Interviewing

There are many irritating things about the interview trail for medicine. You interview for medical school, then four years later you interview for residency, then 3-5 years later for fellowships, and eventually for jobs.

The question most programs seem to ask is "why this program?" I suppose it's a fair question, but they seem to expect some profound answer. Sure, if they have some state of the art something or other that no other program has, it would make sense to expect applicants to know about that and praise them for it. However, most don't. Most programs are the same as most other programs with tiny differences that don't really matter much in the long run. You most likely applied because A. they have a program and B. they are in a desirable location for you.

For some reason location isn't enough. I was at an interview where I answered location, the interviewer looked unimpressed, and then later reworded the question to ask me what specific things I had read or heard about the program made me want to come there. They weren't a stellar program. They were a perfectly adequate program. Would I want to go to their program? Of course! Was there some specific reason that they stood among any other program? No!

Programs in general, and this program in particular, can't even come up with reasons why we should go there. They always brag in their pre-interview powerpoint about how they have lectures, and simulation, and hands on experience! Then you go to the next interview and they tell you about their lectures, and simulation, and hands on experience!

I would love a world where we can cut the crap and the answer "well, you have a spot in a decently desirable geographical location" would be sufficient. But it never will. Let the bullshit continue!

Need to get this blog "off the ground"

I don't post enough. I read blogs fairly often that I love, but I don't post myself. It's too bad really. I have a lot of interesting things that have happened in my life recently. I guess I'm just so busy that I haven't been keeping up with it. I'd like to change that. Right now things are hectic as I am doing a VERY involved Anesthesia/ICU rotation as well as filling out ERAS (to apply for residencies...EEEKK). But the more I get involved in others' blogs and the more I post on my own blog I would really like to become a more solid part of the blogging community. I think it is important.

In other news, I have started volunteering with a Pet Rescue. My hours are minimal now because I don't have the time and although it only involves cleaning the cages where cats are held to hopefully be adopted out, I still feel like I am helping. I would love to do more, however.

I was wondering if there were any way to use my soon to be medical degree to help animals in need. I'm not a veterinarian, but I do have medical experience and there are many similarities between animals and people. That's research for another day.

These things are not the same.

Hello? ...... N-No I'm sorry who are you looking for? Who is this? No I am a psychiatrist not an ophthalmologist. You're IN the hospital? How did you get this number? Well no you need to talk to your medical team in order to call a consult, first of all. Second of all, I'm still a psychiatrist.

Hangs up. Dials another number.

Hello can I please speak to the nurse for Ms. Smith? (pause) Yes hello this is Dr. Psychiatrist and I just received a call from Ms. Smith asking me to see her. She told me you told her to call me and gave her my number. Patients do not call for their own consults. Yes, well although they are both inside the skull they are unrelated. Goodbye.

Hangs up. Looks at us.

Welcome to my life.

So very poor

At the free health clinic:

Doctor: Patient came in the other day with anal pruritis (itchiness). What is it?

Student: Well the only thing I can think of is from pediatrics and it's Enterobius infection.

Doctor: Okay, well if you wanted to test that theory what would you do.

Student: Scotch tape test. Would you do that here in the clinic?

Doctor: No. We don't have any scotch tape here.

Difficult patients

I was working with a doctor who was obviously quite jaded and angry, but rightfully so. I have become more jaded working in the hospital just from the people we have to deal with every day. It's one thing that they aren't compliant and have no desire to help themselves, but it's another thing entirely to then blame the doctors for trying to help them. Nevermind the fact that just trying to illicit a decent history or explain something to them is impossible. Also, being in a spanish heavy area is difficult. Most of them get upset that you don't speak spanish. This particular doctor had no problem saying exactly what was on his mind. I still felt uncomfortable standing next to him as he said it.

Patient: My back hurts so much.
Doctor: I sent you to ortho. They wrote here that you refused physical therapy in the hospital.
Patient: No. They said to me that I had to go to this other hospital for shots in my back and I don't know where that hospital is and they don't take my free health care there.
Doctor: I'm reading the note right now from the ortho doctor. It says that you refused to go to the physical therapy right here in the hospital.
Patient: No I did not.
Doctor: Okay. Fine. We will just assume ortho is lying then. You will go to physical therapy?
Patient: Yeah, ok. What did my MRI show? My back hurts so much.
Doctor: It showed some minor arthritis in your spine that I would expect any 70 year old to have.
Patient: But it hurts so bad! You don't know what this pain is like!

After the doctor told me that he gets upset when patients tell him he doesn't know what the pain is like. Who are they do assume he hasn't felt pain?

(Through a spanish translator)
Patient: I need a referral for ophthalmology.
Doctor: I gave you a referral last time you were here, you made an appointment, and you didn't show up.
Patient: No no no. I called and called and called and they never picked up the phone.
Doctor: That isn't the issue. What I'm telling you is that you had an appointment and you didn't go to it.
Patient: No. I called and called and called. Finally someone picked up the phone and I tried to speak a little english, but they didn't speak spanish and that is not my problem.
Doctor: First of all, you didn't need to call anyone. All you needed to do was show up to your appointment and you did not do that. Second of all, them not speaking spanish and you not speaking english is not their problem, it is your problem. How long have you been in this country?
Patient: 20 years
Doctor: Twenty years?! And you haven't learned any english?? Where are you from?
Patient: Peru
Doctor: If I went to Peru, I would learn Spanish.

These conversations are not unique. The way this particular doctor dealt with it is, but a lot of patients feel entitled. It's difficult not to be hostile when you are being attacked or getting false information or being lied to. Doctors are only human also.

Friday

Chief resident: Ok residents, now that we have just presented the case, any idea what this is? 

(Silence)

Chief resident: Anyone? Any ideas at all? 

(Silence)

Chief resident: Is this some sort of revolt against me? 

(Silence)

Resident: What was the summary again?

Gonna have to be more descriptive than that

Daughter: She is having pain in the front and the back.

Me:  Can she point with one finger where the pain is on her front?

(Daughter and mother exchange looks)

Daughter: She went to the ladies' room and it hurt her.

Me: Ah, so she is having pain when she goes to the bathroom?

Daughter: Yes. In both the front and the back.

Me: Ok, so when did she start having pain with urination?

Daughter: Oh dear! We don't use that kind of language!