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Why people dislike pre-med students

The top five reasons to dislike pre-med students are listed in a recent Wired article. The most interesting part to me, however, were all the comments generated in the discussion. This was apparently the author's intent:

These are sweeping generalizations that are intended to provoke a heated debate, so try not to get too offended.

Ya think? Why in the world would any former pre-med student (including myself) get offended when we're globally accused of not having intellectual curiosity and running organizations into the ground.

I'm not going to lie and say I never came across pre-med people who fit these characterizations, but I think you could substitute any highly-competitive student here (engineering, law, poli-sci) and get the same result. While I agree that the medical student admissions process is a broken system, being a dilweed isn't something that's unique to those going into the medical profession.

I'd also be remiss if I didn't mention this little gem:

Perhaps, instead of separating the brightest students from the rest, pre-med programs weed out all but the few who are willing to give everything up -- hobbies, athletics, even their curiosity -- for the sake of a high-paying job as a body mechanic.

I've heard that "body mechanic" line quite a few times and every time it's gotten under my skin. Nothing against mechanics, but to simplify the art of medicine like this is just ignorant. I would challenge anyone with this belief to follow a local physician around for a day or two, then let's see you honestly say this.

Days are nights and nights are days

Good thing Julie is around or this place would be all but abandoned...

Peds ER has been it's usual beast and I'm running low on sleep as well as motivated time to actually sit down and write. Just about the only thing I've been up for lately is messing around with my Virb profile and browsing through groups on the site.

As a rotator I've gotten more than my fair share of late night/overnight shifts and as such have reverted back to my old days of staying up all night and sleeping during the day. I've noticed that although the work comes easier than it did back when I was a med student, the hours seem much, much longer. It's been a trip especially since I've also had a delivery already this month and another couple that should go down in the next couple days.

Getting them in and getting them out

Considering that most of my patient encounters last a minimum of 15 minutes and have gone up to over an hour, it's a shock to see how quickly things run at a surgeon's office. The surgeons I've worked with up to this point literally just walk in (sometimes without even closing the door behind them), march straight to the surgical wound/injury, poke around a little bit, say "it looks good" or "I don't like the way this looks," instruct an MA/nurse to schedule a follow-up appointment and then just waltz right out. I've been in on encounters that last less than a minute, and I think the longest one was something like 10 minutes, and that was only because the surgeon had to read some insurance paperwork.

A bumpy EHR road

As I mentioned earlier, we're currently in the process of moving from paper charts to an electronic health record over at the Family Practice Center. We're only two days in, but I'm happy to report that it's actually gone a lot more smoothly than I had expected. What's more important is that it seems like everyone has kept a positive attitude about all of the adjustments we've had to make and all of the unplanned problems we've come across.

Put the paper charts away

Tomorrow the Family Practice Center takes the wraps off of its electronic health record and "goes paperless" for the first time. This has been a long time coming and I'm super excited that we're finally leveraging technology for patient visits. No more lost charts, no more lugging around half broken manilla folders, no more jotting down scribbled notes...it should be great. Not to mention that i'll be able to answer messages and review patient charts from home and refilling medications will be a simple point and click process

I feel for those who are slower with the keyboard than the pen and for those afraid of using computers, but it's time to get with the 21st century. After a few weeks worth of training I think everyone in the office has gotten acquainted with eClinicalWorks and should be fine on day one...barring those inevitable first day mixups. Besides, the real test is going to be how long it takes for us to fully migrate away from the aforementioned paper charts and get all of our templates up and running.

Only one week to go

I'm down to my last week on the ICU service, and it's gonna be a doozy. I received the good fortune of having almost twice the amount of night float shifts as all of the other interns, so this last week will be all graveyard...and I mean that literally as well as figuratively. We have a lot of real real sick patients on the service and it's only a matter of time before several of them break that thin thread holding them stable.

Never in synch

I noticed something today while rounding that I've actually been frustrated about for some time. Why is it that when time is of the essence and I just want to get home on the weekend that my attending decides he wants to make rounds a giant teaching exercise? All during the week when we have plenty of time we do speed rounds and just get through the patients. Then we sit around during the afternoon and mop up miscellaneous work when we could be doing as much learning as we could handle. But no, that's not when the teaching happens. It happens over the weekend when we are understaffed and have to see more patients and really don't want to be in the hospital in the first place. Why can't we ever just be in synch with the attendings on this? I appreciate and really do need the learning, but I know there are plenty of other times it can get done. I'm not going to be the resident that suggests we do speed rounds on the weekend, so it looks like this isn't going to change any time soon.

Recruitment season

You gotta love this time of the year. Senior medical students across the nation have had all of their interviews and are now thinking about how they will rank the programs they've visited. This is where we the residents step in. I've spent the last couple of days writing notes to the applicants I've met and ate dinner with and have been fielding phone calls from those who have last minute questions that they forgot to ask while they were visiting. It's actually pretty fun because I can vividly remember being in the same position all of these students are in. Making your choice of residency program is a very big deal and there are lots of factors to consider. Will I have to move? Will I get along with the people in the program? Will I graduate with the tools I need to practice medicine the way I want to? Is there free cafeteria food? ;-)

Today was the beginning of our second-look weekend, which is basically the time when we try to "seal the deal" with the people who have shown the most interest in our residency program. This morning we hung out and played some tackle football, and I'm already sore (I also managed to squeeze in a couple games of tennis and shoot hoops...we're having great weather around here). I'm off in a few minutes to a swanky hotel where everyone will be enjoying an open bar and then a great dinner. This is just day one, however, because tomorrow morning we are going to be feasting on a breakfast that is legendary for being absolutely delicious. I'm already looking forward to next year...

New routine

I've been trying this new thing the past couple of weeks and I'm really starting to get the hang of it. What I've been doing is printing out journal articles that are relevant to patients I've seen in the office or followed peripherally and then reviewing them, making notes, and filing them away in a drawer at work with labels. If I think about it, this really is something that I should have been doing as part of my job, but for some reason I wasn't motivated before to get it going (yeah, I know that's called laziness). It's shameful to say that all of this was spurned not by my insatiable thirst for knowledge, but rather because I thought it would be cool to have an organized file of a bunch of relevant medical topics. I saw some of my senior residents keep a similar file, and I was drawn to the labeled folder tabs and all of the cool office supplies that I would be able to buy to maintain such a collection.

Life in the family practice center

I spent the past month and will spend the rest of this one in the Family Practice Center. Last month I had my service month, which basically meant that I was taking care of the patients who were admitted by family practice in the hospital wards. The good was that compared to the internal medicine service our patient census was much smaller, the bad was that our patients seemed to be in much worse shape. Whenever an admit came in I could expect the patient to have a multitude of medical health problems and that either one or several of them were uncontrolled. I'm not sure if it's because of the patient population or something that we are doing wrong with our management, but the admissions were either really soft or complete train wrecks.