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Arztin

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About Arztin

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  1. Yes, there are people who did it just because they had the grades and weren't really passionate about it. Among those people, some people who left at some point during their training. I saw some really unhappy people, both trainees and attendings. There was a story of an attending who hated his job, but kept doing it because of the money. Sure there are perks, but don't ignore the drawbacks. Keep in mind that the training is pretty intense. You need to drink from a fire hose during preclerkship, and the hours aren't always great during clinical training afterwards. It's also a huge time investment. Many people do 5 yrs of residency + 2 years of training as a fellow afterwards. IMO, it's pretty long. All that to potentially not be able to work where you want. I've seen multiple people break up with their partner during training. I think I've seen all my close friends at some point burn out during their training. Then there are the odd things that you wouldn't do or see in most other fields unless if you are a cop or a firefighter. For example, last week I had to tell a patient and her son that she was going to die within a few hours and there wasn't anything we could do to cure her disease. She wasn't ready to die. Unfortuately, she indeed died 2 hours later. Those aren't easy discussions. At this point, I totally lost count of the number of patients I've seen die. Then there are things that you hear or see that are quite traumatizing, for example, children getting abused etc... I'm personally happy about my choice. I've worked really hard the last few years, and I'm lucky to have a position where I want, with the type of practice that I wanted. Fortunately I'm still passionate about medicine and I love what I do. All that to say: you better be passionate about medicine if you want to pursue this field. If not, do something else.
  2. If you have no passion for medicine, don't do it. Why endure so many years of gruesome training if you hate what you are doing?
  3. Hey there, you only started clerkship. As others have already mentioned, it gets better. Trust me, it really does. It's normal to discover that you dislike something and actually really like something else. Give yourself some time. You might fall in love with a field that you thought you'd hate within a few months. Also, it's perfectly OK to not like internal medicine. It doesn't mean you don't fit in medicine because of that. Many people aren't fond of CTU internal medicine. Keep in mind that academic centers are quite different from community settings. Also, pretty much any med student feels '''stupid'' during their first few months of clerkship. It's perfectly normal. You don't even know how a hospital works, and you keep changing services, and now as a junior clerkship student, you get to see super complex patients with multiple comorbidities on your IM rotation. It's normal to feel overwhelmed. Even junior residents are often overwhelmed on those services. All I'm saying is: you are not stupid, and you are not incompetent. It's normal to feel that way, but remember: you aren't incompetent. I'm sorry you had to deal with someone like that, but just like in every field, you will unfortunately, and inevitably, have to deal with the occasional annoying pedantic micromanaging supervisor. And yes they will waste your time telling you how you should leave a space here and there in your notes, instead of helping you to improve your clinical skills. Remember, your interaction with that person is only temporary. These people aren't easy to work with. Smile, do as you are told and you will do just fine. Remember, it gets better.
  4. Hey there. There is no perfect answer for this. Medical training is harsh enough, and stressful enough. If you impose yourself a super strict budget, you will be even more stressed out. Obviously, nobody's in the same situation but do consider the following: How much are you comfortable with debt? What kind of spender are you? - How much debt do you have at the beginning of med school? Do you have any sort of assistance? Also, remember your electives and interviews in your final year will be pretty expensive. As 1D7 said, do think about what happens after clerkship and residency. Having 300k of debt can itself be very stressful too. I've seen people rent super expensive apartments in med school + going out all the time + using their LoC for travelling multiple times per year. Do they think it was worth it? I don't know but I certainly hope they have no regrets. In my opinion, it's important to make yourself comfortable during training. As I said above, training itself is stressful enough. Imposing yourself an extra artificial stress is not worth it. I had more or less the same mentality starting med school, and quite honestly: no regrets. I bought a brand new sedan for clerkship, and I'm happy I did. I probably spent a few thousand dollars in hobbies, and again, no regrets. If I was extremely frugal, I could have probably saved a few tens of thousands of dollars, but I would be regretting by now. Use your money to take care of yourself: buy quality food, get a comfortable bed, spend your money on some sort of physical activity. You should not be saving money on these things. For the rest, spend wisely. It's OK to order food when you have exams, but eating out every day because you are too lazy to cook is probably not good for your wallet (nor for your health). It's OK to spend on hobbies, but don't spend your money on everything (e.g. travelling + expensive clothes + hobbies + newest iphone and Macbook pro and apple watch + expensive restaurants + table service at the club). It's OK to buy a new car, but spending 80 K on a Tesla when you start med school is probably not a good idea. It's OK to spend money and going out with your med school buddies, and to make friends. But spending 50 dollars for a cab on your way home every week instead of taking the bus is probably unwise. Finally do realize that physicians are notoriously awful at managing their money. Learn to not become one of those. No you certainly don't. A lot of people just want to make their lives easier.
  5. the Tintinalli paeds chapters are fairly basic and easy to read. If you can, read them all. You should know more than enough after that.
  6. first off, congrats. Congrats for being accepted. Congrats for representing diversity, esp. since you are from a less traditional socioeconomic background. You did it. You deserve it. You fit right in. Don't doubt yourself. You will be juuuust fine Enjoy your summer.
  7. Hey there I would say that a lot of what you said is partially true. It's true that managing chronic conditions might seem boring. However, that can be a very good sign. e.g. your diabetic and hypertensive patient has never been admitted to the hospital for a massive STEMI since his diabetes and hypertension are well managed ? Well that's certainly a good sign. Plus you managed to help them quit smoking? even better! The bread and butter of most fields is repetitive. The nephrologist who follows CKD, well there aren't any magical therapy in that regard. The cardiologist who follows the vasovagal syncope patient who has 20 syncopes per week? Not sure they have magical treatments in that regard neither. The ophthalmologist doing the 20th cataract surgery the same day? Not sure what they like about that. Family medicine isn't the only place where you will see patients who won't be grateful, or non compliant patients. Emerg physicians get unpleasant, verbally abusive patients all the time. As a hospitalist, you might be admitting the same patient the 5th time this year for DKA because they refuse to take their insulin as prescribed. As a psychiatrist, you might get the psychotic patient who stopped taking their medications, and now readmitted for psychosis once more. As a vascular surgeon, you might see the critical limb ischaemia patient who kept smoking, and now you have no choice but to perform a limb amputation. As a respirologist, you might get the 120 pack-year end stage COPD patient who still smokes 2 packs a day. As a transplant surgeon, you might get a liver transplant patient who restarted drinking, and now cirrhotic again. Trust me, non compliance is not just in family medicine. Now consider the following: FM = true generalist. You know a bit of everything. The internists will manage complex medical conditions much better than you, but you know how to repair a laceration much better than the internist. The orthopod will know MSK much better than you, but you know how to manage medical conditions better than the orthopod etc... Flexibility and mobility: It's not something you can get with most specialties. You can do palliative care, rural medicine, hospital medicine, emerg, etc... Long-term relations with patients: as the main physician following your patients for 20 years, you will get to know them, and most patients will appreciate you for your job. Contrast this with the orthopedic surgeon who in 1 day saw 50 patients in their fracture clinics. Variety: something you won't get with most other specialties When it comes to your job satisfaction, it really depends on how you perceive things. Some derive it from the work-life balance they get from FM, others from the impact they have on patients, some from the bonds they form with their patients etc... Anyways, it's getting late. I'm out. Don't rule out family medicine just yet. It has a lot to offer! Feel free to PM me if you have questions!
  8. Yeah this is important guys. One of the last worry-free summers ever. Enjoy it. Don't think about the material, courses etc... You'll have to think about it often enough when the school year starts.
  9. 1- It depends where you work. Areas where there aren't enough family docs will more often have this problem. To name a few, people do show up for prescription refills, chronic things for which the ED isn't the place, for severe undertreated hypertension, and really benign stuff sometimes like a wart on their foot. Yes people do show up with chronic pain, including chronic back pain. Yes there are healthy 20 year old adults who go to the ED when they have a common cold. Variety-wise I totally disagree. There isn't a place where you will see presentations as varied as in the ED. You never know what will happen during the shift. There isn't a place where you can see a paeds status epilepticus, then a STEMI, then a shoulder dislocation, then a major trauma, then a septic patient, then a diverticulitis, then a schizophrenic patient, all that in one single shift. On the fast track side, in one shift you can see a big hand laceration for which do a ultrasound guided nerve block, a retinal detachment, a corneal foreign body, a fishing hook stuck, and a patient who had a shoulder patient who was actually having a STEMI all in one shift. Acuity-wise, it depends on the days and where you work. If you work in a low volume center, you will see less high-acuity patients. But in a high volume center, if you are covering the high-acuity area and resusc, you will pretty much always see at least one very sick patient during your shift. 2- It depends where you work. In many large academic hospitals, with all the consultants and the residents available, emerg will often ask the initial labs and consult right away. When you are outside these hospitals, consultants typically only see patients during the day, unless if they need an immediate intervention. From 4 pm to the 8 AM next day, you are actively managing patients. It's up to you if you want to ask for urine lytes if you want to figure out why your patient is in hyponatremia and why they have metabolic alkalosis before consulting the admitting service (although emerg physicians typically don't do this). Obviously, emerg is the place to stabilize and to initiate the treatment - It is not a hospital ward for patients to stay. Eventually if a patient needs to go to the OR, then surgery will need to take over anyways. If a patient needs to be admitted by a medical service, then that will happen. For example, finding brain mets on a guy who seized in the ED means this patient will need to see a consultant regardless. However, a patient who comes with an asthma exacerbation that doesn't need to be admitted ? Emerg will treat it and let the patient go. A shoulder or a wrist got dislocated? They will reduce it and have the patient seen shortly by ortho on an outpatient basis. A patient comes with hypertention undiagnosed but not in hypertensive crisis? The emerg will start a PO medication and have them seen by their family doctor after. (although this should have been managed by their family doctor) As you can see it all depends. I would suggest you to go shadow when it's possible. Hope it helps.
  10. Non tu ne peux pas. Le curriculum est fait tel que tel. Les stages ne peuvent pas être raccourcis.
  11. Family doctors are doing all sort of things right now. Many do ER. Many manage patients in nursing homes. Telehealth is actually very important. Many anxious patients are decompensating. Also, being able to talk to your patients will prevent ED visits. Then, there are the hospitalists doing COVID units as well. Some do COVID clinics / COVID screening clinics. There are also people doing public health.
  12. Good luck everyone! Also, stay home!!!!
  13. Yeah. Fair enough. It's just that working a few months and having to restudy is kind of a bummer. Some guidelines will have changed. Some people will be in a different environment. The annoying part is mainly this: you went from exam knowledge learning mode to practical knowledge learning mode, and now re switch to exam learning mode, and have to cram a bunch of things that will probably be useless in your practice, especially because the fact that we will be thrown in an unfamiliar environment, and having to learn on the spot new practical knowledge. e.g. being thrown in the ICU, or the ED for people not familiar with those. The CFPC said they want to hold the exams in October. Nothing is certain for now. We don't know yet how bad things can get. The worst case scenario would be a terrible one. But quite frankly, timing of RC or CCFP exams, and having to restudy, and having problems with licensing are truly first world problems. There will be many people who will have lost their jobs, with many small business owners going bankrupt.
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