First I’d like to give a shout out, if you will, to this website and its creator(s). A fascinating concept and an equally fascinating read. No doubt.

Next, I’d like to state in clear and unfortunate terms that I am a recent medical school graduate. I state that so you’ll take me seriously, as I plan to offer several insights about the profession in the coming paragraphs. I’ll also state that I’m not a D.O. or an international medical graduate, thus increasing my status, if you will, even more in your minds. Really though, no offense to my osteopathic colleagues and immigrant/temporary emigrant physicians/physicians-in-training.

I’d like to start out in existential mode, if you’ll allow me. *Squints eyes and rubs chin*. Why would anyone in their right mind choose to apply to, or for that matter, attend medical school? Ah! You’re taking on the pensive pose too now, aren’t you?

Brief and simple answers first come to mind. Money. Status. Ego. Race. Ethnicity. Those were too easy to come up with. I’ll expound on those very shortly, but let’s brainstorm, as my KG teacher used to say, and think of a few more. Ah yes, it’s coming to me now. Retardedness. Delusion. Lack of common sense. Boredom. My parents told me to. My parents did not tell me to, but I know they would have if I didn’t. I pretend like my family did not influence my decisions, but in reality (and don’t tell anyone), I’m a complete slave and bitch and indeed they are the reason why I am an aspiring physician.

Okay good, now we’re getting somewhere. We’ve laid the groundwork to incredibly profound thoughts which are yet to come.

I have to go eat dinner now, so as they did in 1980s sit-coms, I’ll make this a to-be-continued. Rest assured that I will be back for several follow-up visits (no put intended.. medical and medical-related jargon is not my cup of tea and frankly bores the shit out of me). Let me rephrase.. I will be with you in my usual brilliant form in the coming days. And to those of you starting to get pissy, I say pipe down, take a step back, and re-evaluate your existence. What do you really have? A kick-ass histology text? Superior ABG obtaining technique? A stethoscope with a hip pediatric chest piece? Sweet pics from your “white coat ceremony” which you subsequently uploaded on Friendster? Wait, did the AMA hook it up with a free Netter’s? Man that is lame. I suggest you take a seat and listen to what I have to say…

Related Link: Mesothelioma Video

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Before starting medical school, I worked many jobs. If something wasn’t going right on the job, not one time did I ever fake that everything was OK. Once I got to medical school, I started to pick up on many students coming to me in private expressing distaste in something that was going on in class or on rotations. These were the same people who I thought were loving every last minute of their medical school days! I admit, I was guilty of faking dissatisfaction with medical school also, especially early on.

What’s different about medical school? Why do people treat it differently than a job? In my opinion, it boils down to this:

Your teachers or attendings are directly evaluating you. While you are a paid employee on a regular job, you’re paying for school. Therefore the dynamics are much different. There is the feeling to “impress” or to otherwise “not piss off” those that are essentially behind the rest of your future. As a result, you “grin and bear” much more than you would in an ideal situation. On a regular job, it is the employers responsibility to assure that the employees are happy. The dynamic shift results in employees that demand a certain standard of treatment. If that treatment falls below a standard cut-off, employees are more vocal about the situation.

You Are Building Your Inner Workplace Dynamics

The problem with “faking it to get by” is that you are actively creating the attitudes and actions that you will use in the workplace from this day forward. The chances that you will magically change once you finish residency and get into practice are slim.

If you are a practice owner, you’re expectations for employee complaints might be much higher — something along the lines of what you’re used to now on the wards.

If you’re a member of a larger practice group, you might be less open about voicing dissatisfactions in the workplace.

Be Careful. It Might Continue Into Residency

Residency might be the first “real job” that many medical students have ever experienced. Taking the attitude to accept whatever is thrown your way — no matter how unfair it might be — with you almost guarantees that you will negatively impact your workplace dynamics for life. Being afraid to voice dissatisfaction with your employer increases your chances to become a disgruntled employee, and you’ll have to vent at some point.

Polite, But Stern

Don’t be afraid to complain when things aren’t right. You do not deserve to be whored out into Scutville on a daily basis. Your primary responsibility is to learn.

If a resident or attending asks you to complete a trivial, menial task such as getting their food or running a personal errand — outright refuse to do it and then offer an explanation as to why you won’t oblige them.

Next, have them explain their reasoning for expecting you to complete such tasks. You just might be surprised at how low you sit on the totem pole.

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Medical school blows. If one were to believe one actually likes medical school, one should please reread the first sentence carefully and completely.

Popularity: 6% [?]

Posted recently at the USMLE website, the Step 2 Committee decided to increase minimum passing scores on both the CK and CS versions of the exam.

Step 2 CK

The Step 2 Committee decided to raise the three-digit score recommended to pass Step 2 CK from 182 to 184. The new minimum passing score will be applied to Step 2 CK examinations for which the first day of testing is on or after July 1, 2007.

Step 2 CS

The Step 2 Committee decided to increase the performance levels required to receive a passing outcome on two of the three Step 2 CS subcomponents: Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP). There will be no change to minimum passing requirements for the Integrated Clinical Encounter (ICE) subcomponent of Step 2 CS. If these increases in the performance levels required to pass were applied to a recent group of first-time examinees, the overall passing rate for examinees from US schools would have decreased less than one percent and the overall passing rate for examinees from international medical schools would have decreased approximately eight percent. The new passing requirements will be applied to Step 2 CS examinations for which the first day of testing is on or after July 15, 2007.

Read the full report here.

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Teams pull together. They’ve got your back. They work together towards a common goal. The term “team” is used very loosely in the medical world. The fact is there is no team in medicine — it’s just a term used to foster some semblance of cohesiveness within dysfunctional rotations. Don’t let them try and tell you otherwise.

Medical school rotations are typically made up of an attending, one or more residents, and one or more medical students. This is what is collectively called the “team” on ward medicine. If you look deeper you’ll soon realize that an accumulation of more than one body isn’t adequate to truly define a team.

The common goal on ward medicine is typically to care for patients. This is really where the teamwork both begins and ends. Unlike a football or basketball team, there is a lot going on behind the scenes in medicine to ensure that teamwork does not truly exist.

• Other students will go behind your back and attempt to show you up. This can include answering questions about your patients or bringing in journal articles when other students aren’t prepared.
• Some residents will not tell you where you need to be and then fault you for not being wherever it is that they (supposedly) wanted you to be.
• Attendings are malignant about “pimping” and some verbally abuse students and/or residents for not knowing the answers.
• You are overworked and very rarely will another person put in some extra effort to make sure you’re out on time.
• Attendings waste tremendous amounts of time. They’ll tell you that they want to round at 5 PM and then not show up until 6:30 PM. No phone calls are made to let the residents know that he is going to be late. You sit around for an hour and a half with your thumb up your ass.
• Nurses, who are sometimes considered part of the “team,” are incredibly slow about getting things done.
• As a student, you are made to complete meaningless extraneous tasks such as coming up with a presentation about some topic you’ll never use ever again. This time could be spent studying for your shelf exam.
• Most residents and attendings don’t care that you have an exam at the end of the rotation to study for. Instead, they’d rather you follow them around and waste 4 hours every day.

With just a few examples, you can see that there really is no teamwork in academic ward medicine. Here is what you actually have:

• The attending is getting paid a monthly bonus on top of his regular clinical (or academic) duties and salary to participate on the wards. Thus by nature of the situation his ward duties come second.
• The residents are there to please the attending and to do the daily “scut” work. They just want to make sure that everything is in order before rounds.
• The students are there because they were told to do so. At best they want to learn something useful to apply to their career. At worst they just want to pass the rotation and could care less if they remember anything 1 day after the shelf exam.
• In order to impress the attending, cut-throat measures on the part of students and residents will sometimes be employed. After all, they want good letters for that competitive fellowship or residency.

So in reality, you have three different individuals: Attending, resident, and student. Each wants something different. This in itself defeats the “team” in medicine.

Contrast this with a football or basketball team. The coach wants to win. The players want to win. They pull together to make it happen.

There is no team in medicine. What once might have been a team has transformed into a cut-throat competitive atmosphere where each participant has their own individual goals. Without well-defined universal objectives that apply to each participant as a whole, teamwork cannot and will not exist.

Popularity: 4% [?]