Speaking to my experience only: med students don't slow me down much. While they are in one room taking however long they want, I'm seeing patients in the other 2 rooms. That way I don't get behind.
The FM doc I shadowed years ago did this exact thing with his students
Yes. I’m in charge of our medical students currently as a fellow and between covering multiple attendings, a large census, and my own research demands I usually have to round first and ignore the student and then have them present to me after we’ve actually seen everyone while we’re walking to the OR. They rotate one my service two weeks at a time which is not enough time to develop a level of trust or comfort to have them do any real invasive procedures. I teach them to suture skin and put skin staples in correctly. I do orient and fix their note writing skills and patient presentations because we get them as late MS2s. I frequently have to leave them with the PA to learn how to do bedside tasks like take out/put in NGTs or drain/vac management and usually initial note writing which I circle back via text with corrections and critique.
Give each student 2-3 patients, max. Have them come in extra early (an hour before you minimum) to prepare their notes. Teach them early on what matters and what doesn't when they present patients. Having the midlevels teaching them basic stuff like you mentioned is completely fine.
Surg-Onc/HPB. But as a follow up - in my medical school you got assigned four weeks onto any service and had minimal choice. So four weeks general surgery, or four weeks colorectal, or four surg-onc, etc. They were all considered 'general surgery' (in reality, they definitely were not, but the academic subspecialists all took turns doing like two days a month of general surgery call). Its possible this is uncommon, but the current students where I am now only spend two weeks on an actual general surgery service and then the other time is 2-4 weeks on specialty services for a total of like 8-12 weeks I believe.
osteopathic.org
Doesn't matter. Nursing board doesn't care and that's who you complain to if there's an issue with advertisingAOA statement on physician-led care, Physician Assistant title change and non-physician clinician use of the title 'Doctor'
Position Statement: The American Osteopathic Association calls for truth in advertising, intellectual honesty and transparency with the use of professional designations of non-physician clinicians in service of the public interest. We also call for organized, collaborative discussions among...
Hasn't anesthesia salaries/jobs been on fire lately? Feel i've seen this on SDN for the last 3 years
Not really.. The work has increased though 3x fold I would say. The call more burdensome.
Aside from surgical specialties are there any other specialities that could be more resistant to scope creep?
This has been asked a million times on SDN. You should be able to find plenty on that using the search function.
I mean this is the midlevel thread with 9 pages already so we can recycle the same talking points and repeated answers to extend the page count
Lol my bad, I forgot that I was on the midlevel dumpster fire thread.I mean this is the midlevel thread with 9 pages already so we can recycle the same talking points and repeated answers to extend the page count
Rads is gonna be pretty hard to take over compared to derm, gas and EM. And demand for imaging is only going to go up as midlevels become more independent and the population ages. And, as crazy as it is to even have to say, its reassuring there arent dozens of new rads residencies popping up annually like we saw in radonc and now EM.
We need to stop hyping up rads so much on SDN, otherwise it will for sure end up like EM/radonc in very near future
Didnt Cali just pass a bill allowing midlevels to independently review images?
Wait what? Link pls this is news to me
No, the bill was edited so they cannot independently review images.
good to hear
There are high risks of threat to the rads job market down the line from AI and outsourcing (via telerads) more so than midlevels independently reading images.
You're assuming private equity and corporate America care. They don't. Radiology practices will be bought and radiology will be increasingly corporatized, so midlevels will likely be prioritized with AI/telerads to maximize profits and cut costs.
That's because no one bothers to do anything. We have a bureaucratic nonsensical system where we worry about "professionalism" aka - med students and residents not doing what a particular attending or nurse wants them to do, yet dont bother to actually do anything.
AI now is better than ever and is still rapidly improving. AI can easily process through huge volumes of images and requires only few radiologists to interpret/verify them. I can def see academic centers and private practice groups relying on a small team of radiologists and advanced AI capabilities to successfully and efficiently run clinical practice. So the job market would saturate rapidly unless we have MS4s/rad residents/attendings being AI savvy.
Robotic surgery with the console in another country with your Trauma surgeon NP as on scene backup for the trocar injury. I can see it now lol
We are actually studying this in the military. A general surgeon on the ground in theater and a robotic trained surgeon in the states.
It makes plenty of sense to me, particularly in the military. I knew a guy that had a live munition stuck in him that the surgeons had to operate around and then extract. Robot seems safer in that situation obviously.
I mean I have an MD and the ortho NPs knows a ton more about replacing a knee or ORIFs than I do. If we both started an ortho residency tomorrow they'd be miles ahead and the product at the end of training would be the same.
Well the point is that PA/NPs aren't doing Orthopedic Surgery residencies. They're doing 8-hour weekday shifts under direct supervision by attendings. Some like to act like they're thinking and doing things on they're own but the more you watch PA/NPs closely (previously dating one), the more you realize how they first confirm everything with their specialist attending first and then come act like they're the one running the show when they come see the patient. I've actually had non-significant changes to plans on patients before by calling the attending directly and expressing my concerns.
This is disappointing because it means med school is a complete waste of time
For someone who is going to do "H&P"s with none of the persons medical history, replace their joint and then consult medicine for any abnormal postop management, yeah they're only using the procedural skills they learned in residency.
The difference is that managing a PEG tube isnt part of a general MD/boards. I'm not supposed to know how to deal with malfunctioning surgical devices. They are supposed to be comfortable managing pressures. More often than not though, the reality is that the patient had known HTN and was supposed to be on XYZ for it but the community surgical subspecialist H&Ps never have any of the patients medical history and theyd rather punt to some poor intern to do the chart review and medrec and leave them a nice set of
I mean you could say this for literally any part of school ever since kindergarten. Just because you don't consciously use it doesnt mean its useless.
I agree. With the caveat that I think the vast majority of NPPs just don’t have the work ethic to survive any residency program, let alone a surgical residency.
Working weekends or past 4pm? SHOCK HORROR
