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LawDoc
Emu Egg
Joined: Jun 19, 2008
Posts: 3
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 Posted: Thu Jun 19, 2008 2:05 am Post subject: Need MD residency program |
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Made it through med school - lectures were fun, clinical rotations a bit rougher. Did well on multiple guess parts of the USMLE, but had to retake the "clinical skills" social-interaction test. Desperate to find a residency program that will give me the chance.
Lost on the '08 match because of backstabbing reference-letter writers and clinical reviewers -- so many MD's (UK MD's are worse than USA ones) do not want to understand anyone different than themselves (like an aspie and/or nondrinker) and way overvalue social niceties.
Will consider any PGY-1 residency in anything - including pathology, surgery, transitional year, internal med, family, etc.
EXCEPT for psychiatry - I agree with one reviewer: "he could not do psychiatry". Yes, too many hard to catch nonverbal cues there. I cant rely on showing technical flaws in delusions!
Anything to avoid another full year waiting for the '09 match and july 09 jobs!
suggestions? |
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BazzaMcKenzie
Wild colonial man
Joined: Aug 22, 2006
Posts: 3702
Location: the Antipodes
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| Posted: Thu Jun 19, 2008 3:37 am Post subject: Re: Need MD residency program |
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no suggestions, but
| LawDoc wrote: | | ... UK MD's are worse than USA ones... |
yeah well that's just like your opinion, dude.
My brother-in-law tells a story about when he was working in hospital casualty in LA - someone came in, in a coma. He looked at the guy and said treat for diabetic coma. All the USA doctors were horrified that he could make a fast dx and prescription without running a battery of tests - thought he was irresponsible and negligent for not doing tests. He said a diabetic coma has a distinctive smell and that was all it could be. Why waste time and money on other tests?
Possibly USA doctors are not the best in the world 
_________________
I just dropped in to see what condition my condition was in.
Strewth!
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LawDoc
Emu Egg
Joined: Jun 19, 2008
Posts: 3
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| Posted: Mon Jun 23, 2008 2:39 am Post subject: UK vs USA Medicine |
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1. By UK docs being worse than US docs, i meant:
In UK, MD's value "fitting in" much more highly than in USA - and will fail you in a rotation if they think you are a bit different.
(yes, the only DSM-4 DX that fits my 'nerd' history is a mild Asperger's, although I had to vigorously deny that to psychiatry preceptors)
2. In UK MD's do rely more on physical diagnosis than on tests. The above comment makes sense. Diabetic coma does often have a slightly fruity 'ketone' smell.
In both countries, though, the standard of care should be that anyone arriving in an emergency room in a coma should get an immediate finger-stick handheld-monitor for blood glucose level, and an IV started immediately.
Finger stick gives results in a minute and is reasonably accurate, with no wait for the lab, and cost of only a dollar.
Glucose low causes coma, and is very common among diabetics who OD on insulin, take insulin then skip meal, etc. Glucose low can kill quick, and has no ketone smell. Treatment - glucose in the IV.
Glucose high can cause dehydration and coma also, this is the typical diabetic coma. Treatment - insulin + lots of normal saline until more complete (electrolytes) lab results come back.
BUT
The UK is so cost conscious (as will be US medicine if Owhammy gets in) that getting tests done can be a serious issue.
For example, consider a 60 year old smoker with personality changes and new onset hallucinations. She even had a little weakness in one hand.
In UK - one must argue with radiologist to get MRI or CT scheduled -- and likely months out. "Not indicated unless other neurological indication like seizures or paralysis"
In USA - run the MRI the next day because most mental illnesses show up at much younger ages.
Had a case like that. In USA on a medical rotation. We did the MRI - followed by a chest CT once the 2 tumors were seen.
Diagnosis == LUNG cancer, metastatic to brain, so could restore some sanity for the patients last months with chemo and radiation. In UK the diagnosis might have been made at autopsy.
3. UK also has rationing by waiting list.
Go to your doc in USA with hernia. He will send you to a surgeon who will confirm diagnosis later that week. You will then have the choice of surgery or waiting and fooling with trusses, and could be operated within 2 weeks of seeing your doc.
In UK - your doc schedules you to see the surgeon, you get appointment (NOT at your convenience or choice of day or time) by MAIL about 6 months out. Then the surgeon confirms the diagnosis and schedules you for surgery -- you get the notice - no choice of day or month - again by MAIL about 6 months out. Then, after you check in to the hospital, you find the operating room has been bumped, and have another delay. OR hernias went on hold to cut costs, since they are only rarely fatal. With luck, your surgery is 15 months from seeing your doc.
4. UK has a parallel private pay system so you can buy your way around some of the rationing-by-waiting-list.
(Yes, I did 12 weeks of surgery rotation in UK) |
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MsTriste
OTS
Joined: Dec 08, 2005
Age: 44
Posts: 3373
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| Posted: Thu Jun 26, 2008 6:10 pm Post subject: |
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If you would consider moving, I recommend Hawaii. There is a critical need for doctors here and only one medical school.
Here's the website: http://jabsom.hawaii.edu/jabsom/
BTW I'm a nurse in a psych hospital and it works great for me. Psych patients (unless they have personality disorders) don't play normal NT games - you take them at face value. I'd rather interact with someone with schizophrenia than an NT any day. |
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spudnik
Ain't I a Stinker
Joined: Feb 20, 2008
Posts: 3775
Location: Calgary, Alberta Canada
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MsTriste
OTS
Joined: Dec 08, 2005
Age: 44
Posts: 3373
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| Posted: Thu Jun 26, 2008 8:57 pm Post subject: Re: Need MD residency program |
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| BazzaMcKenzie wrote: | no suggestions, but
| LawDoc wrote: | | ... UK MD's are worse than USA ones... |
yeah well that's just like your opinion, dude.
My brother-in-law tells a story about when he was working in hospital casualty in LA - someone came in, in a coma. He looked at the guy and said treat for diabetic coma. All the USA doctors were horrified that he could make a fast dx and prescription without running a battery of tests - thought he was irresponsible and negligent for not doing tests. He said a diabetic coma has a distinctive smell and that was all it could be. Why waste time and money on other tests?
Possibly USA doctors are not the best in the world |
Yeah, DKA aka Diabetic Ketoacidosis. I worked in ER and smelled it frequently - I could walk BY a patient's room and know if they had it. Not everybody has the ability to smell it, though, so I was a bit of a celebrity for that. Maybe it's an aspie superpower 
BTW my life has been ruined by a US surgeon and I would happily lynch the majority of them. |
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