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[675015]

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It doesn’t matter if you are a CB or a cook in the Army, everyone learns how to shoot a gun.

That's sort of my point. That's sort of "because that's just how it is." And that's without pointing out that a general medical officer's two hours of hand gun practice is probably equivent to a med students third year clinical skills session on IV placement in terms of how proficient one is afterwards.

Weapons training (which isn't often provides to GMOs for example jnt deployment anyways) has the obvious life saving potential on the battlefield regardless of how rare. We have that with ACLS and BLS certification in medicine that everyone must learn.

I guess with changes in healthcare and an ever expanding fountain of material to master, medical traing Has to be streamlined at some point. Why lament the loss of Iva mastery from a psychiatrists arsenal (or whatever skill doctors are lamenting that medical students are no longer using despite their lack Real world utility)?

 

[clusterF]

Malignant.

 

[Mass Effect]

It doesn’t matter if you are a CB or a cook in the Army, everyone learns how to shoot a gun.

Why though?

I am so, utterly confused right now. I keep hearing this word Malignant. I do not think it means what you think it means.

I could whine about my experience as an intern but let me put it this way; Regularly worked 80, regularly did 30 hours in a row, once went 43 days without a calendar day off (yay for the 24h period!)

Not sure when you would have done such a thing, considering your profile still says resident and the 1-day-off-in-7 (average) has been in place for many years. But yes, I also walked uphill both ways in 10-feet of snow during intern year and I also agree that working 50-60 hours a week is totally doable. My program is actually a lot more cush than the example you gave, but my off-service hours are pretty intense by comparison. Talk about culture shock.

As for the 'bad neighborhood', I literally fell out of my chair laughing. In the US there are a couple of easy ways to avoid murder: 1) Don't be in a gang 2) Don't live with someone in a gang 3) Don't use drugs 4) Don't sleep around or be with someone who sleeps around. Satisfy those criteria and your risk of murder is now less than your chance of winning the lottery

This isn't really fair. I'm sympathetic to people's concerns because I grew up in a bad neighborhood. Our apartment was broken into twice during my childhood, once while we were home. Additionally, there were three separate murders in my apartment complex during my childhood, none of them gang/drug related. At least two turned out to be random and the last one wasn't solved (one was a break-in/robbery, one was a woman who was grabbed and shoved into the nearby woods where she was raped and murdered as she took out her trash, and one was the unsolved case of an army wife who ended up strangled and put in her bathtub while her husband was at work). So while it might be something so rare that you'd never even consider it, murders happen and I personally won't live in dangerous neighborhoods because of how I grew up.

That said, I have yet to come across a city where there aren't GOOD neighborhoods to counter the bad ones. Every city has upscale areas. The OP needs to scope them out.

 

[MacDonaldTriad]

That's sort of my point.
We have that with ACLS and BLS certification in medicine that everyone must learn.

I guess with changes in healthcare and an ever expanding fountain of material to master, medical traing Has to be streamlined at some point. Why lament the loss of Iva mastery from a psychiatrists arsenal (or whatever skill doctors are lamenting that medical students are no longer using despite their lack Real world utility)?

Except for chest compressions and the defibrillator itself, every ACLS intervention requires an IV last time I checked.

If any of you “psychiatrists are not real doctors” trollers are looking for ammo, here you go.

 

[675015]

If any of you “psychiatrists are not real doctors” trollers are looking for ammo, here you go.

Maybe. Or maybe we just a different viewpoint on what defines a "real doctor."

 

[MacDonaldTriad]

Out of the thousands of things unrelated to psychiatry psychiatrists have to do to become psychiatrists, I don’t see starting IVs as anything like a glaring example of extraneous training. In a disaster, it is a fairly simple and useful skill.

 

[675015]

Out of the thousands of things unrelated to psychiatry psychiatrists have to do to become psychiatrists, I don’t see starting IVs as anything like a glaring example of extraneous training. In a disaster, it is a fairly simple and useful skill.

Very true. I'm probably unjustly displacing my frustration on the countless interactions I've had with physicians who each lament something different than I am losing from my training.

 

[clausewitz2]

Except for chest compressions and the defibrillator itself, every ACLS intervention requires an IV last time I checked.

If any of you “psychiatrists are not real doctors” trollers are looking for ammo, here you go.

While you are absolutely right about ACLS protocols requiring IV access, I know that the EM folks at my current institution do not really believe that any of the drugs administered during ACLS are really effective, and argue vociferously that only compressions and electricity are doing anything useful.

Edit: they also prefer intraosseous lines in emergency situations, so still often folks end up without an immediate IV

 

[so721]

Out of the thousands of things unrelated to psychiatry psychiatrists have to do to become psychiatrists, I don’t see starting IVs as anything like a glaring example of extraneous training. In a disaster, it is a fairly simple and useful skill.

An IV is no biggie. I once went to an interview, where one of the psych interns was telling us how he did central lines during his medicine month while working in ICU.

 

[so721]

As the accepting PD, would you expect me to just give you a position without knowing anything about your performance as a resident? Or vouch for your competence without knowing whether you've successfully completed the requirements for the PGY1 year?
Yes--you do NEED your current PD's letter.

BUMP...Just noticed this post and wanted to reply. I wouldn't expect a malignant program director to write a very favorable letter of recommendation? I mean why would they want to loose an extra pair of hands that they ranked.

They are required via ACGME to provide a transcript, would that not suffice? A glowing LOR from this PD doesn't seem likely from what current residents have told me. The PD is quite irrate and Lots of internal politics within the program. But its not hard to get out of the program for a C&A fellowship.

Regarding finding a safe place, the family and I did find a house in a safe area. But the schools are terrible for the kids (especially 13 year old daughter) and we are going to try homeschooling. It's really sad to see the standard of public education in the south and the cycle it creates for kids to resort to drug use, prostitution, stealing etc. How can we expect these areas to progress if we don't start targeting and working on the youth? Anyways, just thought I'd throw that in in case anyone has experience homeschooling kids.

 

[so721]

Also, I thought I would add, since a few people have asked me about it privately...the reason I ranked this program was because of the advice I got from my mentor (my psychiatry preceptor), to rank all places, but also for the added reason that the program did not go unfilled for the past 5 years. That may not have been the best of reasons.

But now that I have moved here, it is seeming a lot safer than I imagined. We are obviously a lot more cautious about our surroundings than we were when we lived in the Northwest, but there are safe areas. I haven't had the opportunity to work yet, but it seems that the call schedule is not too unfair (it's certainly heavy for Psychiatry) but I hope that means that we'll learn a lot more too.

Just thought I'd update since I had received some requests.