Thursday, August 23, 2012

MSU CHM Orientation Day 5: Short and Sweet

And the fifth official orientation day has come and gone. In case you need to get caught up, here are days 1-4:

This morning was spent almost entirely on discussions of debt, budgeting, and management of debt and budgets. We were given a lot of information on the different types of repayment plans that we should consider, and the benefits and drawbacks of each. We were also told about how, if you work for a nonprofit 501(c) (3) business for 120 months (10 years) and make the minimum monthly payment under the income-based repayment plan, any debt you have left over gets erased. Oh, and guess what? Almost all hospitals are classified as this type of nonprofit organization.

There's just one problem.

I'm interested in Emergency Medicine. You might say, "But Justin! That's not a problem. Hospitals all have emergency departments, so it seems like a great fit!" But you'd be wrong. You see, from what I learned today, ER docs and Radiologists work almost exclusively for external groups that are sourced in to operate the hospitals' emergency and radiology departments. This means that the external physician's group is signing their paychecks - NOT the hospital. Things are set up this way because the hospital makes the money off the lab tests assigned by the ER docs and Radiologists. If they also worked directly for the hospital, it opens the hospital up to claims of "conflict of interests."

So, the legal loophole which allows almost all other kinds of doctors to work for a hospital for ten years, making minimum payments before having the remainder of their debt forgiven, pretty much leaves ER docs and Radiologists high and dry. Well, relatively speaking, I guess. After all, they're still all making salaries roughly exactly equal to that of an ER doc or Radiologist, respectively...

After that talk came lunch, and after lunch came Basic Life Support (BLS) certification training. That's right - I am now certified in life support for infants, children, and adults. Circulation! Airway! Breathing! It used to be ABC (Airway, Breathing, Circulation), but they did some studies and found that people were getting so caught up on checking the airway and breathing that they were delaying the restoration of circulation via chest compressions. As it turns out, restoring and maintaining circulation is the most important part of basic life support. The oxygen storage capacity of your blood is such that as long as your blood is pumping through your tissues and organs, enough oxygen will be delivered to make a significant different in quality of life post-trauma, even if artificial breaths are less emphasized than chest compressions.

So, we did that, then we had a Health and Wellness Small Group Discussion. Basically, we focused on maintaining our mental health and wellness by having a very chill hour-long chat session mixed in with a game in which we found out more about everyone else in the group. It was fun, and a nice, easy end to the bulk of orientation week.

After that, I got some dinner from Zoup and had a long conversation with a friend who was having a hard time with the anticipated stress of next week. Personally, I think the faculty and staff may have overemphasized the monumental nature of the stress and hard work that we're going to be experiencing in the coming weeks. I could be wrong, but it feels like after a point, it makes it more difficult to hear over and over about how hard things are going to be when there's absolutely nothing you can do about it at the moment.

After that quality and productive discussion, I took the Biochemistry waiver exam. Alas, I did not pass. I was closer than I thought I would be though, and that felt GREAT. I didn't really expect to pass, especially since I kind of quit studying last Friday (Saturday? I can't remember...) and just decided to wing it. I feel like I'm more than adequately prepared for Biochem this semester, and I'm looking forward to learning more about the medical side of it. We'll see how it goes starting bright and early Monday morning!

Tomorrow will be an interesting day. I signed up to be a member of the team of Admissions Ambassadors. I don't know in what aspect I will be helping out (giving tours? interviews? on a student panel?), but I know that 1.) It feels incredible to finally be on this side of things, 2.) I want to do what I can for the incoming interviewees because I very clearly remember what it's like to be in their shoes, and 3.) We get a free lunch! After the meeting, the whole Grand Rapids class will be heading to Lansing for more end-of-week festivities. There'll be a student organizations fair as well as a Big Sib / Little Sib mixer. Basically, it's a big get-together between the second-years and the first-years that they signed up to take under their wings. We get to do everything in the Spartan Club, which overlooks the Spartan Stadium. Very cool.

Almost done here, but this next bit is very important. Wife got her blood tests back, and there's no autoimmune disease! Hooray! The only (small) downside is that this leaves us with no clue what's wrong with her eyes. She gets her tear ducts plugged on Monday, so hopefully that will help them stay better hydrated and (therefore) less infected. The docs are now convinced that the cause of her vision problems is a bacterial infection. Why they think this now but didn't think so a week ago, I have no clue... Whatever, hopefully their treatment starts to work soon!


Lindy said...

Don't worry about missing out on the 10 year loan forgiveness plan. I don't think many of us expect it to actually be around by the time we hit that 10 year mark. :)

Anonymous said...

I don't know what your faculty said, but they probably didn't overestimate how hard it's going to be. Granted, I'm a few days out from my first set of exams so this is not exactly the best time to ask me of my opinion of med school! But I do think they try to instill a deep fear into you from the beginning (just so a ton of people don't fail the first exams).

It all depends on how you handle the stress. (I think you'll be fine.) At some point you just have to realize that you can't and won't know all of the material, and you just have to go to bed.

My philosophy (passed down from my friends who are M2s and M3s), is to do at least 4-5 real hours of studying (turn off cell phone, internet, etc for 2-3 hours at a time and just study) every day. And if you can't do it one day, it's fine, as long as you shoot for this. But definitely get 7-8 hours of sleep a night. I think this is where a lot of people go wrong- I mean, your REM cycle is when you convert short-term to long-term memory! You REALLY need your sleep!!

I hope that didn't come across as being a lecture, just my two cents from the first three weeks of med school. Gah. Exams on Tuesday and Wednesday. It's too soon!!

Susan said...

Sounds like a great day and sounds like you'll be well prepared to finally begin on Monday! You'll do great!!! Is certainly good news about your wife's blood test results. Much more manageable in the long run!

NoLongerSilent said...

Sounds like a very eventful last day of orientation.

I totally get where you're coming from when you say it's hard to gauge how difficult med school will be, but you'll see just how quickly the difficultly will onset. However, you'll learn to adjust. In my opinion, that's the hardest part...learning how to properly adjust. The material itself isn't hard. It's learning how to handle the vast amount of information they fly through in just one day.

My advice is to try and stay on top of the information as best as you can. Finding time for yourself may be hard but try to schedule something for yourself at some point in the day.

Nevertheless, I'm so excited for your first day. I was definitely excited for mine and ready to get the orientation stuff out of the way.

BTW I've really enjoyed reading your blog posts. Especially since we'll be experiencing some of the same things around the same time. Last, I'm glad that the doctors were able to rule out autoimmune diseases for your wife. I pray that she'll begin to feel better soon.


Anonymous said...

Has to be public sector so not just not for profit. So there are some groups that qualify. And an er doc should turn 400k first year out vs the typical 115k for a fp doc, just sayin

Justin said...

@Anon - I didn't think the compensation what that high for the average ER doc. Do you know where you got that figure, and how region-specific it is?

goingtomedschool said...


I just stumbled upon your blog and I was reading what you had said about the 10-year debt forgiveness plan. Like anon said, EM docs make a fairly good sum. Check out this physician recruiting website.

If that link doesn't work you can go here:

Anyways, not all of the listings have salaries, but the "New York Emergency Medicine" one has a salary of $290k.

Remember that in EM you do shift work, so if you pick up more than full-time you can be making a lot of money. Additionally a lot of EM docs work in Urgent Care Clinics, where the money is good, but shifts can be longer than at the hospital (depending on the facility of course.)

Physician pay does vary from facility to facility. In a more "rural" setting you may end up with a better lifestyle (naps on shift! more intriguing cases before you have to transfer!) but they pay may be less than at other facilities. But then again, maybe not!

And yes, you are right, most docs work in physician's groups as independent contractors, meaning you have to pay Medicaid and Social Security fees on your own and calculate your taxes every month. But if you can handle medical school you can certainly figure out how to dial the IRS once a month or year :)

If loan forgiveness is a lure you can look into PHS or military service, if you are willing to give up the civilian life style!

Blog is great, I love the picture and I'm looking forward to reading. Best of luck to you!

Justin said...

@goingtomedschool - Thanks for the info! I actually went to a seminar on Emergency Medicine the other day, and found out that the national average for EM physicians is about $267K per year, working standard shifts. Not too shabby... We'll see though. I'm still keeping my options open!

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