The Official Anti-Clinical Medicine Thread

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beary said:
Brigham is another one of my top choices! I think my list of interest is much influenced by SDN. :laugh: Maybe we should start a thread of schools we are interested in. Hmm, here's my tentative list:

Iowa (of course)
Michigan
BWH
MGH
Wash U
UTSW
Northwestern
U Chicago
Minnesota

Schools I am interested in but not as sure I will apply:
Cornell
Dartmouth
Mayo
Colorado
U Washington
UCSF
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well, when ERAS application time comes rolling around, be liberal when you select where you will apply. it costs relatively little to apply to a lot of places. when it comes down to finalizing your list of places you will actually go interview at, that's when you should be picky.
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AndyMilonakis said:
umm....boston ain't in the midwest either :laugh:
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Really??!! You can't be serious! :rolleyes:

All I meant is if program A in Boston/Seattle/etc. = program B in the midwest, I will go with program B. But if program A is a better fit for me, than that is where I will go. I spent a summer in Boston and really like it. Have heard good things about Seattle. Have been to Baltimore and LA and can't see living there.
 
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bananaface said:
What do you like in a city?
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Safety is the biggest one for me. I don't want to have to worry about getting mugged or my car broken into.
Generally not too big. Clean. Can drive around. Reasonable cost of living. Close to some outdoor activities. I would like it to have seasons and not just be a similar climate all the time. Not too hot (a problem with UTSW). Big thunderstorms are a bonus (sounds silly, but that actually was one of the biggest things I missed when I spent the summer in Boston!)

So I guess I'm pretty picky. :laugh: Though probably lots of people are looking for these same things. Unfortunately no place is perfect!

Do you like Seattle?
 
yaah said:
Yeah I think confidence comes with experience. Once you start figuring out just what the heck you are supposed to do during the day a lot of the other stuff starts to fall into place. It's all about confidence. If you give a solid answer, even if it's wrong, it sounds better than giving the right answer but prefacing it with "well, I think," or "I'm not sure but..."

This is what I am working on currently. I say too much phrases like, "Possibly" or "Could represent." I don't like that. That's radiology for Pete's sakes!
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hey..there's nothing wrong with that.
 
beary said:
Safety is the biggest one for me. I don't want to have to worry about getting mugged or my car broken into.
Generally not too big. Clean. Can drive around. Reasonable cost of living. Close to some outdoor activities. I would like it to have seasons and not just be a similar climate all the time. Not too hot (a problem with UTSW). Big thunderstorms are a bonus (sounds silly, but that actually was one of the biggest things I missed when I spent the summer in Boston!)

So I guess I'm pretty picky. :laugh: Though probably lots of people are looking for these same things. Unfortunately no place is perfect!

Do you like Seattle?
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All of that stuff varies based on what part of the metro you live in. You won't get mugged anywhere in Seattle as far as I know. Like any big city there are places you don't want to go out at night because there are bums hanging out, etc. And traffic downtown generally bites. It is really better to just take the bus if you can. If I had a choice, I'd live in Bellevue, which is just across the 520 bridge from Seattle. That would eliminate all concerns but freeway traffic. I so need to move to Bellevue.

We have all 4 seasons here. It's not that hot in the summer and not that cold in the winter. Winter is often overcast and gloomy though. There are TONS of outdoor activities here.
 
All this clinical bitterness. One year ago today I was in my last clinical rotation - neurology - where I was instantly paired up with a very attractive senior resident that at least made the rotation palatable. The first patient I had was a "global amnesia" patient who completely forgot everything as soon as I had left the room and made me look like an dingus when I went back with the attending.
 
The pediatric physical exam serves absolutely no purpose. The kids are just squirming around and crying and you just go through the motions of listening to their heart and lungs, etc. You can't actually hear or see anything. We could save so much time if we just did away with it all together. I think we should only do exams relevant to a specific complaint. Like if the kid comes in with a cough, then sure, make a futile attempt to listen to the lungs. If the kid hasn't pooped in a week, listen for bowel sounds. Otherwise, we shouldn't even bother.

I wonder how often a physical exam turns up an important problem in a healthy-appearing child. I bet not very often.
 
Generally if the kid is squirming enough they are ok and the PE will be normal. Pain in the ass though is that you can't always assume that.

You have to listen to the lungs in between the screams. ;) :rolleyes:
 
beary said:
The pediatric physical exam serves absolutely no purpose. The kids are just squirming around and crying and you just go through the motions of listening to their heart and lungs, etc. You can't actually hear or see anything. We could save so much time if we just did away with it all together. I think we should only do exams relevant to a specific complaint. Like if the kid comes in with a cough, then sure, make a futile attempt to listen to the lungs. If the kid hasn't pooped in a week, listen for bowel sounds. Otherwise, we shouldn't even bother.

I wonder how often a physical exam turns up an important problem in a healthy-appearing child. I bet not very often.
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OMG! The force is strong in beary!

It took me half a year to realize this! And it only took you 2 weeks for you to realize this. Amazing!
 
:laugh: :laugh: :laugh: Ahh the memories...

I would attack the chest exam while they were still too surprised to scream. And hopefully get in a quick feel of the tummy. (I started the year with Peds Teams never having examined a kid, and nobody had ever taught me any other method. I didn't even know how to lift a 3-weeker at that point.) And then after the kid decided they didn't like that and started yelling I would examine the oropharynx etc.

Once they scrunch up their faces you can forget about checking their eyes... If they're waving arms and legs and attempting to kick you in the stomach (or face as the case may be) then you can certainly write "moves limbs equally x4" or some such nonsense.

The hardest thing about Peds was going from examining a 2-month-old to a 2-year-old. And you can hear breath sounds in the belly and heart sounds everywhere.

When all else fails, remember - "Sick or not sick?"
 
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bananaface said:
You all need a "getting through rotations for patholgists" tips thread. :laugh:
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heh. that's easy. i'll sum it up.

1. Get to hospital on time.
2. Get work done.
3. Don't kiss ass.
4. Leave early if you can do so.
5. None of this asking, "Is there anything else I can do for you?" No. F*ck that. In line with #3 and #4...just GTFO and go home.
6. P=MD. You can work hard for a P. Or you can do the bare minimum for a P. Just learn your **** and GTFO and go home.
7. Buy a cheap stethoscope. Cuz you only need it for a year.
8. Hold back the chuckles and laughter when you're on weekend rounds and the attending says, "the pathologists won't be looking at that until monday."
9. Establish early on with the attendings that you are indeed going into pathology.
10. Why do all lists have to have 10 items? I'm done.
 
AndyMilonakis said:
4. Leave early if you can do so.
5. None of this asking, "Is there anything else I can do for you?" No. F*ck that. In line with #3 and #4...just GTFO and go home.
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I certainly have this part down. I am supposed to be in peds neuro clinic all day. Am I still there? No. All morning I just sat around and the resident and staff were totally ignoring me and making me feel like I was totally in the way. I saw one patient for about 30 seconds all morning. The resident and staff were totally going out seeing patients all by themselves and ignoring me. So I just flat out got up and left.

Now I am afraid I will get in trouble but I don't really care. They probably won't even notice anyway. I will go back tomorrow morning and see if things are better. I have better stuff to do than just sit there being ignored all day.
 
beary said:
I certainly have this part down. I am supposed to be in peds neuro clinic all day. Am I still there? No. All morning I just sat around and the resident and staff were totally ignoring me and making me feel like I was totally in the way. I saw one patient for about 30 seconds all morning. The resident and staff were totally going out seeing patients all by themselves and ignoring me. So I just flat out got up and left.

Now I am afraid I will get in trouble but I don't really care. They probably won't even notice anyway. I will go back tomorrow morning and see if things are better. I have better stuff to do than just sit there being ignored all day.
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Ahhh do you see the genius of their devilry?

Today they ll ignore you and when you leave coz you are being ignored....

Tommorow they ll say ... "Hey how come i dint see you yesterday?"

If you respond by saying "I was here, but i wasnt getting anything to do...."

They ll come back saying "No YOU should find something useful to do".....even if that means sitting down doing nothing!!!

The devilry!!!!!......I really really hate such devilry!!!!

Ok so these are memories from a flashback a long time ago...but im sure the concept holds valid worldwide

"IN CLINICAL MEDICINE IT IS OK TO WASTE TIME EVEN IF IT MEANS YOU DO NOTHING, BUT YOU ARE SUPPOSED TO STAY!"

Beats me!

Im still ranting though the day has been good so far.....
 
ditto quant.

beary, when they ignore you, you're supposed to be all proactive and **** and ask them if you can see patients with them and yada yada yada.

but we all know it's a load of crap. you did the right thing by leaving.

P=MD

thank you.
 
bananaface said:
If you leave though how are they going to give you a P? Hmmmm?
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I don't think that they will notice or care. I looked at the schedule and apparently a med student is only assigned to this clinic once in a blue moon (lucky me :rolleyes: ) so I think they probably have no idea what to expect. When I disappeared around lunchtime, I bet (hope!) that they just figured that I had a different clinic in the afternoon. That's assuming that their dumb little med student even entered into their minds.

I had a very productive afternoon by taking a four hour nap! :cool:
 
bananaface said:
If you leave though how are they going to give you a P? Hmmmm?
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It takes very little to get a Pass. You have to really screw up (i.e., fondle or curse at patients or set the clinic on fire) to fail. You can potentially fail if you have a real dick for an attending. But in most cases, you can get a Pass with doing the bare minimum (showing up and smiling).

On the flip side, you can work your ass off and also still get a Pass. Clinical clerkship grading is such a crock of ****, it's maddening.
 
I haven't thrown confidential things into bins for years! Actually, the last time I did that I was in high school and working for my school district's payroll department. My boss would leave the office and tell everyone she was going to show me where something was. Then we'd go downstairs and throw crap away for like an hour at a time. She was just really glad to get out of the office because all of my co-workers were catty middle aged women who drive her up the wall. I was sworn to secrecy and told that if anyone asked, we had had a hard time finding the paperwork we were looking for in storage.
 
today i was asked, "what will you miss about medical school?"

my response, "nothing."
 
AndyMilonakis said:
today i was asked, "what will you miss about medical school?"

my response, "nothing."
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I will have a hard time resisting the antisocial urge to stand on the table at grad dinner and yell "SUCKS TO BE YOU!"
 
deschutes said:
I will have a hard time resisting the antisocial urge to stand on the table at grad dinner and yell "SUCKS TO BE YOU!"
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kinda like graduation where i will snatch the diploma from the Dean's hand, proceed to walk off the stage but at the last moment, run straight for the microphone on the podium and scream, "you accepted ME to med school? you *******es!"
 
AndyMilonakis said:
kinda like graduation where i will snatch the diploma from the Dean's hand, proceed to walk off the stage but at the last moment, run straight for the microphone on the podium and scream, "you accepted ME to med school? you *******es!"
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I know where I'm going to be going with my diploma - straight to a fax machine so my residency coordinator will finally have a copy.
 
AndyMilonakis said:
kinda like graduation where i will snatch the diploma from the Dean's hand, proceed to walk off the stage but at the last moment, run straight for the microphone on the podium and scream, "you accepted ME to med school? you *******es!"
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For this I will pay you $101. (But, Canadian.)
 
Tomorrow, as a required part of my pediatrics rotation, I have to go to a local elementary school and read to the kids and play with them at recess. I know I shouldn't be complaining because all things considered this is a pleasant way to spend an afternoon of the hell otherwise known as med school, but why in the world is this part of a pediatrics rotation? I know how to read already. :rolleyes:

I'm gonna take on the 1st graders in tetherball. Or maybe dodgeball. ;)
 
beary said:
Tomorrow, as a required part of my pediatrics rotation, I have to go to a local elementary school and read to the kids and play with them at recess. I know I shouldn't be complaining because all things considered this is a pleasant way to spend an afternoon of the hell otherwise known as med school, but why in the world is this part of a pediatrics rotation? I know how to read already. :rolleyes:

I'm gonna take on the 1st graders in tetherball. Or maybe dodgeball. ;)
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I think it is silly also. It's classic behavior for med schools now, instead of teaching you things you need to know they send you to play with someone as if it is going to help you be more "human."
 
yaah said:
I think it is silly also. It's classic behavior for med schools now, instead of teaching you things you need to know they send you to play with someone as if it is going to help you be more "human."
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these activities should be optional for those with an already expressed interest in something non-human...such as pathology and radiology :rolleyes:
 
beary said:
Tomorrow, as a required part of my pediatrics rotation, I have to go to a local elementary school and read to the kids and play with them at recess. I know I shouldn't be complaining because all things considered this is a pleasant way to spend an afternoon of the hell otherwise known as med school, but why in the world is this part of a pediatrics rotation? I know how to read already. :rolleyes:

I'm gonna take on the 1st graders in tetherball. Or maybe dodgeball. ;)
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Tetherball rocks. I miss those times. Anyway, I too, am currently on Peds, and all I can say is that it is a horrible way to end the third year. All new pathology, new physiology, and new treatments. I wish I was doing another adult medicine service so that I could coast the rest of this year without having to learn anything new(or talk to parents). This is like a regression to last July before we started clinicals. Dammit.
 
Wow, at least you are seeing diseases. I spent most of my pediatrics rotation learning about the differential diagnosis of the fussy baby.
 
yaah said:
Wow, at least you are seeing diseases. I spent most of my pediatrics rotation learning about the differential diagnosis of the fussy baby.
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Actually, the impresion I am under is that we will be doing sepsis work ups on a lot of kids, intermingled with cow/soy milk protein intolerance as cause of food avoidance, sprinkled in with a little viral GE. I do have call Q4, for 4 weeks, which blows ass. At least RSV season is over.
Here's hoping to the pain being over soon. :luck:
 
bananaface said:
Dodgeball will only get you more work for tomorrow. :p
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Yeah, that's a good point. :laugh: Lucky for me there were no dodgeball opportunities.

I got to come home at 3. :cool:
 
UCSFbound said:
Actually, the impresion I am under is that we will be doing sepsis work ups on a lot of kids, intermingled with cow/soy milk protein intolerance as cause of food avoidance, sprinkled in with a little viral GE. I do have call Q4, for 4 weeks, which blows ass. At least RSV season is over.
Here's hoping to the pain being over soon. :luck:
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This is like getting a super sized Big Mac extra value meal.

beary said:
I got to come home at 3.
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This is like getting a Happy Meal.

I prefer the Happy Meal.
 
May this help you fuddle your way through clnical medicine if you are not already befuddled.

bbmuffin said:
ok.... here is chemo boy...
he looks a lot better when i can draw him in person....

and no this is not an all inclusive list.. just what our chemo person gave us to help us remember some common SE

chemoboy.bmp



Ok since he's so small I type it all out here too...
ears are Cs because Cisplatin and Carboplatin cause Ototoxicity
mouth is M because Methotrexate causes Mucocytis
The heart is two Ds Doxyrubicin and Donarubicin cause cardiotoxicity
the hands and feet are Vs because Vincristine and Vinblastine cause periperhal neurotoxicity
The lungs are two Bs because Busulfan and Bleomycin cause pulmonary toxicity
The Bladder is a C and I because Cyclophosphamide and Ifosphamide cause bladder tox
The kidneys are two Cs because Cisplatin and Carboplatin cause nephrotoxicity

if you need me to clarify any of it let me know

And yes i know all the drug names are misspelled
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I just think it's cute.
 
bananaface said:
I just think it's cute.
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That actually is a very useful little diagram! I just got done with peds oncology and that would have been very useful for me with my attending who loved to pimp on chemo side effects. But I don't need to know it anymore, haha. :cool:

I start surg path on Monday, woohoo!
 
beary said:
That actually is a very useful little diagram! I just got done with peds oncology and that would have been very useful for me with my attending who loved to pimp on chemo side effects. But I don't need to know it anymore, haha. :cool:

I start surg path on Monday, woohoo!
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Yay!!!!!! :)
 
So we had this GME orientation today which on my part consisted mostly of sitting and having bad medschool flashbacks. (Havarti666's graph comes to mind.) All of the information was "vitally-important" of course - nothing that you or I hadn't known before.

My favourite moment was when one Path R1 was asked to roleplay a "cultural competency" scenario and the medical interpreter (practically evangelist) asked if he "had ever used an interpreter?"
"Yes, a few times."

Always remember:-

No sex with patients.
Use an interpreter.
Most car crashes happen at 8am post-call and we will continue to study it (but really there's not much we can do about it).
Medical error kills 98,000 people a year and we SHOULD do something about this.

My personal solution: do pathology. :thumbup: :thumbup:
 
deschutes said:
My favourite moment was when one Path R1 was asked to roleplay a "cultural competency" scenario and the medical interpreter (practically evangelist) asked if he "had ever used an interpreter?"
"Yes, a few times."
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Oh geez. I cannot believe you still have to deal with that crap as an R1. I certainly hope it was brief and you will never have to suffer through another thing again.

I thought going into path would get me out of all this doo doo!!
 
beary said:
I thought going into path would get me out of all this doo doo!!
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It does. Eventually. Today only made me manyfold more grateful for having chosen path. I certainly don't see any more of these clinical clapcraptraps in the near future.

There's Step 3, but I refuse to think about it right now. Not while I am on route to stabbing hapless people in the back next week.

I finally have a mommy, so I am going home to spend time with her before she disappears later this week!
 
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