Graduate enrty to medicine and fee's abroad

eth0_

Human error is unpreventable.

Tind777

mmmm!!!

eth0_

Please explain how you could make human error never occur again? Everyone is fallible.

Traumadoc

Fionnanc wrote: »

Lastly echoing the moderater's post, 4 attempts at exam is a joke.

Most postgraduate exams allow you at least 4 attempts often more, I have no problem with multiple exams as there is less pressure on the examiner to get the student through and the student often knows the subject a lot better than if they had got it the first time.
Some of the best doctors I know had difficulties with undergraduate exams and took " the scenic route" through college.

Chunky Monkey

Woah four attempts?? Bloody hell I think we only get two attempts at exams then we have to repeat the year and same goes with assignments- if we are late handing them in three times, we have to repeat the year.

I'd imagine the main reason for not allowing students to repeat many times is funding more than anything.

tallaght01

We used to get 3 attempts to pass.

I know lots of people who utilised the repeats a lot, and I know lots of people who've taken a long time to get their postgrad exam.

There's very little correlation with how a good a doctor they are.

Most people who are actually qualified will tell you that.

Vorsprung

Tind777 wrote: »

well explain this then
http://archives.tcm.ie/irishexaminer/1999/03/05/ihead.htm

This incident occurred because someone had mistakenly placed a vial of KCl in with the NaCl vials. When the antibiotic was mixed up, the SHO has mistakenly picked out the KCl.

Ban the troll tbh.

onetrueone

I'd bet the labels and packaging for the KCL and NaCL are very similar or identical.
Several pharmaceutical companies produce their various products with identical packaging.
Roche is a big culprit in this regard.

Tind777, that was just a really stupid comment to make, you have no idea of the circumstances of that error (Workload factors, tiredness, lack of suitable back up staff etc).

Don't throw stones if you live in a glasshouse.

Vorsprung

onetrueone wrote: »

I'd bet the labels and packaging for the KCL and NaCL are very similar or identical.
Several pharmaceutical companies produce their products with identical packaging.
Roche is a big culprit in this regard.

Yea the old ones in the hospital I work in were exactly the same, apart from a subtle difference on the label. Now the few vials of KCl that are kept on the ward are locked away, and have to be signed out when needed.

onetrueone

And they wonder why errors occur, suitable legislation should be enacted to outlaw companies from producing similar packaging/labels on their different products.

Btw to reduce errors in my Job I talk aloud each product e.g. picking up the KCL I would read aloud "KCL x%" if someone is with me I get them to double check as well.

People look at you like are a nutter but it cuts down almost completely on selection errors.

This method works because sometimes our minds read a label the way we would like it to be, not what it actually is. Talking a loud the product forces our brains to be used in a different way. i.e. using another sense - speach.
Speach and vision is more effective than vision alone.

Hope this helps.

Tind777

<snip> anyone who uses this forum knows I very very rarely interfere with a thread. I'm not into warnings or bannings. But Tind777 is taking the piss a bit. This post contributes nothing to the debate, and seems to be designed only to wind up other posters. Like I said, I'm not into bannings, so I'm happy to let it go with just a deletion as long as it doesn't keep happening. Tind, feel free to PM me if you think I've taken you up the wrong way. Cheers. Tallaght01 <snip>

Vorsprung

onetrueone wrote: »

And they wonder why errors occur, suitable legislation should be enacted to outlaw companies from producing similar packaging/labels on their different products.

Btw to reduce errors in my Job I talk aloud each product e.g. picking up the KCL I would read aloud "KCL x%" if someone is with me I get them to double check as well.

People look at you like are a nutter but it cuts down almost completely on selection errors.

Nurses always double check things with another nurse - even vials of NaCl, but they're absolutely right, it cuts adverse incidents. It should be widespread, and if doctors picked up the habit it wouldn't be half bad at all.

Traumadoc

Its a good point, I remember the Galway incident. It happens every so often, generally when more senior staff get junior staff to perform relatively mundane tasks. Like calling the intern up at 3 am to give IV antibiotics and not explaining to the intern which line is which.
There was an intern on a manslaughter charge in the north a few years ago, from such an incident, I think it was thrown out.

EDIT:here it is

The young Malaysian doctor accused of the manslaughter of a patient
at Belfast's Royal Victoria Hospital was acquitted by a jury which
took just 45 minutes to reach its verdict. In February 1994 Samuel
Beers (36) died when penicillin was injected into a tube leading to
his brain rather than a tube connected to his wrist. The jury
accepted Dr Yin Yin Teoh's explanation that, because the two tubes
were identical, she had to disentangle them and follow them to their
source to establish which was which. She believes that she must have
got the two mixed up again as she reached for a syringe.

Traumadoc

http://findarticles.com/p/articles/mi_qn4161/is_/ai_n14488673

onetrueone

I will add that most Pharmacists working in a communty setting do not get Lunch breaks, I work 9 to 10 hours a day with no Lunch break.
Why is this "no breaks culture" so tolerated in the Medical field?

Traumadoc

You would get in the way of the managers at the trough, sorry i mean canteen.

DrIndy

sure there's never any space in the canteen between 1-2pm! I always grab my 15 minute lunch around that time.

eth0_

Traumadoc wrote: »

because the two tubes
were identical, she had to disentangle them and follow them to their
source to establish which was which. She believes that she must have
got the two mixed up again as she reached for a syringe.

I really don't think that is an acceptable excuse.
Yes she was tired but obviously not so overcome with sleep that she didn't realise she needed to trace each IV line back to source...and then turned round to pick up a syringe and forgot which tube she was holding? I wonder if you asked her colleagues, would they point out any other incidents of incompetence.

Also - isn't that a massive single point of failure? Shouldn't the lines be colour coded or labelled?

Traumadoc

I remember at the time the hospital introduced new protocols for the labeling and colour coding of the various lines- after the fact, and after shafting the intern.

eth0_

Shafting her? I take it she no longer works in medicine?

Traumadoc

You may not believe it an acceptable excuse but she was found innocent. Im sure if the hospital was charged with corporate manslaughter it might have been a different result.

The system is the problem. If it was a nurse providing the medication there would protocols to follow. There should be the same for all providers.

If the system makes you work 100 hours and then allows you to make a life or death decision/mistake something is wrong.

See what the victims wife said:

http://findarticles.com/p/articles/mi_qn4161/is_/ai_n14488673

DrIndy

eth0_ wrote: »

I really don't think that is an acceptable excuse.
Yes she was tired but obviously not so overcome with sleep that she didn't realise she needed to trace each IV line back to source...and then turned round to pick up a syringe and forgot which tube she was holding? I wonder if you asked her colleagues, would they point out any other incidents of incompetence.

Also - isn't that a massive single point of failure? Shouldn't the lines be colour coded or labelled?

You are correct - its not an acceptable excuse when you consider the life or death decisions simple mistakes people make.

If you work in an office and accidently use a blue pen instead of a black pen for a form - then the form is not photocopied properly and cannot be used. No biggie - do it again with a black pen. Simple mistake? yes.

With us, a simple mistake happens - which tube do i use? Someone dies, a chief wage earner is gone as well as a father or mother to children. The ramifications are much bigger, but the error is as simple.

So its not acceptable ever - but it still happens. Should people who use the wrong colour pen to fill in a form be brought up on manslaughter charges?

I'm not minimising the error that happened or trying to excuse or brush off the result - but it does happen and the system has failed when it does, not one single individual. You need checks and balances to minimise significant error - not blaming an individual.

Anthony16

Fionnanc wrote: »

The LC is not an intelligence test. A good work ethic can get gr8 results with an average intelligence in the LC.

I agree.got 580 in the leaving and only consider myself to be of average intelligence:(

wheresthebeef

I feel terribly sorry for those few doctors named in the links above, those incidents will follow them all their lives. It's things like that which terrify me into being so unbelievably careful, to the point of annoying others ;-)
What I will say though, is that in all those situations, any of those junior docs could have sought an independant check from a nurse or another doctor in order to reduce the error. In terms of the doctor who got the two tubes confused, as soon as she identified that the tubes were tangled and similar, she could have stuck a piece of tape onto one of them or marked it somehow. And as someone already said about the KCl, the vial is marked, it has a white label with a red banner. It says Potassium Chloride on the bottle. I find it hard to believe that he picked it up and only looked at the back of the bottle, never checked the drug name, or the expiry date. It is standard practice amongst all nurses to read aloud the name, strength, route and expiry date of a solution, and check it with the prescription, and then allow another nurse do to the same, before its given. These poor guys and girls were under a lot of pressure, no-one would deny that, but they could have done some very simple things that would have only taken them an extra 10 seconds each time to cover their asses. We need more lectures on risk management me thinks.

tallaght01

wheresthebeef wrote: »

I feel terribly sorry for those few doctors named in the links above, those incidents will follow them all their lives. It's things like that which terrify me into being so unbelievably careful, to the point of annoying others ;-)
What I will say though, is that in all those situations, any of those junior docs could have sought an independant check from a nurse or another doctor in order to reduce the error. In terms of the doctor who got the two tubes confused, as soon as she identified that the tubes were tangled and similar, she could have stuck a piece of tape onto one of them or marked it somehow. And as someone already said about the KCl, the vial is marked, it has a white label with a red banner. It says Potassium Chloride on the bottle. I find it hard to believe that he picked it up and only looked at the back of the bottle, never checked the drug name, or the expiry date. It is standard practice amongst all nurses to read aloud the name, strength, route and expiry date of a solution, and check it with the prescription, and then allow another nurse do to the same, before its given. These poor guys and girls were under a lot of pressure, no-one would deny that, but they could have done some very simple things that would have only taken them an extra 10 seconds each time to cover their asses. We need more lectures on risk management me thinks.

Or they could not make people work 24 hour shifts. Or not make docs have to give IV meds, which is a waste of their skills. It's very easy to criticise in hindsight. But me and my colleagues wrote a begging letter to the nursing hierarchy to reinstate one of our nurses when she did a similar thing and she got suspended. She was fantastic, but cocked up. It happens.

imported_guy

Tind777 wrote: »

Hey
Anyone have info on people getting say a 4yr medical degree in eastern europe eg prauge, poland, hungary or even the UK etc. and also what fee's do they have to pay. I know that fees for budapest are €7500 per year but think it takes 6 yrs:(

lets go back on topic a bit

you have loads of options

alot of americans come to eastern europe or carrabien to do the 4 year med degrees (they have them in czech republic, poland, romania and some other countries), most eastern EU contries will require you to learn the language for their clinical years, the fees are alot cheaper in poland than here (i remember the undergrad one being 3500 euro for non-eu, so the graduate one hopefully will be similar) EU univeresties, try Gdansk, Jagiellonian, Lodz, Lublin, Pomeranian, Poznan, Silesia, Warsaw in poland, University of Constanta in romania,
Charles University, Palacky University in czech republic

option 2 is carrabien, there are a few good universties like SABA, xavier, all-saints, AUC, ross, spartan, SGU,

okay in carrabien they require you to have a science/premed degree and MCAT (most of them) for the 4 year course, if you dont have these then they let you into a 5 or 6 year programme, and most of their fees are from 15000-25000 US dollars, per year

i would advise you to go to carrabien rather than EU, because you only study at the university for 2 years, and then you do your clinicals in america, dont have to learn any new languages, the weather will be amazing, good atmosphere, you can relax and study, and you have a high chance of getting a residancy match, and you will be well prepared for USMLEs etc most of these colleges have like 95% first attempt passes at step 1

i'll post links when i get home

drzhivago

Traumadoc wrote: »

Its a good point, I remember the Galway incident. It happens every so often, generally when more senior staff get junior staff to perform relatively mundane tasks. Like calling the intern up at 3 am to give IV antibiotics and not explaining to the intern which line is which.
There was an intern on a manslaughter charge in the north a few years ago, from such an incident, I think it was thrown out.

EDIT:here it is

The young Malaysian doctor accused of the manslaughter of a patient
at Belfast's Royal Victoria Hospital was acquitted by a jury which
took just 45 minutes to reach its verdict. In February 1994 Samuel
Beers (36) died when penicillin was injected into a tube leading to
his brain rather than a tube connected to his wrist. The jury
accepted Dr Yin Yin Teoh's explanation that, because the two tubes
were identical, she had to disentangle them and follow them to their
source to establish which was which. She believes that she must have
got the two mixed up again as she reached for a syringe.

Interesting study I remember both of the cases, and there have been others

Spoke to a pilot friend at the time about human error, in his line of work he said the industry works to engineer out the human error with multiple checks etc, he says its important because they are dealing with peoples lives but not in as direct a way as the doctors involved in these cases

One simple point he made to me at the time stood out and it remains true today, if a hospital was run to the same safety standards as airline industry there would be a warning on the IV Line going to the brain, a protective device would have to be removed before something could be inserted and the bung on the and would be of a special design that would not accept the routine syringe so someone would have to specifically look for the special syringe reinforcing they are injecting somewhere special

Same would apply to potassium which would be locked in a cupboard which would need two keys to open and be signed out at point of dispensing,again a safety measure to engineer out the failure from fatigue of misreading the labels

As a junior doc floating wards at night many years ago I remember coming across a cupboard on a ward where potassium, water for injections and saline for injections were in 3 small pots, overfilled where vials were spilling into the neighbouring pot. Stuff like that should just not be possible