well, i received so many emails on this topic, i definitely had to write a post and open up the forum for your comments…
from the MUA Catalog:
The University has a zero tolerance policy on drug use (including distribution and possession) and excessive alcohol use while enrolled at Medical University of the Americas. Drug use is determined on-site by testing, random or otherwise, with a multi-drug screening kit. All students prior to coming to Nevis will be expected to sign a waiver allowing random drug testing. In the event of a specific complaint about a student, the test will not be random (Refer to the Student Handbook for policy details).
yes, every single person in the MED 3 class was filed into a bathroom with the door slightly ajar yesterday (girls separate from boys, obviously) and instructed to pee into a cup. 60 to 90 seconds later, we headed back to class and that was it. no big deal, right?
or is it?
drug testing is extremely common in Caribbean medical schools. Saba has an even more rigorous process than MUA where some students have the potential to be (randomly) chosen several times each semester. i have no idea if drug testing infringes on our rights or is unethical or immoral. i guess as someone that has “nothing to hide”, i never really gave it much thought.
does MUA have a professional responsibility to ensure that the students they are promoting into the field of medicine are “responsible” drug-free upstanding young citizens? is it a good idea that they are trying to avoid putting people with potentially dangerous addictive substance abuse problems in a profession so close to, well, more drugs? my sister is training to be a pilot, a field with ZERO drug tolerance. why should medicine be any different?
from “Drug abuse among medical students” in the Student BMJ:
Binge drinking and drug abuse in doctors and medical students have always been an occupational hazard, but drug abuse is undergoing a rapid renaissance. Medical students are exposed to the same illicit experiences as other students: exposure to amphetamines, cannabis, ecstasy, LSD, cocaine, and in some cases heroin – not to mention alcohol and tobacco. But medical students are future doctors. Maladaptive coping skills are hard to shake off, and at the moment there is a small, but ever increasing population of junior doctors who use cannabis, amphetamines, cocaine, alcohol, and tobacco recreationally, and as these doctors become more senior, this misuse could begin to present as a sizeable problem.
Dependence on alcohol and other drugs is a known problem among doctors – to what extent the professional competence and quality of care for patients will be affected is not known.
Several calls for the random drug testing of doctors have been made; it is possibly quite laughable that with such drug-wielding power no protocol for testing has been established. Pilots, train drivers, and many others undergo drug testing routinely; yet the “responsible irresponsible” have escaped. My personal concern is that drug abuse has become irreversibly intertwined with youth culture and that there will be a flooding of the medical profession with young doctors who are consistently misusing drugs. It can take one event to shatter the public trust in young doctors and shake the foundation of the entire profession.
what are your thoughts?
I have the usual “if they’re not doing it while they’re working, I don’t give a rats ass” attitude. If nobody minds if a doctor has a glass of wine or a few martinis, I don’t think anyone should mind if they have a few tokes or not either… off the job.
The other thing about drug testing (especially regarding pot) is that if you’ve been around other people who’ve been smoking, you’re going to test positive… for about a month. This is my issue the the new “drug testing for impaired drivers” that they’re trying to introduce here. So, what, even though I almost never smoke anything myself, hanging around people who will is going to impair me for a month? I don’t think so.
As for “harder” drugs… well, I’d sort of prefer I didn’t have an addict as a doctor, but hey… House makes it work, right? ;) (kidding!)
And as the daughter of people who were a typical teenagers in the 70s, this “doctors doing drugs” thing is supposed to be *new*? Hell, my mother does way more drugs than I do…
I think any professional body has a responsibility to the public to turn out members who can uphold the standards of their profession to the best of their ability. I don’t care what anyone says, this is impossible to do while taking drugs. It’s also impossible to take a doctor seriously if they are drug users, recreational or otherwise.
The school also has a responsibility to its students to ‘catch’ any users and try to help them before they drop out/become addicts, etc. In a high stress environment, med school, so I’d consider this a blessing.
Smoking pot or drinking occassionally to relieve stress and relax may seem harmless enough, especially as a student, but doing that as a professional doctor might not be as harmess, so you might as well find better coping strategies now.
As far as it being an infringement of your rights…I can see how peeing in a cup and handing it over to someone might seem that way for sure. I sure wouldn’t be happy doing it. But I guess since you sign a waiver and agree to random drug testing, you’ve already given permission for it to happen.
Ugh, of course Sarah has something opinionated and conservative to say.
yes “ugh”, how irritating of me.
i’ve been under the impression that drug testing tends to target marijuana use because that substance stays in your body longer than harder drugs. i’d personally be more concerned if a physician was abusing something more addictive like other harder drugs or alcohol, yet isn’t it less likely that those would be revealed through drug testing?
i think that the strong arguments for medical uses of marijuana, whether it is legal or not presently, make me question whether it is morally “right” to use tests on doctors that reveal pot use. you don’t know why someone might have pot in their system when tested, and i would support a doctor using it off the job. i’m not really addressing the question if i think drug testing infringes on our rights. after all, some drugs are illegal and schools, etc. do have policies against them. i guess i would say that random drug testing is not ideal for preventing drug problems and seems to be flawed or biased according to what they test for.
Pot is the least of the world’s worries.
Right or wrong governments representing the citizens of our countries have decided laws about “illegal” drugs or excessive use of prescription drugs. If we want to participate in anything regulated by these governments we have decide to or not to follow the laws or find away around them. You can be sure that any learning institution or company which can potentially come in contact with government regulations are not going to risk losing a contract or accreditation due to people they are responsible for. They are going to cover their butts with testing and records supplied by an independent organization.
As noted above, right or wrong, if you want to participate then it is YOUR responsibility to figure out a way to pass the drug tests whether they are fair or not.
As they say on the ball field, whoever owns the ball makes the rules and governments own the ball.
@ Christina: Pol Pot wasn’t.
What really worries me is the amount of alcohol abuse that goes on amongst doctors and surgeons, and how they are able to hide it, even from those close to them. Yes, it’s about time we fall in line with other professional organisations and introduce testing of some sort.
I hope the person in charge of testing all that pee at your school doesn’t mix up any results. That could really mess up someone’s future career prospects!
It is very important to keep the profession clear of people that use elicit drugs. However, being in medical school now I have realized why many people are forced to turn to drugs. Especially those long study days when you are dragging ass and can’t get in the saddle and get things done!!
I think that’s a stupid policy because after they graduate, doctors are going to hand out hundreds of thousands of prescriptions for pharmaceutics that are probably much worse than marijuana or alcohol. I think the university should allocate its funds toward testing birth control pills, depression medication, impotence medication, antibiotics, even artificial sugar, because these are things that the general population take regularly and these are things about which we don’t really know the continuous long-term effects!
I’m shocked how many people are pro-drug usage or could care less. As doctors, it is our fiduciary duty to do all we can in making our patients as healthy as possible and to do them no harm. Drugs generally alter our perception – the question is, does it make us better physicians or worse? If the answer is that it makes you a worse doctor or gives you a handicap, why would you want that? There’s no argument in my mind – and drug effects are not a one-time thing either – would you want to be treated knowing that your doctor tokes up? If you could care less then I am awed at your sense of adventure. You choose to be a doctor, and that comes with privileges as well as responsibilities.
I am heavily disappointed in the lack of logic shown in responses like J’s. I don’t know you, but I urge you to think of repercussions to the things you’re saying if they were enacted. If doctors will prescribe “harder” medications, then wouldn’t it stand to reason that they wouldn’t want their decision-making abilities impaired?
Jenn, thanks for bringing this up – I’ve had my eyes opened. Here in Guad I recently found out that many more people toke up than I thought at first. I couldn’t imagine studying for a path exam while high.
I’m shocked how many people are pro-drug usage or could care less. As doctors, it is our fiduciary duty to do all we can in making our patients as healthy as possible and to do them no harm. Drugs generally alter our perception – the question is, does it make us better physicians or worse? If the answer is that it makes you a worse doctor or gives you a handicap, why would you want that? There’s no argument in my mind – and drug effects are not a one-time thing either – would you want to be treated knowing that your doctor tokes up? If you could care less then I am awed at your sense of adventure. You choose to be a doctor, and that comes with privileges as well as responsibilities.
I am heavily disappointed in the lack of logic shown in responses like J’s. I don’t know you, but I urge you to think of repercussions to the things you’re saying if they were enacted. If doctors will prescribe “harder” medications, then wouldn’t it stand to reason that they wouldn’t want their decision-making abilities impaired?
Jenn, thanks for bringing this up – I’ve had my eyes opened. Here in Guad I recently found out that many more people toke up than I thought at first. I couldn’t imagine studying for a path exam while high.
In conclusion, as long as they’re paying for the test, I’m fine with it.
watch out raeb…”radical doctor” might not like your response either!
I totally agree with you though. These other people need to get off the hippie train
Hmm.. Guess whether the tests are conducted humanely or not could also be a factor..
Whether the tests are justified or not, “due process” should always be kept(not sure if i used that legal term right ;-p)
Random drug testing shouldn’t be allowed, even if you sign your rights away, since the contract to sign away those rights is arguably unconstitutional. People have the right, “…to be secure in their persons, houses, papers, and effects, against unreasonable searches shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”
I’ll have to agree with J… and who seems to have the most balanced lives (spiritually and health wise) hippies or yuppies?
You’re agreeing with yourself? I suppose that’s good..
(and yes I know it’s two different “J’s”)
I’m not sure why you’re comparing hippies and yuppies, but I’d have to say neither of them have much of a grasp on reality.
Sarah,
I feel like you make these huge blanket statements. “these people need to get off the hippie train”
what does that mean? no, seriously.
the hippie train? you think pot smoking is associated with hippies? what kind of isolated world do you live in? the hospital is going to blow your preconceived notions away!!
you know how many responsible, professional adults drink to get wasted?
i am sure 80% of my medical school class did this all the time. um, alcohol is legal, correct. please distinguish between smoking pot and drinking?
or, when you are over prescribing pain killers, tell me what you think of yourself, or the people taking them. and you think doctors smoking pot is bad?
will you tell your attending when he/she is living off no sleep and tons of caffeine that this is affecting his/her ability to perform?
smoking pot is by no means anywhere close to as detrimental as chronic
lack of sleep.
i imagine you will encounter this experience. i know i have, over and over.
just as drinkers don’t show up to the hospital drunk, either do pot smokers.
i am also sure most pot smokers wouldn’t take a “pathology test” stoned, either.
you people are so dramatic!
also, “hippies and yuppies don’t have much grasp on reality”
you understand, when you are done with your residency…even if you are working in a free clinic as a physician (making 80-90K), you will be considered a yuppie.
or do you also think rich people have their own categories? aren’t all rich people “yuppies”?
because you are physician doing “good” you are not a yuppie.
perhaps you should think before you make opinionated statements. i am pretty sure this will not help you in your future.
i am not saying you should not be opinionated, and passionate. i do believe based on my work, i am a “radical doctor”….but when you say such impulsive, disorganized statements as the few discussed above, you should be prepared to have your opinions critiqued.
good luck.
yes, i am distinguishing between pot and say, harder drugs.
i definitely think those would affect a doctor’s ability to perform.
i do not think it is rational for a med school to test its students.
i am sure this is a carribean medical school issue.
this is uncommon (unheard of?) in the states.
First of all, I am not a med student (quite a huge, blanketed assumption on your part eh?)
Secondly, it’s quite simple…
A doctor practicing medicine should not be under the influence of drugs or alcohol, period.
You said “you know how many responsible, professional adults drink to get wasted? i am sure 80% of my medical school class did this all the time”. If I could stop laughing at that statement, I’d probably say something like “well if 80% of your class drank, i guess it’s ok!” Or, “if other professional adults get wasted, then why should i care if my doctor is barfing on his bathroom floor on his off hours??” Luckily for you I can’t stop laughing at that, so I won’t say those things. Anyway..
Thirdly, what I meant by people getting off the hippie train, is people like you who somehow think it’s ok to be an irresponsible professional, and try to rationalize that thought by comparing pot smoking to things like lack of sleep, stress, caffeine overload, etc. See, I think ALL of those things are bad. I don’t think that because a doctor might suffer from one, we should excuse the other. Similarly, I fail to see the correlation between being a drug/alcohol using professional, and prescribing drugs. Are you suggesting that one is a hypocrite if they give prescription drugs to their patients, but don’t do illegal drugs or drink themselves? (I’m saying that tongue in cheek, but you really pretty much DO suggest that).
My comment about yuppies was a response to “J”, suggesting that a “yuppie” is more spiritually and emotionally messed up than a “hippie”. I took from that that he/she was suggesting that pot smoking, drinking, whatever else you associate with hippies, is no worse for a doctor than living an upright, straight lifestyle. While I agree it may not be any worse for the DOCTOR, my main concern in all of this is the PATIENT. The definition of a yuppie really has no bearing on this conversation, but if you’d like one, you’d have to ask J.
I hope this clears things up for you. I have no problem at all having my opinions ‘critiqued’, although I think you’re using that word a little loosely. Also, suggesting that I don’t think just because you don’t happen to agree with me is just immature. ‘I am pretty sure this will not help you in your future’ (nor will personal barbs while ‘critiquing’ something you have issue with). Just something to think about.
radical doctor and J, with all due respect and attempting to maintain civility, RTFA. Secondly, stop throwing your straw men around and deal with the issue. Your wanting to get stoned when you want is getting in the way. It takes thirty seconds to perform a urine test and if you have nothing to hide it’s just an inconvenience ONE MORNING.
You have people’s lives in your hands, for goodness’ sakes. Grow up, especially if you’re serious about this. I’ve yet to see one good, reasonable and logical argument from this camp.
Langdon, I hope you’re not finished law school yet, because:
““…to be secure in their persons, houses, papers, and effects, against ***unreasonable*** searches shall not be violated. . .”
your quote of the fourth amendment here requires that it be shown it was unreasonable (which I suspect it will be difficult to show it is unreasonable) and assuming you take prior cases to mean a drug test is a search , and that’s AFTER you figure out how to apply a FEDERAL mandate to a private firm, and then how to uphold US law in a foreign country, a complete impossibility.
In the end, you will make your decisions and I will make mine. I thank Jenn again for letting me see that other “views” exist to this issue, and now I am better prepared (as well as amazed) at the lackadaisical attitude prevalent in some med students, especially when all it takes sometimes is one google search.
We reap what we sow. I’ll get off my soap box now.
http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1350195&pageindex=1
And sarah’s statements may have been impulsive (I mean, I wasn’t there to time her thinking progress and her typing progress and compare) but her statements seemed very organized. Granted, ad hominem attacks never help, so that’s a definite downer. But reading your first comment, radical doctor, makes me think you don’t have the best intentions in mind when it comes to sarah. She seems nice!
Thanks RAEB..I am nice!
My statements weren’t impulsive. Radical doctor is just a bored person on a sunday night.
This geek’s logic …
As a user of health care services, I expect my health care providers to deliver consistently competent, and trustworthy service (100% certainty).
Administered with appropriate diligence, random drug testing may not be ideal for preventing drug problems, but they are effective for detecting them (90% certainty).
Health care providers with drug problems would find it difficult to deliver consistently competent, and trustworthy service (80% certainty).
80% certainty, while imperfect, is enough for me to support random drug testing of health care professionals. Discarding the practice until a 100% solution is found is illogical.
(full disclosure: I don’t drink alcohol or use drugs)
continuation of full disclosure: ( … or hang around in places where drugs are used)
I’ve email Jenn, but I just wanted to apologize to radical doctor and J . . . .I went out of line there for a second, and meant no disrespect, but I think my comments added to a lack of civility. Not my intention, and I apologize. The last thing I want (and I’m sure the owner needs) is for this to all of a sudden become a moderated forum.
Final word: I think the pros far outweigh the cons for random drug testing, as long as the results are not shown publicly or it is known what is happening with the information gathered.
Just don’t let anyone fingerprint you, Jen. It’s time to come home when the ink pad comes out, okay? And I’ll be there to pick you up from the airport. I promise.
And bollocks to retinal scans too. Nexus cards be damned.