medical school

i can see this thread is going to be a huge hit

nice knowing you

gbx, there is no doubt in my mind that you will get in!

I'm sorry that I gave up being a pre-med a long time ago, but I do remember how intense even the anticipation of making an application is... Where are you in the process? (Didn't you say that you have an interview in January?)

when u tryna start? where?

next fall

first interview on january 10th (minnesota)
haven't heard from anywhere else yet (yeeks!)

would really like to go back to my alma mater (<---- first time i have used that word) or vermont or colorado

i seem to think that i'll have time to do fun stuff outside

who is your interview @ mn with? i had m1les, who values research experience very very highly. woe unto you if you're without.

good luck!

i am without :-/

wait i believe i recall you posting an mcat of 36 or something (i've read here for many years now) and you seem like a smart and interesting dude on here too, just have a good answer to "why minnesota in particular?"

34

answering that is easy! i am from here!

also genuinely interested in fl3x md and their school of public health/int'l health opportunities

That's maybe not actually a good answer. The first one.

:/

I'm also trying to do this right now.

The thing that is terrifying me is that I had every Secondary application done by like, mid-September, and I still haven't heard anything from ten of the twenty schools I applied to. I heard from four schools pretty quickly after sending my secondaries in, and so I thought it was all going to keep on moving as fast as the secondary process. And then my inbox just stopped dead after the first week of October. I still check it like three times a day though.

Or rather it's a good answer but not one the interview is looking for, i think?

Whenever I have gotten the "Why do you want to come here out of everywhere else in the country?" question, it's sounded more like they were trying to make sure they didn't offer a seat to someone who was just going to turn and run as soon as a better offer came along.

I live in California, but my first round of interviews were all on the East Coast, and I guess past experience with Californians suggests that we act interested in the East Coast until the UCs come along and offer $20000 less in tuition. The only time the interviewer didn't actually say something like, "Why in the name of God would you want to leave California" is when I had an interview during the October brushfires.

If you show them that you are a dude who really wants to go to medical school in Minnesota more than anywhere else, hopefully they'll bite. And if they like you, but are afraid you might ditch them for somewhere else, they'll waitlist you and give you the chance to write an impassioned letter about how everyone else is playing for second place in your heart. Or something.

:D :D :D

i go to minnesota

congrats!

thanks, pal!

i am going to fix healthcare

is the plan

Yowza! Rah!

Though I guess this means you're not moving to Portland.

now have a beer or two to celebrate--that is an order

HAHAHAHAHA! A doctor fixing healthcare!

Yeah :-/

Though I'm still thinking I might try and do a mid-school MPH out there. We'll see.

xp - i bought a bottle of "bubbly" and split it with my roommates already. Now I am taking beers to the bike workshop and will celebrate by fixing a bottom bracket that sounds like the Xhosa

kate78: quiet, you.

hey, way to go

yaaaaaaay congratulations!

you can be the white atul gawande

I guess this means "no" to vet skoo?

quiet, you, too, Laurel. i was just into animals that day.

"into" "animals"

i'd be cool with being jonathan kaplan

SO MANY RESPONSES, I CANNOT CHOOSE.

Go sleep with some cute Israeli nurses.

how come nobody ever tells me to do that

actually i'm just gonna be a dermatologist with a time-share in florida

I hear the skiing is choice.

cio and sky me

nobody got my joke about the Xhosa :-(

Sorry, I don't know about any bike parts made after 1974.

i should have said !Kung instead, huh

IT WAS A JOKE ABOUT PEOPLE THAT SPEAK A LANGUAGE WITH CLICKS, LIKE MY BOTTOM BRACKET

Ahahahah I just assumed it was a manufacturer I didn't know. Clearly this is why a Laurel does not go to medical skoo.

!Kung would have worked. I figured you were talking about some noise album or psych band or some shit

congrats

CONGRATULATIONS!!!!

way to go duderoo

oh man i said duderoo i need to stop smoking

congrats, plz don't get co-opted by the system

this is awesome!! congratulations, e!

Congrats, plz drink everything in MN for me.

Congrats, Elk hunting is back on then, plus dissection for tasty meats.

Congrats, I'm attempting to do the same at the age of 32, got to redo my school exams first though.

:D

thanks, dudes!

leigh, are you in the states? like, you're retaking the MCAT?

Nope, I'm in Scotland, I'm going to have to retake my high school exams as they're well out of date and I'm not a graduate then do the UKCAT.

nobody got my joke about the Xhosa :-(

I got it! I roffled!

Congratulations, you'll never regret it.

sweet. does this mean its time to start the JOHN JUSTEN AND FLUFFY BEAR DESTROY A PROMISING MEDICAL CAREER WITH BOOZE thread?

also, tombot, go sleep with some cute israeli nurses

fuckin awes brah!!!!

good job bro

Fantastic news!!!

WOO HOOOOOO!!! :-D

I'm gonna sue you so bad one day...

:D

don't forget about me when you can legally prescribe drugs.

I sat the UKCAT yesterday and did reasonably well so I'm over the first hurdle - just need to get top grades in 5 Highers while working full time, write a stellar personal statement on the ucas form, demonstrate top notch work experience and interview well then I'll be in with a ghost of a chance of making Med School.

i just looked through my copy of netter's. *_*

t-minus one day, ppl.

itt gbx liveblogs med school

omg i am in a lecture

waht are you learning today?

ingratiate yourself to the professor by making an icebreaking dick joke.

Can't wait to hear about how it's going.

if evan can break ice with his dick he's wasting his time in med school.

it's a lecture about stress management

first day of school, here

good luck dude!

lol, we had assigned "stress management" readings in nursing school, too.

What would have helped more: letting us sleep at some point over clinical weekends.

what are they suggesting that you perscribe to yourself to ease the stress level?

decent lol: caloric restriction retards the aging process = share food with others = feeding your academic rivals in order to eliminate them

another h4st1ngs dude is here, too!

o_O
xpost

Wait, but being hungry is stressful!

Still, that's going to be my new reason for bringing treats to class. I'm trying to destroy everyone else's GPA.

xp - In your class or the one ahead of you? If it's the one ahead of you, and the dude is kind of old, that's my ex.

dude, stay relatively sane <3

("Kind of old" = 38 or 39. Uh, don't tell him I said that, okay?)

dude is a year younger than me.

tomorrow, we meet our dead best friends :D

(not to be flip, or anything)

It will be fine. Also, I think if you're not a bit flip about it at some point, it is less fine. (From my limited experience with cadavers, faces and hands are the worst. But I have never had to dissect a head or a penis... I could see where that could be more alarming.)

Oh i've worked with cadavers before, i'm not worried. curious to see who gets shook, tho

That's the kind of bonding you can't just find anywhere! ;)

gbx, how much orientation stuff did your school do? I am in the middle of a week of basically introductions and icebreaking and drinking time before we get started next week.

Technically, three days, all this week:

Wed -- omg yr in med school, here's yr ID, don't stress, dinner + beerz + start short list of hotties
Thurs -- omg yr in anatomy, do's and don'ts in lab, get acquainted with your 'patient'
Fri -- white coat ceremony

Mon -- let's do it to it

also we had a small group session where we collaboratively drafted up some ideas for our class oath, which were then passed via representative to a larger summit. it will be read tomorrow. i have already determined that some of my classmates are awesome, and that some are idiots.

w/o going into specifics, at least one dude had the temerity to suggest that the care provided to a terminal patient we MET YESTERDAY was a waste of money and that all that money (which obv comes from the big healthcare money bucket and isn't earmarked no way) could, like, be used for medicine for the poor and shit.

him: "seriously, what's all that money REALLY doing?"
me: "...well, XXX is alive."
him: "so what?"
me: " >:( "

Well, most lifetime health care spending happens within the last few months of life, when you're circling the drain. There's a big push in the medical industry to reallocate healthcare dollars to younger, stronger, less-sick people, like they do in a lot of countries with socialized medicine. An example would be giving a limited-resource, like a liver transplant, to a 20-year-old instead of a 70-year-old.

"terminal" wasn't accurate, sorry. this patient (who was presented to the entire class as her mother gave a forceful argument for patient advocacy...ie - confidentiality isn't an issue here) is a child with an illness that will likely end with her dying early. dude almost came right out and said mom should just get over it and let her kid die.

Wow, that guy sounds like a charmer. His bedside manner is going to be fabulous.

Doogie Howser: gay [Started by Ned Raggett (Ned), last updated 2 days ago] 13 new answers
medical school [Started by gbx, last updated 2 days ago] 29 new answers

first dissection today. if you would like me to find your thoracoacromial artery, i will do it for a small fee.

passed first anatomy exam yesterday :D
had group discussion today about race. warning: some of your future doctors are inarticulate d-bags

^^^ feeling better about my chances for getting in

warning: some of your future doctors are inarticulate d-bags
SHOCKAH.

some of your future doctors are inarticulate d-bags

"future"

hey lamp are you applying right now?

gbx you are the real hero

hey dude, thanks

I'm going to have to start preparing my ucas application asap.

The law school and grad school threads got revived, so why not...

This is HARD, but awesome. So far medical school >>>> grad school. (I do not know how law school is. I would still guess >>>, though.) I have had nearly two months of being repeatedly reminded that I know basically nothing about medicine or medical science or how to be a doctor. But nobody else does yet, either!

i'm not sure about the comparative intellectual challenge of law and medical schools - it might depend on the person - but it seems like the latter is generally more of an endurance sport

I get the impression there's more expectation that you're actually going to REMEMBER all the shit you learn in med school - or at least that you should

Early on (at least in our curriculum), there is a lot of like, biochemistry stuff, which we need to know for Step I of the Boards next year, but almost certainly won't need to know as a doctor unless you go into research on that specific thing. The basic pathways have some value, but even the instructors are mostly telling us that knowing the various structural differences of isoprene-derived molecules is not a particularly pressing clinical skill.

Knowing the biochemistry will help you understand some of the later, more relevant stuff. Understanding aids retention. So, presumably, you will have a better chance of recalling the more relevant stuff when you need it.

holy shit i'm tired

C-L: where are you going to school, again?

good luck dudes, are you doing medicine in the us?

i am, y

I go to Ge0rget0wn (I do not know why I feel the need to Googleproof that, but I do). Which is delightful! Especially last Tuesday, since we started Gross Anatomy, and then I got to join the mob at the White House after Obama got elected. It was basically all you could ask out of going to med school in DC.

We just converted to systems-based, and they opted to hold off Gross Anatomy for the first three modules (which were mostly biochemistry and cellular physiology and genetic stuff), but we finally put Genetics behind us and now it is time for Cardiopulmonary and cadavers and such.

I am also basically tired all the time, gbx. But yeah this still rules.

our curriculum is olde-skool, and i wish it wasn't. systems/organs and/or case-based would suit my temperament much better. we're doing biochem, histo, and just started genetics (all three salted with nutrition and a few other seminars now and then). biochem is great, but that's because i think that shit is cool. histo is, uh, a thing. genetics is complicated, but whatever.

good luck with anatomy. it's fascinating, and makes everything more immediate, for lack of a better word.

Oh man Nutrition was a minor scandal for us. It was like 95% self-directed learning, but the guy in charge of the exam kept on saying "Seriously, you don't have to put in that much time, the test is just going to be big concepts, not little details or numbers or anything". We had two other, bigger tests the same week so nobody really put any super-gunning energy behind studying for it. And then the exam had a bunch of questions about details and numbers and everybody did horribly.

Genetics was...not my thing. It was not bad or evil or anything, but there wasn't a lot that really caught my interest. But that is the thing about compressed, dedicated modules; I was a little disinterested for the past month, but now it is done. (The tradeoff is that we've never had longer than two weeks in between tests, which itself is kind of advantageous because all the tests are relatively manageable, and bad because everybody is really smart and the average score keeps on being like 85%.) I got weirdly fond of drawing structures and pathways in prep for med school, so I liked biochem, but signal transduction was probably my favorite.

I was not a science major, at all, so it is sort of funny to see how completely incapable med school is at any sort of non-quantitative assessment. They will find a way to graft a multiple choice exam onto EVERYTHING, no matter how awkward.

hey lamp are you applying right now?

yep! i had my first admissions interview yesterday. i have no idea how i did or what the hell i said. i spent at least ten minutes talking to a dude about living in toronto (?) and just kind of hoped not to sound like an idiot.

how much did you guys prepare for your interviews? most of the qns seem to be the sort of stuff in the supplementary apps but then again i've only had one. i'm actually pretty frustrated by how spread out the deadlines for schools are. some schools wanted everything a month ago and there are a couple of schools that don't have deadlines until december.

haha i also like the schools that want a photo of you in the application. and i ran across this when looking at prep for my application: Not only will we give you impartial feedback, but we can assess you in some of the same areas the med schools are assessing you in (ie. physical appearance) Emory University: no fatties plz!

Turn over your secondaries as quickly as possible, regardless of the deadline. For one thing, you'll get considered sooner (which, hopefully, will get you in sooner, which prevents you from spending the first eight months of next year completely losing your mind), and for another, rapid turnaround suggests more interest in that particular school. There was one secondary (Univ. of Chicago) that I got really early (I think they were one of the schools that sent it even before my AMCAS was verified) that I just sat on the entire time, because the questions were a pain in the ass (IIRC they were all like "Tell us why you think the University of Chicago is the best place ever" or something). I finally dashed it off on a whim, and they ended up being one of the first places to reject me. And with good reason!

I went light on interview prep; it took me a lot of soul-searching over a bunch of years to even decide to apply, so the answers to the basic "Why do you want to be a doctor?" type stuff I had basically been forced to lock down just to explain to everybody why I was doing what I was doing. I felt relatively comfortable treating interviews like casual (albeit extremely weird, stressed) conversations; it kind of screwed me at schools where the interview became an interrogation, but it helped at others, where the interview was repeatedly stressed to be "our opportunity to get to know you a little better". (In the same way, I was much more likely to get an interview from schools with open-ended secondary apps than school with fifteen boxes that all required 800-character-maximum statements about my most valuable research/volunteer/clinical experience.) My first interview went a little south early on, so I took the remainder of it as prep for the others I had coming up afterwards. That helped, too. I have also heard repeatedly positive things about the Interview Rating section on studentdoctor.net (although I would recommend avoiding the forums themselves for now. Reading SDN prior to the MCAT or interviews always made me more anxious, because it frequently lapses into insanity and gunner mentality).

The one thing I will say did me good was trying to pick up as much information about the school itself, and especially how it was different (or saw itself as different) from other schools. Like, G-Town matches a really high number of grads into orthopedics every year, and I want to be an orthopod; beyond that, I picked up an interest in medical education policy (and healthcare policy more generally) in grad school and the job I had after grad school, so I was able to push my interest in being in a place where I could get involved with DC political-type stuff. It is really an abnormally good fit. The big thing about reaching the stage of multiple interviews is that schools assume you will be (or have already been) accepted somewhere, and they do not want to offer one of their seats to someone who will bail on them if accepted somewhere "better" (or cheaper, if it's a private school worried about you staying with an in-state public school).

yeah u chicago is one of the december 1st deadlines. i'm not sure what the difference between 'what makes you a good candidate for u chicago?' and 'why u chicago?' qns really are. i kind of hate those qns and would much much prefer talking about research i've done or ways i've exhibited "strong intellectual curiosity". i like the more specific, anecdotal qns. i also really like the ones that are like going on oprah though like some real "tell me about a painful moment from your teenage years" stuff.

The one thing I will say did me good was trying to pick up as much information about the school itself, and especially how it was different (or saw itself as different) from other schools.

this is something i'm very comfortable talking about. all the schools i've applied to have strong immunology departments which is my main interest and i've got things i can talk about for each school. what threw me off was when, after a few minutes of pleasant chit-chat one of the interviewers turned to me and just said "so, why do you want to be a doctor?" and, i mean of course i was prepared for this question, but just having someone ask it so bluntly my prepared answer seemed awkward and forced and weird. i still think it went okay but it left me feeling unhappy afterwards, like i fumbled on my first possession.

also i've been purposefully avoiding SDN since the ppl there had all their secondaries done in like, august and were already getting interviewers when i was just starting my essays.

SDN can be dispiriting, no question. i avoided it pretty diligently, though it is useful for comparing residencies, i gather. like CL, i didn't stress too much about interviews; as a 27 year old post-bacc, i'd had plenty of time to consider my answers to the Big Questions. also, for someone with a background like mine (non-science major, older, non-traditional activities between college and med school), the interviews were a chance to explain myself.

w/r/t non-quantitative assessment: we just had to write a short paper on Mountains Beyond Mountains as part of a longitudinal Physician and Society course, and it was hilarious to see how some of my fellow students reacted. writing papers just isn't something biochemistry majors do. also, most are baffled when i tell them that i, like, READ BOOKS outside of school. like, quote, "wait, you read? like what?" astounding.

also: bang out those secondaries! i sat on a handful, and it definitely bit me in the ass later (ie - did not get interviews because i didn't send back some secondaries until like, now-ish).

i only have one left, which i'm working on right now. i sent the ones i was most hopeful/certain of out first which was probably the right strategy given that i'm still working pretty long hours at my actual job but it left my very unmotivated to finish the last two.

I was in a little group of non-trads back in LA, and I think we all tended to see interviews as our ace in the hole. I still am thankful every day that I didn't apply when I was 21 and straight out of college, because I just wasn't prepared at all. I had a reasonable idea of what I DIDN'T want to do, but not much of what I did. Even four years later, though, I had spent a lot more time sitting and thinking about exactly what I wanted to do and why. But even then I went into my first one thinking, "Alright, even if this goes bad, I have another one at a school I like more next week, so just get used to the rhythm." By the end I tended to be the only person in a dark, conservative suit who still thought interview days were really fun. (They are an anthropological gold mine, for one thing. Also I got to go to a few places I'd never been to before!)

I get so hard up for non-science stuff sometimes, I will go out of my way to find humanities/social science action elsewhere on campus. I think that part of my brain just gets cravings or something. I have taken to writing/revising my lecture notes as though they were an enormous, very technical essay.

Yeah by the end of secondaries I had actually gotten a couple interview offers, so the latecomers tended to slide, including one I just didn't do. Sorry Oregon!

okay done! also i read upthread C-L you applied to TWENTY schools???

There were 24 on my AMCAS, and I did 20 secondaries. Amongst the other applicants I was in contact with last year, 24's a bit lower than average; 30 seemed closer to average. But yeah that turned into about four thousand dollars right there, counting AMCAS and secondaries and airfare for my out of state interviews.

Most counselors promote applying anywhere you have a chance, within budgetary reason, which turns into all the in-states and whatever out of state schools are possible for OOS students with your numbers. Fifty's not uncommon, and I know of at least two anecdotal instances of cracking triple digits (at least one of which was a shotgun approach from a dude with a low GPA). But you'd probably have to take an extended vacation once the secondaries got above like, thirty. (I just gave up a lot of free time for a couple months.)

But that said, it was almost three times as many places as I'd applied to for undergrad and grad school combined, which is nuts.

ugh srsly these interviews

What's been happening?

i turn into a complete idiot, basically. upthread both you and gbx talk about having spent time considering the big questions and i guess i haven't really. im great with background questions or talking about the clinical research opportunites offered at penn but im second guessing my reasons for even applying they seem facile and just ridiculous when spoken aloud and i feel like an inarticulate douchebag. uh, moreso.

also i got my first rejection from lol harvard which isnt a surprise but still sux

FUCK. HISTO.

hate this garbage. normally i'm good at teasing out the inherent interesting-ness/practical applicability/whatever out of most subjects, but histo is just some str8 boring garbage, and is like the poster child of "shit from school you will forget and likely never used again w/o reference" that actual docs like to tell you so much about. i mean, yes, there's obvious merit to a lot of it, but I'm not planning on doing a lot of bench science in the future and mostly it's just sort of galling that I have to go around identifying various laminae >:(

also my final is on tues and i'm, uh, not as prepared as a person ought to be

what is my attitude = bad

Yeah I am really happy that our new curriculum seems to have signed histology away to the smallest possible role it can play. There is usually like one microanatomy lecture and one "lab" (we do not have to use microscopes or anything, we just get shown more slides) per module, surrounded by a dozen-plus physiology lectures.

Good luck, dude. I will give you the sage advice of one of my third-year roommates, given before our first exam: "It is really hard not to pass." It is still pretty sucky to work really hard and still end up getting killed on a test, though.

reading the sdn forums is almost enough to make you not want to be a doctor seriously

reading the internet in general is almost enough to make you want to just end it all, so I think that's just par for the course

WORD to Lamp. If you are applying now, avoid that site like the plague.

Are there any other medical students out there hating Histo like I am?

The law school and grad school threads got revived, so why not...

This is HARD, but awesome. So far medical school >>>> grad school. (I do not know how law school is. I would still guess >>>, though.) I have had nearly two months of being repeatedly reminded that I know basically nothing about medicine or medical science or how to be a doctor. But nobody else does yet, either!

― C-L, Saturday, September 27, 2008 12:43 AM (3 months ago) Bookmark

And so much WORD to this. I am really enjoying medical school, even though I have no idea how the hell I am going to learn enough material to actually become a doctor. But hey, we are all in the same boat!

histo was the worst

I kind of want to post to this every time the law school thread gets updated.

Our module system wedges two or three or four histo/microanatomy lectures into each unit of the body (along with some embryology and gross anatomy and a bunch of physiology), so it is always extremely tempting to dismiss the histo and spend 95% of the study time on the physiology because a) it is boring and b) the return on puzzling through the various slides for the eight or ten questions per test is usually not worth it. I would have really liked embryology to remain a cohesive unit instead of being broken up across modules, but I am pretty cool with microanatomy's dispersal.

Actually the weirdest thing right now, though, is that the most bothersome part of the schedule is all the non-hard-science classes they are throwing at us (like Ethics and such). It is all material founded on really good intentions, but between the blocks of time it eats and the didactic approaches they use, it all comes across like "OK, we should promote ethics, and service, and etc., so let's just schedule some of that and then they will learn about ethics and service and etc." without a lot of effort into justifying its existence beyond explaining how vital ethics and service and etc. are, and really, all it is doing is making ethics and service and etc. an annoying obstruction. I am from a non-science background and even I am kind of longing for the point in March where the rest of the syllabus is all lecture and anatomy through the end of the year.

Also yeah, seriously, SDN is the gaping maw of hell. There is probably an incredible anthropology/sociology article that could be written comparing posts from SDN with posts from JD Underground, though.

Actually the weirdest thing right now, though, is that the most bothersome part of the schedule is all the non-hard-science classes they are throwing at us (like Ethics and such). It is all material founded on really good intentions, but between the blocks of time it eats and the didactic approaches they use, it all comes across like "OK, we should promote ethics, and service, and etc., so let's just schedule some of that and then they will learn about ethics and service and etc." without a lot of effort into justifying its existence beyond explaining how vital ethics and service and etc. are, and really, all it is doing is making ethics and service and etc. an annoying obstruction.

^^^ this. we've got a similar set-up

Same. Don't they know that we have physiology to study? ;).

haha reading these posts is putting a serious dent in my "i just have to get in and then its all smooth sailing" mindset

ha. but no, seriously medical school applications are ridiculous. However, you will make your future a hell of a lot easier if you decide to go to a school that is "pass/fail" in the first year.

And I mean a true "pass/fail", not the foolishness that is honors = A, high pass = B, pass = C, etc.

Haha we have that. We also have a "Low Pass" that is a D, but at least it shows up on transcripts as a regular pass.

Really what bothers me about obligatory service is that the couple of times I have done actual volunteer service, it's been amazing. I am way more handy with a needle than I ever imagined myself being in first year.

btw guys what do you think about immunology? it's fascinating!

that's one of the main areas i'm interested in studying/practicing - i agree it's totally fascinating.

I kind of regret not double majoring in Microbiology/Immunology/Molecular Genetics back when I was an undergrad. But we haven't done very much of the immune system yet; I think it is all part of a big 2nd year curriculum blowout. I am pretty amped. Although I don't think I would do infectious disease, though.

I spent this morning in the anatomy lab studying gastrointestinal structures alone and listening online to the radio show I used to listen to in LA when I was driving to do my Sunday morning ER volunteering back in the day.. It was really about as relaxing as being the only living person in a room full of half-destroyed bodies can be. A+++.

Immuno rocks! Studying it right now, it definitely matches my expectations of what I expected to learn in medical school much more than does histo (ugh).

Also, I loved going to study in the anatomy lab in the mornings when it was quieter and not every single person in my class was freaking out about an upcoming test. Very relaxing, yes.

Yeah, histo was my bete noir, mostly because it had a similar informational volume compared to anatomy, but little of the innate "this is RAD"-ness. I've since learned that we do histo way more comprehensively than other schools??

But yeah, immunology is way more intrinsically interesting and, well, "medical." There's something fascinating to me about how the human immune system, as distributed across the whole species, acts as a massively parallel computational array---like, the problem of producing antibodies/TCRs that actually *work* is being solved by brute force by a bazillion cells across billions of individuals, over hundreds of millions of years. I hadn't really considered ID or immunology as possible specialties, but I'm definitely considering it now.

plus i got props in class on friday from my immuno prof for saying someting 'very clever.' this is a first for me and a much needed morale boost, since i was struggggglin last semester (90% due to old, bad study habits)

http://www.mpg.de/bilderBerichteDokumente/multimedial/bilderWissenschaft/2004/02/Zychlinski1/Web_Zoom.jpeg

keep it up guys. on the new york city heirarchy, doctors always trump lawyers. especially when they're 8 inches taller than you.

keep it up guys. on the new york city heirarchy, doctors always trump lawyers. especially when they're 8 inches taller than you.

― burt_stanton, Sunday, January 25, 2009 10:31 PM (Yesterday) Bookmark

ugh

Hey, you know what sucks, is having an anatomy practical exam that is given via Powerpoint slides instead of bringing everyone to stations at the Anatomy Lab. I can identify the hell out of some abdominal structures on a body, but not when I am not sure whether I am looking at the cecum or an oddly angled stomach or a folded-over colon. It is basically like finding Waldo, and then answering an unrelated question about Waldo's primary arterial supply.

Thankfully the class walked out of that exam in unison basically like \o_O/ so I guess it was not just that I am stupid.

wait what the hell? man, that sucks, C-L. we had our exam reviews on powerpoint and i was always disoriented and lost when they'd point to some bit of pelvic floor---but then at least we had artfully done-up prosections for the exam itself

like str8 alinea style:

http://www.maricazottino.com/public/alinea_bacon.jpg

Anatomy Practical Exams by Grant Achatz would be pretty awesome, come to think of it. "Which section of the lower intestine is shown here, labeled with a daring plum chutney glaze?"

btw i just finished midterms and it feels great

also, C-L do u know a dude named P3t3 (i think) that's working a clinic in M3xic0 this summer

(don't want m3xic0 googlin)

hey congratulations!

neuro is fukkin hard, btw

thanks!

hey horseyshoes, what is yr take on UC art history students..... JUST WONDERING FOR NO REASON

did you meet a girl? i don't know anyone in that department. my experience w/ art history girls is that they are v. v. pretty and kind of boring but i might just be jealous wrt the last part.

my take on UC grad students in general is that they're insane btw.

nah former UC art history student current doctor student

I do not think I know a dude named P3t3 who is in doctor school.

Do you guys mean UC as in University of California, btw? Because apptly Horseshoe thinks I was insane (which honestly was probably correct at the time).

P.S. RENAL 4-EVER.

no, university of chicago! i'm sure uc students are lovely.

Oh OK. We have a handful of Chicago undergrads. They are pretty hardcore, yeah.

haha teaching those undergrads when i was 100% sure they all knew more than me about everything was a traet

oh we start renal stuff in a few weeks, i think? i'll have to check. i'm pretending school does not exist for the next day or two

We just finished renal (sadness). God bless Linda Costanzo - do you guys use her for physio?

Nah, we mostly use Guyton and Hall (which I kind of love). There have been smaller specific physiology books for the lung and the kidney, also, but I am cheap and just stuck with my G&H.

Rhoades and Bell, here, but I've got a copy of Costanzo BRS book

fun facts to know and tell:

yesterday, in neuro, we learned about the vestibulocochlear motor control of eye movement. we also learned why alcohol gives you the spins---the alcohol actually gets into the endolymph of your inner ear, lowering the relative density of the cupola. it floats, which triggers compensatory eye saccades. yr eyes basically move around to follow the movements of your head *that aren't even happening*.

also neat: the reason you go from tipsy (physically), on to stable but increasing "drunk" and then back to "staggering" and "room spinning" is because the alcohol enters, equilibrates, and then leaves. so the terrible room spins you get at the end of the night are because you're sobering up!

FACTS

post-midterm neuro is ridiculously dope, btw

wow gtk

also benign paroxysmal positional vertigo sounds blawful

art history girls are always hotties, and always either a little crazy or a little boring

also gtk

just got this: http://www.ecostudies.org/images/scientists/Ostfeld/Infectious_Disease_Ecology_cover.gif, psyched

also, who i have to lobby to get smart loans (ie - loan repayment is based on % of income, not fixed monthly payments....good incentive for pediatricians/obs etc)

i can give u a buck fifty maybe two bucks... 5% interest

lemme think about it

I used to get inner ear infections like clockwork. It's a special hell, one that involves regular vomiting and an inability to change position at all without vomiting, and an inability to walk without falling (possibly down stairs), and other unpleasant things.

ohhh man i dont even want to think about loans :/ lol market meltdown

id give u a loan but ur credit suxx sorry bro

yeah, there's been a lot of talk at school (well, w/a few ppl) about how market meltdown + possible restructuring of healthcare + less remunerative specialties could = :(

hey i just checked my score it is solid what gives

o u can get one, no prob, lamp has a credit score of bad

i hadnt expected to need loans since i had a fair amount of $$$ saved because i worked f/t through undergrad but ive lost some of that over the last fourteen months and my income has gone down as my living expenses went up so i havent been able to save all that much

it really sux because my financial situation is fairly different from when i first applied and im not sure what the mechanism is for reconciling that

+ acc to max my credit score is bad to madoff

wait so you're going for sure? :D

u guys are going to be doktor buddies!!!!!!!!

http://wwwdelivery.superstock.com/WI/223/1614/PreviewComp/SuperStock_1614R-5160.jpg

had a convo w/classmates yesterday about dcotor school v PA school and even though PA school is shorter and you work right away and it pays well and there's a huge demand, we all realized that we couldn't bear being "bossed around" by a doc

so basically med students in self-centered non-shocker

:-/

LOL tell me about it. I have a friend who did a 6 year pharmacy degree after high school and her second year out she is making $150,000.....

Given that I have already been 8 years out of high school and am a first-year medical student, I now feel more of an incentive to subsubsubsubspecialize in order to justify my many years of education.

And by 8 years, I mean 5 years. I cannot type today.

i am closing in on ten years out and i am a first year student, too, yeeks

Evan, we could've used you at pub quiz the other night when the category was THE HUMAN SKELETON.

oh man they had a whole category for it??

Yeah. 8 or 10 questions. We made a few lucky guesses but overall didn't do so hot.

ugh

:-(

http://www.funkandjunk.com/images/pictures/29508.jpg

currently drafting my B33F letter to the dean.....eek

wish u guys could come to my renal lectures....dr k4tz is the best

alllllllllllllllll done now it is bedtime yay

YAY!!!!!!!!!!!!!!!!!!!! Congratulations. :-)

happy summer! whatcha got planned?

oh and I just want to confirm that you do NOT wear scrubs, white coat, or any other doktor paraphenalia to bars.

going on a climbing trip to devil's tower/spearfish canyon next week, but then it's back to school until the end of june. THEN summer starts.

and no, i def do not wear doctor regalia when out. besides, med student white coats are cut short on purpose to make it clear that you are but a lowly student physician, and not the real deal.

confession, tho: i have worn my UMN Med School hoodie out before, btu that's because it's the only hoodie i've got. also because i want to pick up chicks

i once thought about accidentally letting my stethoscope fall out of my bag will rifling thru it at the coffee shop while sitting next to a pretty girl, but i thought better of it and went back to studying renal physiology

'oh this old thing? no big deal, i'm just a future physician, brushing up on my stuff---not that I need to, of course, i just want to ensure that all those children and little old ladies i plan on helping are going to get the best possible care. after that i have to study for my physical exam....hey, i don't suppose you're busy?'

i don't really get out much :-/

Forget med school, u shd be writing dialogue for some show like "Bones" or related medical-ish stuff. That is, yknow, kind of dum but mostly lol.

not really sure if i'm supposed to be flattered there

Sure you should -- I think yr great. You should actually say that to the ladies and see what happens. If they think you're funny, you have a winnar.

When people ask me what I do or why I moved to DC or whatever, I always say "Oh I came here for school". Part of it is just that I spend almost all my time either in class or studying or hanging out with my friends from med school, so it is like the most normal, unspecial thing in the world to me now. But the bigger thing is that saying you are a med student is a fun way to get asked a bunch of questions that you have like zero idea about, which makes me so uncomfortable. God forbid there should be an actual emergent problem. There is probably not a more dangerous place to have a medical emergency than in a room full of first-year med students.

Also sometimes people will start just telling you stories about things that are wrong with them, which can sometimes be pretty awesome, but sometimes involves highly descriptive explanations of like, their sexual dysfunctions.

But the bigger thing is that saying you are a med student is a fun way to get asked a bunch of questions that you have like zero idea about, which makes me so uncomfortable. God forbid there should be an actual emergent problem. There is probably not a more dangerous place to have a medical emergency than in a room full of first-year med students.

^^^ real. i've def encountered ppl that aren't aware of how long medical training is, so they think that a first-year med student is like nearly a doctor.

I was recently around a medical emergency (which turned out OK) where the only doc present was a psychiatrist specializing in adolescent addictions. He dreads the "is the a doctor in the house?" question big time!

So peeps, how does it feel to be done being an M1?

just finished first week of summer session....M1 ain't over for another five weeks!

I have one neuro exam tomorrow (part of the continuing effort to get us to appreciate Friday exams more and more) and one in mid-June, and then some shelves and then I am done until August.

I am halfway between being comfortable enough with most material to not freak out over anything, and being so tired of burning days studying nonstop that I do not want to study very hard anymore. It is kind of nice, until the inevitable point at which I go down in flames on an exam.

oh man, neuro

really interesting, but i'm glad to be done with it. also so grateful that i swatted the practical portion of the exam, because the written portion did ~not~ go well

just finished first week of summer session....M1 ain't over for another five weeks

damn.... so u get what a month off??

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

^^^ kind of interesting in light of how much medical school costs

huh, i was just coming to post a link to the initial article i read about smart loans: http://www.slate.com/id/2212534/

no, i get a 'real' summer break: done june 20ish, back to school sept 8th.

i keep forgetting Lamp: are you going in the fall???

next fall im doing graduate work in immunology/micro @ the medical school with the idea of applying for the combined md/phd program for 2011 (when ill be 26 lol)

enh, i'm 28

liked that article, btw. i really think that somehow making medical school dramatically more affordable (even though we're getting our educations at half-price??) is pretty crucial to 'saving medicine's soul' or whatever.

also you guys, i had another idea: so, you know how the NHS has a loan repayment program for primary care docs willing to work in underserved areas, right? would it be a terrible idea to propose a similar, alternate program that used first-year residents instead? that is: newly-minted MDs spend a year providing primary care services, and then transition on to whatever more specialized training they match into.

i understand that newly minted MDs don't really know anything, but I feel like many of the primary care deficiencies we're seeing might be able to be addressed by relatively untrained docs??? or would this be wildly dangerous and inappropriate?? i really have to believe that there are some ppl out there that want to be orthopods, but that would also post-pone residency another year if it meant that they got to work in an underserved community and defray some loans

i really have to believe that there are some ppl out there that want to be orthopods, but that would also post-pone residency another year if it meant that they got to work in an underserved community and defray some loans

Yeah this is basically me. Even the orthopod thing! Some kind of like, Doctor version of Teach for America or something.

I briefly was on the MD/PhD path (I decided I wanted to go to medical school about two months after starting graduate school, which was an odd time for an epiphany like that), but I ended up not continuing grad school. The amount of years you have to put in for the double doctorate was kind of terrifying to me, but the prospect of living on that MSTP money was reassuring.

Also we get out on June 20th but have to come back on like August 11th. And I am spending most of that time doing research! (But I am doing it in Los Angeles, which is all I really wanted out of my summer.)

Some kind of like, Doctor version of Teach for America or something.

yeah, this is it exactly.

A friend from UNC med did this--got a sweet assignment in northern california after graduating! I'm not sure how many years he owed doing the underserved primary care doc thing, but I'm pretty sure it defrayed all or almost all of his med school debt via the program. But he wanted to do primary care all along, not continue as a cardiologist or anything.

Oh and Lamp may I just take one moment to bitch that "real" Ph.D.s (the kind I would have been had I not dropped out after four years) none so impressed that the MD/PhDs all finished the PhDs whether or not they had done any decent research by that point. It's like a guarenteed hard stop, even if you haven't published anything.

all finished the PhDs in four years (reg Ph.D. at least six) I mean.

yay done with ms1 yay

:-)

hey congratulations!

boo family's falling apart boo

but thanks dude(tte)s. it's nice to be like actually done for a while

med school lolz

neuro path prof gave us a handy mnemonic for the cranial nerves to day:

frank
sinatra
takes
four
fingers
straight
scotch
each
night
to
ease
tension

first
second
third

get it omglol

gbx do not let med school affect you this way!

i thought it as funny!

People don't need to see Prince Albert...

All people seem to need data processing...

would really like to go back to my alma mater (<---- first time i have used that word) or vermont or colorado

i seem to think that i'll have time to do fun stuff outside

― gbx, Wednesday, December 26, 2007 4:12 PM (1 year ago)

where do you go? my stepdad went to vermont med

i thought it as funny!

Yeah see this is what I mean!

I am in the upper Midwest. Uvm and co and dmouth wouldn't have me :(

but I get instate so

fuck em then

Word

I think we got like ten minutes of a breakdown of "On Old Olympus...", but then they asked to know a bunch of other stuff about all the nerves for the test, so really if you were still having trouble remembering the names of all the nerves you had way bigger issues to deal with. It is still kind of fun to use the "Oh Oh Oh to touch and feel" version, but after a while you just memorize them. I did get some mileage out of Some Say Marry Money But My Brother Says Big Boobs Matter More, though.

oh christ we are getting the super-fun "crazy ER stories" lunch lecture right now and it is BRUTAL

do not ever burn yrself with hydrofluoric acid

or fall and land directly on a CURTAIN ROD in YOUR MOUTH

also unbelievable picture of a dude w/a with 40oz bottle of budweiser in his butt

lol caption 'this bud's for you'

Three reasons (of about 10,000) that the medical profession is not for me. Just reading the curtain rod thing made me woozy.

I candy striped one summer and spent most of my two weeks reading books in the nurse's station because I tried to give a man his own urine to drink (I didn't know the urinal thing wasn't a water pitcher!) and also I was kind of useless w/r/t bodily effluvia.

ok lol at that!!

I figure that if I were a radiologist giving one of those "Come match to radiology" talks to med students I would just show a presentation full of foreign object radiographs. They are so hilarious!

Also once when I was volunteering in an ER I saw a dude come in complaining that somehow he had fallen and a foreign object had gotten stuck up his butt, somehow, and I was so excited that people actually do try and pretend like they didn't MEAN to put that thing in their butt that I almost broke out laughing.

omg ok this is dang unbelievable, an ED doc here (h3nn) cut a dude's leg off ~at the scene~ of a crazy semi crash with a SAWZALL

the pt in the case above claimed to have ~rolled over in his sleep~ onto the 40oz

Hahaha I love the excuses! They really need to post a sign in the ER saying "Look, we know how that thing got in your butt. Don't bother making up a story. We're going to laugh at you anyway (after you leave)."

Oh the fell on something that went up my butt thing happens all the time. A friend who is a PA once encountered a guy on an ER rotation who came in for rectal bleeding but denied any and all erm . . . butt play until she told him that there would be x-rays at which pt he admitted to pleasuring himself with a broom handle which then broke off. In his butt.

- guy cut his own balls off
- lady pulled her own eyeball out cuz of alcoholic hallucinosis

I am guessing this one was initially reported as a Bathtub Accident:

http://i34.tinypic.com/2e53znp.jpg

~~~~shudder~~~~

Maybe ball dude was the fetish guy I told you about who cut off his dick.

RUBBER DUCK.

...you're the one

we are now onto the penis injury section...

lol at u guy who threaded a shoelace up yr penis such that it tied itself into a knot in YOUR BLADDER

YES

pic of CHEWED THROUGH restraints

OMG

.

.

.

.

WHYYYYYYYYYYYYYY??????????????

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

didn't want to be restrained anymore, duh

NOOOOOOOOOOOOOOOOOOOOOOO WHY THE SHOELACE UP THE PENIS

how else are you going to get a shoelace in yr bladder?

GAHHHHHHHHHHHHHHHHHHHHHH

pic of beaded necklace that did same was worse imo

Was urethral insertion in that paraphilia poll a while back? Because let's be honest even people who are eating poo kind of get grossed out at the thought of someone shoving stuff up their peehole.

wait has more than one person done this? Jesus.

Ball dude was briefly lolled at on ILX (unless there's another one). He did it as a bet.

http://news.sky.com/skynews/Home/Sky-News-Archive/Article/200806413297624

Oh I'm sure it's another guy. More ball cutters in this world then you might think.

Paraphilia poll still going. There is currently a revised edition on TMI.

all of these stories were from the local ED, so yeah, more than one ball cutter out there

Police revealed he has a history of mental problems.

Wld never have guessed

btw am now trying to work out the actual mechanics of shoving a shoelace all the way up a urethra. I am also eating lunch. I love this stuff. I want to go to medical school.

OK, maybe not really. I just want to go for all the good parts.

"good" parts

Yeah! This is the good stuff imo.

To be honest I like learning about most medical stuff I just don't think I'd have the discipline to acutally, you know, go to medical school.

It is easier to learn stuff in excruciating detail when it is really really interesting, and most of what you have to learn in medical school is really really interesting. (Not all of it, and that stuff...that can get pretty brutal). And once you get to 3rd year then you are learning based on actual patients, and that is by all accounts 100x more interesting.

wow i want to be an ER doctor!

why am i still reading this thread ;_;

yeah, i'm back to wanting to be an ER doc (which was the plan when i came in)

I think that would be so interesting. DO IT.

I had the most badass prof for anat & phys, old retired guy who taught with his wife & who had been an ER doc in Detroit. Every couple weeks he'd give us some body horror slideshows (w/proper slides, fuck a .ppt) of photos from the Detroit ER. Most memorable was photo of a dude w/a giant hydrocele (meaning his nutsack was a big ole water balloon), nuts almost down to his knees.

He'd grown up in Bolivia, so he had great photos from there too (just of regular things, like llamas to illustrate how oxygen works at different elevations, not crazy people who'd stabbed themselves on PCP). He told us that when he went to medical school there, the instructor was doing a lecture on tonsillectomies, and asked if anyone needed their tonsils out. My prof said he did, so in front of the whole class, he had his tonsils out without anaesthesia. *_*

@_@

He had a hard time saying American-style 'R's, so whenever he had to talk about iron he'd sigh and say, "Irrrr-on, you know, EFF EE."

Bottles up the butt is an old, old story: friend's late dad who served in WWII hospitals in London loved telling us how careful a doc had to be removing them because creating a vacuum back there was not the best idea. Actually I think he just liked attention from grossed-out teenaged girls: 'EW EW EW...no, really? How did that come out? EWWWWWW don't! No!'

omg did not consider the vaccuum

What does that result in? I mean, why is it a problem? (Yes, I R RETARD.)

I'm not a doctor but I think the gist of it is EWWWWW PROLAPSED GUTS or an arse like the Mouth of Cthulhu.

Oh I can sort of imagine it, but I NEED A CLEAR IMAGE. heh

NO! Please do yourself a favor and don't GIS prolapsed rectum. I'm not generally squeamish at all and I think I may vom.

LOL kinda love the idea of gbx getting beyond-the-grave advice from one of the best surgeons ever to walk the halls of his med school.

why would anyone GIS prolapse ~anything???

I was curious!!

To be honest that isn't even the worst medical and/or health related thing I've GISd.

anyone GIS prolapse

Uh oh. I read the description and, no thank you, no GIS for me.

hey med school kids--doing some research on top medical innovations of the last ten years and what kinds of innovations we can look fwd to for the next 10.any ideas for clinics/institutes/hospitals should i contact for comment on this? i have some obvious names (mayo clinic, etc), anyone not on the radar who might be good?

search "atul gawande"

he's got loads of articles on improving the practice of medicine (think there's a new one in the new yorker right now?)

u love him!

also speaking of medical school:

done:
- psych
- pharm
- path

pending:
- neuropathophysiology (GOD HELP ME)
- ENT (??????????)

i do love him!

i dont know that it would be easy to get in touch w/ gawande for an interview in the next couple days

do u want to interview my dad y/n

he has lots of opinions 4 u

i guess u were probably hoping for helpful responses

i forgot yr dad was a doctor!

i sort of assumed he was billy buffalo

i wish

what a thing for a child to do, to wish that her own father was just a man in an animal suit

Hey Max, would your research extend to the focus on medical errors and evidence-based practice and all that? I think To Err is Human from the IOM came out in like 1999 or 2000, and that seems like it was a big deal. There are a couple of books from a few years ago that springboard off that IOM report that are basically all about how tens of thousands were/are dying because nobody was washing their hands and such (I forget the titles offhand, but one is by a guy named Don Berwick and the other is by Robert Wachter and a dude whose name I cant spell). I think that ties in with Intermountain from that piece in the NYT magazine a couple weeks ago, too.

Also as an orthopedics nerd I have to mention the ridiculous advances in trauma surgery and prosthetics that have been going on since the wars started, and the countereffect of psychiatric disorders in people who would have just died in Vietnam or WWII.

the prosthetics thing is definitely on my list--the evidence-based stuff tends a little bit too much towards "policy" for what were looking for? i think? but i may try including it

C-L,

Where does an ortho nerd go for nerdly indulgences? Aside from a stint in the ER, almost all my clinical shadowing before school was orthopedics, and I'm crazy about it. Not in a nerdy way, since I don't know squat, but in an aspirationally nerdy way. Like, my interest in orthopedics almost makes me guilty, but there it is: I secretly just want to use power tools.

Btw, have you been to a Shrin3r's hospital? They might actually be that despicable application essay reason I decided that medicine was a good idea.

also lol at punctuation and putting on airs to win the esteem of a colleague

Oh, also I remembered that it is now basically impossible to talk to neurologists without them going "Oh man just wait a couple of years and we are going to BLOW YOUR MIND with how much we can do" between Deep Brain Stimulation and stem cells and limiting traumatic brain injuries and generally understanding what the hell is going on in the brain. I am not 100% sure what hospitals are at the leading edge of that, though. Between that and learning about concussions from the NFL it is all exciting enough to make me flirt with going into neurology.

I have similarly also heard such things about Interventional Radiology (although sometimes the Interventional Radiologists just talk about making $$$), since they are taking on procedures that used to be done blindly (or with larger incisions) by other fields. Supposedly talent is draining out of cardiothoracic surgery, since you rarely go open-heart anymore, but you can stent all day long. I still have very little idea what the hell interventional radiology actually entails, though, since the conversation rapidly goes from "look at how we can see EXACTLY where this needle is going" to "Look at how awesome all of our equipment is". To be fair it is pretty awesome.

haha, neurology is hilarious, though, esp since it seems like a great deal of it is pointing to the precise location of the lesion, detailing how exactly it is the pathways are disrupted, and then crossing your arms and looking like a kid who built a model. "see, there it is? pretty sweet, huh!" "so now what? does it work?" "...wait, waht"

i have been very persuaded by the neurologists, if only because i tend to be a person who likes to solve a puzzle and then do ~nothing~ about it

and yeah, IR is also pretty intriguing because it is just so deeply nerdy.

actually knowing and CARING how imaging works + knowing enough anatomy and physiology to be able to read scans like a g + buying sweet computers and lol MRIs and thinking of them like someone else thinks about delivery trucks + doing spaceship surgery w/video games + all of the money in the entire world = profit???!!!!!!

i'm actually just wondering when radiology will change its name to something more specific and descriptive.

Actually my institution puts out a higher percentage of orthos than any other med school year after year, so we are kind of indulged. Although there are many dudes who are more typically ortho-y than me (i.e. very tall dudes who played sports at a high level and call each other "bro"), which makes me slightly nervous. Most of my interest was built up over years of athletic training and physical therapy work going way back to high school, where I got to watch all kinds of horrible knee trauma. But then this summer I was at Children's Hospital LA working on an ortho research project and oh man kids with congenital defects <3 <3 <3 so rad Best Ever. Plus hanging with orthos (and PTs) all day was way less about "I am IMPORTANT listen to ME I am an IMPORTANT DOCTOR" than working with/shadowing the avg surgeon in my experience. Maybe it is just a West Coast vs. East Coast thing, though.

I have not been to a Shriner's hospital. There seemed to be some interaction between the Shriner's in LA and CHLA that I didn't get to be a part of, but it looks like the closest one to DC is in Philly. We do not even get to rotate at Children's National Medical Center in DC because that is apparently GWU's (and maybe Howard's) hospital. We get to go to Walter Reed, and they don't, so there is that.

Yeah it is kind of odd to be super-concerned about the fact that there really ought to be some gigantic expansion of primary care and yet at the same time be like "I want to go into a sub-subspecialty, why because it look interesting". I am part of the problem! Although it could be worse, I could be gunning for that #1 Derm spot.

Yeah it is kind of odd to be super-concerned about the fact that there really ought to be some gigantic expansion of primary care and yet at the same time be like "I want to go into a sub-subspecialty, why because it look interesting". I am part of the problem! Although it could be worse, I could be gunning for that #1 Derm spot.

― C-L, Monday, November 23, 2009 6:14 PM (2 seconds ago) Bookmark Suggest Ban Permalink

this is like the central tension, for me. the us and the world just needs more ppl doing general practice and yet surgery/radiology/etc are just so dang intriguing. like i actually worry that i'd go into GP and feel like i'm working a 'desk job', even though i routinely grouse about the how what the world needs is more GPs and less academics/specialists

obv the best choice is to do the thing to which you are most inclined (for whatever reason), but sometimes i think it'd just be crass and selfish if i was like 'fuck it, ophthalmology is my SHIT'. but then you know i think about how the eye is pretty dope and i can understand why someone might want to spend a lot of time dealing with it

Yeah the guys who can come in and give a lecture of like "Look at all this crazy shit that can happen you guys!" are almost always more fun than "Here is why it is bad that people are so fat now", even though obesity and hypertension and all that are way more of an issue than the crazy stuff that people usually only get on House. And then the specialist guys come in and be all "We can do medicine with positrons and lasers and SCIENCE!" and then an old guy tells you what a 3rd heart sound kind of sounds like usually.

The exception for me is with pharm since it is kind of awesome every time I watch ads for boner pills because now when they say "Do not take Viagra if you are taking Nitrates for chest pain, as it may cause an unsafe drop in blood pressure" I can nod my head knowingly.

http://www.hopkinsmedicine.org/geneticmedicine/

max - not sure how widely your defining "innovation" but these dudes (including most recent nobel laureate) are doing some pretty interesting research in medical genetics. i cant think of one specific breakthrough that might be worth writing about but i bet the have a press office that can put u in touch with someone

thanks lamp thats exactly what im looking for

haha, neurology is hilarious, though, esp since it seems like a great deal of it is pointing to the precise location of the lesion, detailing how exactly it is the pathways are disrupted, and then crossing your arms and looking like a kid who built a model. "see, there it is? pretty sweet, huh!" "so now what? does it work?" "...wait, waht"

i have been very persuaded by the neurologists, if only because i tend to be a person who likes to solve a puzzle and then do ~nothing~ about it.

...pretty much. that's why i went into neurology, some combination of one-upnerdship and fatalism.

in real life, localization problems are mostly put into the cold hands of the MRI machine. not everything works out as cleanly as in brazis or blumenfeld. even aside from localization, neurologists have to face more vague, complex and/or unknowable clinical situations than other specialists except psychiatrists (unlike psychiatrists, we're expected to get the answer right). expertly-done clinical neurology takes more time and care than modern medicine usually allows: it's a bit of an anachronism. so it helps to have a self-concept that's heavily dependent on believing you're the only one who has the brains and willpower to sort through the morass of possibilities to find the shining nugget of clinical truth. self-satisfaction in problem-solving and patient care has to make up for the lack of some of the more tangible rewards that accrue to practice in, say, interventional radiology. therapeutic options in neurology are improving all the time, but i'm afraid we're a long way from the sort of revolution that would make treatment and cure the most rewarding part of the field.

old maxim that will tell you if neurology is right for you:

if you don't understand it, it's psychiatry;
once you can explain it, it's neurology;
once you can fix it, it's neurosurgery.

that's about right. neurology, day by day, isn't about the great unknowns (oliver sacks case studies aside). it's mostly about accurately explaining complex (and often obscure) problems we can do little about. and most of our promising/experimental therapies are really surgical and/or interventional (epilepsy surgery, DBS, endovascular procedures, m-a-y-b-e stem cells). someday neurologists as a tribe might show an interest in learning some of those techniques themselves, but for now we're generally happy to pass them off to NSx or Rad.

bottom line, if you like dealing with people and being the only person in the hospital who can figure out what's wrong with Mr X, you're going to have a lot of fun in neuro.

hello plasmon!

(unlike psychiatrists, we're expected to get the answer right)

I will be stealing that line, thankin' U Dr. Plasmon.

Plasmon, don't neurologists ever work closely with cognitive neuropsychologists on therapies, in or out of the hospital setting?

plasmon what are the answers to my neuropathophys exam tomorrow

hello med-ilx!

Plasmon, don't neurologists ever work closely with cognitive neuropsychologists on therapies, in or out of the hospital setting?

there aren't a lot of proven cognitive neuropsych therapies. neuropsychologists help diagnose some neurology patients (doing detailed cognitive testing) and help establish parameters for treatment of others (testing memory in epilepsy patients to see if their baseline level of cognitive function will be severely impaired after temporal lobe resection). cognitive/behavioral neurologists (read: dementia specialists) work the most closely with them. i'm sure there are some promising avenues for therapy, but they aren't established yet.

plasmon what are the answers to my neuropathophys exam tomorrow

path slides? gross or micro? cases and questions? MCQ? short answer?

pathophysiology, all cases and questions. basically: localize!

i just need to know the brainstem a little better

took gross/micro neuro path on monday, did ok :-/

lol exams lol posting 2 ilx :/

good luck bro

Good luck, do not let them catch you on a Central VII lesion that they want you to believe is Bell's Palsy.

i will allow no such thing to happen. if innervation to the forehead is preserved then u kno what THAT means

lol exams lol posting 2 ilx :/

good luck bro

― Lamp, Tuesday, November 24, 2009 5:47 PM (15 minutes ago) Bookmark Suggest Ban Permalink

study time out iirc

haha i was lol'n @ me really - gave up on drinks w/bros 2nite to stay in and "study" i.e. post to ilx

https://www.youtube.com/watch?v=WGgCy-hbp4Q

my downstairs neighbors must haaaaaaaaaate meeeeeeeee

all pacing back and forth to the kitchen, making 100000x cups of tea with a whistling kettle (pro-tip: white or green tea makes for a better caffeine titration than coffee imo)

aren't you guys about to figure out how to cancel sleep anyway

i think i did figure it out, and i think it was a mistake

literally seeing thru time right now

my test went well just fyi thinking good thoughts 4 u future gbx if u can still hear me~~

it is ~*all good*~

http://www.kevinmd.com/blog/2009/11/training-doctor-france-differs-united-states.html

How is everyone doing? hanging in there during exam week?

next week for me. should be pretty chill? our period was only 2.5 weeks

can i post here too? stressed about pharm finals tbh

also genuinely interested in fl3x md and their school of public health/int'l health opportunities

― gbx, Wednesday, December 26, 2007 5:35 PM (1 year ago)

you still heading this direction? public health was the coolest class i took this semester

We had two four-hour exams this week (Monday and then this morning), both of which were absolute monsters. There is one more shorter one on Monday and then winter break. I am so tired, and want 2nd year to be done so I never have to do 2nd year again, but other than that, you know no complaints. If I get a passing grade and it's not so bad that I have to kill myself next quarter to make sure I stay above the pass line, then I am all good.

K3vin I feel it is only appropriate to discuss Pharm here because I spent most of the past two weeks going insane trying to keep track of like, which antibiotics require dose-adjustment in renal insufficiency and which ones in hepatic insufficiency, and then today I got my ass handed to me by the cardiovascular drugs, esp the antiarrhythmics. Like the hypertensives and CHFs and anginas all make sense eventually, and the anticoagulants are comparatively a treat, but then all of a sudden we enter this hellish netherrealm where somehow Amiodarone is considered an agent that it is still OK to use, despite turning your skin kind of blue and having 1 million other toxicities.

Nursing school, not medical school, but whatever: One exam a week for the last month, two 50-75 page chapters a week to read. Two clinicals a week, both of which entails us having to get to the hospital at six in the morning. (It'll increase to three a week for a while after the first of the year.) And just about everyone else other than me works 30+ hours a week. True, it's not even close to what you future doctors have to put up with....

I'm glad I have all of this behind me!

re: Amiodarone, besides all of the potential serious (and potentially fatal) toxicities, I can tell you from personal experience (with an arrhythmia) that it's an extremely nasty drug. What they don't tell you is that it makes you feel like you're having to drag yourself through your life for every second of every day that you have to take it. I'm just glad that my trial with it didn't last very long.

C-L we must be on totally different schedules!

I think you started like a month after we did (we started like the second week of August, or whatever it was 20 weeks ago).

Am kind of envious of nursing school for letting students have some hospital time in the middle of the preclinical sciences. Maybe not so much for the 6 am part, but still. We get to do in-hospital Physical Diagnosis coursework in like March, I think. And then once July rolls around it is 3rd year~

and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~
and then once July rolls around it is 3rd year~

just saw a screening of Living In Emergency

did u???? i wanna talk about it

what is it abt? i am studying

https://www.youtube.com/watch?v=PMuLdA5AbXM

did u watch it for school gbx or on your own?

on my own

well, went to it w/dad and sis, actually. didn't even know it was showing here, but my dad got tickets. kinda wanted to talk with him about it afterwards, but it's late and i needed to get home.

(he is a libertarian surgeon, btw, and i think sometimes we have pretty different outlooks on healthcare, but he seem pretty affected by it, at least during)

haaa - i had heard abt it from my mom - think mb she knows some of the ppl involved - but havent seen it myself

looks like it was only screening today :/ - def something i want to see tho. did u ever end up reading strength in what remains?

not yet! haven't been reading much :-/

I passed cardio! I almost certainly passed pulmonary! I think I passed bacteriology!

Also I am drunk because I am celebrating being 37.5% of one doctor. EXCITEMENT

YES!!!!

congratulations!!

I actually did pass bacteriology! I am kind of hungover!

*Fist pump*

how political is medical school? asking because I was recently in touch with an old friend (with whom I have radically different political views, on some things anyway) whose medical career essentially tanked and went to hell for reasons that he viewed as political (although I'm pretty sure there was more to the story).

not very, ime! i mean ppl have their views, i guess, but save for the existence of some student groups that are inherently political (we've got universal healthcare groups, and both pro-life and pro-choice groups), politics isn't something most of my classmates keep up on.

that being said, the general climate could be regarded by a selective minority as stiflingly ~liberal~. social conservatism doesn't gain a lot of traction around here, nor should it (IMO---if what ppl do with their private lives is something you spend a lot of time getting aggravated about, you might want to avoid a job that places you squarely in other ppl's business).

or do you mean small-scale political, like "office politics" style?

In my experience, you are probably in more risk of getting screwed in terms of the internal politics of academia (which are always insane, although much less so than was my experience with grad school, which had fewer people, and a much different approach to professional education, at least for me).

My school is supposedly kind of rare, but there is a healthy population of conservative oh God Obama is going to ruin medicine now we will only make $150,000 per year WHAT WILL WE DO* here, along with a healthy population of idealistic young liberal sorts like myself. (Discussions of abortion are especially awkward, since Gtown itself is officially pro-life and no abortions are performed at University hospital.) If someone is going on and on publicly about "We must act in the image of Christ" or "Dick Cheney is probably actually Satan" or "Obama's socialized medicine will destroy the foundation of America" then it gets weird, but that's poor judgment as much as anything. My thinking is that to be a good doctor you have to know when to shut the fuck up sometimes, and that includes a lot of quiet nodding with patients and higher-ups who are saying shit you don't believe about shit that isn't important to the work you're trying to do that day. A lot of this is me being naturally non-confrontational, but I think it's valuable to not piss anybody off unless you have to. Some patients are horrible people, but they're still sick.

With that said there is at least a 15% chance I will intentionally pick a fight in our Ethics course next quarter, but that is a whole other story.

*I completely appreciate that $150,000 is a rad amount of money to make, but to be fair $250,000 of debt (plus whatever you carry in from undergrad loans) is a serious consideration. An extra mortgage's worth of debt makes fiscal conservatives get kind of tight, especially when you factor in malpractice insurance and the fact that doctors are by and large horrible at being businessmen.

My thinking is that to be a good doctor you have to know when to shut the fuck up sometimes, and that includes a lot of quiet nodding with patients and higher-ups who are saying shit you don't believe about shit that isn't important to the work you're trying to do that day. A lot of this is me being naturally non-confrontational, but I think it's valuable to not piss anybody off unless you have to. Some patients are horrible people, but they're still sick.

otm x1000000

i should probably stfu more often

It is super-hard sometimes, though! Especially about medical stuff where you feel the need to say something but Zero idea what is going on (at least for now), or when you are having more of a conversation part and have to remember that your normal self-deprecating "Yeah I don't know how they let ME into medical school, I am like two generations removed from hillfolk" shtick is probably not the best thing for someone who is consenting to the idea that you can identify what is going on with them, and how it can be resolved.

My thinking is that to be a good doctor you have to know when to shut the fuck up sometimes, and that includes a lot of quiet nodding with patients and higher-ups who are saying shit you don't believe about shit that isn't important to the work you're trying to do that day. A lot of this is me being naturally non-confrontational, but I think it's valuable to not piss anybody off unless you have to. Some patients are horrible people, but they're still sick.

this is beautiful and otm

ONE DOWN

basically got my best path score thus far with just a shameful amount of guessing

also, this might just be curricular hypochondria, but i think i have actually given myself carpal tunnel syndrome. shooting pain around my wrist when i type or write notes long hand. 2.5 MORE DAYS

good luck man, my finals are done and im on the ride home now. still hungover, but i deserved last night for this semester

also, got an A- on my bioorganic chem final, WHAT UP

also genuinely interested in fl3x md and their school of public health/int'l health opportunities

I can't remember if you ever met my gf when you were still in Chicago? Because she's in a grad program right now for international public service and has recently become super-interested in public health. I bet you two would have lots to talk about, or at least books/resources to recommend each other.

so the political situation i was talking about was abortion. my friend (who is now, I gather, personally against abortion although at the time I think he was not really leaning one way or the other) reported to very pro-choice politically-active chief resident during his residency; my friend wound up getting very bad evaluations and he chalks it up to being politically motivated, although, I think there were other issues at play (he let it slip that he fell asleep during rounds once, although I can't imagine that doesn't happen a lot; and apparently he'd written very bad cross evaluations of people above him that he'd believed would be anonymous but in the end maybe weren't, as he received very poor evaluations in response); the end result of it was that, after getting to residency, I think he was basically completely stalled in his medical career. I think there's a fair amount of bitterness and also egotism involved; also, since I disagree with him on almost everything politically I don't have enormous amounts of empathy about it, but I hadn't really thought about how someone could get sidetracked and potentially derailed at that point into their career path. And I wondered, on things like abortion: what do you, as a medical student, learn about it? How elective is such learning?

It's my understanding that no school has an OB-GYN clerkship where learning how to do any abortive procedure (other than maybe a D&C for non-fetus-related reasons) is taught, which makes sense because any school that could be portrayed as forcing students to learn how to abort fetuses is basically asking for non-stop protests. It is also my understanding (I am not 100% sure this is so, but I am pretty sure it is) that in an elective clerkship opportunity in the fourth year (the curriculum in the first three years is pretty rigid), it is possible to train with a doctor who does perform abortions. Also, I know a girl who is involved in Med Students for Choice, and they just had a convention (in Salt Lake City, which is the weirdest possible place to have that convention) where they seemed to learn some of the basic practice of it. So you can if you want, but you don't have to.

My school is run by Jesuits, so abortion is kind of the elephant in the room. Any fourth year opportunities would have to be off-site (which is not to say at another school; we're affiliated with Washington Hospital Center, Virginia Hospital Center, and some other public hospitals that have nothing to do with Catholicism), and technically doctors can't even prescribe birth control at the University Hospital or Student Health Center on campus. In practice, all but the most fervent believers will happily write you a prescription for contraceptives related to Premenstrual Dysphoria or acne or some other thing that birth control medications also do. You can't do that with abortion, but I am pretty sure there are doctors In our Ethics course, we spent a day talking specifically about the whole Jesuit part of our Jesuit application, and what that meant; I ended up getting laughed at for trying to devise a tortuous but within-the-rules way to work around the ban on in-vitro fertilization. I am kind of curious to see what the explanation is for treatment of ectopic pregnancies that remain viable to the point of causing damage.

I have like Zero desire to do anything related to either gender's reproductive system, so I am sure there are some subtle and infuriating nuances I will never get to encounter. Outside of Ob-Gyn or Family Medicine I do not know why you would be in a position to have an argument about abortion with your attending, so it might just be that the abortion argument is just a stand-in for the guy being either sanctimonious or just stupid enough to get into a moral debate with the chief resident who believes the exact opposite thing as you. There is also the evaluation thing, which kind of seems like the mark of a dude who assigns fault to everyone else's shortcomings but his own. Those people are not good people to have around in general.

Downside of giant replies: I write them in pieces and forget to finish all the sentences:

2nd paragraph: You can't do that with abortion, but I am pretty sure there are doctors who are affiliated with the University Hospital who will do abortions at an off-site location.

i was wondering about that too because i had been reading that not many medical students were learning how to do it but i can see how "be[ing] portrayed as forcing ...." would be bad.

but then again, it seems like something you should know the basic mechanics of since it's so common. forcing people to learn how it's done isn't forcing them to do it. i don't know how doctors learn though.

learn everything i mean, not just that

We haven't learned a ton of procedural stuff of any sort, I guess. Like 95% of our education in the first two years is centered on stuff that is on the first step of the boards, and then we have like physical diagnosis stuff out on the margins (and sometimes that can be of depressingly little value). It's a little better in third year, but you've only got a limited amount of time everywhere. Like I am not sure I will ever learn how to place a coronary stent, beyond the basics of "find the occluded artery, put it there."

thanks, that was very interesting!

I'm still waking up, but, as an aside: a friend of mine did a reproductive health externship this summer that definitely involved abortions, but yeah at no point will we be getting them in the curriculum.

not sure how this is related, but: we actually just began our workshops on the genital/pelvic exams, and the male session involves students working with mock patients, and the female session involves observation and practice with a plastic model. due, apparently, to budget shortfalls, but not the best way to do things imo

w/r/t politics: getting into it with your attendings while you are a student is just bad business, in general. while i'm usually a very even keeled and personable dude, there are some things/ppl that will get my hackles up; was just watching a missed ortho lecture last night that was a reminder that some of the people that are my superiors/instructors/whatever are deeply, deeply douchey. also, there's a possibility that i'll have a resident that's four years younger than me (26 v. 30), which isn't guaranteed weird, but i can see possible tension there

in the end, i will have to remind myself that the person writing my evaluation (of a mere 4 weeks of work) is probably not someone i should get into any kind of protracted ideological disagreement with. because, yeah,

BAM

curious to know what the post-earthquake response as been on y'alls campuses

also my dad just mentioned that he's thinking of trying to get down there sometime in the future (he's a reconstructive surgeon, so he'd be doing "clean up work" as they say), so that's neat.

aaaaaaaaand renal/endo/pharm midterms tomorrow whoops time to get off the internet

hello cushing's disease, how are you

We were in the middle of another charity driving thing so our response was a little slow, tbh. They started a contest btwn the first and second years to see who could raise more, so hopefully we will make more stuff happen.

haha so i just cruised through the note coop wiki (which is where i do a lot of studying, actually) and noticed that we have a new Med Wiki Blog. Called.....The Wog.

lol midwesterners

:-/

also: we had one of those fundraisers, too, between classes! raised a decent sum for PIH, it was good stuff.

"my" student group (PHR-affiliate) is gonna try and do something soon, but it will probably be focused on haitian immigration more than direct relief.

cf my friend j3ff's editorial here: http://www.huffingtonpost.com/jeffrey-kahn/cut-the-red-tape-why-hait_b_434209.html

nother pharm class gbx? thought you took that last semester?

my stepdad (vascular surgeon, experience in trauma) is trying to find a group to go down with.

anyway there was a meeting i couldnt go to last thursday, i'm hoping either the pharm school or the school in general is planning trips down there over spring break, if that's even possible. still waiting to hear

pharm is a year long course for us right now

tomorrow is midterms for

pharm (steroids, diuretics, obesity, HTN, diabetes)
renal (Na balance, K balance, water balance, edema, renal failure)
endocrine (pituitary, adrenal, lipid/obesity, diabetes, bone regulation)

kinda freakin out a bit, but at least it's not finals

damn dude, how long has school been in session for? i'm about to start my second week, i dont think i have any true midterms until week 3ish?

also damn 3 in one day? how many classes are you taking?

six

we've been going since 4 jan

oh wow your break must have been short then (you're going to minn right?). i'm taking nine classes but it's only 21 credits. buying books is going to suck tho

yeah, 22 dec to 4 jan, super short

We got 2 weeks for winter break 1st year and then there's 3 weeks in second and third year, and then 4th year there's the weird extended period where you're supposed to be interviewing for residencies but otherwise are not in school. I forget how long that is for us (like six weeks? eight?).

We just did a three week section of renal and neuro. Renal was kinda weird because last year for renal physiology we had one professor give like a three week series of lectures that very carefully and entertaingly (in as much as renal physiology can be entertaining) explained everything really well, so everybody really liked renal. Then this year it was a bunch of people, and a lot of classes where they just dumped pathology on us, so there are not many of us who kept any interest in nephrology. Neuro is weird because a ton of people hate it but I think it is rad, so I can never accurately gauge the room's interest. It is definitely my favorite thing right now if I were to do a medicine residency instead of a surgical one (when I'd probably still go ortho), but I doubt I'm gonna get a handle on medicine vs. surgery until 3rd year. Sweet sweet 3rd year, so very close.

i'm taking a 5 credit neuro module this semester, not looking forward to this playing out

Neuro pharm seems less horrible than cardio pharm, although I haven't taken the neuro exams yet so maybe I am just full of unwarranted confidence. At the beginning of cardio they even told us, the hardest part of path was heme/onc, which we had just finished, and the hardest part of pharm was going to be cardio. And then they proved themselves right!

Although we did have anesthesia last week as part of neuro, and whoever said anesthesiology is like flying a plane seems totally otm, except I didn't realize that analogy also extended to the fact that accidentally nudging one dial a little too high would result in the plane crashing suddenly into the side of a mountain. That many drugs all at once just seems terrifying to me.

last year for renal physiology we had one professor give like a three week series of lectures that very carefully and entertaingly (in as much as renal physiology can be entertaining) explained everything really well, so everybody really liked renal.

whoah weird this is our situation, too, except that he's back this year. and i'm making him dinner in a few weeks.

i mean i secretly really like renal, even though i'm certain i'm going to do horribly on the test tomorrow. ditto most of this endocrine stuff: i like feedback loops and the like. seems like there's less weensy little facts to remember and more big pictures

just, like, really complex pictures. and ditto: i actually enjoyed taking my neuro final, even though i'd been up for like 24 hours. localization is neat!

localization is neat!

Did you use Blumenfeld? Great book, pretty much anyone I've met who likes neuro after med school learned how to localize from Blumenfeld.

Friday morning, I opened my Neurosciences Grand Rounds presentation (on Neurologically Unexplained Symptoms, aka Functional Neurology) with the maxim/joke I used upthread about the difference between psychiatry, neurology, and neurosurgery. No one in a room half-full of neurologists and neurosurgeons had heard it before. Now I can't find it anywhere online. Did I make it up somehow? I'm not usually that clever...

i hadn't heard it in that form, but i've heard similar jokes? usually a little more mean spirited, though, like psyches don't really know anything, neurologists can't really do anything, and neurosurgeons don't really know what they're doing

http://www.hollywoodreporter.com/hr/content_display/television/news/e3i6e742a66c22a2552a1b148e2c35adb6f

"HMS" is about the exploits of the sexy freshmen class at Harvard Medical School through the eyes of a young female student.

I am glad someone has decided to talk about how much exciting sexy action happens in medical school, because you know, that is absolutely a thing.

f u hms

i am getting laid *right now*

http://www.nytimes.com/2010/02/15/education/15medschools.html?hpw

more abt the exploits of sexy med school freshman

where is dyao

ayo

(d)

is there something you'd like to tell us

??????

lol so I basically am in need of life advice. am at a crossroads in my life. currently studying for law school but wondering if med school would be a better choice. always loved science in high school but majored in lit in college instead without taking *any* science courses. would like to know if there's any path/track in med school where I don't have to take on crushing amounts of debt. that's basically my question in a nutshell.

my contract here is coming up for renewal here so I need to decide if I want to 1) stay here and apply to law school or 2) go back to the states and enroll in some program that will catch me up

goin to bed now but looking forward to your thoughtful responses ~

ok, so i also majored in lit in college w/o taking ANY science. hence: did a post-bacc.

here is the thing w/a post-bacc---it tacks on another year of debt, and another TWO years of "pre-med" (the gap year is unavoidable---you gotta take the MCAT after taking the science classes, which means the summer BEFORE you apply, so there it is).

i was fortunate enough to not have undergraduate loans, so i saw the post-bacc program as a med school tryout, of sorts. if i hated it, shat the bed, w/e, then at least my cumulative debt was only one year of state school. if i liked it, great, off we go.

if it's coming down to law school v. med school, there are def a lot of variables to consider

1) time---law school is shorter, requires no pre-reqs, plus NO RESIDENCY. when u r out u r out, and are a lawyer making a lawyer salary
2) $$$---med school is pricier simply because it's a year longer. also, you'll have the added year of post-bacc, and a gap year of sustaining yourself. AND you won't make shit during residency, so you're ability to rid yourself of debt will be postponed at least 3-4 years longer. AND even though docs make a ton of money, lawyers have the potential to make quite a bit more (i know a 2nd year lawyer who just got a bonus that's equivalent to a 2nd year resident's salary).
3) ~lyfe~ medical school produces physicians, full stop. the time/$$$ constraints basically mean that once you're in, you're in. i mean, obv you can ACTUALLY do w/e you want, and maybe you will follow the example of everyone's favorite asian internist and become a tv star, but really: you're gonna be a doctor. lawyers can kinda do whatever they want, and it seems like "non-practicing" is as endemic to the legal profession as it is to catholicism and judaism. so if it's flexibility/freedom yr after, law school is the better choice.

something else to consider: law SCHOOL seems pretty clearly more "fun"/stimulating than med SCHOOL. i flirted briefly with looking into a MD/JD (ie - heard a good med mal lecture, bought an LSAT book on sale, didn't open it, story of my life, etc), but was talked out of it by my sister (a lawyer). basically, i was like "but law school is intellectually stimulating and you argue all the time! med school is just FACTS" and she was like "yes you are correct, but the PRACTICE of law is/can be stultifying while the PRACTICE of medicine is life-long learning/problem-solving etc"

not actually true, imo ("boring" is what you make of it), but worth thinking about it. do you want another round of stimulating academic life, or do you want what results from it? i'm over simplifying (and sorta making a stereotypical lawyer v. doctor joek), but it might be helpful to frame things that way. law=cheap, quick, "disposable" (u can always do something else) med=pricey, loooooong, u can never leave

i am of course ignoring here all the "noble" reasons ppl choose either law or med, because we already know all of them

god so many typos, med school u have ruined me

im not the best qualified to talk abt this aspect but there are a # of ways to defray the cost of actually attending - although i think its good to be realistic about how much money you'll be making/have for the next ten years - but the biggest cost may be the next year+ of applying. in addition to undergrad courses you'll have to take the mcats and the application process itself costs a bunch of money.

my undergrad was math/econ. once i had decided that i was interested in med school i went back and did a year and a half of std chem/bio courses. i was able to do those p/t while i was working f/t. i took these at my alma mater & the med school admissions ppl helped w/what courses i shld take which was really useful.

like gbx i didnt have any loans and i cld afford the courses on my salary - basically meant that the money i wouldve been saving i spent on school instead. i also spent a lot of time working on volunteer and research xp and studying for the mcats. i was lucky that i had a job that was both remunerative and flexible. unless you're really sure idk how good an idea going to school f/t wld be?

this will be mb a little disjointed but: the med school application process is really draining ime and takes a huge amount of commitment. its not really comparable to grad school or law school. i think its a lot more impt to have settled in your own mind ~why~ you're doing this. certainly that was the one thing that really came through in my interviews - that med schools aren't partic interested in some1 who is ambivalent abt becoming a doctor.

lol @ this monster post. i guess what i'm trying to say is: over and above financial considerations i think its really impt to have considered your goals w/all of this.

there are plenty of reasons to be wary about law school too (law school thread is worth reading)

'when u r out u r out, and are a lawyer making a lawyer salary' = if you go to the right school and have good grades and the economy is good

@lamp: cosign

@iatee: oh of course, i def glossed that. which is another "practical" consideration: you ~will~ have a job when you are done with yr medical training. and it is highly unlikely that we are going to reach any time soon the point where we've got a surplus of american MDs.

but yeah: really consider ~why~ you might want to be a doctor. it's the classic/boring med school application question, but you know it's there for a reason. there are plenty of people out there DYING to get into doctor school, so if you're ambivalent they'll neg you ASAP. also: the application process IS really draining and acts as sort of a final "weeder class." a handful of the ppl i did my post-bacc program with were so daunted/put-off by the whole thing that they bailed and took easier/less stressful routes into healthcare.

haha i will say: its unfortunate but the best way to ~figure it out~ is to do it. not just taking courses but volunteering and talking to doctors does a) give u a better sense of the process and b) clarify what your options are and mb what u want out of the profession

also i had dinner this wknd w/some1 doing her obstetrics residency ~ as much as gbx is right that you're probably more limited in your options with an md there are still a huge range of really ~rewarding~ options once you're in med school. its p exciting imo

i agree!

Daaaaang I look away from this thread for a lecture on neuroleptics and then it blows up.

I would add on the debt question, that there are (at least) three things you can do to limit/eliminate your debt profile:

1) Get into an in-state public medical school. (I was not able to do this! Hi 250k of loans!)

2) Apply for a military scholarship, which pays your tuition plus a stipend, but requires you serve the military for some extended period of time following your residency. You can also apply to USUHS, although weirdly I think the service commitment at USUHS is longer than it is than taking a military scholarship. I am not sure what the application-to-award ratio is with these, but I know many people here who are doing this.

3) Do the National Health Service Corps, which is like the military scholarships except your service commitment is in primary care in an underserved region of the country. If you KNOW you want to do this, do it. If you are not sure, you can sign up later if need be, or be like the rest of us and end up going to a residency program in some specialty in a big city with a million other specialty doctors, and then feel like part of the problem.

Or you can be like me, and just be completely unable to conceive of the size of your debt as a real amount of money, and assume that since it will all be electronically paid from a paycheck direct deposited into your account, you will basically just be moving numbers on a computer at it for 20 or 30 years until it goes away. (I realize this is poor fiscal strategy, but what can you do?)

The percentage of students who matriculate at a medical school but do not go on to become a doctor (for at least some period of time) is in the low single digits.

And yes I will echo gbx and say that the application year is just awful. You work way too hard in July/August knocking out secondaries, spend a ton of money sending those secondaries in, go through a fall that is usually long stretches of silence punctuated by interviews (which are fun, although also very expensive), followed by more silence, followed by decisions that frequently seem deflating and unfair. Honestly it was more stressful than the 1st year of medical school for me, and I was lucky enough to get in in January 2008 to start in August. I know people who were in waitlist hell until mid-July. I would not wish that on anyone. (The second year of medical school is much more difficult than your app year or 1st year. It is best you hear that now, and hear that often.)

Having said that, even with the debt and the stress and the workload and everything, going to med school is the best decision I ever made. But it is def not for everybody.

4) work for the Indian Health Service (which is what i'm planning on doing). the loan repayment isn't nearly as generous as the other options, but the commitment is shorter, and there are openings for specialists, not just primary care.

basically i think it works out to something like ~$20k/year IN ADDITION to your salary, which (at least according to the website) looks commensurate with nat'l averages. so, yr making say 150k/yr as a GP in Juneau AND getting 20k in loan payments on top. if you put yourself on an aggressive loan repayment scheme of yr own design, and hitch it to the IHS LRP, then paying it all off within 5-10 years seems v doable.

addendum: just did some hasty figuring and it looks like a 3-year IHS contract w/full loan benefits, coupled with full physician salary and a "normal" (2k/mo) loan payment schedule, and my in-state debt (ball-parking 160k) = PAID in four years

Daaaaaaang, that is not a bad gig at all.

i know, right? kinda amazed, tbh. plus while the rez can be a hard place or w/e, the prospect of doing doctoring in ALASKA or N. NEW MEXICO sounds prettttttttttttty nice for someone with my extracurricular interests.

haha i thought u meant new new mexico for a minute

i did, but it's still in beta

β mexico

btw in my notes tonight i wrote the ~perfect~ β symbol - i just stared at it for a minute, v proud of myself

haha i used to do that exact thing when i was learning to ß

oops that's not the right one

harßl

thanks dudes! you've all been a *big help*

something else to consider: law SCHOOL seems pretty clearly more "fun"/stimulating than med SCHOOL. i flirted briefly with looking into a MD/JD (ie - heard a good med mal lecture, bought an LSAT book on sale, didn't open it, story of my life, etc), but was talked out of it by my sister (a lawyer). basically, i was like "but law school is intellectually stimulating and you argue all the time! med school is just FACTS" and she was like "yes you are correct, but the PRACTICE of law is/can be stultifying while the PRACTICE of medicine is life-long learning/problem-solving etc"

not actually true, imo ("boring" is what you make of it), but worth thinking about it. do you want another round of stimulating academic life, or do you want what results from it? i'm over simplifying (and sorta making a stereotypical lawyer v. doctor joek), but it might be helpful to frame things that way. law=cheap, quick, "disposable" (u can always do something else) med=pricey, loooooong, u can never leave

yeah this gets close at some of the reasons I'm thinking about med school - I am sort of in love with wikipedia, love learning random shit/accumulating stuff, learning about biological mechanisms and w/e. I've read the law school thread too so I hope my glasses aren't too rose-tinted anymore (will go back and read this thread in its entirety too) and lol it seems that none of these career paths will ever match what I really want ~but that's life~ do realize that I could end up doing tax law or something equally dreadful for the rest of my life if I go down the lawyer path too so whatevs. I guess the biggest difference is that if I go to med school I could actually spend my life helpin other people out instead of tryna bill them for more hours (though I guess I would be just tryna bill insurance companies for more procedures lol)

i also spent a lot of time working on volunteer and research xp and studying for the mcats.

yeah I guess I'll look into doin soem volunteer work and seeing if it's really right. gonna be spinning my wheels for another year no matter what so I guess it's best to explore my options. lol reminds me that maybe my best internship experience was working as a lab tech during 1 summer, maybe I should just aim to be a lab tech instead (and never hope to be comfortably well off)

u have a pretty narrow definition of lawyers! also lolling @ lawyer vs. dr choice

i hate how you have to pick a career and your life is not 400 years long, because i would be a doctor too

yeah it shows that I am lazy in life and don't want to strike out on my own :( (and also cannot excape my stereotype)

you're obviously not lazy
but i help ppl, i think.

i feel like most jobs help other people in some way

lol u shld try working in corp pr :/

i mean i guess multinational corporations are "people" sorta

i said most

how about "there are many jobs where your job is to help people"

guys maybe I should just go to filmyoutube school

maybe wait a while and find something u truly like

yeah I should go ~find myself~ or something. brb gonna go live in a yurt cyaaaaa

ok that was pretty cool did you know yaks can be milked

i'm kinda serious, i just want you to be happy

lol it seems that none of these career paths will ever match what I really want ~but that's life~

ha its ~funny~ part of the reason i started working towards med school was bcuz it seemed like an 'easy' or at least certain way of having a career that was both engaging and meaningful but - and this is def p corny - i think this kind of fulfillment comes from how u engage w/your work more than anything. like the ppl that i knew who were docs growing up legit loved their work & so i had that expectation of medicine but there are plenty of docs that dont - who find it limiting or routine or uninspiring.

like idk what you want out of work - this is ime a p difficult & personal & impt qn to answer in a lot of ways - but thats been my ime so far

altho srsly working in pr suuuuuuuuuuuucked

i think this kind of fulfillment comes from how u engage w/your work more than anything.

this is otm

aw thanks harbl. yeah I guess what I really want from a job is just something that is intellectually stimulating and will keep my mind busy. like my job right now is alright, it pays pretty well and not too demanding and I like teachin g but I feel like I'm on autopilot and withering on the vine while I"m doing this. Iono maybe I should go learn computer science or a hard science or something.

i think i understand in that i really like every subject, including science, was confused and could have done anything so law school was like a natural choice. i also didn't take biology in undergrad. but i can tell you i did not have fun in school. i engage with my work independently (learning information for fun, how to lawyer, so-called "boring" stuff) and in practice a lot more & happier than i did in school. so it's kinda hard to make decisions based on people's accounts of their school experience. imo you should go back and take some science. i miss it and am thinking about MPH, tbh.

but not until i'm 30

lol yeah I guess this is just part of being a 20s something in the 21st century. maybe I can have a lucrative career by transmuting my experiences into the genre of film known as mumblecore

If it's worth anything, I graduated from college totally unaware of what I actually wanted to do. The big realization I came to in my last year of undergrad was that I didn't want to be physician. So I panicked and went to grad school for something else, and realized almost immediately that wasn't what I wanted to do. I had the ridiculous good fortune of being able to interact with med students and docs when I was in grad school (even though I was a historian), and basically just felt like I wanted to be doing what they did.

The shadowing a doc thing, and the volunteering in hospitals and all that clinical experience (or lab experience, if that's what you want to do) is probably mostly to make sure you know what you're getting into, but there's probably some desire to make people see if you react by going "I can see myself doing this every day" or "God this sucks, this is not what I thought it would be". I actually didn't get a whole lot more out of volunteering in an ER other than the realization that I am poorly suited for emergency medicine. But I've had a handful of "I could do that every day, all day, forever" moments around medical school and I've never gotten anything like that from anything else.

Which sounds kind of kool-aidy I know, but hey I have to psych myself up to keep on doing this. I have exams again next week BOOOOO

yay me too >:(

aaaaaaand I have spent the last two hours fixing my bike

I'm happy to be in medical school, but then I also had some solid reasons as to why I wanted to go into a health related field and why medical school was the most appropriate path to take for my own personal interests and goals. I agree for the most part with what many people have already said here, but I guess my 2 cents would be that you make sure that you are interested in medical school and not just health/science. There have been a number (not many, but a sizable few) of my fellow classmates whose are hating medical school at the moment and are realizing that their interests and strengths are better suited for a PhD (not even MSTP, just straight Phd), or health administration, or public health, or health policy, etc. etc. etc. If you are interested in making an impact on health in general, then there are many paths that you can take beyond medical school.

*i have achieved a complete understanding of the male and female endocrine systems*

~_~

Cool!

http://www.imbruglia-inside.com/smiley_headbang.gif

pharm, renal, and endo finals today

TIME OUT, kevin otm

now u know why we are so moody ; )

it's true, my condolences u_u

I took my renal exam today too, weirdly. (And reproductive, with all the male and female endocrine components thereof, is on Tuesday.) Normally if a lecture seems like a barrage of information without any coherence, I figure that staring at for long enough will eventually make it all sink in. And then I had to try to learn the various causes of Nephritic and/or Nephrotic Syndrome, and yeah, I dunno, that just never happened. It all just faded into a blur of "This disease is associated with this kind of IgG/IgA/IgM/C3 deposit and occurs in this kind of patient and presents with this set of symptoms" and it was just a wall of stuff to memorize. It was kinda disappointing. I think it is mostly that so much about most of the diseases is unknown, so all anybody can really tell you is that somehow the alternative complement pathway gets activated or whatever, and next thing you know you're peeing blood.

Still, one more week of exams, then one more quarter, then boards, then 3rd year! This will all be worth it when I can finally tell someone "Yeah, second year sucks, but third year makes up for it" like I have heard 1000000 times.

sweet jaysus it is the ~3/4 LOTTERY~ all week, ppl are just going bananas

Is that for clerkship scheduling?

yup

I got the front end of year 3 sorted which is most important for me

What are you doing first?

so, new this year is a policy that says we don't have to take the boards before doing rotations. I think you can do a max 18 weeks before it's mandatory.

what this means for me is: three week intersecession between year two and Period 1 (six week clerkship) will be total vacation, maybe a bit of board prep. then do Med 1 right off the bat, which will go thru June. take the next six week block off and study for the boards. this is double handy for me cuz a) med 1 "counts" as prep imo and b) I've got a wedding to go to in late July (I'm actually officiating lol) and I want more than the zero days off a clerkship would allow. so step 1 in second week of aug

period three is surg 1, followed by an uncertain two weeks, then ortho.

Whoa, that is way different than our schedule (Step 1 before July 1, four twelve-week blocks, all further subdivided into components). Although I guess that is a better scheduling arrangement for when the long-rumored USMLE changes come and you have to take it after 3rd year instead of 2nd.

ah we are responsible for our own scheduling. it's a bear, everyone is camped out with their laptops waiting for the next selection round

some clarification:

the main "unit" in 3/4 is the six-week Period. There are 8/year, with 4 add'l weeks of wiggle room, split between the winter holidays and the three-week "intercession" that follows the end of year 2 (basically the first three weeks of May).

not every clerkship is six weeks (EM is four, eg), so there is a parallel sequence of 4-week blocks that don't, obviously, line up precisely with the beginning and end of the six-week periods. Throw in the odd 3-weeker and yr 2-week surgical subspecialties, and it gets (O)_(O) very fast.

NOW superimpose a course-selection system that is lottery based: the class is randomly split into, oh, say, ten cohorts. these cohorts are given access to the online scheduling system during strictly defined time windows. yesterday we were given four "rounds," today we had four, thursday we have four, and friday we have three. after that, you can access to the website anytime to shuffle things around (as sites/blocks open up).

the scheduling bugbears so far have been:
1) step 1 (most ppl are taking it ASAP, at the end of period 1 (ie - before July 1), which means that the available period 2 rotations went like hotcakes
2) interviews: everyone's likely taking December of year 4 off, so that compresses the interest in the blocks immediately before/after
3) "free time"/electives: if you want to do any int'l stuff/research/etc then it behooves you to get required shit out of the way ASAP (ie by the end of Y3). if you're lucky/aggressive, you can be done with school COMPLETELY by February of Y4, and just str8 fukkin chill until July. My friend Corey did this and she made a pretty convincing case for it.
4) residency concerns: future GPs/internists/peds ppl can basically do w/e the fuck they want with their schedules, because it just don't matter. EM/ortho ppl ought to have gotten audition/away rotations under their belt before interviewing, which means displacing some of the required stuff they'd probably like to take in y3 and replacing it with electives. no finishing early, less flexibility for y4 goofing off.
5) step 2: CW seems to vary wildly. some are like "it's pass/fail basically, just take it at the end of the month you've set aside for interviews and don't sweat it." others say that it's best to get it over with ASAP before you forget everything from yr non-electives. still others say that scheduling should depend entirely on your step 1 score: bad step 1 = take step 2 ck BEFORE residency applications so you can buff yr resume a bit. good step 1 = take it AFTER interviews so you don't run the risk of a bad score suddenly making you look lazy and less attractive. i'm gonna take it in oct of y4, after residency application, and immediately after a 4 wk med/peds rotation w/2 weeks of off-time for studying. maybe this'll be overkill, who knows, who cares.
6) sanity: i'm taking psyche in the summertime (y4) because fuck it, man, it'll be easy and i want to enjoy the weather. i've got two weeks free after Surg1 that were unplanned, but maybe i won't bother filling them because surg1 is reputed to be exhausting. peds is (supposedly) to be avoided in the winter because a) all the kids have the same thing and b) you will, too.

sweet mother that is a long post

Pssssht I am not opposed to a long post. Details are where the MAGIC is.

I am like 99% sure we go like this:

1) Must take Step 1 before the start of 3rd year (July 1)

2) 3rd year breaks into quarters
--6 weeks of OB-GYN and 6 weeks of Pediatrics (I think there are multiple sites you visit in each 6 week block, I'm not sure)
--12 weeks of surgery, divided into 6 weeks of general surgery and 3 2-week blocks of surgical subspecialties (ortho, neurosurg, transplant, urology, etc. etc.) Surgery is apparently a notorious beast of a time-eater, and you figure out fairly quick if surgery is for you or is not for you.
--12 weeks of medicine, with the option to do 6 weeks at GU Hospital + 6 weeks at Walter Reed or 4 weeks at GU + 4 weeks at Washington Hospital Center + 4 weeks at Virginia Hospital Center.
--Smalls, 6 2-week blocks of everything else (Neurology, Psych, Family Med, etc. etc.), except for Emergency Medicine, which is for 4th year.
--Three week Christmas break, plus one week in between end of 4th quarter and start of 4th year = 52 weeks.

There are like one million strategies for dividing these up (don't do what you want to do first, because you'll be terrible vs. do what you want first because they won't know any better and they'll grade you easier). You can't take Surgery and then immediately do Medicine, or do Medicine and then immediately do Surgery, I think because prior experience with this turned people into zombies at the end of the 2nd one. Ob-Gyn is supposed to be really demanding also, but Peds isn't.

3) Same basic approach to Step 2 CK (If you suck at Step 1 or if the residency you want to do forces you to, do it early enough in 4th year to put it on your applications, otherwise shove it to the side, because it is not hard to pass). Although seriously the Step 2 Clinical Skills, if one of the five cities in America were not Los Angeles (aka cheap excuse to go home for a few days!) I would be pissed. Seriously five cities! What is that? smh

4) 4th year has only two requirements: a month of Medicine AI, and a month of Emergency Medicine, and you can do this at any time in the year. None of this gets scheduled until 3rd year. We get I think everything from Thanksgiving to New Year's off for interviews, and can also take time off from a rotation to do that if necessary. You also generally do the AI for the specialty you want to do up front, and then aways , and then you fill up the rest of fourth year with whatever electives you choose.

5) Somehow by virtue of the passage of time they give you a diploma and are an actual doctor. \o_O/

whoah @ "smalls"!!!!

neuro, psyche, and fam are all required six week rotations here!

wait correction. psyche is six weeks fam and neuro are four. but there's a four week primary care req in addn to med I/II (both six weeks).

surg and sug specialties comprise ten weeks altogether but don't have to be done in succession (some ppl are doing their subs as their FIRST rotation!).

how many dang sites do you have? pretty sure the reason they give s so much license is to evenly distribute the load on training sites. which is sorta weird since, for a relatively small city, MSP is up to it's eyeballs in hospitals and healthcare.

(heck of iPhone typos)

also did not realize that there were only five CS sites. glad Chi is one of em---cheap excuse to visit bros imo

We have five major affiliate hospitals (including the University Hospital), I think, plus there are a bunch of affiliate sites you can do certain rotations at. We have to share the metro area with GW and Howard, plus we split Reed with USUHS and I think some of the suburban Virginia ones with VCU. It is kind of a mess but w/e. Do you guys share anything with Mayo or are they all just tucked away in Rochester the whole time?

I went back to check and apptly I misspoke about smalls, it is 4 wks Psych, 4 wks Family Med, 2 wks Neurology and then 2 wks of something else from like anesthesia and derm and radiology and PM&R and all that. So it is less flexible than I thought, which is actually kinda good because I didn't want to do some of those. (I would rather do 4 weeks of Neuro, but I can always do more in 4th year.)

I've got a bro at the mil school. tell him I said hi. he is from MT and a weird and excellent dude.

4) residency concerns: future GPs/internists/peds ppl can basically do w/e the fuck they want with their schedules, because it just don't matter.

can you explain this to me? are these guys like the jocks or something? what is considered the most demanding specialisation? surgery? (not trolling, here, genuinely interested)