MD & DO Which specialties deal with the nicest patient population and which specialties deal with the rudest patient population?

Dr. Rafiki

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In my experience, it is ironically with the opposite in terms of physician.

Surgeons: the rudest among us yet the patients are so happy with the (wo)man who saved their life, so they are the nicest.

Primary care (especially pediatrics): generally nicer than most other physicians yet the patients are the meanest and expect the most and are the least thankful for what their physician is doing for them.
 
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redsox93

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Optho has the nicest patients I’ve experienced. You can make a huge change in vision in one visit in the office or with cataract surgery and patients seem to really appreciate it
 
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In my experience, it is ironically with the opposite in terms of physician.

Surgeons: the rudest among us yet the patients are so happy with the (wo)man who saved their life, so they are the nicest.

Primary care (especially pediatrics): generally nicer than most other physicians yet the patients are the meanest and expect the most and are the least thankful for what their physician is doing for them.
I imagine ER is prob pretty terrible right?
 
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TelemarketingEnigma

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How nice your patients are to you is going to depend a lot on the context and how you treat them/what you're offering them. For example, I've done a lot of work with patients who inject drugs. They have a reputation for being hard to deal with in traditional settings. But they also get treated horribly in most settings, so who can blame them? Our clinic, on the other hand, operated out of a setting where they felt safer and trusted the staff, so I actually found that most of them are incredibly nice and funny and awesome to care for when they feel safe.

Also going to depend on your own personality, and what kind of people you get along with.
 
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Hi everyone,

I just wanted y’alls opinions on this topic. I’m trying to gather as much info so I can have an educated opinion on what specialty I’d be interested in.
One of my students told me once that they liked OB/Gyn because the patients weren't sick (as in maternity).

I can just hear my pal Homeskool chime in that Anesthesiology is great, because the patients are wall asleep!

If you go into the EM forum in Specialties, you'd get the impression that they have the worst patients. Great threads in there, though.
 
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Vascular patients in vascular clinic made me want to completely quit medicine. Will never forget the daywith back to back postop amp followups where I got threatened verbally for suggesting the patient to cut back on crack or Popeyes respectively to avoid future surgeries.

me: “what relationship if any do you think lifestyle habits have to do with overall health?”

her: “OH SO NOW ITS MY FAULT YALL CUT OFF MY TOE, I OUTTA SHOW YALL WHAT I CAN DO WITH A KNIFE”
 
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Vascular patients in vascular clinic made me want to completely quit medicine. Will never forget the daywith back to back postop amp followups where I got threatened verbally for suggesting the patient to cut back on crack or Popeyes respectively to avoid future surgeries.

me: “what relationship if any do you think lifestyle habits have to do with overall health?”

her: “OH SO NOW ITS MY FAULT YALL CUT OFF MY TOE, I OUTTA SHOW YALL WHAT I CAN DO WITH A KNIFE”
I actually had someone pull a knife out on me.

I said: “put that away, we don’t do that here.”
 
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RangerBob

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This isn't specialty specific but small town physicians could be quite literally killing their patients with bad medicine and the patients would still love them and trust them.

Absolutely. I’m in a small rural-ish community hospital and our patients are so grateful to get any care.

I find my patients (inpatient PM&R) are generally very nice. They’re thankful they survived whatever just happened. If they get a PE or other complication they usually say “well doc, at least it’s not another hemorrhage,” or something to that effect.

VA docs have great patients-most are really appreciative of the care they received. But a handful can be really difficult. The WWII patients are great. Hardly ever complain, super grateful. They could be exsanguinating and going into cardiogenic shock and respiratory distress and they’ll still tell you “it’s ok doc.”
 
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TypeADissection

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Don’t listen to any of these people. Vascular patients are the best. Hearts of gold.

Just ask @TypeADissection

It’s true. Best patient population. Compliant. Healthy. Robust. Fun surgeries. Lifestyle specialty. I can’t believe everyone doesn’t want to be a vascular surgeon.
 
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akwho

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Love my ortho joints patients. They can be a little long winded about things. But you will have some of the most pleasant discussions of your life and they will bring you amazing home cooked goodies.

Will agree that the vascular patients are the most astoundingly non-compliant group of patients I've ever worked with. If you tell them to cut it down to a half pack per day, they will up to two packs a day just to show you who's boss.
 
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FutchaDocta111

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Thanks for all the responses guys. Would anyone know how kind/rude the patients are in psychiatry? I heard from a few med students that psych tends to have the roughest/least compliant patients and was wondering what yall's experience may be like?
 

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Thanks for all the responses guys. Would anyone know how kind/rude the patients are in psychiatry? I heard from a few med students that psych tends to have the roughest/least compliant patients and was wondering what yall's experience may be like?
That would depend on if you’re doing inpatient at a state hospital with psychotic patients, or doing cash pay private practice for high functioning worried (basically) well.
 
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If you're a URM in medicine most patients of the same race are so happy to see "one of their own" sharing that space. They will be so happy to see/interact with you.
I'm not even a med student yet, but I was shadowing a surgeon in my small hometown, and every black patient we interacted with at the hospital was proud of me. I was very confused because I was just a premed student shadowing, but it did make me happy and motivated me some more.
 
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Candidate2017

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What about psych and onc?

Psych varies widely, including setting, pt population. whether you tailor your practice to a niche. Acutely manic or psychotic inpatients can be rude, but not always because there are those who are "pleasantly" manic or psychotic (psychotic little old ladies, sociable manic patients). By far, drug seekers and especially those with personality issues tend to be the rudest in inpatient and outpatient.

All my established outpatients (private insurance) are generally nice, everyday people (including med students). Most of my drug seekers and personality patients have either accepted my boundaries and treatment plan or realized they should go to greener pastures. A $500/hr cash pay clinic would have a different, probably less pleasant population.

Depressed, anxious, or medication compliant schizophrenic patients are usually pretty nice people. The most polite patients I've ever met are prisoners. But you'd be mistaken to label them nice.
 
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TypeADissection

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Will agree that the vascular patients are the most astoundingly non-compliant group of patients I've ever worked with. If you tell them to cut it down to a half pack per day, they will up to two packs a day just to show you who's boss.

I think the strength of vascular is in its breadth of cases. Complex endo, big open, Swiss watch making kind of work, hybrid cases, etc. But to hammer home the point about how hard of an addiction smoking is to some people, I had a guy come in with his foot rotting off his body. Needs a BKA. Case cancelled in PACU because he was chewing snuff. Can’t even make this **** up anymore. Cheers.
 
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calivianya

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How come nobody’s talking about nephrology for worst patients?

Almost every dialysis patient seems like they know dilaudid, benadryl, and phenergan are syringe-compatible and will scream bloody murder if nobody orders it for them, plus they get mad when you point out that drinking that gallon of sweet tea violated their fluid restriction in addition to sending their BG to 600. The yelling is usually done around the mouthful of cheeseburgers/fried chicken that their family snuck in because that 1200 calorie, consistent carb, heart-healthy diet was “killing them.”

And then they wonder why they’re in the hospital to get their right leg amputated, when that leg was fine when they were getting the left one chopped off last year.

They’re nice when their labs get whacked up enough because they skipped dialysis for a week and they’re semi-comatose, but that part doesn’t last long once you get the dialysis running, unfortunately.

I’ve only met a handful of nice renal patients ever.
 
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How come nobody’s talking about nephrology for worst patients?

Almost every dialysis patient seems like they know dilaudid, benadryl, and phenergan are syringe-compatible and will scream bloody murder if nobody orders it for them, plus they get mad when you point out that drinking that gallon of sweet tea violated their fluid restriction in addition to sending their BG to 600. The yelling is usually done around the mouthful of cheeseburgers/fried chicken that their family snuck in because that 1200 calorie, consistent carb, heart-healthy diet was “killing them.”

And then they wonder why they’re in the hospital to get their right leg amputated, when that leg was fine when they were getting the left one chopped off last year.

They’re nice when their labs get whacked up enough because they skipped dialysis for a week and they’re semi-comatose, but that part doesn’t last long once you get the dialysis running, unfortunately.

I’ve only met a handful of nice renal patients ever.
ESRD patients that come to the ED for "chest pain" right before they're about to get their dialysis which would have likely lessened their pain so they could go home and take their oral narcotics but they don't hit as well as IV so they gotta come in...and then get admitted for DIALYSIS. Man, I'll never understand how some people can be so non-compliant with their treatment when they're so close to dying without it.
 
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medicineisforme

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Thanks for all the responses guys. Would anyone know how kind/rude the patients are in psychiatry? I heard from a few med students that psych tends to have the roughest/least compliant patients and was wondering what yall's experience may be like?
Not that I am really talking from experience here but I would say that psych is inherently a very non compliant group by nature; it would also I imagine differ greatly if you are doing in patient vs out patient because in the former patients are more likely to be aggressive (although I get the impression that many are not and are very nice people just struggling). In the latter you will get a mix of people some will be very appreciative and others....
 
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medicineisforme

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Anyone have input on infectious diseases?

While definitely there's a difference in the crowd "politeness" between specialties I think you have to ask yourself the following questions.

- what types of medicine do you like to practice (eg procedures, no procedure, operation, how much patient contact, whether verbal or hands on etc)

- what age population do you want to work with

- healthy or sick people and are you okay with the areas that have a higher mortality rate because of the condition or age of the group

- interaction with colleagues, what is the mentality

- work place environment do you like the hospital, or prefer your own practice, do you prefer high pressure like er or something much more even pace and a little more predictable

- salary (does it matter to you within the field of being an MD what your salary is)

- time in school

- do you prefer your patience to be unconscious or conscious most of the time lol

I think between the above and what you feel yourself drawn to will answer what you might be interested in specializing in. You probably won't feel drawn to a specialty where the patient population is not considered to be pleasant as is seems that is something important to you.

Also I'll add that you can probably manipulate to a certain degree the pleasantness of your patients based on the setting, if you specialize in your specialty, location, population you try to attract and so on because disease doesn't discriminate based on how nice a person is or isn't ;)
Although I will say as a caveat that some specialties are more akin to more cranky, rude, appreciative patients by nature.

Hope this was helpful and good luck!
 
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Anyone have input on infectious diseases?

While definitely there's a difference in the crowd "politeness" between specialties I think you have to ask yourself the following questions.

- what types of medicine do you like to practice (eg procedures, no procedure, operation, how much patient contact, whether verbal or hands on etc)

- what age population do you want to work with

- healthy or sick people and are you okay with the areas that have a higher mortality rate because of the condition or age of the group

- interaction with colleagues, what is the mentality

- work place environment do you like the hospital, or prefer your own practice, do you prefer high pressure like er or something much more even pace and a little more predictable

- salary (does it matter to you within the field of being an MD what your salary is)

- time in school

- do you prefer your patience to be unconscious or conscious most of the time lol

I think between the above and what you feel yourself drawn to will answer what you might be interested in specializing in. You probably won't feel drawn to a specialty where the patient population is not considered to be pleasant as is seems that is something important to you.

Also I'll add that you can probably manipulate to a certain degree the pleasantness of your patients based on the setting, if you specialize in your specialty, location, population you try to attract and so on because disease doesn't discriminate based on how nice a person is or isn't ;)
Although I will say as a caveat that some specialties are more akin to more cranky, rude, appreciative patients by nature.

Hope this was helpful and good luck!
This thread aint that deep lol. You took it from worst/best patient populations to dissecting entire specialties.
 
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medicineisforme

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Anyone have input on infectious diseases?

While definitely there's a difference in the crowd "politeness" between specialties I think you have to ask yourself the following questions.

- what types of medicine do you like to practice (eg procedures, no procedure, operation, how much patient contact, whether verbal or hands on etc)

- what age population do you want to work with

- healthy or sick people and are you okay with the areas that have a higher mortality rate because of the condition or age of the group

- interaction with colleagues, what is the mentality

- work place environment do you like the hospital, or prefer your own practice, do you prefer high pressure like er or something much more even pace and a little more predictable

- salary (does it matter to you within the field of being an MD what your salary is)

- time in school

- do you prefer your patience to be unconscious or conscious most of the time lol

I think between the above and what you feel yourself drawn to will answer what you might be interested in specializing in. You probably won't feel drawn to a specialty where the patient population is not considered to be pleasant as is seems that is something important to you.

Also I'll add that you can probably manipulate to a certain degree the pleasantness of your patients based on the setting, if you specialize in your specialty, location, population you try to attract and so on because disease doesn't discriminate based on how nice a person is or isn't ;)
Although I will say as a caveat that some specialties are more akin to more cranky, rude, appreciative patients by nature.

Hope this was helpful and good luck!
Oh and don't forget lifestyle like schedule and whether you'd be likely called at home to come in etc.
 
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FutchaDocta111

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Anyone have input on infectious diseases?

While definitely there's a difference in the crowd "politeness" between specialties I think you have to ask yourself the following questions.

- what types of medicine do you like to practice (eg procedures, no procedure, operation, how much patient contact, whether verbal or hands on etc)

- what age population do you want to work with

- healthy or sick people and are you okay with the areas that have a higher mortality rate because of the condition or age of the group

- interaction with colleagues, what is the mentality

- work place environment do you like the hospital, or prefer your own practice, do you prefer high pressure like er or something much more even pace and a little more predictable

- salary (does it matter to you within the field of being an MD what your salary is)

- time in school

- do you prefer your patience to be unconscious or conscious most of the time lol

I think between the above and what you feel yourself drawn to will answer what you might be interested in specializing in. You probably won't feel drawn to a specialty where the patient population is not considered to be pleasant as is seems that is something important to you.

Also I'll add that you can probably manipulate to a certain degree the pleasantness of your patients based on the setting, if you specialize in your specialty, location, population you try to attract and so on because disease doesn't discriminate based on how nice a person is or isn't ;)
Although I will say as a caveat that some specialties are more akin to more cranky, rude, appreciative patients by nature.

Hope this was helpful and good luck!
Thanks, I appreciate your input. Gives me a lot to think about as I progress through the next few years of med school!
 

altblue

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How come nobody’s talking about nephrology for worst patients?

Almost every dialysis patient seems like they know dilaudid, benadryl, and phenergan are syringe-compatible and will scream bloody murder if nobody orders it for them, plus they get mad when you point out that drinking that gallon of sweet tea violated their fluid restriction in addition to sending their BG to 600. The yelling is usually done around the mouthful of cheeseburgers/fried chicken that their family snuck in because that 1200 calorie, consistent carb, heart-healthy diet was “killing them.”

And then they wonder why they’re in the hospital to get their right leg amputated, when that leg was fine when they were getting the left one chopped off last year.

They’re nice when their labs get whacked up enough because they skipped dialysis for a week and they’re semi-comatose, but that part doesn’t last long once you get the dialysis running, unfortunately.

I’ve only met a handful of nice renal patients ever.
I had a school mandatory in a nephrology wing during M1... from what I saw it just seemed to be a somewhat depressing subspecialty in a lot of ways. yeah there's some real noncompliance but I can't imagine the toll dialysis or treatment in general takes on patients. lots of comorbidities and coordination with other specialties too, which can lead to miscommunications with other necessary doctors
 
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libertyyne

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How are the patients in adult or peds CT or NSG?
For nsg.ime
Mostly pleasant in clinic, and only need an exam inside of the hospital. And when they start to have social problems in the hospital you dispo to another service .
the flip side is having bad outcomes and seeing patients doing poorly on your service .
 

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That would depend on if you’re doing inpatient at a state hospital with psychotic patients, or doing cash pay private practice for high functioning worried (basically) well.

Actually psychotic population at the state hospital is likely safest due to security measures and patients. Psychosis by itself doesn't equal dangerous/rude. Most chronic schizophrenic patients are the nicest people you'll ever meet who are very ill and often are afraid and seeking help. The ones to be afraid of is the forensic wing at state hospitals where all those non-psychotic, but somehow "not guilty by reason of insanity" antisocial folks end up. The ED and prison populations are also rough. Don't get me started on personality disorders. The substance abusers are loads more dangerous than anyone else.
 
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sunshinefl

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Actually psychotic population at the state hospital is likely safest due to security measures and patients. Psychosis by itself doesn't equal dangerous/rude. Most chronic schizophrenic patients are the nicest people you'll ever meet who are very ill and often are afraid and seeking help. The ones to be afraid of is the forensic wing at state hospitals where all those non-psychotic, but somehow "not guilty by reason of insanity" antisocial folks end up. The ED and prison populations are also rough. Don't get me started on personality disorders. The substance abusers are loads more dangerous than anyone else.
Yes I oversimplified to make a point. Between being a correctional officer, a nursing student, an RN, a medical student, and having a schizophrenic mother, I have had a variety of experience with psychiatric patients in many settings. Since you are in Psychiatry I appreciate you expanding on this for the person who asked.
 
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I used to think the same thing about ESRD patients, but my perspective was very skewed by inpatient only. Once you get to see the people who are compliant and doing well outpatient, you can see that most of them are very nice. PD patients and transplant patients are particularly on the ball and a pleasure to manage. Unfortunately, there is a small subset that are back and forth to the hospital due to their own poor decisions as well as +/- social situations. I thought the attendings were kind of BSing some, but it’s true.

My least favorite patients to see are actually the older ladies who come to clinic for HTN because they have not tolerated any medication ever (loooong list of “allergies”) and get upset when I say quitting smoking, etc would help.

I cannot really think of a specialty that won’t have some trouble with a few patients, but it’s hard to get the full picture if you have not had much exposure to their outpatient experience as well. Outpatient exposure to IM subspecialties was not all encompassing during my residency.
 

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I have to second vascular as being generally frustrating. Any of the various pain specialists will also see a very certain subset of the population.

As far as biggest, most rapid change from often unbearable to extremely pleasant?
Laboring women before and after successful epidural placement. It's like magic
 
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longhaul3

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How are the patients in adult or peds CT or NSG?
For nsg.ime
Mostly pleasant in clinic, and only need an exam inside of the hospital. And when they start to have social problems in the hospital you dispo to another service .
the flip side is having bad outcomes and seeing patients doing poorly on your service .
Agreed for the most part. In addition, neurosurgical patients who are not comatose or close to it are often exceedingly (excessively, really) deferential and almost reverent because of the nature of the work and the mystique of brain surgery. This is especially true for tumor and aneurysm surgery—"brain tumor" and "aneurysm" are highly charged terms in the lay lexicon. I've been watching the Lenox Hill documentary, and the near-idolatry you see from most of the patients and their families is real. One of the confounding things about it is that when patients do really poorly, their loved ones are almost always still grateful.

Spine and pain patients can be a little more difficult. Degenerative spine pathology tracks with obesity, smoking, etc., which retreads the points other people have already brought up, and add in the pain angle and things can get tough. But one of the beautiful things about neurosurgery is that, despite being such a specialized service, it covers almost every patient population, age range, practice setting, and type of pathology (acute vs. chronic, vascular vs. cancer vs. degenerative vs. functional, urgency ranging from hyper-emergency to cosmetic).
 
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redsox93

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Agreed for the most part. In addition, neurosurgical patients who are not comatose or close to it are often exceedingly (excessively, really) deferential and almost reverent because of the nature of the work and the mystique of brain surgery. This is especially true for tumor and aneurysm surgery—"brain tumor" and "aneurysm" are highly charged terms in the lay lexicon. I've been watching the Lenox Hill documentary, and the near-idolatry you see from most of the patients and their families is real. One of the confounding things about it is that when patients do really poorly, their loved ones are almost always still grateful.

Spine and pain patients can be a little more difficult. Degenerative spine pathology tracks with obesity, smoking, etc., which retreads the points other people have already brought up, and add in the pain angle and things can get tough. But one of the beautiful things about neurosurgery is that, despite being such a specialized service, it covers almost every patient population, age range, practice setting, and type of pathology (acute vs. chronic, vascular vs. cancer vs. degenerative vs. functional, urgency ranging from hyper-emergency to cosmetic).
Is this your personal statement
 
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Candidate2017

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Actually psychotic population at the state hospital is likely safest due to security measures and patients.

Safety at state hospitals depends on the state and funding. The state hospitals in my area have a rep of staff and patients getting assaulted, murdered. They are always looking for moonlighters and locums. State hospital with poor funding + criminal history + substance + personality issues = very bad.
 

Matthew9Thirtyfive

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No but I'll chuckle if any of you kids copy it and I read it in your application (kidding, nobody reads them anyway).

Plus it's missing the part about "the first time I saw the human brain."

The first time I saw the human brain was in a decompression crani. Looked like oatmeal.
 
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Mass Effect

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Safety at state hospitals depends on the state and funding. The state hospitals in my area have a rep of staff and patients getting assaulted, murdered. They are always looking for moonlighters and locums. State hospital with poor funding + criminal history + substance + personality issues = very bad.

You should read my whole post. I specifically said the forensic units at state hospital are not good.
 
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