From what my sister told me when she was doing her residency, you actually PUNCH OUT after 80 hours then continue working for another 30 hours or so.

I don't know how you folks do it, but I'm glad you do!

PS Big Red Beta, did you go to Cornell? My sister was a KKG there.

^^Shut up about your damn toner. Wahhhh

I don't think it was a community college she went to. When I see her, I'll have to ask. I'm positive she said it was two years though.

Who said it was too late?:)
What kind of Nurse are you studying to be?

Oh my...wooooow!! awesome!!:rolleyes:

No, I'm saying you're a troll. Go away.

copyboi, you are right to be concerned about the effect of copy machine toner on the human body. Especially after twenty years of exposure. Integumentary contact with toner is fairly harmless unless you lick the exposed area. Inhaling the stuff, though, is a whole other ballgame. Studies conducted at Harvard Medical School have concluded that inhalation of toner fumes over just a 6 month period will, in 99.95% of cases result in severe brain damage with an average IQ loss of 34 points. Also shrinking of the male genitalia will most certainly take place as well as gynemastia, which means your boobies will grow like a girl's. Heaven only knows what's happened to your body over 20 years :( . I suggest you contact an attorney for possible legal action, though.

As for the script pads...physicians are very, um, anal about their prescription pads being nice and neat and always facing the same way because the CMS (Ceter for Medicare/Medicaid Services) does audits of their offices twice a year and one of the things they look for are orderly prescription pads. Failure to comply can result in a fine and loss of payment for the Medicaid/Medicare patients the patient sees.

Good luck with everything; I hope you lose the boobs and your penis grows! :)

No I went to a much more football-centric school about 1200 miles west of Ithaca that also happens to use the nickname "Big Red".

As far as the 80 hours thing...they are much, much more stringent about it now...huge no-no for programs. And I'm doing peds so the risk of going over the work hour limits is much less.

omg!!! lol lol!! KR, your reply to the troll is hilarious and to end it with this statement is a priceless classic!! lol :D:D:D:D

Great Article I read
 

Has anyone read the article in "NewScientist" magazine about xeno organs? It was just saying that in the near future, a person in need of a heart transplant could be offered a pigs organ. I guess there was a group of people who met in China to talk about certain global guidelines in regards to the first clinical trials of xenotransplants. Is there a short supply of human organs or something, because I can't see how this would be possible. It just seems like they would have to make a lot of genetic changes to prevent the organs from being attacked/rejected as foreign by the immune system. I thought it was a great article though.

It's Franken-animals. They have "mostly human genetics" but grow in animals. Ironically, pigs have similar "structures" as humans and one can make transgenic easier from pigs. Also the there is not vertical transfers from infections like there would be with primates--namely monkeypox and other illnesses. Pigs can give something to humans, but I forget what they are...

I have not said anything about the ethics regarding this situation. That is a different question.

And yes, there is a shortage of human organs and that which matches. With the "franken-animals" the heart, etc. can be transgenically cloned in...

If you're talking about certain organs that pigs can give to people I would have some concerns, because pigs are known to carry PERVs. I don't think people would be able to keep them dormant like pigs are able to do. Pigs would have to be genetically engineered in order for them to be totally free of the virus. I don't think they're going to actually start with actual organs though. As I can remember, based on what the article was saying, they'll more likely than not, start with insulin cells from the pancreas in order to treat people who are diabetic. I would really like to see something like this happen successfully. I also wonder how many people would be willing to accept an organ from a pig, once this procedure has been perfected.

I am talking about PERV...

o.k. then we're on the the same page. It can still be done though, they would just have to make some changes genetically.:)

I want to know what kind of funny questions you vets are getting when you receive those phone calls.

It never ends.

Why does my dog keep dragging his butt across the ground?
My dog got sprayed by a skunk, what should I do?
I think my dog/cat has toad poisoning. What should I do?
My dog's eye is out of its socket.
My dog just got attacked by a bunch of bees
My dog has a hunting arrow inside of him. How do I get it out?

I could go on and on about the phone calls we get, and some of the things that I've seen.

The most hilarious one though was this lady and her cat. She called and said that her cat is in heat, and wanted to know how to stop the whining. I asked her about getting her cat fixed, but she didn't want to do that. She just wanted to know if we had some kind of meds that would stop the whining. I started explaining to her the most effective way to stop the crying. I got half way though and she cut me off and said forget it, I'll just get her fixed. I didn't think it was that big of a deal, but I guess she did. She said "Absolutely not. I'll just get her fixed!" :rolleyes:

"My dog has toad poisoning"? Seriously? I can't believe you have to deal with questions like that!

But then, I bet doctors and nurses get some doozies, too. And I bet they see a lot of crazy stuff.

It's somewhat common. It's the younger dogs that seem to be fascinated with toads, and they often try to pick them up. All toads secrete mucus through the skin that's noxious and causes strings of saliva to spill from a dogs mouth. Some toads, like the Colorodo River toad and the marine toad are fatal. But catching any toad in his/her mouth can cause a pet to salivate and paw his/her mouth. It's the poisonous toads that produce substances that are absorbed through the mouth tissues, which then affects the heart and nervous system, then seizures start, then the dog collapses, then he/she can actually die within 30 minutes. Of course it depends on the toad, but overall it's just a mess.

I had no idea! Of course it makes sense, I just never thought about toads that way. Or toads and dogs together, I guess.

Boy, the things you can learn from a vet!

lol

I'm not a vet yet. I'm still in my 2nd year of vet school. Right now, while I'm in school, I'm a part time veterinary assistant.:)

My two favorites are still:

My dog was limping so I gave him a Tylenol, and now he's vomiting, what should I do?

And

My male dog was humping my female and now they're stuck together butt to butt, how do I pull them apart?

I might be dumb enough to do this. I already give my dog two baby asprin when she's limping badly, so I can (almost) picture feeling SO BAD for the dog and just wanting the dog to feel better and you're out of baby asprin but the chewable tylenol is right there, and...

This isn't an out-there concept. You know that we already implant pig valves into people who need new heart valves. When you get a new valve, there are three options, cadaveric, pig or mechanical. Patients do not go on anti-rejection drugs with pig valves because our immune system accepts pig parts fairly well.

lol! kstar, I totally forgot about these. Yes, we've gotten these calls too. Have you gotten any chocolate calls? or what about the Advil ones. "Uhm, I gave my dog some chocolate and now he won't stop vomiting. What should I do?"
Cats are more susceptible to asprin toxicity than dogs. Ibuprofin is like the worst for both.

Thanks for that AOP Angel. This was all new to me until I read the article.

I have a question about. Emergency rooms.

I've spent many of nights (and days) in ER's for illnesses that, in the grande sceme of things, aren't emergencies, but do require immediate care (it can take weeks to get an appt). The doctor who staffs the ER patients-what are they doing? Patients wait hours to be seen by a doctor who only spends 10 mins with them. There are people who've say they've been here from 430pm and still haven't been seen.

I went to an ER where I was literally the only patient waiting to be seen. It still took a half hour to triage and another 2 hours to be seen. What gives?

I would think that the hospital would want to get patients out asap. Why do we wait hours on end? Are ER's a big joke to doctors/nurses? Are yall just lmao-ing behind that registration plexiglass?

I didn't see a problem...until a few years ago, when I was still working for a hospital. I was brought down to the ER with a fairly serious problem, and was virtually ignored (and this was at one of the top 5-10 hospitals in the country, probably the world) until I mentioned I worked for the hospital.

I was brought into a room within 5 minutes.

Most academic medical centers I'm aware of are completing huge expansions of their ER's, but despite this growth, the ER's are still swamped.

The most important thing is that it takes time to give medical care. Lab tests have to be run, CT scans and X-rays have to be taken and so on.

If people are sick enough to be admitted to the hospital then the ER docs have to wait for the physicians from the team that's going to be the primary care givers to come down from whatever they're doing to complete the admission. Meanwhile a bed has to be found, there's a ton of paperwork to be done, and so even those patients who have had decisions made on their care sit in an ER room for a long time. There have been plenty of times when I've been on the wards and my team has been told we're getting an admission and it's 3+ hours before they actually make it to the floor and into a room.

Throw in the occasional serious event (trauma, patient with chest pain who's crashing) that causes everyone to drop what they're doing, and the flow of things get even more disrupted.

Lastly, if you're in the ER towards the end of a shift change, it's going to be even longer as there has to be handoff of patients that are currently in the process of getting care. Check out takes time and is a well documented point in which medical errors occur, so there is an emphasis, particularly in the ER about getting it right.

Certainly, nothing I've said makes it any less frustrating when you're waiting for hours, but it's important to state that the ER is not a joke to doctors and nurses.

If you have to go to the ER for care, it's best to go as early in the morning as you can. Most places I've been have a pretty typical "schedule" where there are very few patients in the morning and things just get busier and busier as the day goes on.

I am not a medical doctor... But let me tell you ER health care personnel are like the hardest working PCP's in the healthcare business... You really do have to be dedicated to work in the ER. There is SOOOO much paperwork to fill out, follow up on what they have to do, triage at some level, making sure you have enough beds--i.e. areas to put people, and the required emergency drugs--like pain killers, drips, etc. to give them--making sure who you are is what your DNA says you are... And that is just for the major accidents if you are at a trauma 1 level hospital. Then, if you are combined teaching, you have to residents and fellows doing their time on the wards. And if you are at a specialized ER, etc. you are cranking out the high risk patients... Another reason why I am NOT a physician!!! :rolleyes:

8 PM+ is NOT the time to go to the ER, generally for "relative wait times"... And dare I say up until 5 AMish is a decent time to go to the ER--relative wait times are "lower", maybe...

Some hospital's ER's fill up around 5 PM+. I know a few physicians that do ER work, and wow, they work their azzes off... Surgery to stabilize the patient. I know the Chief of ER at Cedars-Sinai, LA, and she said bluntly ER care is NOT healthcare... It is true military style triage care... That's why all medical military personnel is awesome at ER care...

So, if you are flu sick, and you are puking blood, goto the ER... If you have a 100 F temp with headache, drink Gatorade, take a Tylenol and CALL to your providers... If you break a bone, go to the ER... If you can walk on your leg, while painful, try to see your GP... If you have a gunshot wound, yeah, go to the ER, but they will report it to the police...

More hospitals are providing 24 hour nurse lines... The nurses can let you know how "emergency" your issues are when you call them. For now, they do not cost money... But at least you do not have to wait and come up out of pocket...

The example is if you break a bone, they have to get the space to do the X-ray and or run you through the CATscan. Then there have to be techs to find the space. There are some SOP's in place here...

The other issue is get your providers in the loop by noting ANY and possibly every health symptom you think you may have... I have started emailing my providers when I have EVERY health alteration overall...

Remember, YOU ARE YOUR OWN BEST HEALTH ADVOCATE!!!

As for Salmonella lunacy that is going on... Save the puke and give it to the lab... I mean seriously... Make them deal with it... I told my OB-GYN that I was going to give her some "stuff" in 10% formalin if I did not get a response and was going to get some chem and path on it... She, laughed and said, no, we are not there yet... And save a small jar full of bloody poop... That might piss them off, but let me tell you, human samples for the CDC is priceless these days...

Is this true? I haven't read it anywhere, but I heard that in Russia, their medical doctors use the same needles over and over again. They just sterilize them. Is that true? And how do other countries medical standards compared to ours?

LOL! Please explain this. How would you stop the loud heat meows?

It's certainly possible. I won't take any sort of stance on the question one way or the other as it pertains to Russia specifically. There are certainly situations where I can believe that it happens.

I'm actually in Australia right now and hanging out with some British medical students so I can answer the question in regards to those countries.

From what I've seen/heard, overall medicine is medicine. The premium on data that has come about because of the movement toward evidence based medicine has made some treatments very standardized (which is actually really beneficial to me because it means that I know the answers to the questions when asked). So that means that in most first world countries things are going to be similar (though not the same). I'd even venture that in the affluent, developed portions of developing nations are going be close as well.

Where I notice the difference most, because it's what impacts me or sticks out the most to me, is the differences in the education and training setups that exist. In the rest of the world students enter medical school directly from HS, and it takes 6 years instead of the 4 years of college and the 4 years of medical school in the States. The post-graduate training systems are also different. Whereas in the states, recent grads go directly into their specialty of choice (or at a minimum a year of something similar to their ultimate goals), in these other countries, the recent grads spend two years in a general training program which will include patients of all ages and several different fields of medicine (including surgical specialties). So needless to say all the other students are very shocked when I (the future pediatrician) am able to say that I have less than 15 days of treating adult patients left in my career.

The other thing that's very noticeable is the working hours for those in training/residency programs. In the US, residents are capped at working 80 hours a week averaged over 4 weeks and get a set salary...in Australia, they're contracted to work 38 hours a week, and get overtime pay when they work more than that. In the UK it's 48 hours, salaried. Everyone thinks we work too hard. I just have to laugh at the concept of only working 38 hours a week since the typical call shift in most US residency programs is 30 consecutive hours. Much of the overseas concern for duty hours comes from studies showing increased errors by those burdened with fatigue, but one of the residents said he had seen the USMLE questions that make up our board certifying process and he thought they were incredibly difficult. I also think that in the US there tends to be more oversight of what inexperienced doctors do by the older residents and the attending physicians but at the same time the interns are given responsibility in patient care. In Australia, my intern is getting good at paperwork but not really making decisions on treatment.

In more general terms of health care quality, the US lags behind other systems, due in large part to the issue of the uninsured. At least in other countries patients don't use the ER as their primary source of care. It's an issue of access to care more than anything else. If you can pay for care in the US, you're golden, but obviously there are wide swaths of our population which don't fit that description.

Certainly, compared to developing countries, we have a lot more "stuff" in our arsenal of care. It's not really a fair comparison. But I think most people would be shocked about how well physicians in these countries care for their patients with the limited resources.

The lady freaked, and I'm sure GC members would too.

I don't think that would be a good idea.;)

Does it have to do with... manipulating something?

lol

I guess you could say that. I always recommend Qtips.:)

I'm not really sure where you went, but I did a rotation at the CHLA ED for a month, and people waited a long time because there were just a lot of people to be seen, and the medical staff were going as quickly as they could through the list. Most of the patients, like you, didn't have true emergencies, and they waited longer than people who had more serious illnesses. The nurses would color-code the patients (red, yellow, blue, green) based on urgency and the docs would take whomever was next on the list based on color/urgency and time of arrival. Wait times were variable once they got into a room - could be 30 min, could be 4 hours.

A clinic or an after-hours urgent care center will probably be faster and easier for you. I recommend establishing relationship with a regular primary care doctor as well, perhaps there is someone with a more flexible schedule near you? Many GP's/internists can fit you in same-day or next-day if you are ill, and may be able to telephone in Rx's for you without an appointment (although I believe this depends on individual state laws). It will likely be cheaper for you too to find a clinic -- ED visits are expensive.

ETA: Residency update: Done with interviews! Rank lists are due Feb 25th and Match Day is March 19th.

To add to the nice explanation Dr. BigRedBeta said:

A VERY LONG TIME AGO they did have large gauged, autoclavable needles wrapped in glass. I have seen them and have used them for research scientific purposes. As for human use, the time I saw them was in the mid-70's to early 80's. "Hamilton Syringes" was the company that made them until sterile plastics were developed... You also did not have small bore gauged needles--like the insulin 30-36 gauge needle syringes like it is now.

Some countries have not had medical equipment upgrades for many years... Some countries have ZERO medical equipment, and clinical labs--like a basic clinical centrifuge is missing... The agency "PATH" is into developing these "user friendly" technologies to "Global Health concerns"...

Autoclavable materials can kill most pathogens, but not ALL pathogens, and definitely not prions or new infective agents. It is thought that aberrant microRNAs can be highly contagious because of its possible ribozyme or structural malformations--this is very cutting edge and speculation at this time. And microRNAs can be at least a 10-20mer sized... That's a primer!!! :eek:


And to Dr. BigRedBeta,

That is what frustrates me about some foreign medical education systems... Oh well... I have heard that if the USMLE was taken by some folks, they are unable to pass it... So in some ways, MD is different levels of education from one country to the next. Which makes the US system pretty good compared to other excellent countries, like Germany, Sweden, France, England and Australia.

And yeah, US public health is in shambles... Unfortunately, someone can have the Nobel Prize in Medicine, cure cancer, be a fantastic surgeon, but it is our "system" of health care at this time that gives us our ridiculously poor treatment outcomes. I hope this changes, I have researched and worked in this area too long and I am so dismayed--there is no reason for what we are seeing!!! And I have heard the same sighs from physicians regarding this lunacy...

if i wants to be a dr. how i go about being one?

4 or 5 years to get your bachelor's degree. During this time you'll need to take 1 year of biology, general chemistry, organic chemistry, physics and likely college math (including calc). You'll also need clinical experience with patients (either through volunteering or shadowing a physician), campus involvement, and probably some type of research activities. You'll also need to score well on the MCAT. Then apply.

IF you get accepted, med school is 4 years - the first two being basic sciences like anatomy, physiology and pathology, then take Step 1 of the USMLE. The third and fourth years are done in the clinics and you learn how to actually take care of patients. During the end of third year/beginning of fourth year, you'll hopefully narrow down a specialty choice (such as pediatrics or surgery or radiology), apply to residency programs in those fields, interview and then submit a list which has the programs ranked in order of your preference. You get matched with a residency program, then residency lasts for 3-7 years depending on what specialty to you enter and if you decide to pursue extra training through a fellowship to become a sub-specialist (eg cardiologist).


Also, I'm not a doctor...yet: 81 days and counting though!

When's Match Day?

March 19th!