taking a day off and feeling guilty

Discussion in 'Clinical Rotations' started by Doctor Bagel, Dec 5, 2008.

  1. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    What's wrong with me? :) I'm a medicine right now, and my assigned scheduled for the next two weeks worked out where I wouldn't get any days off between this last Monday and next Friday with 3 call days thrown in there coupled with a really long day yesterday secondary to other required crap. I told my intern about this yesterday, and she asked my senior if I could take the day off today, and he agreed.

    It's great, but the screwed up thing is I'm feeling like I'm doing something horribly wrong by taking an unassigned day off. I'm almost tempted to offer to come in one extra day next weekend just to make up for it. Anybody else as lame as me? And will I possibly get screwed on evals for being a slacker?

    Also, how long does your school expect you go without getting days off? The residents in the medicine department are required to take 1 in 7 off. We normally get that but don't when we have Saturday call.
     
  2. tkim

    tkim 10 cc's cordrazine
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    The thing you learn pretty early on is that the only person looking out for you is you. If you are supposed to get a day off and you don't speak up, no one else loses but you.

    Conversely, you don't gain anything but a feeling of bitterness if you roll over and take it and never speak up. Save the bitterness for residency.
     
  3. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    This is true, and I've been falling into the bitter trap with this rotation. In my defense, though, I wasn't supposed to get a day off. :eek: It's one of the not very thoughtful aspects of the schedule for my current rotation. The only days off are weekend days when you don't have long call. It normally works out that you get 1 in 7 off, but the Saturday call throws it off.

    I think I've fallen into this weird paranoid med school world where I feel like I can't ask for reasonable accommodations without being judged negatively by someone. And the general vibe at my school is that getting on anyone's bad side will bite you in the ass come time to apply for residencies. 3rd year sucks for people pleasers.
     
  4. Anka

    Anka Senior Member
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    If you're on Saturday call, you get Sunday off, no?
     
  5. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Well you get the afternoon off. We have to round on the morning postcall, which takes several hours.

    Editing to add that postcall lasts about as long as any other day. It's actually worse because we start rounding earlier, which means prerounding is even earlier. I guess I don't count working from 6 to 1 as a day off.
     
    #5 Doctor Bagel, Dec 5, 2008
    Last edited: Dec 5, 2008
  6. had2piknowEM

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    Don't know how long your rotation is, but at my school normally we would go over the schedule in advance and when we noticed something like that, we would get either the weekend before or after off. But as others have said, don't feel guilty...
     
  7. LadyWolverine

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    I'm assuming your inpatient medicine block is like ours - 8 weeks long with q4 call, which means, if you average it out, you should get exactly 4 days off every month. Since it's q4, though, that means 1 whole weekend off (call Thurs->Fri), 1 saturday only off (call Sun->Mon), 1 sunday only off (call Fri->Sat) and 1 weekend where you get no days off (call Sat->Sun). The 12-day-long nonweekenders were the absolute worst. We were expected to come in every day to pre-round/round/work which usually meant 6-6, stay until the designated time on call nights (which work out to be tues, sat, and then wed), and, at one particular hospital, help day float with cross-cover on that postcall sunday once rounds/work was over, which really sucked because we were there until after 5 instead of leaving at 1.

    It sounds like you got lucky. I wouldn't feel guilty, as long as you didn't expressly ask for the day off.

    The inefficiency of the entire process which leads to the extremely long hours is one of the reasons why I became rather disenchanted with inpatient internal medicine from the get-go. The lack of guidance in physical exam skills and in determining a proper assessment and plan is the other. Unfortunately, this is not unique to IM. Which is sad, because I thought that these were the skills I would be focusing on in medical school, not my ability to schedule an appointment with Mr. Jones's PCP, my adeptness at procuring Ms. Doe's records from X outside hospital, or tracking down Substance Abuse to make an appointment for Mr. Brown that he will invariably not go to.
     
    #7 LadyWolverine, Dec 5, 2008
    Last edited: Dec 5, 2008
  8. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Our schedule really isn't too bad especially compared with yours. We're q5 instead of q4, but it does work out the same way with days off. You get a full weekend off the weekend after you do your 12 day thing, and you get Saturday or Sunday off the other weeks.

    Yeah, I'm also not a fan of inpatient internal medicine. I honestly came in thinking I wanted to do IM, but if this is what IM really looks like, I don't want to be there.
     
  9. 45408

    45408 aw buddy
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    Yeah, that sounds pretty familiar. All of my inpatient rotations work pretty similarly. The black weekends suck, because you've got an almost 2 week stretch with no time off. Your hours sound a bit longer (peds and medicine didn't really start until 6:45 or 7:15), but it's the waking up every freaking morning for three weeks with one day off that kills me. Oh, well. I'll be interested to see how I cope when I switch to shift work for my EM rotation in February.
     
  10. themudphud

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    Doc B-- soon enough you will be a tired and bitter late MS3/MS4 and guilt will be what you feel when you are eating your patient's dinner leftovers because you're so hungry from standing in the OR for 15hrs without a break just to throw 2 stitches at the end and then proceeding on to evening rounds on 30 patients :)

    I hope you took the day off...
     
  11. Cards21aceking

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    I think we are both in a similar position. My upper level gave me today off to study, since we're on call tomorrow (Saturday) and our shelf is next Friday. I didn't really have any qualms about it because I realize how much i need to study, but if you feel guilty, there's no problem in studying something about some of the patients that are on your service. That way when you go back, you can show your team the fruits of your efforts on your day off. :)
     
  12. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    That would be a rational and productive thing to do. Since I'm neither, it probably won't happen. :oops: Glad to hear that someone else got a random day off, too.
     
  13. Anka

    Anka Senior Member
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    Black weekends suck, but are a by-product of the call system. The point is, you get daylight hours outside of the hospital. As far as rounding earlier/prerounding earlier, you're there anyway, right? The golden weekend is the payoff for the black (you get two days off). However, you should probably get out of the habit of complaining when the call schedule doesn't go your way. Everyone has rotations where they get a black weekend but no golden, or have an extra day on call compared to the other residents on the rotation that month.

    I probably would have given you an extra day off like your residents did, but this is something everyone deals with, so why complain about it in the first place?

    Anka
     
  14. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Actually it doesn't happen to the residents at this location on wards. They all take a week day off when we have weekend call to give them one day off in 7. I know that students have in no way as hard of a schedule as the residents and interns, but we are the only ones here who have to do the 12 day straight thing.

    And in my defense, I didn't complain about it to anyone on my team. My intern just asked me when I got a day off and realized it wouldn't be for a long time. I didn't bring it up to my team unprompted.
     
  15. Anka

    Anka Senior Member
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    Then that's perfectly appropriate, and you should take your guilt free day off! [and now that you got it from a hard a**, you should KNOW you don't need to feel guilty!]
     
  16. smq123

    smq123 John William Waterhouse
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    :laugh: I've offered to come in the weekend after the rotation was over. That's a sign of a disorder, I think.

    You don't really get any days out of the hospital when you have a black weekend. That's standard for all medical schools that have their students take q4.

    As for how long the school expects you - after a while, it isn't up to the school, and up to your residents and your rotation. As a sub-I, I've gone 3-4 weeks without a day off.
     
  17. futuredo32

    futuredo32 Senior Member
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    Dr.Bagel, I hope you take your day off and do nothing but enjoy it!!!!! :D
     
  18. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Yikes. I think that'd be a pretty good sign that I wouldn't want to do a residency in that program.
     
  19. smq123

    smq123 John William Waterhouse
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    Actually, they were pretty good to the residents, who were literally paged out at the end of the month if they were going to go over the 80 hour/week average.

    The students, though....they really tested your motivation to go into medicine! :laugh:
     
  20. DwyaneWade

    DwyaneWade Reiging *** Cynic
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    My medical school education tells me that you suffer from gunneritis, uncontrolled type.
     
  21. 45408

    45408 aw buddy
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    It is indeed. The closest I've come to that was going to see a patient that I'd grown pretty attached to, because I followed her for an entire month. She's pretty adorable - all 4.5kg of her. :D But even then, it was convenient to stop by since I'm still in the same hospital.
     
  22. Trail Boss

    Trail Boss Senior Member
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    I had two "black weekends" during IM. It didn't even occur to me to ask for a day off.
     
  23. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Well, as you'll read above, I didn't ask for a day off. My intern asked for a day off for me after we discussed my schedule. I didn't ask her to ask him for a day off for me, either, and really had no idea that was a possibility. Believe me, I don't go around asking for extra days off. That's kind of why I feel weird about the whole situation.
     
  24. 45408

    45408 aw buddy
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    [​IMG][​IMG][​IMG] [​IMG][​IMG][​IMG] [​IMG][​IMG][​IMG]

    [​IMG]
     
  25. LadyWolverine

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    I don't get the pyramid at the bottom with the little guys shooting out of the top.
     
  26. Trail Boss

    Trail Boss Senior Member
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    If I had been offered a day off, I would have gone bowling.
     
  27. MattD

    MattD Curmudgeon
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    Honestly? I would feel damn guilty about it.

    Now I don't know you, and I'm certainly not going to bag on you or make assumptions about you or any crap like that, so please don't instantly label me a gunner. At first I was a little irked because I thought you complained to your resident about the schedule and 'scored' a free day off, but you've made it clear that you didn't bring the topic up. You know your situation and I have no room to judge it for you. However, I do think my response to the offer would have been 'thanks, but I can handle the schedule.'

    The reason? Your school is probably very aware that your schedule works out this way. The reason (as has been mentioned) is that a q4 call schedule produces one golden weekend and one black weekend per month. That's the nature of the beast. Also, most schools make the assumption that since you're in 'school', you should be there on 'school days' ie. M-F. This means that if your day off doesn't fall on a weekend, you don't get it. It sucks, but there it is. Now why would I turn down the extra day off? Because EVERY OTHER STUDENT currently on the rotation with me is going to have a weekend like that. EVERY OTHER STUDENT on that rotation before your month, and every one on that rotation after your month, will have that schedule. So I would not take a day off that every other student was not getting. It would make me personally feel like a slacker, and if one of my peers took such a day off, I would think less of them.

    Taking a day off for a legitimate reason is completely acceptable, and I would have no problem covering for a peer who needed to go to a doc appt, had a personal crisis, etc. I simply can't understand students who take off b/c they're hung over, or they're 'burned out', etc. I don't get it.

    Like I said, your situation is unique and different from mine, and I'm not passing judgment on you or criticizing you or anything, I'm just presenting my outlook on that situation.
     
  28. Tired

    Tired Fading away
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    You should feel bad, it's weak.

    Hope you're not too suprised when you get the "high pass" instead of "honors".
     
  29. Ashers

    Ashers Bacteria? Don't exist.
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    Haha. I have too. My chief told me that if he saw me on the service or in the OR he'd consider me crazy. He said that I should just go and enjoy my month with all weekends off and don't dare go on ortho call.
     
  30. bigDinLV

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    One of the best attendings told me this... When someone tells you to go, you should hit the door while the "o" sound is still hanging in the air. :laugh:
     
  31. bigDinLV

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    Yea, some people have to put in long hours to get the good grades. I prefer to just do a great job.
     
  32. MattD

    MattD Curmudgeon
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    As you may or may not have noticed yet, you can do as wonderful of a job as you'd like, but if one little incident sticks in an evaluators craw, that will be the focus of your eval.

    ie.

    Strengths: Student worked well with the team. Always relaxed.

    Weaknesses: Student displays a poor work ethic. Despite having a similar work schedule to other students in his class, the student felt the need to take an extra day off due to fatigue. etc etc etc

    This is a bad eval.


    If you're a screwup, demonstrating a willingness to stay late and plow through may give you some marginal bonus points, although not a ton. If you're a solid student but manage to become perceived as weak, whiny, or lazy, you're gonna get shredded.
     
  33. Tired

    Tired Fading away
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    There's a difference between going when you're told, and making a point to whine to your team about how you don't have any days off in a two-week period.
     
  34. bigDinLV

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    True.. I do have little tolerance for people that whine... If everyone before us survived, i'm sure we will too.
     
  35. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    I'm not really surprised that by your posts since you are who you are, but read the effing posts before making assumptions. And the senior who gave me a day off gave me a good evaluation, so whatever. I got to go to the doctor, get some prescriptions filled, catch up on other school stuff, etc. with no consequences. Well aside from a notoriously abrasive and negative poster thinking I'm weak. I'll take it.
     
  36. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    I see your point, and I actually felt that way, too. It was just that at that day in that point in my life, I couldn't say no. I probably should have, but it had been a long rotation, and randomly getting the offer for a day off was just too fantastically good to be true. Had I not gotten the offer, it would have been fine, but the thought of the day off was so nice that I had to go for it. This last rotation had been especially crappy for me, so any break from it was a good thing.
     
  37. rockit

    rockit Senior Member
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    Don't listen to the psychos. You can get a residency in almost anything without having to kill yourself and if you really truly want to do something, just take an extra year to kiss ass doing research.

    Do work when you have work to do. Stop working when there isn't work to do. When you find what you like, you will genuinely enjoy working long hours because it will be stimulating.

    And if you came in after your rotation was over...wow
     
  38. Tired

    Tired Fading away
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    You must mean the "ammumption" that you were whining.

    Of course, not really an assumption, given that you wrote:


    Oh, and since I was so polite in taking you rude personal attacks, tell us one thing.

    In all honesty, did you get a high pass or honors?
     
  39. Richie Truxillo

    Richie Truxillo Your Scut Monkey Mentor
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    I tell my medical students this. :) Seriously, when I let you go early, go go go! I'm on my second overnight call on peds in 3 days. Run run while you can! :scared:
     
  40. SoCuteMD

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    Honestly, sometimes clerkship directors DON'T realize exactly how things end up working out. After my medicine rotation - once my grade was in - I pointed out to our clerkship director that people assigned to one particular track (of 3) ended up with about 3 more calls, extra weekends, and less time to study than those on the others. THe clerkship director changed it for all the groups subsequent to mine, and chastised me for not speaking up sooner. I recognize that not all people are so open to feedback, but I thought it was a nice response.

    If the whole situation really DID happen the way you mentioned it, then I'd look at the day off as a gift and enjoy it. Tired will be the first one to tell you that med students are useless at best and an impediment to workflow in most cases, so I'm not quite sure why he's got his panties in a twist.

    Some people in medicine are miserable and feel that everyone should be similarly miserable. Some people in medicine are happy and make an effort to make sure that their colleagues are as well. As residents we are just going to have to suck it up and keep going no matter how badly we feel we need a day off, so for now if someone offers you 1 measly day off out of 365 I say enjoy it!
     
  41. MattD

    MattD Curmudgeon
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    That's a fairly sorry and unorganized scheduler then. There's really no reason for students to have uneven schedules. In addition, if the program has a q4 call schedule, as it sounds from the OP's schedule that it does, then everyone involved knows that students are going to have a black weekend if they're expected to be there any time the team is admitting.

    On a side note, going to the program director and complaining about the extra calls AFTER your grades came in (I presume you did this because of a lower grade, and wouldn't have if you'd been top of the class..?), smacks of sour grapes. Perhaps your director was nice about it but many would rightly say you should have spoken up the day of orientation and shooed you out the door. Perhaps that's what happened in your case as you mentioned nothing about grades being changed.

    I'm sorry you feel that you're an impediment. I'm not going to pretend that medical students are huge assets to the team, but it should be fairly easy for a student to figure out the ways that he/she can be helpful and it should also be easy to identify ways that you're slowing things down, and modify your behavior to emphasize the former and minimize the latter. If you're doing that, and behaving yourself on rounds, really the only way I see that a med student can be a big impediment to work flow is if a resident is relying on the student to do something he should be doing himself, and when the student occasionally screws it up as students are prone to do, the resident doesn't have his own work as back up and gets thrown off. This is a resident failure. Medical students are there to learn, and have little experience. A medical student should be RELIABLE, but should not necessarily be relied ON. But that's just my opinion.
     
  42. socmob

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    I'm going to try to save SoCute the trouble of responding to you given how you seem to have misinterpreted a lot of what she wrote. I imagine she spoke to the PD after grades were in in order to AVOID looking like she was just a bitter student trying to influence the grade. Mentioning it afterwards is clearly the better thing to do - I agree that mentioning at the very beginning is an option, but you could argue that some people will view you as a complainer if you do that. Bringing it up after you've done your hard work and it's all said and done (grade's in), is the safest way to go. Not to mention that you don't even know if this had anything to do with her grade. She could have honored the rotation, and who knows if she was even given the harder schedule; maybe she was just doing the right thing.

    Secondly, as much as I loved reading your opinion, as a med student, on med students being impediments to a service (especially the part about being reliable vs. relied on), you missed that SoCute was making a comment about how TIRED (i.e. the SDN user by that name) views med students, and how she was surprised that he was even commenting as he did given how he typically views med students.

    And to the OP - don't feel guilty about your day off! I can't believe that anyone feels you should feel guilty (or worse, should have refused it) by virtue of having a nicer team than the other med students. You lucked out, you got a nice team. That's how third year works! Some people get bastards for attendings and seniors who don't teach and interns who scut them. Some get told to go home at 5 every day, some get held past noon post-call b/c "med students don't have work hour restrictions." Do these people feel guilty whenever these situations come up? Do they refuse to go home earlier than any other med students, refuse to do less scut, refuse teaching opportunities, etc? Hell no, they don't. Totally ridiculous...take your day off and pray there's as few of these types in your class as possible. I know I am.


     
    #42 socmob, Jan 5, 2009
    Last edited: Jan 5, 2009
  43. SoCuteMD

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    Our clerkship director is wonderful and does an excellent job looking out for medical students. Our extra calls had nothing to do with being q4, and more to do with when people came on service and went off service and how that affected how many calls they took. I didn't go to my clerkship director in a "Wah, wah, wah, I had less time to study and this affected my grade" way." I phrased it as, "It's too late for me, but I think it would be great if this were looked at so that it could be changed for subsequent rotations." FWIW - I honored the rotation, thus was not asking for a grade review. I don't think she minded my speaking up too much either, seeing as my dean told me that her unsolicited LOR absolutely had to be submitted to residency programs I applied to.

    You should go back and read my post. I know from past interactions that Tired believes medical students are an impediment. I have a different take on the issue, but if you read my post carefully you'd know that my post wasn't about my perception of medical students.
     
  44. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Don't have my grade yet, but I mentioned above the the one evaluation I have for this time period was very good. If I don't get an A, it will be because of my exam grade or because of evaluations from people before I took this day off.

    Dude, and you know you get off on being rude. Why get mad about being called on it?

    As for what socute pointed out, there actually is scheduling in rotations that is unfair to some students that the clerkship director doesn't notice. We had 2 students in our last rotation who did wind up with 2 extra calls just randomly based on where their call days fell in relation to the rest of the schedule. If they had wanted to point that out, I think it would have perfectly legitimate.
     
  45. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
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    I think this is pretty common. On one rotation, I was lucky enough to have one less call day than one of my friends. Another super-lucky friend got to avoid having a black weekend, which the rest of us did have. That guy is so lucky that he ought to play the lottery. :laugh: The other thing is that different hospitals might have different requirements, so that can affect people's schedules as well. I found out for myself that where you do your rotations can definitely make a huge difference. My second month of medicine (at a different hospital) was *way* cushier than my first.
     
  46. Tired

    Tired Fading away
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    I don't get off on being rude, some folks just have problems with my opinions. Not my fault, and I'm certainly not the only person on SDN who regularly gets railed not joining the ultra-supportive love-fest. And I wasn't mad, just being the kettle telling you what color you are.

    I know. And there's nothing worse than when clerkship directors do that, because it places the student in an awful position. On the one hand, everyone wants some time off. On the other hand, the only way to get one is to go to your team and ask for one. If they would just pay an extra minute's attention to the stupid schedule it would be obvious. But no . . .

    And you can get mad for me calling that weak, but I think deep down you kind of agree with me because otherwise you wouldn't have started this thread about how you feel bad about it. I'm not saying you weren't justified in doing it. Hell, I did it myself. But it is weak.
     
  47. Holistic

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    Imagine a job that requires you to come in 80+ hours a week, have lots of responsibility, helps take care of illegal immigrants and the indigent population, all the while paying someone for the privilege of being able to perform this service while having the equivalent of a masters degree. This is called a medical student and is a complete abuse of power from our superiors, the government, and the schools. I cant understand how anyone can feel guilty taking time off to study, for there families, ect...., until this profession starts treating their students with respect and dignity by paying us for the work we do 3rd and 4th year, or having zero tuition, since the federal government should already foot the bill for us since students are an integral part of indigent and illegal alien healthcare.

    Do you all realize that law students make 15-25 grand in the summer's between years, and grad students get payed a salary to work as TA's and in labs as assistants, but students in medical school work there butts off third year to get yelled at by residents and attendings for not doing things right when they have never done them before, stuck doing residents work they dont want to do, that they are getting paid for, albeit not much but we are paying the school to LEARN not do resident scut work, and to all of you out there who are going to respond DONT COMPLAIN ABOUT SOMETHING YOU CANT CHANGE, THIS IS MEDICINE AND IT IS JUST THE WAY IT IS, ITS ALWAYS BEEN THIS WAY, YOU SHOULD BE THANKFUL FOR THIS PRIVELEGE TO TAKE CARE OF PATIENTS, this is the kind of talk that keeps perpetuating these wrongs.

    The current training model is based on 25 year old white male students, with no families, very little debt, because tution in the 50's and 60's was basically free, traing on the wards. Today, we have non traditional students with families, 50% females who would like to have children someday, and god forbid they get pregnant, with debt loads exceeding 150,000 dollars. What makes the medical profession so resitant to change something that may have worked in the past for these debt and family free young white males, but seems a bit archaic for the current face of the medical student body. Medical Students should work to change this system in the future, dont give into this mindless "thats just the ways it is, because thats how its always been" change only comes about by people with the courage to stand up and fight the good fight against established dogma.
     
  48. beavis

    beavis Fire is cool
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    I am relieved that you don't go to my school...Matty D. I get tired just reading your posts...I can't imagine working with you.
     
  49. cajunchrisbu

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    i would just like to add (as a lowly senior pre-med about to start my first year in med school) that I think its great that Tired is an ass sometimes.... Seriously its F'ing halarious

    haha anyways suck it up if someone calls you weak, everyone gets there at some point in their life.

    :laugh:
     
  50. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    Just an update -- I got an A on the rotation with no ugly comments in my evals either!
     

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