Pre-Employment Screening

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Just_Curious said:
How ocmmon is the drug/urine screening for residencies? In that I'm asking, I have an interest in not submitting to this exam.
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i have no clue as i have never had to "worry" about that, but one of my friends has a 17 year old son who uses niacin to get past them. i would think that they would be pretty common, just because the hospitals dictate the screening, not the residency programs. but what do i know.

warning: be prepared for those who will start attacking you for your "concern" about UDS tests.
 
My residency required drug screening and I had to have it repeated this year to work at a chilren's hospital. I think almost all (if not all) hospitals will require it. I doubt you are going to be able to refuse the test as it is part of the contract for employment. Good luck trying to explain why you will not take it. 😀

Pelivar
 
Yeah I forget where but when I interviewed they were basically like we do drug screens and oh BTW sign this, it will let us do a background check.. If you refuse to sign we wont rank.. (that was the implication).

No drug use for me and nothing to hide so I signed..
 
Are you telling me that many students/residents are "doping"! Man interdepartmental sports has really gotten competative! :laugh:

Paul
 
Peksi,

Have you noticed all the Epogen missing lately? I dont know if it is the EM residents or the Orthopods..
 
California does not allow for pre-employment drug screens so if you are there you don't have to worry about it. But of course you can just walk down to the beach or to Golden Gate Park in San Fran and buy your little "medical necessity" card to buy your own weed legally.

I had to submit to random drug tests all the time in the military, freaking directly observed BS with some perv staring right at your member. I will never allow that humiliation again. They can strip me naked and send me in a bathroom with blue water but no longer will I be someone's free porn!!

If you are a physician, or about to be one, its honestly time to step away from the weed, or anything else illegal. It will end your career. Trust me, I am not all that dead set against people smoking weed, and truthfully, if they legalized it, I might partake a time or two a year. But WTF dude, we are doctors and our minds are worth a lot more than a cheap high. Anyone who has ever killed a bowl or two in their younger years on a regular basis knows that it f-ks up your memory.

You owe it to yourself to step up to the plate and be honest with yourself.....is it really worth it to do such childish things any longer? If you really need a good buzz, then something is missing from your life. Buy a nice expensive red wine and share it with friends, but you are no longer in a position to do illegal stuff.

For the record, I am completely in favor of making our society an Amsterdam in the US. Our prisons are full of minor drug offenders and the drug cartels get richer every day drugs are illegal. We pay more money to fight drugs than we put into our children's schools. Morphine was sold OTC until the early 1900's, and right now in Amsterdam you can head to any pub and pick your brand of Hash. The schools there are far superior to our, and their kids have been turning out great for decades. Just food for thought!

Bet you never met someone who is a proponent for less gun law and less drug laws!!! :laugh:
 
Just_Curious said:
How ocmmon is the drug/urine screening for residencies? In that I'm asking, I have an interest in not submitting to this exam.
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just curious but why would you not submit this exam?
 
Aren't you fine if you just stay clean for a few weeks / month before the test?
 
Agree 100% with what corpsman said. The dangers of some drugs (especially pot) are grotesquely exaggerated by the US government. We all know that pot is safer than aspirin by a longshot. However, if you're going to be a physician, it's time to start following the law, even if the law isn't completely rational. And, of course, if you have a problem with other, more dangerous drugs, you owe it to your patients as well as to yourself to get help and stop using.
 
AlienHand said:
Agree 100% with what corpsman said. The dangers of some drugs (especially pot) are grotesquely exaggerated by the US government. We all know that pot is safer than aspirin by a longshot. However, if you're going to be a physician, it's time to start following the law, even if the law isn't completely rational. And, of course, if you have a problem with other, more dangerous drugs, you owe it to your patients as well as to yourself to get help and stop using.
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I thought widespread narcotics use was only rampant among anesthesia residents? Looks like it's spread to EM too! Next thing you know Family Practice residents will drink beer and learn to have fun.
 
In the words of Cher from Clueless, "It is one thing to spark up a doobie and get laced at parties, but it is quite another to be fried all day." I would think most people that test positive for marijuana fall into the first group - especially if they made it through college and medical school without any problems.

Sure I think screening for marijuana use is silly, and sure I think breaking the law is not the most intelligent thing to do. However, I have to disagree with the thought that becoming a doctor means that we are somehow obligated to follow every law. If we realize the consequences, I don't see anything unethical or immature about breaking laws that we think are unimportant or incorrect. I mean, if you are in Sioux Falls, South Dakota, are you not going to have sex between the twin beds in a motel room because you are a physician? Come on. By the way, does that law really exist? I heard that once, and it stuck in my head.

P.S. I hear Golden Seal does the trick.
 
Flopotomist said:
Aren't you fine if you just stay clean for a few weeks / month before the test?
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As a child of the sixties, a california native and an EP for thirty years, I've seen and lived some of this. I've seen 3 friends kill themselves after being told they would not be physicians anymore. I've seen others lose their careers and families. I've seen a couple go to jail for selling scrips and stealing from the anesthesia stocks. I've seen a few crawl back to practice under scrutiny of the medical boards for the rest of their career.

This isn't about beating the test, it isn't about the rationality of the law, it's about the safety of your patients and whether you get to keep your life. :idea:
 
BKN said:
This isn't about beating the test, it isn't about the rationality of the law, it's about the safety of your patients and whether you get to keep your life. :idea:
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I would agree that making the choice to use marijuana is rather stupid as it could negatively affect your career, but I am not sure I am convinced that recreational use months before employment is even relevant. I think that the abuse of alcohol is FAR more serious of a problem, particularly when a physician in the hospital I work in now was dragged from the OR drunk. (see http://www.insidebayarea.com/dailyreview/localnews/ci_3592302 )
 
One thing that people have to remember is there are many hospitals that for any employee injury that is seen in the ED or occupational health, often times they will require a drug test. In the event that there are drugs that are found in the system, it is my understanding that the hospital can exercise its options to not cover the injury as the person was "under the influence". This apparently goes for needlesticks as well.
 
Flopotomist said:
I would agree that making the choice to use marijuana is rather stupid as it could negatively affect your career, but I am not sure I am convinced that recreational use months before employment is even relevant. I think that the abuse of alcohol is FAR more serious of a problem, particularly when a physician in the hospital I work in now was dragged from the OR drunk. (see http://www.insidebayarea.com/dailyreview/localnews/ci_3592302 )
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I heard about this Neurosurg guy.. Made the news in Chicago, He claims he only had 1 glass of wine FWIW. IMO EtOH is a much much bigger problem than a little weed. The thing is thats a separate discussion.

Since marijuana is illegal (not here to merit this, I think we should legalize it and get rich doing so) it is a matter of breaking the law and possibly ruining your career as BKN said.
 
The fight to legalize marijuana IMO is an economic one, while I dont partake myself I believe the US could make a ton of money if we legalized it.

It would give the farmers something else to grow (reducing farm subsidies), we could tax it like cigarettes, we could reallocate our "drug war" on things like cocaine, heroin, and meth, and we would have fewer arrests for minor drug violations etc.
 
IMO its a win, win, win situation and it is something that IMO is far safer than EtOH.

Rant over.. FWIW as someone who likes many of the libertarian views I would be all for legalizing most drugs.. IMO your body your problem.. But thats just me..
 
BKN said:
As a child of the sixties, a california native and an EP for thirty years, I've seen and lived some of this. I've seen 3 friends kill themselves after being told they would not be physicians anymore. I've seen others lose their careers and families. I've seen a couple go to jail for selling scrips and stealing from the anesthesia stocks. I've seen a few crawl back to practice under scrutiny of the medical boards for the rest of their career.

This isn't about beating the test, it isn't about the rationality of the law, it's about the safety of your patients and whether you get to keep your life. :idea:
Click to expand...

While I can see everyone on this thread's perspective I would like to point out one thing. B/c marijuana in "illegal" we are so quick to tell him/her that they need to grow up, or consider patient safety, or become a role model, and stop smoking. HOWEVER, there are multiple posts that, I have participated in, that do nothing but discuss our favorite alcohol, or how drunk we are gonna be, how many days in a row we are gonna drink and trying to find reasons to drink that no one finds fault with. Last time I checked EtOH is far more taxing on the body, severely impairs your judgment and has destroyed just as many (if not more) careers that occasional toking.

I understand that b/c marijuana is illegal the consequences for being "caught" are far more severe than going out for beer every single night after work, but I still think that we need to put it into a realistic perspective.

I am not trying to start a war or start a discussion on the legality of weed. I just wanted to come at this topic from a different angle. NOTE: I agree that b/c it's a law, you will be punished if caught, you might as well hang up the roach clips and submit to THE MAN...or move to California 😎
 
I think most people on this thread (those in the medical field) and heck people in EM especially (Car acccident, drunk people doing stupid things) will agree that EtOH is far worse, but society has ways to deal with this. We know you cant drink and drive, bartenders (theoretically) wont serve you if you are drunk (if they do they are partially liabile for your actions).

Bottom line is that right or wrong EtOH is an acceptable to society, so is gambling (which is also dangerous) as of right now marijuana isnt and thats where the diff is.

I am not telling anyone to "grow up" per se, but more like BKN said, do you want to ruin your career which is just starting because of this?

Outside of a few posters on here (BKN, Peksi (age unknown)) we are just starting and the "grow up" portion of the statements might have more to do with the possibility of ruining your career rather than an opinion that weed is a childish thing to do.

There are a lot of older people who still toke on occasion and thats fine but I know I wouldnt want to risk all my hard work going for naught because I didnt/couldnt stop breaking the law.
 
BKN said:
As a child of the sixties, a california native and an EP for thirty years, I've seen and lived some of this. I've seen 3 friends kill themselves after being told they would not be physicians anymore. I've seen others lose their careers and families. I've seen a couple go to jail for selling scrips and stealing from the anesthesia stocks. I've seen a few crawl back to practice under scrutiny of the medical boards for the rest of their career.

This isn't about beating the test, it isn't about the rationality of the law, it's about the safety of your patients and whether you get to keep your life. :idea:
Click to expand...

This is your best post ever BKN. I hope someone will take it to heart. And yes guys, I do agree that alcohol, although more socially accepted, is worse at ruining physician careers than any other substance.

Flopotomist- What are you talking about when you say testing for drugs that someone has done "months earlier" than their employment was to begin? I don't believe that most drug screenings for pre-employment test anything more than the "here and now" drugs. So unless you were smoking weed within a month, or doing hard stuff within a few days, you are not going to have a problem. That said, there are hair tests as we all know that can test whether you have literally "EVER" done illigal drugs, and those tests in my opinion are rarely done......anyone know when or why one might be done?

I think if most places were to go to hair analysis to detect if you had EVER done drugs, there would be a lot of residents fired in the first week of their employment :laugh: And you can bet there would be a lot of "cyclists" and "body builders" in the intern class coming in with completely shaved bodies for "competition" purposes.... 😀

Even those eyelashed can cause "drag"........lose em!!
 
kbrown said:
Last time I checked EtOH is far more taxing on the body, severely impairs your judgment and has destroyed just as many (if not more) careers that occasional toking.
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This post may seem a little unfocused, but then so is the subject.

These kind of threads always seem to follow the same curve:

1. How can I beat the test?
2. You shouldn't do drugs because you'll lose your career and your family
3. But MJ is different and besides ETOH is worse
4. Loop to 2, repeat ad infinitum

I'm going to try to add something new.

You notice that I've stayed out of the drinking thread. To the implied charge of hypocrisy, I plead not guilty. Some of you know that I make wine as a hobby. I rarely drink more than a glass in a day, and I never get drunk.

The relative dangers of various drugs are always brought up, particularly ETOH vs cannabis. I'd agree that it seems MJ is the safer. But if you take that approach, you'd probably have to say the same applies for opiates, sympathomimetics and the rest of the illegals.

The missing part of this comparison is population atttributable risk. I suspect far fewer people are using the illegal stuff, therefore if risks were the same, the ETOH badness would be much more evident. I think that addiction is not caused by the drugs. Rather, people with addictive personalities take drugs to feel "different" and will use whatever they can get. If we were Drs. a hundred years ago, when you could get opiates OTC, I imagine we would have seen lots more opiate problems.

As I think most of you know, I trained in addiction hell (East Baltimore). From that experience I developed a strong dislike of all types of users. You can't be in our business and not be affected.

BTW. there's at least one issue with MJ that seems to be underappreciated, mostly because causality is difficult to prove. Usage of all mind altering drugs can lead to motor vehicle accidents, injury and death. I suspect that the impairment from smoking one doob and driving is equal to and lasts longer than drinking to a BAT of .1%

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16321993&query_hl=6&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/..._uids=15992751&query_hl=6&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/...t_uids=8926551&query_hl=1&itool=pubmed_docsum

But the very good news is that chocolate is good for you. An addiction that most of us can get behind. God does love us and wants us to be happy. Apparently there's also a study just out that isn't indexed yet which showed a 50% reduction in all cause mortality in chocolate drinkers.

http://www.ncbi.nlm.nih.gov/entrez/...uids=16390538&query_hl=11&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/...uids=11682694&query_hl=11&itool=pubmed_docsum
 
This thread is encouraging. There have been a few threads about drug testing in med school over in Pre-Allo, and it has been disturbing to me the number of people who say that if you just stop a few months before you'll be fine. It's great to know that the people who are further along in this process really don't advocate the regular use of illegal drugs.
 
mustangsally65 said:
It's great to know that the people who are further along in this process really don't advocate the regular use of illegal drugs.
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But of course we advocate their regular use. Are you crazy? You think we want to be out of a job? Hell, you'll probably want people to stop eating fast food next! 😀

Take care,
Jeff
 
Posted by BKN: As a child of the sixties, a california native and an EP for thirty years, I've seen and lived some of this. I've seen 3 friends kill themselves after being told they would not be physicians anymore. I've seen others lose their careers and families. I've seen a couple go to jail for selling scrips and stealing from the anesthesia stocks. I've seen a few crawl back to practice under scrutiny of the medical boards for the rest of their career.
Click to expand...

This is SAGE advice and information. It would be beneficial to have such information posted as a sticky post of some sort. We can learn more from our mentors than mere medicine. 😉 Thank You BKN
 
Not sure if this is the right place to post but since MJ has been talked about a lot here I figured I'd give it a shot. I used to smoke frequently and even though I stopped months ago, it still showed up on my uds and I was not able to start residency. Regardless of the reasons I started smoking, there is no good excuse for my actions and I will forever have to own up to it and face the consequences. I'm wondering if there is anyone out there that has been through this before that can offer me some advice as to what to do in my year off, how to explain this when I reapply, etc. I realize the dangers of the drug especially in the workplace and would never put my patients at risk, nor have I ever in the past. If you don't have any constructive helpful advice to offer I ask that you please respect what I am going through and don't post anything at all.
 
Sorry to hear about your trouble...you're in a tough spot.
I would look into some formal type of addiction program. If I were a PD and were looking at your re-application. I would want to see that you fully addressed this issue. I think you have to directly address this issue on your next set of applications.
Do you have the option of talking to the program that gave you a spot this year. Your best chance of getting a residency slot would be to find a sympathetic PD, and the one that liked you this year might be willing to give you a second chance if you could turn things around.
Did you match into EM? If so when you go to re-apply I would apply everywhere, as this is going to be a non-starter for most programs.
 
KarlPilkington said:
Sorry to hear about your trouble...you're in a tough spot.
I would look into some formal type of addiction program. If I were a PD and were looking at your re-application. I would want to see that you fully addressed this issue. I think you have to directly address this issue on your next set of applications.
Do you have the option of talking to the program that gave you a spot this year. Your best chance of getting a residency slot would be to find a sympathetic PD, and the one that liked you this year might be willing to give you a second chance if you could turn things around.
Did you match into EM? If so when you go to re-apply I would apply everywhere, as this is going to be a non-starter for most programs.
Click to expand...

Agree that the above situation sucks. I imagine the PD that hired him is unbelievably pissed about being betrayed (unexpected sudden loss of a filled position after the easy ways to fill it with a qualified candidate have passed). It doesn't hurt to try, but that conversation is likely to be ugly.
 
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I agree with the above that enrolling in a treatment program would be a good first step. Submitting to repeat drug tests would be another.

I know docs who have been caught shooting fentanyl on duty who were able to reapply successfully (although they were not able to handle controlled substances after that, thus they had to switch out of Anesthesiology). So while this is a major set-back it is not necessarily a career-ender.

Best of luck to you.
 
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EctopicFetus said:
Yeah I forget where but when I interviewed they were basically like we do drug screens and oh BTW sign this, it will let us do a background check.. If you refuse to sign we wont rank.. (that was the implication).

No drug use for me and nothing to hide so I signed..
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I believe that was ECU. I signed it but felt it was a little invasive. I don't believe I ranked them.

I don't use any drugs but I am not a huge fan of UDS as I've found them to be terribly unreliable in patients I've seen the ER (I rarely order them as they have zero clinical utility in the ER, unless Psych or IM really wants one).

As for the OP: I've never had to take one at any of the hospitals I've worked at, but I do believe there is a stipulation in the contract that there is the possibility of random drug tests.
 
Cerberus said:
I believe that was ECU. I signed it but felt it was a little invasive. I don't believe I ranked them.

I don't use any drugs but I am not a huge fan of UDS as I've found them to be terribly unreliable in patients I've seen the ER (I rarely order them as they have zero clinical utility in the ER, unless Psych or IM really wants one).

As for the OP: I've never had to take one at any of the hospitals I've worked at, but I do believe there is a stipulation in the contract that there is the possibility of random drug tests.
Click to expand...

One of our residents had a patient complaint that they were drunk (they weren't) but this same resident would not have been able to pass a UDS at the time of the complaint and said so to the PD. It got de-escalated without them being required to pee, but it was also clear that the language of our contracts allowed them to drug test us at essentially any time.
 
losingitall said:
Not sure if this is the right place to post but since MJ has been talked about a lot here I figured I'd give it a shot. I used to smoke frequently and even though I stopped months ago, it still showed up on my uds and I was not able to start residency. Regardless of the reasons I started smoking, there is no good excuse for my actions and I will forever have to own up to it and face the consequences. I'm wondering if there is anyone out there that has been through this before that can offer me some advice as to what to do in my year off, how to explain this when I reapply, etc. I realize the dangers of the drug especially in the workplace and would never put my patients at risk, nor have I ever in the past. If you don't have any constructive helpful advice to offer I ask that you please respect what I am going through and don't post anything at all.
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No way to argue for a repeat test? A UDS is just as likely, probably more so, than any other test to have false positives.
 
Arcan57 said:
One of our residents had a patient complaint that they were drunk (they weren't) but this same resident would not have been able to pass a UDS at the time of the complaint and said so to the PD. It got de-escalated without them being required to pee, but it was also clear that the language of our contracts allowed them to drug test us at essentially any time.
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That stinks and is a good example of why it's best to just avoid illegal substances, regardless of the fact that most of us would agree that the occasional toke is harmless.
 
Cerberus said:
That stinks and is a good example of why it's best to just avoid illegal substances, regardless of the fact that most of us would agree that the occasional toke is harmless.
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Specifically to those starting this application cycle, stop smoking weed now to be sure you can pass a drug test come next year when you start residency. It sounds like the poster misjudged how far out they had to stop. I'm no expert on drug testing but I seem to remember that THC is fat soluble, so I would expect that if you've been doing it for years you will have some shift from fat cells into circulation for months.
 
Cerberus said:
I believe that was ECU. I signed it but felt it was a little invasive. I don't believe I ranked them.

I don't use any drugs but I am not a huge fan of UDS as I've found them to be terribly unreliable in patients I've seen the ER (I rarely order them as they have zero clinical utility in the ER, unless Psych or IM really wants one).

As for the OP: I've never had to take one at any of the hospitals I've worked at, but I do believe there is a stipulation in the contract that there is the possibility of random drug tests.
Click to expand...

Unless it has changed, ECU doesn't do that.
Other places may.
 
Cerberus said:
No way to argue for a repeat test? A UDS is just as likely, probably more so, than any other test to have false positives.
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They may have done so already. It's policy where I work (defense contractor for government facility) that a positive test is confirmed by a second test.
 
Gamechanger said:
They may have done so already. It's policy where I work (defense contractor for government facility) that a positive test is confirmed by a second test.
Click to expand...

I think in this situation a second test isn't going to do much. The poster isn't saying "I never smoke weed, I got hosed by a urine test." Rather they are saying "I smoke weed, I hadn't smoked in awhile and the test was positive."

I'm not judging, but pushing for a re-test when you have actually been using what the test is looking for probably isn't a great strategy.

I would use a re-test on your own (ie sign up for a urine drug test) to be sure that you can pass the offical one when the time coes to re-apply.
 
Gamechanger said:
They may have done so already. It's policy where I work (defense contractor for government facility) that a positive test is confirmed by a second test.
Click to expand...

This is completely true. My initial uds showed positive so they sent it for gc/ms for confirmation. I have to go through a recovery program and then reapply for 2013. I'm wondering what everyone's opinion is about 2 things: personal statement and the section that asks you to explain any gap in schooling. I was told programs won't be able to see that I applied the year before but will they be able to see that I previously applied for a license? Then how would I explain. The program I was at encouraged me to reapply- whether they were being nice or not I'm not sure. If I say I took a year to volunteer do research etcand applies to my original program obviously they would know the truth. Or am I better off admitting my mistakes right off the bat and how I've learned from them? Soooo lost. Thanks in advance you guys have already helped a bunch!
 
losingitall said:
This is completely true. My initial uds showed positive so they sent it for gc/ms for confirmation. I have to go through a recovery program and then reapply for 2013. I'm wondering what everyone's opinion is about 2 things: personal statement and the section that asks you to explain any gap in schooling. I was told programs won't be able to see that I applied the year before but will they be able to see that I previously applied for a license? Then how would I explain. The program I was at encouraged me to reapply- whether they were being nice or not I'm not sure. If I say I took a year to volunteer do research etcand applies to my original program obviously they would know the truth. Or am I better off admitting my mistakes right off the bat and how I've learned from them? Soooo lost. Thanks in advance you guys have already helped a bunch!
Click to expand...

At this point, I recommend the truth...don't hide this during the next application cycle...it is too easy to discover and your lie won't sound genuine.

HH
 
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