I'm on Clinical Pathology call this week. This is the one that can drag you in on the weekends, but usually doesn't require coming in on weeknights, but rather answering complicated questions at 2 in the morning. I'd say I'm getting a much better hang of it, but that will ensure I have a terrible shrill screaming pager night, so I'll say nothing of the sort.
I've had one call so far tonight and the day the attendings of my hospital collectively get together and realize that when they get paged by a Dr. (Generic Half of Last Name) to a cell phone number (I got tired of hanging around the hospital phone like a jilted date), they're getting duped by an aggravated resident will be a much rougher one for me. Apparently the lab had been paging this guy since the mid afternoon with no answer despite increasingly urgent messages, which put me on the case. I used my "get surgeons to call me" trick and my phone lit up within three minutes. Mwa ha ha ha ha.
If you are speaking with a patient or actively cutting things inside them, I am absolutely happy understanding a wait. But ignoring the lab all day because you deem their results unimportant? Considering that the last time I had a full call week, I stripped down during an autopsy *five times* because my pager was going off, I'm not hearing it. When I do get nailed at 3 AM, I jolt out of bed, take long enough to flip my computer open and find a good reception spot, and call back. Because chances are the person calling me doesn't really want to wait up for me to call back at 3 AM either.
Things to know about call... hmm...
1. If you're at a hospital that uses a pager system, there *will* be one specific pager alarm that is awful, shrill, and will wake up anyone, which is why you will use it when you're on call, opposed to your normal "chirp and vibrate" for your waking workday. After a couple of times on call, you will have a visceral awful reaction anytime you hear it. If you're in a conference room and that alarm goes off, *everyone* will reflexively twitch, shudder, and snap for you to change it. If you have a significant other, that individual will similarly be negatively conditioned.
2. Pagers hate showers. You can have three hours of absolutely nothing and the minute you get shampoo in your hair, ring!!!
3. Pagers like reckless driving. Fast moving but heavy traffic between freeway exits is prime pager territory.
4. Pagers LOVE the hour before you were due to get up. This way they can ensure you are short slept while depriving you of any opportunity to go to sleep *or* the potential to try to sleep in since "you're already up".
5. Pages love company. If you get ten pages on a Saturday, they will absolutely all be within a half hour of each other, and the sudden flux will make you so paranoid, you won't leave your desk for the rest of what will no doubt be a dead silent rest of your day.
6. Pagers give off psychic energy. If they cannot psychically compel other people to call and wake you up, they will merely falsely broadcast dreams of them going off. If you don't wake up in a suitable panic, they will up the ante by broadcasting dreams of missing critical pages.
7. Pagers loathe patients. Pagers enjoy afflicting patients with whatever ailment will require the most satellite resources at times when those resources cannot possibly be mobilized, requiring stop-gap measures. Pager favorites are HLA matched platelets on Fridays after the Red Cross has closed and organ donations. I can help, but I can't fix until three different labs in two different cities have opened for business at 9 AM on Monday morning. The pagers of surgeons, I'm told, enjoy introducing simultaneous critical patients that require the same specialist.
8. Pagers are offended by blog posts condemning them. Mine just went off.
These should help guide you all in your own experiences.
A freshly minted IMG diving into residency
ClusterMap
4 comments:
Hi Ishie
Of all the med blogs that I have read yours takes the cake as the most down to earth.
I've only read your six most recent posts.. but then again I've only been a fan of yours for about ten minutes.
I do have an aching question that needs a fresh perspective..
If you had the chance to go back in time and redo your MD schooling in America instead of in el Carib, would you and why?
Thanks & bookmarked!
-mc
Hi MC!!! Thanks for reading and for your kind comments.
Your question is a difficult one. Despite being in a breathtaking amount of debt, I'm exactly where I want to be, and the circumstances of getting here, both good and bad, aren't ones I would change because they've been essential for my own growth. I've learned a lot of my own limitations, dealt with a lot of stress, dealt financially and personally with a major crisis, and got to tool around on the beach for two years and jaunt through Europe.
Which is weird, because *that* being said, I would never recommend that someone go the Caribbean route if the US one is an option, and would recommend people do anything they can, particularly with the recent expansion of US med school class sizes, to get into them instead. I will also say I'm very grateful for the opportunity to even be a doctor though, and that was a risk that SGU took on me.
The reason I wouldn't redo mine is that I got through, secured funding the whole way despite some hitches, and wound up at a great program I might not have considered without going the route I did, and once I graduate from my residency program, it's not really an issue. There are two other IMGs and a DO in my residency class (we're a weird group) who feel similarly. But it's easy for us to say that while having a job.
That being said, I know people that have washed out of basic sciences, failed Step 1, been unable to secure residencies, get fired from residencies, or have their residency hospital close and have to redo the process with the same stigma they had before. Those are the people who have regrets and you have no way of knowing if you're going to be one of them unless you are one of them, and statistically, you're more likely to be one of them going offshore.
But honestly, ever since I passed Step 1 and started clinical sciences, I can't think of a time I've said "I regret going to SGU". But I also *do* say "I was really stupid about the way I applied to US med schools and should have investigated my options further."
I do not recommend anyone going into pathology. I recommend that they leave their training as soon as possible and get into INTERNAL MEDICINE (IM) they will be given partial credits for time served in pathology and probability be board eligible in IM in 18 to 24 months. under VCLIA they can still run a lab and do diagnostic work. good choices are Endocrinology ( esp. if they like clinical pathology) if they like biopsy work then go into GI, GU or Renal most will completed their training in 3-5 years including the new fellowships. if income is a consideration then do IM + Pulmonary + Sleep Medicine sleep medicine studies average $1000 to $2000 per case and an average doctor can do 20-30 of these a week so they gross $20,000 per week from just the sleep studies alone . so good income. but please do not delude yourself. pathology is a dying field now with robotics and digital path. get into IM
During my job hunt panic, I considered that though not in the GI mills. I'm very happy with my job but the market is incredibly difficult and you almost certainly have to be geographically flexible. It's not a decision to make likely but it's not quite "abandon your residency and flee". But be prepared to live in a new state.
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