EMT training as part of medical school

[ERDoc]

This thread makes me miss the days when the local Dr. could fix everything. They had to be prepared for whatever came through their doors. If they didn’t have a solution they pretty well made one up. So with this in mind a good dose of pre-hospital care knowledge would possibly be advantageous to make anyone, including Drs. producing more well rounded professionals and better citizens. Don’t get me wrong, specialization gives us great benefits and greater medical bills because so many professionals do not seek diversity in their training. Well rounded may not bring them more money but in the end isn’t service what we are all about? Physicians may never need pre-hospital emergency skills but if they ever do need them. I am sure they will be glad they took the time to prepare. It shouldn’t be the backbone of a medical program but would surely add value if included in pre-med education.

We had a pt come in from one of the oncology offices in cardiac arrest. This particular oncologist is so old he probably diagnosed the first cancer ever found. The guy arrested in the office and the oncologist administered intracardiac epi.

[Kiwiology]

So much of the MS1 and MS2 years are a complete waste of time. I have never once in clinical practice wondered about the CD40 ligand, or Krebs cycle intermediaries, or cholesterol manufacturing pathways, or looked through a microscope at a tumor to see if it was cancer. An injection of some practical knowledge would be a good thing. Some med students who rotate through our department don't even know how to glove up in a sterile manner.

'zilla

Then you need to change how you educated your physicians. We learn all that stuff and you know, actually touch patients at the same time during all 5 years of the MBChB

Mind you, we don't have to pass some silly standardised test either

I have seen a lot of "teach the test" in America as you blokes love standardised tests hmmm, I wonder if that is partly to blame, or it could be a false positive

[Kiwiology]

So much of the MS1 and MS2 years are a complete waste of time. I have never once in clinical practice wondered about the CD40 ligand, or Krebs cycle intermediaries, or cholesterol manufacturing pathways, or looked through a microscope at a tumor to see if it was cancer. An injection of some practical knowledge would be a good thing. Some med students who rotate through our department don't even know how to glove up in a sterile manner.

'zilla

Then you need to change how you educated your physicians. We learn all that stuff and you know, actually touch patients at the same time during all 5 years of the MBChB

Mind you, we don't have to pass some silly standardised test either

I have seen a lot of "teach the test" in America as you blokes love standardised tests hmmm, I wonder if that is partly to blame, or it could be a false positive

[fiznat]

Then you need to change how you educated your physicians.

[chbare]

Then you need to change how you educated your physicians. We learn all that stuff and you know, actually touch patients at the same time during all 5 years of the MBChB

Mind you, we don't have to pass some silly standardised test either

I have seen a lot of "teach the test" in America as you blokes love standardised tests hmmm, I wonder if that is partly to blame, or it could be a false positive

We must also remember that the American physician is fundamentally a scientist. I believe this is why the typical curriculum focuses so heavily on physical science and why a curriculum heavy in physical science is required prior to entering medical school. A physician may be involved in much more than just clinical medicine, such as research. Therefore, I believe this is why the curriculum is heavy on didactic knowledge. Of course, the physician typically spends several years following medical school, touching patients as you put it. I think your assumption that all they do in medical education is "teaching the test" is just a bit myopic.

Take care,

chbare.

[Kiwiology]

We must also remember that the American physician is fundamentally a scientist. I believe this is why the typical curriculum focuses so heavily on physical science and why a curriculum heavy in physical science is required prior to entering medical school. A physician may be involved in much more than just clinical medicine, such as research. Therefore, I believe this is why the curriculum is heavy on didactic knowledge. Of course, the physician typically spends several years following medical school, touching patients as you put it. I think your assumption that all they do in medical education is "teaching the test" is just a bit myopic.

Take care,

chbare.

I did not say you taught the test, but cannot help wonder if that is somehow a confounding variable, or perhaps it is a false positive on my part. Myopic? Heck I am a blind bugger thats for sure so you have that right! LOL

The article made mention that the reasoning behind this program was because medical students lacked fundamental interpersonal and problem solving skills, this is quite worrying

Our medical education is quite different, we place as much emphasis during all years of the medical program on not only learning the science of medicine but also the art of patient touching ... you know, structured community and clinical praxis.

Perhaps your model is why US doctors are so good at ordering lots of expensive tests? </taking the piss>

[Kiwiology]

Where do all of your excellent trained physicians go to work? I have heard NZ has had a los of hospital closures and Health system difficulties.

Not sure where you heard that but yes we have health system problems like any system

I'm not trying to say we're better but it strikes me as odd that during the first two years of medical school in the US there seems to be little to no structured clinical exposure and cannot help wonder if that is part of the problem?

[chbare]

Perhaps your model is why US doctors are so good at ordering lots of expensive tests? </taking the piss>

I hope you really know why defensive medicine is prolific in the United States?

Take care,

chbare.

[Richard B the EMT]

i mention a friend, an MD, 25 years ago, made some pocket money teaching American Red Cross CPR to other doctors. He told me an interesting story regarding that.

He asked the students what to do when discovering a patient who is breathless and pulseless. They all answered "Defib him". He then changed the scenario to finding the patient on a beach. They were unshakable in stating the patient should be shocked. He then asked them if they were in the habit of carrying a defibrillator in the back pocket of their swim trunks, which was when he finally "reached" most of them.

Personal experience, from roughly 37 years ago. Discussion: Burns. Field treatment? Per the lecturer, place the burned part into water and ice. All my squad mates, and the other EMTs in the room just could not get the doctor to understand we didn't carry ice in our "caddy-lances", yet he held steadfast on the ice water. His attitude was, "Why DON'T you carry ice on your ambulances?" Even packing the burned part in a chemical icepack wasn't good enough for this guy.

[Doczilla]

Kiwi, in answer to your question, we order lots of expensive tests because an educated scientific wild ass guess often simply won't do. Patients don't read the book, and terrible disease often lurks with subtle symptoms. Add to the barriers to care in this country with fewer primary care doctors, insurance that is hardly affordable even if you have a job, and a safety net of the ER which has to catch all those with no place else to go.

I have to ask, and I do t mean to sound like I'm belittling, but where did you get your ideas about care in the American system? A lot of it sounds, frankly, like cliff notes written by a journalist, not those of someone who had worked or lived within the system.