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(Serious) Why do 4th year students need supervision but midlevels don't?

Discussion in 'Medical Students - MD' started by MedicineZ0Z, Mar 31, 2018.

  1. MedicineZ0Z

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    Well... 4th year, not 3rd year.
    Experience is over rated in general (to a degree) and RN experience is barely applicable.

    Also keep in mind we're comparing NEW freshly graduated NPs to 4th year students.
     
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  3. W19

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    It's always about blurring the line... You will never hear PharmD, DPT introduce themselves as 'doctor' in healthcare settings because they understand that it's confusing to patients. OTOH, DNP are quick to do that even if they have what I would call a BS doctorate. I hated it when it was left to me as a nurse to clarify to these patients that the person with a long white coat who just saw you was not a doctor i.e. physician, he/she is a nurse practitioner.
     
  4. Cryc_to_the_point

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    Nursing is a hard career and it's hard to get into, but anyone accepted to medical school in the US could do it easily. Nursing is easier to get into than medicine. This isn't a real debatable point.
     
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  5. W19

    W19
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    Not where I live...
     
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  6. rg2o3

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    +1
     
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  7. Cryc_to_the_point

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    Let me know when applicants to nursing start applying to an average of 15 programs and nearly 60% of them get in nowhere.
     
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  8. RNthenDoc

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    If you saw a topic speaking down to your profession, spreading complete falsehoods, would you not speak up, even if it was directed towards a different branch of your profession?

    Guess I’m just old fashioned in that I like to denounce ignorance when I see it. You’re right, I’ll shut up and let everyone keep ****ing on NPs.

    ... do realize that these attitudes are why NPs are militant and why that vocal minority is pulverizing the AMA... but heck, let’s continue to keep spewing falsehoods about a lack of “floor” to being an NP.

    Meanwhile, Naturopathic Doctors are increasing their hold as well...

    But by all means, let’s continue with the backbiting of NPs, who will continue smiling, lobbying, and eating the AMA’s lunch.
     
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  9. Cryc_to_the_point

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    You can be pro NP (and PA) while acknowledging where they are lacking... Just ignoring these real issues isn't "****ing on NPs," it's being honest. Also you're right on Naturopaths, but nobody really debates the foolishness that is so I fail to see your point.
     
  10. NRP

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    Those militant NPs are like that b/c they want less schooling but more power. They are completely inadequate to be practicing independently but they keep pushing an agenda of more smiling patients=better healthcare. How many of them are working in rural underserved places? I'll tell you that Iknowimnotadoctor sure isn't. As long as these online NP mills exist then there should be no reason to not disparage this whole independent practicing idea. Most of these NPs are hiding behind this emotionally manipulative ploy of "Think of the patients" when in fact it's just a business to them.

    If you wanted to be a doctor you should have gone to medical school. If you really cared about patient's lives and wellbeing you would have taken the extra steps to be a doctor. Don't want to be a doctor? Then play the team part but stop asking for the coach's position. There's room for everyone on a team but no room for everyone thinking they can do their own thing. Naturopaths will always be a joke and anyone that follows them will find that out on their own.
     
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  11. MedicineZ0Z

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    If you stayed within your scope under supervision, there wouldn't be any bashing.
    Very well said. It's hilarious really.. trying to take such a shortcut and cheat the whole system.
     
  12. RNthenDoc

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    Reread my original post in this topic, plz.

    Peace to everyone. I’m not an NP, I’m a pre-matriculation MS-1. I will always try to stamp out vitriol that causes regression in my vocation, though.
     
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  13. RNtoMD87

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    Likewise. I agree 1000% about the NPs shouldn't be the cheap and easy doctor route. But to speak about NPs and RNs like theyre all untrained morons, and that school is so simple anyone could do it is simply not true. If that were the case, I'm sure many more people would be standing in line to sign up for a career that can easily pay over 100,000 annually with a 2 year education.
     
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  14. Cryc_to_the_point

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    Can we agree its too easy to become an NP? Can we meet on that common ground @RNtoMD87 ? I don't think most of them are idiots (they exist in every field), but I also don't think independent practice is wise in many cases and I think I can hold that opinion without resorting to name calling. If anything, there are some great NPs being held back by their sub-par colleagues.
     
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  15. RNtoMD87

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    I believe online degree programs shouldn't exist for NP, and I believe in a 5 year practice requirement in the area that they'll be working in.

    I really am curious about the situation if continued 20-30 years from now. I wholeheartedly fight the old wenches who believe nursing is on a crusade to fight the physician patriarchy etc. Huge reason I'm getting out of nursing. But I also respect the profession itself. Just not a lot of the higher education. And if there is one thing that drives me up the wall, its when one of my professors corrects me. "Its DOCTOR Horsley. I've earned my title. Please address me correctly" (When I called her Mrs. Horsley).
     
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  16. Cryc_to_the_point

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    Then I can't speak for others, but you and I despise the same small subset.
     
  17. MedicineZ0Z

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    Ah makes perfect sense.

    Just wait until you've spend 80+ hours a week studying/training for 8 years and someone who did a year or two of online courses/shadowing suddenly has more practice rights than you and openly claims to be better than you.
     
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  18. RNtoMD87

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    I still wouldn't be very upset. I've experienced the same type of thing throughout my life. The medical field is hardly unique when it comes to this.
     
  19. AlbinoHawk DO

    AlbinoHawk DO PeeGeeWai Osteopath
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    The problem is history. Doctors received a certain training and then they made up BS degrees. These BS degrees were forced to teach NPs/PAs because everyone is scared about them getting their license and making a disaster. Instead of upping the game for medical students to be prepared quicker and better, they infantilized medical students. This is why you get stupid rotations where you basically just go shadow because doctors figure "oh well, he'll learn what he needs to in residency." This is atrocious.

    PAs are allowed to do all kinds of things while the med student is slapped into the backseat because "he'll learn in residency, so who cares to teach them now?" Medical school is simply poorly designed. We need to move into a system where med school is cut into a 3 year program because honestly 4th year has become a waste of time, and we know schools could teach 1&2 year curriculum better in 1.5 years if we didn't allow these medical schools to teach random garbage.

    Honestly, just enjoy the ride as it is. You don't have the power to change it and it will not change any time soon. Just be thankful that you have 2 years to screw up.
     
  20. DocEspana

    DocEspana Bullish
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    Student doctor was never great.

    Neither was the lounge.
    <is immediately permabanned for mentioning the L word>
     
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  21. DocEspana

    DocEspana Bullish
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    Just pointing out that your narrarive is way off as the people on "the other side" who "came out of the woodwork" were a bunch of attendings who came by to remind you all that your hubris is blinding you to how dumb your argument sounds. You can totally say a nurse who wants to be a doctor doesn't know how much they dont know about the realities we doctors think about.

    But a 4th year medical student or a first month intern doesnt know how much they dont know about clinical practice (separate from analytic analysis) at first. The people who contested this just degraded to name calling and repeatedly falling back to "this is what i think and i cant be wrong about it as what i think must be an absolute truth" rather than trusting the multiple attendings who all said 'yeah we know why you think that... but its wrong."

    The only reason we arent all posting here still is because we have those pesky jobs that pay better than repeating ourselves ad nauseum.

    Just noting your characterization of the thread is pretty off unless you only read the last 2 pages or so.
     
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  22. MedicineZ0Z

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    It also comes down to liability (ex. doing procedures). This tends to be more regional/institutional dependent though (unopposed program in a southern state vs. big hospital system in New York).
    I do blame the attendings though who don't train med students properly and/or provide training to PA/NPs. This whole midlevel thing was nonsense from the beginning. People want to see a Dr when they're sick, not a nurse or an assistant...
     
  23. Forever Geebs

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    I was actually trying to be diplomatic, but it was late and I was in a state of delirium, so it may not have read how I intended it to. The fact of the matter is those that oppose mid-levels and envy their autonomy likely aren't going to be convinced otherwise, just as those that support autonomy (regardless of their length of training, experience, etc.) felt passionate in their position. This topic is brought up often, tends to trigger people, and usually doesn't end with either side agreeing / seeing eye-to-eye / or compromising. I have a position, and a horse in the race, but have always tried to remain objective on the matter, but despite that, recognize that differing views exist for a reason and perspective is king.

    For what it's worth, I was one of the first to respond to this thread and have been monitoring it since, all 10 pages of it.
     
  24. MedicineZ0Z

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    There's literally not one valid reason to support midlevels in the context of our profession's well being. Working under direct supervision in small numbers to see the colds and ear infections was one thing.. this is different.

    I'd also like to note my posts:likes ratio drastically improved from this thread :) Clearly I have many people agreeing.
     
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  25. DocEspana

    DocEspana Bullish
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    Your phrasing may be loose again, but i dont think anyone here on either side or on any stage of training supported autonomy for midlevels.

    This started with why do licensed midlevels not require direct supervision (dramatically different from no supervision) while unlicensed students do. The absurdity of that question was obvious immediately. But since then the goalposts have been moved 10 different times because every time a new argument comes up in a similar vein it is shot down by those who work in the actual field.

    It *seems* to me that each new goalpost move is an attempt to bait someone into saying something stupid about true autonomy. It wont happen. Because no pne disagrees on that, we are all just having philosphic onanism here about something remarkably specific (clinical readiness on day 1 of residency) that riles up a few med student feathers for reasons i cant understand yet.
     
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  26. Forever Geebs

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    Yes. Agreed. Phrasing was loose but you summed it up well.
     
  27. DocEspana

    DocEspana Bullish
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    I mean, my post to like ratio increases by being irreverent and making jokes. But if we are working this way then @Mad Jack is our God
     
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  28. MedicineZ0Z

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    The true absurdity is why someone who isn't adequately trained (midlevels *AND* med students) is able to practice medicine (midlevels) while not supervised. This concept needs to be repeated quite a few times apparently.
     
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  29. DocEspana

    DocEspana Bullish
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    Midlevels are (with exceptions) adequately trained to do their job right away. Their job is not the same as my job and is very similar but also different than an interns job. And i think you dramatically underestimate the amount of supervision they have until I trust them.

    So no. Repeatedly stating a flawed dictum is not necessary.
     
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  30. IknowImnotadoctor

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    Very good post. I have zero plans on practicing independently out of school; I don't think NP education prepares you enough. I also have zero respect for people who have no idea what they are talking about, constantly insult me and my profession and refuse to listen to attending physicians telling them how wrong they are, and then end up reporting me and getting my account on probation for no justifiable reason.

    The goal posts have moved so far from where we started we may as well be playing a whole different sport. The OP post is without question wrong.
     
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  31. MedicineZ0Z

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    Why do you keep ignoring all the states that allow full independent rights? Soon it'll be each and every state. Like seriously, you love to ignore this core fact for some reason.
    Lol what? It's the NPs who keep claiming to be "as good, if not better than physicians" or "heart of a nurse, brain of a doctor" or nurse Ingram's twitter post with her business card "NPs are the new and better MDs." Not to mention nationwide NPs push for independent rights.

    How can I or anyone in their right mind respect a profession that believes those things (direct quotes)? Ultimately your union stands for that. Sure, it's the minority. But it's a pretty big minority of NPs who believe those quotes and perhaps a majority who loosely believe parts of it.
     
  32. DocEspana

    DocEspana Bullish
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    Again, i know it was pages ago - but im *literally* the person who you pay to go to congress and argue against independent practice. Well was. I do it for free now. Used to get that sweet sweet lobbyist paycheck. Please support your organized medicine groups. They do so much more than you think and yet are so hysterically underfunded compared to other smaller groups because doctors (and students) go "if i dont see 100% success as i define it, im pulling all faith in the organization."

    So let me remind you: literally no one but you and one other person keep bringing that up. Why? Because every person here who has stated an opinion is against it. Including nurses on here.

    Also let me remind you: at no point was that ever the discussion or what anyone has argued about. You just fall back to that when your arguments built around ignorance and hubris fall apart - and cite an argument where everyone agreed with you as if it was some controversial point or even the point at hand at all.

    And no, its too late for you to make it the point Haha.
     
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  33. MedicineZ0Z

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    You know, the problem (literally by default) is that being pro-midlevel = pro-independent rights. The situation is pretty black and white on a national level. Midlevels argue for independent rights and that's what they want. Plain and simple. Not sure how you can support them but oppose them on their core #1 life priority.
     
  34. W19

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    Glad that the state of Missouri agree with our argument that a med school grad is equivalent to or better than PA/NP.... That was pretty much the argument of one the docs (a DO) who sponsored that bill... Med students who do not wish to pursue residency are getting a raw deal...

    Missouri Division of Professional Registration

    39 Assistant Physician (AP) licenses have been issued so far...
     
    #483 W19, Apr 16, 2018
    Last edited: Apr 16, 2018
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  35. RNtoMD87

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    Medicinez0z- There are an ever increasing number of patients, becoming increasingly sick due to Americans lazy, disgusting life choices. They refuse to take charge of their health, exercise, eat healthy, educate themselves on medications etc.

    There are two choices- water down MD education further, in order to push out more MD/DO for a greater patient demand which will be negative to the image of the professsion as a whole and give midlevels a whole new platform to stand on, or allow Midlevels to take up that spot, and know that there is no way they will ever be equal to an MD. Your concern that midlevels will actually compete with MD in the long run is a clue to me that you feel threatened. I don't lose any sleep at night over this, and still want to take the arduous and painful route of becoming an MD over an easier and MUCH cheaper two year route to become an NP simply because I feel this is a midlevel bubble that will burst, and the end result will be disasterous for midlevels, and destructive at best to all nurses.
     
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  36. MedicineZ0Z

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    Other countries live similar lifestyles, have LESS physicians per capita, have little to no midlevels, yet have better outcomes than USA. So no your argument is flawed.
    I already explained the core problem which is that primary care docs are not diagnosing/treating more complex issues with the time they have with their patients. Instead a huge chunk of that time is spent being a referologist.

    And your competition argument has zero basis, as I explained earlier. Most of what doctors do is not overly challenging, only some of it is. Midlevels could arguably do the easy stuff just as well. The point is they shouldn't have the right to do most of what doctors do. You don't simply have the right to compete just because you demand it. Can I sign up for a high level sports competition on the basis that I can make the cut, without actually going through the qualifying process? There's a rite of passage in medicine, and it needs to be kept that way.
     
  37. Oso

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    Everyone in this thread can be forgiven for these 10 pages of madness if they accept our lord and savior @Mad Jack into their hearts
     
  38. DocEspana

    DocEspana Bullish
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    Praise be the mad one
     
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  39. SuaveCardigans

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    Oh @Mad Jack forgive my sin, for I could not let that last thread about midlevels go...
     
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  40. DocEspana

    DocEspana Bullish
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    I mean. No. Thats complete nonsense. Especially since the argument we all got pulled into is about whose better day 1 - which everyone with real world experience told you that you're wrong about. The argument you wsnt to have... about autonomy... no one is having
     
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  41. RNtoMD87

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    Apparently this is a false equivalent because they ARE doing what MDs do.

    Americans are the unhealthiest first worlders. Western Europeans, Canadians and Australians live MUCH healthier lives than the average fat lazy fast food shoveling Americans do. Literally almost every single patient I get under the age of 60 either does IV drugs, smokes crack, has a BMI over 40, has a 60 pack year smoking history, abuses alcohol to an extreme, or has uncontrolled HTN in the realm of 250/120 when untreated yet still makes no diet modifications. Very few are traumas with no other history. If they're traumas its "Got hit by a car while strung out on meth and stumbled out into traffic" etc.

    Americans just aren't a people built for longevity. My copy of "Idiocracy" needs to be moved from my fiction section to the non-fiction section.

    I don't care about "right of passage". In the Army it was all about BS traditions and "dog and pony show" stuff like that. I DO have a problem with unqualified people practicing medicine, but it has nothing to do with some "rite of passage" or tradition. I'm a pragmatist.
     
    #490 RNtoMD87, Apr 16, 2018
    Last edited: Apr 16, 2018
  42. MedicineZ0Z

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    lol no. I assumed everyone knew how ridiculous it was for a student to have autonomy. It was a comparison reference.
    Lol, so a marginally higher obesity rate than Canada for example justifies having 20 times as many midlevels? Despite having more physicians?
     
  43. DocEspana

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    I may not have been clear enough while trying to be snarky. I was saying your suggestion that if you're "pro-np" you're pro-autonomy is total poppycock and a false dichotomy.

    The part about no one having that autonomy argument was clear enough, i guess. It just appears the first half wasnt clear due to stylistic choices by me.
     
  44. RNtoMD87

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    I just really get the idea that while medicinez0z may have a good grasp on science, disease processes etc, that he is still naïve to the workings of the hospital, patients, relationships between specialties, etc.
     
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  45. GoSpursGo

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    There have been a number of posts from this thread reported for personal attacks. While heated debates are encouraged, outright insults are not, so please be careful to not cross that line :) Additionally, I will remind you all about the ignore feature in case there is a particular user that you do not want to hear from again.

    If this thread continues to be reported for personal attacks, it may be closed.
     
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  46. Chibucks15

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    Honestly it may be better off just closing it now haha
     
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  47. MedicineZ0Z

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    Why close a serious discussion about a very serious issue?
     
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  48. IknowImnotadoctor

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    Opinions aren’t going to change. There’s no reason to keep a toxic thread like this open.
     
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  49. Chibucks15

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    It's people yelling at each other, when everyone is steadfast in their opinions. They won't magically change cuz someone throws the insult that stings the most
     
    VA Hopeful Dr likes this.
  50. W19

    W19
    Physician Gold Donor Classifieds Approved 2+ Year Member

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    People have become too sensitive in this forum..
     
    IknowImnotadoctor and RNtoMD87 like this.
  51. RNtoMD87

    RNtoMD87 Probationary Status

    Joined:
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    I can agree. I hope med school won't be full of sensitive people. As I always say "f*^% your feelings." But we gotta play ball by the rules here.
     

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