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医学生学费以外的花费
作者:USMedEdu
发表时间:2009-04-21
更新时间:2009-04-21
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::: 栏目 :::
现代医学vs“中医”
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发信人: docrockville (docrockville), 信区: MedicalCareer
标 题: 医学生学费以外的花费
发信站: BBS 未名空间站 (Mon Apr 20 19:30:45 2009)


THE PRICE IS RIGHT?
The hidden costs of medical school

The New Physician, April 2009

by Steve Woo Volume 58, Issue 3

Everyone knows it costs a lot to go to medical school. Students generally
expect the exorbitant tuition, expensive textbooks and ever-escalating fees.
But who ever mentions the scalpels, study guides and that medical Spanish
class?

These are among the variety of “hidden” costs of attending medical school
—often not considered in budgets and financial aid awards, and which can
take debt-laden students by surprise. Seldom mentioned are tech gadgets like
PDAs, the need for a car, and frequent travel to rotations, residency
interviews and USMLE Step 2 CS test sites.

“A frustrating issue is that the budget that is allotted to you is
estimated, but it is lower than what you are actually spending,” says
Steven Chen, a fourth-year at Johns Hopkins University School of Medicine
and president of its Medical Student Society.

Unless one is fortunate to be accepted to, or attend, one of the handful of
schools that offer free four-year tuition, such as the soon-to-open
University of Central Florida College of Medicine, most students don’t have
much breathing room for unexpected expenses.

The Association of American Medical Colleges (AAMC) states that a graduating
medical student’s average debt is about $150,000. But at least one
financial aid counselor considers that figure much lower than what is
realistic. José Espada, director of student financial services at Indiana
University School of Medicine (IU) in Indianapolis, says the bottom line is
closer to about $250,000, considering loan interest and other costs. For
instance, increased debt can come from participating in international
rotations that students might have to pay for entirely themselves.

In the end, the total expense of medical school might eclipse the most
expensive costs that potential students could have planned for, and such
unknowns can have a chilling effect on the economic diversity of applicants
—and our future physician workforce.

Earning Your Wheels

While undergraduates and graduate students in other fields can often live
without a car, electives and away rotations take medical students off campus
, sometimes halfway across the state, and possibly to the other side of the
country.

IU conducts classes at nine sites including its home campus, and partners
with other universities’ campuses such as Purdue, Notre Dame, Ball State
and the University of Southern Indiana. Like other medical students, IU
students must occasionally travel to these sites for training.

Fourth-year Jennifer Phan already had a car, but the IU student knew others
who had to buy a car to get to all the off-campus rotations.

One rotation required a month-long stay in South Bend. The clinic was 45
minutes away from the arranged housing, and she paid the high gas prices for
the commute. Public transportation could possibly be an option for some,
especially in urban areas. But the odd hours students may have to work could
make that impractical. And in rural areas, public transportation might not
exist.

Phan also did a rotation in Irvine, California. This time transportation was
even more difficult since she did not have her car. Still, she didn’t have
much choice since students are essentially expected to do away rotations.
“It is recommended in some specialties you do a rotation away in another
area to get an evaluation from someone not at your school,” she says.

Her brother provided a place to stay and a way to get to work. “I would
carpool with my brother every day,” she says. “Otherwise I would have had
to rent a car.” And if she had spent that time in a rural area, that car
might have been essential just to buy groceries.

IU third-year Kevin Jenner spent a month in Evansville, a mid-sized city
hours away on the Kentucky border, for his family practice rotation. While
he was there, he had to continue paying the mortgage on his townhouse in
Indianapolis and the cost of staying in a motel.

Tools of the Trade

The cost of medical instruments is commonly overlooked, many students find
out. Your dissection tools, ophthalmoscope, otoscope and stethoscope aren’t
cheap. Jenner says the tools, which for him added up to more than $1,000,
have been unnecessarily expensive considering most have gone unused. “I
didn’t expect to buy all the tools and use them so little,” Jenner says.
“The only things I use on a daily basis are a flashlight and stethoscope.”
He believes these items should be provided by the school.

Other expenses might include the need for a laptop computer, even when you
already have a desktop. This was the case for Phan, who bought a laptop for
her third year. She also had to buy a PDA, another tool not provided by IU.

Chen, the Johns Hopkins fourth-year, says the school’s alumni association
provides a numeric pager to students. “But for a step up to a text pager,
which is much more useful, you have to pay for that yourself,” he says. “
Those can be upwards of $100.”

And with technology comes the expense of equipment breaking down. Jenner’s
laptop recently stopped working, and he had to replace it.

Tests and Test Prep

Students commonly express surprise at the high cost of taking board exams.

Textbook costs are pretty obvious and expected to be expensive. But buying
review books, study guides and other material for these exams adds up to a
significant additional cost, Phan says.

“I didn’t expect my Step 2 exams to be that expensive,” she says, and
estimated that Step 2 alone cost her about $1,000. What made it more
difficult was that the test is only offered in five cities in the United
States: Atlanta, Chicago, Houston, Los Angeles and Philadelphia. Students
away from these cities have to pay the travel expenses. Phan does note that
at her school, students can try to seek out alumni in those cities with whom
they can stay. Phan took the test in Chicago, which was closer to her
school.

Jenner says that test preparation courses and companies can add to the cost.
Some such companies charge more than $500 for coaching.

Jessica Watkins, a medical student in her fifth semester at Ross University,
pointed out that, in her experience, many required certifications are not
included in medical school tuition, such as CPR and first aid. “If you
worked as a nurse before, you probably have the certifications al¬ready
,” she notes. “But otherwise, you’ll have to take, and pay for, these
classes in addition to tuition.”

Interviews and Applications

Espada says costs can appear as society changes during students’ time in
medical school. For example, he mentions that students have an increasing
interest in learning medical Spanish to help them treat Spanish-speaking
patients with limited English.

Espada also says that interest is growing among fourth-years in taking
electives overseas. That could be an unexpected expense since students may
not have considered training abroad when they entered medical school. In
choosing to go abroad, students financially “go into needs and wants.”

Fourth-years have chosen locales such as Australia, Ireland and Asia, he
says. But when students have to travel to residency interviews, in foreign
locales or domestically, they can often incur thousands of dollars in
expenses. Then they would incur the expenses of living in that area if they
successfully get into that program.

As for federal assistance for going abroad, the government “doesn’t spend
money for job hunting,” Espada says. “You can get a private loan for
fourth year. But a private loan is based on credit.”

And as they celebrate graduation, May graduates often fail to anticipate
their lack of income until residency starts in September, Espada says.
Before getting that first paycheck, many face a cross-country move and the
search for a place to live. Seems like those hidden costs don’t end, even
when school does.

Dollars and Sense

Jessica Watkins, a fifth-semester medical student at Ross University, says
it is important for incoming medical students to adjust their budgets to
expect higher costs—especially since incoming students must accept the
school’s offered financial aid package “before you really know what the
year is going to cost you.”

Kevin Jenner, a third-year at Indiana University School of Medicine, says
students need to be careful with loans, which can give a false sense of
security. “When I got my refund of balance on my loans, I felt that I had a
lot of cash,” he says. But in reality, it was money he eventually had to
pay back. To keep from overspending, he says students should live as if they
don’t have any money.

He says to expect surprise costs as a given and that they can come from
anywhere. For instance, Jenner found he needed a new wardrobe to appear
professional to patients and co-workers. He needed some ties and a few nice
shirts, he says. After perusing secondhand stores and finding them lacking,
he chose to buy his clothes new. “That adds up.”
--

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共有1条评论
1   [DrNewbie 于 2010-11-05 02:03:26 提到] [FROM: 98.]
力刀评注:

这是个很有趣的案例,在住院医生面试时时有发生和遇到或类似的场景。这种情况
的应对常常是面试者有意无意地从你反应回答、面部和BODY语言来考察你的反应能
力和个性特点及成熟的素质。表现得好和应答从容合适到位可以让面试者大为开心
或对你留下深刻良好印象,你就得了高分;而相反,应答错误或不当,轻的引起对
方不快或疑虑,严重的,可以说立即被面试者在心里判了死刑--你出局了!

这个CMG提出了个很好得问题,在我所印的下列讨论里,ChiUSMD和Dojo的发言非常
出色,值得大家认真思考和进一步充分讨论,学习提高自己的面试及对这样问题得
脑筋急转弯能力,以及自己的为人处事成熟能力培养。

值得指出的是:那个在麦地喋喋不休到处卖弄她的所谓“英语”并爱好给人改错的
蠢人的发言更充分地反映出其愚蠢和无知,她的所谓良好英语在她的愚蠢脑袋支配
下成了砸她自己脚的石头。此人在麦地已经贩卖了无数的垃圾和错误得东西。我实
在无法忍受这种蠢人无休无止地误导CMG,所以不惜大开杀戒痛砍此ID,得罪了麦地
版规和版主。

说来是坏事,但这也成就了俱乐部的诞生,这里不会再有这种苍蝇和垃圾的泛滥横
行而不受制止。

*****************************************************************************

发信人: kaye ([email protected][email protected]~埋底海豚~热爱游泳), 信区: MedicalCareer
标 题: [合集] 面试碰到的尴尬事
发信站: BBS 未名空间站 (Tue Nov 2 02:42:11 2010, 美东)


☆─────────────────────────────────────☆

ZXCVBNMWUJI (无极) 于 (Sun Oct 31 22:38:21 2010, 美东) 提到:

面试碰到的尴尬事:

我的第一个面试的一个面试官是一个看上去很和蔼的老先生,进去后他一上来就笑眯眯
的问,你是怎么认识Dr.XXX的?Dr.XXX是我到美国后的第一个老板。我说,您认识他?
他微笑地点头,说Dr.XXX跟他一起在XXX做的resident。我于是精神为之一振,把我当初
出国如何联系Dr.XXX到他那儿做POSTDOC给绘声绘色了一遍,末了还加了一句类似“He
is the nicest person I've ever met.”之类的评论。面试官耐心听我说完,然后仍
然笑眯眯地说:“Well, I was not getting along with him very well at that
time.”然后就是blah blah blah blah.我当场差点晕倒。

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Sun Oct 31 23:33:50 2010, 美东) 提到:

You could have said back, Ohh, he must have changed quite a bit.
Or he only gets along well with suck-ups. I jam him up real good.

【 在 ZXCVBNMWUJI (无极) 的大作中提到: 】

☆─────────────────────────────────────☆

fionaww (加州无鱼) 于 (Mon Nov 1 00:00:52 2010, 美东) 提到:

第一句还好,第二句就不行啦。万一人家说,感情你是suck-up阿,不然人家怎么看上
你,把你从国内招来呢?不更晕倒了?


【 在 DrNewbie (NN) 的大作中提到: 】
: You could have said, Ohh, he must have changed quite a bit.
: Or he only gets along well with suck-ups.

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Mon Nov 1 00:03:49 2010, 美东) 提到:

hehehehe.

Third one: Am I such a charming person that I get along so well with him? Or Am I personable that we get along so well.

Fourth one: You should be happy with my people skills now right? Since I can get along with this snob.

If you love my answers and you get my sick humor, please join my club:

Pre_resident_english_corner.

☆─────────────────────────────────────☆

DrNewbie (NN) 于 (Mon Nov 1 01:25:54 2010, 美东) 提到:

The rest are for professionals only. No imitation by amateurs.
The 1st is witty. The 2nd is humor.


☆─────────────────────────────────────☆

dojo (麦地里的豆角) 于 (Mon Nov 1 20:34:37 2010, 美东) 提到:

楼上大哥,你是来搞笑的还是来做广告的?你的这些自以为幽默的答案不是too judgemental ("he must"...lol) 就是自我吹捧。

这个情况下,面试官故意不在开始的时候就说合不来,而是在等楼主说了一大堆以后才
说,其实就是想看楼主遇到尴尬时的反应。象楼上大哥这种回答,把球踢回去,反让面
试官尴尬,我以为不好。我的建议是回答"oh, sorry to hear about that" 就行了,
最多再加一句"I don't know why he treats you and me differently",把这话题带
过就得了。Dr.XXX或者任何一个普通人都不可能跟所有人都合得来,这本是正常现象,
何须画蛇添足

☆─────────────────────────────────────☆

ChiUSMD (治病救热) 于 (Mon Nov 1 20:56:20 2010, 美东) 提到:

I agree. I assume you are a cute girl, and probably got a high remark from
him, otherwise he won't say this political incorrect thing. Go back ask your
boss whatever he said is true or not, then Send him a nice followup email
and make up something 拍一下马屁.

if your boss can send him a short email, 100% you are in or prematched.
My personal experience you will be ranked very high by that program. 美国人的尊师是骨子里的

☆─────────────────────────────────────☆

sfkitty (meow) 于 (Mon Nov 1 21:12:16 2010, 美东) 提到:

这真的是个需要脑筋急转弯的问题,我觉得理想的答案是结合NN和豆角的智慧。“sorry to hear that" ,加上适当的表情(让面试官觉得你的确 feel sorry about it, 而不是随口说说),再加上 “well, I guess he must have changed a lot“, 然后以一个beautiful smile to wrap it up。



☆─────────────────────────────────────☆

dojo (麦地里的豆角) 于 (Mon Nov 1 21:28:20 2010, 美东) 提到:

对的,表情要搭上。但这个must就免了,我对NN第一个答案不满意的就是这个must,显
得好象你多知道Dr.XXX的过去似的。你用"I guess"就对了。

说到底,我觉得这个回马枪问题固然尴尬,但老实应对,或者就是尴尬在那儿傻笑没有
答案,也比表现出自大和judgmental要好,这些性格可是要命的。尤其在正式面试问答
的时候,玩幽默是玩火。

☆─────────────────────────────────────☆

kaye ([email protected][email protected]~埋底海豚~热爱游泳) 于 (Mon Nov 1 23:09:01 2010, 美东) 提到:


dojo(豆角)和chiusmd的分析都很有道理,谢谢!
个人认为是这个问题的正解吧。

☆─────────────────────────────────────☆

ChiUSMD (治病救热) 于 (Mon Nov 1 23:45:44 2010, 美东) 提到:

The old people always have some 童心,he tried to say "got you", just be his
way and do something satisfy his joke. Now matter how smart you are, just
pretend "he got you".

"oops" then smile, or slightly 夸张一下,any other words might turn the
table completely opposite.
American would anwer: "you are good" or "you got me".

在中国,就自罚杯酒。
中美情况差不多,就是不能充大拿。
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共有5条评论
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1 [DrNewbie 于 2010-11-02 14:27:31 提到][删除][修改]
============================================================
Does it matter whether he has changed or not? NO! The best way is to switch gears right away with a neutral, courteous comment. 'Sorry to hear that' is NOT nice at all. Either is 'u got me'. You really have no idea what happened between these two. Could be something nasty. Or his reply could be just a joke. Either way, it is best not to get involved. Along this line, there is no reason to be 'SINCERELY' sorry for it. The 'sorry' line can be interpreted in a bad way: 'You are sorry because I am an ass?'. Better say something neutral without offending either side. 'You got it' works only when he was really joking. What if he was serious? It would be even more awkward.

There isnt any good answer for this awkward situation. Only an immature person would give you a hard time like this. If a person reply in a courteous way, he wins votes. My answer shows integrity, honor and wit. It wins respects from others. The best dealing with this situation is a polite short answer and a quick switch to other topics.

The beauty of my reply is that it does NOT offend either party. Of course, the tone and your body language determines how the msg is delivered and how it will be received. It is saying I dont know his past. All I know he is the nicest person. If what you said about him is true that he was hard to get along, he is very nice now.

'"I don't know why he treats you and me differently" could be taken as very offensive. Right? 'It is because I am an ass?'


2-4 are for laughs only. Hope everyone here knows when to chuckle on a joke. For the people who cant figure out when a joke is told. Here are some clues: suck-ups, jam-up, snob.

All you can brag is how other people drooling over your job. How pathetic.

------------------------------------------------------------------
4 [DrNewbie 于 2010-11-02 13:44:06 提到]
Ur foul mouth cost your job already. You just never learn. You will lose
your job again if you dont know when to hold back your filthy mouth.


You can only take pleasure in getting even by your bragging how the wife of
the boss who fired you left him. You are just plain sick.


BECAUSE YOU HAVE WRITTEN ABOUT THESE FACTS ON PUBLIC WEB SITES, YOU HAVE FORFEITED YOUR PRIVACY.

You are nobody compared with your peers.

Even a monkey can get a score of 50 by throwing darts on a board. So you
think you are smart with scores of 70s? You just got lucky. Period.
Nothing to be proud of.

Talk to anyone who got scores of 70s and ask them whether you just got lucky
or it just doesnt matter. Dont use one case to counter me. Lets talk
about trend or stats.

Your numerous scum filled posts have been deleted by BanZhu. You were so
out of line that even BanZhu was ashamed of you and deleted your mean post
about your ex-boss right after you posted it.

There are many precedents of accomplished people turning into monsters in
their senior years When you were biting every bystander on the street, I
suddenly realized its not me, it is you.

Yes, there are plenty of very smart yet generous, decent people here.

They shoot for much higher goal than you. With your lousy 70s score, no
wonder the best advice you gave to them is to take the less satisfying
prematch. Because you could only get lucky once.

So stop misleading people by using you as an example.

To exclude me from getting info on the medi board, you tried to drag
everyone into ur private club. It just shows how childish you are. Only a
sick person would devise such an evil plan. Even your buddies think you
have gone too far and opened ur private club for public viewing.

You are just a plain sick old man.

--------------------------------------------------------------------

4 [snowfox01 于 2010-11-02 17:25:32 提到] [FROM: 134.74.]
Dr.Newbie:Please be nice to this old man。
难道你没看见你把他生命中唯一的支柱----收集各种贴子,然后大言不惭的copy&post 到自己的网页。给打碎了。同时,他在麦地的“一手遮天” 用那二十年前的狗屁经验来误导新人,也让你给揭穿了。我能理解他的恼羞成怒。他也没几天了,就让他乐呵乐呵吧。

他的英语很好。中国人特别是我们河南人一听就懂。 像“welcome u join my club" 和his is a very unique 8-gua I enjoy to read”还有“I'm sure there you will get more benefits=我坚信在这里你将得到更多的好处。”多么容易的“直”译呀
---------------------------------------------------------------------
5 [DrNewbie 于 2010-11-02 23:00:52 提到]

His best English is:

Bless the God. No wonder people call him the GodFather.
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共有2条评论
1 [DrNewbie 于 2010-11-03 23:04:34 提到][删除][修改] [FROM: 98.119.]
REPLY TO THE ATTACHED COMMENT.

"Must" is perfect here. "May" is NOT.

Would anyone use suck-ups, jam-up in a formal interview as in Joke #2? Would this be a clue that it is a joke? Would anyone use snob in Joke #4? A good joke teller does not start with Hey, I am telling you a joke?

The 'Sorry' line could be interpreted in the wrong way. It is Not like you say sorry when some1 is sick.

Your 'I dont know why he treats us differently' is clearly very OFFENSIVE. It insinuated that the interviewer is an ass cause the Boss is the nicest person in the whole world, right? It is so pathetic that your answer is so appreciated by the MadDoc and put on the front page for people to spit at. Have u noticed that Not a single person responded to the MadDoc's comment? Why? So many people hate me to their guts. Why nobody jumped out and LOLed like you? Simple! Cause your answer is offensive.

Read my reply please before you comment. MadDoc initially made the club private. Only under the protests from some righteous people who think he has gone too far, he made it public a few days later.

Because I use 'real world' examples for English writing practice, a private English club is best suited for this purpose. If you didnt know, a couple of thugs on medi routinely harassed me for correcting their English. Btw, your English is superb. Thats why I thought you would want to help us. But you refused. I am truly sorry for this.

Some people get dark humors. Some dont. It is just a matter of personal tastes. Yes, many did think it was funny.

Clearly, you have got the bad influence from MadDoc. You had a very lousy attitude with your LOLs towards my posts. You are smart enough to have got into a medical school. But your lack of manners will hurt your personal and professional life. Doc is a prime example. Hope you dont follow his path.
-------------------------------------------------------------------
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2 [dojo 于 2010-11-03 22:31:32 提到][删除] [FROM: 71.163.]
Okay, now you say #2-4 are for laughs only, why didn't you say that in your originial post? You could see that fionaww challenged your #2 answer, but you did not tell her you were kidding. Instead you gave two more answers "for laughs", but did any one actually laugh in that thread, before I responded? Your humor is really sick.

I made it clear that your #1 answer is fine except that you shall not say "must". "Maybe he has changed a lot" is an okay answer, but how could you use "must"?

Your comment on my "sorry to hear that" shows that you don't even understand what "sorry" means here. It is a very common, sympathetic response to any kind of misfortune. If you ever tried to describe something unfortunate in your life to an American, you should have heard this sentence before. The sympathetic American saying this would never ever think that he is sorry because you are an ass. Your thinking is ridiculous.

Finally, your conspiracy theory "To exclude me ... you tried to drag everyone into ur private club" really makes me sick, even though I was never a fan of Lao Dao. Lao Dao's club is PUBLIC, everyone in the world can read it, and I joined it on my own without Lao Dao's any email. YOUR club is PRIVATE, and YOU sent me email twice to try to drag me into ur club.
 
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