JPINFV

2 quick questions... 1. Can I substitute a diet coke for tea? 2. Is it only attendings that get tea brought to them, or can residents get in on this too? [and no, before someone gets all outragy against me, I have 2 good legs and can fetch my own darn caffeine goodness]

Oh, the type of course I was thinking of was a survey course. So a survey course of chemistry that includes general, biochem, and organic chemistry counts for nothing in the med school game.

Also, a lot of nursing programs use either a "chemistry for health care professions" or a shorter summary course (the technical name eludes me at the moment for this type of course) instead of the general chemistry for science majors type course. You need to take the chemistry (and physics and biology courses) designed for science majors, or you'll likely not get credit when it comes to apply for med school.

While I'm sure there's a rare person who has worked full time during the first and second years, the answer is largely "no" and definitely not during the 3rd and 4th years. While lecture attendance is variable from "everyone is required to go to lecture" to "most people watch at home and spend "lecture time" as self directed study," everyone understands the information they're responsible for. Furthermore, during rotations (3rd and 4th year), it's hardly unheard of to spend 60-80+ hours a week at the hospital (especially surgery and inpatient medicine rotations... outpatient rotations tend to be kinder hour wise). I routinely had 30 hour shifts as a student during surgery and medicine rotations. This doesn't include time outside of the hospital studying for Step 2 (a large factor in residency applications), shelf exams (standardized tests in what ever field you're rotating in that normally is a part of your grade), and traveling for interviews for residency during 4th year. Oh, and no attending or resident is going to care that the 3rd year med student has to go to work. You're job is medical school, and if you decide not to show up, no one is going to think twice about failing you from your rotation. If you're smart enough to get into a US medical school (MD or DO), then the actual fail out rate is under 10%. You've got an excellent chance at making it out in 4 years like everyone else, and those that don't generally only end up repeating a year. Very few people actually fail out. Now the Caribbean schools are a whole other situation. Unless you want to go into primary care in an under served area or want to go to the military, then there's no such thing as a "free" medical education. Also calling those options "free" understates the downside of those options when looking at them only because it makes medical school "free." DOs get a little extra training in muscular skeletal issues using a historical set of treatments that range from deranged (cranial, Chapmans points, etc) to evidence based (osteopathic manipulative medicine for low back pain is equivalent to traditional medical treatments). Some fields will be easier to get into, some a little harder, but it's largely a push. Additionally, at this time there are separate residency programs only open to DOs, while DOs are allowed into MD residences (granted some bias and discrimination still occurs), however the residency systems are currently being merged into a single unified system. By and large, unless the extra training really interests you, the general consensus in terms of schooling is MD > DO >>>> foreign. Now outside of school and residency, no one cares and the options after residency is essentially the same. No. Even the schools like LECOM that have a more independent study option ("directed study program") still requires their independent study students to be on campus for certain courses and laboratories. That also doesn't apply to 3rd and 4th year. Additionally, all residencies start sometime near the end of June to July 1st with July 1st being the traditional start time. Furthermore, that doesn't include orientation that normally begins a week or two before the official start date. You're still paid for orientation, but it's not really the "start date" that most people think of when it comes to starting residency.

Are we talking in the sense of a first aid "recovery position" type thing? No. Assuming appropriate fluid resuscitation has been done (or else they technically aren't in septic shock), then they need a central line and vasopressors. If you're talking about rolling someone with an ET tube and mechanical ventilation, then you also have to consider the risk of dislodging the ET tube.

Well, there's a couple rules that residents learn very quickly. 1. Making the service run smoothly is more important than responding to slights (real or perceived) from nursing. 2. Every resident has heard stories about the nurses who take delight in paging residents at 2am over nonsense due to prior slights (real or perceived). As a side note, shouldn't this qualify as bulling as well? 3. Some of it may be unintentional due to CHARTING CONVENTIONS (Why do nurses always yell into their EMR? Caps lock... turn it off) or regular use of phrases that have negative connotations (there's a certain light in satire. For those who think that's an over reaction to "no orders given" I've had to calm down a charge nurse because another intern documented "RN heard murmur, but I didn't appreciate it [the murmur]" on a newborn exam in order to justify the spot pulse ox reading. When it comes to murmurs, we defer to nurses if they hear one and we don't.).

In general, no one works during medical school and no one is going to be sympathetic during rotations about a student's job. Even for medical students, 60-80 hour weeks weren't uncommon during 3rd and 4th year.

Quick question. How common do you see the sentiments like those of the OP, who sincerely believes that both NPs should be considered physicians AND practice medicine (the first being the topic of the thread and the second being explicitly mentioned in the first post)?

Of course when we do participate in the threads that explicitly involve us, we get comments made over the fact that we're participating. https://allnurses.com/nurse-colleague-patient/doctors-vs-nurses-983712.html#post8457439 (which, for comparison, I don't think I've seen the reverse at a certain other board where half of it is a wasteland that shan't be entered). Post Graduate Year (PGY) 1 is the first year of residency where as clerkships are done during medical school. Unlike other residency years, however, PGY1 means a completely different thing in terms of experience in April (almost a full year in) than, say, July (fresh faced from med school). Dunning Kruger, and I think for most interns (PGY1), that trough is hit pretty early on into intern year. I also think that the OP on this thread hasn't quite hit the trough yet with regards to his own professional development. The concept of "associate physician" is not one without major controversy and is meant to the solution of, mostly Caribbean graduates, medical school graduates with $300k in debt, but unable to find a residency. Pretty much everyone I've seen who knows about that concept and knows the gap between theory and practice that residency fixes has huge issues with that program.

...and that last sentence is key. There's virtually no difference in both the licensing exam and course work between MDs and DOs, including a large percentage of DOs taking the MD licensing exam in order to be competitive for MD residencies. If we're comparing NPs to MDs and DOs and saying that they're this similar, then do you think you would be able to pass Step 1, 2, and 3, as well as the specialty board certification exam for the field you practice in?

What term would you suggest would be used specifically and solely to describe MDs and DOs if both "physician" and "doctor" are to be used as generic terms in the healthcare setting? If we were to rewrite your post and replace references to MDs and DOs to "RNs and LVNs" and replace the term "physician" to "nurse" with a non-nurse trying to claim that they should be able to use the title of "nurse", how would you feel?

A new temp of 100.4? By all means, please let us know and no one should be getting any flak over that. A continuing temp of 100.4, especially one admitted 3 hours ago and who is already on broad spectrum antibiotics with a septic workup? Yea, that's pretty much why the patient was admitted in the first place. Potassium of 3.4, on the other hand, represents something that is often left to ride without other reasons to treat and is often from a lab almost 24 hours old when night float is being called. Now for the resident who is getting called for every abnormal lab, there's a back story there and I'm willing to take less than even money to bet that the resident probably deserved it for some reason.

...and if your hospital has enough computers for such niceties, then yes, the physician should have been using the physician designated computers. Similarly, I recognized that medicine, like every field, does have a-holes in it. ...and it's a patient safety issue when a team is rounding and no one can get updated labs because a medical student was asked to get them instead of sending a resident or attending and there's a distinct lack of computers available on the unit.

As stated, it's an OSHA issue. I fail to follow the logic that a student grabbing labs for a team actively rounding on the floor at that instant is any different than a resident grabbing labs for a team actively rounding at that moment. I agree that the student, when acting as a part of the entire medical team, has no more right than any other staff member. However, I will also put forth that they have no less right either when the team is actively rounding on the floor. The conversation was regarding a student vacating for a nurse (direct quote, "As a nursing student, we are told that we must always relinquish our computers if staff needs them, and to try to not use the ones at the nurses stations. After all, we are "guests." It's apparent the med students at my facility are not encouraged to have the same courtesy."). It's absurd for me to think of a med student being kicked off of a computer when the entire team is on the floor because it's a med student, but not if it's a resident. I also think the same way regarding nursing students. I don't kick nursing students off computers if I need a computer. There's generally a computer available at one of the three stations (our units are triangle in shape with 2 small 1-2 computer stations at the other points) because I've got 2 good legs and need the exercise anyways. There also aren't any "nursing designated" computers at my hospital any more than there are "physician designated" computers with the exception of the charge nurse computer, which is a sign taped over it (and I try not to camp out on those computers, but sometimes it's any port in a storm). The lack of computers is a recognized problem since the hospital wasn't designed as a teaching hospital, but now has over 100 residents in various programs, thus causing a well known computer shortage (I actively try not to need a computer at 7am because of the sheer number of physicians and nurses needing computers for pre-rounds and sign out respectively). Now if we want to be specific, the hospital does encourage bedside charting for nurses with the in-room computers, but even I recognize that as a stupid idea for numerous reasons, including the lack of efficiency when constantly logging in and out. The funny thing is that I'm at a county hospital. Heck, we don't have an attending lounge. We have a resident lounge that's normally infested with med students from the slower services (not IM or gen surg). No one is coming here because of "Dr. So and So."