The Medical Thread

Well, it's almost impossible to cure birds of feather plucking. And galahs have a nasty bite.

It will be frustrating enough to drive you to drink (Not that that's a very long drive for most students).

edited 27th Mar '13 6:03:19 AM by LoniJay

Heh. I suspect the same thing applies to dealing with people.

edited 27th Mar '13 9:07:04 AM by Pyrite

Long drive? It's a 15 to 20 minute walk if that.

Random question, for my book.

I heard that after graduating high school it takes about 10~12 years to become a doctor, undergraduate, med school, residency and all that.

Do you suppose it would be possible to, well, condense it into a really rigorous (not that real life course isn't already rigorous, of course) 6~8 years long program?

Welp, it depends. It usually takes 4-5 years of medical school to get a basic medical degree (Bachelor equivalent), which means that people can call you "Doctor". But if we're talking about any kind of specialist training, that usually adds another 6 years or more to the length of study (at least).

To condense the whole experience into a 6-8 year programme is ambitious, but difficult. Very difficult.

Okay, so it's theoretically possible.

Okay, perhaps I didn't make it clear enough: what kind of "doctor" are you looking for? You spend 4-5 years in medical school, you get to be called "Doctor" even if you're a completely green house officer / intern. You want further specialisation, you gotta work a lot longer.

The basic degree is usually obtained within 4-5 years; even if you go through internship as part of a training programme (if not, add another one or two years), obtaining Registrar-level qualifications (which is actually the start of specialist training) can take anywhere between 3 to 5 years, and then completing that takes another 3 to 5, give or take. (For comparison.) It usually takes this long because the key to medicine is obtaining practical experience, which you may not be able to gain within the 6-8 year timeframe specified if you're trying to cram everything up to consultant qualifications. (You'd also probably go insane.)

Specifically. ..uh...I don't know, what is that general practicioner that people tend to think when they hear doctor?

Also, I didn't think about the practical experience aspect. Oh right, so it is a straight impossibility, got it.

Ah, on that note... for primary care physicians, the qualifications required depend on what system you're in, and while most countries these days require general practitioners to take some form of specialisation course or residency programme, this was not always the case. For a competent GP character, assume at least registrar-equivalent training.

(Also, what I forgot to mention was getting into medical school itself can take a while depending on your country. Singapore follows the British system, so we start the moment we enter university, while apparently the US requires you to have a B.S. before even starting, so that might result in adding a few more years to your timeline.)

edited 30th Mar '13 5:27:47 AM by Pyrite

what is that general practicioner that people tend to think when they hear doctor?

They're called General practitioners

@Pyrite: hey if you don't mind me asking what sort of doctor are you anyway?

Blurgh, practitioner, that shouldn't be too hard to spell.

A terrible one.

Well, as long as you aren't a backalley one...

What time period are you looking at? It was possible in Australia a few decades ago to become a GP after maybe 8 years. Now you'd be looking at 10+.

You can shorten the schooling time, if you're both smart enough to test out of as many classes as you can and physically strong enough to overbook your remaining classes into a schedule that's much heavier than normal.

Most people now take five years to get a bachelor's degree. When I was in college (late 70's), most people took four years to get a Bachelor's. I got mine in three, by a combination of testing out of as many first-year courses as I could, (which, fortunately for me, was "most of them") and by carrying a class load that was heavier than most of my classmates. I generally had five to seven classroom hours everyday; most of my classmates had three or four, or maybe five hours of class on a day that they considered particularly heavy. However I was not taking a pre-med schedule: I would not have even tried to pack that many classes into each day had I been taking hard sciences with labs. I couldn't have fit them in, even if I had wanted to.

What you can't shorten is the post-degree hands-on training time.

edited 30th Mar '13 6:40:40 AM by Madrugada

Five hours a day is about average for me already, and the number of hours only increases as you progress.

Okay I suddenly hit a snag in a roleplay. I'm stupid and decided "I'm going to play a school nurse!" awhile ago. Normally I can BS my way through it with google but I'm confused at this one partly because the person I'm roleplaying with might have messed up some things.

Their character slipped, hit her head on the floor, got a concussion. They had a headache and then lost consciousness for a brief period of time later. We pointed out that minor concussions don't result in loss of consciousness, so the person said it was a combination of that and tiredness on the part of their character. The character hasn't been getting much sleep recently due to nightmares.

So the character got brought into the nurse's office. What the hell do I do? Google gives me steps for treating a concussion but it's like "If this happens go to a medical professional" I am the medical professional. How would a medical professional access the seriousness of a concussion? Does the loss of consciousness due to tiredness thing make any sense?

I have a feeling I'm putting so much more thought into this roleplay than the other person. They're new. I'm trying to cut them slack. I did worse things in my starting days as a roleplayer.

Unconsciousness followed by lucid interval followed by unconsciousness - warning bells for epidural haematoma are ringing in my head, but it seems unlikely for a mild head injury. Pyrite, would you ask for a CT scan immediately?

...Looks like I'm not going to be able to bluff my way out of this one. (Crap, it's been a while since I've been in the ED.)

From a medical standpoint... It depends on your local ER's policies and what kind of workflow they use to determine if a patient needs a scan or just observation. (I think ours uses the Canadian CT Head Rules.) But even before that: typically, loss of consciousness occurs the moment you sustain the trauma, not a while after. Which is where Yuan's mention of the "lucid interval" of an epidural haematoma comes in. Other things to look out for would be persistent headaches, vomiting, fluctuating consciousness, or new neurological findings (e.g. weakness or numbness, blurring of vision, slurring of speech).

But let's look at this from a more practical standpoint as an RP player. Remember that you're playing a school nurse with limited or no access to advanced neuroimaging - or for that matter, anything else beyond the most basic of investigations. So from an RP standpoint, one way you could fudge things is by sending the character to the local ER for further evaluation, and then cut to the next scene where the player gets a clean bill of health from the doctors there without going into details. (Most primary care providers would do that to play things safe.)

edited 3rd Apr '13 4:30:43 AM by Pyrite

Yeah ER cut away sounds best. Head trauma followed by periods of unconsciousness is not something a school nurse is going to take a risk on.

From a role rolling perspective you could just begin with your character annoying the girl with follow up observations. Shining a pen light into her eyes and asking her to count backwards. You don't need to go into the technical details.

edited 3rd Apr '13 6:02:59 AM by joeyjojo

Okay that helps a lot!! I had a feeling it was going to be something a school nurse wouldn't be able to take care of. Hopefully I will be able to convince the person I'm roleplaying with to do a cutaway to the ER or just a cutaway in general.

Today my wrestling team members asked me to come with that and get hammered. I refused, saying that I have a bad liver (a semi-lie; my dad does have a somewhat weak liver).

I wonder what other excuses I can use to get out of myself from drinking.

Just say that the second last thing you want to do is end up sodding drunk, bereft of all dignity, and puking your guts out all over the floor.

...The last thing you want to do is to have to clean up after everyone else ends up sodding drunk, bereft of all dignity, and puking their guts out all over the floor.

edited 5th Apr '13 9:41:29 PM by Pyrite

Yeah, everyone says that being the one who is sober enough to have to clean up after everyone is the worst.

But hey, blaming health, it's simpler. XP

What my uncle would do is get all his soft drinks poured out into bear glasses. Don't know if that helps.