MS3 AMA - ask us questions

[MilkIsGood]

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By interacting with them on the wards. You still see them, and they still pimp you and will see your presentations. Depending upon the service and the attending, though, that may be all they have to go on when it comes to your evaluation. This is why rounds and ensuring that you don't look like a bonehead is so important.

Usually how long do you work with an attending? 1-2 weeks?

 

[NickNaylor]

Usually how long do you work with an attending? 1-2 weeks?

Yeah, usually 1-2 weeks, though I imagine this is heavily department- and hospital-dependent.

 

[snowflakes]

I think everyone gets a little more cynical to variable degrees, but I'm not so sure. My perspective changed simply because the glamor and mystique faded away. "Medicine" as it is in reality wasn't really what I expected to be despite my clinical experience beforehand. It's not that it's necessarily worse than I was expecting, it just wasn't what I expected.

It's hard as a layman to really think about healthcare and how it's delivered in an intelligent way because you don't really have the experience or judgment necessary to do so. This is why I read threads like the "how I'm going to be a better doctor" or whatever it is and just laugh. It's not that being optimistic and having goals isn't laudable - it is. But those goals are so disconnected from reality in a lot of ways that it's hard to even discuss them in a meaningful way. By no means am I some kind of guru or expert, but once you've gotten your hands dirty I think you develop a perspective that allows you to begin having that conversation with yourself or others.

I think also that it's becoming more and more clear to be how much of a corporate production the delivery of healthcare is. Of course, I recognized at some level as I'm sure most do that it's ultimately all about the Benjamins. But I think I sorely underestimated how deep and fundamental that rot goes. I naively though that people delivering healthcare would actually, you know, give a damn about patients, and sometimes that's so far from the case that it's deeply, deeply saddening if not disturbing. That's not limited just to residents and attendings - it's applicable to all levels of the staff, from LPNs to RNs to midlevels and on up. The processes in place that you see the politicians jerking themselves off about when it comes to Medicare/Medicaid fall so ridiculously short of providing anything close to competent care that you wonder what ***** came up with this system in the first place and how they could possibly be feel good about it.

As I said, everyone knows and appreciates that money is ultimately the driver of all things, healthcare included. I suppose I just didn't expect how strong that driver was. I'll admit that being in a position to avoid that nonsense as much as possible is a huge factor in determining my career goals. I really, truly believe that third-party payers are the physician's worst enemy, and avoiding them at all costs if possible is a wise thing to do. When you talk to physicians about the worst parts of the job, it's not really the hours or the hard work. I think most physicians have no problem doing those things if they feel like they're actually helping the patient. Instead, things like shrinking reimbursement, limited time available to work with patients, and having to deal with more and more bureacratic nonsense are what they complain about and lead to deep dissatisfaction, among other things. All those things are related to third-party payers and their ability to manipulate how you practice medicine.

Thanks, I appreciate this thoughtful response.

 

[LostinLift]

Looking back on your first 3 years, is there anything you would have done differently? Anything you would recommend to incoming first years that isn't often mentioned? Even small tips about lifestyle/studying/shadowing/etc.

 

[lobo.solo]

Congrats on deciding what field of medicine you'll do! I want to get published before 3rd year how can I approach this without looking like a gunner? How would you go about trying to write a case study during 3rd year? Thanks🙂

 

[NervousNerd]

Mr Naylor,

Were you single or in a relationship upon entering MS1?

-If single, was the dating scene rough considering class rigor?

-If dating, how was it managing such time consuming classes with dating and spending time with your SO?

 

[ridethecliche]

Congrats on deciding what field of medicine you'll do! I want to get published before 3rd year how can I approach this without looking like a gunner? How would you go about trying to write a case study during 3rd year? Thanks🙂

You could probably get published your MS1 summer if you can get in somewhere with a high project load. Retrospective studies are doable in 3 months and you could probably do a case report or two as well.