The Medical Thread

[AOII Angel]

Originally Posted by Kappamd

For those of you in medical school,
How many schools did you apply to? Did you apply to any considered "out-of-state?" I've been researching and all the schools I've looked at make it seem as though if you are from out of state, you have little to no chance of even being interviewed, let alone being admitted. I go to school in Ohio and we have our fair share of medical schools, so it would be nice to know if I should focus my efforts or here or look elsewhere.

I applied to all three schools in the state of Louisiana but didn't fill out the secondary application to Tulane. I was accepted to both LSU campuses and chose LSU-Shreveport. Most state schools will NOT take out of state students (unless of course they are big name schools) because the state funds the education of these students in part. If mostly out of state residents were admitted to a state school, there would be hell to pay! As others have said, your best bet is to apply in state unless you are a stellar applicant with loads of research or willing to pay the big bucks for a private school education.

[BigRedBeta]

Originally Posted by AOII Angel

I applied to all three schools in the state of Louisiana but didn't fill out the secondary application to Tulane. I was accepted to both LSU campuses and chose LSU-Shreveport. Most state schools will NOT take out of state students (unless of course they are big name schools) because the state funds the education of these students in part. If mostly out of state residents were admitted to a state school, there would be hell to pay! As others have said, your best bet is to apply in state unless you are a stellar applicant with loads of research or willing to pay the big bucks for a private school education.

While I agree that in-state is best...I think that the overall goal for most people should simply be to become a doctor (without going to a foreign school). Simply because of the difficulty of getting in anywhere, the prudent strategy is to apply to a broad spectrum of schools.

And research matters only at those schools that value research heavily. Certainly there are some schools where research is a requirement for admission and some schools where it is a simply a nice bonus.

[cheerfulgreek]

Earlier today, I was reading an article on new medical research. A new study in rats showed that removing some of the bone marrow could actually strengthen bones and speed up recovery after a fracture or a break. Has anyone heard of this? If this is true, I would think doctors would have to give the patient some kind of bone growth hormone if some of the bone marrow were to be extracted.

[BigRedBeta]

Originally Posted by cheerfulgreek

Earlier today, I was reading an article on new medical research. A new study in rats showed that removing some of the bone marrow could actually strengthen bones and speed up recovery after a fracture or a break. Has anyone heard of this? If this is true, I would think doctors would have to give the patient some kind of bone growth hormone if some of the bone marrow were to be extracted.

1) If it's being done in rats, it's certainly very new. This technique will be a long way from be implemented in humans.

2) Unless the article talked about giving other medications why would "bone growth hormone" need to be given? The marrow produces blood cells, not bone. I have no idea the exact mechanism of how removing marrow would speed the process, but it seems like the point is that whatever is in a rat's marrow may be slowing down bone growth...

[cheerfulgreek]

Originally Posted by BigRedBeta

1) If it's being done in rats, it's certainly very new. This technique will be a long way from be implemented in humans.

2) Unless the article talked about giving other medications why would "bone growth hormone" need to be given? The marrow produces blood cells, not bone. I have no idea the exact mechanism of how removing marrow would speed the process, but it seems like the point is that whatever is in a rat's marrow may be slowing down bone growth...

True, bone marrow does produce new blood cells, but I always thought it usually inhibits the formation of new bone as well. There's actually a clinically approved drug that encourages the growth of new bone though, which is why I mentioned a bone growth hormone. The reason why the hormone would need to be given, is because it would be used to treat weakened or broken bones. I know bone marrow generates the stem cells that would usually help repair bones, but apparently this new treatment is said to work faster.

[SigKapSweetie]

I'm so tired of third year. I'm on ambulatory as my last rotation, and I'm already very, very sure that I'm not going into primary care, and my clinics just drrrraaaaaaggggg. I want to be a fourth year already! Come on!

Did anyone else feel like, after deciding what their specialty would be, studying other specialties got a whole lot more boring?

[AKA_Monet]

The Medicated Child...

A Frontline presentation on April 8, 2008. I think some other GCer posted some information on it. It is very good program.

What say you GC doctors or healthcare to be clinicians?

[BigRedBeta]

Sooooo....update from the other med students?

SoEnchanting, hope your score for that IM shelf worked out okay. I did really well (for me anyways).

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

Currently on OB/GYN, just finishing up my (incredibly slow) week of GYN ONC. Our department really puts an effort on teaching, the residents are great, and for the most part the patients have been wonderful too (which I find a little surprising being a male student). Really enjoying the mix of surgery, clinic, and procedures that the specialty offers. I can see why men would get into the field. I just wouldn't want to spend my days focused from knees to navels. Also, I want the moment when my fingers are in a vagina to be the high point of my day...

Have benign GYN Surgery next week and then I finish up with Labor and Delivery, so I end 3rd year with a sleep deprived fizzle. I'll be working at the busiest L&D service in the city (about 3500 births a year) that gets all the suburban couples coming in the door. Expected to be in at 5am every day for pre-rounds, and have a q3 call schedule...sweet.

Anyone else?

[cheerfulgreek]

One year of school done for me. I'm going to enjoy the hell out of this summer.

[AKA_Monet]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

I thought you guys hate the Ph.D.'s... LOL

What was it besides switching meds that you did not like about psych? Just asking? There is a new field called behavioral genetics that has a lot of neurology involved... And there is a nice article in Newsweek about children that are severely emotionally disturbed and their treatment. They basically say their amygdala is malformed or has a birth defect that exacerbates their behavioral processing... And they also point out that the meds are not studied in clinical trials with children.

[BigRedBeta]

I didn't like the fact that some of the providers (not just MD's but also NP's and PA's) I was with made changes to medications when the patient was experiencing some improvement (but not total) after only 4 weeks - even if they were handling the side effects okay (though they had some) and had room to go up on doses. Several times the provider literally said, "I think we're doing okay, but we might get better results if we switch it up". When you throw in the amount of time to taper off the meds, start the new one, wait the appropriate 4-6 weeks to see a response, adjust the dose from there, it's nearly a 2 month process.

The most egregious moment was when a woman came in saying, quote "I feel great, I can't remember the last time I felt this good, I'm not having any side effects at all", and the NP then spent the rest of the appointment telling this woman what they'd do if she did start having side effects. He seriously went over the side effect profile of Drug A (which she was on), told her they'd go to Drug B, went over the side effects of that med, went on to explain that Drug C was in a different class, went over the side effects of that pill, and ended up on Drug D and the possibility that at that point they might have to reconsider her diagnosis because she'd be refractory to treatment at that point. It was seriously like he looked at his watch, saw that only two minutes had been spent finding out that she was doing great and decided that he needed to fill the remaining 18 minutes of the visit talking about something. The thing is that this was at the County Health Dept, and this woman wasn't extremely high functioning before her illness, so I know she left absolutely confused about the single side effect she was supposed to be watching for in regards to the drug she was on.

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

[SoEnchanting]

Originally Posted by BigRedBeta

Sooooo....update from the other med students?

SoEnchanting, hope your score for that IM shelf worked out okay. I did really well (for me anyways).

Hey there! I am proud to say that I just completed the first week of my 4th year of medical school! I would say I did decent on the IM shelf in Feb., but not as well as I would have liked. I just don't think 8 weeks is enough time to get everything solid. I had 6 weeks of Pediatrics after that, which was much crazier than I had anticipated. And then I finished the year with Ob/gyn - by far the busiest rotation I've had this year. I dunno if it was bad luck (or good depending on how you looked at it), or whatever, but my call nights were insane. It was a lot of fun though, and I agree the mix of clinic and surgery time was nice.

I'm on another 4 week rotation now, with all inpatient medicine. There is just something about 4th year rotations that make them better! I took the CS a few weeks ago in Atlanta - it seemed too easy to be true, so I'll hold my comments on that until I get my score back. Taking the CK in July, so that's pretty much my focus of the next few weeks. That and figuring out LORs, personal statement, ERAS stuff - man, can you believe graduation is just over the horizon!

Originally Posted by BigRedBeta

Also, I want the moment when my fingers are in a vagina to be the high point of my day...

LMAO!

Originally Posted by BigRedBeta

Expected to be in at 5am every day for pre-rounds, and have a q3 call schedule...sweet.

Sounds about right.. All I can say is hang in there. The good news it's so busy that it flies by really, really fast.

[SoEnchanting]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

Originally Posted by AKA_Monet

I thought you guys hate the Ph.D.'s... LOL

I think I was really lucky with my Psych rotation. With the exception of a few random days at the hospital doing admissions and **shudder** ECT, I spent the most of my time with a child/adolescent psych who made all his appts 30-60 minutes. I got to see a lof of therapy, where some of my rotation partners did not. They just saw med refills, and.. well that's about it. Anything else was handled by their counselor. That stinks. I wasn't aware there was any love lost between the two fields, though. Maybe we're sheltered here...

[AGDee]

I spent 13 years as an Occupational Therapist with 9 of them in child/adolescent psych and the other 4 with adult.. mostly inpatient although I worked partial day treatment in adolescent for quite a while. I concur that the child/adolescent psych is much more rewarding. The bottom line is this: In adult psych, most of the problems are more biochemical (schizophrenia, bipolar, clinical depression) so it's "medicate, medicate, medicate" whereas with the kids, while a few are biochemical, more are having situational problems like coping with abuse, dysfunctional families, etc., so therapy is more useful and many of them can work through things and develop healthier coping strategies. Their thought processes are easier to work with also. While therapy definitely helps in conjunction with medication for the more biochemically oriented, it's geared more toward coping with mental illness, the importance of staying on meds, when to call your doctor, etc. Additionally, given the type of disorder, their thought processes are more difficulty to work with in a therapeutic way. Until Mr. Doe stops seeing hallucinations, it's going to be pretty difficult to do much "talk" therapy. Yet, they only get to stay inpatient for 3-5 days these days and that isn't enough time to get anywhere. They used to stay in for two months so you had that whole time to work with the meds, observe differences and side effects first hand, etc. The best psychiatrists I worked with were the adolescent psychiatrists because they were more versed in talk therapy too. They didn't just medicate. I would think it would get boring to just medicate all the time, but that's what a lot of them do.

[AKA_Monet]

Originally Posted by BigRedBeta

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

Don't know that much about prescribing folks the correct drug and dealing with the side effect symptoms. As someone who has suffered a strong side effect and an adverse reaction, I am just happy the ER physicians figured it out and I was able to have some relief...

As far as your observation, doctor--I agree. LOL. But, I have seen it work and when it does, much is accomplished... It should not be that animosity. I never walked into a basic science lab thinking the physician was clueless, in fact, they were my best pupils when I've had to teach them a technique. Whereas, other Ph.D.--yeah, they are some asshats that are clueless about the benefits of the greater society. I am sorry you are encountering that...

I usually get the physicians wondering why I did not go to med school. I tell them my dad was a dentist, and then ask them, what do you do when you find out a patient is allergic to penicillin, and you ASKED her what her allergies were, so this patient sues you for malpractice (a day out your life) and on the claim, it says "allergic to ALL the 'cillins' " Ampicillin, Amoxicillin, Penicillin--ALL of them!!!

I had a whole row of residents fallin' out over that one...