Because/. doesn't have edit, I'm having to reply to self:
To be clear: the ABMS specialty board examinations are completely different from the "medical boards" (which is how most laymen refer to USMLE Steps 1/2/3, because those are exactly analogous to the nursing boards, bar exam, CPA exam, etc. - they are a prerequisite for practicing in the field rather than a certification of special further training).
We have a competitive application system in the US by which residency slots are allocated to medical students. Just as there are more applicants to med school than there are admission slots, there are more applicants to highly-competitive specialties than there are slots. Having clear, nationally-comparable test scores is much more meritocratic than reserving all the [CHOOSE HIGHLY COMPETITIVE SPECIALTY HERE] slots for graduates of the top ten med schools.
I want a doctor who knows when the American Medical Association is trying to put one over on them.
That's easy: they always are.
I want doctors who know when their politicians are trying to put one over on them.
That's easy: they always are.
I want doctors to know enough about IT to understand that.
Here is the usual physician response to IT: if you're making our lives simpler, it's great. But if anything has to be done on the computer, it's probably just saving the hospital money by making doctors (who don't usually work for the hospital) do the data entry job that used to be done by a clerk (who did work for the hospital).
Back when I was a chemistry major thinking I wanted to be a chemist, I laughed at premeds for their memorizing, don't-care-why, grade-grubbing ways. Then I realized I didn't like being a chemist (thankfully before I graduated) and decided to go to med school. When I got there, I realized that all those premeds had spent four years acquiring skills that were actually adaptive in the med-school environment. Everyone there is smart - not gobsmackingly brilliant, and often fairly conventional in their thinking, but definitely smart. They're all motivated. They all study hard. And so the only way to distinguish yourself in that crowd is to be able not only to know all the basic stuff but to know all of the minutiae as well. The why is unimportant, because professors who don't have TA's can't (or won't) grade 100+ essay exams when the expected turnaround for scores is 2-3 days. You won't be tested on why. (If it really matters, you'll learn why later.) But you'll be tested on the drugs nobody has used in 20 years.
Oh, you sign one of those, too. But while the specific questions are copyrightable, the underlying facts aren't - they're all in textbooks. Good luck proving anything when it's all handwritten and passed around sub rosa. BTW, the AMA has nothing to do with this. It's the specific board and possibly the ABMS.
There is a lot of confusion among people who aren't physicians about what, exactly, is meant by "boards" and "board certified". Just remember: medicine is populated entirely by people who are good at tests. They may have other skills, and they may not. But they're all good at taking tests.
When a physician is described as "board-certified", that means that s/he has taken a specialty examination given (in almost all cases) by a member of the American Board of Medical Specialties. In some fields, this only has a written component; in others, especially surgical fields, oral examinations are standard as well as the writtens. These examinations serve to certify that you know that particular specialty. They are not required to practice medicine, and physicians are not limited by law to practice only in areas of medicine for which they have received formal training. Insurers providing coverage and hospitals allowing privileges outside of your area are a different matter, but as a matter of law, a general-practice MD can perform neurosurgery in his office.
A permanent, unrestricted medical license in the US is predicated on passing the US Medical Licensure Examination Steps 1, 2, and 3 (unless you're an osteopath and you take the COMLEX, but that's a small number of people and in any case the principle is very similar). Furthermore, you will have to do at least an internship (the first year of residency after medical school) in order to be granted a permanent, unrestricted medical license. (Graduates of non-US/Canada medical schools may have to do two or even three years of residency.)
So yes, people do get together and discuss things. In particular, memorizing questions serves the purpose of identifying what the question-makers think is important. This is not always trivial; as medical specialties have moved their written examinations onto computers in recent years and K-type (Choose A if 1 and 3 are right, B if 2 and 4 are right, C if 4 only is right, D is 1, 2, and 3 are right, and E if all are incorrect) questions have been eliminated, there has been a significant influx of new questions from younger examiners. Like all examiners, they tend to submit questions from their own interests rather than just covering a broad enough base to be sure that the examinee is capable of practicing safe medicine. The line between pass and fail has to fall somewhere, and if you're academically relatively weak, knowing the likely subject matter (or the likely rare association between two things) can make the difference between pass and fail.
The USMLE 1/2/3 all have prep courses and study books with sample questions, just like the SAT. If you don't study how the questions are asked, you are unlikely to do your best. However, the base of knowledge is just immense - Step 3 considers anything that you might encounter in a general practice to be fair game. To pass the test, you're going to need to know the stuff.
The specialty board examinations don't take anyone who couldn't 1) get a residency in that specialty and 2) pass their way through it (which is not a given - people fail out of residencies all the time). Dermatology, the subject of this article, is populated exclusively by people who gradated in the top 5-10% of their med school class. Their intelligence and drive to study isn't really in question. What's happening is mostly a matter of pride; even though only a vanishingly small percentage of people who take the test will fail, it is incredibly embarrassing to be the one who does.
R = radiology? The oral examinations are alive and well in anesthesiology and the surgical specialties. And the cost is covered by the examinees. The American Board of Anesthesiology, for example, charges $950 just to enroll in certification. The written exam is $600 and the oral is $2100. And they get another $2100 for every ten years for the re-examination.
Depends on your disease process. A total proctocolectomy for severe ulcerative colitis is a very different procedure with very different goals from those of a total colectomy for a mass, and the vast majority of people who have tumors have hemicolectomies. Yes, if you have to eliminate every bit of colorectal tissue, it's a more complicated procedure, but tumors don't generally call for that, and rectal tumors often get (at least temporary) colostomies - you don't want the stress of chemo on a brand new anastomosis down there.
These two don't match up. Care to explain? A total colectomy usually only takes about two hours.
Anyway, this device is essentially an upgraded version of the standard endoscopic instruments and as such isn't really a huge change - though I'm sure it's nice. They say "cancers" but I'm pretty sure that they mean the gastric equivalent of colon polyps.
You know, if you really think that you can build a profitable company that cares for its workers and pays them a "living wage", do so. There are plenty of progressive folk in the US who would - at least in theory - love to have such a thing. It's funny, though, that none of them have arisen. Right? Nothing is stopping you, and after all you've got all sorts of rich folk in the entertainment industry who are dying to have labor respected.
This is the only sensible idea in the comments so far. Whatever you do, it has to be something that does not in any way detract from the wedding invitation as a wedding invitation. It should not be overly cutesy, or odd. It should not resemble a novelty birthday card. Even the guy I know who had his wedding in Vegas sent out traditional wedding invitations.
Regardless of the formality of the ceremony itself, or the reception afterward, a wedding is a major social event that deserves a proper invitation. If you can work in a way (like a QR code on the back) that will serve as an Easter egg without breaking that up, great. Otherwise, you're just going to leave all the non-geeks wondering what the hell is going on.
It's not a "bit" of convenience. It's a remarkable freedom of movement. And as for driving from DC to NO, if you're worried missing the scenery here it goes: Pine trees. Pine trees. City. Pine trees. Pine trees. I live in the Gulf coastal plain; there are some nice things about living here, but the scenery is rarely one of them.
Telling anyone else in the jury about it is grounds for a mistrial. Of course, in almost every state (OR and LA excepted), one holdout will prevent a conviction and cause a mistrial, and nobody can force you to tell why. You might choose to tell the judge, if you liked.
The line of cars is just approximating a bus. The only advantage is that you have a "last mile" effect of delivering you right to your driveway.
Except that unlike a bus, it's not occupied by anyone who's not with me (e.g., if they're drunk, I probably am too and don't mind), I can leave my possessions in it, it travels on my schedule (it goes just as many places at 3 AM as at noon), and, of course, it takes me directly to my destination.
Imagine if a 16-hour drive could be done as an overnight trip - you get off work on Friday for a week's vacation, you go home and put the suitcases in the car, eat a bit of dinner, and hit the road. You can be well rested and 1000 miles away by lunchtime the next day. All of a sudden, New Orleans is a weekend trip from DC.
being required to draw on their life experience without being allowed to do things such as looking up terms they may not understand
Actually, you can only draw on your general life experience; you are not allowed to introduce any specialized knowledge that you may have into the deliberations. One example that comes to mind would be a person who does not speak English being brought into the courtroom to testify in a language that one of the jurors happens to speak. The juror is actually not supposed to listen to the words the witness says, but is to rely solely on the translator's statements. If there is an inaccurate translation, it is the job of the other side to have their own translator present who can have the lawyer object to the translation.
Then you have to worry about appointment books, etc., being subpoenaed. And if you find yourself part of an organization trying to do something bad, then your best bet is to leave before you rise high enough in the hierarchy that you can't get off scot-free by turning state's evidence.
If you have to do something illegal, do it alone and work in cash.
Remember, kids: if you have to do something illegal, do not write it down. Anywhere. Once you do, it's no longer something contained solely in your mind and nowhere else, and it is probably subject to subpoena, which will be deemed eminently legal. Don't put it in your diary. Don't tell anyone (you'll lose your expectation of privacy). If you must break the law, never ever speak about it. Do it and move on.
OK, I know why your example is wrong, but I'm not in IT, so forgive the stupid question. Why is AC's example really bad? If a and b are equal, do some function. How should that be written?
Slashdot Mirror
Because /. doesn't have edit, I'm having to reply to self:
To be clear: the ABMS specialty board examinations are completely different from the "medical boards" (which is how most laymen refer to USMLE Steps 1/2/3, because those are exactly analogous to the nursing boards, bar exam, CPA exam, etc. - they are a prerequisite for practicing in the field rather than a certification of special further training).
more apprenticeships / trades learning system
More than 80 hours/week in residency? Of that, no more than about 5 hours/week is direct didactic learning.
We have a competitive application system in the US by which residency slots are allocated to medical students. Just as there are more applicants to med school than there are admission slots, there are more applicants to highly-competitive specialties than there are slots. Having clear, nationally-comparable test scores is much more meritocratic than reserving all the [CHOOSE HIGHLY COMPETITIVE SPECIALTY HERE] slots for graduates of the top ten med schools.
I want a doctor who knows when the American Medical Association is trying to put one over on them.
That's easy: they always are.
I want doctors who know when their politicians are trying to put one over on them.
That's easy: they always are.
I want doctors to know enough about IT to understand that.
Here is the usual physician response to IT: if you're making our lives simpler, it's great. But if anything has to be done on the computer, it's probably just saving the hospital money by making doctors (who don't usually work for the hospital) do the data entry job that used to be done by a clerk (who did work for the hospital).
Back when I was a chemistry major thinking I wanted to be a chemist, I laughed at premeds for their memorizing, don't-care-why, grade-grubbing ways. Then I realized I didn't like being a chemist (thankfully before I graduated) and decided to go to med school. When I got there, I realized that all those premeds had spent four years acquiring skills that were actually adaptive in the med-school environment. Everyone there is smart - not gobsmackingly brilliant, and often fairly conventional in their thinking, but definitely smart. They're all motivated. They all study hard. And so the only way to distinguish yourself in that crowd is to be able not only to know all the basic stuff but to know all of the minutiae as well. The why is unimportant, because professors who don't have TA's can't (or won't) grade 100+ essay exams when the expected turnaround for scores is 2-3 days. You won't be tested on why. (If it really matters, you'll learn why later.) But you'll be tested on the drugs nobody has used in 20 years.
That's basically a California state employees' union, AFAICT. Private sector docs are forbidden to bargain collectively with insurers.
Oh, you sign one of those, too. But while the specific questions are copyrightable, the underlying facts aren't - they're all in textbooks. Good luck proving anything when it's all handwritten and passed around sub rosa. BTW, the AMA has nothing to do with this. It's the specific board and possibly the ABMS.
There is a lot of confusion among people who aren't physicians about what, exactly, is meant by "boards" and "board certified". Just remember: medicine is populated entirely by people who are good at tests. They may have other skills, and they may not. But they're all good at taking tests.
When a physician is described as "board-certified", that means that s/he has taken a specialty examination given (in almost all cases) by a member of the American Board of Medical Specialties. In some fields, this only has a written component; in others, especially surgical fields, oral examinations are standard as well as the writtens. These examinations serve to certify that you know that particular specialty. They are not required to practice medicine, and physicians are not limited by law to practice only in areas of medicine for which they have received formal training. Insurers providing coverage and hospitals allowing privileges outside of your area are a different matter, but as a matter of law, a general-practice MD can perform neurosurgery in his office.
A permanent, unrestricted medical license in the US is predicated on passing the US Medical Licensure Examination Steps 1, 2, and 3 (unless you're an osteopath and you take the COMLEX, but that's a small number of people and in any case the principle is very similar). Furthermore, you will have to do at least an internship (the first year of residency after medical school) in order to be granted a permanent, unrestricted medical license. (Graduates of non-US/Canada medical schools may have to do two or even three years of residency.)
So yes, people do get together and discuss things. In particular, memorizing questions serves the purpose of identifying what the question-makers think is important. This is not always trivial; as medical specialties have moved their written examinations onto computers in recent years and K-type (Choose A if 1 and 3 are right, B if 2 and 4 are right, C if 4 only is right, D is 1, 2, and 3 are right, and E if all are incorrect) questions have been eliminated, there has been a significant influx of new questions from younger examiners. Like all examiners, they tend to submit questions from their own interests rather than just covering a broad enough base to be sure that the examinee is capable of practicing safe medicine. The line between pass and fail has to fall somewhere, and if you're academically relatively weak, knowing the likely subject matter (or the likely rare association between two things) can make the difference between pass and fail.
The USMLE 1/2/3 all have prep courses and study books with sample questions, just like the SAT. If you don't study how the questions are asked, you are unlikely to do your best. However, the base of knowledge is just immense - Step 3 considers anything that you might encounter in a general practice to be fair game. To pass the test, you're going to need to know the stuff.
The specialty board examinations don't take anyone who couldn't 1) get a residency in that specialty and 2) pass their way through it (which is not a given - people fail out of residencies all the time). Dermatology, the subject of this article, is populated exclusively by people who gradated in the top 5-10% of their med school class. Their intelligence and drive to study isn't really in question. What's happening is mostly a matter of pride; even though only a vanishingly small percentage of people who take the test will fail, it is incredibly embarrassing to be the one who does.
R = radiology? The oral examinations are alive and well in anesthesiology and the surgical specialties. And the cost is covered by the examinees. The American Board of Anesthesiology, for example, charges $950 just to enroll in certification. The written exam is $600 and the oral is $2100. And they get another $2100 for every ten years for the re-examination.
Depends on your disease process. A total proctocolectomy for severe ulcerative colitis is a very different procedure with very different goals from those of a total colectomy for a mass, and the vast majority of people who have tumors have hemicolectomies. Yes, if you have to eliminate every bit of colorectal tissue, it's a more complicated procedure, but tumors don't generally call for that, and rectal tumors often get (at least temporary) colostomies - you don't want the stress of chemo on a brand new anastomosis down there.
a small tumour from my colon
The operation took six hours
These two don't match up. Care to explain? A total colectomy usually only takes about two hours.
Anyway, this device is essentially an upgraded version of the standard endoscopic instruments and as such isn't really a huge change - though I'm sure it's nice. They say "cancers" but I'm pretty sure that they mean the gastric equivalent of colon polyps.
You know, if you really think that you can build a profitable company that cares for its workers and pays them a "living wage", do so. There are plenty of progressive folk in the US who would - at least in theory - love to have such a thing. It's funny, though, that none of them have arisen. Right? Nothing is stopping you, and after all you've got all sorts of rich folk in the entertainment industry who are dying to have labor respected.
This is the only sensible idea in the comments so far. Whatever you do, it has to be something that does not in any way detract from the wedding invitation as a wedding invitation. It should not be overly cutesy, or odd. It should not resemble a novelty birthday card. Even the guy I know who had his wedding in Vegas sent out traditional wedding invitations.
Regardless of the formality of the ceremony itself, or the reception afterward, a wedding is a major social event that deserves a proper invitation. If you can work in a way (like a QR code on the back) that will serve as an Easter egg without breaking that up, great. Otherwise, you're just going to leave all the non-geeks wondering what the hell is going on.
It's not a "bit" of convenience. It's a remarkable freedom of movement. And as for driving from DC to NO, if you're worried missing the scenery here it goes: Pine trees. Pine trees. City. Pine trees. Pine trees. I live in the Gulf coastal plain; there are some nice things about living here, but the scenery is rarely one of them.
Telling anyone else in the jury about it is grounds for a mistrial. Of course, in almost every state (OR and LA excepted), one holdout will prevent a conviction and cause a mistrial, and nobody can force you to tell why. You might choose to tell the judge, if you liked.
The line of cars is just approximating a bus. The only advantage is that you have a "last mile" effect of delivering you right to your driveway.
Except that unlike a bus, it's not occupied by anyone who's not with me (e.g., if they're drunk, I probably am too and don't mind), I can leave my possessions in it, it travels on my schedule (it goes just as many places at 3 AM as at noon), and, of course, it takes me directly to my destination.
Imagine if a 16-hour drive could be done as an overnight trip - you get off work on Friday for a week's vacation, you go home and put the suitcases in the car, eat a bit of dinner, and hit the road. You can be well rested and 1000 miles away by lunchtime the next day. All of a sudden, New Orleans is a weekend trip from DC.
the money you are out by missing work
And parking, and gas... and with jury pay as low as it is, most people actually have to pay to serve on a jury.
As someone pointed out the other day, unless they send it by certified mail, you can just toss the summons in the trash.
being required to draw on their life experience without being allowed to do things such as looking up terms they may not understand
Actually, you can only draw on your general life experience; you are not allowed to introduce any specialized knowledge that you may have into the deliberations. One example that comes to mind would be a person who does not speak English being brought into the courtroom to testify in a language that one of the jurors happens to speak. The juror is actually not supposed to listen to the words the witness says, but is to rely solely on the translator's statements. If there is an inaccurate translation, it is the job of the other side to have their own translator present who can have the lawyer object to the translation.
Poor choice of words by WorBlux. The streambed is public, even if the water isn't.
Then you have to worry about appointment books, etc., being subpoenaed. And if you find yourself part of an organization trying to do something bad, then your best bet is to leave before you rise high enough in the hierarchy that you can't get off scot-free by turning state's evidence.
If you have to do something illegal, do it alone and work in cash.
Remember, kids: if you have to do something illegal, do not write it down. Anywhere. Once you do, it's no longer something contained solely in your mind and nowhere else, and it is probably subject to subpoena, which will be deemed eminently legal. Don't put it in your diary. Don't tell anyone (you'll lose your expectation of privacy). If you must break the law, never ever speak about it. Do it and move on.
Thanks, AC. Mentioned once before.
Yeah, an AC popped in. Thanks, though. I missed that semicolon the first time around.
Thanks, AC.
OK, I know why your example is wrong, but I'm not in IT, so forgive the stupid question. Why is AC's example really bad? If a and b are equal, do some function. How should that be written?