Pathology Residency Here I come

I matched into pathology at Emory University today!

Very excited, it is one of the best programs in the country, I am shocked they accepted me! Very goof program!!

Medical School Cost: Break down by Year of My Medical School Costs

I was able to find my sum total of tuition vs housing cost at school. Refund is what I got back per fall/winter/ spring to spend on food, power, cell phone, car , and all other bills.

True Cost of Medical School: My Personal Story

 

The crux is: If we are doing rotations in 3rd and 4th year, why the price goes up so much. IF anything, it needs to be cut by about 10-15,000 dollars in 3rd and 4th year.

I am not sitting in lecture listening to professors in 3rd and 4th year. My biggest goal in life outside of being a good doctor is to lobby congress and the US government to reformat tuition fees for medical schools in the future.

As a 4th year, I know what I want to go into and I have 2 more months of required rotations and paying incredible money for these. It's not a matter of seeing how the system works, I have seen that all through 3rd year and half of 4th year. They fail to realize the financial impact on us as students.

3rd and 4th year of medical education tuition fees needs to be changed.

Medical School Debt: I don't understand these numbers!

So, I just completed a questionairre administered by the AAMC, which they give all graduating medical students.  On completion of the survey they give you links to the survey data from prior years (can be found here: AAMC Graduating Medical School Survey Data). So I clicked on the link and started reading the data from 2013. I graduate this year (2014).

I was shocked to find the following above, as seen in the picture! 2013 medical student graduates have an average medical school debt of $135,084. Either a majority of medical students lied on the survey or everyone in school is getting alot more help from parents and scholarships than I ever imagined.

Personally, I am out $307,000 as of 2/14/14. My interest goes up every day, so my total gets a little higher every day.  I have no idea where the AAMC questionnaire figure is coming from. If I was only out $135,000 at the end of these 4 years that would be a huge sigh of relief.

My best guess is that students have either parents rich enough to pay for all of it, or maybe they had income before college and saved up enough.I know this:  there are not THAT many medical school scholarships.

Letters behind a name are pricey! I paid roughly $150,000 per letter, M and D. I will be there soon and that makes me happy. Also, my parents paid for my entire undergrad studies and apartment, so I came in debt free. I cannot imagine being a soon to be medical school graduate with $60,000 in undergrad debt (that is a low number) and then pay for Medical school on their own as well. I am blessed my parents took care of undergrad for me. They also bought me a 2012 Volkswagen GTI for graduation (it is in mint condition). I cannot complain about my situation, but I simply want to point out that the number on the survey seems fictitious.

Do I regret going to medical school because I am out over $300,000 dollars? At times I have been. I think as I get into residency and start doing what I enjoy that I will not regret it one bit. Overall though, I do not think I would change my decision to go to medical school. I have told many friends, family and strangers that I if I could do it over, I would instead have gone to pharmacy school. How true is that? I don't know. I may write a blog on that in the future. 

Side note: I somewhat envy the students in medical school who had Mommy and Daddy pay for medical school along with their cell phone bill, car insurance, groceries, etc while in medical school! They need to be judoslapped for they do not know the value of the dollar! ( I am NOT saying these students are ungrateful, but trust me, they do not know the value of the dollar as someone who has to pay for every little thing) That is just my 2 cents on medical school debt.

-MD in 14

Needs Repair: The True Story of Free Healthcare, Status of Cook County Hospital January 2014

I am a 4th year medical student, I just completed my Subinternship at Cook County Hopsital in January.  I just wanted to post a couple of thoughts before I forget about them. To sum up the status of that hospital and system, two words, as seen by the picture of the two toilets I have attached: NEEDS REPAIR.

The picture I posted is two toliets (one urnial, one toliet) in the SAME bathroom on one of the main medicine floors at Cook County Hospital. These 2 signs were there for all 4 weeks of the rotation, I kid you not. Also, one of the major flourescent lights in the same bathroom was out for 3 weeks of the rotation and half of the bathroom was dark. This is NOT a joke. This is John H. Stroger/ Cook County Hospital in 2014.  This is a broken and out of order hospital.

The main thing I noticed about the Cook County Hospital, which I noticed during there my 3rd year in December 2012, is the ancillary staff are overall horrendous!  The attending doctors and the residents are all hardworking and amazing people, but the nurses, phlebotomists, and some of the lab personnel.

I will never forget when the pneumatic tube system, used for sending specimens to the lab was broken for 3 hours or so, I walked down a tube of blood  to the laboratory and told the woman who handles processing that the tube system was down, her response was: "I know it's down. Good and I don't give a damn". There was no need from her part to phone anyone to fix it or tell me help was on the way. It meant less work for her and so she didn't care. This sentiment is the epitome of the attitudes of the ancillary staff at Cook County.


 Other things that occur: phlebotomy, the people who are supposed to draw blood rarely do their  job on time. This delays all patient care. They are some of the laziest people I have ever seen. I used to draw blood, it is not hard work. It rarely gets done right at Stroger/Cook County.

The transport system meant to get patients from place A to B is horrendous. They are all lazy people and people never get to procedures and appointments on time because of these workers who have a horrendous attitude to do any work.

A good proportion of nurses are LAZY and many times are flat out rude when you ask them about patient issues. They are mostly middle aged, african american sassy women. The rest are either philipino or Indian.

I will never forget this encounter:
My patient needed a urine sample before she went for CT scan. My resident told me to go see the nurse in person and remind her to get it as soon as possible because it was ordered 5 hours ago and still had not been collected. So, I go to the patient's room and run into the nurse outside of it. I ask her if she could collect the specimen as soon as she could. Her response: "Do you know where the urine cups are?" You can collect it yourself."  My response: "I am sorry that is your job, I am not doing it!" This attitude is seen on a daily basis. It is because the nurses are unionized by the government and thus it is very hard to fire them for poor work ethic.

County is a poorly managed, GOVERNMENT RUN hospital.  Anyone who supports UNIVERSAL healthcare needs to rotate or shadow at this abysmal hospital for 1 month. Those people will change their mind about what GOVERNMENT healthcare entails.

My last opinion on County: I have a MASSIVE amount of respect for the residents that complete their training there. You have to be incredibly patient to deal with the constant bullshit of that institution. Patience that I do not have.

anyways, County was a good learning experience as far as interesting patient cases go. As a place to work or train? I could not do it.

-MD in 14

Preliminary Rank List for Pathology today!

I just got done doing my preliminary rank list for pathology! The deadline for submitting and certifying the list is February 26th 2014.

According to data from the 2013 NRMP match data: 

-Applicants matched to their 1st choice 49.6% of the time. 2013 was the FIRST time that this number was less than 50%!

-In the years 1997-2005 this number was much higher! In those years the average percent chance of matching into your first choice was about 57-58%.  It is a whole 10% less this year! Things are getting more competitive. I am glad to be going into pathology because the crazy competition for pathology has not gotten as intense as other specialties.

-If you take the the percent matched into 1st, 2nd or 3rd choice the percents from 2013 match:
49.6% matched into their first choice, 15.2% matched into their 2nd choice, and 9.7% matched into their 3rd choice.  So for me to get choice 1-3, I add all those up which is about a 75% chance of matching into 1 of my top 3 choices! I am happy with this, since all 3 of my top 3 choices are awesome places! See the photo to see more details:

My top 3 rank list:
#1 University of Minnesota Pathology
#2 Medical College of Wisconsin Milwaukee Program
#3 Emory University Pathology

I will be happy at either 3 of those places and my chances of getting in are high if we go with the statistics!

-MD in 14 

The typical Cook County patient

I am on my sub internship as a 4th year at Stroger Cook County Hospital in Chicago. This hospital deals with the undeserved, the poorest of the poor in Chicago. This note I found on the second week of my rotation by an attending doctor, greatly sums up about 50% of the patient we care for at this  facility:

"I saw him today and know him very well from before as multiples times before, whines about being examined, refuses blood work and threatens to leave AMA. I have informed him that his condition is potentially lethal and he should cooperate. At times becomes verbally abusive."

It describes a patient I was taking care of. He had heart failure and was admitted for worsening of his heart failure. He had edema in his feet and an extremely difficult time breathing. 

Stroger is a special place, blood draws never get done because they are not enough phlebotomists. The ones that they do have are lazy (I used to be one I know what it takes to draw blood, and it is simple job). If a patient is in the bathroom or not in there room for a minute, the phlebotomist will put "patient refused blood draw", just so they do not have to work. 

The transporters are also horid. They never want to take their patients to their procedures on time. 

But overall the patient you see are shocking. For example, in the last week alone I have seen 4 patients on my team with chronic hepatitis C with liver Cirrohsis killing them slowly. I have also seen a case of a patient with Hepatitis B who has a tumor called hepatocellular carcinoma, this tumor comes in patients with chronic hepatitis B infection. It is a very rare tumor and the patient I saw had a highly advanced tumor. 

My current patient is homeless and we think is faking symptoms so he has a place to stay. A test for arm weakness is to raise the arm over the head and let it drop. If the patient is truly weak and has no use of an arm, the arm will hit them in the face. If they are faking, when you let go of the arm over their face, they will let it drop, but before it hits their face, they move the arm so it misses their face. My patient keeps doing this. He is here for a home, and I do not blame him. It was 1 degree today, and maybe 5 degrees yesterday, and that was not including wind chill. 

Cook county Hospital is a crazy place to work. Very eye opening to see how sad the conditions some people are in. We are fortunate to be middle class and have insurance and have good care. Cook County, patients do have good doctors and residents, but its the facilities and the stage at the disease most patients are in, that there is not always alot of hope.  

-MD in 14