of liberty university are anti gay not neutral. Heck Id have trouble recommending the patient talk with the family right away if the family was very anti gay let alone some religious nut jobs who claim to care what genital(s) you prefer.

Not all religious leaders are Jerry Falwell. Most aren't, in fact. And the phrase "religious nut jobs" shows animus towards something that is a very sincere part of the lives of a majority of Americans.

Tired is exactly right. Discouraging a patient from relying on their social support network is the wrong move. You have to help the patient come to their own conclusions, without expecting one conclusion or another. Above all you have to make sure they're in a safe place. Ask them if they fear retribution or abuse from their family. But if they don't, you encourage them to discuss things with their family.
 
I love how everyone insisted that LUCOM would be like every other medical school, and would be secular in all but name, despite the warnings myself and others did our best to provide.

LUCOM is shaping up to be exactly what I expected- a completely nutty neocon evangelical medical school that disregards diversity in religion and opinion and rules over its students with an iron fist.

I'll admit, LUCOM does seem... different. I can't see that question being asked at Loma Linda. A while ago I asked people what they would think if BYU were to start a med school. I can say with surety a BYU med school would not ask questions like that.
 
If, as a previous poster has pointed out, that the correct answer was obvious because it was an advice question (what would you advise?) and the three distractors were all procedures, then the item writer is unaware that NBOME frowns upon this style of question big time.

ie it's like asking something like this:

A woman about to give birth would be best treated by a

A) Accountant
B) Mechanic
C) New Car Salesman
D) Obstetrician
E) Pilot

4/5 distractors are so obviously wrong that's the correct answer pops out.

Hence, this merely confirms even more my belief that the Faculty at LUCOM don't know what they're doing. Whoever was responsible for preparing that exam should have been on t he ball and ask the item writer to fix the item.



I'll wade in: I don't have a big problem with the question. I don't necessarily agree with it, and I don't really understand what the point of asking a question like that is. But the question itself suffers more from clumsy execution than anything else.

Suppose I phrase it like this:

---------------------------------------
A woman struggling with her sexuality comes to your clinic. She is experiencing tension between her deep religious values and her attraction to other women. What would be an appropriate course of action?"

A - ________
B - ________
C - Encourage her to discuss this issue with trusted friends, family members, or clergy
D - ________
--------------------------------------

Anyone really have a problem with answer (c)? The problem with the question at LUCOM was that they referred to this as "direct to holiness" or whatever weirdo Protestant nonsense is vogue in that denomination. But I would argue that what they were getting at was an answer along the lines of, "Encourage the patient to discuss this with a trusted representative of their faith." And that is a perfectly acceptable answer.

And before everyone jumps in further with, "No! You have to tell her it's fine to be gay!" recognize that that course of action would be wrong and unprofessional. While it is trendy these days to encourage people to abandon a lifetime of religious faith and values anytime it conflicts with the latest issue of Cosmo, that sentiment from a doctor is inappropriate. It shows a profound lack of understanding about the various things beyond sexuality that go into a person's identity. If you tell this type of patient that they should dismiss their faith and pursue their sexuality, it is very possible you will ruin the patient-physician relationship. Even if they ultimately come to the same conclusion, there is a grieving process that goes along with the loss of a lifelong faith, and a doctor's casual dismissal of that religion will not endear you to the patient, even if you are right.

These kind of issues are not uncommon, and the best possible outcome is for people to work through it themselves, with the physician serving as support, and not a director of action.

Just my 0.02.
 
Not all religious leaders are Jerry Falwell. Most aren't, in fact. And the phrase "religious nut jobs" shows animus towards something that is a very sincere part of the lives of a majority of Americans.

Tired is exactly right. Discouraging a patient from relying on their social support network is the wrong move. You have to help the patient come to their own conclusions, without expecting one conclusion or another. Above all you have to make sure they're in a safe place. Ask them if they fear retribution or abuse from their family. But if they don't, you encourage them to discuss things with their family.

I used Falwell and the southern baptist / nut job quote as that's who liberty university is affiliated with. It's a totally different story if the patient was of a church that isn't anti gay. To clarify, not referring to social supports is for when the social support is anti gay which Falwell and and southern baptists, which is the founder and main sect of liberty U, are. Since we're talking liberty U my interpretation of 'steering towards holiness' is conversion therapy. If this were another different Christian university I'd think different
 
While it is trendy these days to encourage people to abandon a lifetime of religious faith and values anytime it conflicts with the latest issue of Cosmo, that sentiment from a doctor is inappropriate. It shows a profound lack of understanding about the various things beyond sexuality that go into a person's identity. If you tell this type of patient that they should dismiss their faith and pursue their sexuality, it is very possible you will ruin the patient-physician relationship. Even if they ultimately come to the same conclusion, there is a grieving process that goes along with the loss of a lifelong faith, and a doctor's casual dismissal of that religion will not endear you to the patient, even if you are right.

These kind of issues are not uncommon, and the best possible outcome is for people to work through it themselves, with the physician serving as support, and not a director of action.

Tired, I know you're not ready to come out of the closet as a budding Psychiatrist yet, but these posts are making it difficult for you to keep your personal identity issues to yourself.

When you're ready to explore these scary feelings, keep in mind the military has some PGY2 slots open for you to consider and is ready to support you through this transition.
 
I'll wade in: I don't have a big problem with the question. I don't necessarily agree with it, and I don't really understand what the point of asking a question like that is. But the question itself suffers more from clumsy execution than anything else.

Suppose I phrase it like this:

---------------------------------------
A woman struggling with her sexuality comes to your clinic. She is experiencing tension between her deep religious values and her attraction to other women. What would be an appropriate course of action?"

A - ________
B - ________
C - Encourage her to discuss this issue with trusted friends, family members, or clergy
D - ________
--------------------------------------

Anyone really have a problem with answer (c)? The problem with the question at LUCOM was that they referred to this as "direct to holiness" or whatever weirdo Protestant nonsense is vogue in that denomination. But I would argue that what they were getting at was an answer along the lines of, "Encourage the patient to discuss this with a trusted representative of their faith." And that is a perfectly acceptable answer.

And before everyone jumps in further with, "No! You have to tell her it's fine to be gay!" recognize that that course of action would be wrong and unprofessional. While it is trendy these days to encourage people to abandon a lifetime of religious faith and values anytime it conflicts with the latest issue of Cosmo, that sentiment from a doctor is inappropriate. It shows a profound lack of understanding about the various things beyond sexuality that go into a person's identity. If you tell this type of patient that they should dismiss their faith and pursue their sexuality, it is very possible you will ruin the patient-physician relationship. Even if they ultimately come to the same conclusion, there is a grieving process that goes along with the loss of a lifelong faith, and a doctor's casual dismissal of that religion will not endear you to the patient, even if you are right.

These kind of issues are not uncommon, and the best possible outcome is for people to work through it themselves, with the physician serving as support, and not a director of action.

Just my 0.02.
The question simply stated that she was Christian . It didn't say that she was conflicted about her religious beliefs clashing with being gay. I'm Christian and I would not be conflicted about it if I were suddenly Gay.

In the medical world you can only give religious advice if you are the same religion as the patient. Students who are not Christian might have felt reluctant to put that answer.

If this patient had approached me in a more social setting and had shared this with me, even though I am a doctor, the setting was not formal. I would have given her a different answer (assuming that she felt conflicted about being Christian and gay). Or, if I felt that I didn't have the right counselling training, I would refer her to a trusted counselor for LGBT members who are now coming out and how to handle this.

I would want to be an ally for this person...helping them at church (being their confident) but being a physician in my clinic.
 
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You're letting your politics get in the way of your responsibilities as a physician. This is a very destructive to your patients, though probably more common than we like to admit.

- No one is referring anyone to any organization. When a patient has a spiritual crisis (which is what this is), it is helpful in all circumstances to discuss it with their spiritual advisor. You don't have to agree with the religion. But if the patient is already part of it, they will never come to an internal resolution on the issue unless they confront the tension with their religion directly.

- Ditto for family. I just don't feel like typing the same thing twice.

The only biased view in your scenario is your own. The patient has tension between their sexuality and their faith. They need to explore both sides in order to come to a resolution that they can live with. Your solution (keep them away from their faith) is bad, and will result in long term inner turmoil, because the underlying conflict is never actually addressed.
This question us making a hefty assumsumtion that this person was in turmoil over their faith and sexual identity. Dr. Mintle touched in this for 1 minute at the end of class and it was in response to a student's question.

Maybe it's because I grew up around tolerant people but I didn't realize that the question was addressing this conflict, hence why I chose the most medically inclined answer
 
If I saw in a patient's chart that she was Christian. And she mentions to me that she way gay... I would ask her questions about how that has impacted her life and if she feels comfortable discussing it with me. If she brings up that she feels as though she is abandoning her rreligion then I would gently explore that and advise her to talk to a trusted clergy member. There are also licensed psychiatrists whose specialty is to help people to transition or understand their new identity and why it makes them so anxious.
 
As a physician, I would also explore health related questions like safe sex behaviors, alcohol and smoking (since according to our lecture, LGBT members are more likely to smoke and abuse alcohol than their straight counterparts ...I took this with a grain of salt)
 
Really, we've decided to evaluate this school based on a poorly worded exam question? So what, the guy was on his fourth scotch and FUBAR'd one. What was the average score on this exam? Was the overall result different from other outcomes? If your entire stance is the question offended you, then I renew my recommendation, get over yourself.

P.S. it's only battery if you didn't deserve it. We always know when we have it coming. Being worldly and being smacked by your parents doesn't count. PM me in 20 years and we'll find out who was right.
 
I understand you're angry about this situation, but if you take a breath and step back, you'll see that your interpretation doesn't make any sense. The patient came to a doctor to discuss their sexuality. The stem explicitly stated she was Christian. The answer choices dealt with the apparent tension between those two. Did you really think the patient was seeing the doctor to ensure her sexuality was appropriately documented in her outpatient record?

And no, you should never give your patients any religious advice, even if you are the same faith. When you're acting as a physician, stay in your lane. However, encouraging them to discuss spiritual issues with their spiritual advisors is not religious advice.
And btw.. I was not angry about it the way other students were. It was the only one that I had gotten wrong (I'm an A student you know) ... I understand that Liberty is very Christian and that doesn't bother me. But when the majority of students did not put that answer, it is clearly a bad question. I was just disappointed that this professor could not see past that and got upset that students were challenging her
 
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Really, we've decided to evaluate this school based on a poorly worded exam question? So what, the guy was on his fourth scotch and FUBAR'd one. What was the average score on this exam? Was the overall result different from other outcomes? If your entire stance is the question offended you, then I renew my recommendation, get over yourself.

P.S. it's only battery if you didn't deserve it. We always know when we have it coming. Being worldly and being smacked by your parents doesn't count. PM me in 20 years and we'll find out who was right.
Wow. So I guess you're one of those people who support any Form of abuse...including domestic abuse... it's only battery if you didn't deserve it? Wow.
 
Wow. So I guess you're one of those people who support any Form of abuse...including domestic abuse... it's only batter if you didn't deserve it? Wow.

Lol. You're making my point for me. I'm speaking figuratively about small children fighting out a disagreement vs. growing up, becoming a doctor, and being emotionally devastated by the harsh reality that your opinion doesn't mean ****. Get a good psychologist, you're green to be sure.

Oh and FYI... I'm not saying this to be mean, I just see it all the time. Read "House of God" it may help. Real shame is you're an "a" student as you say. Get a "b" and live a little, you're wound entirely too tight. Sorry.
 
Well thank you for your jaded pessimistic view doc. And my brilliance is not because I'm wound up...it's because I study. I do get out. I play sports and I have dinners with my friends and we chat and laugh and have fun. I also volunteer and do community projects with my classmates
 
Lol. You're making my point for me. I'm speaking figuratively about small children fighting out a disagreement vs. growing up, becoming a doctor, and being emotionally devastated by the harsh reality that your opinion doesn't mean ****. Get a good psychologist, you're green to be sure.

Oh and FYI... I'm not saying this to be mean, I just see it all the time. Read "House of God" it may help. Real shame is you're an "a" student as you say. Get a "b" and live a little, you're wound entirely too tight. Sorry.
Btw..house of God shows your age. It's outdated. Have a great pessimistic life that will leave u with alot of regret and bitterness
 
You're letting your politics get in the way of your responsibilities as a physician. This is a very destructive to your patients, though probably more common than we like to admit.

- No one is referring anyone to any organization. When a patient has a spiritual crisis (which is what this is), it is helpful in all circumstances to discuss it with their spiritual advisor. You don't have to agree with the religion. But if the patient is already part of it, they will never come to an internal resolution on the issue unless they confront the tension with their religion directly.

- Ditto for family. I just don't feel like typing the same thing twice.

The only biased view in your scenario is your own. The patient has tension between their sexuality and their faith. They need to explore both sides in order to come to a resolution that they can live with. Your solution (keep them away from their faith) is bad, and will result in long term inner turmoil, because the underlying conflict is never actually addressed.

There is a world of difference between 'steering towards holiness' and referring to a more tolerant group to explore any religious identity issues. One implies being gay is unholy or wrong. And it's inappropriate to refer to an anti gay religious group like Liberty's Falwell and the southern baptists. That's like referring a paranoid schizophrenic to a conspiracy theorist meeting. Refer to a (sane) tolerant religious group if needed. Same with family. It's inappropriate to refer them to family members who will only hurt them, at least initially. Long term therapy is a whole different shebang which I assume this question isn't inquiring about.
 
Well thank you for your jaded pessimistic view doc. And my brilliance is not because I'm wound up...it's because I study. I do get out. I play sports and I have dinners with my friends and we chat and laugh and have fun. I also volunteer and do community projects with my classmates

Ha. I didn't impeach your qualifications or ask for a resume. You should really re-read this thread closely, maybe with your counselor. You panicked someone didn't believe you matriculated, defended the legitimacy of your upbringing, and now you're attempting to demonstrate what a social butterfly you are, but you're not wound too tight. Chillax lol.
 
Ha. I didn't impeach your qualifications or ask for a resume. You should really re-read this thread closely, maybe with your counselor. You panicked someone didn't believe you matriculated, defended the legitimacy of your upbringing, and now you're attempting to demonstrate what a social butterfly you are, but you're not wound too tight. Chillax lol.
I guess you translated my devotion to my studies and over zealousness into being wound up too tight. It's ok... not everyone can be successful in medicine...some do turn out to be jaded and bitter. I truly am sorry for you. I hope you find peace.
 
This thread is an out of control psychodynamic crystal ball of fantastic...

Tired - psychiatrists can be meatheads too, just not so much legally authorized bone carpentry... but, like, carpentry of the mind, man... while benchpressing...
 
You're missing the point. You don't refer her to any specific group. She is already a part of a faith. That is one half of the tension she is experiencing. She needs to discuss it with a representative of that group. Doesn't matter if it's the Southern Baptists, a local Hindu temple, or a Wiccan circle. Your job isn't to find her a different religious interpretation, it's to provide support during a difficult time.

You want to refer her to a "tolerant" or "sane" organization because that's your opinion, and that's where you're confusing your opinion with what's medically appropriate. In a way, you're no different than the people you're criticizing. This is why you need to retain your objectivity in circumstances like this. There's no right or wrong answer in these situations, only what the patient can ultimately live peacefully with.

There is a right or wrong and referring to a group that won't accept her or maybe wants to harm her is part of that wrong. Doesn't matter if she is a part of that group. Our first rule is do no harm and referring to a place that's going to cast her out as a sinner, try to convert her, etc isn't appropriate. This can be appropriate later as part of long term therapy when she is stable but when the patient commits suicide after going to a southern baptist gay conversion event or God forbid gets murdered by an intolerant Falwell follower, it's your referral that led to this worst case scenario. Apologies for the hyperbole but it's necessary to show the nuances of physicians referring to spiritual advisors and/or 'steering towards holiness'
 
Kevin Baker - no one is "referring [the patient] to a group that won't accept her or ... wants to harm her..."

Tired is pointing out in his example that his pretend patient has a conflict between their sexual desires and their religion of choice, which (in the pretend patient's opinion) considers these desires immoral.

We can help support our patients in processing through these conflicts, but the ultimately these conflicts belong to them and they must decide how to work through their conflicting values.
 
Kevin Baker - no one is "referring [the patient] to a group that won't accept her or ... wants to harm her..."

Tired is pointing out in his example that his pretend patient has a conflict between their sexual desires and their religion of choice, which (in the pretend patient's opinion) considers these desires immoral.

We can help support our patients in processing through these conflicts, but the ultimately these conflicts belong tho them and they must decide how to work through their conflicting values.

No one is saying that? Because I can think of quite a few religions including southern baptists who don't accept homosexuality as a lifestyle and quite a few churches including southern baptist one who practiced in recent memory or practice gay conversion therapy. Should we refer to the spiritual advisors if the patient is a member of that group? Remember, my original argument was to refrain from referring to anti gay groups, not all religious groups. Find a tolerant group to refer to.
 
No one is saying that? Because I can think of quite a few religions including southern baptists who don't accept homosexuality as a lifestyle and quite a few churches including southern baptist one who practiced in recent memory or practice gay conversion therapy. Should we refer to the spiritual advisors if the patient is a member of that group? Remember, my original argument was to refrain from referring to anti gay groups, not all religious groups. Find a tolerant group to refer to.

The core question in both pretend examples is proper management of patients presenting with conflicting values and no medical concerns. By referring only to groups that adhere to your values, you're projecting your values onto the patient and the patient will ultimately resent and resist your attempts to influence their individuality and their independence. Trust your patient's capacity to work out their own conflicts, just as you are working out your own.

Caveat: The LUCOM example was somewhat more directive than the above.
 
The core question in both pretend examples is proper management of patients presenting with conflicting values and no medical concerns. By referring only to groups that adhere to your values, you're projecting your values onto the patient and the patient will ultimately resent and resist your attempts to influence their individuality and their independence. Trust your patient's capacity to work out their own conflicts, just as you are working out your own.

Caveat: The LUCOM example was somewhat more directive than the above.

The only core value I'm attempting to project is tolerance. Or better yet, intolerance of intolerance. People in conflict need some sort of safe space to work things out. I don't mean the college campus level of safe spaces but there is a middle ground between southern baptist conversion therapy, attending sermons where they denounce gays, etc. and complete acceptance. If one is referring to the anti gay extreme one is doing a disservice. Yes your patient has capacity to work through conflict but you have an obligation to set them on the right path and referring to groups with conversion therapy and/or an official church statement against homosexuality, isn't it.
 
Unfortunately you couldn't be more wrong, both in your interpretation of "do no harm" and your belief that it is appropriate to impose your own beliefs on patients. This is really paternalism at it's finest, and while I appreciate that you are coming from a place of love, your efforts will ultimately do more harm than good.

You have to trust your patients to do what is best for them, and work through their own issues, no matter how strongly you feel that they are wrong.

What belief am I imposing? That it's not acceptable to refer a patient already a member of an intolerant organization back there where she can continue getting railed against every Sunday? Or converted? My belief is for tolerance or better yet intolerance to intolerance. If you are to refer do it to an area where the patient will not be harmed. Yes this is an example of paternalism but I hope you aren't arguing paternalism is always bad. It's the backbone of do no harm and other medical ethics such as therapeutic no disclosure
 
You know what, I change my answer I think the best thing is to evaluate where the pt is on the Cass identity model before making any recommendations. I feel like tired and Kevin are assuming the pt is at different stages and I think you really have to figure out where this woman is at and meet her at that level
 
No one is referring anyone to any organization. When a patient has a spiritual crisis (which is what this is), it is helpful in all circumstances to discuss it with their spiritual advisor. You don't have to agree with the religion..

I'm not sure if I'm agreeing or disagree with this post as a whole-- just want to point out that "THEIR" is the key word here. The PATIENT's own spiritual advisor, should they have one, not the physician's or physicians themselves. Considering the patient's spirituality as you consider their overall health makes sense and is appropriate; implementing your own spirituality is not.
 
The only core value I'm attempting to project is tolerance. Or better yet, intolerance of intolerance. People in conflict need some sort of safe space to work things out. I don't mean the college campus level of safe spaces but there is a middle ground between southern baptist conversion therapy, attending sermons where they denounce gays, etc. and complete acceptance. If one is referring to the anti gay extreme one is doing a disservice. Yes your patient has capacity to work through conflict but you have an obligation to set them on the right path and referring to groups with conversion therapy and/or an official church statement against homosexuality, isn't it.

Take a step back. The pretent patient identifies herself as "a Christian woman" in the LUCOM question and has "deep religious values" in Tired's (better) question.

What does mean to the patient? What does it mean to be "a Christian?" What are her "deep religious values?" With whom does she feel comfortable processing these questions? You have a 15 minute PCM appointment to help her process multiple, deep rooted conflicts, what do you do?

Your refusal to support her decision to be a part of an organization that may not support her sexual lifestyle projects your value that she should live out her sexual desires regardless of her religious values, even abandon her religion entirely. You are imposing your belief that you know what groups or values she needs to identify with and live out, and that you know exactly which organizations will fit the bill of "tolerant, doctor approved" seal of quality. You are imposing your belief that you can show her the way to happiness in a 15 minute doctor visit.

Take a step back. This pretend patient, in both examples, has a lot of processing to do with whomever she considers a supportive authority. Friends, family, and as Tired said, it "doesn't matter if it's the Southern Baptists, a local Hindu temple, or a Wiccan circle." She will choose which groups she wants to be a part of and which groups she wants to allow to influence her life. You can point out conflict and suffering based on her lifestyle (religious) choices (if these are present), but you cross a boundary when you tell the patient they shouldn't be part of Southern Baptists, a Hindu Temple, or a Wiccan Circle.
 
Lol. You're making my point for me. I'm speaking figuratively about small children fighting out a disagreement vs. growing up, becoming a doctor, and being emotionally devastated by the harsh reality that your opinion doesn't mean ****. Get a good psychologist, you're green to be sure.

Oh and FYI... I'm not saying this to be mean, I just see it all the time. Read "House of God" it may help. Real shame is you're an "a" student as you say. Get a "b" and live a little, you're wound entirely too tight. Sorry.
I love when premeds tell medical students how to do medical school. It's quite amusing.
 
Your refusal to support her decision to be a part of an organization that may not support her sexual lifestyle projects your value that she should live out her sexual desires regardless of her religious values, even abandon her religion entirely. You are imposing your belief that you know what groups or values she needs to identify with and live out, and that you know exactly which organizations will fit the bill of "tolerant, doctor approved" seal of quality. You are imposing your belief that you can show her the way to happiness in a 15 minute doctor visit.

Take a step back. This pretend patient, in both examples, has a lot of processing to do with whomever she considers a supportive authority. Friends, family, and as Tired said, it "doesn't matter if it's the Southern Baptists, a local Hindu temple, or a Wiccan circle." She will choose which groups she wants to be a part of and which groups she wants to allow to influence her life. You can point out conflict and suffering based on her lifestyle (religious) choices (if these are present), but you cross a boundary when you tell the patient they shouldn't be part of Southern Baptists, a Hindu Temple, or a Wiccan Circle.

I hear you. I think we are talking past each other with some misunderstandings of the scenario. I'm not advocating telling a patient to forsake her religion, abandon it, or supporting "a decision to be part of an organization that doesn't support her lifestyle".

I am advocating not referring someone to these organizations (or "to steer them towards holiness") IF these organizations are anti gay even if the patient is a current or former member of them. If she goes on her own thats her decision. But it's not appropriate to refer them to an intolerant organization. Nor am I advocating she lives out her sexual desires. Again, if she does it on her own, that's her decision. If you or Tired feel it is appropriate to refer a gay or questioning individual to an anti-gay organization I don't know what to say or argue other than the distress from going to these anti gay organizations, the weekly sermons against them, the political statements and conventions against homosexuality, the conversion therapy, the ever present lobbying against gay marriage, and the culture of the group, etc. imo, outweighs any spiritual benefit especially when there are more tolerant options that also have spiritual options. Refer elsewhere. Don't tell them they should abandon the religion. Hope that clarifies.
 
"Holiness" is not a prescription. Physicians are not trained to baptize, marry, etc. They are trained to diagnose and heal. A responsible prescription, therefore, would be therapy in whatever form deemed appropriate to make the patient happy and healthy.
 
ultimately physicians will have their own way of handling things. Some will be more empathetic and others will impose their viewpoints.

The main thing to remember is to always be an advocate for the patient...their well being and happiness is your responsibility as a physician. Do no harm and be a strong advocate for the patient.

I would try my best to delicately explore whether or not the patient has inner conflicts with being gay and I would wait for them to express a conflict between their religion and sexual identity. I would ask them what they would feel more comfortable doing... such as discussing it with a trusted clergy member or an LGBT counselor. In this way I am respecting my patient's right to make their own decisions. I would in no way encourage them in the path towards holiness, because my idea of what is holy and morally good may not be appropriate for everyone. My idea of what is holy many be in contradiction to a Jehova's witness or to a Muslim patient. on the flip side, if I were a Muslim physician... I can't tell my patient to pursue holiness because I can get sured...and... I, if i were Muslim, do not believe in Christ and I do not know how a Christian should seek out holiness.

That was my qualm with that question. I wasn't bashing Christians or LUCOM ... just stating that it was a poor question that should have been thrown out before and after the exam (but it was not).
 
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About me:
LUCOM student
Non-religious hippie from a BIG ***** city

PROS:
  1. nice/ friendly faculty & workers
  2. awesome OMM tables
CONS:
  1. Poor clinical rotations compared to other schools (most likely worse than every other school)
  2. Clinical rotations are chosen by a lottery system which is heavily biased against single students (people without a ring on their fingers or little mouths to feed)
  3. Lecture capture only gets released after 24hours. Lecture capture can’t run @ 2x speed with the current software.
  4. For $2k, we received a *******y laptop that’s an embarrassment to the tech world
  5. Building hours: lack of access on Sunday mornings (who wants to study when you can go to church and repent your sins with other sinners?)
  6. COMPASS meetings – small get togethers to talk about feelings and religion. This is where I go to lala-land and reminisce and dream about partying in Vegas. This is a big waste of time as I could be studying, doing chores, sleeping or sinning.
SUBJECTIVE:
Obviously I’m really worried about the quality of clinical rotations. The lack of diversity I’ll be able to see at the clinical sites LUCOM currently has will probably hinder my chances of learning as much as I can before audition rotations. Don’t get me wrong, the clinicians who teach at our school and work in the sites we’ll be rotating at are top-notch. I do not think the system of having students with families picking which rotation site they want first is fair to the single students. To my knowledge, no other school implements this kind of “lottery”. The bible says “For God does not show favoritism” Romans 2:11 (NIV). What’s up with this hypocrisy? I’m pretty sure within the single student “lotto” there’s some favoritism being played out already. Will I get on my knee pads like these special students have probably done from the get-go? Way too early to bust them out in my journey!!

There’s a lot of complaining going on within the student body. Students argue with clinicians about answers to quiz/test questions, especially after the release of class rank. It seems like students believe being in the top at LUCOM matters?! Ha! With the “holiness” answer, this was the first time they busted out a question and answer like that. Not bad I would say considering I’m in conservative territory. I wanted to go with the most appropriate clinical answer but if people were paying attention, Dr. Mintle emphasized pursing holiness in her lecture, whatever that means. Will this question be on boards? NOPE. Just let it go people! It’s just one irrelevant question! People complain about school politics, other students, this and that…things that are pretty much petty and SO not critical their studies and more importantly their board scores.

Like any other school, LUCOM is cliquish, very much like high school. Do people abide by those crazy policies in the student handbook? That’s like asking a straight man not to get wood when looking at a beautiful naked woman. NOT going to happen as students are just as naughty as they were in high school and undergrad. Don’t worry about abiding by the handbook with the ridiculous policies. All the beliefs here in SDN are false! Hell even the Christian students don’t abide by the scandalous ones like giving into lust, drinking a ton, lying etc. We’re all sinners here….You just have to deal with the closed-minded or religious statements people make. Shouldn’t be a big issue unless you’re a delicate flower.

I don’t mind the religion or closed mindedness some faculty and many students have in this school. The compass sessions and obscure religious questions that may come in the future I can live with, but will I mind not being able to learn as much as other students from better programs during my 3rd year? Am I at a disadvantage because I chose LUCOM? Hell, will I even obtain a residency seat with comparable scores with candidates across the country? The only thing that current, future, and prospective students should be worried about is this school’s ability to prepare them for boards, clinicals, and ultimately earning that coveted residency spot.

For the haters and supporters of LUCOM, only after the first few class matches can we objectively judge LUCOM as an institution that produces quality newly minted residents. All this trolling here on SDN, even warranted, shouldn’t cloud an objective judgement of the end result. I truly believe the people in charge of running the show are trying their best to make this happen, but will their efforts be enough? ******** I hope so. Time will be the judge and GOD, Satan, and whatever THING you believe in will be watching.

TLDR: Don’t come if you’re single. Only come if you don’t mind dealing with bull ***** prematurely in your journey to become a doctor.
 
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You are hysterical. Love your post. I also didn't think it was fair to give married students and students with family first dibs on 3rd yr rotations. I get the concept about not breaking up families...but that's not equality.

People with families knew what they were getting themselves into when they chose to come to med school and the fact that they are getting special treatment is discriminatory. One can argue that they are being given an unfair advantage over other students. But I guess I sound selfish by saying that right. Also, the Library is closed for that one hour during convocation, that's very inconvenient.
 
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Probably the same reason I'm "wasting my time on you" and Goro "wastes his time on me." Better to evaluate people's arguments instead of focusing on where they are in their career.
He said she should be studying less and relax- I mean, I'd love to study less and relax myself, but in medical school that just isn't an option.
 
You are hysterical. Love your post. I also didn't think it was fair to give married students and students with family first dibs on 3rd yr rotations. I get the concept about not breaking up families...but that's not equality. People with families knew what they were getting themselves into when they chose to come to med school and the fact that they are getting special treatment is discriminatory. One can argue that they are being given an unfair advantage over other students. But I guess I sound selfish by saying that right. Also... the Library is closed for that one hour during convocation.... ugh!

I'm not against compass... I do like my compass facilitator.... but on Friday afternoons??? Really?

For the record... married students and students with family do not have "first dibs" on all 3rd yr rotations... only for the Lynchburg site if they chose to stay here and that was only if their spouse has a job here or if their child/children are enrolled in school here.
 
Suicide is not uncommon in medical schools and residency, but as you mention, it is rarely discussed openly. For all the biting comments about House of God that have been directed to you, I do generally recommend reading it. I think that the way it treats physician suicide is one of the best that I have ever encountered. As I'm sure you know, the suicide rate among physicians is about double that of the general population, and the rate among female physicians is around four times the general rate. Ironic that it's military suicides that get us up in arms...

I drank a ton in my younger years. I would not have survived at your school. I hope you can make the best of it there. It sounds like you have the right perspective. Keep your head down, get the scores you want, and match to the specialty you want. I wasn't particularly well-liked at my school by the faculty and administration. Living well is the best revenge.

That, and not donating money when they call you for fundraisers.
Yea they fed us all the statistics about med student and physician suicide...we had an in depth discussion about it during our compass sessions. House of God was a reading recommendation. I was advised by residents to read it after 3rd year. Right now I'm reading something neurological 🙂
 
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For the record... married students and students with family do not have "first dibs" on all 3rd yr rotations... only for the Lynchburg site if they chose to stay here and that was only if their spouse has a job here or if their child/children are enrolled in school here.
You are correct. Still it's discriminatory... because the majority of lucom students would like to stay in the lynchburg area and rotate at the big Centra hospital
 
I found it a nice prep before I started 3rd year. I also made the mistake of letting my wife read it. I still get comments about how I'm probably banging nursing students in the call rooms at night.
haha... I'm sorry... although stress can do that to some people (whistles)
 
As ****ed up as it sounds I'm kind of assuming that all of us will have classmates that commit suicide at some point. Aren't our suicide rates like the same a prisoners?
 
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