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住院医生的工作和“幸福”讨论
作者:USMedEdu
发表时间:2008-09-17
更新时间:2008-09-17
浏览:1135次
评论:0篇
地址:10.
::: 栏目 :::
现代医学vs“中医”
社会、艺术与医学
住院/FELLOW单位
中外医学网站精选
国内外医学交流信息
生物医学人物
力刀美加医学教育专
临床见习/实习/义工
医学生理学诺贝尔奖
医生助理(PA)职业
医学书籍照片及图谱
社会与医学瞬间定格
医学典故/医史杂谈
USMLE复习和考试
申请和面试住院医生
住院医生生活和工作
FELLOWSHIP
医生就业、工作及生
医学科普及问题解答
美加医学院申请/MCA
中美医学临床教育比
医学新进展及新闻
社会医学伦理

发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:25:12 2008)

上周末和一个在NYC做intern的老朋友打电话,才知道原来我生活在天堂中.

比较数据如下:
她: 6am进病房,8pm回家(如果不on call),11pm回家(如果on call)
我: 7-8am进病房, 5pm之前回家(如果不on call), 第二天2pm之前回家(overnight
call)

她: 平时管11个病人,on call 至少18个病人
我: 平时管3-5个病人, post call最多8-10个病人

她: 很多scut work (抽血, IV, 护送病人,等等)
我: 没有任何scut work

她: "护士都很凶,很懒,还经常骂人,我是最底层的,被当做奴隶用,出了任何事情都怪到
我头上,经常听到you will be kicked out of program的威胁,只有一些senior比较友
好"
我: 很友善的环境,绝大多数护士都很友好,至少非常尊重医生,哪怕你是啥也不懂的
intern,只有被一个护士抱怨过我用了她的电脑. Residents, intern 之间都相处的很
融洽,每个月都要以各种名义搞两三次party.

结论就是: 她每天上班就感觉进了地狱,一定要transfer, 而我死皮赖脸也要留下去.
--



发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:35:44 2008)

如果非要经过这样的身心折磨,那我宁愿"学的慢一点,学的少一点,晚一点独当一面".
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.173.]



发信人: lzumc2008 (麦地MyHoney), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 22:35:28 2008)

你是幸福的:-)

你同学要赶紧找下家了,那里就别呆了,真怕人.
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 75.66.]




发信人: acne (麦地米虫), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:44:36 2008)

为什么?我到现在也不理解scut work对practice有什么帮助?


发信人: snowflake07 (bing), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:45:38 2008)

看了你的帖子感触很深,这也是我近些天让我矛盾的地方:舒服vs进步快?
我医学院刚毕业就出来了,临床经验也只是intern那时候的一点点,由于当时知道自己
要出国,Intern也就没好好做,混了过来。
这几天一直在思索这个问题,到底是在一个轻松的地方舒服的过日子,还是在tough的
环境里在努一把力?但是总没有勇气给自己答案。
也想请教版上的前辈,给我一些建议。

者] [本篇全文] [进入讨论区] [返回顶部] [修改文章] [删除文章] [转寄] [转贴] [ 11 ]

发信人: acne (麦地米虫), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:51:42 2008)

我觉得有效的临床学习/操练时间越长越好。你可以连续工作30小时,但是都是scut
work。记得你将来不是当护士/secretary,而是当医生。

每个人的耐受程度不同,以自己觉得可以接受为好。

attending水平很重要,你可以看上10个病人,但是“酒肉穿肠过”没留下印象,有的
水平高的attending,点拨你两句,或是问你两个问题,你立刻就明白了。没有太多
education的地方,再轻松也不要去,不然将来肯定出问题。



发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 01:15:13 2008)

我觉得所谓轻松舒服,或者tough,并不是说病人多少,临床经验多少,或者学习任务轻重,
而是工作环境和所接触的人,是否让自己觉得愉快宽容,是否有继续工作的热情和信心,
这就是为啥面试的时候, program director总是要介绍我们这里非常lay-back,没有
scut work.

做医生没有一个不努力学习,回家看书的,也没有任何一个program真的是天堂的.
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.173.]



发信人: sdmd08 (Beyond the sea), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 10:12:44 2008)

3-5 patients a day is a kind of small number.

Make sure to study on your teammates' patients (classic ones, intereting
ones). Certain work load is necessary to get the experience. Seeing patients
is the best way to learn practicing medicine. Of course, I assume one is
reading on her/his patients regularly. You know the difference in your
knowledge on your vs your teammate's patients.

I don't believe scutwork will contribute directly to your practice either.
Your friend's patients number is at the high side but not terrible. If she
can make time to read on her patients a little bit, she will improve very
rapidly.

Since you are a lady, it is wonderful for your family. Just try to use your
time wisely to learn from your teammates' patients. There are a lot of ways
to waste time if you are on duty but finished all your work.




发信人: M1998 (MMM), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 12:54:29 2008)

I am kind agree with HappyDoc's comments.

1. normally, for new interns, the first 3 months is the most tough, since in
some programs, everyone, including the RN's will try to give the intern
hard time, asking the intern to do lots of scut work. But usually it will
last 3-6 month during the intern year.

2. yeah, the scut work will not directly contribute to the clinical work
later, but you still can learn lots of things/tricks from it, e.g., how to
deal with NG tube/Foley tube, etc., not to mention, how to work under stress
, or work more efficiently, which will be VERY useful for the next 20-30
year practice.

3. one of the big different for the practice here, YOU WILL BE ON YOUR OWN
AFTER YOUR RESIDENCY, so for IM resident, you only have 3 yrs to learn, then
later in practice, you have to deal with patient yourself, not like in
China, you will have senior physicians to ask for help. Even for persons
going for subspecialty, except for GI/cardio/onco people, I still saw people
sometimes have to do combination practice of IM/subspecialty for several
years, if they want to stay in the big city, (which most CMG do).

4. Totally agree that "Seeing patients is the best way to learn practicing
medicine." as an intern, 3-5 patient/day is too less, you will regret it
later if it keep going like this, since your practice will be much BUSY than
this, and how could you handle it then?

5. From my own experience, I did not have any clinical experience after I
graduate from medical school, but I was very luck in a very busy residency
program, and I worked hard and learned a lot during my first two years, when
I was PGY3, I almost do not need any attending to deal with almost all the
cases.

6. After all those years of practice, I still appreciate for those hard
training, since now dealing with my current patient load is a "piece of cake
", on the other side, we just had someone resigned, since he could not
tolerate the load, although, this is not a busy program.

GL.

--


发信人: madmice (麦地疯耗子), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Wed Sep 17 00:08:30 2008)

我的数据:

普内:6:30am进病房,先自己round,然后是8 am consultant round,要看那个人,
有快又慢,然后12点,周一到周四的seminar,周五没有,是早上8点的grant round。
然后下午干活,基本上6点到6点半回家(不值班)。Short call早上8点开始到下午3点
,cap是5个。long call下午一点开始,一般第二天两三点可以回家。Cap也是5个。六
天一个轮回。
整个team 有时两个有时三个intern,一个senior,team cap 是13个。

没有任何scut work。
护士态度十分好,,夜班时候很多医嘱都是自动的,不用医生下的。有特殊情况才要。

发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:25:12 2008)

上周末和一个在NYC做intern的老朋友打电话,才知道原来我生活在天堂中.

比较数据如下:
她: 6am进病房,8pm回家(如果不on call),11pm回家(如果on call)
我: 7-8am进病房, 5pm之前回家(如果不on call), 第二天2pm之前回家(overnight
call)

她: 平时管11个病人,on call 至少18个病人
我: 平时管3-5个病人, post call最多8-10个病人

她: 很多scut work (抽血, IV, 护送病人,等等)
我: 没有任何scut work

她: "护士都很凶,很懒,还经常骂人,我是最底层的,被当做奴隶用,出了任何事情都怪到
我头上,经常听到you will be kicked out of program的威胁,只有一些senior比较友
好"
我: 很友善的环境,绝大多数护士都很友好,至少非常尊重医生,哪怕你是啥也不懂的
intern,只有被一个护士抱怨过我用了她的电脑. Residents, intern 之间都相处的很
融洽,每个月都要以各种名义搞两三次party.

结论就是: 她每天上班就感觉进了地狱,一定要transfer, 而我死皮赖脸也要留下去.
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.173.]


发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:31:10 2008)

我真的忘记了,好象在NYC北部.
--



发信人: HappyDoc (快乐一生), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:32:30 2008)

我相信你的老朋友会比你学到得更多,学会的更快,更早能够独挡一面。前提是你和他
/她是一样的专业。



发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 20:35:44 2008)

如果非要经过这样的身心折磨,那我宁愿"学的慢一点,学的少一点,晚一点独当一面".
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.173.]


发信人: stomach (stomach), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:11:13 2008)

我们的护士也很好,基本医生就是负责分析报告,做临床判断等等,当然催催结果,找
人重新读片子什么的是要做地。 通常6am-4pm,on-call 6am-next 12pm,这个有点
tough,而且on-call要管的是两层楼几十个病人和全院的新入住病人。所以要是再做
SCUTWORK估计会出人命了
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 75.9.]



发信人: acne (麦地米虫), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:44:36 2008)

为什么?我到现在也不理解scut work对practice有什么帮助?
【 在 HappyDoc (快乐一生) 的大作中提到: 】
: 我相信你的老朋友会比你学到得更多,学会的更快,更早能够独挡一面。前提是你和他
: /她是一样的专业。



发信人: snowflake07 (bing), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:45:38 2008)

看了你的帖子感触很深,这也是我近些天让我矛盾的地方:舒服vs进步快?
我医学院刚毕业就出来了,临床经验也只是intern那时候的一点点,由于当时知道自己
要出国,Intern也就没好好做,混了过来。
这几天一直在思索这个问题,到底是在一个轻松的地方舒服的过日子,还是在tough的
环境里在努一把力?但是总没有勇气给自己答案。
也想请教版上的前辈,给我一些建议。



发信人: acne (麦地米虫), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Mon Sep 15 23:51:42 2008)

我觉得有效的临床学习/操练时间越长越好。你可以连续工作30小时,但是都是scut
work。记得你将来不是当护士/secretary,而是当医生。

每个人的耐受程度不同,以自己觉得可以接受为好。

attending水平很重要,你可以看上10个病人,但是“酒肉穿肠过”没留下印象,有的
水平高的attending,点拨你两句,或是问你两个问题,你立刻就明白了。没有太多
education的地方,再轻松也不要去,不然将来肯定出问题。



发信人: siyan (麦地小狐狸), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 01:15:13 2008)

我觉得所谓轻松舒服,或者tough,并不是说病人多少,临床经验多少,或者学习任务轻重,
而是工作环境和所接触的人,是否让自己觉得愉快宽容,是否有继续工作的热情和信心,
这就是为啥面试的时候, program director总是要介绍我们这里非常lay-back,没有
scut work.

做医生没有一个不努力学习,回家看书的,也没有任何一个program真的是天堂的.
--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 70.173.]




发信人: sdmd08 (Beyond the sea), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 10:12:44 2008)

3-5 patients a day is a kind of small number.

Make sure to study on your teammates' patients (classic ones, intereting
ones). Certain work load is necessary to get the experience. Seeing patients
is the best way to learn practicing medicine. Of course, I assume one is
reading on her/his patients regularly. You know the difference in your
knowledge on your vs your teammate's patients.

I don't believe scutwork will contribute directly to your practice either.
Your friend's patients number is at the high side but not terrible. If she
can make time to read on her patients a little bit, she will improve very
rapidly.

Since you are a lady, it is wonderful for your family. Just try to use your
time wisely to learn from your teammates' patients. There are a lot of ways
to waste time if you are on duty but finished all your work.




发信人: M1998 (MMM), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Tue Sep 16 12:54:29 2008)

I am kind agree with HappyDoc's comments.

1. normally, for new interns, the first 3 months is the most tough, since in
some programs, everyone, including the RN's will try to give the intern
hard time, asking the intern to do lots of scut work. But usually it will
last 3-6 month during the intern year.

2. yeah, the scut work will not directly contribute to the clinical work
later, but you still can learn lots of things/tricks from it, e.g., how to
deal with NG tube/Foley tube, etc., not to mention, how to work under stress
, or work more efficiently, which will be VERY useful for the next 20-30
year practice.

3. one of the big different for the practice here, YOU WILL BE ON YOUR OWN
AFTER YOUR RESIDENCY, so for IM resident, you only have 3 yrs to learn, then
later in practice, you have to deal with patient yourself, not like in
China, you will have senior physicians to ask for help. Even for persons
going for subspecialty, except for GI/cardio/onco people, I still saw people
sometimes have to do combination practice of IM/subspecialty for several
years, if they want to stay in the big city, (which most CMG do).

4. Totally agree that "Seeing patients is the best way to learn practicing
medicine." as an intern, 3-5 patient/day is too less, you will regret it
later if it keep going like this, since your practice will be much BUSY than
this, and how could you handle it then?

5. From my own experience, I did not have any clinical experience after I
graduate from medical school, but I was very luck in a very busy residency
program, and I worked hard and learned a lot during my first two years, when
I was PGY3, I almost do not need any attending to deal with almost all the
cases.

6. After all those years of practice, I still appreciate for those hard
training, since now dealing with my current patient load is a "piece of cake
", on the other side, we just had someone resigned, since he could not
tolerate the load, although, this is not a busy program.

GL.

--

※ 来源:·WWW 未名空间站 海外: mitbbs.com 中国: mitbbs.cn·[FROM: 199.79.]




发信人: madmice (麦地疯耗子), 信区: MedicalCareer
标 题: Re: 没有比较,就不知道啥叫幸福
发信站: BBS 未名空间站 (Wed Sep 17 00:08:30 2008)

我的数据:

普内:6:30am进病房,先自己round,然后是8 am consultant round,要看那个人,
有快又慢,然后12点,周一到周四的seminar,周五没有,是早上8点的grant round。
然后下午干活,基本上6点到6点半回家(不值班)。Short call早上8点开始到下午3点
,cap是5个。long call下午一点开始,一般第二天两三点可以回家。Cap也是5个。六
天一个轮回。
整个team 有时两个有时三个intern,一个senior,team cap 是13个。

没有任何scut work。
护士态度十分好,,夜班时候很多医嘱都是自动的,不用医生下的。有特殊情况才要。

忙不代表进步快.管病人少不代表轻松舒服.


我们program的宗旨是,不用医生的工资来干别的事,医生多看病人,多和病人说几句话,
比干那些scut work重要的多.

忙不代表进步快. 管病人少不代表轻松舒服.

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