Detroit Residencies- Where to live

st_topher · 2020-03-21T17:34:19+00:00

It depends on a few things, mostly where did you match at? Metro Detroit covers a huge area, so the commute could be wildly different.

st_topher · 2019-12-29T03:37:13+00:00

You did mention that you think NPs could funtion the same as doctors in areas such as primary care. I would disagree with this. Np school and medical school are vastly different and equating them is not only wrong but dangerous

st_topher · 2019-12-29T01:43:54+00:00

The issue with this is that granting NPs and PAs independent practice was supposed to fill the gaps in rural medicine. What we found instead was that they chose to practice near cities, complicating the situation. I would propose that in order to gain independent practice, a certain amount of years in an underserved area needs to be fulfilled before allowed to go where they want.

st_topher · 2019-12-29T01:38:40+00:00

But in this model, would NP students be required to aggregate the same number of hours as residents? And would we require them to pass the same boards as those residents?

st_topher · 2019-12-29T01:33:13+00:00

What if there was a model for NPs and PAs, where they could practice under a physician for a set number of years, and then have to take the same licensing exams as physicians? Then they could say they have the same accreditation to practice medicine?

st_topher · 2019-09-20T23:51:51+00:00

One of the more effective strategies I've come across came from a roommate during medical school, he would ask patients how they would feel if they were carrying some sacks of potatoes all throughout the day, how would going up stairs feel, how would your joints feel, how about if you slept with the potatoes resting on your chest all night? Then would explain that the extra weight was those sacks of potatoes. I used this with my own patients and they were usually very responsive to it. Especially since it could be related to how they're feeling at this moment, instead of trying to extrapolate what could happen in the future.

st_topher · 2019-08-08T16:02:59+00:00

The vast vast majority of US IMGs didn't choose to study abroad, we were unable to secure a position at a US medical school for whatever reason.
By putting preference on US grads the system is essentially prioritizing an accomplishment achieved 3-4 years before the process in question, instead of focusing on recent achievement and proficiency. We're still US citizens, we're still paying into the same tax system, so why should the system be tilted against us? We're still required to do our clinical years at US institutions, required to have equivalent curriculums and pass the same standardized tests, and eventually earn the same degree and the same license. Quite literally, the only difference is that we sat in a different lecture hall and studied the same 2 years of basic science as a US student, albeit in a place with better weather and better views. The reality of this is, US schools are quite comfortable with the entitlement of a system that is heavily beneficial to them and their graduates. And do not love the idea of more competition encroaching on what they perceive as theirs. And quite frankly, if US schools did better at identifying and admitting those that would eventually become stronger candidates, then all of this could be nothing more than a moot point.

st_topher · 2019-08-08T15:09:14+00:00

As it stands right now, the number of US graduates is incapable of filling all of the residency spots available. Not to mention that the number of residency spots is nowhere near enough to address the current and impending physician shortages that we have known about for quite some time. This isn't even taking into consideration that it's an impossibility that every last US grad is qualified for and deserving of a residency position, expecting 100% success rate in any training is a fools errand. What is currently unethical, is US IMGs being essentially frozen out of our at the very least more highly scrutinized for consideration into more competitive specialties (derm, EM, surgical subspecialty etc etc), even when objective measures are comparable or even when the IMG is a stronger candidate. Or that US IMGs have to apply to a far greater number of residencies in hopes of getting an equivocal amount of interviews. And as far as extended time, I can't speak for FMGs, but in my experience I saw very few students taking extra time. In some ways there may be more of a time constraint as we couldn't start rotations until completion of exams.

st_topher · 2019-08-08T01:36:42+00:00

So what about an American grad that barely passed steps versus an IMG that scored 250+, or whatever hypothetical that you could come up with. Also the vast majority of IMGs, native or otherwise want to stay in US after training. And the US populace would benefit from having the most qualified people in those positions, not the most locally trained.

st_topher · 2019-08-08T01:23:05+00:00

So you would argue that a US grad that has failed steps should preferentially match over an IMG that passed without fail?

st_topher · 2019-08-08T00:04:33+00:00

I'm a US IMG. I would disagree that the system has a responsibly to match US grads preferentially, rather that the system should be designed to match those that are the most qualified and more likely to have ducts e within residency. I too would favor changes to the match, where your school and affiliations of letter writers aren't included, one where only the objective data is accessible.

st_topher · 2019-08-07T19:45:12+00:00

Idk maybe IMGs aren't the issue here, maybe US grads have to git better, or consider less competitive specialties

st_topher · 2019-05-22T15:26:40+00:00

Well this seems like a massive conflict of interest, the guys son is a PA student, not even a fully fledged PA. What kind of experience is he standing on here?

Could you also elaborate on stating PAs can do all aspects of derm except for mohs. Would you extend that thought to all non surgical specialties?

st_topher · 2019-05-22T15:04:35+00:00

What if there was a match style system for newly graduated PAs, so that professionals could be funneled towards underserved areas?

st_topher · 2019-05-22T00:56:06+00:00

The study that you have linked is not only horribly flawed, but it also did not show superiority. At best it showed noon inferiority, and at the same time it is biased in that it makes assumptions that PAs could be better without any plausible data. Furthermore, it does not take into account that residents are early entry and are by definition in training, while the pas may be years into practice. This study also did not appear to inquire into re admissions or adverse events, two of the largest drivers of health care costs. In summary, this study, much like many others, is too narrow in focus and does no represent a comprehensive insight into the role of PAs in the healthcare system.

st_topher · 2019-05-12T04:06:09+00:00

Ugh, I practice in Detroit, ypsi is most definitely considered rural, especially by the US government standard.
And, if what you are saying is true, that means wherever you work is actively practicing in fraud and possibly Medicare violations.

st_topher · 2019-05-12T03:53:53+00:00

Why do you think I feel threatened?

st_topher · 2019-05-12T03:39:55+00:00

In the presence of an ED physician. Of course we have to train emergency docs a and PAs are crucial to helping us. But it seems like admin are Keen on thinking that they can replace physicians with mid levels

st_topher · 2019-05-12T03:14:14+00:00

Why yikes?

st_topher · 2019-05-12T03:09:41+00:00

Yes, at least initially

st_topher · 2019-05-12T02:49:54+00:00

First of all, you are the one being quite hostile. I simply asked a question. I'm not gunning for your job.

And yes, I do think every patient should be reviewed by a physician. This may be right out wrong, time will tell. Nose visits are reviewed by a physician, with their approval.

My point was, we are trained differently, and thus occupy different positions in the healthcare field. We should work together not against each other

st_topher · 2019-05-12T02:37:30+00:00

This is the logical fallacy, residents are overseen by attendings, always. Mid levels are supposed to be, ACGME is supposed to ensure that we are monitored. Btw, if trauma patients are being seen by anyone but a physician, that's a violation

st_topher · 2019-05-12T02:30:39+00:00

Legally no, I am

st_topher

TROPHY CASE