05-29-2013, 11:37 AM | #51 | |
Join Date: Aug 2007
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Re: What level Physician skill should an MD have?
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B) Med school intensity is far, far beyond undergraduate education. C) Society definitely seems to be seeing a return well above 2 cp/year of undergraduate education. Which is good, because university is expensive (even outside the US, where other people foot the bill). |
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05-29-2013, 11:47 AM | #52 | |||
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Join Date: Jul 2004
Location: Montréal, Québec
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Re: What level Physician skill should an MD have?
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Don't lose sight of the fact that the GURPS skill system is incredibly skewed toward stupidly dangerous tasks. The game outright assumes that nobody at a normal job is rolling at less than +4, if not that +7 I just suggested. And I should add that I have no disrespect for or dislike of physicians. I am friends with several, and respect their work immensely. I just don't see any proof that they're better at being physicians than most mechanics are at being mechanics or most nannies are at being nannies, or that they're smarter and more talented than the next person. They seem like pretty ordinary people with pretty ordinary degrees of success and failure . . . it's just that 95%+ of their failures allow a do-over, just like other failures. The idea that every failure kills someone or makes someone worse is fiction; most conditions are slow enough to allow retry after retry. Even my cholecystitis took 20 years and dozens of tries to diagnose!
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Sean "Dr. Kromm" Punch <kromm@sjgames.com> GURPS Line Editor, Steve Jackson Games My DreamWidth [Just GURPS News] |
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05-29-2013, 12:27 PM | #53 | |
Join Date: Aug 2010
Location: The Land of Enchantment
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Re: What level Physician skill should an MD have?
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And, at least I don't feel like a heretic for wanting Surgery-14, now. Thanks. I mean, otherwise how would you differentiate between an ER doc and a surgeon who both have Physician-12, Diagnosis-12, and Surgery-12? (I assure you that you don't want an ER doc removing your gallbladder.) In the U.S., I got a bachelor's degree in four years, and then spent four more years getting an M.D. There are a very few programs that give combined BS/MDs in six years. I would propose that those medical students with whom you met in a social situation and with whom you weren't very impressed were not being observed "doing their thing." (Physics is going to be low on the priorities list.) I'm not saying they're all savants, but they certainly ain't stupid and lazy. I saw an analysis of the required reading at a major U.S. medical school once which assumed reasonable reading speeds, allowed 6 hours of sleep a night on average, and that the students double-tasked by (for instance) reading while they were eating or on the toilet... and it was still impossible to complete all of the reading (assuming that they attended all lectures). So, anyone who survives medical school has proven, at the very least, that they are very good at learning. Probably by prioritizing well, and leaning heavily on the education that they already have. (I certainly leaned on my biochemistry BS.) And they tend to be very motivated, if only due to the Darwinian pressures that are placed upon them. Next- I would also describe a cholecystectomy as "easy" but, brother, all things are relative! In game terms it's not "easy" in the same way as the example in the basic set, i.e. a driving roll to commute to work. Yes, I can (and damned near have) done them in my sleep, but again, I trained for five years in a residency. Even an inguinal hernia repair might not count as easy in GURPS terms- inguinal anatomy is confusing, and you wouldn't want a non-surgeon doing yours at default. I now understand why you were modeling a fresh medical-school graduate. Your explanation is noted and, frankly, I'll agree that skills of 10-12 are reasonable for such a fresh graduate. But that's a bad model, unless you're talking about a resident, who by definition are reasonably fresh medical school graduates. Most independently practicing doctors with whom anyone deals will have also done a residency, though granted not all are as long as mine. My medical school plus my residency utterly consumed a decade of my life; I don't remember doing anything but studying and working (where'd that wife come from?)- and that's not including college. And I was not kidding about 100-hour work weeks in my residency (though that has changed). I maintain that this gets me to PhD equivalence. They are both terminal degrees, after all. A typical (American) surgeon graduated college at 22, medical school at 26, and residency at 31 or 32. (It sounds like your average Canadian GS does it a year or two younger.) And then spends the rest of his life reading journals. This jives with your example PhD. If you still disagree we'll have to have an XBox challenge to decide the matter or something. THAT'S RIGHT- I just called out Kromm! (hey, what's that buzzing sound...?) Finally- If the BS is "optional" in Canada, well, that's Canada. I won't start that flame-war. ;P But it also might explain your not being very impressed- those medical students lacking a BS haven't really proven themselves yet. (Or did you mean that they had attended college, but just didn't formalize a degree?) But, really, I'm kind of arguing with myself here, aren't I? You already granted me Surgery-14. I'll shut up and step back from the ledge, now... Last edited by acrosome; 05-29-2013 at 12:48 PM. |
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05-29-2013, 12:37 PM | #54 | ||
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Join Date: Jul 2004
Location: Montréal, Québec
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Re: What level Physician skill should an MD have?
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In practice, just about nobody gets admitted without one. But in principle, if you were what GURPS would call some genius with IQ + Healer of 15+, you might just be able to ace the admission exam and stroll in. I know nobody who has done so. I do, however, believe in waiving academic credentials for those who can prove equivalence through exams. Especially in the tax-supported Canadian system, I see no good reason to force capable people to sleepwalk through four years of proving it. There's some evidence that this is destructive, as it deprives people of productive youthful years focused on their terminal profession.
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Sean "Dr. Kromm" Punch <kromm@sjgames.com> GURPS Line Editor, Steve Jackson Games My DreamWidth [Just GURPS News] |
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05-29-2013, 12:55 PM | #55 | |
Join Date: Aug 2007
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Re: What level Physician skill should an MD have?
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What that means is that since we have a good target effective final skill (16), if we have a baseline skill (IQ+skill+talent+bonuses), we can back out a task difficulty. Or the other way around: baseline skills and TDMs are not independent. Of course, this should only be done for the hardest tasks which are expected to be handled routinely (most tasks will be significantly easier). Or, to put it differently, if training people to Skill 16 is affordable, and they get +6 in equipment bonuses, we'll happily set them to performing difficulty -6 jobs routinely (because, well, they can). If you start to add up the time and training put into our medical corps, it starts to look like that is where we are: skills around 16, good tech bonuses, very, very hard tasks. |
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05-29-2013, 01:01 PM | #56 | |
Join Date: Aug 2010
Location: The Land of Enchantment
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Re: What level Physician skill should an MD have?
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How about: Automatic Removing a splinter, shrapnel, or other superficial foreign body Trivial Removing a small lipoma, or a cyst; placing a central line Very Easy Removing a pilonidal cyst; hemorrhoidectomy; phlebectomy Easy hemorrhoidectomy; external fixation of midshaft long bone fracture Very Favorable laparoscopic hernia repairs; segmental small bowel resections Favorable laparoscopic cholecystectomy; gastric banding Average Nissen fundoplication; partial colectomy; sleeve gastrectomy; most anatomic arterial bypasses; IM nail Unfavorable gastric bypass; meningioma excision; repairing a stab wound to the ventricle; carotid endarterectomy; total joint replacement Very Unfavorable Total mesorectal excision; coronary bypass; AAA repair; extranatomic arterial bypass; laminectomy Hard Whipple, astrocytoma excision; ruptured AAA repair; acetabular repair Actually I guess this doesn't help much- I could produce any arbitrary list, couldn't I? But on the other hand if you throw things from other specialties in there, like coronary bypass, then it skews most other things down into easier categories... Hmm. Thinking... EDIT- Wow, this is hard, since I'm trying to include procedures that are not in my specialty. I have no idea how to rate laminectomies and such, for instance. (A lot of orthopedic procedures have unimpressive outcomes- a hand that barely works, etc., even on a sucess.) And I think I'm inflating the vascular procedures, and I might be conflating difficulty of diagnosis with difficulty of the procedure, or something. I'm giving up... :) If the need ever arises I'm sure I can wing it. I mean, really, for most adventuring needs we're talking about trauma, right? The GURPS rules for that are pretty good, though they randomize a lot, and the healing rates seem optimistic. Last edited by acrosome; 05-29-2013 at 01:19 PM. Reason: for thinking |
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05-29-2013, 01:07 PM | #57 |
Join Date: May 2009
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Re: What level Physician skill should an MD have?
Many skills can be augmented by Techniques, we see this predominantly with combat skills. There is no reason this cannot be extended to specific applications of non combat skills There are some Techniques that specifically reduce predictable penalties, are there any penalties that seem suitable for Medical Techniques.
Example Chest Surgery, Surgery/A Default Surgery -3, cannot exceed Surgery
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Maxwell Kensington "Snotkins" Von Smacksalot III |
05-29-2013, 01:16 PM | #58 |
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Join Date: Jul 2004
Location: Montréal, Québec
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Re: What level Physician skill should an MD have?
You can see things that way, but I don't. Few tasks truly don't allow retries that waste only time. Even "high-risk" ones are like that . . . the risk develops if nobody retries, not the instant someone fails at all. I'd use accumulated odds of success for this. At skill 12, say, two tries are like 14, three are like 16. I'd only go with those as baselines for tasks at which failure is tantamount to critical failure, which is a rare set of tasks indeed. I really don't buy into the belief that we have so much intellectual and professional capital that we're expecting holes in one from just about everybody. That doesn't match reality as I've experienced it anywhere I've lived.
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Sean "Dr. Kromm" Punch <kromm@sjgames.com> GURPS Line Editor, Steve Jackson Games My DreamWidth [Just GURPS News] |
05-29-2013, 01:23 PM | #59 |
Petitioner: Word of IN Filk
Join Date: Aug 2007
Location: Longmont, CO
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Re: What level Physician skill should an MD have?
Agreed. If anything, 12 is sometimes generous ... ;-)
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“It's not railroading if you offer the PCs tickets and they stampede to the box office, waving their money. Metaphorically speaking” --Elizabeth McCoy, In Nomine Line Editor Author: "What Doesn't Kill Me Makes Me Stronger" |
05-29-2013, 01:23 PM | #60 |
Join Date: Aug 2012
Location: Estonia
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Re: What level Physician skill should an MD have?
Made me think - whats the penalty to get a hole in one?
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