Wednesday, October 19, 2011

The Tyranny of Residency

Great choice nurses... Great choice PAs. Honestly. If you guys want to explore new areas of medicine you can. Tired of working in the ER? Go to the OR. Tired of the OR, go to derm, or psyche. Nice options.

But what for us? What if you do your ER residency and practice for twelve years and then can't stand the sight of it anymore? What if you, in that time, have become a pretty damn good primary care physician? Well, you won't have to do a whole residency and fellowship to get boarded in Family Practice will you? I mean if you want to change you don't have to go back to square one do you? Three years of training? Credit for time served right?

No, nor can you, if you are a Family Practice doc, with lots of small town ER experience or big town ER experience, can you get credit for time served.

We are so jealously guarding our fences that we haven't seen that our house is on fire. It's a huge freaking fire too.


  1. Holy f*cking sh&t! Were you just reading my mind or WHAT??

    The bullsh&t has finally made me want to quit all of this completely. I f*cking HATE Press and Ganey and wish a painful POX on both of them.

    Switch? CAN'T. Good luck with that. This whole f*cking field is a lost cause. Every c@ck sucking bureaucrat in Washington and in the board rooms of hospitals have created this Frank-f*cken-stein mess.

  2. Family Practice?!?!?!
    I know your a Georgia fan,and love pain & Humiliation what with that 3 for 21 streak against the Gators, but seriously, are you into F&M*?
    Cause you'd get more respect turning Homo and wearing a dress to this years "Cocktail Party" than claiming FP as a "specialty".
    Seriously, its a "Specialty" that specializes by NOT specializing, claims to have the best bedside manor while having the highest ratio of Foreign Molestor Greeks(FMGs), Greek as a first language residents, and if it wasn't for Drug Salesmens free drug samples they'd be broker than Greece.
    And yeah, I'm a little bitter cause I did a transitional year at an FP program, and the turd-burglar Chief Resident(some homo greek name) put me on call the last night, and expected me to stay and round the next day when I already told him I was outta there at 8am...
    Technicially the Internship was over at Midnight, but I didn't have the balls to leave, thats what comes from hangin round Ass Bandits for a year...
    Personally, I like what my current Bro-mance, Rand Paul did when the Ophthalmology Board started that whole "Re-certification" fraud.
    patients don't care, and the possibilities are endless.....
    Its like when people brag about bein "AOA"
    I always say "Assholes of America!?!?! Me Too!!!!!!!!!!!!!!"

    Frank, AOA life memeber

  3. Technically yes, 911. But, these days with all the cutbacks a nurse can't move into another specialty easily. The support structure is all but gone so it can be a dangerous decision to change specialties, or even begin in nursing. There are many thousands of US educated RNs out of work. If you are new, (pretty much since the end of 2007), if you are employed in a decent nursing job and had some sort of residency, you are one of the lucky ones. I know several with @100,000 college debt that cannot get interviews. Right now, if you have 2-5 years experience as an acute care nurse, you are OK. If you have less or more years experience, your prospects are limited.


  4. @SCRN
    $100,000 for a Nursing degree?...
    I wouldn't interview them either, unless there really hot, which is why those Phillipino Nurses do so well
    No ugly Crocks, ill fitting scrubs to hide that 40+BMI, and they age really well, like My Urologists Nurse, Imelda.

    Seriously, my Med school was only $5,000/year, which might as well been $500,000, which is why I went Navy...
    well, seein "Officer & a Gentleman" didn't hurt. And the Navy paid for books, lab fees, and some $500/month, which if I'd put in a good no-load mutual fund, I'd probably be lucky to have enough for a case of Milwaukee's Best...
    and with a scholarship you could spend your student loan money like God intended, on a Motorcycle.


  5. Frank... I picked FP as a freaking example and you turn it into a homo diatribe. Here's a challenge... I give you a subject, you turn it into a homo diatribe...

    Subject... Icebergs. Go!

    SCRN, I hear there's all kinds of money for travellers. This not true?

  6. 911,
    Traveling was big money a while back. But right about the time the economy tanked and people pulled out of electives and postponed babies, that all stopped almost dead for a while. Actually many hospitals froze everything in nursing and were laying off. Thus the glut of both experienced and new nurses without residency today.

    I've heard some travel is picking up again. There was a lot of scrambling to get "off the plane" and on firm ground when the economy tanked.

    If you had been an experienced hired gun a while back 911, you probably would have made more as an RN.

    And Frank, some of those cute little filipino nurses have a serious mean streak...

    -SCRN :o)

  7. but didn't you switch?


  8. I knew an ER doc who opened up a med spa...botox, fillers, etc. Seems to be doing well.

    SCRN is right about nursing. Really hard for the newbies to even get an interview. I'm just grateful to have a job.

  9. Icebergs??
    there was this Homo in residency, in the call room, we'd wanta watch something Man-ly like Wrestling, or Football, or Top Gun for the 500,000th time, and he'd be watching "Titanic".
    Not the one with Dicraprio, the Gay Porn version.
    Sitting next to his boyfriend.
    And we Couldn't TELL!!!!! Cause we couldn't ASK, and if Bin Laden hid out in that Call Room he'd still be alive.
    Seriously, one time at FP Noon Conference, and it was never a Medical topic, but something like "The 90's: Decade of the Gatekeeper" or "Do you have what it takes to charge for a 920004?"
    anyway, the Butt Pirate Greek Chief Resident said "The Greeks invented(Blank)" and I whispered to my buddy,
    "They invented Homos too!"
    except I didn't really whisper it, cause I've got the Ass-burgers, and said it in a normal conversational tone...

    the End


  10. Frank, at least in my field of Family Medicine I have actual personal interaction with my patients, make a difference in their lives, and in most cases form great relationships with them.

    Anesthesia is great for you anti social personality types that just want a pre sedated patient the CRNA worked up, dosed, and all you do is pass gas for a few hours while you play on your iphone while the surgeon does all the work.

    I really think your whole field is a sham and we should probably re-purpose you to do something else and let the CRNA's take over. They do 90% of the work now anyways.

    Oh, and to hell with Auburn.

  11. Dr. Dawg...
    I don't have an iphone.
    And if my team had to struggle and cheap shot Vanderbilt just to pull out a last second "W" I'd slam someone who picked a more lucrative, I mean professionally challenging specialty too.
    And how many of your patients Tramp-Stamps have you seen? And even if you have, how many have you stuck a 16g Tuohey through???
    See, in Chess we call that a "ZugZwang" which means your screwed either way. If you've seen many of your Patients Tramp Stamps your a perverted wierdo, cause why do you need to see there back in order to write a Prozac scrip?
    And if you haven't, an antisocial gas passer has more intimate knowledge of his patients backsides, than you, the Gatekeeper, wait, what are you calling it this year,
    the "Family Medicine Specialist"
    And it's not right that One "Specialty" claims to know everything, Maybe I don't want you feeling my daughters breasts after checkin out my Prostrate...
    And I'll give you 2.7 on this years Auburn-Georgia game.
    Not points, thats gonna be Murray's Creatinine after about 42 TFL's...


  12. Frank,

    I felt your daughters breasts LONG before I ever got a hold of your prostate.

    Sorry, I thought you already knew that.

    As for our QB, I'm third on the transplant list to donate but with Fairley taking his game to the NFL I'm pretty confident I won't be needed!

    Finally, I wouldn't expect a gas passer to know that Prozac is a shitty drug and we have much better options in the generic market now. Read yesterday that 10% of Americans are on an SSRI currently. 89% more and we'll be that nice wonderful place where we all hold hands and sing kumbayah all day long. We are the 99%.

  13. Dr. Dawg,
    Et tu Brutus? which is latin for
    "So's Your Old Man!!"
    Guess you don't have any of your Nurse Practitioner's charts to sign...
    or makin sure your not on call the night of the BCS championship...
    and good cheap shot on my daughter's breasts, I'm an Auburn fan, we appreciate dirty, I mean "hardnosed" play.
    and when YOUR daughter needs an Epidural, I won't say
    "Your gonna feel a little Prick"
    12 years in practice and I still love sayin that...:)


  14. Frank and Dr. Dawg should switch for a day. I wonder what would happen.


  15. I can guarantee you this, the recap of the day in the bar afterwards would be some good reality TV. Methinks ole Drackman would be a hell of a drinking buddy, even if he did go to a cow college and probably never learned to hold his liquor.

    Frank, we've gotten so bad I don't even request not to be on call the week of the SEC Championship game anymore.

  16. Ahhhh the submissive Dawg goes Belly up to the Alpha Dog...
    and OK, I did take a "Principals of Poultry Science" class, laugh now, we'll see what happens when the A-rabs unleash the E-bola and only a few mutant chickens survive...
    and I know your just happy to argue with someone who didn't learn English in a Madrassah...
    seriously, a few years back we used to play this game.
    "9-11 Hijackers or new FP House Staff?" and it was really hard, cause those 9-11 Hijackers were pretty clean cut.
    and I do pull for UGA once in a while, cause you've got a fellow Christ-killer at QB, while Auburn hasn't had one playing since Junior Rosegreen a few yrs back.
    thats right, I pull for UGA when there not playin Florida, Soucth Carolina, Ga Tech, Tennessee, Kentucky, or Vanderbilt...


  17. When is Frank going to learn the difference between "you're" and "your"? Someone with that much education should know the difference.

    And don't blame spell check or some BS, you screwed it up multiple times in multiple posts.


  18. careful anon.,
    frank is crazy like a fox... Tosses a lot of those out there juswaiting to be called on 'em so he can call you a homo.

  19. @ Annonymous...
    first of all, English is my third language, so Blow Me, Lech Mich, and if I could type Hebrew, I'd tell you to kiss your sisters (redacted)
    thats "kus akhata hatzola" which is really arabic, thats right, Jews curse in Arabic, thats why they hate us so much...
    and Languages change, I'd say they "evolve" but I don't believe in Evil-lution...
    No way you got from Dinosaurs to Geckos in 5,000 years.
    its why you can't understand Chaucer in the original Old English, except that part in the Miller's Tail, the one the Homo English professor made us read freshman year at THE 2010 SEC & BCS CHAMPIONS...
    Seriously, its evolving in front of our ears,
    for instance, just try dropping an "N-Word" at work, and instead of knowing winks and nods of approval like you'd get even 10 years ago, you'll get fired faster than if you swapped in a porno instead of "the difficult airway chapter 47"...
    In 20 years people won't even remember how to say the "N Word"...
    and its like how I got suspended for a week in 5th grade for dropping a "Fart" while now-a-days 8 year old Vietnamese kids tell me to go (redacted) my round eyed old ass.....
    and 1000 years ago your ancestors were probably complaining about the yokels misusing "Thou and Thee" while MY ancestors were getting kicked out of every Country in the known world..
    we got kicked out of SPAIN for cryin out loud..
    and you can tell the difference between "There and their" by content, its understood, like when the Realtor says its a "Safe" neighborhood...


  20. Sounds like Frank needs to switch to decaf and might want to bump up his daily Metamucil intake. Lots of nasty stuff backed up in there (or is it their, or they're, I'm so confused?) that needs to be released.

    Or maybe he just needs to get laid more to get the poison out of his system.

    -Anon again

  21. hey anon,
    kus akhata hatzola,
    now I've gotta take a dump.

    :)Frank :)

  22. Anon 8:57 is a girl (embarrassed to say).


  23. @ SCRN
    and you know Anon 8:57's(sounds like scripture)sex how???
    the preoccupation with irreverent grammatical rules? Bowel Cleansing?
    Hazy memories of hot steamy girl-on-girl-on-girl masage-a-twats??

  24. @Frank
    IDK, I just know these things. Somehow, I also don't believe that this person is the "hot, steamy" type either. Being a card carrying member of the straight female club, I/we still have the ability to size the other clubs up, and, nope just don't see that going on either for anon.