UTSW put on blast

[Lawpy]

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The idea of volunteering is that you do something for someone else’s benefit, not your own. The goals here are primarily to ensure continuity patient care and relieve strain on caregivers who’ve been drowning in covid and overworked the whole pandemic. There are some potential benefits to the med student, but ultimately it’s about most efficiently getting **** done that needs to be done for patients.

I spent a year and a half running hospital epidemiology and infection control at my facility. We had surgery nurses pulld to cover hospital floors and the ER and the nursing home, because we were short because staff were out sick or quarantined or caring for a loved one who was sick.
We had business office staff and admins out with mops and wipes cleaning and disinfecting. We had registration staff and maintenance staff acting as specimen couriers driving samples to the state lab, I had IT and admins fetching supplies. We had all kinds people doing all kinds of things to get he job done and plenty of people volunteering to do whatever was needed because that’s what it takes in a crisis. We took all comers.

When you’re in a crisis you need people to jump in and do whatever is needed that’s in their capacity to do. Most of this is a manpower issue. There might not be value to you as a med student picking up trays, transporting patients, or relieving exhausted nurses or CNAs who are at their breaking points dealing with this, and freeing up other staff to focus on higher yield tasks that require their training, but those ARE things that need to happen for good patient care to be provided, so they are in fact very valuable tasks.

i’d argue that a few people could benefit seeing what this beatdown has been like firsthand. just because you aren’t advancing your clinical skills doesn’t mean it can’t be valuable and informative to you also.

But if you don’t want the unpaid volunteering, nobody is holding a gun to your head making you do it.

There are right and wrong ways to get med students to volunteer and help out, and UTSW imo messed it up. Schools should follow the NYU model (of repurposing med students for clinical duties like graduating MS4s early) or reduce med school debt AND ease absurdly strict liability restrictions to get med students to act in clinical capacity early on. Turning med students into CNAs for free is flat out an idiotic approach. Those responsibilities should be a supplement not a primary focus. Med students can transport patients and deliver supplies ON TOP of the clinical duties they do

 

[wholeheartedly]

There are right and wrong ways to get med students to volunteer and help out, and UTSW imo messed it up. Schools should follow the NYU model (of repurposing med students for clinical duties like graduating MS4s early) or reduce med school debt AND absurdly strict liability restrictions to get med students to act in clinical capacity early on. Turning med students into CNAs for free is flat out an idiotic approach

only because you’re looking at this from the standpoint of what‘s in it for you. this is ultimately out patient care.

it’s unpaid and they called it volunteering. nobody has to do it, but some might for the greater good. that’s the definition of volunteering.

now i wouldn’t be opposed to them paying or something, but no ones being misled here and anyone has free will not to do this.

 

[Lawpy]

only because you’re looking at this from the standpoint of what‘s in it for you. this is ultimately out patient care.

it’s unpaid and they called it volunteering. nobody has to do it, but some might for the greater good. that’s the definition of volunteering.

now i wouldn’t be opposed to them paying or something, but no ones being misled here and anyone has free will not to do this.

Even in the context of patient care, assigning clinical duties to med students is necessary because the hospital is severely short staffed. This means the liability restrictions must be severely reduced.

 

[0ncogene]

I keep reading this and i can't

"We are launching a new program with UT using volunteer Med Students as staff supporters. The Med Students will work in a supportive fashion assisting the PCA’s & nursing staff with general tasks associated with the Unlicensed Clinical Staff role such as assisting with vital signs, transport, picking up trays, and other non-professional tasks identified by the Charge RN. They can even help cover call lights during staff meal breaks to improve the odds of core staff getting a full 30 minutes uninterrupted."

UTSW was clearly looking for MS1s/MS2s to act like CNAs and premed volunteers

This infuriates me. I absolutely hate it when medical students or junior residents are taken advantage of.

 

[0ncogene]

only because you’re looking at this from the standpoint of what‘s in it for you. this is ultimately out patient care.

it’s unpaid and they called it volunteering. nobody has to do it, but some might for the greater good. that’s the definition of volunteering.

now i wouldn’t be opposed to them paying or something, but no ones being misled here and anyone has free will not to do this.

In that case, they should be asking everyone to volunteer for this role including the admins, nurses, PAs/NPs, physicians, and even the janitor. Everyone can be trained to do simple tasks on the floor to help patients. Med students do not have more free time than any of these people. They are just an easier target.

 

[Redpancreas]

In that case, they should be asking everyone to volunteer for this role including the admins, nurses, PAs/NPs, physicians, and even the janitor. Everyone can be trained to do simple tasks on the floor to help patients. Med students do not have more free time than any of these people. They are just an easier target.

Hate to say it, but 100% agree with this. I just don’t see PAs/NPs, administrators, etc. volunteering for this.

I do still maintain a shift or two wouldn’t kill a student and it would be interesting to see how the nursing-NA hierarchy is and see what goes on. Sometimes I see the labs I order when I’m admitting a patient and then go to the bedside for something else and seeing how much grief I’m giving the nurses puts things in perspective. Like do we really need to be drawing this amount of blood from the patient just for this lab? Also, when the labs aren’t drawn, it’s not that the “lazy nurse” didn’t draw them unless they have a mid/PICC line. I say that because that’s what I thought before residency. It’s that the phlebotomist was paged and they’re not coming for whatever reason. One thing I wished they’d required for all residents to master is phlebotomy and ultrasound guided IVs training. It would empower us to do a whole lot more for our patients and ensure the labs we wanted got drawn. That said, careful what you wish for because I hear that’s the case in NYC and it’s not a happy situation.

 

[Ganon]

It's not *just* volunteering. Those students are PAYING into the system for the opportunity to pick up trays and stuff

 

[VA Hopeful Dr]

It's not *just* volunteering. Those students are PAYING into the system for the opportunity to pick up trays and stuff

Except its voluntary. That's the only part of this that matters. If they aren't forcing you to do it, who cares?

 

[Med Ed]

Peak SDN. 10/10. Would read again.

 

[Lawpy]

 

[Billiam95]

The idea of volunteering is that you do something for someone else’s benefit, not your own. The goals here are primarily to ensure continuity patient care and relieve strain on caregivers who’ve been drowning in covid and overworked the whole pandemic. There are some potential benefits to the med student, but ultimately it’s about most efficiently getting **** done that needs to be done for patients.

I spent a year and a half running hospital epidemiology and infection control at my facility. We had surgery nurses pulld to cover hospital floors and the ER and the nursing home, because we were short because staff were out sick or quarantined or caring for a loved one who was sick.
We had business office staff and admins out with mops and wipes cleaning and disinfecting. We had registration staff and maintenance staff acting as specimen couriers driving samples to the state lab, I had IT and admins fetching supplies. We had all kinds people doing all kinds of things to get he job done and plenty of people volunteering to do whatever was needed because that’s what it takes in a crisis. We took all comers.

When you’re in a crisis you need people to jump in and do whatever is needed that’s in their capacity to do. Most of this is a manpower issue. There might not be value to you as a med student picking up trays, transporting patients, or relieving exhausted nurses or CNAs who are at their breaking points dealing with this, and freeing up other staff to focus on higher yield tasks that require their training, but those ARE things that need to happen for good patient care to be provided, so they are in fact very valuable tasks.

i’d argue that a few people could benefit seeing what this beatdown has been like firsthand. just because you aren’t advancing your clinical skills doesn’t mean it can’t be valuable and informative to you also.

But if you don’t want the unpaid volunteering, nobody is holding a gun to your head making you do it.

Dollars to donuts, UTSW is most likely short staffed due to poor pay and poor working conditions for CNAs and RNs - instead of addressing the root problems (increasing pay, rewarding retention, decreasing nursing ratios), admin is trying to paper over the issues with free labor from brown-nosing medical students.

 

[Ganon]

Except its voluntary. That's the only part of this that matters. If they aren't forcing you to do it, who cares?

Because of the power dynamic at play.

In a situation where the medical system has all the power, the student has a pressure that changes the consent/voluntaryism.


If a typical attending doctor asks another typical attending doctor out on a date, no big deal.
If the chief of surgery asks a surgery resident out on a date with the implication that it could effect their career if they refuse… that’s a big deal.

Similarly here we have something billed as a “great experience” being offered to med students. Imagine admin looking at the CV and saying, “Heck, why did this person turn down that great experience?!”

 

[VA Hopeful Dr]

Because of the power dynamic at play.

In a situation where the medical system has all the power, the student has a pressure that changes the consent/voluntaryism.


If a typical attending doctor asks another typical attending doctor out on a date, no big deal.
If the chief of surgery asks a surgery resident out on a date with the implication that it could effect their career if they refuse… that’s a big deal.

Similarly here we have something billed as a “great experience” being offered to med students. Imagine admin looking at the CV and saying, “Heck, why did this person turn down that great experience?!”

Are medical students already doing lots of volunteering during med school?

If yes, this is just one more opportunity take it or leave it.

If not, then why would not doing this matter at all.

 

[Stagg737]

Because of the power dynamic at play.

In a situation where the medical system has all the power, the student has a pressure that changes the consent/voluntaryism.


If a typical attending doctor asks another typical attending doctor out on a date, no big deal.
If the chief of surgery asks a surgery resident out on a date with the implication that it could effect their career if they refuse… that’s a big deal.

Similarly here we have something billed as a “great experience” being offered to med students. Imagine admin looking at the CV and saying, “Heck, why did this person turn down that great experience?!”

This is an unrepresentative fallacy. There's a huge difference in an attending approaching a single resident and pressuring them to do something specifically for their and an entire administration sending out a mass e-mail asking for volunteers which may or may not be a net financial/administrative benefit to the hospital. Serious question, do you really think that the admin is going to approach specific students or classes and pressure them or that anyone is going to look at a CV and be concerned that this random volunteer activity is missing?

I get the concern about power dynamics, but this would be an incredibly bizarre example of it and seems completely irrelevant. These students aren't being abused or oppressed by the system, and frankly the false outrage or unnecessary outrage seems childish. If the students were voluntold or if UTSW students come forward about being singled out, then that's a totally different case. But they weren't. This just seems to be another argument that's much ado about nothing, and it seems like all this indignation would be better targeted elsewhere.

 

[Lawpy]

If the students were voluntold or if UTSW students come forward about being singled out, it's a different case.

The above reddit posts seem to suggest that way, otherwise they wouldn't be so cheering to quickly cancel that opportunity

 

[Splenda88]

This is an unrepresentative fallacy. There's a huge difference in an attending approaching a single resident and pressuring them to do something specifically for their and an entire administration sending out a mass e-mail asking for volunteers which may or may not be a net financial/administrative benefit to the hospital. Serious question, do you really think that the admin is going to approach specific students or classes and pressure them or that anyone is going to look at a CV and be concerned that this random volunteer activity is missing?

I get the concern about power dynamics, but this would be an incredibly bizarre example of it and seems completely irrelevant. If the students were voluntold or if UTSW students come forward about being singled out, it's a different case. But this just seems to be another argument that's much ado about nothing.

The problem is words got around in medical school at the speed of light. It's worse than middle school or high school. Some people will be seen as good team players" among some faculties and others won't.

I was very close with my Neuroanatomy professor in med school; that individual knew most of the 'gossipy' things that happened in my class before I did, and was not shy about letting me know other faculty members know these things.

I dont know how it is everywhere, but many of friends who attended med school in the US said their institutions were similar to mine in term of gossip and BS etc...

 

[Goro]

Because of the power dynamic at play.

In a situation where the medical system has all the power, the student has a pressure that changes the consent/voluntaryism.


If a typical attending doctor asks another typical attending doctor out on a date, no big deal.
If the chief of surgery asks a surgery resident out on a date with the implication that it could effect their career if they refuse… that’s a big deal.

Similarly here we have something billed as a “great experience” being offered to med students. Imagine admin looking at the CV and saying, “Heck, why did this person turn down that great experience?!”

Straw man - Wikipedia

en.wikipedia.org

 

[Redpancreas]

The problem is words got around in medical school at the speed of light. It's worse than middle school or high school. Some people will be seen as good team players" among some faculties and others won't.

I was very close with my Neuroanatomy professor in med school; that individual knew most of the 'gossipy' things that happened in my class before I did, and was not shy about letting me know other faculty members know these things.

I dont know how it is everywhere, but many of friends who attended med school in the US said their institutions were similar to mine in term of gossip and BS etc...

It's not like that. There's like usually 100+ students who hardly know each other these days especially in light of COVID. We don't know our professors in M1/2 and many are PhDs and don't serve as longitudinal mentors to us. No neuroanatomy professor is going to even know the name of any student in their class let alone know if they are volunteering on the side for something compared to another student. Think Professor Binns from Harry Potter. It's basically like that.

 

[wholeheartedly]

Dollars to donuts, UTSW is most likely short staffed due to poor pay and poor working conditions for CNAs and RNs - instead of addressing the root problems (increasing pay, rewarding retention, decreasing nursing ratios), admin is trying to paper over the issues with free labor from brown-nosing medical students.

I’ve worked in healthcare a long time. I’m very familiar with all of the toxic problems in healthcare and idiot admins. I left an awesome good paying job, with great benefits, that I enjoyed and was very intellectually challenging because I refused to compromise my integrity for some bean counter to meet their bottom line and got retaliated against because of it.. That cost me everything I’d spend over a decade working toward. Trust me, I get how completely corrupt the system is.

However, these massive systemic problems aren’t going to be fixed in weeks and patients need care today. This is voluntary to help during a global crisis. Some of us believe patients shouldn’t have to suffer because of the system is messed up. That would be the reason I would consider volunteering in this situation despite the other stuff.

Yes, doing this helps corrupt admin, but it also takes a load off the CNAs and nurses being screwed and helps patients.

If it was mandatory, I would have a whole different set of feelings about the situation.

And no I wouldn’t do this voluntarily if there wasn’t a global crisis.

And yes we should absolutely fix all of those things as soon as possible.

 

[Lawpy]

I’ve worked in healthcare a long time. I’m very familiar with all of the toxic problems in healthcare and idiot admins. I left an awesome good paying job, with great benefits, that I enjoyed and was very intellectually challenging because I refused to compromise my integrity for some bean counter to meet their bottom line and got retaliated against because of it.. That cost me everything I’d spend over a decade working toward. Trust me, I get how completely corrupt the system is.

However, these massive systemic problems aren’t going to be fixed in weeks and patients need care today. This is voluntary to help during a global crisis. Some of us believe patients shouldn’t have to suffer because of the system is messed up. That would be the reason I would consider volunteering in this situation despite the other stuff.

Yes, doing this helps corrupt admin, but it also takes a load of the CNAs and nurses being screwed and helps patients.

If it was mandatory, I would have a whole different set of feelings about the situation.

And yes we should absolutely fix all of those things as soon as possible.

Again, if patients need care today, 2 immediate things need to be done

1. Give med students clinical responsibilities.

2. Mass send this volunteer opportunity TO EVERYONE affiliated with the hospital system, med school and other health professional schools and not just to MS1s/MS2s.

 

[TelemarketingEnigma]

while I do think this was a dumb "opportunity" and this should ideally be a paid job, as a 4th year currently slaving over ERAS I have to say for the people freaking out about coercion that with all the other much more impressive volunteering most med students I know are doing, this kind of thing would barely be a blip on most resumes. Granted I do have a particularly volunteer heavy resume, but I wouldn't have even listed this on ERAS probably. There's plenty of other ways to brown-nose with admin and this is not an important one worth freaking out about in that sense.

 

[Med Ed]

ICU nurse says Upstate hospital facing nurse shortage, staff is 'drowning'
Florida hospitals, overwhelmed with COVID, describe nursing shortage, financial hits
Maryland Faces One Of Its Worst Nursing Shortages In History, Health Officials Say
Virginia nurses warn pandemic-related burnout could worsen the nursing shortage
Connecticut Grapples With Nursing Shortage
North Texas Hospitals Cope With Ongoing Nursing Shortages While Fighting COVID-19
Nevada hospitals wrestle with nursing shortage
Nursing shortage impacting Lowcountry hospitals
'They're really tired:' 2nd wave of COVID causes nursing shortage at Triangle hospitals
Nurse shortages in California reaching crisis point
Iowa hospitals, nursing homes report widespread nursing shortage

 

[RangerBob]

ICU nurse says Upstate hospital facing nurse shortage, staff is 'drowning'
Florida hospitals, overwhelmed with COVID, describe nursing shortage, financial hits
Maryland Faces One Of Its Worst Nursing Shortages In History, Health Officials Say
Virginia nurses warn pandemic-related burnout could worsen the nursing shortage
Connecticut Grapples With Nursing Shortage
North Texas Hospitals Cope With Ongoing Nursing Shortages While Fighting COVID-19
Nevada hospitals wrestle with nursing shortage
Nursing shortage impacting Lowcountry hospitals
'They're really tired:' 2nd wave of COVID causes nursing shortage at Triangle hospitals
Nurse shortages in California reaching crisis point
Iowa hospitals, nursing homes report widespread nursing shortage

As all theses articles allude to, we’re in unprecedented territory. Italy was rushing med students into action during their surge. Retired RNs and MDs were asked to come back to work. Everyone essentially got promoted to the “next level,@ with the exception of ICU docs—their “promotion” was to care for even more patients/oversee hospitalists trying to do the job of intensifiers.

There’s a shortage everywhere and it’s all hands on deck—I can’t blame a med school administration for asking a bunch of professional and capable future physicians who might actually want clinical experience, to have the opportunity to pitch in. Let’s be honest—med students aren’t very helpful to the healthcare system until they actually become residents/attendings. The proposal is meant to help overburdened RNs who are going over their ratios delegate some work to people who can presumably be trusted and relied on, and would benefit from the experience as well.

 

[Ganon]

Straw man - Wikipedia

en.wikipedia.org

An example demonstrating why consent in a power differential is not the same is not a straw man argument. Low-effort response to a learned, informed opinion.

Serious question, do you really think that the admin is going to approach specific students or classes and pressure them or that anyone is going to look at a CV and be concerned that this random volunteer activity is missing?

It depends on how the class reacts and how many take up the opportunity. Standing out in a negative way can hugely kneecap medical students, even if that negative way is simply *not* doing an extra activity. I have examples of this in practice, but they are too specific and would be identifying. Maybe you just aren't familiar with how cutthroat med schools are right now?

Again, this wasn't a volunteer experience offered to everyone regardless of background, it was pointed directly at a specific demographic that is more likely to feel like they *have* to help.

If it makes anybody feel any better about my opinions here, I spearheaded one of these campaigns to get staff back into the hospitals to combat the shortage of RNs for a major hospital system. When I did that, I specifically *DID NOT* reach out to the medical school to try to browbeat students into helping because I understood the power dynamics at play.

Sorry, y'all, I'm not backing down on this one.

 

[GoSpursGo]

Maybe you just aren't familiar with how cutthroat med schools are right now?

I think more than anything, it's this lazy-ass argument that is ticking me off about this thread. The person you replied to is a RESIDENT, meaning they just graduated in the last couple of years. I graduated in the last 10 years. I feel like several people have given very reasonable explanations for why this might not be exploitative, and by and large the counter-argument seems to boil down to "you just don't understand." We do understand, we just disagree with you.

We can reasonably disagree on this topic. But goodness gracious, the holier-than-thou and dismissive response being given to the contrary viewpoint in this thread is insulting.

 

[Stagg737]

The above reddit posts seem to suggest that way, otherwise they wouldn't be so cheering to quickly cancel that opportunity

Med students cheer about stupid things all the time. I once got an ovation from our entire 200+ class for (incorrectly) arguing that a test answer should be counted as correct. Besides, it seems that there were plenty of students who actually did sign up for the activity, you really think that they're comforted knowing they don't get to do this now because a bunch of their classmates whined about it?

The problem is words got around in medical school at the speed of light. It's worse than middle school or high school. Some people will be seen as good team players" among some faculties and others won't.

I was very close with my Neuroanatomy professor in med school; that individual knew most of the 'gossipy' things that happened in my class before I did, and was not shy about letting me know other faculty members know these things.

I dont know how it is everywhere, but many of friends who attended med school in the US said their institutions were similar to mine in term of gossip and BS etc...

You really think that faculty are going to care enough about this to tank people's careers? If they have enough time to pull that then they're either not busy enough or they're the cattier than the average admin.

Again, if patients need care today, 2 immediate things need to be done

1. Give med students clinical responsibilities.

2. Mass send this volunteer opportunity TO EVERYONE affiliated with the hospital system, med school and other health professional schools and not just to MS1s/MS2s.

1. M3's and M4's already have clinical responsibilities related to COVID at many places. If you're suggesting early graduation to full clinical duties like in Italy, I'd consider looking at the outcomes on the health and mental of those students before rushing to support that. Cliffnotes, severe depression doubled to nearly 50% of early graduates, severe anxiety tripled to nearly 50% of early graduates, and rates of burnout significantly increased while sense of accomplishment went basically unchanged. Error - Cookies Turned Off
Yes, this is a critical situation, but throwing students into positions they're not ready to handle is not the right choice, imo. Though we already seemed to be doing that with mid-levels, so what the heck I guess.

2. Fair, but I'm guessing M3 and M4s are already involved as they're on their rotations and other health professionals aren't likely to volunteer to do extra of what they're already getting paid to do. Though I do agree that this could have been marketed to a broader group (pre-meds as well).

Again, this wasn't a volunteer experience offered to everyone regardless of background, it was pointed directly at a specific demographic that is more likely to feel like they *have* to help.

Yes, offering it to M1s and M2s only is such a narrow demographic. They're CLEARLY being targeted for oppression. /sarcasm

If it makes anybody feel any better about my opinions here, I spearheaded one of these campaigns to get staff back into the hospitals to combat the shortage of RNs for a major hospital system. When I did that, I specifically *DID NOT* reach out to the medical school to try to browbeat students into helping because I understood the power dynamics at play.

Good for you, but this is a crap argument that perpetuates the idea that med students are children who need to be protected and not adults capable of making their own decisions. It's the same concept as med schools having dress codes for didactics or mandatory lectures, but prohibiting students from doing something instead of requiring it. If they don't want to do it, they don't have to do it. Yes, med students and their classes should rally together and stand up for their rights, especially if they feel they're being coerced by a power-dynamic system that relies on an argument of appealing to authority and little else. But med students are still adults. They do not need to be treated like a protected class who can't make their own decisions or need guardians swooping to rescue medical students en masse.

That argument is the thing that bothers me the most about this whole thread. These aren't 6 year olds who don't know not to take candy from strangers, they're adults and their entitled to decide whether they want to participate in a situation like this or not without everyone else telling them what they should or shouldn't be doing.

It depends on how the class reacts and how many take up the opportunity. Standing out in a negative way can hugely kneecap medical students, even if that negative way is simply *not* doing an extra activity. I have examples of this in practice, but they are too specific and would be identifying. Maybe you just aren't familiar with how cutthroat med schools are right now?

Lol, is this a joke? I directly work with med students every day and am acutely aware about how cut-throat they can be. But how could I possibly know? It's not like I...went to med school... And from the reddit thread it doesn't seem like anyone was "browbeaten" into this, and I have a hard time taking a lot of these arguments seriously considering they're coming from a user named "F***worksomuch"...

I get it, med students get singled out. I've seen it too. I just don't believe that any non-malignant admin would go after students for not volunteering for a...wait for it...VOLUNTARY opportunity. Everything about the way the messages were worded suggested that this was not the case and actually seemed to discourage some people from participating. This is coming from someone who went to a med school with malignant administrators as well as someone who was singled-out by them more than once (both positively and negatively).

 

[Lawpy]

M3's and M4's already have clinical responsibilities related to COVID at many places. If you're suggesting early graduation to full clinical duties like in Italy, I'd consider looking at the outcomes on the health and mental of those students before rushing to support that. Cliffnotes, severe depression doubled to nearly 50% of early graduates, severe anxiety tripled to nearly 50% of early graduates, and rates of burnout significantly increased while sense of accomplishment went basically unchanged. Error - Cookies Turned Off

Interesting. NYU graduated their MS4s early last year. Did they experience similar problems?

Even then, I'm not sure what to do with these findings other than push for much better institutional mental health support, because depression, anxiety and other burnout-induced problems are widely pervasive across health professions. That shouldn't be used to discourage med students from helping out clinically

Also i was suggesting more in the lines of early clinical exposure for MS1s and MS2s for some clinical tasks under both attending and RN supervision. With a steep nurse shortage, MS1s and MS2s learning a lot what nurses do clinically (on top of helping out with transport) would help a lot.

 

[Lawpy]

Let’s be honest—med students aren’t very helpful to the healthcare system until they actually become residents/attendings.

Weren't med students sent to the wards to help out during the Spanish flu pandemic?

 

[RangerBob]

Weren't med students sent to the wards to help out during the Spanish flu pandemic?

I don't know, but it sounds likely considering how bad it was. If your pilot has a heart attack, you get the co-pilot to fly. If he/she is out too, then you get whoever knows anything about flying, even if it's just a small single-engine jet.

My original comment was meant more to say that med students are like toddlers in a sense---lots of potential after a fairly lengthy gestation/training period/apprenticeship so to speak, during which they require a lot of work and input to the extent that the team would be far more efficient without them. This eventually pays off for society because you eventually get a fully trained attending, but in the current moment med students are not a ton of use unless you know how to use them.

My toddler can't help me round. But he can fetch things really easy, set the table (poorly, and incompletely), clean up messes (poorly!) and pickup/put away toys (pretty good at that!). I can do them all better/quicker on my own, but then I would've be raising a very functional future adult. Med students can't/shouldn't independently take care of patients (at least not until stuff really hits the fan), but they sure can take vitals, place IVs after some training, do regular assessments, etc.

Edit: Not trying to say med students are actually like toddlers. Just that medical education is similar to the process of becoming an adult--it's a long, slow process and requires a LOT of time and effort on the part of others. Unlike other fields where it's much less work/time. I took a job as a cashier once. My (dedicated) orientation was a week long, but they could've taught me everything within a day max.

 

[NicMouse64]

I have no issues with asking medical students to come volunteer in times of need. My main issues boil down to essentially 3 things.
1. Paying up to 60k/year to put ourselves at risk while nurses get paid 100/hr to do what we would be asked to do.
2. No disability/health insurance.
3. The tasks they would have the medical students perform.

Part of the problem with the proposal is a large reflection of the overall problem with medical education. I had an attending attest my notes on my ICU rotation because the resident working on my patients didn't know to put their notes in before rounds. Guess what, he was able to bill and my note was actually useful and used to advance patient care. I've had rotations where attendings use my notes and it makes a huge difference and saves them time when the resident is overwhelmed with consults. I have got to put in A-lines and CVLs on night call. I am decently proficient at A-lines and IVs. I know how to move patients, give IV meds, etc. We CAN be utilized and have it contribute to our education. But not all of us got the clinical training to actually be deemed useful in the clinical setting as an M4. This gets back to the thread with @efle .

If an institution wants to use us during a pandemic, I would volunteer so long as I get paid, am covered in the case of illness, and allow medical students to actually perform procedures and tasks concomitant to our level of training. Get rid of all the administrative BS that prevents us from doing those things in the first place. I also don't think anyone before the M3 year should be utilized. There's not point unless acting as a scribe or being put on an IV team.

 

[VA Hopeful Dr]

I have no issues with asking medical students to come volunteer in times of need. My main issues boil down to essentially 3 things.
1. Paying up to 60k/year to put ourselves at risk while nurses get paid 100/hr to do what we would be asked to do.
2. No disability/health insurance.
3. The tasks they would have the medical students perform.

Part of the problem with the proposal is a large reflection of the overall problem with medical education. I had an attending attest my notes on my ICU rotation because the resident working on my patients didn't know to put their notes in before rounds. Guess what, he was able to bill and my note was actually useful and used to advance patient care. I've had rotations where attendings use my notes and it makes a huge difference and saves them time when the resident is overwhelmed with consults. I have got to put in A-lines and CVLs on night call. I am decently proficient at A-lines and IVs. I know how to move patients, give IV meds, etc. We CAN be utilized and have it contribute to our education. But not all of us got the clinical training to actually be deemed useful in the clinical setting as an M4. This gets back to the thread with @efle .

If an institution wants to use us during a pandemic, I would volunteer so long as I get paid, am covered in the case of illness, and allow medical students to actually perform procedures and tasks concomitant to our level of training. Get rid of all the administrative BS that prevents us from doing those things in the first place. I also don't think anyone before the M3 year should be utilized. There's not point unless acting as a scribe or being put on an IV team.

That's not exactly how volunteering works. That's just a job.

 

[Stagg737]

Interesting. NYU graduated their MS4s early last year. Did they experience similar problems?

Even then, I'm not sure what to do with these findings other than push for much better institutional mental health support, because depression, anxiety and other burnout-induced problems are widely pervasive across health professions. That shouldn't be used to discourage med students from helping out clinically

Also i was suggesting more in the lines of early clinical exposure for MS1s and MS2s for some clinical tasks under both attending and RN supervision. With a steep nurse shortage, MS1s and MS2s learning a lot what nurses do clinically (on top of helping out with transport) would help a lot.

Not really sure, but they only had a class of 20 students to graduate early so not really sure that data would be particularly useful. Oto, the study on the Italian system had N<1,000, so could actually get some potentially meaningful data there.

 

[deleted966164]

Medical student in their pre-med past: "Sure! I will do anything for those volunteer hours! It has always been my dream to be a doctor and help people!" (go on and don't do much because of limited ability...)

Fast forward a few years...

Those pre-meds who now really are medical students in times of a pandemic: "I will not volunteer! My time is too valuable! I don't want to take any risks (although most of us had the chance or are required to get vaccinated if able)..."

Life expectancy of lofty ideals is very short.

👎

 

[Lawpy]

Medical student in their pre-med past: "Sure! I will do anything for those volunteer hours! It has always been my dream to be a doctor and help people!" (go on and don't do much because of limited ability...)

Fast forward a few years...

Those pre-meds who now really are medical students in times of a pandemic: "I will not volunteer! My time is too valuable! I don't want to take any risks (although most of us had the chance or are required to get vaccinated if able)..."

Life expectancy of lofty ideals is very short.

👎

Who knew adcoms and PDs cared about different things? News to me too

 

[deleted966164]

Who knew adcoms and PDs cared about different things? News to me too

Of course they do! But... besides going to medical school and working towards residency and so on one also has to see the bigger picture and be human.

 

[Lawpy]

Of course they do! But... besides going to medical school and working towards residency and so on one also has to see the bigger picture and be human.

And seeing the bigger picture involves knowing what volunteering opportunity is truly genuine in helping people

 

[sunshinefl]

Medical student in their pre-med past: "Sure! I will do anything for those volunteer hours! It has always been my dream to be a doctor and help people!" (go on and don't do much because of limited ability...)

Fast forward a few years...

Those pre-meds who now really are medical students in times of a pandemic: "I will not volunteer! My time is too valuable! I don't want to take any risks (although most of us had the chance or are required to get vaccinated if able)..."

Life expectancy of lofty ideals is very short.

👎

Fast forward more years and that’s why they were asking physicians to volunteer to work extra COVID hours during the pandemic for free, while travel nurses make thousands of dollars per week profiting on the pandemic.

value your worth and time.

 

[Med Ed]

Fast forward more years and that’s why they were asking physicians to volunteer to work extra COVID hours during the pandemic for free, while travel nurses make thousands of dollars per week profiting on the pandemic.

value your worth and time.

741 locums tenens job listings for critical care physicians

 

[sunshinefl]

741 locums tenens job listings for critical care physicians

Yes, so don’t work for free.

 

[VA Hopeful Dr]

Fast forward more years and that’s why they were asking physicians to volunteer to work extra COVID hours during the pandemic for free, while travel nurses make thousands of dollars per week profiting on the pandemic.

value your worth and time.

Were a significant number of physicians actually working for free?

 

[Redpancreas]

Who knew adcoms and PDs cared about different things? News to me too

They do. Being a PD is basically a thankless job. It’s nothing like we think it is on the other side. The PDs already have a system in place and have very little they actually control. On the other hand, they’re fielding 1000s of issues from people who think their issue is the most important. Being chief is kind of similar from second hand experience as many of my close friends are now. They're always telling me how they are constantly arbitrating resident issues, getting calls from physicians/residents outside the program complaining, etc. etc. They all had a vision when they initially became chief but now they're all overwhelmed with day to day stuff, moonlighting, and fellowship applications.

-----
One quick point about this "opportunity". I have been reflecting on what I would have gathered from this as a medical student. Frankly not much...but if I did it now, I think I would learn a lot which is why I guess hindsight is 20/20. Just though I'd outline a few things so anyone volunteering for these shifts at UTSW or other places doing things similar can look out for these things and perhaps learn something.

1.) How do nurses draw blood and what are the modes of IV access draws and administration. This isn't taught well in pre-clinicals or frankly clinicals. You don't need to know what color tube each lab goes into, but it may be a useful experience to see the nursing perspective when residents (including myself) order a bajillion things on admission and how the nurses (who basically execute our orders) handle that so that when you're a resident, you can coordinate care efficiently.

2.) How vitals are drawn in the hospital. Note the frequencies allowed for various things on various floors, the sometimes lack of attention to detail taken when taking vitals unfortunately, and etc (why the first step is always recheck, which most RNs do before calling you). Also note the escalation that takes place when labs are abnormal and the policies nurses have to do. Speaking of that, understanding nursing indications for ICU is also important. It's not just intubation and pressors. Starting as a resident, you're really naive to that whole perspective and when a patient's admitted for DKA on an insulin gtt but hemodynamically stable/mentating well/on RA, sometimes it's hard to understand from a physician's perspective why the patient needs ICU. Nurses aren't dumb, they're just following their policies.

3.) How many times nurses attempt to educate patients or attempt to resolve a dispute before paging the physician or resident on call.

Frankly, if any of you do a shift and have questions, I am happy to answer them via PM!

 

[Ganon]

I think more than anything, it's this lazy-ass argument that is ticking me off about this thread. The person you replied to is a RESIDENT, meaning they just graduated in the last couple of years. I graduated in the last 10 years. I feel like several people have given very reasonable explanations for why this might not be exploitative, and by and large the counter-argument seems to boil down to "you just don't understand." We do understand, we just disagree with you.

We can reasonably disagree on this topic. But goodness gracious, the holier-than-thou and dismissive response being given to the contrary viewpoint in this thread is insulting.

In the context of a power dynamic, when the individuals on a higher level of the food chain argue that there is no exploitation going on toward the individuals lower on the food chain, maybe the opinions of the exploited demographic hold more weight?

Sorry, I'm just a little wary of anyone arguing the case that a hospital network isn't being exploitive, especially with regards to a job and situation that I am *currently* employed in. These things aren't some philosophical debate for me, they're what I'm faced with when I clock in.

Holier-than-thou? Absolutely not.
I'm just a lowly med student.
However, I happen to be a lowly med student who has been on the front lines of the covid pandemic as an ICU RN and seen insane, inhumane exploitation, so that may be why I'm so vehemently turned off when I see evidence of exploitation elsewhere.

 

[GoSpursGo]

In the context of a power dynamic, when the individuals on a higher level of the food chain argue that there is no exploitation going on toward the individuals lower on the food chain, maybe the opinions of the exploited demographic hold more weight?

Sorry, I'm just a little wary of anyone arguing the case that a hospital network isn't being exploitive, especially with regards to a job and situation that I am *currently* employed in. These things aren't some philosophical debate for me, they're what I'm faced with when I clock in.

Holier-than-thou? Absolutely not.
I'm just a lowly med student.
However, I happen to be a lowly med student who has been on the front lines of the covid pandemic as an ICU RN and seen insane, inhumane exploitation, so that may be why I'm so vehemently turned off when I see evidence of exploitation elsewhere.

As I said. A big piece of your argument basically boils down to “you just don’t understand because you’re not a current med student.” So I don’t know how you expect me to reasonably engage with you when you’re going to just invalidate anything I say because I’m not a med student, but it is insulting to those of us who did in fact recently graduate.

 

[operaman]

In the context of a power dynamic, when the individuals on a higher level of the food chain argue that there is no exploitation going on toward the individuals lower on the food chain, maybe the opinions of the exploited demographic hold more weight?

Sorry, I'm just a little wary of anyone arguing the case that a hospital network isn't being exploitive, especially with regards to a job and situation that I am *currently* employed in. These things aren't some philosophical debate for me, they're what I'm faced with when I clock in.

Holier-than-thou? Absolutely not.
I'm just a lowly med student.
However, I happen to be a lowly med student who has been on the front lines of the covid pandemic as an ICU RN and seen insane, inhumane exploitation, so that may be why I'm so vehemently turned off when I see evidence of exploitation elsewhere.

I don’t see how or why the opinions of the allegedly exploited/oppressed should carry more weight on anything except for how it “feels” for them. If anything, the further removed from executive decision-making one is, the less likely they are to understand the bigger picture, so they tend to hyper focus on their tiny little fiefdom and discuss grievances with similarly blinded colleagues.

It’s like the British peerage and the idea that the noble elite is better equipped to understand issues and make decisions because they aren’t shackled by the day to day struggles of subsistence. Similarly, those of us who have finished training and have a bigger picture perspective may be able to see what those down the totem pole cannot see.

This is even more true when we consider the push for social media clout that compels people to post this kind of thing on Reddit or Twitter. The likes and upvotes of the angry and blind mob yield far more reward for a pseudo-outraged poster than the reasoned and nuanced arguments of those with perspective.

So I can grant you that the exploited do in fact feel exploited, but if anything that makes their opinion far less credible as to whether they actually are.

 

[deleted1081396]

Who knew adcoms and PDs cared about different things? News to me too

It's all in the game. We only did it because adcoms demanded it. A lot of us probably loathed volunteering. I certainly did and I dropped it as soon as I got my acceptance letter. My residency app is almost completely devoid of volunteering and I've still gotten plenty of interviews, so PDs don't seem to care at all. Nor should they, frankly. It says nothing about one's ability to do the job.

 

[Ganon]

I don’t see how or why the opinions of the allegedly exploited/oppressed should carry more weight on anything except for how it “feels” for them. If anything, the further removed from executive decision-making one is, the less likely they are to understand the bigger picture, so they tend to hyper focus on their tiny little fiefdom and discuss grievances with similarly blinded colleagues.

It’s like the British peerage and the idea that the noble elite is better equipped to understand issues and make decisions because they aren’t shackled by the day to day struggles of subsistence. Similarly, those of us who have finished training and have a bigger picture perspective may be able to see what those down the totem pole cannot see.

This is even more true when we consider the push for social media clout that compels people to post this kind of thing on Reddit or Twitter. The likes and upvotes of the angry and blind mob yield far more reward for a pseudo-outraged poster than the reasoned and nuanced arguments of those with perspective.

So I can grant you that the exploited do in fact feel exploited, but if anything that makes their opinion far less credible as to whether they actually are.

I'm going to break down a scenario:

Nursing students enter floor.
Management calls all CNA staff to the break room. They are all told to clock out and go home because there's nursing students to do their work for the day.

The CNA staff all glare and curse at the nursing students as they walk away. Those nursing students are being made to do their job for free, and are directly taking money from the CNA staff's family. The nursing students are contracted in the hospital... They don't have a say in what's going on.

Your argument is that because the nursing students are choosing to go to nursing school they must not be being exploited, but when you hear the whole story it's pretty obvious that they are.

The above case probably sounds really crazy, right? Well I was the nursing student. Saw it with my own eyes.

Your argument only makes any sense if UTSW *can't* get staff to work those menial tasks. The truth is they CAN, they do not WANT TO. Why pay when you can take someone's salary and keep it for a productivity bonus, while taking advantage of the cutthroat nature of med school to get free labor?

You keep saying I'm not giving examples, but it's because I thought the above was pretty obvious. Maybe it's only obvious if you've lived it, which is why I do believe the opinion of someone who has witnessed oppression (please note, I don't feel oppressed and don't like using that language when there is *real* oppression going on in the world, but it fits the argument) is more valuable than an attending physician who is stroking their chin about situations they aren't in.

 

[GoSpursGo]

an attending physician who is stroking their chin about situations they aren't in.

again, you are intentionally being insulting for no reason other than it you feel like you’re scoring points on an attending.

You are correct that it is obvious that a power dynamic exists, and that it is possible for exploitation to occur in such a setting. It is not obvious to me, or a number of other users in this thread that exploitation was occurring in this specific case. But the grandstanding and potshots certainly arent helping to convince anyone.

 

[Goro]

It's all in the game. We only did it because adcoms demanded it. A lot of us probably loathed volunteering. I certainly did and I dropped it as soon as I got my acceptance letter. My residency app is almost completely devoid of volunteering and I've still gotten plenty of interviews, so PDs don't seem to care at all. Nor should they, frankly. It says nothing about one's ability to do the job.

I'm surprised that you're losing sight of the types of volunteering going here and int he false equivalence you're trying to construct.

Whether pre-meds hate the volunteering pre-req is irrelevant. The reason they need to do it is to show off their altruism because Medicine is a service profession. Your career isn't comparable to, say, a banker or a pilot. Even as a doctor, you're sacrificing a lot of your time that your non-medical peers don't have to do. That includes throwing yourself into harm's way with acting out patients, drunks, or pandemics.

Of course PDs don't care about volunteering! They want other things out of you.

The UTXSW medical students aren't volunteering to look good for residency, they're doing because they see a need and it fulfills them to fill said need. A few years ago a bunch of my students cleaned out an empty city lot and built an entire playing field. They didn't do because they were forced, or for brownie points, but because they wanted to.

This isn't a situation like in the Army where the sergeant goes:
"I need three volunteers.
[Points at troops]
You, you and you!"

And jeeze, some of you are acting like the students have been put in chains and whipped.

 

[operaman]

I'm going to break down a scenario:

Nursing students enter floor.
Management calls all CNA staff to the break room. They are all told to clock out and go home because there's nursing students to do their work for the day.

The CNA staff all glare and curse at the nursing students as they walk away. Those nursing students are being made to do their job for free, and are directly taking money from the CNA staff's family. The nursing students are contracted in the hospital... They don't have a say in what's going on.

Your argument is that because the nursing students are choosing to go to nursing school they must not be being exploited, but when you hear the whole story it's pretty obvious that they are.

The above case probably sounds really crazy, right? Well I was the nursing student. Saw it with my own eyes.

Your argument only makes any sense if UTSW *can't* get staff to work those menial tasks. The truth is they CAN, they do not WANT TO. Why pay when you can take someone's salary and keep it for a productivity bonus, while taking advantage of the cutthroat nature of med school to get free labor?

You keep saying I'm not giving examples, but it's because I thought the above was pretty obvious. Maybe it's only obvious if you've lived it, which is why I do believe the opinion of someone who has witnessed oppression (please note, I don't feel oppressed and don't like using that language when there is *real* oppression going on in the world, but it fits the argument) is more valuable than an attending physician who is stroking their chin about situations they aren't in.

Unfortunately your example has too much false equivalence to carry much weight. The key difference among many is that the nursing students were there for required rotations. Now if they had a couple candy stripers come on the unit and sent home their CNA staff, it would at least be a little closer to the scenario here.

The other key difference is that right now there truly is a staffing shortage and things are dire in many places. Nobody is sending home CNAs when the volunteer MS1s arrive. They are actively hiring and desperately trying to get more staff on their wards, just like every other major hospital in America. They’re even paying temp contract workers huge salaries just to fill the gaps. A few do-gooder MS1s aren’t going to solve a problem that big, but they can get some clinical time while helping their colleagues in a time of need.

Your thought that the oppressed or those who have witnessed oppression have some special insight here is simply laughable. I know that idea is currently in vogue, but it’s simply nonsensical when considered with any modicum of reason. The only thing they have are their subjective feelings on the matter, and while we should listen to them as compassionate leaders, it doesn’t make their conclusions as to what’s actually going on or what we should do about it any less wrong.

 

[GoSpursGo]

Your thought that the oppressed or those who have witnessed oppression have some special insight here is simply laughable. I know that idea is currently in vogue, but it’s simply nonsensical when considered with any modicum of reason. The only thing they have are their subjective feelings on the matter, and while we should listen to them as compassionate leaders, it doesn’t make their conclusions as to what’s actually going on or what we should do about it any less wrong.

So I generally agree with your points, and I think I probably agree with what you’re trying to say, but I do think that for legitimately oppressed groups have special insight that needs to be listened and attended to. The problem that I see is that all too frequently, the term “oppression” is thrown around any time there is any power differential. Clearly in the setting of a power differential the opportunity for abuse exists, but we need to be careful that we not reflexively call any person in a subordinate position oppressed. When we start calling literally every subordinate group oppressed, then the term loses all meaning, and it becomes easier to ignore when groups are facing true abuse and oppression.