Student tox screen?

[keshtahn]

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Anyone ever been or heard of a visiting away rotation student being asked to do a drug screen?

If you have/haven't/know something, please list program with answer!

Sketchy, I know. Sorry guys

 

[DeadCactus]

Maybe, you know, just stop getting high at a time when it could really screw up your career?

 

[keshtahn]

Maybe, you know, just stop getting high at a time when it could really screw up your career?

I cannot have said it better myself. No sarcastic at all.

However, maybe I have stopped getting high for some time but am just very paranoia about the possible residual traces at a time when it could really screw up my career.

:nail bite:

 

[turkeyjerky]

Smoke some bud and chill out man. I haven't heard of this before, although they definitely do before beginning residency.

 

[Vee]

I never had to as a student OR before starting residency.

 

[b-real]

You may want to check on VSAS, as schools will list their requirements for visiting students. There are definitely schools that drug screen, cause our dean highlighted to process of obtaining said screen for aways.

 

[la gringa]

we had to do one before starting residency, but never in med school. had to for 1 of 3 hospitals where i'm credentialed.

i for one think healthcare professionals should have random screenings after the initial pre-employment one. everyone knows you're gonna have one before starting...

 

[EctopicFetus]

never.. not student rotations, not residency, not credentialing for a real job or moonlighting

 

[Dwindlin]

Holy cow. My class was screen just prior to starting MSI, again at the start of MSIII and if you rotate at the local VA or AFB Hospital you get another. I figured this was the norm, apparently it is not.

 

[Indryd]

Sketchy, I know. Sorry guys

 

[wook]

never.. not student rotations, not residency, not credentialing for a real job or moonlighting

I had to do it for residency, and 3 of 5 places which I credentialed. Each place had fine print that says that I could be subject to a random test.

It's interesting that different places do such different things.



Thanks.


Wook

 

[The White Coat Investor]

The only employer I ever had to piss for was the US Military.

 

[deleted109597]

I had to for my first residency but not my second. I actually think it's a good thing. While many people may agree or disagree about how "bad" marijuana is, the fact is that it, and all other drugs not prescribed, are illegal. If you're willing to break one law, they have no reason to believe you won't break others because you have a different morality compass.

 

[la gringa]

agree, mcninja

 

[Groove]

I can't think of anything more stupid than a med student smoking pot and taking the risk of getting caught in any circumstance. If you get flagged on a tox screen at any point, you're career is over. If you get flagged on a tox screen for residency, your career is over. If you get pulled over by the police and they find some in your car, again...career is over. Don't be an ***** dude.

I don't smoke pot, but personally, I'd rather pot smokers be on the road at night creeping at 30mph than alcoholics cruising at 90mph, but that's not the laws that we have right now. Pot is still illegal and you will be prosecuted as such.

Please PM me your real name, so if you interview I can be sure to make sure you don't match. I don't like the idea of working a trauma or code with a stoned colleague. Just me.

And keep in mind, you can be asked at any point during residency to take a drug screen even though it usually never happens. If someone even thought you smelled like reefer, you might get asked to piss in a cup. Your life would take a dramatic turn for the worse. Talk about royally f'ing up your life dude...

I know about a guy who was in another residency program, different specialty, few months from completion who got busted for a similar circumstance. Lost his residency... we're talking 3-4 months from graduating. He had to start a new residency all over, different specialty, and that's only because they covered for him in their reasoning for him being "let go". Don't be that guy.

 

[ihearttriangles]

I had to for my first residency but not my second. I actually think it's a good thing. While many people may agree or disagree about how "bad" marijuana is, the fact is that it, and all other drugs not prescribed, are illegal. If you're willing to break one law, they have no reason to believe you won't break others because you have a different morality compass.

The problem with the law is that it is sometimes wrong. We don't have to look too far in our past to find laws that banned African Americans from accessing many basic services (healthcare, education, the right to vote). Even today some states have pretty ridiculously laws (oral sex is illegal in some states). So, personally the fact that the use of marijuana is illegal in some states (not all, California for example the use is not illegal and even the possession of less than an ounce is just an infraction, not even a misdemeanor), does not overly concern me.

The issue is whether or not smoking marijuana will impair your ability to deliver excellent patient care. Clearly, no one would want to receive care from a provider who was either high or still feeling some of the effects from being high the previous day. Same with alcohol, same with prescription drugs. The problem is that you can test positive for marijuana even weeks after last smoking it so I don't know how relevant a screen for marijuana would be for determining whether or not someone is fit to provide care.

And by the way I don't use marijuana.

 

[Indryd]

The problem with the law is that it is sometimes wrong. We don't have to look too far in our past to find laws that banned African Americans from accessing many basic services (healthcare, education, the right to vote). Even today some states have pretty ridiculously laws (oral sex is illegal in some states). So, personally the fact that the use of marijuana is illegal in some states (not all, California for example the use is not illegal and even the possession of less than an ounce is just an infraction, not even a misdemeanor), does not overly concern me.

The issue is whether or not smoking marijuana will impair your ability to deliver excellent patient care. Clearly, no one would want to receive care from a provider who was either high or still feeling some of the effects from being high the previous day. Same with alcohol, same with prescription drugs. The problem is that you can test positive for marijuana even weeks after last smoking it so I don't know how relevant a screen for marijuana would be for determining whether or not someone is fit to provide care.

And by the way I don't use marijuana.

I kind of get where you are coming from, but a law--legitimate or not--is a law.

 

[keshtahn]

You guys are all right of not screwing up my career. Really this is a bit sobering as at my medical school marijuana is quite commonplace and wouldn't even turn a head at a party.

What school? Well...you'd be surprised. Or maybe not. Depends on how you are feel about the supposed "elite" 😳S

I also agree that breaking even a stupid law is still breaking a law and is stupid.

I don't like the idea of working a trauma or code with a stoned colleague. Just me.

It would be of interest, to see a study comparing performance/mistakes of doctors who just completed a 16/24/36 hour shift and are back at work 10 hours later to doctors who got stoned before going to bed 10 hours ago and are now back at work.

I guarantee the exhausted and sleep deprived guys would lose.

Yet until recently it was expected that students and residents would pull 36 hour shifts, go sleep 8 hours, and be back at the hospital (let's be truthful, it still happens all over the place, despite regulations).

No stigma, in fact really it garners respect and deference, to working insane hours and being willing to work despite exhaustion (really this is reckless behavior, no?).

Also, imagine being a resident who just worked 35 hours and saying "I am not comfortable doing xyz because I am exhausted and there is a good chance I will make a major mistake and put my patient in danger". This is a perfectly rational and altruistic move, but would be seen as a terrible weakness and is the kind of thing that would stick with you the rest of your career.

In other words, you are expected to work exhausted, despite the fact that everyone knows it is very risky.

By contrast, if I smoked one in Amsterdam on the second day of my 2 week vacation and come home to a random drug screen completely sober and ready to go, goodbye career!

My own stupidity for thinking about risking my career over a puff of smoke aside, as well as all deference to law, can you all see the insanity in the above?

 

[keshtahn]

Please PM me your real name, so if you interview I can be sure to make sure you don't match.

My name....is Inigo Montoya

 

[pseudoknot]

If you're willing to break one law, they have no reason to believe you won't break others because you have a different morality compass.

Just to be the devil's advocate, I'm not sure that logic is really valid. I mean, I exceed the speed limit almost every time I drive to work, and I would have a hard time accounting for part of my MP3 collection, but I've never committed tax fraud or murder. I don't think that breaking one law means that you have a "different morality compass."

On the other hand, I don't think drug users belong in the ED. Well, I guess they do, but not as healthcare providers. 😉

 

[Bojack Horseman]

My name....is Inigo Montoya

👍👍👍😎

 

[DeadCactus]

I disagree that popping positive on a drug test shows you have a lacking moral compass. I do think it qualifies as a legitimate reason to question your judgement. Risking a decade of education and debt to get high isn't exactly the most astounding representation of one's critical thinking skills...

 

[Indryd]

I disagree that popping positive on a drug test shows you have a lacking moral compass. I do think it qualifies as a legitimate reason to question your judgement. Risking a decade of education and debt to get high isn't exactly the most astounding representation of one's critical thinking skills...

This is kinda how I feel too. The poor judgment part anyway. I think that's a touch different from critical thinking skills. Judgment encompasses much more of your mind and personality than just your critical thinking. Regardless, it falls under "stupid" no matter how you slice it.

 

[SoCuteMD]

Something made me think about the ways in which a physician finds themselves penniless/homeless/down and out earlier today. On the whole, we're pretty lucky - whether we think it pays enough or the hours are what we deserve - it's very hard for us to be unemployed. Amongst the stories I have heard, though, there are two common themes - sex and drugs. Get caught diverting drugs and you can kiss your ability to practice goodbye. Turn yourself in voluntarily for rehab after diverting drugs, and you are still looking at practicing under a microscope for the rest of your career. Yeah, a little pot probably isn't all that harmful (I honestly wouldn't know - never tried it), but I bet that doctor who thought that "little bit of morphine" or "a few oxycodone" wouldn't hurt probably lived to regret that thought. Just, no thanks. I've invested way too much time and money into this career to see it disappear.

Make your own choices based on the risk-benefit. For me, the calculation is pretty damn clear.

 

[Groove]

Agree 100% with SoCuteMD... You guys can justify it 100 billion ways, but the facts are that there isn't a single court that is going to have a jury pool that agrees that you have the right to use marijuana and practice medicine...period. They all might be smoking it, but they sure as hell don't want to be treated by a physician who smokes it regularly. Fair? Who gives a damn, it's the law and you don't live above it, regardless of your internal moral tenets. Don't agree with it? Go practice in Amsterdam then.

Got a rich family? No? Then you owe tons of debt. It would suck to lose your ability to pay that back and be owing Uncle Sam to your death bed, able to work as perhaps a pharmaceutical sales rep... at best.

Hey, keep firing it up though. After all, all your buddies are doing it and they are doctors. Gonna suck when your tox screen for residency comes back positive, or you confide in a nurse/fellow resident about your habits during residency, only to have it leak out and get reported ending up with a random drug screen request, or have a nurse think she smells reefer on your jacket which you were wearing last night when you went out and smoked a doob in your car....same result. Yea...good luck with that champ. I'll keep practicing medicine. My scotch and cigars are legal and I only ever drink AFTER the occasional shift, so I'm safe... You, however, are not.

 

[meowdoc]

Agree 100% with SoCuteMD... You guys can justify it 100 billion ways, but the facts are that there isn't a single court that is going to have a jury pool that agrees that you have the right to use marijuana and practice medicine...period. They all might be smoking it, but they sure as hell don't want to be treated by a physician who smokes it regularly. Fair? Who gives a damn, it's the law and you don't live above it, regardless of your internal moral tenets. Don't agree with it? Go practice in Amsterdam then.

Got a rich family? No? Then you owe tons of debt. It would suck to lose your ability to pay that back and be owing Uncle Sam to your death bed, able to work as perhaps a pharmaceutical sales rep... at best.

Hey, keep firing it up though. After all, all your buddies are doing it and they are doctors. Gonna suck when your tox screen for residency comes back positive, or you confide in a nurse/fellow resident about your habits during residency, only to have it leak out and get reported ending up with a random drug screen request, or have a nurse think she smells reefer on your jacket which you were wearing last night when you went out and smoked a doob in your car....same result. Yea...good luck with that champ. I'll keep practicing medicine. My scotch and cigars are legal and I only ever drink AFTER the occasional shift, so I'm safe... You, however, are not.

Dude.. you are like the biggest buzz kill EVER

 

[KarlPilkington]

I know plenty of good docs that smoke pot, all of whom would get fired in an instant if they failed a drug screen. Its all about the amount of risk you wanna walk around with. The folks I know that smoke, come to work clean and sober and do great work, but for me, I like passing my drug screens every time.
The time to debate the merits of marijuana is not after you've failed your hospital drug test. You don't have to follow all the laws, you just gotta be willing to live with the consequences. The folks that write hospital policy and give out DEA numbers don't tend to be the most progressive thinkers...

 

[corpsmanUP]

The truth is, we will all look back at this debate and laugh in about 20 years. The marijuana train is travelling from west to east, starting with legalization for "medical reasons" and eventually will become one of the most highly taxed and profitable products in history. I don't personally smoke pot, but I know several colleagues around the country who do or did. None of them are dangerous providers and all have families, responsiblities they live up to.

My guess is there are plenty of doctors in California, and the other 15 states where medicinal marijuana is legal, who now have their own cards to legally smoke. So it's interesting to see where that would fit into this argument.

I for one have never seen someone who came to the ED who was simply there for doing something under the influence of marijuana. We all see drunks every day and the sequelae of their dependence. Every shift I see some poor soul who is cirrhotic or in DT's. But I have never had to admit someone to the hospital for acute marijuana induced Cheeto consumption!!

This conversation will someday be like talking about how we used to not be able to shop on Sundays due to the Blue laws.

Right now I think it is simply too risky to one's career to smoke weed if you are a physician, medical student, resident. A nice scotch and a fine Cuban-knock off go a long way toward uphoria 🙂

 

[fiznat]

Don't agree with it? Go practice in Amsterdam then.
...
Hey, keep firing it up though. After all, all your buddies are doing it and they are doctors. Gonna suck when...

Do you talk to people like this in real life? I understand your point, and even agree with you for the most part, but dude. Ease up, he gets it. We all do.

 

[deleted109597]

Do you talk to people like this in real life? I understand your point, and even agree with you for the most part, but dude. Ease up, he gets it. We all do.

I don't think he gets it, or he wouldn't be asking how to avoid places that test. Frankly, most of us only know the places we went to. And for someone to come onto a forum asking how to avoid the law, makes me think that blazing must be a pretty big part of their life.
As before, if you want to try it, and think you can get away with it, none of us will turn you in. But most of us won't help either. If they want to change the law I'm not going to argue against it.

 

[Groove]

Do you talk to people like this in real life?

Yea, I'm pretty blunt. He needs to hear it. Maybe you do to.

My personal thoughts on marijuana are irrelevant. I have no clue whether it should be legalized or not, nor do I care since all it ever did was put me to sleep in college. Drunks are more dangerous on the road than pot heads, but then again... I know of plenty of CEOs and even ex-Presidents who were alcoholics, but all I envision with pot legalized is a bunch of lazy, apathetic chuckleheads that make grocery shopping for me a pain in the ass because the snack food aisle is perpetually empty.

As McNinja said, if the guy "got it" he wouldn't have followed up with postings that basically implicit lack of culpability due to his particular philosophical musings on the relative safety of "responsible" marijuana use versus sleep deprivation, etc..

As I said, philosophy and policy debate is not the point of this thread. The law is the law and you risk much as a physician for breaking it. Probably the most insecure and potentially devastating time of your entire career is in the transition between medical school and residency and even during residency. If he wanted to pick a time in his life to really mind the p's and q's, it's the time right now.

If I didn't give a ****, I wouldn't have posted. I'm trying to keep him out of trouble. Most of us on this thread are.

 

[ccfccp]

As someone who is going through the licensure process now, I will tell you that it is double dangerous as a student or resident. Once you have your medical license, you at least have the guarantee of peer-reviewed hearing and a legal process before losing your license. If you get caught BEFORE you are licensed, however, good like finding a state where you can get a NEW license. If you have your license, you're innocent until proven guilty. If not, no one's likely to to give you that chance.

I agree with AD that this is likely not going to be an issue in 10-20 years, but it's not a risk I'd be willing to take today.

 

[arb011]

If one is smart and responsible about it I really don't see an issue with someone engaging in this activity every once in a while. If you are responsible about when you use it, who you use it with, and you KNOW you will not be screened in the foreseeable future, what's the big deal?

 

[gutonc]

If one is smart and responsible about it I really don't see an issue with someone engaging in this activity every once in a while. If you are responsible about when you use it, who you use it with, and you KNOW you will not be screened in the foreseeable future, what's the big deal?

Oy vey. Look, if you want to get high, go ahead and get high. But don't come bitching to us a few years down the road when you lose your residency spot and any chance of a career in medicine because your UDS came back positive.

 

[Nervous Ned]

If one is smart and responsible about it I really don't see an issue with someone engaging in this activity every once in a while. If you are responsible about when you use it, who you use it with, and you KNOW you will not be screened in the foreseeable future, what's the big deal?

It's just asking for trouble. Personal feelings about civil disobedience aside, there are certain things that are just a really bad idea if you want to be a physician. Getting on the wrong side of the law with regard to prescription or illegal drugs is one of the big ones. Once you reach this level where you're transitioning to residency, breaking drug laws is not just a dumb kid stunt any more. At my residency orientation, they handed me a card with my DEA number, and I was writing scripts for controlled substances on my first shift. Those of you who are MS4s will be doing the same in a few short months. Welcome to the ranks of adulthood.

 

[corpsmanUP]

A really interesting spin on this argument would be what a physician can and cannot do in California. Pretty much everyone who wants one has a "card" and I would guess a bunch of docs do as well. And since California is a state where they don't randomly test or test pre-employment as far as I know, then unless you get sideways with the law you are probably safe. And since you carry a card that basically lets you walk in to a cannabis bar and toke it up, or buy from a dispensary (literally hundreds), then getting sideways with the law is tough. So my guess is it may be more acceptable in a place like this. Here in Texas they still send people to the pen for years for a small MJ offense under the right circumstances.

 

[pseudoknot]

Even in California you'd still be violating federal law. Doesn't seem like a good idea for members of our highly regulated and scrutinized profession, but to each his own.

 

[arb011]

Oy vey. Look, if you want to get high, go ahead and get high. But don't come bitching to us a few years down the road when you lose your residency spot and any chance of a career in medicine because your UDS came back positive.

Won't happen because I don't use it, as you assumed I do. I was just pointing out that if one does choose to partake there is no reason why it should be an issue. Again, this is putting all personal opinions aside.

 

[deleted109597]

Won't happen because I don't use it, as you assumed I do. I was just pointing out that if one does choose to partake there is no reason why it should be an issue. Again, this is putting all personal opinions aside.

Wow. So change your drug from marijuana to opiates. Or stealing. Or any other crime. Your statement still makes the same logical sense.

It's still illegal.

Remember, integrity is the ability to do the right thing even when nobody is watching. What you're advocating is that it's only wrong if you get caught.

 

[arb011]

Wow. So change your drug from marijuana to opiates. Or stealing. Or any other crime. Your statement still makes the same logical sense.

It's still illegal.

Remember, integrity is the ability to do the right thing even when nobody is watching. What you're advocating is that it's only wrong if you get caught.

Just because it's illegal doesn't mean it's wrong. I don't do it because it IS illegal and I do still have some respect for the law. It is not fair to compare using marijuana to stealing. One is clearly morally unjust while the morality of the other is quite debatable.

Again, all I'm saying is that if one chooses to use it responsibly there is no reason why they should get caught. And again, this is leaving all opinions on morality aside. I am not saying that it's only wrong if you get caught. However, I am confident in saying that there is no one in the field of medicine, or in society in general, who follows every rule and law to a T. And remember, in many cities it is not a criminal offense and getting caught is equivalent to getting a traffic ticket.

 

[Arcan57]

Won't happen because I don't use it, as you assumed I do. I was just pointing out that if one does choose to partake there is no reason why it should be an issue. Again, this is putting all personal opinions aside.

If you honestly think there's no reason it should be an issue, then you're hosed when it comes to dealing with administration (ie authority). Not being able to smoke pot isn't even close to the top of list of things that you can't do (or have to do) that make "no sense". The consequences for not toeing the line tend to be pretty severe, and the number of people that get a pass because they make a lot of money for the hospital is steadily shrinking.

 

[arb011]

If you honestly think there's no reason it should be an issue, then you're hosed when it comes to dealing with administration (ie authority). Not being able to smoke pot isn't even close to the top of list of things that you can't do (or have to do) that make "no sense". The consequences for not toeing the line tend to be pretty severe, and the number of people that get a pass because they make a lot of money for the hospital is steadily shrinking.

I am not saying that it shouldn't be an issue when dealing with administration. Obviously that would be a huge issue. But I don't think this is the appropriate place to be talking about this topic, so no more responses from me.

 

[deleted109597]

Just because it's illegal doesn't mean it's wrong.

Sorry, but that's the definition of illegal as it pertains to the law. Now, as far as the degree of criminality then yes, I agree with you that it is pretty close to a victimless crime. And yes, the fact that it is illegal and alcohol is not is a bit of a double standard. But we aren't arguing whether society should accept marijuana as legal, we are discussing whether or not physicians/medical students should be commiting illegal acts, especially ones with such a stigma as drug use.

 

[shopsteward]

it is pretty close to a victimless crime/QUOTE]

Illegal drug use is only a victimless crime if you grow your own. Otherwise you are either subverting systems intended to provide assistance to the medically needy (for prescription drugs) or you are buying into organised crime (for illegal drugs). There are victims aplenty from both of those activities.

 

[StevieStud]

Pick which physician you would allow to attend to the critical needs of a family member:

A) Senile
B) Obese
C) Stoned
D) Drunk


My vote is for B. The other 3 not so much.

Remember that vote as you go through your medical career. You can be a lot of things, but senile, drunk or stoned is not one of the options.

 

[AOAmed]

+

 

[Wroooong]

The real question is how stoned do you have to be to start throwing shade in a 6 year old thread?

 

[BoardingDoc]

Lol. This guy is seriously out of touch.

This is coming from the person who just responded to a statement made nearly 6 years ago. Brilliant.

 

[Groove]

Did I just get quoted from 2011? That's an epic forum search for "pot".

I don't even remember this thread.

 

[Siggy]

I mean... it's not like he's trying to sell coke or anything.