medical school

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)

nah, it's just that your more competitive residencies tend to demand that their applicants meet criteria that are either deemphasized or irrelevant to primary care. like, emergency medicine program directors want (according to an article I read in Academic Medicine, given to me by someone on the faculty) prospective residents to do an "audition" rotation---that is, if I want to have a shot at getting into the EM program at Cook County, it would be in my interests to schedule an away rotation there sometime before interviewing in my fourth year. thus, i gotta do EM at home early (and well), and apply for the away rotation, which often requires a few months of lead time.

primary care programs, on the other hand, have their requirements met by the standard curriculum that MS3/4 students are expected to complete for graduation.

what are the more competitive residences?

generally, the "lifestyle"/ROAD to happiness specialties are among the most competitive:

Radiology, Opthamology, Anesthesiology, Dermatology. And, increasingly, Emergency Medicine (never on call, 15/days a week, 3 days on/off, excellent pay, etc).

Also, things like plastics and ortho are competitive, though not exactly for the same reasons (everyone's still making a shitload of money, but surgery simply cannot compare to the work from home aspect of rads or derm's 30hr work week).

After that, it varies (IMO). The main point i was making though was simply that yr PCC specialties don't have to focus as much on scheduling because they don't need to have covered certain material/gotten letters from relevant clerkships before applying. whereas: just talking to a girl who wants derm BAD and is freaking that she won't get one of the very few derm slots in Y3, which is necessary for her to do advanced work/get the right letters before applying early in Y4.

also, attn C-L et al: http://journals.lww.com/academicmedicine/Fulltext/2009/03000/Selection_Criteria_for_Residency__Results_of_a.24.aspx

Awwww now I kinda feel like I have to do 10 points better on Step 1 than I thought. Oh well.

Scratching my head over "wants to derm BAD."

I mean not to harsh on derms but I dunno dying to have that as your med career seems kinda lame to me.

Like you might as well be an MBA or something.

https://www.youtube.com/watch?v=mGFoAX2Rf6g

The ascent of dermatology into the realm of Most Competitive Residencies is basically a social science PhD dissertation waiting to happen. (I could not do it myself--when I considered doing a PhD, it was about admissions processes and the MCAT, and maybe the USMLE--but yeah someone should do this in history/anthropology/sociology of medicine.) Essentially, the residency is short, the hours are not nearly as brutal as anything surgical, or even the other medical specialties, so people can have a life outside medicine, and there is a ton of stuff you can do private pay (Botox etc.) that is a gigantic profit center, so the money destroys everything but like plastic surgery (whose residency is much more difficult). Telemedicine is also an option, which permits more freedom of where to live. Derm seems to be the most efficient pathway to success and fortune in medicine.

There are also people who are super-excited about dermatology in general. I don't know why.

Question: if you have big-time melanoma what sort of doc treats you? Oncologist?

Who Treats Melanoma?

Often, a team of doctors and other health care professionals with special skills will work together to treat melanoma. This team may include:

Dermatologist: has special training to diagnose and treat skin problems
Surgeon: performs operations to repair or remove parts of the body
Medical oncologist: specializes in diagnosing and treating cancer; he or she may be your main doctor and the one who heads up your health care team
Radiation oncologist: specially trained to use radiation to treat cancer
Plastic surgeon: specializes in reducing scarring or other visible results of treatment

yeah this chick is basically straight up: derm means that i will make BANK and can be a mom and live in the burbs. she's sweet but also the most stereotypically suburban minnesotan person i have ever met (blonde blue-eyed thick accent, is "weirded out" easily, works out all the time, would be vapid if she wasn't so smart, etc)

i don't get it. i mean, she basically admits that she has no interest in dermatology as, like, a SCIENCE, just as a life.

Ha, I like how the role of the dermatologist in that is to be like, "Yep. That sure is melanoma. Well, my job here is done." It makes sense that the oncologist would be the lead, since the primary concerns are gonna be lymph node involvement and metastasis like most other cancers.

i will say tho that the derm lecturers we had were CRAZY about dermatology and the skin as an organ. very capable cheerleaders, imo. but they're academics and probably got into derm when it was just a sub of internal medicine, and not the horrible profession it is now.

before i decided that immuno was the place for me my other big idea was derm. volunteered at a clinic for about four months and just - basically so much stuff about derm is rad and visible in an interesting way. gbx's lecturers otm.

yeah, see, that's the thing: it IS cool (so is the eye!! so is imaging!!), which is why it's doubly infuriating when someone is by all accounts (imo) utterly disinterested, intellectually, in the specialty they're gunning so hard to get (this gal cleans. up.).

saw a weirdo erosion when i was shadowing at a clinic for NAmerican alcoholics---you could actually look at it and go "yup that is through X layers and visibly advancing." medical/physiological processes made, as you said, totally visible.

haha i remember @ the same time i was volunteering there was a long travails of the ruling class piece in the nyt abt how like harvard med students couldnt get (desirable) derm residencies bcuz they were so competitive now. after that i stopped thinking derm was a reasonable path but i still think its cool.

even really basic derm treatments like removing moles is tactile and ~interesting~ i think? esp in the sense that there is clarity and precision to it. i least i think so?

Well my dermatologist spends her days writing Retin-A scripts and hawking IPL. Seems uber-boring and not even very medical. She may as well be selling Avon or something.

I think with every specialty, there will be some people who are like "That is the least interesting thing I could ever imagine doing" and some people who have that moment where they see themselves doing that thing for the rest of their lives. I know lots of people who think orthopedics isn't very interesting, and TONS of people who have ruled out neurology already, but ortho and neuro are 1 and 2 for me. And like, at this point I have zero interest in private practice, and a strong desire to keep a foot in academic medicine, but there are way way more people who would prefer to have an office somewhere and never put up with med school bureaucracy again.

yeah, academic med is only interesting to me (at this point) as means to be an educator, really. i really like teaching/instructing, so staying involved with an Institution is sort of appealing. otoh, i could just, you know, teach kids how to do bike maintenance once a week and maybe feel just as fulfilled, who knows

in other news: i've been bouncing between ortho, EM, and peds as possibilities (lol that basically covers everything) and today a brief conversation with a classmate about EM and a visit to a good friend's Meet Our Residents page (he's pgy2) suddenly crystallized my decision to at the very least structure my initial schedule around EM. also funny: when i mentioned that one of the tertiary benefits of EM is the short residency for an old guy like me, the dude was like "you're 29? you're even older than all the people i regularly make fun of for being old!"

also had our last day of internal medicine mini-clerkships (once a week, interview/phys with a single patient, 5-10 min presentation at the end of the day), and my preceptor said some very flattering things, which has me feeling pretty chuffed iirc. thank god he can't see my grades :o

i'm just getting into the good stuff in my neuro course and it's definitely the most interesting science class i've taken in pharm school, not including public health which i loved

oh god so now i'm skimming the FIRST AID GUIDE TO THE WARDS and they're saying that you should chedule yr EM rotation near the end of yr third year because you'll have covered most of the material in your other stuff, and will thus be better informed. which is of course otm. i, however, enthusiastically scheduled it as my fourth rotation (after Med I, Surg I, and an ortho elective), even though the draft/lottery meant there were plenty of slots available in the spring.

now i'm worried i'm gonna fuck up/not be impressive and i really want to get a good LOR (esp since i'm going through HCMC, which is the OG EM program in the country, and highly respected) :(

why i'm worrying about this now and not, say, studying for my impending GI exam is beyond me, but w/e

it's amazing, the first two years i've been *yawn* w/e when my classmates starting sounding careerist, and now i'm getting totally mercenary about planning my future.

I was just at a Surgery Interest talk thing last night and they were like "honestly it doesn't matter when you do what you're planning to do; any reasonable instructor is going to know that people doing a rotation early are still going to be mostly clueless, and adjust accordingly." And man did I ever need to hear that. (All of the panelists were coincidentally people who did surgery 1st to get it out of the way and then loved it way more than they had expected.)

Most of the awesome docs and fourth years I've ever talked to were just like "Show up, be enthusiastic, work hard, and admit when you don't know what you're doing", whereas most of the people who are like "behold my secret formula" were kinda douchebags. Hopefully that means something.

that IS reassuring tbh.

Also I would assume your disinterest in studying for GI is because it is SO BORING. At least the pathology, anyway. I think we are going to get some lectures on parasites in the next couple days and hopefully that will make up for all the pathology.

I kinda like GI???

Basically the digestive and reproductive systems are only interesting to me as sources of metabolic and hormonal imbalances, so from like the diaphragm to the pelvis I just kind of endure it. (Although I guess the adrenals and a lot of the spine are also in that space, and I do enjoy the adrenals and the spine.)

ok i am in small group and all we're talking about is farts, it's hilarious

LOL, in his efforts to make sure N. and I never went to med school, N's dad was extremely fond of playing an old reel-to-reel tape from 1949's International Crepitation Competition.

Maybe the U of M has a copy?

aaaaaand apparently someone did a study here (that got published in NEJM) to investigate why we have floaters.

as in poop floaters?

yup

CW was that they were fatty/oily, apparently they are full of air!

BOAK well then, that lamb curry can wait...

99 POOP BALLOONS

to add to the list of med school band names:

TOXIC MEGACOLON

I would listen to a band called Volvulus, unless they were prog-rock.

Additionally, a bunch of my friends play various medical school functions under the name "Palpable Thrill".

oh volvulus is a good one

https://www.youtube.com/watch?v=6ZF9DLwKlb0

wowwwww someone's getting a call from the ~professional standards committee~

There is a really decent chance that two years from now, the schedule will work out today so that the 2012 class Match Day falls on the first day of the NCAA tournament. That will be like the best day.

btw did u kno it is

SPRINK BREANG TWENTY THOUSAND TEN YEARS OLD!???!?!?!!?????!!!!!!