School Performance and Primary Care

[Everglide]

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Lecture + 18 hours/week for your first exams isn't slacking. I would call that "slightly less than average". Then again I think some people in this thread made it sound like you need to study 80 hours/week to pass.

Enjoy the games and booze 😀

 

[CopToEM]

Also, doing this for patients??? Please, save it for the interview.

I'm going to catch hell for this... but, by all means, please put in the minimal amount of effort that you possibly can. With an attitude like that, perhaps they can transfer someone in second year to fill your empty slot.

 

[ManBroDude]

I'm going to catch hell for this... but, by all means, please put in the minimal amount of effort that you possibly can. With an attitude like that, perhaps they can transfer someone in second year to fill your empty slot.

You know, this is an anonymous board for the most part, and everyone's entitled to their opinion. While I completely disagree with OP's motives for medicine and his apparent indifference to his patient's care, hey, we all have to admit that out of the thousands and thousands of new medical students in the US every year, there are quite a few that hold his stance. They might not be as vocal as OP is, but they're out there, putting on the show for ad-coms nationwide.

Truth be told, though, everything will change when OP is in rotations or even residency, and a mistake he makes will cripple or even kill a patient. Patients will die on us all, by our own hand, and that is enough to scare all of us into trying harder. It only takes one. One week of MS1 does not a scared-stiff doctor make.

That being said, what if OP has a family, or a child at home with special needs? Can you fault him then for wanting to get in and out and be done with it so he can be at home with his kids at 5:30p each night? SDN pre-meds are a lousy bunch of self-centered teenagers who can't even grasp the notion of being there for your family, it seems to me most of the time. Martyr yourself all you want, I want to actually go to my kid's baseball games and stuff.

Silly thread though. You got my support OP, because if it wasn't for bros like you there wouldn't be a 90th percentile for the gunner bros.

 

[LesBois88]

I'm going to catch hell for this... but, by all means, please put in the minimal amount of effort that you possibly can. With an attitude like that, perhaps they can transfer someone in second year to fill your empty slot.

Spoken like a pre-med. Just wait, you'll see.

 

[mechanictodr]

I'm going to catch hell for this... but, by all means, please put in the minimal amount of effort that you possibly can. With an attitude like that, perhaps they can transfer someone in second year to fill your empty slot.

Haha, like everglide said, I'm putting in just less than the average amount of time. Right at about 50 hours including lecture. There are some that are already laying down 80+ hour weeks and after talking to them it only seemed to pay off for a couple. This is a test takers world. If you're good at multiple choice then you have it made.

DannyD, putting on a show for admissions? I don't even know what you're talking about🙄. They ask for certain things in the requirements and in the questions they ask during interviews. It's not too hard to know what answer they're looking for. This forum tells you everything they want. Is that so different from every fluffy paper you ever wrote just to agree with the professor and get the easy A? Its the same game. Give them what they want and slide on through. You want the degree, they want your cash and someone who agrees with their point of view.

 

[CopToEM]

Spoken like a pre-med. Just wait, you'll see.

I won't, actually, but I catch your drift. You're right that probably greater than 95% of people who go into it with an attitude like the one I'm implying lose all compassion along the way. I can promise you though, I've already seen the worst of humanity, and still have every ounce of mine. 36 years and counting. "Cop"ToEM for a reason.

OP, I do wish you the best of luck, but never forget who pays the bills at the end of the day... the people.

 

[mechanictodr]

OP, I do wish you the best of luck, but never forget who pays the bills at the end of the day... the people.

I won't. Just like a car salesman or any other businessman, I'll need them to keep coming back if I want to get paid. Isn't that part of the job though?

Besides, when did we get on the subject of me doing a bad job? I scored above average so that's good. If I had put in 80 hour weeks and only scored average or worse I could see some reason for concern. My whole point with the thread was to see if med school really had to be taken to the extreme like some/most on this forum seem to think. It's quite apparent that for the average student who wants a less coveted residency option not that much effort above a normal full time job is required. What's wrong with that? On to round two.

 

[DoctorQuack]

I shadowed a DO who runs a successful family practice and makes 300k+ by monopolizing the home-health market in town.

FM != low pay or low prestige

 

[HM3]

My neighbor makes over 300k running an air conditioner repair business. 🙄

 

[mechanictodr]

Well, time to dig this thread out again. So year three is under way, COMLEX 1 is done and on to rotations. So the amount of effort needed to get into a basic primary care specialty is lower than I originally mentioned. It's not just me, other students I'm meeting who want FP/IM/PSYCH are also doing some pretty minimal hours. My last rotation was under 40 hours of total time with the preceptor and I spend zero extra time studying or reading... did just fine. The whole notion that you have to be totally extreme is not true. This can be done with a regular amount of effort once you get into medical school.

Anyway, I'll continue to update this from time to time. I think it's good for students to know that not everyone does the 80+ billion hours per week of work and then goes home to read and do board study. It's really not necessary.

 

[cliquesh]

Well, time to dig this thread out again. So year three is under way, COMLEX 1 is done and on to rotations. So the amount of effort needed to get into a basic primary care specialty is lower than I originally mentioned. It's not just me, other students I'm meeting who want FP/IM/PSYCH are also doing some pretty minimal hours. My last rotation was under 40 hours of total time with the preceptor and I spend zero extra time studying or reading... did just fine. The whole notion that you have to be totally extreme is not true. This can be done with a regular amount of effort once you get into medical school.

Anyway, I'll continue to update this from time to time. I think it's good for students to know that not everyone does the 80+ billion hours per week of work and then goes home to read and do board study. It's really not necessary.

If you just want to punt everything to a specialist, I agree with you.

 

[mechanictodr]

If you just want to punt everything to a specialist, I agree with you.

I am thinking that 🙂 My last rotation was with a general internist/hospitalist. We did three 12 hours shifts a week and that was it. Clock in and clock out. Most of the complicated stuff got punted to sub-specialties. However, for the 36hr week (40 if you include a lecture and some socializing) I would say this is the way to go. No pager and no calls once you check out for the day and no wondering what ever happened to so and so either. You just come back after your 4 day weekend and get the sign out sheet and start over. Pretty sweet gig and decent pay.

 

[EmCEm]

Great. Appreciate the information.

 

[KnuxNole]

I am thinking that 🙂 My last rotation was with a general internist/hospitalist. We did three 12 hours shifts a week and that was it. Clock in and clock out. Most of the complicated stuff got punted to sub-specialties. However, for the 36hr week (40 if you include a lecture and some socializing) I would say this is the way to go. No pager and no calls once you check out for the day and no wondering what ever happened to so and so either. You just come back after your 4 day weekend and get the sign out sheet and start over. Pretty sweet gig and decent pay.

Just remember that you will have to work long hours during residency. Afterwards, you can tailor your practice to what you want. Even though FM for example might be more "chill" than say neurosurgery, you'll still be taking call and having some months of long hours. Although you don't need to go "extreme", I would recommend extra time reading nightly when you do start training. It doesn't have to be a lot, 30 mins a night is not asking much in the slightest and doesn't deter from you having a life outside of work. They might not expect much from a mere med student, but you'll get chewed out if you don't keep up with readings in residency. As a hospitalist though, it might take a while to get the good gigs depending on location. Regardless, just don't ever verbalize that you punt everything to subspecialities, or they will roll their eyes every time they look at you or see your name on their called ID. You don't wanna be known as the hospitalist where everyone thinks "Oh god, it's the NP in MD/DO's clothing calling again!". Of course, you'll be well versed in the basics so you'll be adequate at figuring out what you can manage vs. what needs consulted after lots of training and reading you'll do 😀

 

[ShyRem]

As a currently working hospitalist, I can tell you I work 7 12 to 14 hour days in a row, then have 7 off. My patients are not generally simple. Even a simple hip fracture is not usually easy and have other issues that need management and have usually been neglected for far too long... As in the patient comes in with hip fracture, in dka, and profoundly untreated hypothyroid with critical aortic stenosis. No kidding. Now if you get a job at a low level community hospital your patients will likely not be that complicated because you will be shipping them to a higher level facility. Heck, these days many lower level hospitals ship even their cardiac rule outs with normal troponins to a higher level facility.

The week off is nice, but don't kid yourself - most hospitalists work their butts off.

 

[mechanictodr]

So, into year two of residency. Year one was busy no doubt. Just physically takes a lot of hours to get the job done. Year two of internal medicine hasn't been nearly as bad and actually I think with about the same effort I put into medical school I could manage a sub-specialty. Honestly, this is what people should talk about more on this forum. It does not take the hours people claim to excel in this field. I worked one or two 80 hour weeks and that was pure choice to get some procedures in. I'm on an outpatient rotation now and I pulled about 31 hours last week. Hit the gym every day... except Sunday. Day of rest and all, haha. So, sorry to resurrect this old thread, but people need to chill out over this profession. You put in what you want. There will always be someone way worse than you at it and the program will have it's attention focused on that individual.

 

[Matthew9Thirtyfive]

So, into year two of residency. Year one was busy no doubt. Just physically takes a lot of hours to get the job done. Year two of internal medicine hasn't been nearly as bad and actually I think with about the same effort I put into medical school I could manage a sub-specialty. Honestly, this is what people should talk about more on this forum. It does not take the hours people claim to excel in this field. I worked one or two 80 hour weeks and that was pure choice to get some procedures in. I'm on an outpatient rotation now and I pulled about 31 hours last week. Hit the gym every day... except Sunday. Day of rest and all, haha. So, sorry to resurrect this old thread, but people need to chill out over this profession. You put in what you want. There will always be someone way worse than you at it and the program will have it's attention focused on that individual.

Thanks for checking in. I'm sure many people overestimate how many hours it takes to become a proficient doctor (or fall into the trap of thinking that because it's always been done that way, that must be how it needs to be done), but I'm wondering if there is a point at which you are just going to miss stuff you should be learning to take great care of your patients. Do you think you're where the harder working (hours wise--can't comment on your work ethic as it is possible to haul ass and still work normal hours) residents are, or do you think you're on track to being a decent doc if nothing complex or weird comes your way?

 

[mechanictodr]

Thanks for checking in. I'm sure many people overestimate how many hours it takes to become a proficient doctor (or fall into the trap of thinking that because it's always been done that way, that must be how it needs to be done), but I'm wondering if there is a point at which you are just going to miss stuff you should be learning to take great care of your patients. Do you think you're where the harder working (hours wise--can't comment on your work ethic as it is possible to haul ass and still work normal hours) residents are, or do you think you're on track to being a decent doc if nothing complex or weird comes your way?

Decent? Easily. I don't think any of the lack of time studying did anything. Board scores were good, not great, but good. My in-service exam was above average for my class. Get good remarks on end of rotation reviews. Honestly, that was the whole point of this thread. Just make your time count. IF you have to be the A+ physician it will cost you all your free time. If being average in your class give or take is ok with you then it can be done with far less effort. It's that last 10-15% on an exam that really costs the time to get. You can get 80's through med school and really not be too tough on yourself. The same applies in residency. Like I said, intern year is just messy with the long shifts and scut work. There is no way to make that better and be successful.

Also, complex and weird just means you have a broad differential. You'll see someday. This stuff is often cookie cutter in how you work it up and the odd stuff will work itself to the surface in time. It's the deadly things you don't want to miss.

 

[Matthew9Thirtyfive]

Decent? Easily. I don't think any of the lack of time studying did anything. Board scores were good, not great, but good. My in-service exam was above average for my class. Get good remarks on end of rotation reviews. Honestly, that was the whole point of this thread. Just make your time count. IF you have to be the A+ physician it will cost you all your free time. If being average in your class give or take is ok with you then it can be done with far less effort. It's that last 10-15% on an exam that really costs the time to get. You can get 80's through med school and really not be too tough on yourself. The same applies in residency. Like I said, intern year is just messy with the long shifts and scut work. There is no way to make that better and be successful.

Also, complex and weird just means you have a broad differential. You'll see someday. This stuff is often cookie cutter in how you work it up and the odd stuff will work itself to the surface in time. It's the deadly things you don't want to miss.

Thanks for keeping us updated. It's actually refreshing to hear that one can be a competent doctor without killing oneself. The reason I asked about missing stuff is because we had something come through medical the other day that would have gone south quickly if we didn't get him over to the ED when we did. I would hate to miss something because I took it easy in school/residency, but it doesn't sound like there's necessarily that polarity.

 

[cliquesh]

Thanks for checking in. I'm sure many people overestimate how many hours it takes to become a proficient doctor (or fall into the trap of thinking that because it's always been done that way, that must be how it needs to be done), but I'm wondering if there is a point at which you are just going to miss stuff you should be learning to take great care of your patients. Do you think you're where the harder working (hours wise--can't comment on your work ethic as it is possible to haul ass and still work normal hours) residents are, or do you think you're on track to being a decent doc if nothing complex or weird comes your way?

I think there is a distinct difference between the "casual"physician and the "hardcore live and breathe medicine" physician. I personally would not trust most doctors to provide care for my family.

Maybe it doesn't matter so much in the outpatient setting if you know when to refer a patient. However, in a tertiary academic center with complex patients I would trust the guy who literally wrote the book about the patient's disease.

 

[Matthew9Thirtyfive]

I think there is a distinct difference between the "casual"physician and the "hardcore live and breathe medicine" physician. I personally would not trust most doctors to provide care for my family.

Maybe it doesn't matter so much in the outpatient setting if you know when to refer a patient. However, in a tertiary academic center with complex patients I would trust the guy who literally wrote the book about the patient's disease.

I agree. But I don't think that's what OP was ever going for. I agree that if you're in the outpatient setting and know when someone looks bad or something doesn't look right, that should be adequate. I wouldn't want my hospitalits to have skated through though.

And I'm the live and breathe it sort of guy anyway, despite wanting FM.

 

[ScottTenorman54]

Nice. Glad to hear things are working out, OP. Keep doing you 👍