medical school

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nb all doctors everywhere do "diagnostic interventions" a lot, it isn't limited to those two (nor are they Bad For Your Health). but for some reason i feel like "...holy shit it worked" is very slightly more endemic to surg and psych than other specialties. whereas in neurology they tell you EXACTLY and in great detail what is wrong with you and then shrug and go write a paper about it (BOOM!)

nb nb i'm not really this flip about people's health, btw, but this thread and a handful of friends are where i feel comfortable with some levity

well if it isn't old 11 cameras simon (gbx), Friday, 28 September 2012 02:21 (eleven years ago) link

Your search - "evinces zero abdominal symptoms" - did not match any documents.

Everyone has symptoms, there's always going to be symptoms in cats syndrome, that's the diagnostic hallmark. Wouldn't be much of a syndrome if there were no symptoms or signs.

In neuro we can sometimes say exactly what's wrong, but a lot of the time I'm more like, "yep, that kind of thing can happen in a normal brain, it's just changing up tricks on you, nbd, hang in there champ".

Plasmon, Friday, 28 September 2012 02:31 (eleven years ago) link

I like the idea of cats syndrome

the physical impossibility of sb in the mind of someone fping (silby), Friday, 28 September 2012 15:23 (eleven years ago) link

Patients suffer terrible disfigurement, sometimes permanent.

http://the-void.co.uk/wp-content/uploads/2008/06/CatsTOP.jpg

purveyor of generations (in orbit), Friday, 28 September 2012 15:30 (eleven years ago) link

hey geebs and others: can i ask a semi obscure health/surgical question here and get directed toward answers? i've tried the vast array of med website symptom porn out there, trust.

goole, Friday, 28 September 2012 19:14 (eleven years ago) link

I figure it is reasonable to provide a forum for that and for me to be all bitchy about residency (I had to do a random night float yesterday u guyz, I was very sleepy and had to do a wad of admissions): The thread where we are physicians (and/or surgeons)

Also really maybe I just want to have this thread to hear stories of ERASing and interviews and such

Dr. (C-L), Friday, 28 September 2012 21:35 (eleven years ago) link

haven't posted itt in a while

month 3/9 of 4th year pharmacy rotations now over. i've been at this particular site for a couple months now (my university's namesake health center) and am really bummed that i have to change sites next week. the medical team i worked with was so, so great - i put in so many hours of extra work researching things for them, reading on my own so i could hold my own in rounds the next day, just generally trying to impress them. i admired my attending so damn much - not only her ridiculous knowledge base and confidence, but the way she talked to patients; the way she talked about caring for patients; how she was given to editorializing in the middle of rounds about the way we (big we) cared for patients, how we fail patients, who gets left behind. i worked exhaustively on a clinical research project that resulted in some major shit-stirring (in a good way!) in the hospital and some small but positive policy changes, which I was pretty proud of. the project also involved lots of just talking to patients every day by myself; all the health care peeps itt know what it's like to talk to a patient and feel like they trust you completely, that you're really reaching them. it doesn't happen with every patient but it's what makes working in health care worthwhile. overall the months went well & i secured a couple of what i think are strong recommendations for pharmacy residency...

and yet, i realized for sure over the last couple of months, after a year or two of wavering, and after having long talks with a lot of people, that i actually want to be a physician. lol. i met with one of the deans of admissions to the med school yesterday to chat about my path and things i'd have to do to strengthen my candidacy. i talked today with a couple of the attendings i'd worked with here to ask them to stay in touch w/r/t recommendations and shadowing (which i think seems kind of silly given that i'll have had 2-3 years experience of direct patient care and working directly with physicians by the time i apply, but the admissions dude made it pretty clear formal shadowing is a must). i'm pretty much knee deep in the pharmacy game at this point, so my 'plan' is to finish a residency and work part-time following that, taking the classes i need to take and studying for the MCAT, and applying for 2015. i'm kind of scaring myself because i am getting more and more serious about this, and no one in my life will tell me STOP THIS IS A TERRIBLE IDEA, which i had sort of been counting on, but there you go

la goonies (k3vin k.), Friday, 28 September 2012 22:24 (eleven years ago) link

ONE OF US! ONE OF US! ONE OF US!

Seriously that is a rad and gigantic decision and worth doing (at least in my experience as a guy who worked 13 hrs overnight yesterday and was mopey the whole time). The shadowing and various other hoops of fire are not like NECESSARY or else you will die, but I can say as a dude who interviewed a handful of prospective students last year, there are almost definitely more applicants who are basically fine candidates on paper than there are spots, so some of the silly nonsense is there to make sure you check off all the right boxes to let you proceed to the interview stage. And there basically is where being a guy who figured out he wanted to do medicine midway through doing something else is most beneficial, because you will know 100% why you want to put yourself through this, and the unyielding horde of dark-suited 21 year olds with 3.8 GPAs and 34 MCATs do not always totally have that down yet.

Dr. (C-L), Friday, 28 September 2012 22:35 (eleven years ago) link

whoa kev

well if it isn't old 11 cameras simon (gbx), Saturday, 29 September 2012 01:13 (eleven years ago) link

right?

as i said it's something i've been moving toward for a couple years now - 'wavering' was a poor choice of words (especially so i would think when it comes to drafting a personal statement*). i've been thinking about this for a while but now i could not be more sure that this is what i want. my pharmacy education has been very good to me; i've made a lot of great friends and made some good connections in the field; i've thought for the last couple of years though that i really was interested in something different, something not really offered** by the current pharmacy curriculum. i've got some friends in medical school, plus my stepfather is a surgeon - i've toyed with the idea of medical school for a while now.

my suspicions/ideas were validated during my experiences over my first few months on rotations. i've come to experience the difference between pharmacy and medical educations firsthand by working with these medical teams ove the last few months - in pharmacy school we tend to focus more on what the recommendations are rather than what the actual physiology or evidence behind those recommendations are - i found this out a couple months ago when i began my gen med rotation at the health center - i remember an instance, forget what specifically, but i remarked that the recommendations for a particular patient was [x]...the attending i mentioned earlier replied with "ok, what's the evidence for that?"....this was new to me...in pharmacy school we were taught more to memorize the guidelines rather than to really probe the primary literature - you'd really be surprised by how few primary lit articles we were required to read! anyway the whole culture of pharmacy vs medicine was different like that...so i spent most of that month somewhat neglecting my pharmacy responsibilities (though i still got an A) and instead did a lot of
independent reading for my medical team to try to keep the pace with them...that is what interested me more

anyway my very pretentious observation, which i've noticed all throughout pharmacy school, is that pharmacy students tend to be sort of incurious in this regard; i guess very few of my peers were interested in the same things i was, whether it was literature or ways of studying for things; as i mentioned before, in pharmacy school tests were very much geared toward the slides delivered for a particular lecture or etc rather than really evaluating primary medical literature. we're taught to know 'facts' rather than to think through a particular case. i grew bored of this kind of studying i guess

working with medical students, medical interns, and residents over the past few months, i've gotten to appreciate exactly the kind of work a rising physician has to put in to stay afloat in this world. when i was 18, this wasn't a life i'd have wanted for myself; even a few years ago when i entered pharmacy school, the rigors of medical school and keeping up with the literature is not something i'd have thought myself ready for or willing to take on. over the last few years, tho, my values regarding methods of education have changed; i've found myself more interested in the MD world of education, the constant reading that entails, etc. maybe most importantly, clinically, i've worked with physicians and pharmacists and envy the relationship physicians can have with patients; in pharm school we're 'taught' that pharmacists are the most accessible HCPs, which i suppose is true enough; yet i'm convinced esp recently that physicians have the most meaningful relationships with patients - they trust yall the most - plus it is physicians who have the final say anyway.

i've been drinkin a little so i'll fix any problems tomorrow...but yeah, med school, i likes it

la goonies (k3vin k.), Saturday, 29 September 2012 04:51 (eleven years ago) link

i'm hella rambing i think, sorry

la goonies (k3vin k.), Saturday, 29 September 2012 04:54 (eleven years ago) link

you've got some asterisks to follow up on too ;)

the physical impossibility of sb in the mind of someone fping (silby), Saturday, 29 September 2012 04:59 (eleven years ago) link

FOUR MORE YEARS, FOUR MORE YEARS

well if it isn't old 11 cameras simon (gbx), Saturday, 29 September 2012 05:45 (eleven years ago) link

you could polish that up into an application personal statement!

congrats k3v!

barthes simpson, Saturday, 29 September 2012 14:10 (eleven years ago) link

ha, i didn't really explain the pharmacy vs medicine thing very well. i'll have to be a little less *makes drinky-drinky motion* when it comes time to actually compose a personal statement. most of that was written on my phone on a car ride home from a bar, so excuse the typos and general drunkenness ;)

i think what c-l mentioned earlier is important. i think it's beneficial for me, not just as an applicant but for my general health, that i came to this decision somewhat organically. as i mentioned i'd been thinking about it for a couple years and more recently doing a little research into it, but actually working with physicians, resident physicians, medical students, etc (as well as nurses, patient care assistants, dietitians, physical therapists! all of whom do amazing work!) and getting to know the way they think, the way they approach patient care, the way they learn, has made me sure that medicine is what i want to do. to reiterate - and this is important for me i think in terms of a personal statement, interviews, etc - it's not just that i've decided that i don't want to do pharmacy (because my pharmacy education has been and continues to be very good to me), but specifically that i've gotten an extended taste of this doctor stuff and have decided that *this* is what i want to be doing. put another way, my change of career trajectory isn't motivated so much by a negative thought ("i don't want to do this") but by a postive thought ("i want to do *this*"). so *being a physician* is what i want to do; i'm sure of it; this is something the admissions guy i met with impressed upon me too - playing devil's advocate, he was saying "ok, so you've had this change in career trajectory. what makes you sure, or makes us at the school sure, that you won't want to be a dentist in a few years?". so that's something i'll have to figure out how to articulate when the time comes - which is still a ways away, haha. if i were running a campaign for presidency i've just formed an exploratory committee - talking to people in the know (what exactly do i have to do to do this?) and networking (with my physician acquaintances i've made, people i've impressed: "look, if i do do this, you have my back, right?") - and haven't announced my candidacy just yet. lots of work to be done. and again, it'll be a couple years before i actually begin applying. i'll be an old man at that point

xp haha!

la goonies (k3vin k.), Saturday, 29 September 2012 14:17 (eleven years ago) link

Yeah I came to this from an entirely other kind of graduate study and I remember my first interview was with a guy who was CONVINCED I was going to somehow abandon medical school and go back to my graduate studies. I pretty much burned down my PhD bridges and turned down a not-small sum of money to stay in graduate school for the not-guaranteed chance to enter medicine. I think there are some people who will just assume that anyone who comes to this later in life than like, age 16 is not fully into it.

But then I interviewed with other places (specifically the place that let me in) where it couldn't have been more of an asset. Med school interviews are weird, that's why it helps to have a lot of them.

Dr. (C-L), Saturday, 29 September 2012 15:39 (eleven years ago) link

http://sphotos-b.xx.fbcdn.net/hphotos-snc7/581551_882263115486_1092645578_n.jpg

another exciting friday night

well if it isn't old 11 cameras simon (gbx), Saturday, 13 October 2012 01:44 (eleven years ago) link

two weeks pass...
one month passes...

gbx, C-L: you dudes were a little older when you entered medical school, right? did you have all of your prerequisite classes taken by the time you'd graduated or did you have to "go back" and take a few classes? i had a (terrible) meeting with my school's pre-med advisor i'd set up so i could ask him questions such as you know, where i should take these classes i need etc; when he wasn't depressing me with his indifference he did impress upon me the idea that it is definitely preferable to take these classes at the main campus as a full-time student rather than taking part-time or "night classes" or at the satellite campuses etc. which i mean, in a way, duh, but given my situation (i plan on working part-time after i graduate this spring) this may not be feasible or even possible. what were your experiences, if any, wrt this?

k3vin k., Tuesday, 11 December 2012 03:47 (eleven years ago) link

I was 26 when I started, yes. I had been a pre-med as an undergrad, but a pretty indifferent one with a couple soft spots (enough to apply to all the schools who were literally just "1 year orgo, 1 year G chem, 1 year physics, 1 year bio", not enough for "it'd be super if there was some statistics, and maybe some biochem"), so I ended up taking a few classes elsewhere (a summer school Statistics course at UC Davis when I was in San Francisco, a set of biochemistry courses through UCLA Extension at night, and a bio course at UC Irvine during Summer school as well) while finishing grad school/working. I do remember being told specifically NOT to pursue things like community college-level coursework, even for the basic prerequisite-level Bio/Chem/Physics courses, because it is regarded unfavorably compared to taking the same courses at a 4-year school level. I assume the same would apply to online coursework. I GUESS it is preferable to do full time study (that way you are properly taking your courses against the unyielding herd of premed robots) but if you are taking university-level coursework (which includes stuff like University Extension courses as far as I know) then you're demonstrating you are capable of handling the material. The location matters, since an A at a place where an A is understood to be an achievement is better than a place where everybody gets an A, and both are preferable to a place nobody has ever heard of where an A possibly means nothing.

The problem with being a non-traditional applicant, really, is that many of us have really unique situations that do not project out as well. I am pretty sure if I existed solely as undergrad me, coming out of my large well-known undergrad school with my GPA and my MCAT score, I could have determined a rough probability of my acceptance. Instead, I had my undergrad GPA and my MCAT plus also I was going to be a historian of medicine for a minute, and then I wasn't because I wanted to be a doctor, and I was pretty sure that I was one of no more than a handful of applicants (and possibly the only applicant) ever who presented a similar story. I felt I was qualified enough for acceptance, but I had zero idea whether that was actually going to happen until interviews started coming in, and I could peg myself to the probability of x interviews = y chance of acceptance to one of them.

I feel like this is possibly where your pre-med advisor is coming from; they definitely know what it takes to come from your school and get into med school because that's what they've experienced. Like, I dunno, let's say 4% of undergrads there with a 3.3 GPA and a 28 MCAT get in somewhere, and 50% of kids with a 3.5 and a 30, and 99% of kids with a 3.9 and a 40 (it's never 100%; I like to think this is because a small percentage of super-over-achievers are either terrible sociopaths incapable of human interaction, or just spazzy Asperger types). Those aren't the exact numbers, but the exact numbers exist somewhere, and you could be easily matched to them if you didn't have this weird "Pharmacy school" data point in the way.

Dr. (C-L), Tuesday, 11 December 2012 05:08 (eleven years ago) link

yeah that's the thing, i really have no idea whether that's a positive or a negative thing. i think it's a positive, and i'm certainly going to use it as a positive when it comes personal statement time and (hopefully) interview time. my main issue right now, other than finding a job for the time being, is figuring out where and when i am going to take these classes (and there are quite a few i need to take). i just sent a long email to one of the deans of admissions at uconn, whom i met with a few months ago (via a mutual friend) and was really kind and helpful. gah

k3vin k., Tuesday, 11 December 2012 05:56 (eleven years ago) link

i was in a similar situation when i was applying - i hadn't really considered med school until my undergrad was mostly over and so i had to take three courses post-graduation to meet the prerequisites to apply. i just took them at my undergrad alma mater - the admissions office was p understanding and i didn't really have to do to much other than book an appointment and pay for the classes. i never had the impression that it made much of a difference in my interviews although i think it did make a difference in how well i actually did in the courses themselves, since i was working a reasonably demanding f/t job while taking them. and ime my interviewers seemed more interested in the work that i was doing btw graduating and applying than my marks in the courses i had taken, which i feel just kinda got rolled together the rest of my undergraduate performance. so i guess my advice would be to put some serious thought into what sort of work you'll be doing outside of your coursework as that 's probably what's going to set you apart in the application process

f (Lamp), Tuesday, 11 December 2012 06:20 (eleven years ago) link

i had basically zero pre-med courses under my belt at graduation: upper-level math, english, and i'm not even sure those are required anymore.

i didn't want to take two years for a post-bacc, so i applied to a "dedicated" program at montana state for no reason other than it was in montana. i was actually their first-ever applicant (the website went live before the program had been approved by the board of regents), and i was basically accepted over the phone.

it was the first year of the program AND the person running it was transitioning to a new job out east, so it definitely wasn't as smoothly run as some of your fancier post-bacc programs. and really, it ended up being almost equivalent to enrolling in undergrad courses and going part-time: all our classes were with the undergrads, and according to their scheduling needs. this meant only 2-3 courses at a time (max), and spread out over 15 months. i actually had to take a few more classes than others, because my current med school (and where i had expected to have the best chance of matriculating, being my home state) was one of the last remaining to require stuff like biochem and english and stats and psych and so on. i think a lot more schools have pared it down to phys/chem/orgo and basically nothing else?

if it had been possible to even ~get~ a job, i probably could've managed it, but work is hard to come by out there. only one of my cohort was working, but she had already lived in town for a few years, and was and is a superhuman (40+hr/wk as an EMT, pulled a 4.0 and a 39 on the MCAT...went on to attend my alma mater's med school and is now a gen surg resident. this woman was a DRAMA major, ppl)

that said, i think C-L/Lamp are right about the focus largely being on what you're doing with your time that ISN'T post-bacc classes. post-bacc students, even at the boot-campier programs, have the luxury of being pre-meds w/o the distractions of humanities requirements and being idiot 20 year olds. i think schools likely hold their performance to a slightly higher standard if they're going full-time and not working. otoh, if you're actually doing shit while ALSO taking classes, that demonstrates ~gumption~ and the ability to manage yr time and so on, so maybe they'll give you a break.

i'm not really the best person to ask, in a way---i only landed two med school interviews! otoh my "missing years" were a lot weirder and tougher to explain coherently than yours, k3v, pharm school ought to be a feather in yr cap. i was applying as an english major (and one with a marginally above average undergrad GPA from a fancy school), who had made a documentary (never picked up) on and off for a couple years while working shit jobs (blatantly ski bumming), then worked as an ad writer, then did a post-bacc, then worked shit jobs again and "played in a rock band" while submitting applications in my "gap year." i had very solid post-bacc grades from a western land-grant university that i clearly went to in order to be near the mountains, an above average MCAT (hoisted to the right of the curve almost entirely due to the reading/language section), a string of volunteer experiences that weren't long-term since i moved so much, and lots and lots of good stories that no one would ask me or care about.

one attending who had worked on an admissions board told me that i must've been "catnip" to med schools (i wasn't), while others have looked at me with varying degrees of confusion and/or suspicion when they hear about my pre-medicine life (lives), like "who let you in?"

tl;dr i'm sure you'll be fine.

well if it isn't old 11 cameras simon (gbx), Tuesday, 11 December 2012 17:10 (eleven years ago) link

Basically everybody will tell you that it is vastly preferable to have some kind of other life experience you bring to the table, but what that means is "assuming all other things are equal". You absolutely do have a leg up on 21-year-old college seniors who are applying to medical school because that's what they're supposed to do, but that advantage gets reduced by the all the things they have that you do not (potentially grades/MCAT scores, and having knocked out everything on the Big Checklist of things you're supposed to have on your medical school application (research, volunteering, shadowing, medical trips abroad, leadership, etc.) because they pursued undergrad with that specific goal in mind.

I spent a year between leaving grad school and applying to med school hitting other checklist points (volunteering, EMT work, biochemistry courses that produced some additional science coursework A grades and got me a letter of rec from a science professor), while also working (at a vaguely healthcareish job which probably was more clinically valuable than anything on the checklist). Basically my thinking was I needed to get interviews, and so I figured the better I could make myself look on paper, the better chance I'd have of being able to make or break myself in person. (I specifically remember thinking I needed at least four, because that's when the probabilities are pretty safe, and my now-alma-mater was my fourth interview, and the only one where the guy legit told me "So you're going to get in." He was also the only interviewer who was really excited about my wacky history adventures; the others ranged from "that's cool" to "why should we believe you won't just go back to being a historian? YOU HAVE TO COMMIT TO MEDICINE")

Dr. (C-L), Tuesday, 11 December 2012 18:45 (eleven years ago) link

lamp, C-L, gbx, thanks so much for the thoughtful replies, it means a lot to me really

re: post-bacc, this is what the gist of my email was about. the post-bacc program at uconn offers two tracks, one for non-science majors (this is probably what gbx would have taken) and another one for students who majored in "science" but lack the prerequisite credits; this one is more of a pick-and-choose when it comes to the classes one takes and is more tailored to the individual's schedule. i think it would be best for me to do this, though when i met with the guy (who also happens to direct the program, i've recently learned) back in september he recommended against it mainly because he thought it'd be redundant with my history. back then i didn't really realize how many classes i still need: i need two semesters of physics, an orgo lab, maybe even some chemistry depending on whether my AP credits are good, a genetics class and probably some sort of statistics class. so i'm going to see what he recommends (of course i stilll would have to apply and get into the program!). my options are what i've just mentioned, which i think based both on the structure of the program and uconn's good name would be...ideal? but of course there is also the option of taking classes outside of the official program, which i think is doable. also there is the option of online classes, which i guess has its positives and negatives: given the fact that i'm like, not an undergrad anymore, it'd probably be the most convenient, and likely it'd be relatively cheap. but there's always the risk that, even if they're offered by reputable universities and are "accredited", that they (1) may not be accepted everywhere and (2) even if they are, they might be viewed unfavorably compared with actual live classes.

one...advantage i might have in this process, i guess, is time - i think the earliest i'll apply would be for fall of 2015. this should give me some time to shore up some of my weaknesses that C-L mentioned. for one thing, i've got pretty much no "research experience" (ugh). i do have ~some~ 'clinical' research experience from a few months ago that i like to talk about but i'm not sure if that "counts" really, idk. i don't even know where to start or whether it's worth it. i do have some friends i could talk to i guess, and there's always the option of professors from pharmacy school.

there's another thing i've been thinking about recently. one of my professors, whom i admire a lot, and happen to have a rotation with in april, is involved with a (relatively well-known?) refugee clinic in mae sot, thailand (i think he helped establish the pharmacy there or something). a very good friend of mine worked (well, for free) there for 3 or 4 months after he graduated a couple years ago. this is something that i've kind of been dreaming about doing** ever since our first public health class with the guy, and i'm thinking this summer might be a great chance to get to do it, not only because it's something i really want to do but because it would potentially "look good" (ugh) for medical school. depending on when my classes start (and my financial situation, lololol), this could be a good option for "something to do" between graduation and post-bacc classes. i need to have a serious conversation with my friend and then potentially bring it up with my prof.

i haven't been able to fall asleep at night at all for the past week or so, just thinking about all of this. it's terror mostly, but it's part excitement too. i don't know if all this is going to go smoothly or if it'll be a complete mess, but it's what i want to try and i'm gonna fuckin go for it.

**like 4 years ago my dream was to be a pharmacist for MSF for a while after i graduated, lol. then i learned you need like 3 years of professional experience to even apply

k3vin k., Wednesday, 12 December 2012 01:55 (eleven years ago) link

one month passes...

Greetings ilx physicals and physicians-to-be.

I am not, nor shall I ever be, a medical student and/or physician, but I am headed back to school for social work and am interested in eventually practicing in a health care setting (hospital, hospice, long-term care facility, etc.).

I'd love to hear your experiences working with social workers. What is the hospital dynamic between medical and social services departments? Other thoughts/experiences?

quincie, Saturday, 19 January 2013 22:42 (eleven years ago) link

um I meant to write *physicians*, not *physicals* duh.

quincie, Saturday, 19 January 2013 22:43 (eleven years ago) link

I've worked closely with the social workers on the inpatient Neurology service ever since I was a resident. One veteran SW in particular is my favorite: seen it all, great sense of humor, relaxed and friendly, willing to go the extra mile to help people out.

A surprisingly huge amount of inpatient care depends on social work, including sometimes the need for admission in the first place (caregiver fatigue / "acopia"). Since my main goal as a doctor is to figure out what's *really* going on, my final diagnosis and plan often revolves around social work issues, and I often arrange family meetings to sort out the necessary details. As a resident I used to joke that I was going to do a fellowship in Neuro Social Work. The inclination is longstanding: my Dad's a social worker and so are many of our family friends, and I did some similar work part time as an undergrad, volunteering for a teen help hotline etc.

AFAIK the alliance I like to think I have with the SW team isn't necessarily the rule. I get the sense that some doctors are way less interested in the details and just want the social aspects of the case sorted out so they can discharge the patient and free up a bed. Which is a shame.

Plasmon, Sunday, 20 January 2013 04:29 (eleven years ago) link

Yeah so my job right now (I do a lot of inpatient medicine at the Baltimore VA and the OTHER University affiliated tertiary care center in town) is very frequently as much about social issues as about medical issues. We have 2 people on a list of 13 who are medically fine but with us indefinitely pending impossible social situation resolutions, and probably 3-4 others who are as much about social/placement issues as about whatever we're doing medically. I do not strictly want to just get people OTMFL (off the list) but after you get stuck doing nothing for a person who has no medical issues but can't get placed or settled, it gets really frustrating really quickly. In theory my job exists for some sort of educational benefit, and in practice the learning is frequently shunted because patients who are medically unstable (or regrettably unfixable) cannot go to where they are better served.

I am not a fan of interdisciplinary rounds (social work, case manager, usually utilization review, sometimes PT/OT, sometimes nutrition, sometimes pastoral care) at all, though. Frequently you go in saying "Here is what this dude needs to be able to leave" and the response is "Yeah his insurance doesn't cover anything" or "he's not qualified for admission criteria" or some other version of "Hahaha fuck your medical work, this guy stays until people who have nothing to do with his medical care decide to do what they feel like". It's not the fault of the social worker or the case manager or whomever is saying this, but some of them (especially Utilization Review people--MY GOD) basically accuse you of being shitty at medicine for not following rules made arbitrarily by possibly insane people.

Dr. (C-L), Sunday, 20 January 2013 05:33 (eleven years ago) link

This is good info, thanks! I only started thing *seriously* about changing careers to social work when circumstances took me to the ER with an elderly neighbor. Her closest relatives (distant cousins, actually) were out of state, and she wasn't in a condition to manage her care. . . when the ER social worker came in to see her it was like a light bulb went off--"oh hey there are social workers at hospitals!" Thank god!

I'm one of those people who gets really calm and centered when surrounded by stress/chaos/uncertainty/ppl freaking out, and I'm pretty good at herding cats to get shit done. These things seem to be U&K for social workers in hospitals. But I am slightly concerned about the politics in the hospital setting, i.e. are social workers really taken seriously/appreciated by members of the medical care team?

quincie, Sunday, 20 January 2013 10:40 (eleven years ago) link

I've got a business-side question for the doctors here. I had a corneal scrape on the Tuesday after Thanksgiving. When I went back a week later for the followup, was told my surgeon had some kind of emergency so I had to see the (non-cornea-procedure) ophthalmologist. He took out the bandage contact and scheduled me for another followup a month later (two weeks ago) - during this he said my original surgeon would not be returning, couldn't tell me what the emergency was. Also made it very clear that he was not a fan of the procedure and wouldn't do the second eye regardless of how dramatically successful etc. Finally he caved and said he'd write me a referral to yet another ophthalmologist who might do the second scrape.

Fortunately, when I went to schedule with this other doctor, the scheduler casually mentioned she'd talked to my original surgeon - he's now practicing in another town, not far. I was overjoyed, asked if she could give me his contact details - which she did, but still put in the referral request to the third doctor. I'm now scheduled with my original surgeon in his new practice, but wondered - how much of a thing is this now? Is it due to non-compete contracts? Are there rules about doctors contacting their existing patients when they change practices? This whole "emergency" thing makes me never want to see doctor #2 ever again.

Jaq, Sunday, 20 January 2013 16:32 (eleven years ago) link

This is eerily similar to hair salons refusing to tell you where your favorite stylist decamped to, no?

quincie, Sunday, 20 January 2013 16:43 (eleven years ago) link

i have no clue about that, tbh

well if it isn't old 11 cameras simon (gbx), Sunday, 20 January 2013 16:53 (eleven years ago) link

I've never had that happen before, either! People have generally told me where they were off to, so I could follow if I wanted. The last time was my primary care doctor, 7 years ago though.

Jaq, Sunday, 20 January 2013 16:56 (eleven years ago) link

To Quincie: if anything, since the hospital staff deal with a handful of social workers who are terrible, the ones who are actually super-helpful are almost universally beloved. People who get into medicine because they think medicine is interesting get very frustrated with people who are not medically interesting but nonetheless eat up hours and hours of work related to their non-medical needs. Really good support staff make our lives easier, and we really like that. Like, the only difference between teams at the VAs are the variously assigned case managers and social workers, and everybody would rather be on the one with the really good social worker and the INCREDIBLE case manager than the ones with the terrible, terrible social worker (the other case managers all pale in comparison to the great one, so that part is essentially a wash).

Dr. (C-L), Monday, 21 January 2013 00:13 (eleven years ago) link

Is it due to non-compete contracts

Yep.

kate78, Monday, 21 January 2013 06:55 (eleven years ago) link

Good to know. Dr #2 made out like it was some part of HIPPA.

Jaq, Monday, 21 January 2013 14:31 (eleven years ago) link

one month passes...

god i hope this works

well if it isn't old 11 cameras simon (gbx), Thursday, 21 February 2013 02:18 (eleven years ago) link

http://billyplus.com/wp-content/uploads/2012/03/fingers-crossed.jpg

Plasmon, Thursday, 21 February 2013 02:32 (eleven years ago) link

good luck!!

k3vin k., Thursday, 21 February 2013 02:39 (eleven years ago) link

i finalized my list post-call, on 3.5hrs of sleep in 34hrs of wakefulness, and through actively revolting contact lenses. i think we're good, lined up, imma try not to think about gary anderson in '98

well if it isn't old 11 cameras simon (gbx), Thursday, 21 February 2013 02:42 (eleven years ago) link

More like Vinatieri in the snow.

Plasmon, Thursday, 21 February 2013 02:55 (eleven years ago) link

i do have a soft spot for new england

well if it isn't old 11 cameras simon (gbx), Thursday, 21 February 2013 03:11 (eleven years ago) link

what's happening, gbx?

Women, Fire, and Dangerous Zings (silby), Thursday, 21 February 2013 03:14 (eleven years ago) link

http://harrypotter.wikia.com/wiki/Sorting_Hat

nb i have not read these books but this seems about right

well if it isn't old 11 cameras simon (gbx), Thursday, 21 February 2013 03:18 (eleven years ago) link

I wonder if the sorting hat is actually an NP-complete problem

Women, Fire, and Dangerous Zings (silby), Thursday, 21 February 2013 03:27 (eleven years ago) link

Awwww yeah. I have been harassing the 4th year students with us in the MICU this month about their rank lists and such and such, and totally forgot to harass you. It is the most magical time~

The 3rd Friday in March is awesome, assuming the 3rd Monday in March is not the worst day.

Dr. (C-L), Thursday, 21 February 2013 03:28 (eleven years ago) link

(nb for others: gbx is now reaching the end of his direct involvement in the matching process. He has spent the past several months going around to programs and interviewing them and being interviewed by them. Either tonight or tomorrow or the next day (I forget) he and the other 4th year students are required to submit their final ranked list of programs to the National Resident Matching Program, which is for all intents and purposes a big computer in the sky, or a sorting hat as above.)

(So between now and the 3rd Monday in March, what the big sorting hat computer does is take every 4th year student's ranks and put them against the ranks of every residency program. The algorithm roughly favors the applicant, so that you will be assigned to your top choice program unless your top choice has also been selected by other people who that program likes more than you.)

(What happens on the 3rd Monday in March is that you get an email saying "You have matched!" or the worst e-mail, which means you have been thrust into the pool of the unsorted, and you spend the remainder of your week attempting to pair yourself with a program whose spots remain unfulfilled. You do not get to find out exactly WHERE you have matched until Noon EST on the 3rd Friday in March, which is also typically the 2nd day of the NCAA tournament, and sometimes also St. Patrick's Day. What I'm suggesting is that you and your friends drink like champions, unless things go poorly.)

Dr. (C-L), Thursday, 21 February 2013 03:36 (eleven years ago) link

are you still matching psych programs gbx?

Women, Fire, and Dangerous Zings (silby), Thursday, 21 February 2013 03:44 (eleven years ago) link


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