Better to write for yourself and have no public, than to write for the public and have no self. - Cyril Connolly
Monday, June 27, 2005
Rookie Season
As I mentioned to someone earlier today, most hospitals' fiscal year tends to begin on July 1. Particularly teaching hospitals. July 1 is also the traditional beginning of the academic year, and with it, hospitals receive a whole new crop of interns (1 yr. rotation - fresh out of med school), residents (3 yr. training stint), and fellows (post doctoral specialty training). During these phases, it's not unusual for these "doctors in training" to change hospitals two or three times in their quest to become an independent M.D.

As with trying to get oriented to any new job, these poor folks not only need to find the copier, but they are bombarded and overwhelmed with trying to figure out how to order tests, get lab results, access reports and the results from those tests, determine where to scam free food at all hours of the night and day, and basically, just find the restroom and survive. Oh, and they are doctors too. Did I mention that??

Second and 3rd year residents and fellows have game, but interns and new residents?? Interns are straight out of medical school. They are 23 or 24 years old and chances are very good that they have never touched an actual patient aside from perhaps taking a patient's history, temperature, or blood pressure under strict supervision. But, they have lots of book learning crammed in their brains, just ready to unleash on the first unsuspecting patient who will be THE enigma of diagnostic medicine, a real puzzle, one which they alone will solve, and become instantly famous for their cunning diagnostic instincts. It's called "looking for zebras". Instead, most patients are simply your run of the mill horse, and not a Thoroughbred either.

In many smaller teaching hospitals, these rookies are increasingly made up of foreign medical graduates. These are generally bright, well trained kids who graduated at the top of their class. They've had to prove some level of English competency (usually through a series of standardized tests which really can't judge fluency, let alone comprehension and diction), but think about it: coming to the US and being immersed into a system that literally thrives on archaic jargon and acronyms (watch "ER" lately?), has it's own code of ethics, culture and rules, and it's a wonder any of them survive. Native speakers of the English language are mystified by the whole thing - what chance do they have?

So. What I'm trying to say here is: Give the healthcare system a wide berth for the first couple of weeks in July if you have a choice in the matter, unless you have an appointment with your regular physician. Especially the Emergency Rooms. We have very strict training, quality assurance, oversight and orientation protocols to make sure no one gets hurt. I'm just telling you, there is truly a first time for everything. Especially if you're a physician. Whether it's stitching a cut, performing a spinal tap, or inserting a chest tube; you might not like to be the guinea pig.
posted by Broadsheet @ 10:31 PM  
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