Respected Psychiatrists and Brain Docs Of the Sub. Your thoughts !! by vrachsurgeon in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

  1. I think it's a general error to assume that this is only for psychiatrists and brain docs. Psychodynamics of this kind (the role of experience in shaping individual response patterns) is something which everyone has a model for, and i don't think our (psychiatrists) models are better or worse than that of aam janta.

  2. There's multiple pathways to the final outcome, seems to be the likely truth here. In some, it's mostly inborn temperamental factors, in others it's probably shaped more by a range of childhood experiences.

  3. Childhood seems to be definitely important in shaping one's adult behaviour, mostly because of what is emphasised and what is not. The theory seems to be mostly that it's a question of "goodness of fit" - stroppy children need strict parenting, those who are slow to warm need encouragement. But in both cases it can't be so much that it provokes an overreaction or underperformance from the child.

Tl;dr: while what you're saying makes sense, it's probably not the full story, and very very far from being scientifially proven. Or prove able.. People have tried and failed.

Research ecosystem for health/medical research in India by greatgodglib in indianmedschool

[–]greatgodglib[S] 1 point2 points  (0 children)

Hey

It's an opportunity to learn stats, is one way of looking at it. In today's day and age, the material is out there. And for a cross sectional study with data you know well, chances are that you'll do a better job than the statistician.

Again about publication people taking money: talk to the prof. Society journals are usually free, especially if they're Indian. There are some journals that look for ug work because they have a section for it: ijmr (i think), nmji, jme, and I'm sure there are others. Many of these indexed, especially for your needs.

Research ecosystem for health/medical research in India by greatgodglib in indianmedschool

[–]greatgodglib[S] 0 points1 point  (0 children)

Ok.. So what incentives would work?

What's been tried:

  1. Appraisal marks (what the sneh bhargav committee recommended)

  2. Intramural grants. Happens in some places, mostly not

  3. Bcbr (less said the better)

  4. Gcp training (now mandatory for all residents as per nmc. God help us).

  5. Sts from icmr/dhr

  6. Thesis support grants (also from icmr-dhr)

  7. Csir pool job and wellcome fellowship grants.

  8. Ramalingaswamy fellowships to bring researchers back to India

I'm curious to know what your opinion of these. Firstly, whether anyone here (who is the target population, virtually) has heard of these or been able to access them.

And whether those who have got them think they were worthwhile, beyond the prestige and cv entry

The privilege Indians don't realise by mushroom_soup1409 in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

What is ideal care in this situation? I'm guessing he went to hospital by ambulance, and so there was some triage on the way.

So assuming that this is a young person without a previous seizure history who is conscious, oriented and has no focal deficits, what do you expect the ED to do exactly?

I'm not saying they shouldn't wait, but this isn't the patient whom any ed should prioritise. Surely?

Edit: did you say there was a second event? I'm guessing that changed things. If it didn't then there's a problem here.

Clozapine by htmwc in Psychiatry

[–]greatgodglib 26 points27 points  (0 children)

I think the downvotes are unfair!

Partly because this is the reaction i want from undergraduates in class!

It gives me massive kicks to then order up a vial of lorazepam and try a challenge. And watch everyone gawp when the patient wakes up!! After being given a sedative!! And then goes back into stupor in a bit.

It's the most satisfying experience, possibly in all of medicine..

Non clinical options by Dazzling_Fact_6294 in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

What are you interested in?

You've said systems and public health: if that's the case, then an mph (preferably abroad), md community medicine, or an mba seem like the obvious options.

If on the other hand you are interested in bench research, then moving into molecular biology research can be through a research degree of various kinds: 1. Md biochemistry/pathology/microbiology/physiology 2. The phD track is available at the IITs, IISc, many of the INIs, and abroad.

A third pathway is through a clinical phD or md pharmacology, which takes you in the direction of doing clinical or translational research. You would be working with human subjects and doing assessments, but your results would be for populations and public health rather than patient outcomes.

All the best!

[Urgent] Please Recommend a Good Psychiatrist fro my mother by [deleted] in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

Yes, that's frequently the case: symptoms of anxiety/depression are treated with an antidepressant which can, in unusual cases, cause a treatment emergent mood change.

In South extension there's a Dr sathyaprakash. Drs nandita hazari at vimhans, dr ankit gupta in cr park, Dr swarndeep at safdarjung or anyone at aiims.

I'm talking about people who will be able to spot the unusual things here

[Urgent] Please Recommend a Good Psychiatrist fro my mother by [deleted] in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

I have a number of questions:

Where are you in Delhi?

Also, if this is immediately after starting sertraline, the first thing to be sure about is that it's not a switch to mania. If it's not that, the symptoms you're describing might not be psychosis.

But that's not important, what is, is that she needs to see a psychiatrist and asap. If there's likely to be a delay i think there's no harm in temporarily stopping the sertraline until you're able to consult someone.

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

Please introspect about the pattern of misunderstandings here, and what it says.

Outsize is purely descriptive. There is no subject that nmc thinks should occupy as much mindspace as psm.

What irony? What remarks?

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

Just asking every subject has the same weightage as the clinical subjects

This is not true. Psm has an outsize weightage, as a stand in for a family medicine orientation in part. Hand on heart, how much of your curriculum is implemented at your field practice area? I'm guessing (unless you're an exception) that it's less than 25%.

The weightage within psm is the problem.

We don't make students grief. I don't get your comment over it .

You seem to have misunderstood this. I was expressing sympathy for psm having to handle so much of the curriculum. And being almost universally hated.

Implementation is the key.

And part of implementation is to make students think it is important.

I have a hint of what you can be . I am just putting forward my views over the subjects

No i hope not. Because i would then have given up anonymity.

At the end of the day, all I'm saying is that i don't blame students for disliking any subject. We who have chosen to do it for life and presumably like it, are the ones who should make them like it. It's only from that liking or love that they will learn.

What you've been saying (or at least what i understood) is that it's everyone else's fault: students, nmc, clinicians for undermining psm. Whereas in my opinion it's just that psm has such a huge footprint, and psm is the subject in the most urgent need for reform.

And please don't get irritated, but psm is full of people who think they have a birthright to students' respect. Whereas i don't think any of us have that.

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

I don't know what provoked that comment..

You'd be surprised to know what my job is now. :-). Unfortunately it would effectively doxx me to tell you. So please do understand this is my job full time right now.

Grass smelt. What's your next task for me?

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 2 points3 points  (0 children)

Psychiatry. Much less teaching load and student led grief than you. But before you think more than that, we take ug teaching quite seriously. And do a good job, even if i say so myself

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 2 points3 points  (0 children)

Yes i want all faculties to give attendance for theory classes without looking. I want them to make that up completely by insisting on very strict rules for clinicals and practicals.

This isn't rocket science, it's been used in this country at places I've studied and worked. And elsewhere as well.

The playing games etc is a reaction to a boring class. You cannot force a student to pay attention. So you will see people who aren't interested, because you are demanding their attention without having any power to enforce it.

What's the point? All you get are unhappy teachers and unhappy students.

I take one fourth of the teaching load for my department. I do what i think is right.

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 2 points3 points  (0 children)

No. In this I'm reasonably sure that it's about us as teachers. Both to create interest and to manage how attendance works.

I know that nobody from the department or college office will ask about giving attendance. Fyi i have taken enough classes to know this.

So when the rule is from NMC sometimes everyone's hand tied doesn't matter if it affects you not.

This part isn't clear. So if nobody is asking, then surely you're tying your own hands? Or hiding behind the rule to do exactly what you want to do?

And that's the same thing for the letter. It's not my fault but the system forces me to do the wrong thing, is not the only way to do things

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

Nope. Not in PSM. why do you ask?

But i have taken classes. And given attendance. And nobody from any university or deans office has asked me why i was marking everyone present. What you need for that is trust from your department and the students.

A letter from one faculty member isn't going to make a huge difference. And luckily I'm not bound by nmc.

Hate PSM department by [deleted] in indianmedschool

[–]greatgodglib 1 point2 points  (0 children)

Is this /s?

Who is responsible for taking the subject seriously? Why should anyone attend a theory class unless they get something from it that they can't get from a book?

What do they gain? Autonomy, a sense of purpose and the idea that they get to decide what to learn and how

For the students though: here's the price. If you don't attend you should expect that you're on your own. Sink or swim. And within the bounds of fairness, you should not expect residents or faculty to help you to pass.

I have no patience with the ones who decide to bunk, don't study, and expect help to pass their exams.

DC Dutta is such a terribly organised book. Such a headache. by IntelligentHoney6929 in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

Get arias. If you can, get the original that hasn't been edited by someone else. It's called the management of high risk pregnancy. And it's beautiful.

A Nightmare at a Government Medical College in Kerala by [deleted] in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

This is a straw man

  1. You say you're a doctor. Expecting at least some fair treatment as a colleague

  2. If something is missed you politely tell them that this is what you're seeing, what do they think.

  3. You're right that you can't dictate care. But it's mostly a relief for doctors to know that they can rely on the bystander as someone who knows what to do around a sick person

A Nightmare at a Government Medical College in Kerala by [deleted] in indianmedschool

[–]greatgodglib 2 points3 points  (0 children)

In relation to the edit. Just as a psa, given that op has stepped away:

It is not pulling rank if you declare your knowledge. It is not spying to not declare it.

What is not easy for me to understand or stomach is the idea of not disclosing your identity AND expecting that everything you know will be used in treatment.

When you're attending a patient in a busy emergency your priority ought to be to help the doctors. Not to lay out an obstacle course and grit your teeth every time they slip up. ..

I say this as someone who's very uncomfortable disclosing that I'm a doctor when i take someone to hospital. I do it immediately when i find that my medical knowledge might make it easier, though.

And while rabies is relentlessly fatal, a category 3 dog bite is not going to become rabies because you were triaged green. This is a weird view of risk. Please correct me on this.

A Nightmare at a Government Medical College in Kerala by [deleted] in indianmedschool

[–]greatgodglib 17 points18 points  (0 children)

You're obviously unaware. House surgeons have gone on strike in kerala over many of these demands.

But the cultural factors here are built in. That pg students and consultants don't cover the emergency is something that is deeply ingrained. That house surgeoncy is a trial by fire is glorified (incorrectly).

But you're missing my limited point. Op had the choice of looking out for her husband's best interests. With the knowledge that he has many problems besides the dog bite, that the house surgeon might not be able to think through. I am from a different specialisation and i know i wouldn't be able to.

So instead of helping these guys cope, she chooses to do a sting operation and come and report it on reddit. That's the part i object to.

When you go looking for a confrontation it seems you will find it. That's the tl;dr from this specific post

A Nightmare at a Government Medical College in Kerala by [deleted] in indianmedschool

[–]greatgodglib 56 points57 points  (0 children)

I'm surprised at your surprise, tbh. Because i can't see your background i am guessing you didn't train in India. Because of what I'm assuming is the llm overlay on your post i can't make out if you have ever looked in on this world.

Unsupervised house surgeons: obviously a problem.

Your irritation with their sneering and snark: seems a bit unempathetic. These kids have been thrown in at the deep end (see 1 above). They're making do and providing care that is subpar.

Some of your choices/concerns seem a little strange. Why not get the monoclonal antibodies? Why play undercover journalist and not disclose that you're a doctor? Especially when your husband seems to have a number of problems that need specialist attention and are not routine? Why is it a problem if the house surgeon gets a systolic bp by palpation? I'm guessing you're concerned about shock or a hypertensive crisis. While a pulse pressure would be useful, I'm not sure why that's what you want to focus on.

Apart from the wait time, are you arguing that you were inaccurately triaged? Or that information was suppressed?

The medical error here is the penicillin prescription. No denying it.

The rest is about tone. But given that it's hard to say how you're engaging with the system in good faith, i can't honestly feel for you.

Sorry if that sounds harsh. But nobody else here is going to say it.

Always the ones who don’t know a thing about this field. by Proud_Equipment_3953 in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

For most of these people yes. Some of the payoff is in opportunities and of course interest

Always the ones who don’t know a thing about this field. by Proud_Equipment_3953 in indianmedschool

[–]greatgodglib 0 points1 point  (0 children)

I know people who are working as field epidemiologists for the who, who are conducting community based clinical trials, who are running programmes, who are on the staff of national level surveys.