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Fresh fry

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  1. Like
    Fresh fry got a reaction from benelli104 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  2. Like
    Fresh fry got a reaction from apple94 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  3. Like
    Fresh fry got a reaction from Snowmen in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  4. Like
    Fresh fry got a reaction from Neural_Ark in Future Of Surgery   
    Preface: I can speak on my province and my specialty but how generaliazable that is, I have no idea. I also like making up words apparently.
     
     
    This is the major detractor for many people looking at surgical specialties; your livelihood and your ability to set your own schedule and pace are not completely in your control. OR time is an almost an absolute necessity to be a surgeon. I say almost because I am aware of a few people, in a few odd situations, who are trained surgeons who do not actually operate. These situations are definitely not the rule and probably only encompass at most 5% of trained surgeons. They also tend to be closer to the end on the retirement spectrum and are from subspecialties where they can rely on niche aspects of their profession. Examples include:
     
    Gen surgeon who strictly does ICU
    Gen surgeon who does trauma coordinator
    O&Gs who has given up gyne and only does obs
    Uro and ENT who only do outpatient (scoping) and refer surgical patients to their partners
    Various who work as assists (almost 100% people who are retiring/semi-retired)
     
    Most people who go on to become surgeons absolutely intend to operate and to be able to maintain your skills and be able to afford to be part of a practice you generally need 4-5 OR days a month (obviously variable). So a graduating surgeon, who probably owes a couple hundred grand, needs to find what we essentially call a "job" but the reality is much more complicated.
     
    1st hurdle is location and career stream. Like other aspects of medicine surgery is broken down into academic and community designations. Academics work in what we call the "ivory tower", medical school or university affiliated centers. These are big centers that offer a wide spectrum of care and for most specialties if you want to work as an academic surgeon you need a lot more training and to fill a required niche (last time I will use the word "niche" I promise). This can be surgeon-educator, surgeon-scientist, or specialist-surgeon. These are your PhDs or people with high end fellowships that bring something unique to the center. OR time is usually divided up by the academic center but the total ammount available is dependent on the province. 
     
    Aside: To put a rumor to rest it is not about the amount of physical ORs or space. Many large centers have multiple unused ORs and only operate them at a limited capacity. Building one is usually not an issue either. The hold up is always 1) operating and staffing costs 2) post op bed numbers. 
     
    Physicians are fee for service but nurses/housekeeping/techs certainly are not. The province pays these people's salary and they pay to maintain, equip, and staff the ORs. Each OR runs at a staggering operating cost per suite and it is always humbling to walk into one knowing that a measurable proportion of our country's GDP is being spent in this one room on a yearly basis. Surgical beds also cost. I have heard many different figures but it is almost certainly in the low thousands of dollars per day per bed. Each surgical bed requires staffing and equipment costs too which all get factored in. The surgeon pays for none of this and it is all provided contractually for them providing a service to the community/province. They are, without blowing up their heads even more, a community resource because they posses a capability to perform a service no one else in the community can. A surgeon is a living breathing angry and bitter MRI machine with legs in one sense.
     
    One of the ways provinces/regions control health care costs is OR time. It is a massive part of the budget and is easily controlled by allocation of resources and time. 
     
    In short: the ORs are there, there is no shortage of trained people to keep them going or surgeons to operate, the restriction is in the funding department.
     
    Back to surgeon types. A community surgeon is someone with a much broader scope of practice. They will work in community hospitals and will provide a base level of capabilities that is usually dictated by their respective colleges. They tend to be the work-a-day type of surgeons and do the bulk of the more common operations. Community Gen surge will do appy's, choley's, maybe some basic bowel work, but the transplants and heavy oncology stuff is all going to the big academic centers. Same goes in most specialties. Community surgeons are the generalists doing the general things that there is a high demand for. To get one of these "jobs" you need OR time and to either make or join a practice.
     
    As a rule almost no surgeons go solo they all join a practice. A practice means you can pool resources and more importantly: call. As part of a service a surgeon provides a community they are expected to provide a certain amount of call and support to the community site. They ma have to sit on a board or be available to perform a certain required service. Having never negotiated a contract I am not entirely sure how this works but from what I do understand you basically need to find a community that can support the surgeon with OR time and patient catchment that has an open space or retiring surgeon already filling that role.
     
    Think of it like this: OR time is like farm land, there is only so much of it and all of it is essentially spoken for. If you want to be a farmer you can take over for someone who is retiring, find someone who is farming and wants to subdivide their land and share it with you, or find some land no one is farming and set up shop. As a rule the first analogy generally applies to academic centers where OR time is tightly regulated and most services are well covered with a waiting list of potential previous surgical graduates waiting on the periphery to pounce on any openings. In my program the people who are retiring have essentially selected their replacements who are undergoing fellowships the practice has pretty much dictated to them to fill the requirements of the center. These people have traded about 95% of their decision making for an academic job with security but will be set for life. This is just becoming the reality of academic surgery. Big centers will need oncology, transplant, and other specialists. These roles have been filled and you need to project many years out to find a gap to fill and then shape your career path toward that end. 
     
    Community surgery is much more like the second and third analogies. As smaller centers grow they pick up capabilities and their populace demands better access to services so more surgeons get hired on to provide a new capability or help someone who has been doing it at a limited capacity on their own. The downsides to this is it is very difficult to forecast, the centers are smaller meaning you will have limited support, no residents, and a heavier call burden. You will also not have much choice as to where you live as you basically take a job wherever you can. OR time is usually controlled by a board and you negotiate your access before setting up shop.
     
     
    There is obviously more to it than this but this is a general overview. I would say to anyone looking at anything in medicine "get away from your med school and see how they do things in the community". Most of us don't end up working in big centers and you tend to get blinded in med school to a very limited way of how we do things. There is a whole world outside of academics that is worth seeing and knowing about to help you with your career choices. 
     
    GL
  5. Like
    Fresh fry got a reaction from lachouette in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  6. Like
    Fresh fry got a reaction from DentalDayum in Alberta physician refuses to prescibe birth control   
    1) Your first argument comparing prescribing OBC to performing a bronchoscopy is crap because everyone who graduates their fourth/third year of medicine is qualified to prescribe OBC. It is not a specialist procedure or an obscure set of medications, it is basic primary care. Not wanting to prescribe it is not the same things as not being able to.
     
    2) This is not about "mushy" or "entitled" patients wants, this is about access to primary care which women's health is a big part of. If you ever slime your way into medical school you will learn that OBC is used for many non-prophylactic conditions. This "physician" is taking over the role of a real doctor who prescribes OBC she has a patient relationship in the same way that everyone who comes to emerge to see an emerge doc does. There is a set of basic services that are essential to primary medicine of which this is one despite what your personal stone aged opinion on the matter may be. The patients have gone to see her with the understanding that she is able to provide this service only to find that she does not when it is too late to make alternate arrangements. If she had sent out a letter to every patient in the practice beforehand stating that she would not provide this service then your argument might hold some water. You can always tell when people has never had a real job or lived in the real world because they are so quick to cast of other peoples real problems like not having the ability to get more time off work.
     
    3) Every physician is qualified to prescribe OBC. So you don't look like a total moron next time look up the word draconian.
     
    4) Most of the people here have taken logic at some point in their education so trying to use some buzzwords and mashing them in with right wing newspeak like "political correct" and "feminism" just makes you look even that more ridiculous. When euthanasia becomes legal here it will be provided by specialists as well, refer back to point 1.
     
    OBC is a necessary and essential tool in basic primary care, that is a fact and not an opinion, and especially one that is fit to be challenged by some ignorant premed. Women's health is a major part of primary practice and if this charlatan had a moral objection to it then perhaps she should have chosen a different career path. With any luck she will be forced to soon anyway.
  7. Like
    Fresh fry got a reaction from fakedocpizzaface in Content Vs Presentaiton Of Answer   
    Kramer always says "you don't sell the steak, you sell the sizzle". But then again he did get fired from a job he didn't even work at.
  8. Like
    Fresh fry got a reaction from Butterfly_ in Why U Of A Med?   
    I don't want to get into a whole thing here suffice it to say that the kind of people who can pull off a 4.0 while volunteering and engaging in multiple ECs have certain personality traits that sometimes don't correlate well to turning off the competition switch even when there is no incentive (not everyone of course but stereotypes exist for a reason).
     
    The pass/fail system is great and definitely makes med school palatable but there is still tons of competition. At the U of A the community clerkship spots are highly coveted because of the hands on opportunities (and subsequently the quality of the reference letters that can be obtained) provided. There are only 20 spots and usually 40 serious applicants. There is competition for club leadership (CV building) and sometimes it can be down right cut-throat. The year I was applying for leadership of the emergency medicine club there were 20 people interested in 3 positions. Then there is just the ordinary everyday run of the mill social status and class politics that permeates everything. Medical school is like a repeat of high school with the same playground prison complex, the nonstop fashion show, and the relentless competition to determine who is the smartest person in the room. I personally hated high school the first time around, having to repeat it with a collection of some of the most socially inept and emotionally stunted helicopter parented children has been soul crushing. Can't recall which class it is, either the 2017s or 2018s, but they were pushing the professionalism button (anonymous electronic professionalism complaint)  on each other so much the faculty seriously considered scrapping the whole thing. They were ratting each other out for the most minor of offences. 4 years is a long time to have to play nice with the gestapo; seriously its like a never ending north korean birthday party.
     
    U of C on the other hand has an average age of 26-27, has a pile of PhD and masters peeps, and is known as a laid back group with some variation from year to year.  
     
    You would think that none of this matters and that you are only there for the education, and yes social involvement is on a sliding scale but it cannot be avoided altogether. You still end up spending 6-8 hours a day with your class preclerk and significantly more time with a select group during clerkship.
     
    The pass/fail thing only matters for preclerk as well. As soon as clerkship starts its back to game on. Then the amount you engage (and are engaged) in competition comes down to what residency you want and how vocal you are about getting it. I know of many people who wanted competitive specialties who kept it quiet until the CaRMS tour because they didn't want the target on their back. Two people who got emerge last year surprised everyone because they kept it to themselves so well to avoid the emerge war. If you want general pathology and no one considers you much of a threat then this is all moot but if you are an optho or anesthesia gunner and look good on paper then you are standing in between someone and their dreams. Determined and driven people usually get want they want. Determined, driven, and amoral never fail.
     
    This is all my own personal opinion, and comes after 5 years (sickness not failure, this is not a vendetta just run of the mill jadedness) of slogging through this so don't take it as fact. The U of A is a great school in many respects but so is the U of C and so is Queens and almost everywhere in Canada. If I could offer any advice on how I would chose it would be with an eye on what and where you want to do residency because then it matters. If you want to do urology then U of C is not for you. They have no program of their own and only match usually 1 person a year. If you want cardiac surgery then U of A is great because they have a program and it's notoriously brutal meaning that no want wants it, meaning you could slide into with home field advantage. If you just want family medicine then go to Queens, they have an excellent family program and a nice small cohesive class. Calgary's family medicine program on the other hand is probably the worst in the country or fighting hard for the honor. Just my two cents. GL
  9. Like
    Fresh fry got a reaction from j17f in Content Vs Presentaiton Of Answer   
    Kramer always says "you don't sell the steak, you sell the sizzle". But then again he did get fired from a job he didn't even work at.
  10. Like
    Fresh fry got a reaction from MDLaval in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  11. Like
    Fresh fry got a reaction from 1D7 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Med students often look at residents or preceptors and wonder how they got so jaded then they tell themselves that "that will never be me, I will never cut off a patient, or use big words, or make a joke at the patients expense". The thing is everyone comes into this a reasonably good person with mostly solid motives; we all want to be "good doctors", do the right thing. The sad thing is that after a year or two of 1/4 call, where your worth as a person is determined by how quickly and efficiently you can keep the system moving, all of that goes out the window. It is a broken system that makes broken doctors. Of course it is program dependent. Psych residents work chill hours with preceptors whose billing is based on hour long chunks of time, O&G residents are on the other end of that spectrum and are literally sleep deprived all of the time while being expected to catch the next baby or do the next assessment. In hard core surgical specialties residents get treated like crap and any praise (or lack of discipline) comes from doing as much as their preceptors work as possible. Dictate, round, operate, admit, go go go. Of course med students get a small taste of this as they are coming through. All of this patient centered stuff takes time, which is the one thing that is always in demand. 
     
    The day you realize you have no choice but do the wrong thing because there just isn't enough time not to, or that you prioritize not getting yelled at over a patient's praise, is the day you will understand where your friends are now.
  12. Like
    Fresh fry got a reaction from Intermediate in -   
    It is very difficult to be objective about these things and you have no idea what they are looking for in some situations. Unless you tripped coming through the door and told the interviewer that you are prejudice against all races, it probably didn't go as bad as it did in your head.
     
    I thought I blew my interview in Calgary (many years ago). They asked us to interpret a painting and I totally missed the point, There were other stations that I thought I did poorly on too but in the end they accepted me (went to a different school).
     
    Here is the crappy part: there is nothing you can do now to change anything, you have to do what all of us have done before you and try your best to get through the next couple months without driving yourself crazy and second guessing yourself. It's done, it's over, you did your best at the time I'm sure. Take a deep breath and we can chat more if your fears are confirmed.
  13. Like
    Fresh fry got a reaction from aquanaut in I Want The Ivy League   
    Correcting someone's English on an online post is usually the height of bad manners, especially when I only speak one language. 
     
    Please know that I did not spend 15 minutes of my time doing this to make fun of you or make you feel bad. I did it to illustrate a point. If you are serious about applying to an Ivy League school for medical education I would say your biggest barrier, and the first you would have to overcome at this point, is your written English. I would highly consider attending an English university and start writing and speaking with native English speakers as much as possible. 
     
    As you are aware your GPA needs to be consistently at a 4.0 level and fortunately I don't think they will even look at your Moroccan marks. As someone else has mentioned a strong MCAT is also required and a large portion of that is the verbal section which is also in English.
     
    I am not here to shoot down your dreams, only to help you achieve them. I wouldn't say that this is impossible but if you succeed it would probably be worthy of a TV movie. GL 
  14. Like
    Fresh fry got a reaction from distressedpremed in Having Some Second Thoughts About Medicine Due To "better" Options Elsewhere?   
    This will sound cliched but it is something I have found to be absolutely true: if there is something you love as much, or more, than medicine (and especially surgery) -> do that. The only way to get through this is the knowledge that there is nothing else. No word of a lie I have thought about bailing on this every single day for things like being a janitor or collecting bottles, i couldn't imagine if there was something else I was talented at that paid reasonably that I could switch too. Most of the times these are just passing thoughts, other times they are seriously alluring. This isn't a "job" it is not  a"career" it is something much more (not to pump it up and sound all douchy) and at 0300 in the morning on your 7th night on call in 3 weeks when you have to go see the whiny hernia lady who's husband is an obnoxious prick and insists that you reassure him that she isn't in adrenal fatigue, you may just walk out the door and head home if this isn't the only thing you want to do.
     
    GL   
  15. Like
    Fresh fry got a reaction from Intermediate in 24 Yrs Old, Continue 2Nd Ug Or Work?   
    I am a resident. I started undergrad at age 28, med at 31 and I have thrown everything I have at this, sacrificed my family's happiness, and have many more years to go before I am anywhere near a stable staff job.
     
    On most days I would trade this for 70 grand a year and no debt in a stable 9-5 provided I didn't treated like complete crap and I got to use my brain for at least 15 minutes a day. Every now and then though I see or do something that no other person on the planet gets to do and I am filled with awe and would gladly sacrifice it all all over again.
     
    I can't tell you it will be ok if it doesn't work out because i don't know the answer myself. What I do know, or rather the reason I don't quit on those days when everything totally sucks is because as cliched as this sounds; you only get one turn at this game and for some people not aiming for the top spot is the ultimate betrayal to oneself.    
     
    I think if you are asking strangers on a website what will make you happy you have someone you need to get better acquainted with and I would do that before i made any life decisions. 
     
    GL
  16. Like
    Fresh fry got a reaction from lulu95 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  17. Like
    Fresh fry got a reaction from trimethoprim in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  18. Like
    Fresh fry got a reaction from luciferase in Pre-med Frequently Asked Questions   
    This is one of the best things I've read on here in a while. Its a hard road, keep expectations reasonable and remember you are only human, all you can do is your best. GL
  19. Like
    Fresh fry got a reaction from Melly731 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Absolutely not. People are bastard coated bastards with bastard filling. 
     
    If you ever find a happy resident find out who their dealer is.
  20. Like
    Fresh fry got a reaction from kol26 in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Yup, except the family part. I wish I could do it but it makes me miserable. Can't stand the Doc McStuffins crap, the same people with the same problems, fixing insulin for people who won't exercise, tweaking inhalers, beta blockers, coumadin. Screening, oh god I hate screening. Not having enough time to do a good job. Glad there are good people out there that can do it but I would kill for a short residency in something I could do.
     
    This is definitely not my last career, pay the bills, stack some cash, then maybe switch out to working in the stock room at walmart where I never have to see another human again.
  21. Like
    Fresh fry got a reaction from mdjdot in What To Wear On Interview Day?   
    girl clothes 
  22. Like
    Fresh fry got a reaction from goleafsgochris in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Yup, except the family part. I wish I could do it but it makes me miserable. Can't stand the Doc McStuffins crap, the same people with the same problems, fixing insulin for people who won't exercise, tweaking inhalers, beta blockers, coumadin. Screening, oh god I hate screening. Not having enough time to do a good job. Glad there are good people out there that can do it but I would kill for a short residency in something I could do.
     
    This is definitely not my last career, pay the bills, stack some cash, then maybe switch out to working in the stock room at walmart where I never have to see another human again.
  23. Like
    Fresh fry got a reaction from Friendly Magpie in -   
    It is very difficult to be objective about these things and you have no idea what they are looking for in some situations. Unless you tripped coming through the door and told the interviewer that you are prejudice against all races, it probably didn't go as bad as it did in your head.
     
    I thought I blew my interview in Calgary (many years ago). They asked us to interpret a painting and I totally missed the point, There were other stations that I thought I did poorly on too but in the end they accepted me (went to a different school).
     
    Here is the crappy part: there is nothing you can do now to change anything, you have to do what all of us have done before you and try your best to get through the next couple months without driving yourself crazy and second guessing yourself. It's done, it's over, you did your best at the time I'm sure. Take a deep breath and we can chat more if your fears are confirmed.
  24. Like
    Fresh fry got a reaction from MT_93 in Do You Regret Doing Medicine Over Dentistry?   
    In a rough patch so not capable of an objective answer (if such a thing is ever possible). Never considered dent and not particularly suited for it. Never want to have to base care on a patients ability to pay eg: pulling teeth because it's cheaper than the alternatives. 
     
    This week though I would give anything to pick another career, perhaps a non-surgical specialty, but something not involving medicine altogether is more appealing. 
     
    Things that are getting to me is: 1) the broken system 2) a backwards culture towards education 3) no time for anything except work and studying.
     
    I'm sure it will pass and there have been times where this has been the best thing that has ever happened to me. I don't think anything worth having comes without struggles and sacrifice, just not sure where the line is.
  25. Like
    Fresh fry got a reaction from JohnGrisham in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?   
    Yup, except the family part. I wish I could do it but it makes me miserable. Can't stand the Doc McStuffins crap, the same people with the same problems, fixing insulin for people who won't exercise, tweaking inhalers, beta blockers, coumadin. Screening, oh god I hate screening. Not having enough time to do a good job. Glad there are good people out there that can do it but I would kill for a short residency in something I could do.
     
    This is definitely not my last career, pay the bills, stack some cash, then maybe switch out to working in the stock room at walmart where I never have to see another human again.
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