Back to residency after recommending cannabis

[gutonc]

It looks disgusting btw. Hospital breakfast with 2 bud lights.

The sort of person who needs 2 Bud Lights with breakfast in the hospital probably doesn't usually eat that well at home.

---

Members don't see this ad.

 

[Arcan57]

I spoke with our pharmacist about how they bought the beer and wine for the pharmacy back in the day. He said he went to the local liquor store and got whatever was on sale. If my last days are in-house, I will dis-inherit any of my family that allows Natty light to be my last taste of fermented hops and Franzia the last gasp of wine.

I remember receiving a patient in residency from a small rural hospital in a dry county. She had OD'ed on antifreeze and the hospital didn't have fomepizole or IV ETOH on hand. They ended up sending a deputy to the next county for a liquor run and she spent the first hour of her transport knocking back Crown and coke till they had to cut her off for getting too belligerent. I've always wondered what influenced the decision on choice of liquor.

 

[Shikima]

I remember receiving a patient in residency from a small rural hospital in a dry county. She had OD'ed on antifreeze and the hospital didn't have fomepizole or IV ETOH on hand. They ended up sending a deputy to the next county for a liquor run and she spent the first hour of her transport knocking back Crown and coke till they had to cut her off for getting too belligerent. I've always wondered what influenced the decision on choice of liquor.

Clearly the martini's weren't on sale.

 

[gotname]

Our surgeons order 2 beers tid all the time to avoid alcohol withdrawal.

I would imagine that it wouldn't or shouldn't matter in desperate times but do people ever demand a particular drink in the same way some demand particular opiates?

 

[rokshana]

https://www.yahoo.com/health/french-drug-trial-disaster-leaves-one-brain-dead-164933973.html

and go...

 

[RangerBob]

https://www.yahoo.com/health/french-drug-trial-disaster-leaves-one-brain-dead-164933973.html

and go...

I heard about this too. What makes it even more unfortunate is I believe it was just a safety study and all the volunteers were fairly young and perfectly healthy.

The article I read suggested it was a study on the drug's efficacy for depression/anxiety rather than pain as the above article, but either way, this is a solemn reminder that advances in medicine sometimes come at the largest price we can pay. Unfortunately by its nature, medicine relies on others' suffering so that we have something to alleviate/remedy. But, there's often a temporal offset--we've now essentially eradicated Polio (I , but not until after watching countless become paralyzed from it. Yet we're still studying and trying to remedy Alzheimer's--my grandmother passed away from it and she wished that others wouldn't have to suffer from what she did when she was still aware of what she was losing.

Medicine is one of the noblest of pursuits, but I sure wish disease didn't exist and that there would be no need for us. It's always struck me as one of the ironies of medicine--our vocation is to alleviate suffering, and our calling is to strive to essentially put ourselves out of a job. Sadly, I think we're all aware that we can never fully achieve that--there's always a new problem and more suffering behind every door.

I sincerely hope in this case, where the participants weren't even expected to benefit from the drug (other than perhaps a small financial incentive and the idea that they would be helping those with depression or pain if the drug proved safe), that we're able to learn something that can somehow help alleviate the suffering of others.

 

[Trauma Surgeon]

Interesting post!
To OP, if you are not willing to accept the reality and in my opinion excellent advice you have received from aprogdirector, since you are so pro-cannabis, why don't you just seek a career in research and just prove your point? You say you already have "treated" over 1000 patients so you are not short of patients for a study...

 

[michaelrack]

http://www.theonion.com/graphic/how-get-medical-marijuana-card-52204

 

[j4pac]

http://www.theonion.com/graphic/how-get-medical-marijuana-card-52204

Step 5: Discuss with your physician whether Green Crack, Stevie Wonder, or Ghost Train Haze is best suited to your medical needs

Blahaha!!!!

 

[gutonc]

Blahaha!!!!

It's only funny because it's a ridiculous question. Everyone knows that Stevie Wonder is the only thing that works.

 

[Law2Doc]

I would imagine that it wouldn't or shouldn't matter in desperate times but do people ever demand a particular drink in the same way some demand particular opiates?

We sent the med student who was nominated for the beer run for a similar situation to just ask the patient what brand of (domestic) beer she drank. But my experience is these kinds of patients aren't real picky (and that's why you get situations with antifreeze and the like).

 

[Crayola227]

Can we get a psych eval for OP? Sounds like he's manic. We all know weed is benign. Just don't talk about it at work.

can we please not throw around a manic state, which is actually serious medical condition with a lot of social stigma attached to it, in a derogatory manner?

aren't we getting a little close to a TOS violation suggesting a psych eval for OP?

 

[tiedyeddog]

Our surgeons order 2 beers tid all the time to avoid alcohol withdrawal. One of our ICU attendings actually did the same... putting it down the NG tube if necessary. I always thought benzos were a cleaner method, but what do I know?

It looks disgusting btw. Hospital breakfast with 2 bud lights.

We order beer TID all the time in the neuro ICU. We literally do that more than trying to do CIWA and knocking someone out with benzo's. Making someone comatose with the CIWA scale is terrible in the neuro ICU, especially in the post-subarachnoid hemorrhage patients, in which vasospasm might be causing permanent damage without us knowing it in our patients.

 

[blebb]

can we please not throw around a manic state, which is actually serious medical condition with a lot of social stigma attached to it, in a derogatory manner?

aren't we getting a little close to a TOS violation suggesting a psych eval for OP?

It's called sarcasm you literal weirdo

 

[Crayola227]

It's called sarcasm you literal weirdo

again, namecalling which I just saw chastised by mod in this very thread

just thought I would speak up, just got off another thread about stigma towards bipolar physicians
https://forums.studentdoctor.net/th...as-a-bipolar-physician.1050906/#post-17334896

 

[WingedOx]

Still, sarcasm aside, based on the OPs decision making and posting, I'm not sure that there isn't a bit of a mental health problem there.

 

[Giic]

Just when you think you've heard every story, SDN comes through with a doozy. Thank you, internet.

Ok. Now, back to your questions.

#1. Almost certainly no. Not sure if there are any FM PDs on any threads, but any credit you get would probably max out at 6 months. That is IM. FM might not even be able to give that much.
#2. For many PDs, yes. But not as much as your initial dropping out was by itself. It shows uncertainty in your mind and makes me worry that when things gets difficult, you will drop out again.
#3. Save cash for applying to literally *every* FM program in the country, cultivate and use whatever connections you have at your home medical school and prior residency to see if you can get a face-to-face with an actual FM PD.
#4. Unknowable. You are not just a below average student anymore. You are a prior grad with a sketchy career decision. Small pro-tip: If completing a residency is your priority, be ready to totally jettison the bontanicals until you are done and gone from training. If you limit your applications to Cannabis-friendly states (which may not have cannabis friendly PDs), you are screwing yourself. If you talk about how great cannabis is to the wrong person, you will literally have your application flushed down the toilet no matter what else happens.

LMAO.
"Cultivate" and use whatever connections you have - LOL.

 

[Giic]

.

 

[Giic]

Greeting SDN! Its been a while and I appreciate any input!

I left a residency after intern year on great terms in 2012 (6 months notice, they found a replacement from same institution, No bad blood whatsoever), moved to California, got licensed and started recommending cannabis to pay the bills. Since then I have also worked urgent care at festivals and concerts and done some volunteering, but nothing in the hospital. It has been an interesting experience and I know the healing power of plants is real, especially cannabis.

Nothing bad happened during intern year, I got along great with everyone and did fine in rotations, I just took a chance. I told my PD way early about my intentions.


4 questions????
1- is it possible to enter as a PGY-2?
2- is being a "cannabis doc" a huge red flag (i know it will depend on the program)
3- what should i be doing to match in 2017?
4- what are my chances?

much love and respect

To answer your questions:
1- Absolutely not. You are in no position to supervise interns. You haven't been in medical practice for 5 years (it will be 5 years when you start).
2- If you want to be a cannabis doctor, fine. But you have no business in medicine. No, that is not medicine. Why would you need a family medicine residency to practice your chosen field of "Cannabis Medicine"? If I was the program director, I would only wonder why you want to be in my program. If it is just a back-up plan for financial reasons, then I absolutely will not accept you.
3- Whatever you feel like. After all, that is what you did back in 2012 - whatever you felt like.
4- Low.

You know, you really give yourself a fancy name "cannabis doctor". How did you get into this business? Why are/were you so hell bent on this line of work, so convinced that this drug cures all? I'm sure I can guess the reason.
Nothing irks me more than people who go into medicine for all the wrong reasons. They are the reason why crap happens, and why the profession gets a bad rap.
I read through the threads and saw where you asked IMPD if he has any other cures for seizures, insomnia, etc..... You know - they teach that in residency.

 

[Giic]

Not really. Oldest, safest, best medicine on the planet. Most useful plant on the planet. Put down your lancet and wash your hands this is 2016.

LOL you know nothing about medicine.

 

[Giic]

You seem extremely passionate about what you do and that's great. However, if you believe these people don't know enough about weed to speak on it as they "haven't worked in the field" then is it not logical to assume that maybe you don't know enough about what you need to get back into residency (they do) because you are not privy to the ins & outs of the medical field as you're not in it?

I ask because you willingly asked for advice but seem to argue when it is given. This seems more like you are explaining why you love your job than why you want to go back to residency.

And you mentioned despising suffering, wanting to end it and how weed helps a lot of it. As a patient, I think that suffering is like on of those huge Taco Bell burritos I see advertised on TV - there are very many layers to it. Everyone is different in regards to what will make them feel better. However, many times, feeling better may not be synonymous with actually being better.

So funny how he/she can be so one-track minded. How can you claim weed cures everything, attack everyone by saying they don't know your 'field' - yet you only completed intern year of PMR, and therefore you don't know ANY medicine??? The failure to see other people's viewpoint, despite being a neophyte in their area of expertise?
So it really begs the question of the INTENTION of wanting to go back into medicine. Clearly, it's not because he/she subscribes to any of this. Seems like it's just to make money and remain afloat.
Being so cantankerous and rigid, he/she will probably be kicked out of whatever program they get into.
This thread makes me mad.

 

[Crayola227]

To answer your questions:
1- Absolutely not. You are in no position to supervise interns. You haven't been in medical practice for 5 years (it will be 5 years when you start).
2- If you want to be a cannabis doctor, fine. But you have no business in medicine. No, that is not medicine. Why would you need a family medicine residency to practice your chosen field of "Cannabis Medicine"? If I was the program director, I would only wonder why you want to be in my program. If it is just a back-up plan for financial reasons, then I absolutely will not accept you.
3- Whatever you feel like. After all, that is what you did back in 2012 - whatever you felt like.
4- Low.

You know, you really give yourself a fancy name "cannabis doctor". How did you get into this business? Why are/were you so hell bent on this line of work, so convinced that this drug cures all? I'm sure I can guess the reason.
Nothing irks me more than people who go into medicine for all the wrong reasons. They are the reason why crap happens, and why the profession gets a bad rap.
I read through the threads and saw where you asked IMPD if he has any other cures for seizures, insomnia, etc..... You know - they teach that in residency.

Hell, they teach that in med school.

 

[Giic]

boThis will be my last post on this thread. It's clear we're talking past each other.



Actually, if you take some advice on this thread, you will have some chance of getting a spot. I don't think that you need to give up / turn against cannabis completely, but you need to tone it down, stop prescribing unless allowed in the state you're training in and approved by your program



What are you smoking? (That's a joke, in case it wasn't obvious) That's not what I'm saying at all. Many of my patients have, and will use cannabis. And in fact, I've written "MJ Letters" so they can get it if they qualify. But I think that the evidence that MJ is actually effective is terrible. And I want more evidence. Will I refuse to give MJ to someone because there is no evidence? Nope. (Or, yes, I will give it to them). But I won't go wild recommending it for a bunch of things that we have no idea if it works.

Here's our disagreement, in a nut shell. Your common sense happens to equal my concern that this is all placebo effect. And that's the rub. You're position might be that, if it really was all placebo effect, who cares? They feel better, so mission accomplished. My position is that we don't treat people with placebos. There is a vocal group in medicine who feels we should consider bringing back placebos, since they actually work quite well for subjective complaints.


Probably not. But cannabis addiction does happen. And the more we use it, the more likely we are to get some subgroup addicted. This is exactly what we have seen from the expansion of use of narcotics. We were told by well meaning people that people in pain don't get addicted. And now it's clear that it happens, and increasing the supply gets bystanders addicted.


Prescription drugs are not the #1 killer in the US. And when we do look at prescription drugs that kill, its the narcotics that lead the way. And we should be using less of them. I have no idea what peanut butter has to do with anything.


This is ridiculous. I can talk to my patients about cannabis. I was only tested when hired, never since. We don't get randomly tested. Your conclusion is incorrect.

You're so convinced that you're right, you can't see the other side of the discussion. And honestly, that's terrifying.

Over and out.

Quite a thoughtful post, and you spelled out a lot of things most of us wanted to articulate. The last sentence is the most significant: so convinced you're right, can't see the other side = terrifying....

I think the question "what are you smoking" is a valid one here...

 

[Giic]

ah, brain fart. The last couple states I've lived in have required at least two years for an unrestricted license.

Which, as far as I'm concerned, struck me as the biggest irony of this thread. Everyone talks about how California medical license is the hardest one to get, and they are so strict, and blah blah blah.... But apparently, docs who complete only intern year, and who want to practice Cannabis Medicine, and who get **all** their CME from the journal of Cannabinomics are all good.

 

[Raryn]

Which, as far as I'm concerned, struck me as the biggest irony of this thread. Everyone talks about how California medical license is the hardest one to get, and they are so strict, and blah blah blah.... But apparently, docs who complete only intern year, and who want to practice Cannabis Medicine, and who get **all** their CME from the journal of Cannabinomics are all good.

For US grads, something like ~35 states will license you after 1 year. For foreign grads, the number was 1-2 (WI and for most schools Georgia) but there was legislation to decrease it further.

 

[Impromptu]

My question is how did the OP pay for his/her student loans for medical school? Was his/her career choice that lucrative? It might have been.

I do like the idea of doing honest research to try and disprove the benefits of cannabis. That would show a true love of science, skepticism, and the scientific method. Who better to do that research? Get that under your belt and you may have an even better chance.

I know people who hold convictions just as deep for essential oils, and will not let a single shade of doubt invade their faith, and there is far less evidence there. It wanders into the realm of faith and religion.