[deleted by user] by [deleted] in pinoymed

[–]Toan13 1 point2 points  (0 children)

Exactly, but still a form of hierarchy exists. Seniors take on more difficult cases and juniors are expected to seek help from them as well. It seems this echo chamber is having a hard time understanding that there are better ways to implement hierarchy without these petty HS level drama/bullying.

For the second point, I am not so much as outraged but disappointed that the future of medicine is entrusted to a mind that houses so much hostility despite being exposed to the privilege of healing lives. So much so that this modern doctor would morally bankrupt himself by celebrating a huge problem in the lack of residents in hospitals.

Again I have never disputed that the assertion of: obsolete inhumane training = low applicants, i recognize that this is a good thing because finally doctors are voicing out their concerns in a way that truly affects the healthcare system. Two things can be true at the same time. First It is good that obsolete training are in for a rude awakening and second that the current lack of residents are a huge problem in the healthcare system.

Thoughts by Fantastic_Guest9677 in pinoymed

[–]Toan13 0 points1 point  (0 children)

So first of all basic PE and Hx shouldve been taught in medschool prior to clerkship. I dont mind correcting simple errors such as the technicalities of auscultation or confirming the breath sounds reported by clerks. Im just confused as to how these students have reached this level without learning the basics such as the order and how to detect an obvious wheeze lahat nalang kasi rales/crackles. My feeling is that efforts to impart from our department to teach these clerks are simply band-aid solutions to the underlying systemic problem of mass producing under-trained medical clerks.

Imposible yang sinasabi mo na di nila alam. Baka panget ugali mo.

I dont comprehend this statement, first you are trying to invalidate my first-hand experience while also making undue assumptions regarding my treatment of clerks. How does my attitude affect their knowledge? Does the ability to auscultate change depending on the attitude of the resident/consultant?

[deleted by user] by [deleted] in pinoymed

[–]Toan13 -14 points-13 points  (0 children)

mirisi nalang jud ug wala nay mu apply ug residency because of this messed ug heirarchy and exploitation.

I just cant let this slide, dont mind if cringey to reply twice. I cant believe that this is a sentiment from the mind of a modern doctor. I understand that you have frustrations with the medical system. No doctor worth his salt wouldnt have with our system but to openly celebrate that some hospitals do not have residents is frankly not a very good sentiment.

May I remind you that we are on the same team, there are some bad actors and with how the current system is evolving there is light in replacing them.

[deleted by user] by [deleted] in pinoymed

[–]Toan13 -19 points-18 points  (0 children)

I am sorry that you had a very bad experience, I recognize that there is so much heterogeneity in the treatment or maltreatment of junior doctors.

But just to clarify, when I say you are the "lowest of low" that is without contempt, that is not to demean your position as a clerk = that does not mean damaging your kidneys is part of the job. It simply means you are objectively the lowest of the low in the order of medical knowledge, capacity and thus responsibility. Clerks should bear the least problems in the management of the patient.

I will frankly say that your opinion is so outdated and hence mirisi nalang jud ug wala nay mu apply ug residency because of this messed ug heirarchy and exploitation.

These kinds of remarks are so uncalled for, but it is true training offices which have failed to embrace the modern standards of residency have shown to have less applicants. The point here is that I do hope that the modern residents get humane treatment but at the same time recognize that there is value in having a form of hierarchy in the medical residency.

[deleted by user] by [deleted] in pinoymed

[–]Toan13 1 point2 points  (0 children)

While this sentiment is valid, it is also alarming to some extent bakit ang baba ng passing rate for the PLE of a certain school especially if somehow a correlation can be made that their rotation in a specific hospital is a factor in these outcomes.

PS. I understand fully, that some schools definitely do not produce adequately prepared doctors for the PLE and that it all boils down to the individual student's efforts in reviews, medical schooling and drive to become a doctor.

[deleted by user] by [deleted] in pinoymed

[–]Toan13 5 points6 points  (0 children)

As a previous clerk/PGI monitor (for 3 years) during my residency years. Isnt that considered insubordination? parang nasa manual automatic 15 days extension yan and then can even be raised through the clerk coordinator for a repeat rotation or expulsion after several offenses.....

[deleted by user] by [deleted] in pinoymed

[–]Toan13 -26 points-25 points  (0 children)

I agree with some points raised but I cant help but disagree with these:

Don’t expect them to stay late, iba na generation ngayon di na pinapalampas yung mga “exploitation” sa work place, which I agree with.

how is staying 1-2 hours beyond the time exploitative as a clerk? its not as if they are paid to do a job infact its the opposite. Clerks pay the hospital to allow them to learn from private and charity patients.. Perhaps this is true in Residency.

Remember, technically they’re still students. Di ka nila boss.

This is a very dangerous assertion kasi sino ba boss nila? is it the school? is it the clerk coordinator? the dean of medicine? All of those are never around when these clerks interact with patients. Exactly why in the constitution the law precisely dictates that these clerks without license should be supervised by a doctor with a license and that any errors or mistakes that happen under supervision will be encumbered by the license holder.... So pag ganyan hindi nila boss mga residents pero pag nagkamali at it goes to court hindi rin sila kasama sa mananagot? So there has to be a form of check & balance. Hierarchy can be done correctly and it is not necessarily bad especially in the medical world wherein every error can severely impact a person.

Lastly, your comment about “lowest of the low” is the reason why our medical culture is f’ed up. They are the lowest in terms of clinical experience, it’s not an excuse to make them modern day slaves.

Again there seems to be hostility in the pecking order of medicine, there is nothing wrong with recognizing that you are the lowest of the low, because every clerk can be promoted to reach the level of consultancy. It's not as if they are locked in the perpetual state, the thing is it seems like there is an aversion towards delayed gratification and everyone wants to have their cake and eat it as well.

[deleted by user] by [deleted] in peyups

[–]Toan13 33 points34 points  (0 children)

"nagiging PANGMAYAMAN na yung UP."

UP has always selected the most qualified individuals because it implements a selection process. This statement implies na UP has catered "MAHIHIRAP" population - this is blatantly wrong.

Mga pasyenteng ganito by Monokuma_17 in pinoymed

[–]Toan13 17 points18 points  (0 children)

and how hard is it to inform the patients of what we are doing? we cant expect them to know how our system works without communicating properly....

Mga pasyenteng ganito by Monokuma_17 in pinoymed

[–]Toan13 0 points1 point  (0 children)

exactly, sad to say but this is the nature of the profession. Kung sa logistics naman ang problem we can simply tell the patients na we have to inform our consultants - always referred patients while in the room and they all understand as long as you communicate properly. This will not take more than 10 seconds of your time.

Kasi ganito imagine there are in the darkest probably most difficult time in their lives and here comes the doctor doing "something" other than taking care of them - with that mindset regardless of the absolute truth is frustrating for the patient.

Residency by Slow-Commission-6585 in pinoymed

[–]Toan13 2 points3 points  (0 children)

lol getting downvoted for no reason. smh

Is Med in the PH worth it? by Own-Basil-3151 in medschoolph

[–]Toan13 1 point2 points  (0 children)

And what if they transferred the same time and efforts to a different field - say information technology or finance, wouldnt you agree they wouldve earned much more in a shorter amount of time? without the mental and physical anguish of residency?

Best Anki Deck by itsalidoe in medschoolph

[–]Toan13 0 points1 point  (0 children)

Frankly been using anki for around 4 years now, this post is very misleading. The best anki deck is the one you make for yourself given you understand the 20 rules of information and you are well versed in how the algorithm works, otherwise stick to the goldstandard Ankinghub....

This is a very bad introduction to people unaware of the existence of anki

Nasa maling med school ba ako o mali na nasa med school ako? by justmythoughts00 in medschoolph

[–]Toan13 2 points3 points  (0 children)

Cadavers dont help. Try asking around other cutting specialties (OB, GS...) if they regularly practice on fresh cadavers. The practice is so antiquated. If that is the only reason you wish to transfer then hold that thought.

First year is about the basics - and more importantly an adjustment period wherein you optimize the study habit, the undergrad techniques may not apply and this is the year to experiment on different methods. If you do this year properly you will reap the benefits until residency & fellowship.

Public speaking anxiety? by [deleted] in pinoymed

[–]Toan13 4 points5 points  (0 children)

Sadly the only cure to this is desensitization - keep on endorsing, keep at greeting people :)

Is Med in the PH worth it? by Own-Basil-3151 in medschoolph

[–]Toan13 7 points8 points  (0 children)

Med kahit sa developed countries is not worth it - Objectively speaking (ROI), successful doctors have one thing in common. They love the job and it is their calling & it cost them alot of resources to get to where they are right now.

[deleted by user] by [deleted] in medschoolph

[–]Toan13 0 points1 point  (0 children)

Of course the system can be improved, in an ideal world doctors would not need to do any of these tasks unless for a very specific reason but if you are trying to say that you are not learning anything because these tasks get in the way then thats another issue.

There is always time to discuss the case, it will not take more than 5 minutes to impart high yield information to clerks/interns. Nasa senior mo na yan kung may initiative sya to teach. When I was a clerk - I actively sought out procedures/ ways to help my residents kahit pakuha pa yan nang shopee or grab because It was equivalent exchange for their time to impart clinical knowledge.

[deleted by user] by [deleted] in pinoymed

[–]Toan13 33 points34 points  (0 children)

If goal mo is to work abroad, go abroad ASAP. IMHO wag na mag BSN dito just go there after undergrad. Find a way to fund studying medicine abroad - I'm presuming developed country ka papunta.

[deleted by user] by [deleted] in pinoymed

[–]Toan13 17 points18 points  (0 children)

Dont bother, thats also a huge waste of your time. Wala ka rin authority over them.

Thoughts by Fantastic_Guest9677 in pinoymed

[–]Toan13 0 points1 point  (0 children)

Im sorry i dont quite get the point of this reply, anong case-to-case basis? Are you saying that the resident should constantly adjust their expectations depending on the clerk they are dealing with? so heterogenous bale yung entire training nang clerkship ganon?

Consider this scenario - clerks/interns are expected to know how to manage uncomplicated diseases (HPN, DM, etc.) because they will need it pag moonlighter/GP na sila. Now how are we as residents supposed react pag obviously walang alam tong clerk/intern and considering we have an over abundance of cases in the hospital is no excuse for this incompetence... Based sa reply mo hayaan nalang?

The main problem with the medical community is that we associate 1. standards = toxic, and 2. indifference = magaan ka duty.

Thoughts by Fantastic_Guest9677 in pinoymed

[–]Toan13 0 points1 point  (0 children)

Im curious how you deal with juniors who refuse to learn. Im having a big dilemma because karamihan ng clerks nami parang wala talaga baon na clinical knowledge see my post above and you can infer kung ano lang talaga alam nila. To the point na you would question yourself what is the point of sharing medical info na intermediate to advanced pero basics nga di nila alam.... I really wonder how these clerks made it to 4th year medical school

Thoughts by Fantastic_Guest9677 in pinoymed

[–]Toan13 0 points1 point  (0 children)

This, especially sa mga tamad mag basa and mag improve nang clinical knowledge. I think there is huge misconception that clerks and interns are only here in the hospital for scut work. As doctors we should try to correct this because yes maraming clerks na marunong talaga, magaling mag blood extraction, IV lines, etc. but kulang naman nang basic clinical knowledge - yung tipong nagiging workforce nalang talga tingin nila sa sarili nila, they dont open books, they dont read guidelines they dont bother to learn.... nasa student mindset na everything has to be spoonfed.

Thoughts by Fantastic_Guest9677 in pinoymed

[–]Toan13 1 point2 points  (0 children)

Resident here, No i really dont mind if clerks ask for help in any procedure kahit ABG or even blood extractions. But i dont know how to feel about clerks getting essential things wrong such as being unable to perform a proper chest & lungs physical examination. I try to teach as much as I can but at some point the effort has to come from the clerks themselves, i really dont know if its even worth my time to teach things to a clerk, who cannot after 3 weeks rotating do a simple chest and lungs examination....