The Medical Thread

[SoEnchanting]

Originally Posted by BigRedBeta

We do 6 weeks on inpatient, 3 weeks of a selective (I'm doing ER at the VA, which isn't a real ER, but it's good for learning bread and butter initial work-up type stuff) and then 3 weeks of outpatient clinic. Our outpatient clinic time is only for a half day each day, the other half being taken up by small group work on high-impact cases...essentially a more challenging PBL session with much more questioning/pimping.

What school do you go to? What specialties are you thinking about? Where are you hoping to end up for Residency?

Wow, again @ all the variety in clinical experience! I'm with the same attending all day every day. He does inpatient in the morning and clinic in the afternoon. He went to medical school in Nebraska, too. I'll have to remember to ask him which and let you know. I go to school in Florida, but I don't plan on staying here. As far as residency, I'm torn between Gen. Surgery and FM. I love them both for different reasons, and so I will have to figure that out over the next few months. Are you leaning towards anything yet?

Originally Posted by cheerfulgreek

I was watching Nightline and a few months ago they had a topic about student loans. Some people are going to med school to be doctors just so they can pay off their loans. For some it isn't what they truely want to do for a living. That's sad. School should be free.

When I was a kid I wanted to be a dolphin trainer at a zoo. I wanted to do that for a long time, after I saw a mother give birth to a calf at a zoo. I didn't change my my mind until I got to highschool. That's when I made the decision to be a vet.

Awww! As an animal lover, I think being a vet is awesome! I see how it could get get very hard though, dealing with things like neglect or animal fighting. Is vet school like med school you have to do more training after you graduate? Is there some special training you have to do for something like marine veterinary medicine, or is that all a part of the same program?

Going to med school to pay off your loans is crazy! I had no debt from college. Even with some scholarship help, my loan statements from med school would make you lightheaded. Not to mention the new legislation in the works trying to make residents, who don't make a whole lot for the hours they work, pay their loans right out of school. Stop the madness!

Originally Posted by BigRedBeta

On a side note, I have an ex-girlfriend who is a third year med student at a different school (Creighton) and her parents are paying her medical tuition for her...I really wish I hadn't screwed that one up.

LOL Yeah for real!

[cheerfulgreek]

Originally Posted by SoEnchanting

Is vet school like med school you have to do more training after you graduate? Is there some special training you have to do for something like marine veterinary medicine, or is that all a part of the same program?

Yeah, there's always more training after graduation.

Nope, it isn't the same program. If you wanna go into a specialty program such as marine veterinary medicine, you have to go through a residency program after completing 4 years of veterinary school, then you go into that specialty.

[BigRedBeta]

Originally Posted by SoEnchanting

Wow, again @ all the variety in clinical experience! I'm with the same attending all day every day. He does inpatient in the morning and clinic in the afternoon. He went to medical school in Nebraska, too. I'll have to remember to ask him which and let you know. I go to school in Florida, but I don't plan on staying here. As far as residency, I'm torn between Gen. Surgery and FM. I love them both for different reasons, and so I will have to figure that out over the next few months. Are you leaning towards anything yet?

Did you ever figure out where your attending went?

What interests you about Surg and Family? Do you have an interest in eventually ending up in a rural community?

When do you start putting together your 4th year schedules? Are you going to try to do a surgery sub-I? Any away rotations? Anything you're REALLY excited to do for a month?

[cheerfulgreek]

Close to 10% of men and women in America are now taking drugs to combat depression. At one time this was a rare condition, but now it's become so common. I subscribe to "Scientific American Mind" magazine and I was reading this article on depression. It was saying that in the past three generations, increasing numbers of Americans have been prescribed antidepressants. In many cases, such prescriptions are the only mental health care the patients receive. One cause of the rise in antidepressant use is that many doctors combine conventional sadness as from the loss of a loved one or a life changing event such as a divorce with the more serious condition of clinical depression. Also, a second contributing factor, is a change in the standard diagnostic guide which caused many milder mental ailments to fall under "disorder" which I think would be considered kind of a neutral label. That could be anything. It was saying that a clinically depressed person may not be able to drag her/himself out of bed. I just wonder why it has gotten so bad, and how does medication really stop this problem?

[SoEnchanting]

Originally Posted by cheerfulgreek

Close to 10% of men and women in America are now taking drugs to combat depression. At one time this was a rare condition, but now it's become so common. I subscribe to "Scientific American Mind" magazine and I was reading this article on depression. It was saying that in the past three generations, increasing numbers of Americans have been prescribed antidepressants. In many cases, such prescriptions are the only mental health care the patients receive. One cause of the rise in antidepressant use is that many doctors combine conventional sadness as from the loss of a loved one or a life changing event such as a divorce with the more serious condition of clinical depression. Also, a second contributing factor, is a change in the standard diagnostic guide which caused many milder mental ailments to fall under "disorder" which I think would be considered kind of a neutral label. That could be anything. It was saying that a clinically depressed person may not be able to drag her/himself out of bed. I just wonder why it has gotten so bad, and how does medication really stop this problem?

This is an interesting topic, cheerfulgreek. SoEnchanting's opinion is that the rise in the incidence of depression is a result of a combination of things - people are more willing to talk about it and doctors have a plethora of good antidepressants to throw at you than in generations past.

[AKA_Monet]

Originally Posted by cheerfulgreek

Close to 10% of men and women in America are now taking drugs to combat depression. At one time this was a rare condition, but now it's become so common. I subscribe to "Scientific American Mind" magazine and I was reading this article on depression. It was saying that in the past three generations, increasing numbers of Americans have been prescribed antidepressants. In many cases, such prescriptions are the only mental health care the patients receive. One cause of the rise in antidepressant use is that many doctors combine conventional sadness as from the loss of a loved one or a life changing event such as a divorce with the more serious condition of clinical depression. Also, a second contributing factor, is a change in the standard diagnostic guide which caused many milder mental ailments to fall under "disorder" which I think would be considered kind of a neutral label. That could be anything. It was saying that a clinically depressed person may not be able to drag her/himself out of bed. I just wonder why it has gotten so bad, and how does medication really stop this problem?

I agree with what was said before. Also the issue is what neurotransmitter systems are active during times of stress. The issue is some clinical depressions are due to chemical imbalances. I would say ~25%, roughly 75% have environmental cues due to circumstances. The combination of both: chemical imbalances with stressful environments causes the misjudgments of healthy responses to conflicts.

I don't think depression has gotten worse or situations for depression are worse, I think there is increased reporting. Moreover, most depressive episodes are considered reason to arrest, making the treatment absent and worse.

Medication used solely alone does not treat depression. Dr. David Burns one of the foremost psychiatrists on depression and bipolar disorders states it MUST be in combination with various talk therapies and/or mindfulness trainings. Cognitive is the best therapy with medication treatment. Mindfulness with yoga breath and exercises seems to have good preliminary responses at this time.

40 years ago, most people attended church to get that meditative experience. However, now, there are a variety of practices and quite a few people are cynical. That does not negate the importance of some "spiritual/soul" work to ease the neurohormones involved in the stress response.

[SoEnchanting]

Originally Posted by BigRedBeta

Did you ever figure out where your attending went?

What interests you about Surg and Family? Do you have an interest in eventually ending up in a rural community?

When do you start putting together your 4th year schedules? Are you going to try to do a surgery sub-I? Any away rotations? Anything you're REALLY excited to do for a month?

No, sorry I stopped working with him before I got to ask him! I'm with a new attending now after they found out I wasn't getting that much inpatient experience. I'm with a doc now who's triple boarded in Medicine/Critical Care/Pulmonology. Wowsers!

I have things that I love about both FM and Surgery. I like the continuity and relationships that are formed with patients in FM, but I think the OR and procedures in general are fun. I don't like that FM is all outpatient (I get bored doing one thing or being in one place for too long), but I hate surgeons' hours... especially if I have any hopes of having a life/family outside of medicine one day.

We're in the process of putting together our schedules now, focusing mostly on the few required 4th year rotations. Our sub-I's and electives will be scheduled within the next month or two. And of course, no away rotations want to hear from you until the summer. I'm not sure what sub-I's I'll do next summer/fall, but I'm avoiding surgery until I'm pretty sure that's what I want to do. I have been so indecisive lately. I don't know what I want to do when 3rd year ends! It seems like this point in life has come rather quickly - so many decisions to make in a short period of time...

[KillarneyRose]

Originally Posted by BigRedBeta

You're also working 80 hours a week.

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.

[KillarneyRose]

Originally Posted by copyboi

How healthy is copy machine toner? If you are breathing it in or get it on your skin can it do any damage to you? I am 49 and have been working at Kinko's for 20 years as a copy guy. I am concerned about the possible long term affects.

On another note, why do doctors always get upset if their prescription pads are not all nice and neat when we pad them together at a rush request? Some of you medical people are so damn impatient! I gets me so ANGRY!!

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!

[cheerfulgreek]

Originally Posted by KillarneyRose

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

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

[cheerfulgreek]

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.

[BigRedBeta]

Originally Posted by KillarneyRose

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.

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.

[BigRedBeta]

Wow, again @ all the variety in clinical experience! I'm with the same attending all day every day. He does inpatient in the morning and clinic in the afternoon. He went to medical school in Nebraska, too. I'll have to remember to ask him which and let you know. I go to school in Florida, but I don't plan on staying here. As far as residency, I'm torn between Gen. Surgery and FM. I love them both for different reasons, and so I will have to figure that out over the next few months. Are you leaning towards anything yet?

Nearly 100% towards some sort of peds specialty - my top three are pulm, cards and GI - in that order at the moment. The biggest question at the moment is whether to go peds or med/peds. There are a lot of things pushing me towards med/peds at the moment - but I'm not super thrilled about adults, and even less excited by geriatric patients. But I think med/peds offers better education, gives more inpatient management experience, and a lot of the peds fellowships (in particular cards) are really favoring med/peds applicants...So we'll see what happens. I'm looking at places all over the country at the moment. If I had to pick today, without having any real idea about what the programs are like, I'm most interested in Portland OR (OHSU), Charlottesville VA (UVa) and Denver (CU)vif I'm going to do only peds (none of those has a med/peds program). For med/peds, Nashville or Memphis (Vandy or UT), Little Rock AK (Arkansas) and Salt Lake City UT, are high on my list...

[cheerfulgreek]

SoEnchanting and BigRedBeta, I totally see what you mean about the student loans. Fortunately I have no federal debt, but I will by 2011. I think a lot of students that do take the higher paying med jobs that they really don't want, I think they just wanna live comfortable lives. Meaning, being able to pay back federal debt while still being able to do the things they want to do. I know, that sucks, but school isn't cheap, and now it would kind of seem like a big waste of time going to school for a business type job and end up becomming an office manager or car salesman. Nothing against those professions, but a lot of times fields that aren't really considered to be specialized, those graduating students sometimes, if not a lot of times, find themselves doing something they didn't go to school for, and then they end up living check to check after the student loans kick in.

[BigRedBeta]

Why do you think you have lupus?

If you truly do have lupus, then a physician can provide treatment that will greatly improve your condition and make you feel a lot better. Given the significant progression of the disease, the medications can prevent a number of the eventual complications the lupus causes.