Lifestyle as a Med Student

[cmn623]

I'm wondering if anyone could share with me a little bit about what it is like to be a med student in Ireland. I realize that becoming a doctor takes a lot of devotion and requires the input of much effort and studying and, this is something that I feel I am ready for. However, should I get accepted at an Irish school, I would defiantly like to take advantage of being in Ireland and learning more about my heritage. So.. basically what I am asking is if all you Med students have any time to enjoy yourself when you do have so much work and that is, more than likely, your first priority.

Also.. I heard that UCD does not have a program for those intending to become ob/gyns. Is this true? If so what schools do allow students to pursue this career and are there any ways to get around this at UCD?

Thanks all!

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[leorl]

Medicine here is a lot more lifestyle-pleasant than medicine in the US . Here, you have to do an awful lot of work which is self-motivated (ie. sometimes nearly teaching yourself whole subjects without much direction), but there's plenty of time for playing too. Do a search in these forums. You'll find that many of us here are involved in some very time-intensive extracurriculars in addition to studying medicine. It's one of the more enjoyable things too...getting to do something that you know you wouldn't have had time for if you were studying in the US.

By the way...if you write a ps...i wouldn't necessarily harp on the fact of your Irish heritage...if you feel like it, mention it...but you wouldn't believe how many people are over here "finding their roots." I might actually slap some tourist the next time they say it.

 

[1stMed]

Hi...
I'm a 1st Med student and I absolutely LOVE it! Don't get me wrong... it's long hours and tonnes of work, but there's a great comradery between all the students.
We're all in it together kinda, so we all help each other out! Don't get me wrong it's not the Brady bunch or anything... but they're a good crowd!
Definatley... you do need to be dedicated, but you have to step back once in a while and enjoy yourself! It's a hard slog.... but I'd like to think it'll be worth it eventually!

Good Luck!

 

[cmn623]

Thanks for the responses. Also, I wouldn't consider myself a tourist considering I was born/lived in Ireland and visit family regularly. However, I realize that I did not phrase that statement in the best way and, because of this, did not convey what I have just said and I apologize for that. Regardless of my situation though, I don't think that anyone trying to gain an appreciation of where they came from should irk you in such a way, leorl. Many of my friends here have distance connections to a variety of countries, among which include Ireland, and I find it great as well as important that they have the desire to learn more about their heritage. I don't think that deserves a "slap" haha In any case, what I meant in my former statement is that I wish to take advantage of being back in the country should I end up going to school there. I also thought that my past might enhance my ps, showing that I have a true and genuine affinity for the country. Do you or anyone else have any thoughts on that?

 

[cmn623]

By the way 1stMed.. where do you go to school. It seems like you're really enjoying yourself

 

[Sage880]

Regardless of my situation though, I don't think that anyone trying to gain an appreciation of where they came from should irk you in such a way, leorl. Many of my friends here have distance connections to a variety of countries, among which include Ireland, and I find it great as well as important that they have the desire to learn more about their heritage. I don't think that deserves a "slap" haha

Seriously, don't take it personally. But you'll see here when you get here. Every second person and their neighbour coming over here is "Irish and trying to find their roots" and sometimes I think it annoys the Irish who live here.

Med school life is fine here. Probably less stressful at the start then north America. But a lot of the curriculums have started to change (UCD and UCC especially) to be more like the American bottom-up, harder at the start style. In the past, first year was a breeze and then every year got harder with third and fifth being killer. They're starting to re-distribute the load the last couple years but I really think that's a good thing.

Also, you can't tell from this forum at all but med school is much more pleasent to be in over here due to the lower amount of hard-core type "A" personalities.

 

[VeerTheTIGuy]

I'm curious to hear some responses from medics in their clinical years (esp 4/5th years). Although I attend med school in the UK, I'm assuming it's similar and want to try and get a grasp as to how the lifestyle differs from their preclin years

 

[leorl]

okay, well obviously lifestyle has to change. You can't go to the pub every night and get drunk and show up to ward rounds hungover. And also your class becomes split so you don't see 1/3-1/2 of your class at various points. You have to do a lot more work by yourself because it's dependent on what you see during rotation and what is expected of you at the rotation. Less lectures, more self-reading. Also, it's the time when you're actually expected to know something and prepare to be a full working doctor...so the info you're learning has to stick. It isn't like preclin where you can get by cramming and then forgetting.

 

[Badkarma25]

i really have to be the voice of dissension here....if you have a degree from a north american school, then you will have LOADS of free time here. not to take away anything from the other people who posted in this thread, and while recognizing that different people need to do more or less work to achieve the same results here, the first 3 years of the program at ucd are a joke compared to my undergrad degree. fewer hours of classes and labs per week, fewer assignments, just more free time. now in fairness, i know some of this might have changed with regard to the new modularization thing going on, but i don't think it could have changed that much. i've had a part-time job working 20 hours a week for the past 2 years and i've traveled to more places than you shake a stick at. my advice would be live it up and travel and enjoy the freedom. all you have to do is work smart, which is not the same as working hard.

 

[pattycanuck]

I have to agree wholeheartedly with bk25 - the ethos should be work smart. What he is doing is pretty much what I and many others did in Ireland and we got to either work or play hard while studying and traveling around Ireland and Europe.

And you can go to the pub every night ... just that you don't have to get sloshed every single time ... think of it like the meeting place of a culture. Ireland has pubs, Americans and Canadians have coffee shops (in Canada it's Tim Hortons's - oh by the way, they have Timmy's there too!). Like Timmy's there is one pub on every corner

 

[leorl]

i really have to be the voice of dissension here....if you have a degree from a north american school, then you will have LOADS of free time here. not to take away anything from the other people who posted in this thread, and while recognizing that different people need to do more or less work to achieve the same results here, the first 3 years of the program at ucd are a joke compared to my undergrad degree. fewer hours of classes and labs per week, fewer assignments, just more free time. now in fairness, i know some of this might have changed with regard to the new modularization thing going on, but i don't think it could have changed that much. i've had a part-time job working 20 hours a week for the past 2 years and i've traveled to more places than you shake a stick at. my advice would be live it up and travel and enjoy the freedom. all you have to do is work smart, which is not the same as working hard.

Agreed. I was answering the specific post appearing above mine, which asked about the difference in lifestyle change BETWEEN clinical and preclinical years.

In PRECLINICAL years, you have a lot of free time, time to really enjoy yourself and study well too.

In CLINICAL years, the lifestyle CHANGES. Because you're now working in a professional setting, you cannot be drinking every night and showing up hungover the next morning, and you have to do more self-directed reading according to what you see which may eat up more time (especially in core rotations) because you don't have time to do the reading while you're in hospital. There will be times as well that you need to spend more time in hospital to get more practice doing clinical maneuvers or actually, just be seen and get some face time in. Also, the travel time involved in going to some of your more distant teaching hospitals. However, many people manage to maintain doing their extracurriculars and what's necessary for clinical coursework. Another pertainent point for North Americans is that it's often during clinical years that you will be preparing for the USMLE as well. So obviously, your care-free preclinical years will basically end once you get into the middle of your clinical years.

 

[1stMed]

By the way 1stMed.. where do you go to school. It seems like you're really enjoying yourself

Sorry for the delay in replying! Anatomy was taking over! Yeah I'm in RCSI... so there's a huge mix of people!!...Makes for a really interesting year!

Wouldn't swap it!!

 

[VeerTheTIGuy]

thanks leorl for the replies. i'm trying to get more of a grasp of what will be expected of us in the clinical rotations (esp. compared to US clinical years - or even just a US clerkship), but I guess that's a topic for another thread...

 

[leorl]

In US clinicals, you're actually part of the team. You're assigned patients, with whom you're meant to direct management (with supervision, obviously). This means that you're sort of more learning by doing instead of learning by theory - this is just on medicine rotations. I'm not sure if clinical experiences is different in core rotations. You have more to do sooner - as in, you'd be expected to preround, present your patient, present changes in your patient's care, further investigations and management depending on the course of disease progression during stay, etc. It's nice.

Over here, it's much more observational. You maybe don't spend so much time doing in hospital. You have lots of breaks where you're holding up the wall and in those times, you do some reading if you're motivated to (moreso in your core rotations). You also spend non-teaching time taking histories and practicing examinations, but you're not assigned specific patients. You pick random suitable ones, jot down your notes and then try to track down an intern/SHO/reg to try to present it to for feedback. In some rotations, you may be assigned patients to follow - but your ideas of management might not come so much into play as in US rotations.

I'll try to think of more differences later. After being here awhile, doing US electives is refreshing because you actually get to do something...instead of learning the theory about or watching someone do something.

 

[JediBookworm]

Thanks for the insight, leorl. Sounds like Irish clinicals aren't that involving...anybody know about clinicals in Canada or UK? What about differences in residencies/internships?

 

[leorl]

Some Irish rotations can be involving, just on general, not as much as the US.

From what I've seen about internship - it's nearly the same every where...paperwork paperwork paperwork. Only the Irish seem to have a lot more of it . Sometimes I think interns here get frustrated because they don't get to use any of the medicine learned...they're pretty much errand rats in some cases. That's a universal frustration but I think in the US, interns may get to do slightly more medicine...there's a very good buddy system that happens in the hospitals. The senior doctor is in charge of the junior doctor and must make sure he/she does good teaching, otherwise the junior and the other team members will give him a poor evaluation. Likewise, the fellow is in charge of the senior and making sure the senior is on the ball. So there's a lot more top-down method of ensuring everyone's getting good training.

Whereas here, I don't really see that happening. The interns are given their jobs to do, they go off and do them, and I don't really see too much team interaction in terms of intern teaching and a top-down method. But it must happen somehow.

 

[JediBookworm]

That makes sense...I guess there is a reason why the UK system is undergoing changes to become more like the US system in terms of postgraduate medicine...

 

[leorl]

well, they have an interestingly bizarre problem. Basically, not enough consultancy places but an oversupply of junior doctors (someone definitely screwed up in the planning somewhere). So lots of people in seemingly static jobs, or even failing to get a job. The Irish system is changing too, it will be interesting to see if it improves things (ie. more consultants and more consultant-based care, + increase in Irish junior doctors). A lot of what junior doctors do here...is what you see more specialized nurses doing in US hospitals. For instance, respiratory nurses doing ABGs instead of interns being bleeped at 4 am to do them, etc.

Now in the US, it's kind of the opposite problem. It is nice to have a person for every job, but it's becoming very very specialized (which means a loss of overall skills). And it just means trying to coordinate more people, which can be inefficient and a pain in the butt.

My observation of US and Irish hospitals is that even though they way they're run may be different, and even though the US hospitals have more access to resources - you can see nearly the same problems/frustrations happening in both (ie. not enough beds, inefficiency through bureacracy or interdepartmental miscommunication, etc.)

 

[leorl]

Now, i know i've kind of implied that Irish rotations not being as involving is a bad thing, but it isn't really. It suits someone like myself who has other things going on in my life and it's nice to not feel guilty about leaving hospital and not having to worry about looking bad to the team or consultant. As long as you make good use of your time in hospital, engage with the team and ask questions and try to find out more, you'll do fine. It's nice being able to learn what you need to and have some free time too

 

[VeerTheTIGuy]

thanks for the responses leorl, i've gotten the same response about UK schools from some of my friends in higher years...i'm just worried about the transition from UK clinical years to a US residency...but i guess only time will tell

 

[pattycanuck]

The Irish system is changing too, it will be interesting to see if it improves things (ie. more consultants and more consultant-based care, + increase in Irish junior doctors). A lot of what junior doctors do here...is what you see more specialized nurses doing in US hospitals. For instance, respiratory nurses doing ABGs instead of interns being bleeped at 4 am to do them, etc.

Do you think that the Irish system will change in your time there as a graduate (if you stay)? Now that I worked in that system and have seen it against the Canadian and Australian systems (and for my wife, US, Canadian, and Australian), our summaries of comparison say that (at least):

1) the Irish system is waaaay to slow in changing
2) the chances of it changing because of the setup now are pretty poor
3) the amount of power and earnings of individuals (consultants and administration - presently in the establishment is pretty high - they definitely do not want changes)

You can see this in a example issues - there are many more:

1) the A&E crisis -my wife was an A&E registrar (equivalent of senior resident) in Beaumont hospital (the major neurological centre in Ireland and a major trauma centre on the northside of Dublin associated with Surgeons) before coming back to Canada - no joke - it looked like a third world country in there (I saw it was well) ... al the time ... and it's not going to change anytime soon
2) the European Working Time Directive (max 56 hrs/wk worked)- that has been talkled about, placed into IRISH law and muddled over for the past 4 years - still no sign of it in the wards; for post graduate surgery, they've placed a rule (general message) in by saying that their time working is an "educational" experience and does not include time at work - so welcome back to the 100+hr weeks juniors!
3) nurses - wait till you first night on call - 50% of your call (and for some your day job) is placing IV lines - yes, you are a part/full time phlebotomist (in NA, you may only put in as many IVs as on the number of fingers on your hands) - compared to NA nurses in terms of tasks and responsibilities, they are roughly the equivalent of orderlies (leorl just wondering, where are there respiratiory nurses in James or Tallaght? I haven't heard of that from my mates who work there as SHOs and registrars?)
4) older consultants - when are they going to relinquish power anytime soon? only when they retire, or jokingly when they "die". These guys wont want to do call, and when faced with young pups coming through the ranks and wanting to do call and other things that older old-school consultants don't want to do, then you'll have disputes. It will filter down to the junior level as well as when certain consultants are on call, some juniors will work (when working with the old-school) and some wont (when working with the new). With the registrars coming in now, do you think that they will like to work call as well as they have been dogged over the past few years of their training; that can only preclude that this generation of registrars will not be onboard and that change of this can happen only at the grass roots level.

My two cents on this topic ... open to debate

 

[leorl]

it definitely is a debate. I basically see and thought of all your points, and this is why I remain very skeptical about the changes that are about to take place. I've said before - the theory behind these are very good and make sense, but I'm afraid in practice it's going to make a further mess of things.

Very quickly because I'm studying for exams:
1) I have no idea how long it will take for change to come through. It's meant to come in as soon as next year (EUWTD meant to be enforced, blah blah blah) but you and I know how long it takes things to change in this country. However, I think EUWTD is actually meant to be enforced from Jan 1 2008. They are more resistant to change, especially with very conservative old-world consultants obviously dissenting.

There is a very real fear that as junior doctors, we will end up working for free. EUWTD limits work hours which on the outside sounds quite good, but it won't be put into practice. Junior doctors will end up working the same hours but because those hours can't be put on books, essentially they will end up working for free (whereas they got overtime before). Junior doctors also do not really have the authority to say "oh sorry, EUWTD, I gotta go now..." without looking unambitious and lacking in motivation to senior doctors from whom they need their evaluations, and a lot of the old world consultants will be of the mind that "I put in those hours as an intern and so should they, whatever paid or not."

I can't say about beaumont...but they're not known to have a fab A&E...neither is the mater. I actually think James's A&E is okay, Tallaght...way too small. When I said about the respiratory nurses, I was referring to US hospitals...not Irish ones . I don't think I've seen a resp nurse here, although I've seen respiratory PTs.

If you want to limit intern hours, that means there must be increasing resources to take over intern's jobs (which actually interns shouldn't be doing any how if they want to focus more on medicine - taking bloods, running errands, etc.). Either more intern posts to rotate shifts with subsequent increase in SHO/registrar/consultant spots, or hire more ancilliary health professionals. Yet they refuse to hire and train more nurses to do this stuff. They have phlebotomists, but somehow there's still a shortage - maybe phlebotomists don't do call in this country or something. Basically the limit to this country's grand plans is the limit in resources - no money means you can't change anything. But in some ways it isn't a question about not having enough money...it's the enormous wastefulness that happens here sometimes.

 

[leorl]

thanks for the responses leorl, i've gotten the same response about UK schools from some of my friends in higher years...i'm just worried about the transition from UK clinical years to a US residency...but i guess only time will tell

This is why if you're interested in practicing in the US, you should try to get some US experience in (electives and such). some programs even if they accept you may make you do an observational period. From what I've heard, we catch up fine...it may be a steeper learning curve in the first weeks or so, but then you'll get the hang of it.

When I did my first US elective, talk about massive adjustment and you look like a complete fool the first week, but then once you get the hang of it it's fine. Mainly in the way they write notes (ie getting used to writing SOAPS and admit orders). But in terms of history/presentation, it's basically the same as how we learn here - but I mean, this should be universal because there's really only one way to do a H&P efficiently, with slight personal differences in style maybe.

 

[VeerTheTIGuy]

This is why if you're interested in practicing in the US, you should try to get some US experience in (electives and such). some programs even if they accept you may make you do an observational period. From what I've heard, we catch up fine...it may be a steeper learning curve in the first weeks or so, but then you'll get the hang of it.

When I did my first US elective, talk about massive adjustment and you look like a complete fool the first week, but then once you get the hang of it it's fine. Mainly in the way they write notes (ie getting used to writing SOAPS and admit orders). But in terms of history/presentation, it's basically the same as how we learn here - but I mean, this should be universal because there's really only one way to do a H&P efficiently, with slight personal differences in style maybe.

yeah, even though i've got a few years before i start clinicals, i've already been looking for US electives...i've been fortunate enough to spend almost all my summer free time with different docs back in my home city, so hopefully this experience will help when the time comes...

thanks for all the info/advice

 

[JediBookworm]

Hmmm seems like I have to do some digging around during my pre-clinical years...how is the UK system similar or different to the Irish one? Is there anybody who has done an internship in a UK hospital after obtaining an Irish degree?

 

[leorl]

Yes. Quite a few Irish docs secure places in UK hospitals. I actually know a Canadian who did it and she's now in Belfast (although I think she had an EU passport. not sure though). However, while there is still interest, a few people are shying away from it now because the UK have changed their junior doctor program to the Foundation programme (which I'm not too familiar with), which involves 2 years of internship instead of the normal 1 year, not to mention the difficulties with the UK system at present. You might find in your time that maybe more Irish (from up north) would be interested in this than FMGs, as FMG allowance into the UK system has apparently gotten significantly stricter.

 

[Sage880]

i really have to be the voice of dissension here....if you have a degree from a north american school, then you will have LOADS of free time here. not to take away anything from the other people who posted in this thread, and while recognizing that different people need to do more or less work to achieve the same results here, the first 3 years of the program at ucd are a joke compared to my undergrad degree. fewer hours of classes and labs per week, fewer assignments, just more free time. now in fairness, i know some of this might have changed with regard to the new modularization thing going on, but i don't think it could have changed that much. i've had a part-time job working 20 hours a week for the past 2 years and i've traveled to more places than you shake a stick at. my advice would be live it up and travel and enjoy the freedom. all you have to do is work smart, which is not the same as working hard.

Have you seen the new ciriculum at UCC (and I heard UCD)? They've added some courses and pushed back pharm and path (and clinical skills) to start in first year. The first and second years are actually fairly swamped.

Right now they drop both those courses on us in third year. And after spending most nights in the library, I'd love to have started those courses during the first two year snoozefest.

 

[PaddyofNine]

I can't say about beaumont...but they're not known to have a fab A&E...neither is the mater. I actually think James's A&E is okay, Tallaght...way too small.

What about our cool, spanking new A&E in Vincent's?

 

[cmn623]

I had heard from a cousin there in med school that they were crying out for doctors in ireland.. maybe that was just GPs not too sure. Anyways my concern is what is it looking like for jobs for med school graduates over in Ireland? im presuming that, because of the shortage of residences in ireland, there is also a shortage of jobs for specialized doctors over there?? I would preferentially like to study in Ireland over the US because I would like to stay there.. but it seems like this might be a rather stupid decision on my part, should I be fortunate enough to be accepted to US schools as well. Like I have mentioned I do have EU citizenship but it sounds like even this may not be all too helpful in securing residency and then a job. If I am given the opportunity .. would it be better for me to study in America and then try to get a job after that in Ireland?? My confusion is deepened in that I've heard that it is better to go to a medical school in the country you intend to practice in for many reasons among which include procedural differences within hospitals in different countries. From reading your comments i have to say that i found it scary that during residency med school students are basically taking over the role of nurses instead of getting hands on experience in their own areas.. it seems like, in this respect, irish students couldnt possibly be as prepared as US students to go off on their own after residency (on the basis of experience).. then and again i am not in school over there nor have i been through residency so im hoping you could all shed some light on these concerns... i would love to study in ireland but it seems like, for what you have all said, it might be better to wait it out and study in the US and then see whats available. so confused...

 

[leorl]

To Paddy, I unfortunately have never had the pleasure of visiting Vincent's They are Trinity unfriendly ;( hehe just kidding.

I wouldn't say they are crying out for doctors in Ireland - there is a bit of a shortage, but a crying out means exactly that - it doesn't mean they have the resources to fund increased services. I do think that there probably is more shortage at a GP level - it's amazing really, there are no GP services in some of the most needy places.

The situation isn't here yet where there is a shortage of higher doctor positions (not like in the UK). What happens when you graduate and if you intend to stay, is that you are placed in one of your teaching or affiliate hospitals for your intern year, so you don't necessarily have to go searching for a job. After the intern year, for those who chose to stay quite a few decide to go elsewhere (ie. back home for non-Irish) and a few stay on.

During residency..med school students aren't taking over the role of nurses! no way! med students - we try procedures once in awhile, given the opportunity...but it's not a regular thing. Intern year, you will be probably doing a lot of things like taking bloods, etc. However, you musn't assume this is a nurse's job either. In the US, things have gotten so specialized that nurses do assume those duties. But it's arrogant to think that just because you do the same thing here, that you are being "relegated to nurses' duties." You have to know how to do the same things and do them well, otherwise you'll look like a fool of a doctor.

I think your confusion is lying in the differences between intern year here and intern year in the US. Intern year in the US is a singular experience - it is defined as the first year of your residency and therefore specialized. Intern year everywhere else in the world is not connected to your specialization of interest, but is a general skills-gathering time. You do 6 months of medicine, 6 months of surgery and aren't specialized yet. It is in this time that you do pick up some skills, but we've just noted here that you do an awful lot of paper pushing and pricking as well (same as intern year anywhere).

You're also confusing "residency." Residency is the period after graduation, in which you are practicing in the field you're specializing in. You can be let loose after residency to practice on your own, but this isn't at a student level. During residency, you acquire all the skills you need to be an independent consultant/attending. It basically doesn't have anything to do with medical school training except that you've obviously had to graduate from medical school to enter a residency. So it is nearly impossible to be unprepared or unfit for practice after following the progression of education, so your fears of Irish graduates being unprepared is mislaid.

As I said before, for any FMG coming to the US system, there is a catchup period while you get used to the US system (1 week to a month or so), just as there would be for a US grad starting into the UK/EU/Oz system. It's more a period of adjustment rather than a skills thing. For instance, no medical school really teaches you how to do an internal jugular line - you might have had a chance to do one in schooling, but it's not a regular occurrence. In the US, you learn and practice doing it during your residency (surgical or IM), so even if you have graduated from a foreign school, you're not "behind" in that respect.

 

[cmn623]

Thanks for the clarification leorl, I was defiantly very confused. So you're saying that intern year in Ireland is part of the 5 years of medical school (if you are in a 5 year program)? and this is separate from residency. Also I didn't mean to demean nursing positions, you are very right that doctors must be well-rounded, I just thought for some reason that this is what they were doing during their specialization period, which is what led to my concern. Thanks again for clearing things up for me!