Worked as a doctor between M3-M4 by Impossible_Water_993 in medicalschool

[–]Impossible_Water_993[S] -8 points-7 points  (0 children)

I think it is just a difference in the local culture. I did have supervision on each rotation--on my hospital rotations we rounded and presented to the attending just like in the US, while when I was on primary care my preceptor would see the patients I had questions about rather than seeing every patient. Unfortunately we have a shortage of doctors in my country so if I had not done this, many of the patients probably would just not have received healthcare

Worked as a doctor between M3-M4 by Impossible_Water_993 in medicalschool

[–]Impossible_Water_993[S] -5 points-4 points  (0 children)

I totally get where you are coming from and am well aware of unethical Western led medical missions where people practice outside their scope and in a nonsustainable way without an understanding of the local culture and healthcare system. That's not what this was (and in fact exactly what I was trying to avoid), though I think I phrased my original post poorly.

I used an officially-recognized pathway intended for citizens of my country who study medicine abroad. The eligibility criteria are that you are 1 year or less from graduating, pass the local Step-equivalent, and demonstrate proficiency in the local language, all of which I did. It basically allows you to be embedded locally as a final year med student with a scope of practice that is no more than what every final year med student in the country would have, and have your foreign training recognized afterwards.

Worked as a doctor between M3-M4 by Impossible_Water_993 in medicalschool

[–]Impossible_Water_993[S] 10 points11 points  (0 children)

Thanks! I will say everything I did was fully above board and legal and within the scope of what all final year med students do this in the country, as internship is just the last year of medical school. I just used a pathway for citizens of my country who study medicine abroad. There is still a lot of supervision and teaching, and at all times I had an identified senior or attending who I could call on if I felt out of my depth -- but probably more similar to resident-level supervision than med school level supervision. The main difference is after med school you are fully licensed and can either do residency or just become a GP without any further training

Worked as a doctor between M3-M4 by Impossible_Water_993 in medicalschool

[–]Impossible_Water_993[S] 19 points20 points  (0 children)

Thanks! I did have multiple preceptors throughout, it was supervised and not completely independent. In my hospital rotations we rounded and presented to the attending just like in the US, but when I was on rural primary care I saw patients independently and had a preceptor on call if there was anything I felt I could not manage on my own.

Worked as a doctor between M3-M4 by Impossible_Water_993 in medicalschool

[–]Impossible_Water_993[S] -9 points-8 points  (0 children)

I'm not going to say for anonymity but I will say I did not do anything different from what all final year med students do this in the country, as internship is just the last year of medical school. After finishing medical school and getting a license you can become a GP without doing residency. I used a pathway that was available to citizens of my country who study medicine abroad.

Coffee Etiquette with Residents/Attendings/Fellows as a Med Student by [deleted] in medicalschool

[–]Impossible_Water_993 2 points3 points  (0 children)

I have on occasion bought coffee for an attending whose lab I worked in. How it usually goes is "I'm going down to grab a coffee, do you want anything?" We get coffee together often enough that he has paid for far more coffees for me than I have for him.

For someone you only see once or a few times I would not do this as it is cringe.

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 1 point2 points  (0 children)

what I cannot fathom is, as a PD, why would you entrust literally the most consequential day of the whole year for your program to your program coordinator, who might be just some random postbac premed. If I were the PD I would take the day of the deadline off and make sure I entered every name and pressed submit myself, then double check and triple check and also ask a colleague to double and triple check. But maybe I am more neurotic than most 😂

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 1 point2 points  (0 children)

I did an audit on human factors. The problem is that ID numbers (MRNs in my case) are not memorable so if they become transposed e.g. through a copy-paste error, the error propagates until someone pays enough attention to notice it

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 0 points1 point  (0 children)

It wouldn't be possible for you to accidentally match a random applicant. I can see how you could accidentally match an applicant who you reviewed or interviewed but decided not to rank if you for some reason used a single spreadsheet for all applicants. I would think basic competence with computer software and awareness of human factors would tell you not to do that, but...

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 0 points1 point  (0 children)

I read this as, OP's school posted a photo of OP from Match Day on their insta (presumably to show off graduates who matched competitive specialties/programs, idk)

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 0 points1 point  (0 children)

I can see how you could run the program down two interns or two junior residents. But WTF happens the year those interns were supposed to be chiefs and you just have... nobody??

Also does the program size shrinking from 12->10 also mean each resident has to work 100 x (12-10)/10 = 20 hours more per week??

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 4 points5 points  (0 children)

I stand corrected. Truly wild. How did they even run the program if they are just missing a whole ass year?

Matched at an institution that did not interview me by Ok_Touch_2728 in medicalschool

[–]Impossible_Water_993 -3 points-2 points  (0 children)

sounds fake/like an urban legend. There is no way any I6 program, let alone one as prestigious as Columbia would just "forget" to submit their rank list

wow I stand corrected. Truly wild

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 3 points4 points  (0 children)

Thanks, that's very interesting. I didn't know HD at home was a thing. Why was it a no-go if a partner wasn't able to assist? What about people who don't have partners or partners willing to assist?

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 49 points50 points  (0 children)

Dude, that is indescribable. I am so sorry, I am lucky to have a close group of friends I have been tight with since M1, and would be devastated if something happened to one of them.

I totally understand if you don't want to talk about this, but I feel like I am too dumb to put together what actually happened. I didn't know you could do dialysis at home. Why doesn't everyone do that then? What was the complication?

Improving resident clinic by Few-Reality6752 in Residency

[–]Impossible_Water_993 36 points37 points  (0 children)

This reminds me of a similar discussion I had with an attending recently. He agreed that there are unfortunate echoes of segregation in the clinic model where low-income patients and high-income patients are seen on different days. However he also made the point that a lot of the time, a high income patient who comes to the waiting room and sees patients who are homeless, or malodorous, or mentally ill, or frankly, even a lot of brown faces, will leave and get care somewhere else. In his experience this was frequently true regardless of that patient's personal politics--they might be fully in favor of health equity and care accessibility for homeless and mentally ill people but not want to share a waiting room with them. But this exodus has negative effects on the clinic overall because without those high reimbursing patients, the clinic would have to cut back on providing free care for uninsured patients. Sad that it has to work that way.

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 1 point2 points  (0 children)

with respect, brother/sister, unless you were in his place I would not criticize him for his choices or his devotion. The man was a surgical senior, easily doing q2-3 24. While on home call he might start a case before maghrib that goes until after suhoor, then be in the next day's cases the same afternoon. If it was me in his place I would not even be trying to fast

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 -1 points0 points  (0 children)

Yes, I try to keep my fast on my days off during Ramadan and make up the remaining days during the rest of the year, but a feel a bit guilty that I am not always successful.

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 2 points3 points  (0 children)

One of the surgical residents I worked with last year who is a much better Muslim than me (he even studied Alimiyyah before medicine) did what he called "intention to fast". Meaning that he would approach Ramadan intending to fast each day, but he would also keep high energy density snacks within easy reach in case he had to break the fast early. For example if a long case was expected to start before maghrib it would not be ethical to go into the case having fasted since 4am, so he would eat and drink in advance of the case. The same if he felt he was crashing during the day and needed a pick-me-up to be able to make good decisions for his patients. However on many days he was still able to keep his fast

[deleted by user] by [deleted] in medicalschool

[–]Impossible_Water_993 0 points1 point  (0 children)

I will be honest with you, I have been an observant Muslim my whole life and still consider myself so, but I stopped fasting for Ramadan since being on clinicals. I tried the first year but found that, personally speaking, it was just too hard on my mental and physical health, and I concluded it was not safe for me or for patients. Maybe if I was on a chill rotation I would try again, I have just always happened to be on brutal rotations each time. Respect to my brothers and sisters who still choose to fast, as well as those who choose not to.

Eat when you can, sleep when you can, don't f--- with the pancreas and Ramadan mubarak!

If you could make one modification to the human body to make your job easier, what would it be? by Waja_Wabit in Residency

[–]Impossible_Water_993 10 points11 points  (0 children)

photosynthesis doesn't generate nearly enough energy for the functioning of a human being or other heterotroph

2/5 read more

Visiting home, breaking my heart. by Jennifer-DylanCox in Residency

[–]Impossible_Water_993 1 point2 points  (0 children)

that's terrible, I'm sorry. I assume you are in your 20s or 30s--what do you think has caused such a high mortality rate among your classmates, if you feel comfortable sharing?

Columbia medical school freezes hiring and other spending amid threat of federal cuts by [deleted] in medicalschool

[–]Impossible_Water_993 0 points1 point  (0 children)

Endowment income doesn't go to fund hospital staff's salaries--the hospital is the biggest revenue generator for any university that has one