Sample Elevation Certificate Florida: Fill & Download for Free

I've lived just about everywhere,and I can say objectively; the south is better. It wasn't always this way. But starting in the mid to late 80s, things started to flip. Now, it's hard to argue against living in the south. And by south, I mean Dixie. Texas to Virginia, and everything south, if you drew a line from one to the other.The weather is better. I live in Northwest Georgia. We get three and a half seasons. We get a winter, but it only lasts a minute or two. If you really love cold weather and snow, head up to the upper elevations of the Appalachian Mountains, you'll find plenty of it. And when you get sick of it, you can come back down and get warm. I can't begin to tell you how nice it is to not have to deal with icy and snowy roads. I've lived in Kansas, Colorado, New York and New Hampshire. Three to five months out of the year,.getting from point A to point B is a gauntlet in those places. Not so in the south. Even in the places with a winter, it may be a month of dealing with cold weather related problems.The parties are better. You know what the north doesn't have? Mardi Gras. It doesn't have low country boils. It doesn't have good Bar B Que. It doesn't have a festival going on within an hours drive at all times. We do down soutb. Mardi Gras, which is celebrated in more than just NOLA, is in February. Think about that. What do you do in Cleveland in February? Not much out doors beyond shoveling snow.Businesses are shifting south. A lot of the the industrial job loss up north isn't to Mexico or Asia. A good deal of it is in Dixie. There's a damn good reason for it. It costs a lot less to put a factory in Alabama than it does in Michigan. We have a naturally lower cost of living, as AC is now cheaper than heat. We have a better infrastructure because roads don't freeze and thaw, freeze and thaw, etc., for half the year. You don't lose a lot of work days to weather. You have access to warm weather ports. Railroads are readily available. Airports don't shut down. Two things kept the south poor: the destruction of the Civil War and the heat. It took about 100 years to get rebuilt after Sherman and the boys burned their way through Georgia. Several major cities were literally flattened. So, things finally got up and running again around the 60s. The heat made heavy industry nearly impossible. HVAC systems just couldn't keep them cool enough. That changed in the 80s, and the cotton fields are now making automobiles and tech hardware.The education system is finally catching up, but it is still a place that values skilled trades. The south is traditionally an agricultural region. Agriculture doesn't care how educated you are. You need to be smart, but mostly, you better have a strong back. You better be able to fix things. You better know how to live off the land. Despite industrialization, these ideals are still pretty common. The north has started to lose those ideals. The north has gone from industrialized to metropolitanization. Making things is not as important as making money. Subtle, but significant. Education for educations sake, rather than education with a specific purpose. The south is not like that. At least not yet. Education is still seen as a means to an ends. Technical and vocational schools are destination campuses for a majority of kids rather than liberal arts schools. A certification in a skilled labor or tech field is more valued than a four year degree, unless it's a continuation of the former. And our colleges are also destination schools. Duke, Vanderbilt, GA Tech, Emory, Tulane, UF, NC State and many others are more than just football factories. They are among the top 100 in the world. And why not? Great weather, lots to do and low cost of living.But it isn't just post secondary schools. Our k-12 schools are on the rise. It used to be that a public school education in the south meant being in a system that was in the bottom half, of the bottom half. That is changing. Slowly, bit surely, the south is popping school districts into the upper crust.The south is a sample platter of the rest of the USA, and the world. We have everything the rest of the country has, but in a smaller scale. We have mountains with all of the things you want to do on a mountain, minus altitude sickness. We have tropical paradises, that are still places you can get lost in. Plus, you can drive to the Florida Keys. Try driving to Hawaii. We have deserts in Texas. We have surfing a along the Atlantic coast, but the waves are as likely to kill you. And the surfers are more polite than their California cousins. We are more culturally diverse. We have four languages spoken down here. Two are local dialects. Creole and Gicci/Gulla, Spanish and English. We have better food. We have fresher food. We have aligators and muscidine grapes. We got wine country, craft beer and the world's best whiskey. The Scots, in Scotland, use our old whiskey barrels to make their whisky. We got better music. Jazz, Blues, Soul, Rock and Roll, Blue Grass and country were pretty much invented or perfected in the south. And our Hip Hop is right up there with anything coming out of NYC and LA. Outcast, Ludacris, Master P, and a ton more made thr “Dirty South” a force to recon with.Nobody retires and heads up north. Disney wasn't put in Detroit for a reason. Hollywood is heading to Atlanta for a reason. Atlanta has the busiest airport in the world because ice on the wings sucks. Good music, good food and good times are best had outdoors. We can do it 12 months out of the year. What's not to love?

It's three (or four years if internship is included as PGY1 in some programs) of rotating through monthly different training sections. One might conclude it's putting the resident through a taste of as many different subspecialties and training situations as can be crammed into that period of time so that completion of training leaves the doctor ready to enter practice without supervision. The other stated goal of the training is to prepare for passing board certification exams.Some residencies in internal medicine are getting prospective internists to declare two paths at the start. One path leads to subspecialty fellowship, (gastroenterology, pulmonsry/critical care, cardiology, nephrology, neurology, infectious diseases, etc) while the other leads to general internal medicine and primary care providers. Another, but not widespread in its prevalence, is the path to hospitalist training. Hospitalists take care of hospitalized patients only. The goal is the clinic-based doctors can see their office patients, only, when someone in their practice is hospitalized.Residency starts out being an adventure to get a grip on your self-doubt then gradually becomes a learning experiencing fulfilling one’s dreams to treat patients with illnesses. The adage used to describe obtaining basic procedure experience is ‘watch one, do one, teach one’. Examples of procedures all residents will learn: spinal tap, thoracentesis, paracentesis, central venous access (femoral, subclavian and internal jugular), thoracostomy tube insertion, endotracheal tube insertion, nasogastric tube insertion, indwelling and straight (in and out) urinary bladder catheter insertion, Advanced Cardiac Life Support (ACLS) code supervision, pericardiocentesis, arterial puncture for blood gas sample and for catheter insertion, pulmonary artery catheter insertion (Swan-Ganz). Other procedures may or may not be performed, but need to be understood: Cardiac stress testing, endoscopy (upper and lower), EKG, lab and pathology results interpretation, echocardiograms, radiology studies interpretation, pulmonary function tests, etc.Once these procedures are learned, the resident becomes a valuable hospital asset. He may be in charge of an ICU overnight when the attending physician is off. He may be on call for various sections or the whole hospital.A lot depends on the size of the hospital, the number of other residents to share duties, the number of in-house specialties, the structure of didactic and grand rounds for teaching. (some programs utilize off-site cooperation for subspecialties that are not strong in that location, invasive cardiothoracic surgery, neurosurgery, nephrology dialysis, or similar). Some programs are reknowned by their strength of department heads for research, teaching methods, and record of graduates becoming certified and more. The Father of Modern (US) Medicine, Sir William Osler, created the method of bedside training at Johns Hopkins University Hospital in Baltimore, MD beginning late in the 1890s.Don't be too concerned about where the training is located. Many are in impoverished urban areas with bad crime and run-down neighborhoods. This happens to be where the older programs had started so they're still there. But, it's also important to go where the sickest patients are. To see the worst pathology as part of your training is to be prepared for the career ahead. Not to mention, the number of hours you will be at work make your off time less important. Its not necessary to move to Florida or California. Detroit, where I trained, served my needs great. (Heavy US bias, just glean what you can if you're from elsewhere. I'm not going to explain what I can't)Finally, internal medicine residents as they gain experience and on into their careers are the teachers to the rest. It will start out for students and junior house staff, and progress to teaching in lectures and possibly conducting clinical investigations and research. The effort to learn, is often accompianied by the desire to explain what you've learned. Its well recognized as a sign of intelligence. But, it's also more than just being erudite. Patients benefit greatly from being educated on the diseases, investigations and treatments to which they are being subjected.Its a very broad question. I'll stop here. Having completed mine in 1995, things are skewed by time and I'm sure others would update my info, if it's drastically wrong.EDIT: Here’s an essay to illustrate a resident’s role in patient care:Bruce McFarlandJuly 19, 2009 ·The eyes have itWhen I was an intern in inner-city Detroit, I was on-call in the hospital one night, when I got paged by the nurse upstairs from me in the lounge where I slept.Usually, I could handle any number of problems from my bed with advice over the phone. You can adjust the heparin rate for a partial thromboplastin time result (a test to see if someone with a blood clot is getting adequate anti-coagulation therapy), or you can authorize the, ever-requested, sleeper prescription for the insomniac (usually those come in like clockwork from 9:30 to 11 pm). Likewise, there was the haldol order for the elderly sundowner (those who get confused after dark when their usual surroundings are no longer visible in the room around them, and they become berserk). I wasn't too surprised when I got the standard request for something for constipation, but was slightly perturbed when one of my fellow interns had not had the foresight to order these "prns" at the time of admission (prn means, per required needs, and is therapy that can be thought of as 'optional' at the discretion of the nurse, when certain, commonly expected, needs arise).Occasionally, there were the unavoidable situations for which you had to get out of bed: An IV line that went bad and the nurse can't restart it; an x-ray that you ordered needs your interpretation to decide what the patient has wrong: a person in pain to evaluate and alleviate. It got to the point when the nurse would cajole you for your instinct to handle something over the phone, without coming to see the patient. The phrase, "Come quick! Patient in pain!" became a routine code for, 'this is for real, wake up.' But it was in that context on one particular night, that I had a "CQ, PIP!" (so to speak).So, as I left the intern lounge, I was not quite sure what to expect, but I did know there was someone ON THE FLOOR ABOVE ME screaming loud enough for me to hear them. In these situations, the stairs are quicker than the elevators, so I bound up the stairs, to find a nurse in the hall just pointing me to the right room. I hardly needed her help, because a man kept screaming like a banshee which had the effect of a homing beacon to draw me to his problem. And as I breached the doorway to his room, the evidence of why he yelled was eminently apparent. Here was a gentleman of about 70 with a bad case of exophthalmos (a condition usually caused by hyperthyroidism, in which autoimmune disease creates antibodies that trigger excess growth of the eyeball in the socket, to the point of it bulging out, and making the person look, perpetually startled.) However, as it turned out, this man had been rubbing his eye, rather absent-mindedly, when he had managed to dislodge it forward, out of the eye socket! While it was not dangling loose by the optic nerve, it was obviously out-of place. And it had the effect of causing him to panic. Now, I had never seen this before, nor had I read about what to do if something like this should ever happen on my watch. But, just by the seat of my pants, I reached out, tugging his upper and lower eyelids farther apart, and with the most satisfying, "slurp" sound, the eye popped back into its orbital cradle. And the whole room, nay, the whole floor, heaved a collective sigh, of relief.3 Comments