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Deleted member 13628

User requested account closure
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Oct 27, 2017
1,098
I understand that. And you, as a health care provider, can refuse to do it on the grounds of your morals, because at the end of the day, the patient's rights cannot go over your rights to refuse (and let's not get into the debate if it's moral to refuse, because that's a whole other beast).

But as a human being, I cannot in good consciousness tell a patient to search for other means, that can be violent and traumatize his or her family and not allow them to grow and transcend beyond his or her death. I personally do not find that moral.

So that's the good thing, if you refuse, which you can, someone like me can takeover and everyone wins.

I would not actually tell someone to "find some other way to off yourself". But they would be forced to find a different avenue because at that point I would be of no use to them. I can't provide that service on medical or moral grounds. Thankfully, I don't see this practice ever becoming widespread.
 

EarthBound64

User was permanently banned at own request
Banned
Oct 25, 2017
1,802
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v1perz53

Member
Oct 25, 2017
276
Don't mean to come in here and be a downer, but man am I jealous of all the people in here saying how much they love their jobs despite the hours and stress. I'm a PGY-1 in pediatrics, and honestly I kind of hate what medicine is, at least how the US practice of medicine is. My fiancee is a PGY-3 in neurology and she kind of shares my sentiments. I feel super fulfilled when I actually get to do something and help a kid get better, and I certainly love working with children, but that has turned out to be so far and away the minimum of my actual job. I feel like on a daily basis I spend 10% of my day actually talking to patients and 90% in front of a computer documenting and managing orders or dealing with dumb bureaucracy. What I do every day isn't what I signed up for when I went to medical school, and I think this field does an awful job of showing prospective doctors what their actual life will be like in practice. I did all the things, I shadowed doctors, I volunteered, but the slice you see is so different than how it actually is in practice. And the hours... I know it will get better after residency, but currently any month that I am on floors, NICU or Nursery the hours are 7 to 7 (either AM to PM for days or PM to AM for nights), and that is 7 months of the year for me. I have a 30 minute commute, sign out takes ~1 hour, and I work 6 days a week. That means that of the 24 hours in a day, 14 of them are at work 6 days a week, and 10 are at home. Leaving 2 hours a day to go to the gym, cook dinner and see my fiancee at all if I want to sleep 8 hours a night, which unfortunately I found I need to remain mostly functional. I don't exist as a person most days aside from my job, and it is so draining. The one weekend day I do have, I end up sleeping late because I finally can, and most of the day is gone. And as a PGY-2 and 3, my program has a Q4 24 hour call schedule, so I have to look forward to the same 7 AM to 7 PM schedule most days, except 2 days a week I have to stay for a full 24 hours (and in my program you don't really sleep at all on your 24 hour calls). Just a bit depressing to know that my next 2.5 years I can barely exist, can barely see friends or family. Which would be fine, but I also don't feel like most of what I do has any real impact, I feel like it is just so the hospital avoids getting sued (ok that was a bit cynical, but I certainly feel like the entire medical process is super inefficient). 3rd and 4th year of medical school were just as bad, if not worse schedule wise, since for rotations I had to be in from when the residents got in to when they left, while also studying for a test at the end of each rotation that would determine my entire future. I feel like I gave away the best years of my life for future financial stability, and right now it is hard to feel like that trade was worth it.

And I feel stuck. I have almost 300k in debt, so while I could drop out now and try something else, the weight of my loans is too frightening to take that chance, and the financial burden that would put on my current and future family is too high for me to make that decision, especially given that I can't be sure I would like that other thing more (or that I won't like medicine more once I actually finish residency). I just wish medicine was a bit more like I expected it to be, instead of what it turned out as. Or maybe I just picked the wrong field. I really enjoy the parts of my days where I am interacting with patients, but that is only ~2 hours of my 12 hour day, and if I knew that going in I'm not sure I would've made the same choice. Don't mean to be a huge downer, and sorry for the rant, just felt like sharing my side after seeing so many that seem to be coping with this much better than I am, and are able to continue loving medicine despite the hardships.
 

Sgtpepper89

Member
Oct 26, 2017
1,069
Sweden
Well its a tough subject with a huge grey zone. Where are you supposed to draw the line within the laws of who and whom that is supposed to perform and approve it, and what criterias?

Cant imagine giving injections to every single suicidal person be a good idea.
 

Spartancarver

Attempted to circumvent ban with alt account
Banned
Oct 27, 2017
3,453
Internal medicine MD PGY-2 here. Currently on MICU for the next 3 weeks. Hooray 28 hour overnight long calls *_*
 

EarthBound64

User was permanently banned at own request
Banned
Oct 25, 2017
1,802
Connecticut
Well its a tough subject with a huge grey zone. Where are you supposed to draw the line within the laws of who and whom that is supposed to perform and approve it, and what criterias?

Cant imagine giving injections to every single suicidal person be a good idea.

And I believe those are all important things to discuss, and lay specific guidelines for.

Just that someone saying "it's not the job of a healthcare provider" completely cuts the conversation off from taking place to begin with.
And, unfortunately, there are many - both in the medical field, and in the lawmaking field - who share that view and don't let it get beyond that point.
 

Juan29.Zapata

Member
Oct 25, 2017
2,354
Colombia
I would not actually tell someone to "find some other way to off yourself". But they would be forced to find a different avenue because at that point I would be of no use to them. I can't provide that service on medical or moral grounds. Thankfully, I don't see this practice ever becoming widespread.
Well then, let's agree to disagree then. I'm glad that lawmakers are not physicians, because I do not find it fair. But that's just me.

Also it won't ever become widespread because palliative care exists, thankfully. I do gotta say that more physicians should train in palliative care because many people ask for euthanasia since their doctors don't solve their pain and suffering (which are not the same things BTW!).
 

Deleted member 13628

User requested account closure
Banned
Oct 27, 2017
1,098
Well then, let's agree to disagree then. I'm glad that lawmakers are not physicians, because I do not find it fair. But that's just me.

Also it won't ever become widespread because palliative care exists, thankfully. I do gotta say that more physicians should train in palliative care because many people ask for euthanasia since their doctors don't solve their pain and suffering (which are not the same things BTW!).

Exactly. That's why I said it makes no sense on medical grounds in addition to ethical. If a patient has metastatic lung cancer, they're not going to survive long without assistance from mechanical ventilation. Often less than hours depending on the tumor burden. Instead of focusing on keeping them comfortable during that time, why inject a suicide cocktail into them (which actually would lead to more pain and suffering)? Any decent hospital and ICU is well trained in palliation.
 

Tarot Deck

Avenger
Oct 27, 2017
4,233
Radiologyst here.

Still hanging in this career before the robots take over.

Edit: what a crazy story, btw. I' be never met a nurse or doctor with HIV, but I don't think that is a hazard by itself
 

Morrison71

Member
Oct 27, 2017
999
Radiologyst here.

Still hanging in this career before the robots take over.

Edit: what a crazy story, btw. I' be never met a nurse or doctor with HIV, but I don't think that is a hazard by itself
Yeah that's scary. One of the reasons I wanted to be a lab tech was job security and the high placement rate. I don't think it will get terribly bad. People still have to take care of the machines. I can see as the older techs retire, places not filling their jobs. I would hate seeing that and hopefully it doesn't get much worse than that.
 

Juan29.Zapata

Member
Oct 25, 2017
2,354
Colombia
Exactly. That's why I said it makes no sense on medical grounds in addition to ethical. If a patient has metastatic lung cancer, they're not going to survive long without assistance from mechanical ventilation. Often less than hours depending on the tumor burden. Instead of focusing on keeping them comfortable during that time, why inject a suicide cocktail into them (which actually would lead to more pain and suffering)? Any decent hospital and ICU is well trained in palliation.
Remember my example of the twenty-something year old Belgian woman who suffered from depression and got her euthanasia granted. Yes she received all treatments that were available to her, and multiple psychiatrists approved her to receive euthanasia. Palliative care goes beyond her. Even though I agree with your sentiment of calming pain before considering euthanasia.
 

EarthBound64

User was permanently banned at own request
Banned
Oct 25, 2017
1,802
Connecticut
Remember my example of the twenty-something year old Belgian woman who suffered from depression and got her euthanasia granted. Yes she received all treatments that were available to her, and multiple psychiatrists approved her to receive euthanasia. Palliative care goes beyond her. Even though I agree with your sentiment of calming pain before considering euthanasia.

Another thing to consider is the case of Charlie Gard at the GOSH.
The fact that - at the other board - there were people in favor of keeping him "alive" like that because "you don't know what it's like to lose a child" was terrifying.
 
Oct 27, 2017
69
It probably does really matter on the environment. Like even different ERs are probably wildly different depending on hospital size/location. Have you ever heard of someone being denied a job because of disease? I mean yeah there's HIV/Hep, but I'm wondering if there are people doing surgery with really bad heart conditions and stuff like that which could be a huge disaster in a stressful situation. Does a pathologist get fired if they start showing signs of dementia?

I think you bring up really important ethical questions. As a specialty, we are often in charge of policing ourselves and can be very protective of people even when they've exceeded their safety profile. I think with the loss of paternalism, litigious bombardment from lawsuits, and a general loss of faith by the public, we feel the need to protect our own. Or maybe for fear of being next.

Loans indenture us to fear of failure and loss of livelihood which, in addition to our cultural valuation of hierarchy (remnant of apprenticeship), makes it difficult to accuse another physician of inability to function. Part of the problem is how punitive our system is in rehabilitating people for mental illness or drug abuse, the very same illnesses our method of training is responsible for. All of these things are wrong and need to be corrected: we need to give who aren't suited to medicine an easy out once they're in, we need to be understanding of those who voluntarily come forward in crisis, and we need to honor those who have served us in medicine rather than robbing them of their pride.

In regard to your specific examples, I've heard of surgeons with tremors and other conditions who have continued to operate when they should not have; I don't believe they should be allowed to continue. Similar for the pathologist. Again, the issue remains that usually only other physicians are fit to judge impairment (can you tell me the pathologic diagnosis is incorrect? I can't.)

Don't mean to come in here and be a downer, but man am I jealous of all the people in here saying how much they love their jobs despite the hours and stress. I'm a PGY-1 in pediatrics, and honestly I kind of hate what medicine is, at least how the US practice of medicine is.

[...]

And I feel stuck. .

Thanks so much for sharing. I know we got derailed with infectious diseases and euthanasia, but I think this is what the thread is really for.

I was one of the people who said he loves his job and frankly, I've been there too. I ended my intern year certifiably and without doubt clinically depressed for many of the reasons you mentioned. You're right to say that you don't know what you're getting into--no one does until they're in it, which is the problem with a system that has you $100k in the hole before you even hit clinical rotations; med schools should be covered like in many other first-world countries.

Intern year is frustrating because you have no power and lots of responsibility (which is, in a ratio, the equation for satisfaction). Also you're new to your system and usual clinical workups; as an intern I spent so much time writing charts and being inefficient about things, it was miserable. Now those things are in such auto-pilot that I spend much more time sitting with my patients, explaining what's going to happen (because I actually know what it is). I have my own interns to help me out with notes. I know everyone in the ER better. I really enjoy coming to work--and I used to really dread it.

It gets better. Ultimately, you're the one in charge of your career. I don't think there's anything abnormal about the way you feel right now, just take time to go after those moments where you connect with patient's; your attendings aren't going to ask you about them on rounds, but they keep you going.

Yikes. How does that even happen?
I went through different fields (that is, I'm not a medical student - so maybe things are much more expensive?), but, living in the US, after 12 years of university, I "only" had around $100k in debt.

I think the average loan debt for medical schools is $300-350k. Mine certainly falls within that range. Add undergraduate loans if you went straight to med school.
 

EarthBound64

User was permanently banned at own request
Banned
Oct 25, 2017
1,802
Connecticut
I think the average loan debt for medical schools is $300-350k. Mine certainly falls within that range. Add undergraduate loans if you went straight to med school.

Yikes is that frightening.
I can definitely see where that would make you feel "locked in" after a certain point.

For what it's worth, my ~$100k was from Education.
 

Deleted member 13628

User requested account closure
Banned
Oct 27, 2017
1,098
Med school loans are ridiculous. At the very least they will eventually be paid off but it will be a pretty decent chunk of your income each month.
 

v1perz53

Member
Oct 25, 2017
276
Yikes. How does that even happen?
I went through different fields (that is, I'm not a medical student - so maybe things are much more expensive?), but, living in the US, after 12 years of university, I "only" had around $100k in debt.

My path took me through 2 years of graduate school before Medical School, and I went to school in NYC to be near family with really high cost of living. All told, I walked in to med school already $50k in debt from grad school (luckily I went to a state school for undergrad and my parents were able to cover it). During med school, I went to a state school again but tuition was still over $40k per year, room and board was over $20k per year and that already basically hits my $300k total before factoring in any other spending (I lived incredibly frugally during med school). I mean, honestly one of our REQUIRED EXAMS costs $1550 without travel expenses (test is only given in like 5 locations across the US).

Thanks so much for sharing. I know we got derailed with infectious diseases and euthanasia, but I think this is what the thread is really for.

I was one of the people who said he loves his job and frankly, I've been there too. I ended my intern year certifiably and without doubt clinically depressed for many of the reasons you mentioned. You're right to say that you don't know what you're getting into--no one does until they're in it, which is the problem with a system that has you $100k in the hole before you even hit clinical rotations; med schools should be covered like in many other first-world countries.

Intern year is frustrating because you have no power and lots of responsibility (which is, in a ratio, the equation for satisfaction). Also you're new to your system and usual clinical workups; as an intern I spent so much time writing charts and being inefficient about things, it was miserable. Now those things are in such auto-pilot that I spend much more time sitting with my patients, explaining what's going to happen (because I actually know what it is). I have my own interns to help me out with notes. I know everyone in the ER better. I really enjoy coming to work--and I used to really dread it.

It gets better. Ultimately, you're the one in charge of your career. I don't think there's anything abnormal about the way you feel right now, just take time to go after those moments where you connect with patient's; your attendings aren't going to ask you about them on rounds, but they keep you going.

Thank you for sharing as well. You don't know how much it helps to know that other people go through these feelings too, and that some can end up happy afterwards anyway. It is just such a scary prospect to put yourself in so much debt for something that you can't know how it will actually be in the end. I truly do love medicine, I just don't love being a doctor right now (or at least being a resident). Your post gives me hope that I can get to a point where actually interacting with patients is more of what I do each day instead of all the other things. Because I love that part, I love my clinic days and seeing my new babies come in for their check ups every few weeks (we get a set clinic day so we can follow the same kids from birth for our 3 years of residency). I also love the ER, where charting is a much more expedient and surface level process and you get much more hands on time. So there is enough that I do like to see a future that is good, it is just knowing that the next 2.5 years won't really get better that makes it rough currently. But I do want to try to keep a more positive perspective and get the good out of what I can, I just wish I had a bit more time to myself to do some things for me, I think it would make all of this a bit easier. 12 to 14 hour days 6 days a week is just so incredibly draining.

Med school loans are ridiculous. At the very least they will eventually be paid off but it will be a pretty decent chunk of your income each month.

Luckily the more recent repayment options are a bit better. I am currently using an income based repayment option, where my loan payments are 15% of my monthly income. So they will never take more from me per month than I can afford (always 15%), but as a resident making less money my payments are smaller and I don't pay off much per month, and as my salary goes up my payments get larger. Mostly just banking on the public service loan forgiveness program not being destroyed by the time I get my 10 years of public service work in.
 

hans_castorp

Member
Oct 27, 2017
1,459
Last year student here. Will be a doctor by May.
Right now struggling to find time to write my thesis, finish my rotations and prepare my National Exam.

Can't wait for my rotations to be over and start the residency. These past two months have been really shitty.
 

br0ken_shad0w

Member
Oct 27, 2017
2,095
Washington
Nurse here, been on an IMU/stepdown for almost 5 years, thinking of going back to school again. Bedside has been wearing me out.

I feel you v1perz23 even as a nurse. My resident friends at the hospital work insane hours and get paid peanuts as their stipends. It's still crazy to think I get paid more than them despite working twice as many hours per week. I still have debt to pay from nursing school, a mere 20k now and the thought of medical school + residency is still scaring me even though I'm interested in taking over uncle's practice.
 

Neolith

Member
Oct 25, 2017
129
IAMtheFMan Rainy Thanks for the solid advice to you both.

Rainy i'm also at one of the Philly schools, small world huh?

I think I remember seeing someone being a path resident around here. Does anyone know who it is? I'd love to poke their brain a bit.
 

Cation

The Fallen
Oct 28, 2017
3,603
Neurosurgery PGY-5

Tired all the time. Always on call. Operating every day.

Love my job.
When did you start research? Im an M1 thinking of joining a clinical research lab. In undergrad I did basic science research in computational/Ochem and got 1 paper, so I want to do something more like application based
 

Juan29.Zapata

Member
Oct 25, 2017
2,354
Colombia
Don't mean to come in here and be a downer, but man am I jealous of all the people in here saying how much they love their jobs despite the hours and stress.

I've struggled a long time with studying medicine as well, I didn't feel fulfilled while many of my peers said they were, only this year I've been feeling better about my career choice. I hope it gets better for you, man. And don't worry, you're just venting.
 

M-PG71C

Member
Oct 29, 2017
139
Both my wife and I are RNs, we both graduated with our BSN's many years ago. My wife is currently going after her DNP to become an FNP and works in PCU Oncology and is also in the Navy Reserve as an RN. I work for the VA on an oncology med/surg unit. It's been good, neither one of us have student loan debt and her DNP is paid for thanks to the GI Bill.

My advice for any future student who wants to enter healthcare: Work as a CNA. It is painfully easy to obtain (Six weeks of class/clinical and a state exam), it looks damn good on any resume no matter what path you end up taking, and it teaches you skills that no book can ever teach you. Learning how to talk to patients and expressing empathy is an art. It can't be taught out of a book. Knowing how to manage your time. Learning to effectively deal with outrageous patient ratios (Which, the higher up the chain you climb, the worse that seems to become but I digress). There is a whole lot here and some of the finest providers and nurses I have had the pleasure of working with started from the very bottom.

My advice to any future MD: Learn to trust and respect your RNs. We are your eyes and ears. We are here to help you and take care of our patients. We have the same goal! We literally play on the same team! There is nothing more I hate in either of our professions then bickering among colleagues or attempts to have a pissing contest. I don't get paid enough to do either! Neither do you. ;)
 
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Chan

Banned
Oct 25, 2017
5,334
Im a nurse student in 3rd and last year. Currently working on the exam essay for the bachelors degree and the article search is killing my soul.

Time goes really fast and I have no idea in what field I want to work.. its not helping that the lack of nurses is so big that I can work wherever I want..

I regret nursing school every day, its not that I hate patient care, I hate it when they talk. ICU bores the fuck outta me so you know what, I'm gonna go work for OneLegacy as an underpaid perfusionist.
 
Oct 25, 2017
2,190
Eh, on and off again premed here. Dealing with chronic illness is hard. My bachelor's is in English, but I do hear that non trads might be beneficial.

My chances of getting in an MD or do program is low, but I at least want to try.

Working as a nursing assistant currently. I do want to do research but I have no idea who to approach about it.
 
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Chan

Banned
Oct 25, 2017
5,334
Both my wife and I are RNs, we both graduated with our BSN's many years ago. My wife is currently going after her DNP to become an FNP and works in PCU Oncology and is also in the Navy Reserve as an RN. I work for the VA on an oncology med/surg unit. It's been good, neither one of us have student loan debt and her DNP is paid for thanks to the GI Bill.

My advice for any future student who wants to enter healthcare: Work as a CNA. It is painfully easy to obtain (Six weeks of class/clinical and a state exam), it looks damn good on any resume no matter what path you end up taking, and it teaches you skills that no book can ever teach you. Learning how to talk to patients and expressing empathy is an art. It can't be taught out of a book. Knowing how to manage your time. Learning to effectively deal with outrageous patient ratios (Which, the higher up the chain you climb, the worse that seems to become but I digress). There is a whole lot here and some of the finest providers and nurses I have had the pleasure of working with started from the very bottom.

My advice to any future MD: Learn to trust and respect your RNs. We are your eyes and ears. We are here to help you and take care of our patients. We have the same goal! We literally play on the same team! There is nothing more I hate in either of our professions then bickering among colleagues or attempts to have a pissing contest. I don't get paid enough to do either! Neither do you. ;)

CNA work is probably the most difficult thing ever, especially on a med/surg unit where they're all bed bound. I get it done but I come from an ED background where we just get shit done (pun intended). While CNA will help you with your bedside skills, I recommend the route I took and thats EMT. The thing about 95% of nursing students suck at is assessing a patient, that's kinda the first thing they teach you to do as an EMT (other than how to apply a bandaid), I transitioned into the ED as a tech/secretary and those were great learning opportunities. Especially as unit secretary, I was sitting alongside the providers and were able to pick their brain about patho and what nots. ED unit secretary is either a tier above or below the difficulty of CNA, no joke, having 4 or 5 providers asking you to do things for them is the worst. I'm still working in the ED on a per diem basis and now work in cardiology and fuck is it boring but I get to do stupid ass care plans that make no sense.That being said, nursing school is nowhere near as difficult as anyone says, its just getting through the tedious crap that they put you through. Just say yes ma'am, please, and thank you; if the instructor is adamant that the earth is flat then fuck it the earth is flat for that semester. Most people will tell you that you can't work and go to nursing school and that's another crock of lies. I work a full time job and a per diem job, go through a local ADN program and then have your hospital pay for your BSN afterwards (one of my hospitals requires it now because they recently got Magnet Accreditation). There are private for profit colleges that churn out BSN students that have no idea what they're doing and only taught how to pass the NCLEX. I think they're charging around 130k for a BSN?

That being said, I don't know how these new doctors cope with life with literally a half million in debt unless you go through in an instate public school. Especially with how reimbursements keep getting lower and lower, one of the cardiologists I work with told me he gets $0.30 on the dollar that he bills (that being said he didn't tell me how much he actually bills for) he did go on about how one of his patients showed him a bill for a STEMI intervention, the hospital charged the patient $500 for cotton balls. We really need a single payer system that subsidizes healthcare education.
 

EQLibriM

Member
Oct 27, 2017
389
IM in my surgery internship right now, cant wait for it to be over haha. Super nice people, but its nothing I want to do. I have my eyes set on becoming a GP or a psychiatrist.

GEtting kind of annoyed by the ridiculously long days tbh, suppose that that is another reason to not pursue a career in surgery
 

Sgtpepper89

Member
Oct 26, 2017
1,069
Sweden
I really feel sorry for you americans and your terrible school and health systems. I rather pay high taxes and have everything "free".
 

Chan

Banned
Oct 25, 2017
5,334
IM in my surgery internship right now, cant wait for it to be over haha. Super nice people, but its nothing I want to do. I have my eyes set on becoming a GP or a psychiatrist.

GEtting kind of annoyed by the ridiculously long days tbh, suppose that that is another reason to not pursue a career in surgery

Eh general surgery sucks, it gets better if you have a first assist. Plastics though, that's Big Baller Brand lifestyle.
 

Deleted member 3815

User requested account closure
Banned
Oct 25, 2017
6,633
I used to be a dental nurse or more aptly a dental assistant.

It isn't a career path that I recommend people doing as the hours are long, you're on your feet all day, the pay is terrible and it's a thankless job as you get ignored by the patient and dentist.
 

br0ken_shad0w

Member
Oct 27, 2017
2,095
Washington
My advice for any future student who wants to enter healthcare: Work as a CNA. It is painfully easy to obtain (Six weeks of class/clinical and a state exam), it looks damn good on any resume no matter what path you end up taking, and it teaches you skills that no book can ever teach you. Learning how to talk to patients and expressing empathy is an art. It can't be taught out of a book. Knowing how to manage your time. Learning to effectively deal with outrageous patient ratios (Which, the higher up the chain you climb, the worse that seems to become but I digress). There is a whole lot here and some of the finest providers and nurses I have had the pleasure of working with started from the very bottom.

Echoing this and don't go into this profession because you just want a stable job and get paid decently. As a nurse, it's a lot of people interaction and a lot of hard work.
 

Chan

Banned
Oct 25, 2017
5,334
Echoing this and don't go into this profession because you just want a stable job and get paid decently. As a nurse, it's a lot of people interaction and a lot of hard work.

Eh it doesn't have to be a lot of people interaction; there are people do bedside nursing and people who do procedures. I personally just like doing whatever procedure I'm supposed to be doing and getting the hell out.
 

M-PG71C

Member
Oct 29, 2017
139
Echoing this and don't go into this profession because you just want a stable job and get paid decently. As a nurse, it's a lot of people interaction and a lot of hard work.

I agree. As a RN, you get to know everybody on a first name basis. Pharmacist, PT, OT, RT, Lab, Social Work, etc. You have to be willing to interact and you have to do it well. Even if you get away from bedside nursing, communication is still paramount. Whether that be a discharge planner, case manager, RN Circulator, etc.

@ Chen

I dunno man, I know plenty of RN's who do things like PICC/IV teams and other "procedure" like jobs and they still have to talk to the patient (alot) whether they like it or not, including a "time-out" prior to procedure. And yeah, those private colleges....that is insane. A RN makes a damn good living but they don't make $130k student debt good. My wife's DNP at a local university is not even close to that (Barely $50k total). I can't speak for everyone's program but we had plenty of people who either dropped out or failed out (especially first semester). It was a pain in the ass to get in and it took me three application cycles (which, sadly, allowed me to complete another major in between the fact lol) before I started. I know some private colleges are different in this regard but then you end up paying for it later on (RE: Stupid amount of debt).

I did work during my first degree but I would not recommend that to anyone. The deeper I got into nursing school the more I had to reduce work. I can't speak for everyone but for me, it was too much.

And yes, Physicians do not get paid enough. I do not understand how in the hell a cardiac surgeon or a radiation oncologist makes considerably less than any single member on the Board of Directors for a health system. And you know those management assholes could give two solitary fucks to anyone who is a clinician.
 

SabinFigaro

Member
Oct 27, 2017
203
When did you start research? Im an M1 thinking of joining a clinical research lab. In undergrad I did basic science research in computational/Ochem and got 1 paper, so I want to do something more like application based
I completed a Master's in Neurobiology prior to entering med school. I initially envisioned going the PhD route into pure academia, but eventually realized that a decent majority of a research career is focused on grant writing and funding applications, whereas I enjoyed research more for the actual animal and bench work. That hands-on approach was likely my inspiration for choosing a surgical career, and neurosurgery was a natural extension of my research interests.

As an M1, you have a lot of opportunities to pursue either basic or clinical science work, although your involvement on how motivated you are and how much time you're willing to invest. If you have a field in mind, the simplest thing to do is contact a faculty member in that department and introduce yourself and your interests. Otherwise, you can contact a resident. Everybody is used to getting cold-called, so don't be shy. There's always quite a bit of scut work to be done that faculty or residents are more than willing to pass on to eager med students.

You can basically look at 3 different types of projects:

(1) Case report: Simplest to research and write, good way to boost your CV, and a good way to show a potential supervisor that you have the ability to complete a smaller project. These are actually getting easier to publish due to the proliferation of paid and open-access journals, although there is some difficulty getting into a formal peer-reviewed journal, depending on your specialty. The latter are always preferred. However, one can tend to write these up fairly quickly and shop them around multiple journals before acceptance. Adding a literature review will likely lead to an increased chance of acceptance, although will take more effort.

(2) Clinical science: Varies in complexity, from a simple retrospective series, to more developed prospective cohorts, to full-blown RCTs, and all the stuff in-between (i.e. meta-analyses). Your role depends on the type of study. As a medical student, you could likely be a first, second or third author on a retrospective review depending on your skill, motivation and level of involvement. The data are already there, you just need to sift through the noise; meaning, a familiarity with stats and interpretations. This tends to be difficult if you don't have prior experience, although bigger labs will have dedicated statisticians. Prospective studies and RCTs will already have people working on them, but you may be able to insert yourself into a minor role, accepting a less prominent authorship.

(3) Basic science: The most difficult type of research to perform, due to the need for resources and longer duration required for experiment completion. Cell and molecular work are usually "easier" or "faster" than animal work, but can vary wildly based on the experiment. The biggest roadblock will be your inability to commit to the daily lab work because of your medical studies. Reserving these for the summer months is feasible, although you need to have a protocol up and running the moment you get started, and have to have clear goals. Even then, a few months is likely inadequate, unless another student takes over, and you might be busy with other commitments (i.e. USMLE). This is what I did in the summers of M1 and M2, but I had a basic science background coming in and was able to set something up with a colleague of my graduate supervisor. Again, if you pursue this avenue it may be beneficial to take on a more minor role, such as data analysis or similar, which is lesser authorship but also less work and responsibility.

So, my recommendation is to get involved early. Even if you don't know exactly which field you want, the ability to plan, research and perform a project is transferable across specialties. When residency applications are up, program directors are less likely to care that you did a case series in psychiatric patients as opposed to a neurosurgical issue, for example. If you presented or published, that's more important, because it shows you had initiative. Don't worry about primary authorship; accepting third author for the small part that you played in a project is a very good opportunity. Try to take your projects to local, national or international conferences if feasible.

Lastly, don't bite off more than you can chew. Lots of medical students try to get involved, and then fizzle out because they don't keep up with the work. I remember every student who has ever contacted me to get involved in a project, the majority of whom worked hard and were able to get published in some avenue. I also remember those who were given a role, and for one reason or another did little to no work. I remember those students just as well, as do the faculty involved.
 

bulletbill10

One Winged Slayer
Member
Oct 25, 2017
393
I'm in the last year of my neuropsychology residency. Actually have the interview for my first "real" job this week!
 

Maehdros

Member
Oct 29, 2017
51
I'm a PGY 4 radiology resident. 2.5 more years to go. I'm looking forward to finishing training and finally starting a career.
 

Cation

The Fallen
Oct 28, 2017
3,603

Oh wow, thank you for this. This has been the most helpful advice I have received yet! I have been asking around and no one has given me this much information. In undergrad, I did basic science research on green catalyst design for 3 years and it took forever to get a paper.

Thanks for this explanation, I'll email a few professors and see who responds.
 
Oct 30, 2017
15
I graduated from med school last year and I'm currently on my first year of my internal medicine residency on this really big Brazilian city. This is also my first year living away from my family and friends, since my med school was on my birth town.

It's been a tough year. I was pretty in love with medicine throughout school but being an actual physician with the actual responsibilities of a physician is taking a toll on me. Just thinking about crucial details I might miss and how it might affect people's lives makes me a little nauseous.

The hospital where my residency takes place is also huge and filled with brilliant minds. Sometimes I feel like an impostor seeing all these amazing colleagues who are smart and confident while I'm constantly feeling like I struggle with the most basic concepts.

I'm starting therapy soon, so I hope it helps.
 

Saito

Member
Oct 25, 2017
1,806
Nurse at a privately owned practice. It's painfully frustrating at times. The little moments keep you going. We had an elderly patient come in today just to drop off some Halloween candy for me and the physician I work under.
 

Chase Satellite

Avenger
Oct 30, 2017
19
M2 here! Just shelved out 610 bucks to register for Step 1. Hope I can keep my stress levels under control as I get closer to the test date...
 

Asklepios

Member
Oct 28, 2017
1,505
United Kingdom
I graduated from med school last year and I'm currently on my first year of my internal medicine residency on this really big Brazilian city. This is also my first year living away from my family and friends, since my med school was on my birth town.

It's been a tough year. I was pretty in love with medicine throughout school but being an actual physician with the actual responsibilities of a physician is taking a toll on me. Just thinking about crucial details I might miss and how it might affect people's lives makes me a little nauseous.

The hospital where my residency takes place is also huge and filled with brilliant minds. Sometimes I feel like an impostor seeing all these amazing colleagues who are smart and confident while I'm constantly feeling like I struggle with the most basic concepts.

I'm starting therapy soon, so I hope it helps.

PGY-1 Internal Medicine resident here. I feel you man. It can be overwhelming to even contemplate absorbing everything in this vast field. I think the best way to do it is to learn from these "brilliant minds" you speak of. Not just the management bit but their attitude and bedside manner as well. As for missing out on crucial bits, it happens inevtiably. I just make sure I never miss out on the same stuff ever again.

While skimming upTodate and Washington manual (for the basics) can be great for rounds, I honestly feel with patients, you just need to appear like you know your shit. Fake it till you make it, indeed. Hope therapy offers you some solid support to power through this.
 

DanMagz

Member
Oct 27, 2017
69
I have been a critical care nurse for almost 10 years. Currently finishing up my first semester of CRNA school.
 

Sammex

Member
Oct 25, 2017
4,712
Hi everyone. After a summer job in IT support turned into a 8 year stint, I decided to go back to uni a few years ago and just graduated in Sports Therapy. I'm now applying for a pre-reg MSc in Physiotherapy, hopefully starting next September or Jan 19 depending where I end up. Eventually I'd like to specialise in pain management.

In the meanwhile I'm working with my uni and the NHS/local care centres to run outpatient activity groups for cancer, leg ulcer, back pain, fibro, chronic pain, and elderly patients.
 

bulletbill10

One Winged Slayer
Member
Oct 25, 2017
393
Awesome, did it go well??



In my own news: Just received my passing score on COMLEX Step 3. All done with that! Now just gotta pass Pathology boards in a year and a half. Dear me...

It went pretty well. It was more of a casual meet and greet than I thought it would be, but it still seems like a great opportunity. They have also since sent me a follow-up invitation for a more formal interview, but that isn't until early next year. Still pretty exciting!