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I was attending the ER yesterday. It had been a slow day, not many patients to see. That is usually a bad omen, since slow days tend to get shitty in any second with complicated patients.
I was having a coffee in a moment I had to spare when suddenly the speakers go off:
"Dr. Vargas, please call 1402. Dr Vargas, please call 1402."
So I call the ER. The EMTs were bringing in a 69 years-old female with a syncope (she had fainted at home while having dinner with her family, and she was being brought by ambulance.
When she arrived, she was awake and had no symptoms at all, but she had a long medical record:
- A stroke 1 year ago.
- A cerebral hemorrhage 2 years ago while under anticoagulant therapy
- A high frequency arrythmia (a paroxystical atrial fibrilation; the upper cavities of the heart, called the atriums or auriculae, start an unorganized beating not being in sync with the rest of the heart) in treatment
- A stage II breast cancer in treatment.
First thing I do when I get to her is take her by the wrist to get her pulse while I say:
"Hello, ma'am. How are you feeling?"
I instantly notice the extremely slow pulse. Maybe 30 beats per minute. The heart is supposed to beat at around 60 x minute...
"I feel a little dizzy but I'm ok. This happens to me all the time, I'm used to it but my daughter insisted to bring me in..."
The EMTs connect the heart monitors (which I don't know why wasn't connected en route to the hospital).
I see this:
![[image loading]](http://i.ytimg.com/vi/mVQzDsXKOSI/0.jpg) Oh, bollocks...
My face after reading up the heart monitor was something like this:
![[image loading]](http://1.bp.blogspot.com/_FmWfayiHQ98/SToyfo5GdWI/AAAAAAAAAUc/8ARGqhyoh24/s320/scrubs2-46.jpg) Yeah, I was not amused. It wasn't funny, like, at all.
Blood pressure: 80/40. Low.
Her slow heartbeat was compromising her blood pressure, and thus, the perfusion of her organs. She needed a pacemaker.
You see, the heart is a muscle. It beats because a pacemaker, located in the upper right portion of the heart, called the right atrium, has a bit of muscle tissue that has the ability to set off an electric discharge which propagates through the heart via the conduction system which consists, simply, of three "cables" or branches which derive from a common "cable" which comes from the heart's pacemaker.
![[image loading]](http://mdmedicine.files.wordpress.com/2011/04/cardiac-conduction-system.jpg) TL;DR: The electrical system of the heart, for dummies.
If that "common cable" isn't able to conduct the electrical impulse, the lower portion of the heart, called the ventricles, set off their own electrical discharge to keep the heart beating. The only problem is their discharge frequency is much, much lower than the atrial pacemaker. Rougly half of it, which isn't enough to supply the enough blood pressure to the body and brain. Hence, you pass out.
If all the atrial impulses are blocked, you get a 3rd degree AV block, or full heart AV block, a condition that requires the inmediate use of a pacemaker, either external or internal. If you fail to provide a pacemaker, the heart can stop beating alltogether, leading to an obvious conclusion:
![[image loading]](http://l.yimg.com/ck/image/A1386/138637/300_138637.jpg) Sup, bro...
And I didn't have one. And our low complexity hospital isn't prepared for such a thing.
So I had to somehow get an external pacemaker AND move my patient to a class A complexity center. I call the EMT dispatch, and their advanced medicalized ambulance wasn't available. They could send an external pacemaker and the equipment to operate it, but couldn't spare a medicalized ambulance.
I had to move my patient myself.
After a long 30 minutes, the pacemaker arrives to our hospital.
I knock my patient out with IV Midazolam and set the external pacemaker which starts stimulating.
We begin at 25 mA and rising.
Electrical capture at 40 mA.
Mechanical capture at 60 mA. Her heart was now beating at 70 beats per minute.
We get her into the hospital's ambulance, and rush to our reference center. There, a cardiologyst was waiting with an internal pacemaker equipment. The cardiologyst said "Since you stood up with your patient all the way from 50 miles out, you might as well stay with me and assist me in the placement of the pacemaker."
My patient got the pacemaker that same evening. And I assisted the procedure.
Today, after checking the correct functioning of the apparatus, she was discharged. She feels fine, and just came to the hospital to visit me. She brought me a large box of chocolates and a white rose, and said:
"I know this little present does not match your efforts, but I'd like to thank you for saving my life and being with me all the way."
She brought a smile on my face.
And reminded me again that I was born for this and how much I love what I do.
Thank you for reading.
 
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i feel kind of bad for this, but .. "sup bro" totally cracked me up >.>
oh well, happy end so good :')
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On August 03 2012 02:04 UmbraaeternuS wrote:
I had to move my patient myself.
So how did you get her to a hospital 50 miles from your with no specialized ambulance?
Great read as always, your blogs are probably some of the highest quality ones on TL ^_^
quick question though: what made you want to become a doctor in the 1st place?
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Another great read. Damn, sometimes I wish I would do something as great as you for a living. Never change, man.
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On August 03 2012 02:22 LazyFailKid wrote:
So how did you get her to a hospital 50 miles from your with no specialized ambulance?
With our own basic ambulance, an emergency medications portable kit, the defib, the external pacemaker and myself.
On August 03 2012 02:22 LazyFailKid wrote:
quick question though: what made you want to become a doctor in the 1st place?
I basically grew up in one. My mother is a nutritionist and used to work back in the 80's and 90's in the very same hospital I work now. Mom took me with her whenever she could and I wondered at how cool doctors were, saving lifes and making us feel better. They seemed so serious and wise man. I wanted to become one for as long as I can remember (except in junior high when I wanted to be an astronomer, ROFL).
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Umbraa saving lives all day ereday.
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I love your posts, they give incredible insight into a world that I know very little about. Thanks so much for sharing!
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Again, incredible, a great blog in a sea of mediocre ones. Thank you 
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Good thing they actually took her to consult. Sometimes patients like these can disregard a syncope as just a "faint" and not consult, she was very close to dying.
Pretty cool, I wonder if there's anything else you can do besides an external pacemaker while waiting for the real deal, particularly considering she also has AF, which can get pretty bad with any chronotropic drugs.
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I love reading these.
I gotta mention - I'm a physicist, not a biologist or doctor, so my scale could be off, but 60 mA seems like a lot amount to be putting into a person - I guess it's because you're using an external pacemaker, and an internal one would use much less current?
Anyway, great blog.
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On August 03 2012 05:53 mordk wrote:
Good thing they actually took her to consult. Sometimes patients like these can disregard a syncope as just a "faint" and not consult, she was very close to dying.
Pretty cool, I wonder if there's anything else you can do besides an external pacemaker while waiting for the real deal, particularly considering she also has AF, which can get pretty bad with any chronotropic drugs.
Not much. You can try atropine, but being a 3rd degree block, it's merely a diagnostical trial, not treatment. If it goes out of it, it was a blocked AF. If it doesn't, it's a pure 3rd degree block. In her particular case, it was a rare thing: She had a sick synus syndrome. Her syncope was a Stokes-Adams attack probably because of the low output. Go figure...
P.S: You're an intern, right?? If so, spoiler:
+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente.
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Always great to read. A little motivation for the next 10 years can't hurt
You're a baller
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Your blog, as always, delivers in a big way. I got a rush of emotion out of the end of that. It's nice to be appreciated, it's nicer that people like you exist. It helps me validate all the faith I have in humanity and my belief that all the world needs is caring people.
Humanity is my religion. And individuals like you are the reason I believe so strongly in it. Keep doing what you're doing, and thanks for the story.
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On August 03 2012 06:29 UmbraaeternuS wrote:Show nested quote +On August 03 2012 05:53 mordk wrote:
Good thing they actually took her to consult. Sometimes patients like these can disregard a syncope as just a "faint" and not consult, she was very close to dying.
Pretty cool, I wonder if there's anything else you can do besides an external pacemaker while waiting for the real deal, particularly considering she also has AF, which can get pretty bad with any chronotropic drugs. Not much. You can try atropine, but being a 3rd degree block, it's merely a diagnostical trial, not treatment. If it goes out of it, it was a blocked AF. If it doesn't, it's a pure 3rd degree block. In her particular case, it was a rare thing: She had a sick synus syndrome. Her syncope was a Stokes-Adams attack probably because of the low output. Go figure... P.S: You're an intern, right?? If so, spoiler: + Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente.
Yeah I'm almost there :D... And I'm trying to cover up most of what I don't know asking whatever comes up in my mind in my internships. I think pretty much anything they teach to me can be useful somewhere along the road. Emergency rotation was pretty good, but there's always SOMETHING left to study again
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thedeadhaji
39489 Posts
Assuming that you attended med school in South America, did you learn the medical terms in english as standard curriculum? O__O
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On August 03 2012 10:36 thedeadhaji wrote:
Assuming that you attended med school in South America, did you learn the medical terms in english as standard curriculum? O__O
Why? Did I fuck up writing something? o_o
No, it wasn't standard curriculum. I just read a lot on medschool and my main study sources were textbooks and papers written in english.
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Great read! Glad it turned out well.
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The pictures really don't add anything considering this is a serious blog and that women would have died if you hadn't done what you did. I guess you add them to break up the seriousness and make it seem less like bragging about being a hero.
(which you totally are)
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I've fallen in love with your blogs. I love listening to doctor stories, hehe
And the Scrubs picture was the cherry on top
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These are always totally fascinating, and way better than TV Show portrayals because this is real, not Hollywood. 5/5
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True, but as someone who is in the medical field, and has worked with doctors and such, I can tell you that Scrubs is probably the most accurate portrayal that has been on TV recently
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Wow. Not the "you got her treated and kept her alive" wow, but the "you stayed with her, in a basic ambulance, for 50 miles" wow. I'm guessing you weren't the only doctor there, or had someone able to cover while you were gone.
Also, and this is entirely different, how did you get that heart monitor picture? I can't imagine you stopping to get a pic while you were treating her.
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Sweden33719 Posts
I can understand why people become Doctors now...
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Good read, you're awesome
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Good thing I saw this right before bed. I can go to bed with a smile on my face.
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I like how you look at the heart monitor, go "Oh shit"... and pick up your phone and takes a picture of it to show us.
j/k
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Whenever I read blogs like yours and Snet's I feel grateful that there are people like you on this planet and it gives me hope for humanity.
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This should be a reminder to everyone, how much there is to be gained by simply giving people thanks and appreciation for their effort in the care industry. It's easy to forget, as once you are in need of someone in that branch of work, you probably have alot of things going on for you, but a simple "you make a difference" can go a long way and inspire people.
Thank you for sharing man, appreciate it
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Thanks for the share again.
Now I realize why people enter medicine. Truly saving lives on a daily basis. Also, your English is great haha.
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Would it have been feasible to use something to up her heart-rate artificially to buy time instead of the external pacemaker? say, 8mg of ephedrine or something similar?
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Wow man, you're truly a hero.
I read your blog about your scumbag colleagues when you first posted and I thought that even though what he did sucked it wouldn't affect you too much because you seemed like it would only be a matter of time before you became a resident and this blog only confirms what I thought.
Keep posting these blogs, I really enjoy reading them, even if they make me realise that I will probably never come close to making the world a better place on the same level that people like you do.
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great read! thanks for writing
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On August 03 2012 21:36 CluEleSs_UK wrote:
Would it have been feasible to use something to up her heart-rate artificially to buy time instead of the external pacemaker? say, 8mg of ephedrine or something similar?
Yes. The Advanced Cardiac Life Support algorythm for bradycardia treatment states you can use up to 10mcg/min of Epinephrine in an infussion, but it is a 3rd line drug. Dopamine is the 2nd line drug, in doses ranging from 2mcg/kg/min up to 10 mcg/kg/min. The issue here was that in order to use either Epinephrine or Dopamine in an infussion, you need to have an infusion pump, because you need really accurate amounts of either drug you use going through the IV line. My hospital doesn't have an infusion pump and there's a great deal of risk using Epinephrine in fixed doses without an infusion pump, particularly when you have an underlying fast-paced arythmia such as the atrial fibrilation my patient had.
Being atropine the 1st line drug, and since my patient didn't respond to it, her best choice was the pacemaker.
Also, for those wondering about the monitor pic:
Google can help you find anything.
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Awesome shit as always.
I too was about to ask about how you got your mastery of technical English... (I suppose the question now is, is your technical language as good in Spanish?
On August 03 2012 06:29 UmbraaeternuS wrote:+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente.
A digression, but could anyone explain to me what's "animo wn" and "te pitebai"? What's the tense and root of pitebai?
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On August 04 2012 01:13 JieXian wrote:Awesome shit as always. I too was about to ask about how you got your mastery of technical English... (I suppose the question now is, is your technical language as good in Spanish? Show nested quote +On August 03 2012 06:29 UmbraaeternuS wrote:+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente. A digression, but could anyone explain to me what's "animo wn" and "te pitebai"? What's the tense and root of pitebai?
How I got the mastery of technical english? I'm far from mastery of technical english. I just read a lot and study, and most of the good stuff to learn is in english.
I don't think it's as good as my spanish, but I think it's OK. And spanish isn't my native language... It's german. My father's family descents from german inmigrants who colonized southern Chile, and I spent most of my time at my grandma's house, and she speaks german fluently, so I learned there. Plus, I spent over 10 years in a german school.
And those other terms you ask about are chilean deformations of certain words, such as "wn" being the contraction of "huevon" or "weon" which is used as a familiar term, being the equivalent of "dude", but in other ocasions may be used as an insult, as an equivalent to "asshole"; context to determine the meaning of it is pretty important, as you might imagine. "Piteabai" is a neologysm, derived from the slang "pitear" which means "to destroy/break".
Chileans speak a pretty weird spanish...
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The problem is, as one day it gives you a smile when u save a life, another day it will make you sad, when even tho u put ur best effort into saving ones life, the person doesn't survive. This is what i value more about doctors than saving lives, cause i'm pretty sure it's a very hard thing to live with. I went into chemistry cause i don't believe i can deal with people dying even tho i did everything i could to save them.
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China6327 Posts
Hats off, to a doctor, sincerely.
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These blogs are really amazing, idk why you aren't featured yet  .
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On August 04 2012 08:29 docvoc wrote:These blogs are really amazing, idk why you aren't featured yet .
actually .. he is 
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On August 04 2012 06:29 Hellboy.100 wrote:
The problem is, as one day it gives you a smile when u save a life, another day it will make you sad, when even tho u put ur best effort into saving ones life, the person doesn't survive. This is what i value more about doctors than saving lives, cause i'm pretty sure it's a very hard thing to live with. I went into chemistry cause i don't believe i can deal with people dying even tho i did everything i could to save them.
Eventually you learn that this WILL happen, and it will happen repeatedly. You have to learn to live with that because otherwise it could end up affecting you. However, you mustn't cross the line into not caring enough. It's a fine line and a struggle where each of us needs to find his/her own balance, without ever compromising the prime values behind medicine or failing to give the best possible care.
Also note that in some occasions, best possible care doesn't equate to saving a person's life.
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Great blog.
Small correction: SA node is in the right atrium.
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If I ever win the lottery, remind me to get your hospital up to the highest standard.  Great doctors need great equipment, and since you work there, obviously they have great doctors.
Good work.
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On August 04 2012 02:16 UmbraaeternuS wrote:Show nested quote +On August 04 2012 01:13 JieXian wrote:Awesome shit as always. I too was about to ask about how you got your mastery of technical English... (I suppose the question now is, is your technical language as good in Spanish? On August 03 2012 06:29 UmbraaeternuS wrote:+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente. A digression, but could anyone explain to me what's "animo wn" and "te pitebai"? What's the tense and root of pitebai? How I got the mastery of technical english? I'm far from mastery of technical english. I just read a lot and study, and most of the good stuff to learn is in english. I don't think it's as good as my spanish, but I think it's OK. And spanish isn't my native language... It's german. My father's family descents from german inmigrants who colonized southern Chile, and I spent most of my time at my grandma's house, and she speaks german fluently, so I learned there. Plus, I spent over 10 years in a german school. And those other terms you ask about are chilean deformations of certain words, such as "wn" being the contraction of "huevon" or "weon" which is used as a familiar term, being the equivalent of "dude", but in other ocasions may be used as an insult, as an equivalent to "asshole"; context to determine the meaning of it is pretty important, as you might imagine. "Piteabai" is a neologysm, derived from the slang "pitear" which means "to destroy/break". Chileans speak a pretty weird spanish...
Ok not "mastery", but good enough to let the readers feel absolutely comfortable reading and understanding what you're trying to say, which is definitely something to be proud or happy about.
Out of curosity once more, can you write about something like this in German?
And I still don't get pitear... I'd expect something like te piteas or te pitearás or te pitee (subjunctive?) but pitebai? ...
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On August 04 2012 17:09 GabrielB wrote:
Great blog.
Small correction: SA node is in the right atrium.
Hurr durr, you're right xD
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On August 05 2012 00:04 JieXian wrote:Show nested quote +On August 04 2012 02:16 UmbraaeternuS wrote:On August 04 2012 01:13 JieXian wrote:Awesome shit as always. I too was about to ask about how you got your mastery of technical English... (I suppose the question now is, is your technical language as good in Spanish? On August 03 2012 06:29 UmbraaeternuS wrote:+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente. A digression, but could anyone explain to me what's "animo wn" and "te pitebai"? What's the tense and root of pitebai? How I got the mastery of technical english? I'm far from mastery of technical english. I just read a lot and study, and most of the good stuff to learn is in english. I don't think it's as good as my spanish, but I think it's OK. And spanish isn't my native language... It's german. My father's family descents from german inmigrants who colonized southern Chile, and I spent most of my time at my grandma's house, and she speaks german fluently, so I learned there. Plus, I spent over 10 years in a german school. And those other terms you ask about are chilean deformations of certain words, such as "wn" being the contraction of "huevon" or "weon" which is used as a familiar term, being the equivalent of "dude", but in other ocasions may be used as an insult, as an equivalent to "asshole"; context to determine the meaning of it is pretty important, as you might imagine. "Piteabai" is a neologysm, derived from the slang "pitear" which means "to destroy/break". Chileans speak a pretty weird spanish... Ok not "mastery", but good enough to let the readers feel absolutely comfortable reading and understanding what you're trying to say, which is definitely something to be proud or happy about. Out of curosity once more, can you write about something like this in German? And I still don't get pitear... I'd expect something like te piteas or te pitearás or te pitee (subjunctive?) but pitebai? ...
Thanks a lot for the compliment .
To explain the issue with that word is a little difficult; "pitear" is a deformation. It comes from "coa", the language/dialect of the convicts, and means "break/destroy/kill". In Chile we deform the "you" derivation of any verb with the "ai" suffix; for example "Te comiai las plantas?" (You ate the plants?) or "Pateabai mal la pelota" (you kicked the ball poorly).
+ Show Spoiler +Und Ich möchte nicht auf Deutsch schreiben Es ist schwierig
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On August 05 2012 01:20 UmbraaeternuS wrote:Show nested quote +On August 05 2012 00:04 JieXian wrote:On August 04 2012 02:16 UmbraaeternuS wrote:On August 04 2012 01:13 JieXian wrote:Awesome shit as always. I too was about to ask about how you got your mastery of technical English... (I suppose the question now is, is your technical language as good in Spanish? On August 03 2012 06:29 UmbraaeternuS wrote:+ Show Spoiler +Animo wn, pongale huevos al asunto y aprovecha de preguntar y aprender todo lo que puedas, porque esto si no lo cachabas del internado, te piteabai a la paciente... Recuerda siempre la responsabilidad que llevamos con nosotros, porque en nuestro saber, que son nuestras manos, está la vida del paciente. A digression, but could anyone explain to me what's "animo wn" and "te pitebai"? What's the tense and root of pitebai? How I got the mastery of technical english? I'm far from mastery of technical english. I just read a lot and study, and most of the good stuff to learn is in english. I don't think it's as good as my spanish, but I think it's OK. And spanish isn't my native language... It's german. My father's family descents from german inmigrants who colonized southern Chile, and I spent most of my time at my grandma's house, and she speaks german fluently, so I learned there. Plus, I spent over 10 years in a german school. And those other terms you ask about are chilean deformations of certain words, such as "wn" being the contraction of "huevon" or "weon" which is used as a familiar term, being the equivalent of "dude", but in other ocasions may be used as an insult, as an equivalent to "asshole"; context to determine the meaning of it is pretty important, as you might imagine. "Piteabai" is a neologysm, derived from the slang "pitear" which means "to destroy/break". Chileans speak a pretty weird spanish... Ok not "mastery", but good enough to let the readers feel absolutely comfortable reading and understanding what you're trying to say, which is definitely something to be proud or happy about. Out of curosity once more, can you write about something like this in German? And I still don't get pitear... I'd expect something like te piteas or te pitearás or te pitee (subjunctive?) but pitebai? ... Thanks a lot for the compliment . To explain the issue with that word is a little difficult; "pitear" is a deformation. It comes from "coa", the language/dialect of the convicts, and means "break/destroy/kill". In Chile we deform the "you" derivation of any verb with the "ai" suffix; for example "Te comiai las plantas?" (You ate the plants?) or "Pateabai mal la pelota" (you kicked the ball poorly). + Show Spoiler +Und Ich möchte nicht auf Deutsch schreiben Es ist schwierig
@@ wow thanks for the explaination
Edit: I guess huevón is probably something like cabrón in spain
+ Show Spoiler +Also bist du ein bisshen vie ich mit mein Chinesisch Und ja, ist Deutsch bloody-schwierig :D
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That was a really nice blog to read, thanks for shareing :D
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My grandma was at 20 Beats per minute last month and she got a pacemaker too.
On August 03 2012 11:43 Ero-Sennin wrote:
I've fallen in love with your blogs. I love listening to doctor stories, hehe
And the Scrubs picture was the cherry on top
I also echo this person's sentiments.
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I seriously love reading your blogs. Every post has meaning, emotion, tension, and impact. You always leave me hungry for more.
Hats off to you for saving someone's life. You have my respect.
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That's really cool. I like how you explain everything. I never studied medicine or biology so when you explain things like how the heart regulates itself, I get really interested. Thanks for sharing.
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I'm all warm and fuzzy. Thank you for sharing your passion.
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yo umbra, what rank are you in the medical fraternity? you sound way experienced, the kinda doctor i'd want treating me if i were to end up in hospital.
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On August 07 2012 21:36 pangshai wrote:
yo umbra, what rank are you in the medical fraternity? you sound way experienced, the kinda doctor i'd want treating me if i were to end up in hospital.
I'm still fairly young. I'm 26, and have been practicing for almost 2 years now. I guess that puts me in the newbies court, I have a shitton of things to learn.
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*edit* this damn iPhone app made me doublepost
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Man, can't wait til I become a doctor. Assuming i get into medschool, be joining the ranks in a decade~
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Really interesting read -- and slightly humorous too! I'll have to check out more from you. I think it's really cool to have firsthand accounts like this from doctors working in places outside of the US. Just out of curiosity, what is the education path like in Chile with regard to medicine? Specifically, how does it differ from the one in US? I was a researcher in a stem cell lab with a Colombian doctor who entered medical school right after high school. Is the medical school system in Chile the same as the system in Colombia, where you can choose to apply to medical school immediately out of highschool/secondary school without first undergoing college/university (undergraduate studies in case I'm using the wrong term)? Seems like there'd be advantages and disadvantages. cheers
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On August 08 2012 12:18 FallDownMarigold wrote:
Really interesting read -- and slightly humorous too! I'll have to check out more from you. I think it's really cool to have firsthand accounts like this from doctors working in places outside of the US. Just out of curiosity, what is the education path like in Chile with regard to medicine? Specifically, how does it differ from the one in US? I was a researcher in a stem cell lab with a Colombian doctor who entered medical school right after high school. Is the medical school system in Chile the same as the system in Colombia, where you can choose to apply to medical school immediately out of highschool/secondary school without first undergoing college/university (undergraduate studies in case I'm using the wrong term)? Seems like there'd be advantages and disadvantages. cheers
After highschool, you can apply directly to a med school in which the first two years are of training in basic sciences, and the 3rd to 5th year are those in which you're trained in clinical knowledge and skills. 6th and 7th year are those of the internships, in which you have a supervised practice in rotations throught the 4 large medical specialties (internal medicine, surgery, OB-Gyn, pediatrics) and minor rotations through radiology, neurology, dermathology, traumathology, ER, etc.
After that, there's this exam called the EMN ("Examen Medico Nacional" or Medical National Exam, which approval is mandatory for a physician to get his medical license and to get to practice medicine.
After that you can either to a primary specialty/residence, if you get the spot, or you can work for a few years and then do your residency.
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Northern Ireland24229 Posts
Really cool read, as someone who gave up an ambition to be a Doctor years ago, it's nice to see that I was right. I couldn't deal with that kind of pressure and responsibility, much respect to those of you that can!
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EPT
