My Job As A: Doctor

eVeNtInE · 28-12-2009 11:13pm #1

This post has been deleted.

sam34 · 28-12-2009 11:22pm

ok lads and lassies, i'm in on this one!

i'll write a post over the next few days about life as a doc

in the meantime, post up any questions here and i'll do my best

jumpguy · 29-12-2009 1:52pm

How do they decide who gets accepted to GP training?

How did you know you wanted to be a doctor?

Do most Irish doctors leave for other countries? Is it the poor hygiene in Irish hospitals, or lack of equipment? Lack of facilities?

sam34 · 29-12-2009 7:44pm

jumpguy wrote: »

How do they decide who gets accepted to GP training?

i'm not 100% au fait with this, as i'm not a GP, but there's a thread on it over in health sciences at the moment.

it seems you probably need an honours medical degree, have some unusual hobbies/interests (not reading/music!) and have shown an interest in GP practice, ie spent some time working with a gp - weekends etc.

jumpguy wrote: »

How did you know you wanted to be a doctor?

ammmmm, hard one to answer, tbh.

always wanted to, never had anything else i wanted to do (apart from being an astronaut!)

i know that may not seem very helpful.

i must say though, that i was very naive about what it entailed, both in terms of volume of work, type of work and duration of training. i hadnt a clue really.

i guess (and i dont want to seem patronising or miss-worldish here) but i have a huge interest in people's stories, their histories, and their quality of life... i want to help people and get them the best quality of life they can have. i give a damn and i want to put that to good use.

jumpguy wrote: »

Do most Irish doctors leave for other countries? Is it the poor hygiene in Irish hospitals, or lack of equipment? Lack of facilities?

most people do leave for some period of time.

usually its for training reasons. people go to do fellowships or other research. it depends on how specialised an area you want to get into.

if you get a gp scheme here, you wont need to leave.

DrIndy · 29-12-2009 10:55pm

If you get training schemes in ireland then you don't need to leave the country - but many people will almost invariably end up doing a fellowship in america or (to a lesser extent) england after they are finished their training scheme especially in medicine and surgery.

Other people leave because they want to though as medicine is a portable degree and allows you to work in many places doing many different roles.

I am not entirely sure why I did medicine to be honest and many times have thought about why I did not study engineering instead in college - I could have finished a PhD by this stage and doing some top notch fancy huge machines and buildings. But no, I did medicine in university because I always wanted to - the job and the training that went into the job was not entirely how I expected it and I certainly did not like being an intern.

But I do love my job now and my patients and greatly enjoy the interaction and the craic associated with it. I'm doing emergency medicine now (A&E) - no its not like ER - but there is nearly as much blood, gore and stabbings though. I do emergency medicine because I enjoy multi-tasking and acting under pressure - its gets the adrenaline going.

But horses for courses!

Xtina!! · 29-12-2009 11:51pm

DrIndy wrote: »

If you get training schemes in ireland then you don't need to leave the country - but many people will almost invariably end up doing a fellowship in america or (to a lesser extent) england after they are finished their training scheme especially in medicine and surgery.

Other people leave because they want to though as medicine is a portable degree and allows you to work in many places doing many different roles.

I am not entirely sure why I did medicine to be honest and many times have thought about why I am not an engineer now - finished a PhD and doing some top notch fancy huge machines and buildings. But no, I did medicine because I always wanted to - the job and the training that went into the job was not entirely how I expected it and I certainly did not like being an intern.

But I do love my job now and my patients and greatly enjoy the interaction and the craic associated with it. I'm doing emergency medicine now (A&E) - no its not like ER - but there is nearly as much blood, gore and stabbings though. I do emergency medicine because I enjoy multi-tasking and acting under pressure - its gets the adrenaline going.

But horses for courses!

Hey!:)
You say you completed a phd in engineering, which involves a lot of maths. I was wondering do you know of any areas of medicine which involve using maths? Im hoping to study medicine, and I love maths in school, and I have heard that there are certain areas of medicine which involve the application of maths, such as neurology afaik.

And if you dont mind me asking, have you ever regretted moving away from engineering (or something else) or do you regret going into medicine?

And if you ever were given then the oppurtunity to choose your career all over again from scratch, would you still do medicine?
I do tend to have periods of doubht from time to time, but I do know I want to study medicine, but of course I always like to look for reassurance!:D

And if you ever were given then the oppurtunity to choose your career all over again from scratch, would you still do medicine?

jumpguy · 30-12-2009 2:13am

Thanks for all your responses! Helpful so far.

I have more to ask though, where did ye study medicine? Is there a big difference in the quality? Is Trinity the best place? What about Cork or Galway (outside Dublin)?

Carsinian Thau · 30-12-2009 3:39am

jumpguy wrote: »

Thanks for all your responses! Helpful so far. I have more to ask though, where did ye study medicine? Is there a big difference in the quality? Is Trinity the best place? What about Cork or Galway (outside Dublin)?

While I'm not finished my medical degree yet, (or even close to finishing it to be honest), I get the impression that they're all about the same in terms of quality. So if you feel like basing your decision as to which one you should attend on that, assume they're all equal and let the other factors influence your decision.

DrIndy · 30-12-2009 8:50am

Xtina!! wrote: »

Hey!:)
You say you completed a phd in engineering, which involves a lot of maths. I was wondering do you know of any areas of medicine which involve using maths? Im hoping to study medicine, and I love maths in school, and I have heard that there are certain areas of medicine which involve the application of maths, such as neurology afaik.

And if you dont mind me asking, have you ever regretted moving away from engineering (or something else) or do you regret going into medicine?

And if you ever were given then the oppurtunity to choose your career all over again from scratch, would you still do medicine?
I do tend to have periods of doubht from time to time, but I do know I want to study medicine, but of course I always like to look for reassurance!:D

And if you ever were given then the oppurtunity to choose your career all over again from scratch, would you still do medicine?

Apologies - it was my phrasing - I was musing on my alternative career path which would have been to to engineering - it would have been my second choice. I never actually did do engineering and went from school into medicine!

Apologies - I can see how it looks different the way I wrote it and will edit it.

sam34 · 30-12-2009 5:31pm

Xtina!! wrote: »

And if you ever were given then the oppurtunity to choose your career all over again from scratch, would you still do medicine?
I do tend to have periods of doubht from time to time, but I do know I want to study medicine, but of course I always like to look for reassurance!:D

yep, i would do it all again in a heartbeat.

but, i think you should be prepared for the sheer volume of work involved....... i wasnt at all prepared for this, i was quite naive, really.

college is tough. you will have some great times in college, but you will work damn hard.

i found the first two years quite hard, because it was all basic sciences stuff, and no clinical work. i felt like it was far removed from what i wanted to do, which was see patients... instead i was learning all ths tedious biochem stuff. i really struggled for those two years, and if im honest, i considered dropping out. what stopped me was that a) i had nothing else that i wanted to do and b) i couldnt face telling my parents. so i persevered, and im glad i did.

(i odnt know if things have changed since, as far as i know they were intending to bring more clinical stuff into the first two years)

the clinical years are great - you learn loaaaaaaaads of stuff about such a variety of things. a lot of the learning is self-directed though. and you will have to hang around on wards a lot, waiting for the junior docs to come to you.

intern year is a great year. again, you will work hard, but you will finally have money to enjoy your time off and go on holidays etc. you will be working in the same hospital as a lot of your classmates and teh camaraderie is great.

some of the work you do is frustrating, as you are doing other peoples jobs.... ferrying xrays around, taking bloods, doing ECGs etc... none of these need to be done by a doctor. but as you get more experience, you will get more responsibility and become more confident yourself.

it is a great job, there are drawbacks, as with any job, but all-in-all its a great job.

knowing what i do now, i would do it all again.

sam34 · 30-12-2009 5:39pm

jumpguy wrote: »

Thanks for all your responses! Helpful so far. I have more to ask though, where did ye study medicine? Is there a big difference in the quality? Is Trinity the best place? What about Cork or Galway (outside Dublin)?

there isnt really much difference between them, tbh.

im not sure if this was addressd earlier in the thread, but some med schools are phasing out human dissection. i think this is a disaster. you learn so much from human dissection, i dont think you can pick it up from computers or books.

of course, i dont actually know which colleges are getting rid of it, so thats not very helpful :rolleyes: , sorry, but you could give them a ring and find out

Carsinian Thau · 30-12-2009 8:33pm

sam34 wrote: »

there isnt really much difference between them, tbh.

im not sure if this was addressd earlier in the thread, but some med schools are phasing out human dissection. i think this is a disaster. you learn so much from human dissection, i dont think you can pick it up from computers or books.

of course, i dont actually know which colleges are getting rid of it, so thats not very helpful :rolleyes: , sorry, but you could give them a ring and find out

I know for a fact that NUIG (my medschool) and UCD both still do dissections so we can add them to the list.

Personally, I'm not a fan of dissections, I feel as if I didn't learn that much from them and that my time spent looking over texts and atlases served me better. However, I will admit that this could be due to the fact that I was put in a group of students who predominately want to be surgeons and had a habit of pushing other people out of the way (occasionally literally) so it could just be my individual circumstances that lowered my opinion of dissections.

sam34 · 30-12-2009 8:58pm

Carsinian Thau wrote: »

I know for a fact that NUIG (my medschool) and UCD both still do dissections so we can add them to the list.

Personally, I'm not a fan of dissections, I feel as if I didn't learn that much from them and that my time spent looking over texts and atlases served me better. However, I will admit that this could be due to the fact that I was put in a group of students who predominately want to be surgeons and had a habit of pushing other people out of the way (occasionally literally) so it could just be my individual circumstances that lowered my opinion of dissections.

i'd say you were unfortunate and that coloured your opinion.

i think there really is no substitute for human dissection, having the real thing in fornt of you. it gives you a real tangible sense of where everything is, what size things are, what goes where, what connects to what etc etc etc. it hammers home your grasp of complex strucures.

its 12 years since i did anatomy, but when i read journal papers now about areas of teh brain, i can conjure up an image of that brain area from the dissecting room..... that to me is invaluable, and will never be as good frrom a book.

HQvhs · 30-12-2009 9:06pm

sam34 wrote: »

i'd say you were unfortunate and that coloured your opinion.

i think there really is no substitute for human dissection, having the real thing in fornt of you. it gives you a real tangible sense of where everything is, what size things are, what goes where, what connects to what etc etc etc. it hammers home your grasp of complex strucures.

its 12 years since i did anatomy, but when i read journal papers now about areas of teh brain, i can conjure up an image of that brain area from the dissecting room..... that to me is invaluable, and will never be as good frrom a book.

You can RCSI to that list. You're right, there's no substitution for proper dissection. The only caveat I could add is that you need to know what it is you're looking for beforehand. Otherwise I find I learn nothing and it can be quite boring. But if you read up a bit beforehand and have a general idea of what you're doing it's invaluable!

A Neurotic · 30-12-2009 9:10pm

Carsinian Thau wrote: »

I know for a fact that NUIG (my medschool) and UCD both still do dissections so we can add them to the list.

Weekly dissections in Trinity also

sam34 wrote:

i found the first two years quite hard, because it was all basic sciences stuff, and no clinical work. i felt like it was far removed from what i wanted to do, which was see patients... instead i was learning all ths tedious biochem stuff. i really struggled for those two years, and if im honest, i considered dropping out. what stopped me was that a) i had nothing else that i wanted to do and b) i couldnt face telling my parents. so i persevered, and im glad i did.

I've just finished my first semester of first year and feel much the same way. Although my lecturers do their best to include the odd relevant clinical tidbit or two at the end of each lecture, a fair bit of what I'm learning (biochem in particular) just seems so incredibly impractical and, you said it, tedious.

I'm glad to read what you said there. I'm nowhere near considering dropping out, but I'm a bit disheartened after failing all of my exams before Christmas. Thanks

sam34 · 30-12-2009 9:21pm

A Neurotic wrote: »

Weekly dissections in Trinity also

I've just finished my first semester of first year and feel much the same way. Although my lecturers do their best to include the odd relevant clinical tidbit or two at the end of each lecture, a fair bit of what I'm learning (biochem in particular) just seems so incredibly impractical and, you said it, tedious.

I'm glad to read what you said there. I'm nowhere near considering dropping out, but I'm a bit disheartened after failing all of my exams before Christmas. Thanks

biochem is a f*cking nightmare. jesus, i still shudder when i think about it.

if it's any consolation, i failed my christmas,easter and summer biochem exams in first year, and the summer ones in second year, so spent both summers repeating.

once i got to the clinical years i never looked back, and never got less than honours in any further college exam, and i passed all my royal college membership exams at first attempt. in fact, the only thing i have failed since biochem has been my driving test!

i dont want to brag by saying that, but i want you to know that failing these christmas exams, while it is a b*tch, it is not insurmountable and it doesnt really matter in the big scheme of things. it does not reflect on your ultimate competence as a doctor.

so, chin up!

WIZE · 30-12-2009 9:38pm

2 Questions

If you have a patient who is very ill and you believe they may have 6 months to live . How do you deal with that situation of telling them and how would you prepare the patient for the news .

&

Do you think people die sooner from worry when they are told they are sick (Cancer ) then if they were treated for symptoms of the deseases

sam34 · 30-12-2009 9:58pm

Most Haunted wrote: »

If you have a patient who is very ill and you believe they may have 6 months to live . How do you deal with that situation of telling them and how would you prepare the patient for the news

i dont have to do this really, as im a psychiatrist, so someone else should be able to answer it better

some general pointers:

suss out what the patient wants to know - some people dont want to be told, and would prefer not to know.

others want to know everything

make sure they have someone with tehm for support

dont abandon them- they will have questions immediately, and again in teh hours and days to come

im sure theres more, i cant think of it now, as i say its not something i ever have to do , thankfully

Jammyc · 05-01-2010 2:40am

Anyone entered as a graduate? I'm just wondering how ye dealed with what looks like a crippling financial problem after graduating! (I know that sounds terrible but I would be disheartened if I got to 27 years old, graduated from med school and had been in a position to start a family and not being able to for financial reasons)

Going on this aswell, with both the course and the job itself, how do your personal relationships be afftected? Do you ever feel that you spend youre entire day caring for someone that you barely have the energy to care for someone else?

Many thanks!

sam34 · 05-01-2010 7:43pm

Jammyc wrote: »

Anyone entered as a graduate? I'm just wondering how ye dealed with what looks like a crippling financial problem after graduating! (I know that sounds terrible but I would be disheartened if I got to 27 years old, graduated from med school and had been in a position to start a family and not being able to for financial reasons)

doesnt apply to me, so cant answer this one

Jammyc wrote: »

Going on this aswell, with both the course and the job itself, how do your personal relationships be afftected? Do you ever feel that you spend youre entire day caring for someone that you barely have the energy to care for someone else?

Many thanks!

i don't think its down to an emotional drain, its mainly just the time issue. as i write this, things are supposed to be changing, with teh european working time directive coming in, meaning noone will work more than 48 hours a week.

however, up to now, the ridiculous hours meant that you were hardly at home, and when you were at home you were too exhausted to do much.
when i was an intern, we did weekends where you came into work at 10am on a saturday and you went at home at 5pm the following monday. thats 57 hours :eek:. its crazy, and dangerous.

{the only thing i remember fondly from those weekends is how i scared off jehovahs witnesses for life... i had gotten less than 2 hours sleep in that 57 hr period, and those two hours had been in broken spurts , so i was wrecked. i landed home and was on my way upstairs to bed, when the JWs called. they asked if they could come in, so i said no. they asked why - on a good day i'd retort with something about how i dont invite strangers into my home. on this day however, i lost it, totally lost it with them... actually started crying and whimpering about how tired i was and how i deserved peace and quiet in my own home...... they never called again

}

but i digress... when you're working a normal week, plus at least one night on call per week, plus frequent weekends on call, it can be hard make and sustain relationships. a lot of people wont put up with the tiredness, lack of availability etc.

another issue is the moving around- on some schemes you make big geographical moves every 6 months, so that makes relationships harder.

i know i certainly blame the fact that both of us were junior docs for the demise of one relationship of mine :mad:

A Neurotic · 06-01-2010 4:45pm

Some questions for sam34,

How does Psychiatry compare to the other branches of Medicine in terms of hours, difficulty, pay? Would you mind giving me a very general outline of what you do on a typical day? Is counselling an aspect of your work at all?

Thanks.

DC09 · 06-01-2010 8:26pm

what wages do ya start on when ya first go into the hospital?

sam34 · 07-01-2010 12:03am

A Neurotic wrote: »

Some questions for sam34,

How does Psychiatry compare to the other branches of Medicine in terms of hours, difficulty, pay? Would you mind giving me a very general outline of what you do on a typical day? Is counselling an aspect of your work at all?

Thanks.

hi

a) hours

i'll answer this as if the working time directive hasnt been enforced (because i dont know how thats going to work realistically)

you do the core 9 to 5 mon to fri (well, 9 to 4 on fri) and whatever on-call rota is in your unit - could be anything from 1 in 5 to 1 in 14 depending on where you're working, so that means one overnight every x number of days and one weekend every x no of weekends

most psych jobs are genuinely 9 to 5, whereas most med/surgical jobs are actually 8 to 6 (and possibly longer)

b)difficulty

hard for me to answer as i only did med and surg as an intern.

having spoken to friends who were doing gp training, and thus did 6 months in psych as well as med and surg, they would say they found it quite an adjustment to come to psych.

the focus is very different, as is the pace.

if you're on call for surgery, you can see the A&E referrals quite quickly, a surgical history is complete in ten minutes.

a psych history on the other hand can take an hour or more.

so, while the med/surg people might see 20 patients on a night on call, the psych may see 8, but be busy for the same amount of time.

in terms of academic difficulty - i really cant answer, as i never did med/surg to membership exam standard

the current pass rates for the psych membership exams are about 30-35%, which is low when compared to other specialties.

c) pay
basic salary is the same across grades of nchd, irrespective of specialty. obviously the more overtime you do the more you earn.
surgical sho's and reg's are the richest nchds!

d) typical day
for a general psych trainee:

ward round of in-patients. some of the very unwell people need to be seen daily, others only need to be seen on alternate days. one day a week most teams have a team meeting that everyone attends, ie docs, ward nurses, community nurses, social workers, occupational therapists, psychologists etc... they doscuss current in-patients as well as out-patients and people they are worried about... this can take three or more hours in some cases

"ward work" can be time consuming- ordering and following up on investigations for teh in-patients, speaking to gp's and families, reviewing the patients when any physical issues come up etc

you would have one or two out-patient clinics a week, where you review people who are in teh community... soem will be very stable, some will be relapsing, some will be just after discharge. there will also be newly referred people to see at these clinics

depending on the team and teh service, you may have responsibility for a hostel/group home/rehab unit in teh community, so might spend half a day there per week.

there will always be unscheduled emergency assessments to be done - depending on the unit policy they may be seen in a&e or on teh unit itself.

also, if attached to a general hospital you will get requests for psych opinions on the medical and surgical wards - this can keep you quite busy.

my current job is a bit more specialised (old age psychiatry) , so my day is different - we dont have out-patients clinics, we do all our work by calling to teh patients home. there are a lot of advantages to that but it is time consuming if you cover a large geographical area.

e) counselling

this is a pet peeve of mine! psychiatrists are not counsellors!!!

so, no, counselling is not part of the day.

some team members - psychologists, nurses and social workers- may do some counselling, but the psychiatrists dont.

hope that helps... any more q's, fire away

07-01-2010 12:09am

What is this Working Time Directive I keep hearing about? I've heard positive and negative opinions on it, what will it mean for future and current interns and junior docs?

sam34 · 07-01-2010 12:37am

Israel Attractive Maze wrote: »

What is this Working Time Directive I keep hearing about? I've heard positive and negative opinions on it, what will it mean for future and current interns and junior docs?

basically, its european law that states that noone can work more than 48 hours a week, and that the max shift duration is 13 hours, and that you need 11 hours off after a 13 hr shift (i think that last bit is correct) there are a few other stipulations as well

it will mean an end to teh crazy 57 hr shifts, but it will mean poorer training and less continuity of care for patients.

we're supposed to be compliant with it since last august, but a lot of hospitals are burying their heads in the sand

thats it in a nut shell!

07-01-2010 1:47am

Oh right! I heard from a junior doc recently that it'll cut interns' pay loads with the loss of overtime. But I suppose they've already lost that pay in the recession anyway.

A Neurotic · 08-01-2010 12:35am

sam34 wrote: »

basically, its european law that states that noone can work more than 48 hours a week, and that the max shift duration is 13 hours, and that you need 11 hours off after a 13 hr shift (i think that last bit is correct) there are a few other stipulations as well

it will mean an end to teh crazy 57 hr shifts, but it will mean poorer training and less continuity of care for patients.

we're supposed to be compliant with it since last august, but a lot of hospitals are burying their heads in the sand

thats it in a nut shell!

Sorry for going slightly OT, but how on earth are hospitals getting away with this!? Can't they be reported to the EU and forced to comply? Is it simply a lack of staff and inability to care for patients on those hours?

I must be incredibly naieve, but it just seems ridiculous to me that the HSE/Ireland's hospitals would so shamelessly break an EU law

sam34 · 08-01-2010 11:43am

A Neurotic wrote: »

Sorry for going slightly OT, but how on earth are hospitals getting away with this!? Can't they be reported to the EU and forced to comply? Is it simply a lack of staff and inability to care for patients on those hours?

I must be incredibly naieve, but it just seems ridiculous to me that the HSE/Ireland's hospitals would so shamelessly break an EU law

it does come down to a lack of staff really. if there are 5 junior docs in a psych unit, or on the medial/surgical/obstetrics rota, the unit simply cannot be covered 24/7 if you adhere to the EWTD. the ward needs to be covered, out-patients clinics, community work, and all this allowing for one person to be gone home after a night shift and someone else being at home during teh day because theyre doing that night on call, and someone else being on holidays....... AFAIK, you need a minimun of 9 people available to make it any way workable.

i dont know if theyre getting fined or not, or if theyre just hoping nobody will notice.

its certainly not being implemented in most places that i know of.

Piste · 10-01-2010 9:26pm

Phew I'm glad to know there are other people who've failed their 1st year med exams. I have my first one tomorrow and the chances of me passing it are very, very slim.

It's a big shock going from the leaving cert where you have to get ~90% in 6 subjects to get into medicine, to college where you're hoping you can scrape 50%

sam34 · 10-01-2010 10:05pm

Piste wrote: »

Phew I'm glad to know there are other people who've failed their 1st year med exams. I have my first one tomorrow and the chances of me passing it are very, very slim.

It's a big shock going from the leaving cert where you have to get ~90% in 6 subjects to get into medicine, to college where you're hoping you can scrape 50%

i hear ya!

as i said in an earlier post, it doesnt matter in the big scheme of things.

the pre-clinical years are damn tough, and the fact that its not clinical stuff, and seems so far removed from what you want to be studying, makes it tougher.

you will look back in time and see that those who got the highest marks in the class do not necessarily make the best clinicians. and similarly, those who scrape through biochem do not make the worst clinicians.

so chin up!

as someone said to me when i was in tears over failing yet another bloody mcq, "this too will pass"

Narkius Maximus · 11-01-2010 12:57pm

Piste wrote: »

Phew I'm glad to know there are other people who've failed their 1st year med exams. I have my first one tomorrow and the chances of me passing it are very, very slim.

It's a big shock going from the leaving cert where you have to get ~90% in 6 subjects to get into medicine, to college where you're hoping you can scrape 50%

Forget your leaving cert, you are in a whole other world of negative marking, crippling exams where 50% is the be all and end all! I remember before going into MCQs calculating how many questions you had to answer to get 50% allowing for a couple of wrong answers with regards negative marking. The margin for error was so tight it was hilarious. Just enjoy it, take it handy, work little and often rather than a major cram. Remember you will need some of this in a couple of years!

Good luck

My Job As A: Doctor

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