Why would anyone do an emergency medicine residency?

[RNtoMD87]

This is what I was thinking! Jealous, man.

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[miacomet]

Yep. Growing up virtually all I ever ate was squirrel gravy and rice, baked coon, red beans and rice, jumbalaya, moms home recipe vegetable beef/venison soup, chicken and dumplings, etc and I used to complain (mostly because a pot would last 3-4 days.) and I went hog wild when I turned 17 and had my first job. Ate fast food all the time. Didn’t take but a few years for me to grow tired of all that garbage and want real food again.

confused- you got sick of not great food, then went crazy for fast food? why continue the suffering?

 

[RNtoMD87]

confused- you got sick of not great food, then went crazy for fast food? why continue the suffering?

Because I literally ate pizza maybe 4 times before I was 17, had burgers maybe a dozen, had never been to a restaurant, and since I’d never had it I went crazy. It was something new to me. I think I was 21 the first time I had Taco Bell.

My moms cooking was great, it’s just that’s all I ever ate. We ate cheap. My father insisted that we be able to eat on 2 dollars a day average. And we usually did, unless we had a lot of meat getting close to expiration or something.

 

[MedicineZ0Z]

Yeah but still, 36 hours? I mean most MDs work what 60 hours minimum? You have to compare apples to apples.

Paywise nursing can’t be beat. Comes down to job satisfaction.

And there are doctors who make 600k.. 800k... 1.5 million and so on. There are business minded family docs who make upper 6 figures too,even 7 figures. The former isn't even that uncommon considering you only need okayish business acumen to make mid 6 figs in medicine.
How many nurses are able to hit the 400k range? Which is not unreasonable for a family doctors (not a specialist) who's got a half decent business sense.

And business aside, there are family docs who post on these forums that clear above 300k without doing any crazy hours or crazy work in pretty good geographic areas. And I'm using family med as an example to keep it to a very fair comparison.
I have heard of PAs doing 300k but they're working 80 hours minimum. You can also go nuts in family med and work >80hrs and go way higher than that. But hour for hour, medicine kills all mainstream professions when it comes to money. And yes I know bankers etc can make millions. But the few who do are better compared to the neurosurgery guys making 2.5-3 million given proportional sampling.

 

[RNtoMD87]

I know that, but I’m calculating in debt, lost wages, compounding interest etc.

Doctors catch up but it takes them awhile. In many cases 50 or older. Not saying it’s inferior, but far from easy money.

 

[MedicineZ0Z]

I know that, but I’m calculating in debt, lost wages, compounding interest etc.

Doctors catch up but it takes them awhile. In many cases 50 or older. Not saying it’s inferior, but far from easy money.

It doesn't take them a while if maximizing income is their goal. There are so many ways to make money in medicine, and very few ways to do in nursing.
You're referring to doctors who are clueless financially and just want to be paid a basic salary for seeing 3 patients an hour. In that case, then yes. For those who know have business acumen, they'll be light years ahead of others and the debt is paid off in a couple years.

 

[RNtoMD87]

I mean I’m a very financial minded person, but I never want to put that ahead of my patients. I’d honestly rather take my time and see them fewer per hour, to make sure I am thorough and hear their complaints.


I’m not really concerned with money. Even on my “low” wages I’m able to save a good bit each month, and live comfortably.

 

[miacomet]

It doesn't take them a while if maximizing income is their goal. There are so many ways to make money in medicine, and very few ways to do in nursing.
You're referring to doctors who are clueless financially and just want to be paid a basic salary for seeing 3 patients an hour. In that case, then yes. For those who know have business acumen, they'll be light years ahead of others and the debt is paid off in a couple years.

Most docs are not great business people. Tell us more....

 

[miacomet]

Because I literally ate pizza maybe 4 times before I was 17, had burgers maybe a dozen, had never been to a restaurant, and since I’d never had it I went crazy. It was something new to me. I think I was 21 the first time I had Taco Bell.

My moms cooking was great, it’s just that’s all I ever ate. We ate cheap. My father insisted that we be able to eat on 2 dollars a day average. And we usually did, unless we had a lot of meat getting close to expiration or something.

I still don't get it. Why would anyone want Taco Bell?

 

[Dr Mantis Toboggan]

I still don't get it. Why would anyone want Taco Bell?

So, you’ve never had alcohol?!? 4th meal is real.

 

[miacomet]

So, you’ve never had alcohol?!? 4th meal is real.

Sure. But Taco Bell would not be near the top of my list...

 

[MedicineZ0Z]

I mean I’m a very financial minded person, but I never want to put that ahead of my patients. I’d honestly rather take my time and see them fewer per hour, to make sure I am thorough and hear their complaints.


I’m not really concerned with money. Even on my “low” wages I’m able to save a good bit each month, and live comfortably.

Chatting about sports and movies with patients doesn't improve patient care. If anything it distracts from the diagnosis/plan.
I've seen doctors see 7-8 patients per hour and still provide high quality care, it's cause they don't waste time and do just medicine.

 

[Apollyon]

I've seen doctors see 7-8 patients per hour and still provide high quality care, it's cause they don't waste time and do just medicine.

Doing what? Psych, urgent care, neurology, ENT, what? I just can't see, in my mind's eye, which field can provide "high quality care", constantly, continuously, in only 7-8 minutes each.

 

[MedicineZ0Z]

Doing what? Psych, urgent care, neurology, ENT, what? I just can't see, in my mind's eye, which field can provide "high quality care", constantly, continuously, in only 7-8 minutes each.

This is primary care. And it's actually not hard. You have a couple highly efficient MAs who room patients and rapidly document basic history/chief complaint, put things up to date and the doctor comes in once everything is ready. You can finalize the history, do a focused physical if needed, and give your diagnosis/plan all in 7-8 mins. The MA then finishes the note. In contrast I've seen attendings talk about football and take forever to do their note, come up with the same assessment & plan in 3x the duration.
It works when you double/triple book time slots and are going room to room while MAs work in a circle basically.

As for specialties, actually lot of fields have very high volume rapid visits (ex. derm) by nature.

 

[RNtoMD87]

Chatting about sports and movies with patients doesn't improve patient care. If anything it distracts from the diagnosis/plan.
I've seen doctors see 7-8 patients per hour and still provide high quality care, it's cause they don't waste time and do just medicine.

Eh well good. I don’t watch sports or movies as both are a pointless waste of time. I don’t own a television...

I’m talking about instead of rushing them in and out of my office, I want to address their concerns. I’ve had many of my own personal health issues missed due to half ass primary care doctors.

 

[VA Hopeful Dr]

This is primary care. And it's actually not hard. You have a couple highly efficient MAs who room patients and rapidly document basic history/chief complaint, put things up to date and the doctor comes in once everything is ready. You can finalize the history, do a focused physical if needed, and give your diagnosis/plan all in 7-8 mins. The MA then finishes the note. In contrast I've seen attendings talk about football and take forever to do their note, come up with the same assessment & plan in 3x the duration.
It works when you double/triple book time slots and are going room to room while MAs work in a circle basically.

As for specialties, actually lot of fields have very high volume rapid visits (ex. derm) by nature.

If you are seeing that many patients in primary care you're not doing a good job. Period.

 

[Apollyon]

This is primary care. And it's actually not hard. You have a couple highly efficient MAs who room patients and rapidly document basic history/chief complaint, put things up to date and the doctor comes in once everything is ready. You can finalize the history, do a focused physical if needed, and give your diagnosis/plan all in 7-8 mins. The MA then finishes the note. In contrast I've seen attendings talk about football and take forever to do their note, come up with the same assessment & plan in 3x the duration.
It works when you double/triple book time slots and are going room to room while MAs work in a circle basically.

As for specialties, actually lot of fields have very high volume rapid visits (ex. derm) by nature.

I thought PC was all "touchy-feely" and relationship building. Entire visit in 7 minutes by the doc - doesn't sound like primary care.

 

[RNtoMD87]

If my doctor only gave me 7 minutes of his time I wouldn't go back to him. I would find someone that I could discuss my health with. This was my issue with an NP I went to once. She played candy crush on her phone the whole time, and said "You're in nursing school and you're just self diagnosing yourself. You're fine. Nothings wrong with you".

Yep, well my Vit D level was 10, test was like 320, plus I had diagnoses she completely missed and had been missed my entire life, because of doctors that don't feel like spending time with their patients, or don't listen.

 

[MedicineZ0Z]

Eh well good. I don’t watch sports or movies as both are a pointless waste of time. I don’t own a television...

I’m talking about instead of rushing them in and out of my office, I want to address their concerns. I’ve had many of my own personal health issues missed due to half ass primary care doctors.

Taking a lot of time = / = being thorough. You can address complaints and ensure preventative screening isn't being missed without wasting a single minute.

I thought PC was all "touchy-feely" and relationship building. Entire visit in 7 minutes by the doc - doesn't sound like primary care.

How many minutes do you need for a peds ear ache? Uncomplicated cellulitis? Follow up on normal lab results? Controlled diabetes follow up? URI symptoms of <3 day?
Some patients will take a lot longer but quick simple cases don't. Also, that's why you have 2-3 MAs. They will spend additional time documenting concerns.

 

[RNtoMD87]

Being really fast like that is a good way to miss something. As a Dr. I'm sure you know how some problems aren't immediately apparent. Some may not be noticed by the patient yet.

Some of these patients you may could spend a short time with, but many require more than 7 minutes of thorough, focused time.

Are you a primary care doc? Do you believe in "A stitch in time saves nine" or would you rather do the bare minimum, not catch other problems and let them get worse, and require more resources to correct?

 

[MedicineZ0Z]

Being really fast like that is a good way to miss something. As a Dr. I'm sure you know how some problems aren't immediately apparent. Some may not be noticed by the patient yet.

Some of these patients you may could spend a short time with, but many require more than 7 minutes of thorough, focused time.

Are you a primary care doc? Do you believe in "A stitch in time saves nine" or would you rather do the bare minimum, not catch other problems and let them get worse, and require more resources to correct?

I think you missed my point. Lot of primary care is not that time consuming and is straight forward. Indeed 10-20% of the day is not straight forward and needs more time. That is where the time should go... not talking about irrelevant randomness (attending spending 5 minutes talking about what his daughter is doing) with a patient who came to check that his labs are okay.

Also, what exactly are you suggesting? To go looking for symptoms that aren't actually there and triggering unnecessary workups?

 

[RNtoMD87]

No, but also not feel like they're running you in and out of their office. I hate when I'm explaining symptoms to a doctor and its obvious that they're not even listening and just waiting to push you out and get the next person in.

 

[MedicineZ0Z]

No, but also not feel like they're running you in and out of their office. I hate when I'm explaining symptoms to a doctor and its obvious that they're not even listening and just waiting to push you out and get the next person in.

That's not being focused and isn't always fixed by spending more time. Also, your complaint may very well warrant a lengthy visit.

Anyway, I do agree with what you're saying overall. My point is that extensive visits are the minority and a good chunk of office visits can be done rapidly given their nature.

 

[RNtoMD87]

I think we do agree. Business does need to be business. I think we are just looking at two sides of the same idea.

However, the way you feel about nurses, I feel even more so about MAs. My last ex was a cardiologist MA, and their understanding can be very limited. Especially outside of their specific area. She didn't really understand how the heart worked electrically and physically. To be fair, she seemed to know almost as much as the nurses. Never had a high opinion of clinic nurses.

 

[MedicineZ0Z]

I think we do agree. Business does need to be business. I think we are just looking at two sides of the same idea.

However, the way you feel about nurses, I feel even more so about MAs. My last ex was a cardiologist MA, and their understanding can be very limited. Especially outside of their specific area. She didn't really understand how the heart worked electrically and physically. To be fair, she seemed to know almost as much as the nurses. Never had a high opinion of clinic nurses.

They don't need to know anything though and frankly they don't. Their job is to put the patient's words into the chart and scribe once you come in. Also to check box things and present them quickly after (ex. screening).

 

[RNtoMD87]

I never understood why someone would go through RN school to do something like nursing home or clinic. Low pay, low satisfaction.

 

[SpacemanSpifff]

Taking a lot of time = / = being thorough. You can address complaints and ensure preventative screening isn't being missed without wasting a single minute.


How many minutes do you need for a peds ear ache? Uncomplicated cellulitis? Follow up on normal lab results? Controlled diabetes follow up? URI symptoms of <3 day?
Some patients will take a lot longer but quick simple cases don't. Also, that's why you have 2-3 MAs. They will spend additional time documenting concerns.

Spoken like a med student. The simplicity of a complaint does not always equate to the difficulty of an encounter. Some of the most challenging patient interactions are for the simplest complaints. Convincing the first time mom that the milia on her newborn is harmless, reassuring the 65yo worried well that their bronchitis will not improve with antibiotics, etc. Medically, these are 1 minute complaints. But you don't just make a diagnosis and walk out the door. At least not if you want to actually keep your patient panel/PG scores.

 

[RNtoMD87]

Spoken like a med student. The simplicity of a complaint does not always equate to the difficulty of an encounter. Some of the most challenging patient interactions are for the simplest complaints. Convincing the first time mom that the milia on her newborn is harmless, reassuring the 65yo worried well that their bronchitis will not improve with antibiotics, etc. Medically, these are 1 minute complaints. But you don't just make a diagnosis and walk out the door. At least not if you want to actually keep your patient panel/PG scores.

I can’t speak on outpatient, but inpatient this is totally true. I have medically complicated patients, and just plain complicated frustrating patients and they aren’t usually both.

 

[VA Hopeful Dr]

I thought PC was all "touchy-feely" and relationship building. Entire visit in 7 minutes by the doc - doesn't sound like primary care.

There are doctors like this - we have several in our group. They are the ones who refer to endocrine as soon as metformin isn't enough to control diabetes, cardiology for every single episode of chest pain, nephrology for hypertension that lisinopril can't control, and ortho for a sore knee.

They also tend to be much free-er with narcotics and benzos than the rest of us.

 

[sylvanthus]

I can’t speak on outpatient, but inpatient this is totally true. I have medically complicated patients, and just plain complicated frustrating patients and they aren’t usually both.

Totally agree, ive noticed a trend that the least sick patients sometimes take up the most of my time on medicine floors just due to being huge pains in the ass. Since I am in NY and in a nursing run hospital, any patient (errrr excuse my customer) complaint is a 5 alarm fire that needs immediate attention.

 

[RNtoMD87]

Man I hate that term. Customer. They were brainwashing us in school to call them customers- I refuse. Also, since I practically can’t get fired as a nurse I refuse to kiss my patients ass. I’ve really gotten freer with my tongue.

 

[miacomet]

Totally agree, ive noticed a trend that the least sick patients sometimes take up the most of my time on medicine floors just due to being huge pains in the ass. Since I am in NY and in a nursing run hospital, any patient (errrr excuse my customer) complaint is a 5 alarm fire that needs immediate attention.

The NY situation is out of control. I've worked in other union states, and the nurses have been fine. What is with New York?

 

[sylvanthus]

NY is the 12 circle of hell. Cannot wait to get out of this dump. 180 days to go.

 

[pkm296]

NY is the 12 circle of hell. Cannot wait to get out of this dump. 180 days to go.

IDoes this apply to all parts of New York or mostly the city? I've heard horror stories about NYC but still love the idea of moving to upstate some day (an idea based on my love of snow) but not if this is a statewide issue. Sorry random question...

A primary care doctor who tries to have 7 min appointment is why we see 90 y/o train wrecks with advanced dementia who come into the ED as full code. Also in the clinic setting it takes me on average 15 seconds to make one small talk comment be it movie weather or parking and it lets my patient know I see them as a person and not a bundle of complaints. It's important to build rapport. (My subspecialty training sadly involves a clinic)

 

[MedicineZ0Z]

Spoken like a med student. The simplicity of a complaint does not always equate to the difficulty of an encounter. Some of the most challenging patient interactions are for the simplest complaints. Convincing the first time mom that the milia on her newborn is harmless, reassuring the 65yo worried well that their bronchitis will not improve with antibiotics, etc. Medically, these are 1 minute complaints. But you don't just make a diagnosis and walk out the door. At least not if you want to actually keep your patient panel/PG scores.

I've rotated in settings where I was seeing 25-30 patients a day (if not slightly more) and had dozens and dozens of those complaints. Addressed them myself. Attending came in to give the blessing and patient left satisfied. Please don't equate being a med student to not understanding the complexity of the complaints.
And you make your diagnosis in 1 minute and then spend 15 minutes explaining why antibiotics don't help? lol.

 

[NITRAS]

I never understood why someone would go through RN school to do something like nursing home or clinic. Low pay, low satisfaction.

Different strokes for different folks. Some people like 8-5 jobs with holidays off. There are some really good clinic RN's out there. They don't run IV pumps, they also don't have to wipe people's bottoms. I heard a story about a home health RN who ran her own company and was making more than most MD's.

And @MedicineZ0Z , if I discharge someone who spent a week in the hospital and the PCP spent 5 minutes. . . . .they don't have a firm grasp on what the heck happened or what they need to manage/look out for.
And be aware some of the people responding work in primary care and know a thing or two about what they are saying.

 

[NITRAS]

And when will people realize that physician pay is based on how much production you make (how much money you bring in) and how much you can be replaced with.

The cost or duration of your education means nothing.

 

[SpacemanSpifff]

I've rotated in settings where I was seeing 25-30 patients a day (if not slightly more) and had dozens and dozens of those complaints. Addressed them myself. Attending came in to give the blessing and patient left satisfied. Please don't equate being a med student to not understanding the complexity of the complaints.
And you make your diagnosis in 1 minute and then spend 15 minutes explaining why antibiotics don't help? lol.

It was not a comment on your intelligence or ability, only your experience. Recognize that you are in the infancy of your career. As you accumulate more experience you will begin to realize how little you really know -- that has been my experience during residency.

Re: the bolded - sometimes. Granted, in the ED this is compressed into a 5 minute conversation. My job frequently revolves primarily around communication. Patient satisfaction is not everything, but poor communication leads to disgruntled patients, return visits, and replicated work. Spending time ensuring that the guy with the corneal abrasion understands that his pain won't disappear in 24 hours ensures he doesn't come back tomorrow unnecessarily.

 

[Apollyon]

It was not a comment on your intelligence or ability, only your experience. Recognize that you are in the infancy of your career. As you accumulate more experience you will begin to realize how little you really know -- that has been my experience during residency.

Re: the bolded - sometimes. Granted, in the ED this is compressed into a 5 minute conversation. My job frequently revolves primarily around communication. Patient satisfaction is not everything, but poor communication leads to disgruntled patients, return visits, and replicated work. Spending time ensuring that the guy with the corneal abrasion understands that his pain won't disappear in 24 hours ensures he doesn't come back tomorrow unnecessarily.

Good discharge instructions are better than an accurate diagnosis.

 

[Lexdiamondz]

So should we take a flip position that medicine is very easy? And that most of medical education is a waste of time?

Part of my original point here was why do EM docs get furious over FM working in the ED but don't lose their minds over NPs. As a student I've put in 2 chest tubes, placed central lines and intubated a few dozen times now. Most NPs/PAs haven't even seen one. I can easily argue I'm far more qualified to work independently in my present state than an NP is. But that proposal would be seen an insane yet NPs are welcomed in with no resistance.

Except in what world do you think we aren't upset over this. Literally >100 responses in a thread expressing malcontent over the idea of NPs working independently and you still harp on this FP thing.

 

[Lexdiamondz]

Where on earth are you intubating a few dozen times as a student? Unless you mean an anesthesia rotation

I mean I'll be honest, I straight up don't believe half the things this person posts about themselves. The idea that they're doing chest tubes (where there are EM residents present) and intubating in the ER and ICU as an MS3 when there are medicine residents who've literally never done a tube is kind of ridiculous.

But hey, it's the internet and anyone can be anything they'd like.

 

[sylvanthus]

I mean I'll be honest, I straight up don't believe half the things this person posts about themselves. The idea that they're doing chest tubes (where there are EM residents present) and intubating in the ER and ICU as an MS3 when there are medicine residents who've literally never done a tube is kind of ridiculous.

But hey, it's the internet and anyone can be anything they'd like.

Ehh its possible, though I know nothing of this persons posting history. I rotated at a ****ty site for my 3rd and 4th year, there were no residents so we were treated like residents. I think I had something like 12 central lines, 60 intubations, a couple LPs, para, etc by the end of medical school. Granted, the site was shut down after I graduated, hah.

 

[Boatswain2PA]

I mean I'll be honest, I straight up don't believe half the things this person posts about themselves. The idea that they're doing chest tubes (where there are EM residents present) and intubating in the ER and ICU as an MS3 when there are medicine residents who've literally never done a tube is kind of ridiculous.

That's interesting. During my one year of clinicals in PA school I intubated several times and put in several chest tubes, including one on a toddler during a resuscitation. Also put in a bolt, did a couple of colonoscopies, and assisted in numerous surgeries including several C-sections and a thoracotomy. All under very close direct supervision from a physician, PA, or an NP. I think this was pretty typical for my classmates.

I figured MS3/4 students would get similar procedural experiences.

 

[docbsb2015]

That's interesting. During my one year of clinicals in PA school I intubated several times and put in several chest tubes, including one on a toddler during a resuscitation. Also put in a bolt, did a couple of colonoscopies, and assisted in numerous surgeries including several C-sections and a thoracotomy. All under very close direct supervision from a physician, PA, or an NP. I think this was pretty typical for my classmates.

I figured MS3/4 students would get similar procedural experiences.

You did a colonoscopy as a PA student????

 

[MedicineZ0Z]

Different strokes for different folks. Some people like 8-5 jobs with holidays off. There are some really good clinic RN's out there. They don't run IV pumps, they also don't have to wipe people's bottoms. I heard a story about a home health RN who ran her own company and was making more than most MD's.

And @MedicineZ0Z , if I discharge someone who spent a week in the hospital and the PCP spent 5 minutes. . . . .they don't have a firm grasp on what the heck happened or what they need to manage/look out for.
And be aware some of the people responding work in primary care and know a thing or two about what they are saying.

I've rotated with very competent doctors who saw high volumes of patients in a relatively short span of time (per patient on average) and rotated with docs who were slow and took their time and were far less competent. I wouldn't correlate time spent to quality of outcomes. And again, some patients require a lot more time. But to imply that all 30 out of 30 patients per day are highly complex is nonsense.

I mean I'll be honest, I straight up don't believe half the things this person posts about themselves. The idea that they're doing chest tubes (where there are EM residents present) and intubating in the ER and ICU as an MS3 when there are medicine residents who've literally never done a tube is kind of ridiculous.

But hey, it's the internet and anyone can be anything they'd like.

As an MS4 mostly** and yes you get to do stuff when you're on nights with one resident or the residents on service have hit their minimum numbers & have 0 interest in doing more (ex. IM residents going into rheum, allergy etc.).
You don't allow med students to intubate or place lines?

That's interesting. During my one year of clinicals in PA school I intubated several times and put in several chest tubes, including one on a toddler during a resuscitation. Also put in a bolt, did a couple of colonoscopies, and assisted in numerous surgeries including several C-sections and a thoracotomy. All under very close direct supervision from a physician, PA, or an NP. I think this was pretty typical for my classmates.

I figured MS3/4 students would get similar procedural experiences.

yeah... no.

 

[Lexdiamondz]

As an MS4 mostly** and yes you get to do stuff when you're on nights with one resident or the residents on service have hit their minimum numbers & have 0 interest in doing more (ex. IM residents going into rheum, allergy etc.).
You don't allow med students to intubate or place lines?

CVLs sure, if I trust you and you've shown yourself to be procedurally competent in the past. I've given probably half-dozen or so CVLs to sub-is.

Intubations are generally at the discretion of the attending, and in the ED are generally a hard no. I tubed alot on anaesthesia as an MS4 but never in the ED prior to residency.

 

[MedicineZ0Z]

CVLs sure, if I trust you and you've shown yourself to be procedurally competent in the past. I've given probably half-dozen or so CVLs to sub-is.

Intubations are generally at the discretion of the attending, and in the ED are generally a hard no. I tubed alot on anaesthesia as an MS4 but never in the ED prior to residency.

I've rotated in 2 EDs and both let me intubate. My classmate rotated in 3 other EDs and he got to intubate in 2/3. I would agree that a majority of EDs wouldn't let a med student intubate but quite a few do.
Why are they a hard no?? Are they difficult intubations? Risky (ex. upper GI bleeds) where you need the first pass? Residents around who need the exp?

When EM residents aren't around, no reason a student can't intubate. I've gotten a 2nd pass twice (once in the ed, once in the icu) as well.
Especially true if you have a lot of numbers from anesthesia etc. because at that point your airway skills are on par with some em interns.

 

[deleted547339]

I've rotated with very competent doctors who saw high volumes of patients in a relatively short span of time (per patient on average) and rotated with docs who were slow and took their time and were far less competent. I wouldn't correlate time spent to quality of outcomes. And again, some patients require a lot more time. But to imply that all 30 out of 30 patients per day are highly complex is nonsense.

As an MS4 mostly** and yes you get to do stuff when you're on nights with one resident or the residents on service have hit their minimum numbers & have 0 interest in doing more (ex. IM residents going into rheum, allergy etc.).
You don't allow med students to intubate or place lines?

yeah... no.

Dude. Literally everyone on this board has more experience than you and is telling you you’re wrong. You can’t be that high volume and be a good doctor. You either severely lack insight or are a troll.

 

[VA Hopeful Dr]

Dude. Literally everyone on this board has more experience than you and is telling you you’re wrong. You can’t be that high volume and be a good doctor. You either severely lack insight or are a troll.

Oh oh, I know which it is!

 

[Boatswain2PA]

You did a colonoscopy as a PA student????

Rural setting, family practice doc who did lots of them. Let me "drive" the camera at first, and eventually had me pretty much do complete ones before end of rotation.

I kinda thought that would be normal experience as a student, apparently not.