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446474 tn?1446347682

How to choose a medical field for all the wanta be Drs out there

As you will see it is all bout the "Goo Tolerance Index"...
From the Canadian Association Medical Journal

The Goo Tolerance Index: a foolproof method for choosing a medical specialty

    Julie Curwin MD

+ Author Affiliations

    Psychiatrist, Sydney, NS

For most of us the holiday season is a time of good cheer — a time for feasts and merrymaking and good old-fashioned unbridled consumerism. But for senior medical students it is also a time of hand wringing and sleepless nights. Yes, for those of you who have forgotten the pain, the annual ritual of the CaRMS (Canadian Residency Matching Service) match is upon us. Applications and curricula vitae have been sent out, reference letters have been written, interviews are being arranged, and clinical clerks across the land are wrestling with the question: “What am I going to do with the rest of my life/next year?”

I vividly remember the trauma of my own CaRMS experience: navigating the match and not at all sure what I wanted to be when I grew up, I became paranoid and applied for pretty much everything everywhere. A friend of mine even tried to convince me to apply for a urology training position.

“You might have to stand around in pee all day,” he said, “but at least you get to do it in expensive Italian loafers.”

“Thanks,” I replied, “but I'd rather have shoes that are cheap and don't stink.”

But his comment planted the seed of an idea in my head, which I have since developed into a foolproof method for helping medical students choose the right specialty. I call it the Goo Tolerance Index. It is based on 3 basic premises, all of which are founded on rigorous scientific research (or at least I asked around, and everyone seemed to think they were pretty cool):

1. The practice of medicine involves a lot of goo.

2. Goo is yucky.

3. Tolerance to goo is as good a predictor as any of what specialty one is suited for.

This is how the index works: Students are first prompted to rate their own goo tolerance on a scale of 1–10. They then consult my patented Gooiness Reference of Selected Specialties Scale (GROSSS — see next section) to find their match with an appropriate specialty. For example, because my own goo tolerance is close to zero, I chose psychiatry — a specialty where patients generally stay on their side of the desk and are never touched below the waist. (On those rare occasions when things do get gooey, the psychiatrist simply calls for a nurse or sends the patient back to his or her family physician.)

Gooiness Reference of Selected Specialties Scale (GROSSS)
Low-goo specialties (score 1–3)

Psychiatry

Very little goo is involved, unless you count emotional goo.

Radiology

Practically goo-free. You get to sit around in a sterile office all day looking at pictures of goo, but you never have to touch it. Your Italian loafers do not get stinky.

Neurology

You do have to touch people, but most of the time their bodily fluids are not leaking all over you. (If they are, call the neurosurgeon.)
Moderate-goo specialties (score 4–6)

Family medicine

Lots of mucus, earwax and toe jam, with an occasional smattering of pus and vomit. Overall, though, the goo tends to be stable and relatively odour-free. Also, it is interspersed with enough insurance forms to minimize the impact.

Internal medicine

A little gooier than family medicine. If you do not enjoy the tangy aroma of infectious diarrhea, stay away from this specialty.

Pediatrics

Patients are often very gooey and have not gained full goo-control. However, they are relatively easy to tolerate because the goo has not had 75 years to fester.
High-goo specialties (score 7–9)

All surgical specialties

Surgery is perfect for those who like to be up to their elbows in goo. When goo gets explosive — think projectile vomiting, arterial spray, or tense, pus-filled abscesses — who do you think they're going to call? (Not the psychiatrist, I can assure you.)

Note: Be wary of surgical specialties such as ophthalmology that try to fool you by assigning pretty names to their goo, such as “aqueous humour” and “vitreous humour.” Let's be honest: when a nail gun meets an eyeball, there is nothing humorous about it — it's just aqueous goo and vitreous goo.

Emergency medicine

This specialty is made worse by the fact that the goo is entirely unpredictable. The emergency physician can be relaxing with a Bratwurst sandwich one minute and picking someone's intestines off the floor the next.

Dermatology

This is a specialty for the true goo connoisseur. Dermatologists delight in taking photos of the gooiest lesions they can find, then presenting them in slide shows with catchy titles such as “101 really cool penile warts.”
Extreme-goo specialties (score ≥ 10)

Pathology

If festering abscesses and explosive melena are not gooey enough for you, this specialty is a perfect choice. Pathology is the only specialty where you get to work with decomposing, bug-infested goo and use words such as “putrefaction” and “necrosis.” Plus you get to solve murders single-handedly and hang out with all those hot-looking crime-scene investigators.
Previous Section

Conclusion

I believe that my Goo Tolerance Index will be a helpful tool for those of you facing the momentous decision of choosing a medical specialty. And may your gooiest memories of this holiday season be of turkey drippings, plum pudding and sloppy kisses under the mistletoe.


Hector
6 Responses
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Avatar universal
I was crying from laughing so hard; I can appreciate 'goo' from an educators standpoint (I have low goo tolerance so I don't teach children younger than 8-potty training has been completed!). Thank you for sharing a hearty belly laugh and giving me an extra 10 seconds of life.
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Avatar universal
The " Goo index" was great!  lmao!
Is it just coincidence that both  these amusing tales take place in Canada,or are you somehow saying that the doctors possibly in the U.S use something a little more sophisticated when choosing than the "Goo Index": :0)

Will

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665963 tn?1360723554
You sure make it difficult to wallow in my self pity.,   Just can't do that and laugh at the same time!  Thank You!!!
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1794638 tn?1345155061
Now thats some Gooey info...    Love the Goo !    
Hope your doing great !  
C
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419309 tn?1326503291
Love the Goo Index! LOL
The cautionary note about surgical opthalmology had me in stitches. :)
Thanks for the laughs.
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446474 tn?1446347682
The wonders of improvisation during emergency situations.
Off-label use of Super Soaker Max-D 5000!

"A novel method for the removal of ear cerumen"

    David A. Keegan*,
    Susan L. Bannister†

    *Departments of Family Medicine and Paediatrics; †Department of Pediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont.

We describe the off-label use of a recreational device (the Super Soaker Max-D 5000) in the alleviation of a socially emergent ear condition.

A 45-year-old male complained of a profound reduction in his left ear acuity while staying at an island cottage in rural Ontario. His hearing loss was reducing his ability to hear his newborn son cry in the middle of the night, requiring his wife to carry out all late-night child care. As a result, correction of the problem was considered urgent.

The patient had been swimming multiple times a day for 6 days. He had had several ear infections as a child but was otherwise well. He admitted having used a Q-tip in his ear “once or twice” recently in the affected ear.

An otoscope being available, examination of the external ears was conducted. The nature of his problem was revealed as bilaterally impacted cement-like ear cerumen.

Neither a formal ear syringe, nor a syringe of any kind was available on the island. The day was very hot, and no one was particularly in the mood to boat to Honey Harbour and then drive 45 minutes to Midland, just on account of ear wax. One of the owners of the property was consulted in his capacity as a professional engineer and the owner of a superbly stocked tool shed (rivalling a mid-sized Canadian Tire). He was not able to offer any substitute contraption of his own but suggested we approach his 4-year-old grandson to see if we could use his pressured water cannon.

D.K. (a family and emergency physician) assessed the utility of the Super Soaker Max-D 5000. He was surprised to note that it was able to deliver a superbly pressured narrow stream of water equivalent to, or perhaps exceeding, the quality of that achieved with standard ear-syringing instruments. The owner of the Super Soaker Max-D 5000 was sought out; after hearing an explanation of its intended application, he granted permission for its use.

Verbal consent (covering risks and benefits) was obtained from the patient. He then changed into swimming shorts, located himself on an ideal location on the deck and held a Tupperware container (product number 1611-16) to the side of his neck, in lieu of a kidney basin. The Super Soaker Max-D 5000 was filled with body-temperature water and then mildly pressurized using the blue hand-pump. The trigger was depressed, releasing a gentle, narrow jet of water, which was then aimed along the posterior wall of the ear canal (Fig. 1). After approximately 15 seconds, the jet was aimed along the anterior wall. This cycle was repeated (with occasional repressurizing) until the Super Soaker was empty.

Midway through the second load's stream, wax particles began to run out of the ear. Just after starting the third load, a large plug of wax burst forth from the patient's ear. The 3 generations of family members present took turns admiring (or recoiling from) the specimen. The patient exclaimed in joy, “I can hear again!”

The entire process was repeated for the right ear. Otoscopy was repeated, revealing both tympanic membranes to be free of cerumen, intact and in excellent condition.

The patient later reported a resumption in his nighttime ability to hear his infant son crying, which led to his being able to promptly jump out of bed and attend to his son's needs, excluding breast-feeding. This return to normal enhanced the state of their marital bliss on this island location.

Comments: The clinician operator of the device was impressed by the Super Soaker's ease of use for this procedure. Specifically, the ability to control a narrow, mildly pressurized jet of water was considered excellent. As well, the device only had to be refilled once or twice before the cerumen was removed from each ear. This is in contrast to his experience of requiring up to 10 or more refills of standard ear-syringing equipment. Using the Super Soaker in standard practice could then lead to decreased overall time spent on this procedure, resulting in shorter waiting times for patients through increased physician efficiency.

A disadvantage to the Super Soaker was that the very useful blue hand-pump (used to pressurize the water) also prevented the device from getting close to the ear. This meant that the jet had to start approximately 5.0–7.5 cm from the patient, leading to significant backsplash toward the operator, and significant dousing of the patient (well in excess of that from the use of standard ear-syringing equipment). Any risk to the operator from this backsplash could be reduced in the future with the use of protective personal equipment, including a face-shield and gown.

We feel that prospective randomized trials are warranted to evaluate the utility of the Super Soaker Max-D 5000 in clinical settings.

Footnotes:

    Disclaimer: Despite what bush-mad physicians may get up to on their private islands, CMAJ by no means endorses this particular application of the Super Soaker Max-Whatever. Do not try this at home.

    Acknowledgements: The authors would like to particularly thank Mr. Charlie Bannister, age 4, for his gracious loan of his Super Soaker Max-D 5000 for this pressing clinical and social need.

    Competing interests: None of the authors holds stock in the Super Soaker Max-D 5000, water pistols or any devices of that kind.

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