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Could you PM me his name/contact info as well?
Thanks!
Thanks!
I wouldn't say Law2Doc is slamming any doors shut. It is much more politically correct to encourage people on pre-allo, but these responses often do not help prepare an applicant for obstacles he/she may face.
Objective obstacles are the standards that must be met to graduate from med school and the standards that must be met to graduate from residency. These are more cut and dry, but also may have alternative solutions. What are the clinical competancies required and how are they evaluated? What alternatives are acceptable? Will a med school or residency accept a clinical competancy based on knowledge or must the skill actually be performed. Is it acceptable to perform skill on a sim manequin or must it be demonstrated in practice? What skills and physical duties are required when on clinical rotations? What are the options (such having an assistant with you) that are acceptable to a program or school?
I do encourage you to read the thread in the residency forum regarding "calling in sick". It demonstrates some of the intolerance of "weakness" some residents have in other residents. In the arena of overworked and stressed out residents, significant resentments of others can occur when people feel they are being worked harder to balance another residents needs. Unfortunately, for some residents compassion for others does not extend to their fellow residents at times and some institutions do not have a cushion to provide backup in the face of sick time or the personal needs of residents.
Sorry for the long post! Best of luck to you on your journey.
i met a lady named jody who's a md/phd quad at uconn but lost her contact info. i also had not regained my personality or sense of self after injury when i met her, so we didnt talk much...do you know her, bean?
by and you, too, i meant good luck to you too. while i appreciate you, it sounded personal and kind of creepy when i read it and realized the insinuation.
Why is it that people lose touch with reality when it comes to medicine? If someone with physical disabilities wanted to be a home contracter or plumer, people wouldn't encourage said person but would point out how unrealistic it is. I don't mean to be insensitive, but there must be logic along with emotions when approaching such a topic. Medicine is a very demanding field, and at this point, needs all the help it can get (shortage etc). If someone who is not in medical school aknowledges that they do not have the abilities to get through the standard requirements of medical school and residency, why do we get all emotional and support this idea? Just a thought.
Its helpful to hear the nuances like this to bring them up to the disabled drs. who have done it. and also, for instance, the usmle requirements from the other poster. these are things you wouldnt necessarily think of unless youve been thru it. so anything else you can think of would be great and i'll list them out and ask...i'm gonna start putting together a list "causes of concern"...would be a good analysis tool i think.
i talked to a c7 doc 2 days ago, he started the site disaboom.com. amazing guy. he said he conducts a better physical exam than most other docs in his med group. but his words were "you can do it and love it."
he did not seem to be too concerned for me asa far as tribulations. his only warning was that the 6-week surgical rotation allowed little sleep because it takes a quad like 3 hours to empty bowels and shower and get dressed so that allowed only 2 hrs sleep. he said to do the rotation in plastics to minimize this problem.
everyone realizes that i'm a para but have minimal hand function, right? i can pick things up with tenodesis, etc so my hands are good for most everyday things. still is a big deficit for medicine, however...
Why is it that people lose touch with reality when it comes to medicine? If someone with physical disabilities wanted to be a home contracter or plumer, people wouldn't encourage said person but would point out how unrealistic it is. I don't mean to be insensitive, but there must be logic along with emotions when approaching such a topic. Medicine is a very demanding field, and at this point, needs all the help it can get (shortage etc). If someone who is not in medical school aknowledges that they do not have the abilities to get through the standard requirements of medical school and residency, why do we get all emotional and support this idea? Just a thought.
Speaking as a recently graduated physician and an incoming resident, the OP is making unreasonable demands of the system.
1. Unreasonable demands of his fellow students. What happens for your anatomy group? Do they just do all the work while you get to observe? Part of getting through anatomy is dealing with physical exhaustion, from which you would presumably be exempt. What about students on your surgery team? Are they going to have to do spend extra hours in cases since you can't go?
2. Unreasonable demands of clinical faculty. Part of the completion of our neuro clerkship included demonstrating competance doing LPs on a simulator. Are you exempt from this? Do they instead try to determine if you understand the theory of lumbar puncture? It just makes no sense and would not be fair to your classmates against whom they would be forced to try to compare you for a grade. Also the faculty would presumably be essentially unwilling to give you a poor clinical eval (even if it were deserved) for fear of reprisal.
3. Hugely unreasonable demands of his future resident colleagues. Let's say that you do match into PM&R. Are you going to be a 100% member of your housestaff team? No way. So where does that extra work that you are not doing go? It doesn't just dissapear into the mist -- it goes to your felllow residents. They will be people who likely did not know you and may feel (justly) slighted for being placed into a class that is essentially -1. Someone else brought up the issue of call -- will you be exempt? Can you run a code? Can you admit patients quickly and thoroughly or are the incoming residents going to get slammed with the carry over from your "shift." The accomadations that will have to be made for you will be made on the backs of your fellow residents - none of whom will be asked for their permission.
Medicine is not a birthright. Lazymed's comparison to manual labor jobs is spot on. If you want to become a quad/tetra plumber you would be laughed out of town. I could go through the litany of physical/technical skills that I have picked up in med school - IV access, suturing, central lines, LPs, thoracentesis, hell - I bet I could even get through a post-morterm C-section if you held a gun to my head. If you think I'm bragging you are missing the point. I don't just know how to think, I know how to do. I'm not a grad student of human medicine, I'm a doctor.
Thank you for the very thoughtful post.
The point here is not that he is discouraging. Its that hes not constructive.
Telling me that I NEED to suture and stay over night, etc. does not help the situation when this has been proven false in the past.
Why doesn't the analogy compare?The analogy does not hold and is based in ignorance. I'm not going to spend any more time defending my choices to some anonymous group of naysayers. This was never the intent of the thread. Start your own thread and call it "keep quads from entering med school" and have your fun.
Agreed. A lot of SDNers tend to think otherwise.Medicine is not a birthright.
I think a lot of the procedures learned in medical skill aren't ever used by doctors depending on the specialty they go into (ie. delivering babies, suturing) or just aren't preformed by physicians period (ie. foleys, IV's, CPR). Having exposure to them is educational, but if you aren't going to use them it's not the end of the world IMHO that you don't physically perform them during your training. On the other hand, the physical exam is the bread and butter of every physician's practice, so it would be a big setback not to be able to perform them.
Medicine is largely cerebral, so I think it's an asset to any medical school to have a highly intelligent candidate matriculate even if accomodations have to be made.
I think a lot of the procedures learned in medical skill aren't ever used by doctors depending on the specialty they go into (ie. delivering babies, suturing) or just aren't preformed by physicians period (ie. foleys, IV's, CPR).
Wait until your internship year when you (a physician) are alone on the wards at night and someone's IV comes out and the nurses cannot get a line in and so they call you (and they will). And then the patient starts to code and you need to start doing chest compressions or facemask bagging to keep him alive, maybe put in a central line or a chest tube (which have to be anchored in with a suture BTW). This IS what a doctor is supposed to be able to do. Having this background and skillset is a huge part of what it means to be a doctor. Doctors aren't just specialists. You get to be a doctor first and a specialist second. That's the whole point of many specialties requiring prelim years in medicine or surgery (as the specialty OP wants to go into does). And why they teach this kind of stuff in the latter half of med school. You aren't qualified to be a doctor after the first two years of med school. You hopefully are more prepared after the latter two. You definitely will be after the ordeal known as the prelim or internship year. And once you are a doctor, you can become a specialist. But you always retain the doctoring part in your back pocket.
Medicine is partly cerebral, but a very big part is not. Which is why the latter, more heavily weighted years of med school are the clinical (procedurally oriented) ones.
Impossible. Wait until you learn the actual steps of the physical exam and then tell me if someone with only one arm could be a master of it.
1- Did you attain the GPA and MCAT scores as a quadriplegic? From your posts it seems like this is recent is it? The reason I ask is because you might have a better chance if you were disabled a while ago and were able to pull off this success despite that.
Sorry, but I have to take issue with this statement.. What's the implication here--that people with physical disabilities are somehow less capable of intellectual ability and academic success?
I think posters are doing well to ask the hard questions here, as I think they have a place. Personally, I've often wondered if I have what it takes to complete the physical requirements of med school/residency and if I would truly be able to be a good attending. Honestly, I don't know. I'd like to think I can, but I won't want to go to med school if I didn't feel I could be a good, competent physician, and it's hard to get a straight answer on that.
Wait until youre in practice and you get a catastrophic injury. If you are in pm&r, ip sci/abi, little need for hands on work, do you give up your entire practice because you can't suture? The same rationality follows...
I don't get your logic. If you can do the job, you can do the job, but if you cannot do the job, you cannot do the job. The clinical years of med school and the prelim year are part of the path to this career, regardless of how much you'd like to deemphasize them. If you can do them (or can find places to make accomodations), fantastic. If you cannot do them, then you'll find something else. I'm not telling you to give up. Just telling you that you can't redefine medical training because it might make your dream unattainable at many places.
Also, remember the hospital runs just fine when there are no students around. They may help out in the OR and run errands, but when they go on vacations, things still happen.
Your air of condescension is not going to help you. No one here has told you not to apply, so go ahead and do so. We're not holding you back.learn what sci is and then you can comment. i'm worried that they allowed you to graduate.
Wait until your internship year when you (a physician) are alone on the wards at night and someone's IV comes out and the nurses cannot get a line in and so they call you (and they will). And then the patient starts to code and you need to start doing chest compressions or facemask bagging to keep him alive, maybe put in a central line or a chest tube (which have to be anchored in with a suture BTW). This IS what a doctor is supposed to be able to do. Having this background and skillset is a huge part of what it means to be a doctor. Doctors aren't just specialists. You get to be a doctor first and a specialist second. That's the whole point of many specialties requiring prelim years in medicine or surgery (as the specialty OP wants to go into does). And why they teach this kind of stuff in the latter half of med school. You aren't qualified to be a doctor after the first two years of med school. You hopefully are more prepared after the latter two. You definitely will be after the ordeal known as the prelim or internship year. And once you are a doctor, you can become a specialist. But you always retain the doctoring part in your back pocket.
Medicine is partly cerebral, but a very big part is not. Which is why the latter, more heavily weighted years of med school are the clinical (procedurally oriented) ones.
Wait until youre in practice and you get a catastrophic injury. If you are in pm&r, ip sci/abi, little need for hands on work, do you give up your entire practice because you can't suture? The same rationality follows...
Theres a large grp of physicians and faculty who are pushing for quads in medicine. I'm not going to let some group of med students/first-year residents, who have not practiced and have such an incomplete perspective of physicianship, try to change my mind. Esp since you also have no perspective on disability.
Per the above situation, I would plan to not let that happen.
This was back in 1990:
http://query.nytimes.com/gst/fullpage.html?res=9E0CE7DA173CF934A15752C1A964958260
Great discussion! I am sorry the OP is having to have it, and I hope he finds a rewarding career for himself in whatever field he so desires!
I actually had a discussion with my Ob-gyn and surgery course directors when I ended up on crutches and couldnt scrub on cases. (Only 1 week of gyn and a couple weeks of surgery but I wasnt sure for how much of my gen surgery rotation I would be on crutches....) While my situation obviously doesnt compare at all to what the OP has to face, we did talk about what they wanted every student to get out of the rotation.
The surgery clerkship director really didnt care if I could retract or throw sutures. She really wanted every student to know how to approach an accute abdomen, a trauma pt, etc. She wanted a student to know the indications for surgery, post-op management, potential complications and how to deal with them, etc. (Yes, she wanted us to see cases up-close which you cant do from a stool in the corner of the room, but that was far less important. She also wanted me to have a chance to experience surgery and the field. But thats a different story.)
Also, remember the hospital runs just fine when there are no students around. They may help out in the OR and run errands, but when they go on vacations, things still happen.
I think the OP clearly knows he is going to face many challenges and ultimately limitations. But I think we need to think about what it means to be a physician and go to medical school, not just "can he take overnight call."
learn what sci is and then you can comment. i'm worried that they allowed you to graduate.
I am not a terrible person or clinician.
It's not an issue of my being constructive. Constructive implies that there is something you can do on your own to accomplish what you need to to be a doctor. But in fact, IMHO, you are going to have to rely on some school's willingness to modify their clinical year curriculum to make it possible for you to complete it. And then a residency to do the same. So no, I cannot be constructive because I don't see anything you can do on your own, beyond find schools that have made accommodations. If they want to do that, that's up to them -- I don't have the ability to close any doors on you. I actually hope you get what you want, but I see lots of good reasons why you might not, and I think you oversimplify things when you want schools to revise what constitutes clinical medical training so that you can get to an end target that you believe you can actually do.
And no, the reference to "walking rounds" was not a dig at you -- that is what they are called (as opposed to "table rounds" where you go over patients at a conference table -- which is less common) when you actually go from room to room throughout the hospital seeing patients. And these rounds tend to involve lots of stairs and multiple floors, and chasing of attendings who rapidly race around the wards and stop for no one (certainly not a lowly med student), so again you'd need adjustments to be made to even participate in this daily event.
I certainly know of a lot of schools that send out questionnaires to applicants requiring them to verify that they have the physical ability, dexterity and visual and auditory acuity necessary to make it through their clinical years. They do this because in their opinion, you need these abilities to get through the clinical years, ie to become a doctor through their school. A HUGE part of the clinical years of med school is procedural. You learn to put in lines and tubes, suture, intubate, put in foleys, do LPs, deliver babies, perform physical exams, chest compressions and CPR and running codes. There is a ton of chasing around the residents, fetching charts and other scut, standing/scrubbing in on surgeries, doing overnight calls. And this all culminates with residency, where you are going to at times be alone on the wards trying to keep your charges alive, which often means having to do a lot of these procedural things on your own. If you are up to the task then great. If you expect these tasks to be eliminated so you can become a doctor on your own terms, then I just don't agree, largely for the reasons mentioned by Amory Blaine above. You don't get to define what constitutes medical training. You need to become a doctor first and a specialist second. Not jump to specialist just because that is a pace you can manage.
The folks who are not being constructive are those who are saying "you can do it" without having ever done a clinical clerkship year of medicine and having no notion of what it involves.
I guess it's helpful when you're an intern and the hospital dumps the scut work on you, but my point is that when you're an attending you won't be doing most of these hands-on things pre-meds dream about but are done by nurses in real life. Who would have an easier time starting an IV? The nurse whose been doing it daily for 5 yrs of the physician who hasn't started one since they were a resident 5 yrs ago? My PCP barely knows how to give a shot because his nurses always do it for him. In the two years I spent working in the ED, I never saw a physician do compressions or start lines on a coding patient because that was the nurses/paramedics job.
My point is that from the point of being a source of slave labor for the hospital, they're essential skills, but from the point of view of a physicians they're activities not essential because they are rarely encountered.
1- Did you attain the GPA and MCAT scores as a quadriplegic? From your posts it seems like this is recent is it? The reason I ask is because you might have a better chance if you were disabled a while ago and were able to pull off this success despite that.
I guess it's helpful when you're an intern and the hospital dumps the scut work on you, but my point is that when you're an attending you won't be doing most of these hands-on things pre-meds dream about but are done by nurses in real life.
i think that's its commendable that you have the desire to pursue medical school. what i think you really need to ask physicians is what will be the expectations of internship, residency, and post-residency life? applying for state medical licensure, as many states ask if you have any physical limitations, and if so, what they are. applying for hospital privileges, as again, they will ask about physical limitations. will your malpractice rates be significantly different for a given specialty, given your disability?
not trying to discourage you, but these are real issues that you'll eventually face within medicine, regardless of the specialty you enter into.
Now, maybe the OP DOES deserve a spot in medical school and residency. I don't know, and that's not my call to make. But insisting that these physical diagnosis maneuvers are not "important" or that not being able to do them is a "trivial problem" is unrealistic.
It's up to medical educators and schools to determine what defines a physician and whether a quadriplegic doctor is beneficial or harmful to society not us SDNers (although it is fun to debate). It's the OPs decision whether he/she wants to invest their time and money in something that may be difficult for them to obtain.
The big question, I think is how is the OP going to be able to preform a physical without help? Since there are doctors out there who practice with similar disabilities...it's apparently a surmountable obstacle.
I'd say being able to do H&Ps is vital to every doctors existence but the value of procedures is highly variable.
Is a pathologist harmful to their patients because they're not the best at delivering babies? Is an immunologist with poor suture skills a detriment to society? Is a psychologist worse off if they can't preform a proper cricothyrotomy?
You're saying that these skills define the essence of a physician and I'd say they are secondary to a physicians ability to properly diagnosis and create treatment plans for their patients.
I am surprised by how important and critical everyone makes medical school to be. If you don't put in a chest tube or even an IV during medical school, the world will keep turning. Sure, there is some element of "work" during clinical rotations, but completing school is not some grand achievement like the commencement speeches make it out to be.
Maybe some places are hugely understaffed by students and residents and they actually "need" you to put in that chest tube, but I doubt it. In my experience the "workload" is just an illusion. I have never seen a code where the transitional resident going into PM&R is the only person there and has to "save the patient's life." There are plenty of residents around (surgery, ER, Anes, etc.) who actually need to learn vital procedures for their career.
I believe 100% that a person with disabilities like this could do an excellent physical exam, but I'm sorry for even commenting. As has been said numerous times, the OP is not interested in critique of his plan just advice on where to apply.
That's all well and good if it were just pre-meds chatting in here, but there have been doctors and school faculty posting in here, in addition to the fact that many/most medical schools use medical students as interviewers. So, just because you aren't one of them doesn't change the fact that actually there are a number of people in this thread who will be involved in making that decision.This thread is veering way off the original question, which was asking about schools that would be willing to make accommodations for the OP. You guys aren't the be all end all on this topic despite what you may think. Medical schools will be the ones making that decision, not you and arguing about it is pointless.
That's all well and good if it were just pre-meds chatting in here, but there have been doctors and school faculty posting in here, in addition to the fact that many/most medical schools use medical students as interviewers. So, just because you aren't one of them doesn't change the fact that actually there are a number of people in this thread who will be involved in making that decision.
Hi, welcome to the Internet. That's what we do here.I really don't see the point of debating this at all.
Your air of condescension is not going to help you.
Hi, welcome to the Internet. That's what we do here.
I think our perspectives here may be different since I made it all the way up to the primary and some secondary applications as an able-body. Then, the accident threw a wrench in the spokes. So you may have a clearer perspective. And I realize that nagging desire to not give up all my dreams is noise. I think the accident just focused my goals and desires.
I just hope I don't run across people like this on my way.