Smoking during the USMLE

[batch5000]

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Can we smoke cigarettes at our testing stations? Or do we have to go out in the hallway for a smoke?

 

[batch5000]

Can we smoke cigarettes at our testing stations? Or do we have to go out in the hallway for a smoke?

Nevermind. I looked it up. My testing center allows smoking at the stations. Phew.

 

[AndyRSC]

That's good. Watch out for the liquor at Prometric, though. It's seriously watered down.

 

[batch5000]

That's good. Watch out for the liquor at Prometric, though. It's seriously watered down.

LOL! I don't think that they would allow liquor during the USMLE Afterwards though, sure.

 

[Valadi]

Nevermind. I looked it up. My testing center allows smoking at the stations. Phew.

Woah your place allows smoking at the testing stations? Like at you computer cubicle??

 

[CardiologyJosh]

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[Siggy]

WTF? Are we serious here? You're going to be a physician, and you smoke? Did you, I don't know, miss all that lung cancer/heart disease/shortened lifespan stuff in High School, and General Bio, as well as medical school and clinic rotations? How about all the attention the dangers of smoking gets in the media these days? Miss that too?

Pathetic.

I hope you don't have any vices that adversely affect your health.

 

[CardiologyJosh]

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[Siggy]

No chocolate.
No alcohol - will be opting for the sparkling cider when match day 2018 arrives.
No coffee.
No fried foods.
No fast food.
No soda.
Seldom do I eat candy.
My lungs are pinker than a fairy armadillo.

You don't get to be a doctor and extend advice that you cannot reasonably follow as well.

Do you abstain from unsafe sexual practices?

Do you get 30 minutes of exercise a day?

Do you ever not get enough sleep?

 

[DesiMaster]

No chocolate.
No alcohol - will be opting for the sparkling cider when match day 2018 arrives.
No coffee.
No fried foods.
No fast food.
No soda.
Seldom do I eat candy.
My lungs are pinker than a fairy armadillo.

You don't get to be a doctor and extend advice that you cannot reasonably follow as well.

First of all, GTFO the Medical Student Section. Secondly, as a physician, you're not supposed to judge your patients so once again, stop giving advice which you have no rightful place to give. Thirdly, OP never asked for your opinion. Yeah smoking is bad and blah blah blah; we all know it. We all also know it is an addiction, deal with it.

Also, CardiologyJosh, your lungs could be black as hell too, but your ignorant ass would never know that without someone opening you up.

 

[CardiologyJosh]

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[CardiologyJosh]

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[CardiologyJosh]

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[Aclamity]

No chocolate.
No alcohol - will be opting for the sparkling cider when match day 2018 arrives.
No coffee.
No fried foods.
No fast food.
No soda.
Seldom do I eat candy.
My lungs are pinker than a fairy armadillo.

You don't get to be a doctor and extend advice that you cannot reasonably follow as well.

WTF? Are we serious here? did you, I don't know, miss all the evidence that a moderate amount of alcohol is good for your health and a bit of chocolate is good for your psyche? You're going to have lots of colleagues who smoke--I really hope this isn't how you act in real life. Plus, if you're ever going to get any questions on behavioral science correct, you should review the pre-contemplation/contemplation/etc stages of getting people to quit... berating them is NOT the right approach.

And you darn well get to be a doctor and extend advice you can't follow. It's like you live under a rock; did you know 99% of your classmates will NOT be opting for the cider? Should they not be allowed to tell their steatohepatitis patients to abstain from alcohol? I like to eat candy. Am I not allowed to discourage my Type II diabetic patients from doing the same?

 

[Aclamity]

Pretty sure I was judging the people who will be my colleagues; patients get unyielding compassion, understanding, and support. Colleagues are met with a critical eye when it is appropriate. And the addiction card is far too much of a convenient argument to pull. People overcome their addictions, and hospitals have programs in place to help make that process easier for it's staff.

I'm totally justified in everything I've said here. Though you're "GTFO" was cute. Nope, lungs clean as a whistle. These sentiments are not born out of ignorance, rather, they are born from humility.

If you live in NY, NY I'm pretty sure your lungs are nowhere near clean as a whistle

 

[Valadi]

WTF? Are we serious here? You're going to be a physician, and you smoke? Did you, I don't know, miss all that lung cancer/heart disease/shortened lifespan stuff in High School, and General Bio, as well as medical school and clinic rotations? How about all the attention the dangers of smoking gets in the media these days? Miss that too?

Pathetic.

Excessive judging is more detrimental to your health and happiness than smoking.

I like a cigarette every now and then and cigars on special occasions. There is nothing wrong with a person occasionally indulging a vice when they know its risks.

http://www.youtube.com/watch?v=kI0mOnmErnU

 

[CardiologyJosh]

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[CardiologyJosh]

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[loveoforganic]

If they allow you to smoke in the cubicle, I also hope they allow other students to hit you over the head with a chair. Just saying

Edit:

Oh yeah, I caught my PI (did cancer research in college) smoking outside our building. I snatched the butt from her hand and said "you're ****ing kidding me, right?"

You're a ****ing idiot. Good luck on wards

 

[CardiologyJosh]

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[AndyRSC]

You're a ****ing idiot. Good luck on wards

I second that. SDN has a bright future ahead of it.

 

[batch5000]

Should have added "and not be judged" regarding the comment about getting to be a doctor. Also, operative word was "reasonably". And I didn't say I judged for alcohol, or candy, did I? I simply mentioned that these are not things I put in my body.
I didn't say I was trying to help anyone overcome their addiction. I just can't believe how nonchalant people are being about SMOKING TOBACCO DURING A USMLE EXAM. There are resources for you to quit; that's where you get help. Not from a stranger on the internet.

Oh yeah, I caught my PI (did cancer research in college) smoking outside our building. I snatched the butt from her hand and said "you're ****ing kidding me, right?"

Finally, there is a difference between extending advice pertinent for a disease someone else has, and not helping yourself. As a physician, it is your responsibility to say "you have a mass on your lung, time to stop smoking"; at the same time however, this should frighten the **** out of you.

Listen, addiction is a serious disease and a disability. I can't help that I have this affliction. Fortunately though, people far more compassionate than yourself have the human decency to make accommodations for people ailing and suffering from a disease as serious as tobacco addiction. Can you imagine how much of a disadvantage it would be if I had to get up every 15 minutes for a cigarette during the exam? We put ramps on sidewalks for a reason. We have sign language interpreters at major gatherings. We have seeing eye dogs for the blind. And we make accommodations for people who have disabilities such as tobacco addiction. So while I am impressed that you swim seven hours a day and that you wear condoms with strangers, many of us are simply not capable of that. I just thank God everyday that there are people looking out for those of us that aren't Superman.

Good day to you sir.

 

[CardiologyJosh]

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[Houmd]

Successful troll is successful👍

 

[scarshapedstar]

Never really understood the tobacco thing until somebody handed me a clove cigarette at a party. Tasted nice, felt good, kinda dizzy. Bought a pack and I was well on my way to being hooked for three years - waiting tables is also infamously conducive to addiction. I have an addictive personality to begin with, but withdrawal sucks hard. It took a lot of nicorette for me to break the habit. You can't do well in school if you can't concentrate, and I don't care what kind of straight edge Jedi you think you are, if you got hooked at a time like med school -- when there's always a test around the corner -- you'd smoke up or you'd flunk out. I'm very lucky to have had a gap year to detox.

Funny thing is, even though I've been there, I can feel the temptation to berate people who come into clinic with 'a cough' and a 2-pack-a-day habit, so I can totally understand the moralizing upthread from people who have no idea what it feels like to be a nicotine slave, to rationalize and make light of a serious medical problem because there's no way to just put life on pause while you spend six months hiking in Patagonia or whatever it takes to keep you from craving another damn pack.

So is it worth scoring lower on the most important test of your life to save yourself one day of tobacco exposure? Hell no. What more needs to be said?

 

[loveoforganic]

How did you become addicted in the first place? Exactly. Don't say you can't help yourself, and don't ever put tobacco in the same category as blindness or the inability to walk. Again, I lend compassion to the people I serve; the rest, (ie, colleagues), it's case by case. Help yourself and try and be a better role model to your patients, and then maybe I'll toss you some of that compassion you so desperately need from a stranger on the internet.

His cruel uncle john dressed him as john wayne everyday throughout his childhood and threatened to beat his mother if he didn't smoke 5 packs of cigarettes a day, from the age of 5 onward, in respect for john wayne.

Seriously, you need to learn to recognize you have no idea of the events that have transpired in any given individual's life that could have led them down a certain path. What if your PI had just found out his/her parent had died and had a moment of weakness, relapsing into a previous vice?

This degree of moral high ground, I'm really having a hard time believing it isn't trolling, but am typing this anyway for the 1/1000 chance you aren't trolling.

Listen, addiction is a serious disease and a disability. I can't help that I have this affliction. Fortunately though, people far more compassionate than yourself have the human decency to make accommodations for people ailing and suffering from a disease as serious as tobacco addiction. Can you imagine how much of a disadvantage it would be if I had to get up every 15 minutes for a cigarette during the exam? We put ramps on sidewalks for a reason. We have sign language interpreters at major gatherings. We have seeing eye dogs for the blind. And we make accommodations for people who have disabilities such as tobacco addiction. So while I am impressed that you swim seven hours a day and that you wear condoms with strangers, many of us are simply not capable of that. I just thank God everyday that there are people looking out for those of us that aren't Superman.

Good day to you sir.

Thank you for this thread. I would previously have assumed there was no way smoking would be allowed in any testing center. If I had been taking step i and someone unexpectedly lit up a cigarette, I would probably end up in prison for assault. So you saved me from that potential unsavory fate. I will specifically ask testing centers about this

Edit:

Successful troll is successful👍

Most likely, everyone goes for a spin occasionally 😀

 

[CardiologyJosh]

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[batch5000]

Again, it is irrelevant how someone started smoking; what matters is that they conquer it, for the sake of their community. It's not just for their sake anymore; they are role models in the community, and people look up to them. So, kick the habit, or be prepared for career-long judgement. (and these sentiments are shared with a plethora of physicians I have shadowed,) so don't even question my morality or what I call reality.

The thing is, I really want to quit. I just don't know how. And with everyone being so judgmental, I get so discouraged. So I go back to my comfort zone ... my pack of Camel Non-filters. I light one up and say to myself "This is going to be the last one! Yep, I quit right after this last cig." But of course, I am always just fooling myself. I just wish I had some role models in my life. If there were only some strong people like you who were there to support me and cheer me on as I conquer the addiction process, maybe I could?

Would you help me?

 

[Siggy]

PS - the failure of any one individual to do these 3 things, hardly qualify as vices detrimental to their health.

You'll change your opinion on things like having multiple partners when you get into medical school and learn the actual failure rate for condoms. It's much higher than you think.

 

[CardiologyJosh]

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[Siggy]

Should they not be allowed to tell their steatohepatitis patients to abstain from alcohol? I like to eat candy. Am I not allowed to discourage my Type II diabetic patients from doing the same?

Shouldn't having a shared fatty liver disease experience lead to better empathy? Global communication skills ++

 

[batch5000]

Yeah yeah yeah, mock if you want, you know I'm right. Whether you think you can quit, or not quit, you're probably right. Tobacco addiction is hardly a disease. It is something people struggle with, sure, but not a disease in and of itself. Cancer's a disease.

I do know you are right. But it is hard enough managing my Type II DM through exercise and diet alone when I am confined to a wheelchair. And having Domino's deliver is a lot simpler than trying to prepare meals alone when you have limited mobility. With all that I have to deal with, quitting smoking seems like climbing Mt. Everest or something. Smoking gives me about the only joy that I have in life sometimes. So put yourself in my shoes for just one moment. What should I do? I need more that just "Buck up kid and kick it!" 😡

 

[CardiologyJosh]

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[batch5000]

I know you think it's cute or clever to mock actual afflictions people SUFFER from, but excuses are like *******s; everyone has one and they all stink.

You must believe that everyone in medical school is Superman, like yourself. You will be surprised to find that many of us suffer from disease much like the general population. You will see students with cancer, ulcerative colitis, lupus, spina bifida, and yes ... people with type II DM who are wheelchair bound because of peripheral artery disease. Sure, we may all have excuses, some of which we will not believe or understand. But you will soon find yourself at a dead end with your patients when you tire of their excuses. You must work with their excuses. Don't treat your patients like your buddies when you are spotting them at the gym. And for a good Step 1 tie-in ... you never abandon your patients!

 

[CardiologyJosh]

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[batch5000]

You are correct; however, tobacco addiction, is not a disease. So quit whining about deserving special treatment for it, and ****ing change things for yourself. The tone of your previous post was mockery, so the excuses comment was a polite way of calling you an ******* for portraying yourself as having those afflictions when clearly you don't; because guess what? I have legal guardianship over someone in a wheelchair, so that was the wrong example to try and dose me with humility and make a mockery of.

I don't think you understand ... I am in a wheelchair. Plus, your patients will whine and want special treatment. Get used to it.

 

[CardiologyJosh]

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[batch5000]

Wow, you missed my original point didn't you? Patients get unyielding compassion and empathy; colleagues, who know better than to set a bad example in their community, don't. Now, if I want to call you a cock, as a physician, for smoking, I get to. This is not something, however, I do to my patients. Do you get the point now? And I don't care if you are in a wheelchair or not, the point is, that comment was still mockery; that you only find joy in smoking? Really? So then what little happiness is a career in medicine going to yield for you? Did I just? You're god damn right I just went there. Physicians are supposed to be emotionally stable, so do want to keep hamstringing on a ****ty argument or do you want to concede that you're just ignorant?

You are right. It is a bad argument. I mean what should I do though? Everyone in my life is just an enabler. My parents buy me cartons of cigs for me (its all they can afford for me. We come from a very working-class background.) And you have the USMLE testing center bending over backwards for me so that I can smoke at my cubicle. Everyone makes it so hard for me to quit.

 

[CardiologyJosh]

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[batch5000]

I should get to bed. I hope we can continue this conversation later, CardiologyJosh. You have gotten me thinking. Maybe quitting is something I can do. For now I will quit this cigarette I am smoking now.

Ok ... maybe I will have one more in bed. But I'm trying!

 

[CardiologyJosh]

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[TooMuchResearch]

http://forums.studentdoctor.net/showthread.php?t=821286

Last year's thread was more civil. But no, you can't smoke in the test center. You should be allowed to smoke outside, assuming you can do it fast enough. Also, I think the correct response was something along the lines of "tell me what you know about the health benefits of quitting smoking."

 

[Valadi]

Wow, you missed my original point didn't you? Patients get unyielding compassion and empathy; colleagues, who know better than to set a bad example in their community, don't. Now, if I want to call you a cock, as a physician, for smoking, I get to. This is not something, however, I do to my patients. Do you get the point now? And I don't care if you are in a wheelchair or not, the point is, that comment was still mockery; that you only find joy in smoking? Really? So then what little happiness is a career in medicine going to yield for you? Did I just? You're god damn right I just went there. Physicians are supposed to be emotionally stable, so do want to keep hamstringing on a ****ty argument or do you want to concede that you're just ignorant?

You realize physicians are someone's patient too, right?

You're going to be in for a big surprise thinking that "physicians are supposed to be emotionally stable." There's a reason that divorce, dissatisfaction, depression, and higher suicide rate than the general population exist in the physician population. You can easily google or pubmed this information.

This is a high stress career champ. When you're on with your coresidents at 2am and they're debating if it was all worth it, I want you to tell me how far your arguments go when they reach for a cigarette or a vending machine twinkie. You will get much further practicing the empathy you preach. Medical professionals are just human.

 

[CardiologyJosh]

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[loveoforganic]

http://forums.studentdoctor.net/showthread.php?t=821286

Last year's thread was more civil. But no, you can't smoke in the test center. You should be allowed to smoke outside, assuming you can do it fast enough. Also, I think the correct response was something along the lines of "tell me what you know about the health benefits of quitting smoking."

Based on independent reading, an evidence-based progression would be like

1) Would it be alright if I talk to you about your smoking?
2) What do you know about the health benefits of smoking cessation? (as you said)

From here, you have two paths depending on knowledge - education about ill effects of smoking or discussion of pros and cons of smoking and pros and cons of smoking cessation. Progress into helping find alternatives to replace the good aspects of smoking, providing methods to make cessation less painful, highlighting benefits of cessation that coincide with the individual's values (more money to provide for family/fun, being around longer for your kids, whatever).

Health behavior change is a big interest of mine - I highly recommend looking into motivational interviewing for anyone with similar interests

 

[Valadi]

I don't think I have ever seen so many words say nothing at all.

Haha! batch had the right approach for talking to you. Apparently you're too high up on your horse for anyone else's viewpoints (or data, for that matter) to reach you. Good day to you kid.

 

[Siggy]

higher suicide rate than the general population exist in the physician population.

Physicians make runs at suicide at the same rate as the general population. We're just better at it than the general population.

 

[Nymphicus]

Pretty sure I was judging the people who will be my colleagues; patients get unyielding compassion, understanding, and support. Colleagues are met with a critical eye when it is appropriate.

Is this the right word?

 

[AndyRSC]

Health behavior change is a big interest of mine

Something that stuck with me from a CME course I took ages ago:

When assessing readiness to quit, have the patient put it on a scale of 1 to 10, then ask "why not less?" rather than "why not more?" This allegedly forces the patient to face the reasons to do so and acknowledge the motivators already present, rather than make up excuses.

 

[loveoforganic]

Something that stuck with me from a CME course I took ages ago:

When assessing readiness to quit, have the patient put it on a scale of 1 to 10, then ask "why not less?" rather than "why not more?" This allegedly forces the patient to face the reasons to do so and acknowledge the motivators already present, rather than make up excuses.

👍 Loved finding out about this technique. Very easy to elicit a lot of change talk as well as find out things to keep in mind for further discussions. A whole lot easier to master than something like directive reflective listening as well. Basically, just.. say it 😛