Midwifery Students Tribe 2009 - Page 5 - Mothering Forums

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#121 of 1527 Old 01-16-2009, 11:57 AM
 
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I'm still apprenticing, but these are my feelings thus far:

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Originally Posted by Om Girl View Post
MN has voluntary licensure laws and I'm currently studying them now to determine where I stand.

On another note: What do you think about fees?
*If you miss the birth (on your own accord) do you charge a full fee?
No, I wouldn't... but I sure hope that would never happen... and if I did miss a birth it would be intention to have a colleague attending in my stead. In which case, no refund.

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*If you miss the birth (on your clients' accord) do you charge a full fee?
Yes. Good communication is key here.

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Originally Posted by Om Girl View Post
*If you have to transport do you charge a full fee?
Yes... Hiring me as midwife does not guarantee one a homebirth, it means I will do what I can to give them a safe birth at home. If homebirth is no longer the safest option we will transport and I will accompany client as doula (at most hospitals, and I would advise them at time of hire if I wouldn't go to their hospital). This may change if our legislation passes this year, it's a felony right now to practice mw without a license and they only give licenses to CNMs... if I'm legal I would accompany clients to any hospital.

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When do you charge full fees and when do you accept less than full fee?
I might give a sliding scale if I felt it was warranted, but at my discretion.
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#122 of 1527 Old 01-16-2009, 12:56 PM
 
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I love that the midwives I work with are so relaxed about the money aspects. We don't require payment in full before X amount of weeks. We certianly wouldn't refuse to be at a birth if the fees were not paid. We tell the clients that they can pay what they can, when they can. I asked my preceptor about her philosophy and she said, "We've never NOT been paid. Once it took 2 years, but we got paid." I think this takes a lot of pressure and anxiety off the moms. They need to be thinking about their pregnancy, getting prepared for labor and their beautiful baby(ies). We also except bartering. One client paid off some of her bill by making herbal baths for us.


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#123 of 1527 Old 01-16-2009, 03:04 PM
 
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Originally Posted by 636Jen View Post
I love that the midwives I work with are so relaxed about the money aspects. We don't require payment in full before X amount of weeks. We certianly wouldn't refuse to be at a birth if the fees were not paid. We tell the clients that they can pay what they can, when they can. I asked my preceptor about her philosophy and she said, "We've never NOT been paid. Once it took 2 years, but we got paid." I think this takes a lot of pressure and anxiety off the moms. They need to be thinking about their pregnancy, getting prepared for labor and their beautiful baby(ies). We also except bartering. One client paid off some of her bill by making herbal baths for us.


This is a lovely idea, but I'm not sure how it would work.

If a midwife is working to provide for her family (either soley or with the help of a partner), she needs to be able to be paid money so she can pay her own bills, mortgage and buy food, gas, etc for her family plus supplies for her practice.

How does that work with your practice? Do most people pay the full fee, so you still actually get mostly money? Do they just take as long as they need to to pay the full fee, or do you cut it down instead? How do you explain the fee/payments at a consult - do you say I charge this, but do what you can?

I am just sincerely wondering how this is handled so the midwives don't feel taken advantage of, but the clients aren't deciding to go to the hospital because they can't afford homebirth. Thanks!
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#124 of 1527 Old 01-16-2009, 05:21 PM
 
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Question for all of us students...
As I've been eeking out money for supplies to add to my birth bag and realizing more and more how much everything costs, I've been thinking hard about what is really necessary and what is just "nice" to have.
I know from my previous training that O2 doesn't really "DO" a whole lot for normal patients who are able to ventilate normally. It's something to do, but based on evidence, it doesn't actually raise oxygen saturation levels signifigantly, and they're expensive and slightly dangerous to carry....
So, for those homebirth midwives... are you planning on or do you already carry O2 or would you feel comfortable not bringing it?
What do you think your clients would think if you DIDn't bring it?
inquiring minds want to know....
- Jen
I carry O2 and have used it a couple times. We've had babies that have been in pretty good respiratory distress and the oxygen really helped to dry out their lungs. I think both babies would have ended up being transferred if we didn't have blow-by available
I've also had a Mom that went into shock after a large hemorrhage and again, O2 was beneficial.
I myself would not choose to go without carrying it.

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#125 of 1527 Old 01-16-2009, 05:41 PM
 
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This is a lovely idea, but I'm not sure how it would work.

If a midwife is working to provide for her family (either soley or with the help of a partner), she needs to be able to be paid money so she can pay her own bills, mortgage and buy food, gas, etc for her family plus supplies for her practice.

How does that work with your practice? Do most people pay the full fee, so you still actually get mostly money? Do they just take as long as they need to to pay the full fee, or do you cut it down instead? How do you explain the fee/payments at a consult - do you say I charge this, but do what you can?

I am just sincerely wondering how this is handled so the midwives don't feel taken advantage of, but the clients aren't deciding to go to the hospital because they can't afford homebirth. Thanks!
Yes, this did not work for us. We have had our practice for a year and a half. In the beginning, we were a lot more wishy washy about payment. Whatever someone said they could pay seemed to be ok. Well, it was not long before I was feeling burned out and under appreciated. I was paying more money on gas and childcare then I was bringing in. My husband was growing resentful that I was gone all the time. There was no reward in it for him. I would be gone for 60 hours a week and barely bring home any income! I started seeing the negative effects this was having on me. While I love my job, it's not a hobby. It's my business. I use the money to pay my bills. I noticed that some clients would choose to spend money elsewhere but not pay us. It is really hard for me to love my job, and the personal sacrifice both me and my family make, when that is happening.

Now we have gotten more business like about money. This job is hard! We are very clear and up front about what our sliding scale is and that payment should be made in full by 36 weeks. Of course, there are always certain cases where things may be different, where we will allow payments after the birth or reduce the fee below our sliding scale. But that is the exception rather then the rule.
I feel like since we've been upfront with this during our interviews, we've both been happy. The Midwives and the clients. We know how much we are getting paid and when. The clients come up with the payment plan and they feel good accepting the responsibility for that. There also seems to be more respect on both of our parts, and I feel my services are more valued.

Christa
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#126 of 1527 Old 01-17-2009, 09:49 PM
 
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Hi gals!

I have been a busy bee today with AAMI work. I went out to the kitchen to refill my water bottle and noticed it was past 4 pm, whoops! I should probably learn to pay more attention to the time so that I remember to eat. Before I saw the clock I was wondering why I was so hungry

How is everyone else doing?

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#127 of 1527 Old 01-17-2009, 10:20 PM
 
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How is everyone else doing?
it sounds like you have indeed been a busy bee!

I'm trying to make myself get back in section 4A... right now I'm reading the chemistry chapter in HM1 and it is kind of making me . Parts of it are easy for me to understand while others not so much. Ah well, I persevere.
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#128 of 1527 Old 01-18-2009, 12:55 AM
 
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Originally Posted by busybusymomma View Post
it sounds like you have indeed been a busy bee!

I'm trying to make myself get back in section 4A... right now I'm reading the chemistry chapter in HM1 and it is kind of making me . Parts of it are easy for me to understand while others not so much. Ah well, I persevere.
Oy, Chem. I remember that class before I switched high schools to one that didn't offer it. Hopefully I will do better with it this time around.

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#129 of 1527 Old 01-19-2009, 12:59 AM
 
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Hi ladies just found this tread and wanted to introduce myself and get some ideas. My name is Dy. I am mother to 3 wonderful home schooled kids. My first was born in a hospital with a CNM my last two were born at home. I have been a doula and CBE for 6 years and an apprentice midwife for the last year. I have been doing self directed study but decided to look into some distance programs for a little more structure. The school doesn't need to be accredited since I live in Utah and licensure is not mandatory and anyone can sit for the NARM if they have the appropriate paper work. I had narrowed my choices down to AAMI and Midwife to be programs. I saw a few older posts regarding opinions on the two. Here are things that are important to me:cost(MTB get a big bonus here obvously), depth of study(I have heard that AAMI is better for this but that it also has a lot more busy work. I do not do well with this and feel that it is not a good way for most people to learn..thus the reason I home school my kids flexibility(both programs seem good for this). I will be able to get most of my skills taken care of with my apprentice ship plus I plan to do trip to the Philippines to work in their birth center one of the next few summers so I am not as concerned with the skills sections.
Any opinions would be great. Right now I am leaning toward MTB but don't want to have to redo anything if I change my mind. I am already frustrated with that as I was looking at schools. I have my BS degree is psychology but I was pre med/nursing before I decided I didn't like hospitals so took a huge amount of midwifery applicable classes. Most of the schools I have talked to have not been giving with allowing me to transfer those credits and I find in really frustrating. I know I am still probably 3 years out but I still have no desire to pay for stuff I have already done. KWIM.
Another question..what is the easiest way to find this group again? I don't spend a lot of time on mothering and am still not real proficient in navigating.
Thanks,
Dy

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#130 of 1527 Old 01-19-2009, 01:09 AM
 
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Welcome to the group Dy! You should be subscribed now to the thread because you posted, so when anyone else posts you should get an update in your email inbox.

With respect to AAMI vs MTB. I am currently enrolled in AAMI and I have not seen the MTB curriculum. I will say AAMI is very very in depth. With regards to the "busy work" there is a lot of it depending on your definition of busy work... however it's not busy work in the sense of do this just for the sake of doing it. It's all organizational stuff that helps with your studies and also hugely sets you up with loads of stuff that you'll need when your practicing. I don't mean just skills, I mean a lot of things you'll use all in the day to day runnings of your practice.

I hope that helps. My brain is tired right now. I'm sure others will chime in as well.

Good luck deciding

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#131 of 1527 Old 01-19-2009, 04:28 AM - Thread Starter
 
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I have seen both programs, and honestly, you couldn't pay me to do MTB. AAMI does have "busy work" but what little there is goes towards setting your practice, etc. AAMI is the hardest program out there I could find. Also, if you wait for a tuition cut opportunity with AAMI you can gt some good deals. I waited for a long time and ended up only paying half tuition. AAMI is not the absolute cheapest by it is the best deal by far.

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#132 of 1527 Old 01-19-2009, 07:19 AM
 
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Welcome to the group Dy! You should be subscribed now to the thread because you posted, so when anyone else posts you should get an update in your email inbox.
slightly OT, but that isn't necessarily true. one must set one's account to automatically subscribe to threads in the control panel. and even then there's a choice to be notified of subscriptions by email instantly, by email daily or without notifications (you can read subscriptions from your control panel). otherwise one can manually subscribe to each thread by clicking on "thread tools" on the top right.

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#133 of 1527 Old 01-19-2009, 03:36 PM
 
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I think I would be ok with the UC thing... I won't know for sure until it happens though! I would prefer open communication though if they had no intention of calling me for the birth or if I was going to still be providing possible support if suddenly in labor they felt they wanted me there or what.
Well, I'm going to revisit this subject, although it's been a few days... for those of you who would be willing to support a mama during a UC, how would a mama go about finding you? This is the dilemma I'm in right now... I want a UC, but DH is not comfortable with that. For his comfort level, I feel like I need to have a MW available "just in case", with the understanding that I may choose not to call. But, at the same time I know that UC is so frowned-upon that the thought of just calling up midwives and straight out asking them if they'd support a UCing mama is a bit scary. Thoughts?

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if you have licensing or registration how did you decide you would or wouldn't license/register with your state?
Well, my state is a little screwy with the licensure. I will get my CPM, because that is the first step towards licensure here, and I will not risk jail time for that. However, my state requires more than CPM. But, with the medical climate with regards to midwives, it's virtually impossible to get those things to fulfill the states licensure requirements (like OB backup). So while I will be CPM, technically I will not be licensed for my state, which is a bit of a weird place to be, and I'm not really sure how that'll work out yet.

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On another note: What do you think about fees?
*If you miss the birth (on your own accord) do you charge a full fee?
*If you miss the birth (on your clients' accord) do you charge a full fee?
*If you have to transport do you charge a full fee?
When do you charge full fees and when do you accept less than full fee?
I think the only time I wouldn't be charging full fees would be if mama had to transfer care prior to labor (if she risked out), and decided that she didn't want me to "doula" her through her hospital birth. I would still offer pp/BF support though. If I was negligent in missing a birth, then yes, I would offer a partial refund, but if it was just a matter of, you called, I was there within an hour, but I missed it, then no, I wouldn't offer one.

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depth of study(I have heard that AAMI is better for this but that it also has a lot more busy work. I do not do well with this and feel that it is not a good way for most people to learn..thus the reason I home school my kids
I think this really depends upon your definition of "busy work"... for me, busy work is work that has no real purpose other than just keeping you busy, and nothing at AAMI meets that definition. Yes, AAMI has a LOT of work, but every single piece of it serves a purpose. None of it is "just because".

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Another question..what is the easiest way to find this group again? I don't spend a lot of time on mothering and am still not real proficient in navigating.
Well, you can subscribe to the thread, so you don't have to navigate to the individual board. But, now that you've posted in it, the icon for the thread has changed - this signifies that you're participating in it, and that makes it easier to find if you're looking through this particular section of the board.

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#134 of 1527 Old 01-19-2009, 08:55 PM
 
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in regards to finding support for a UC I would call and ask. Yes- it would mean risking not fining someone by being honest, but there are many midwives who are open to providing support to UC mamas, and it would be a great situation if you could find one. Or maybe you can find a m/w who will be hands off enough for you to be comfortable with, while DH still feels the security that a professional brings. Many midwives will stand back and watch, so long as you talk about it up front, and then you could have a built in photographer, etc.

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#135 of 1527 Old 01-20-2009, 03:17 AM
 
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I agree with rebirth. When I one day get to be certified, I would be willing to be the mw on call for a UC. Just gotta call around...

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#136 of 1527 Old 01-20-2009, 07:07 AM
 
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Well, I'm going to revisit this subject, although it's been a few days... for those of you who would be willing to support a mama during a UC, how would a mama go about finding you? This is the dilemma I'm in right now... I want a UC, but DH is not comfortable with that. For his comfort level, I feel like I need to have a MW available "just in case", with the understanding that I may choose not to call. But, at the same time I know that UC is so frowned-upon that the thought of just calling up midwives and straight out asking them if they'd support a UCing mama is a bit scary. Thoughts?
I reckon start with asking around people in your local area who the most relaxed/ hands-off mw around is and then just call and ask. say straight up you're thinking about UC and looking for someone to provide prenatal care and maybe backup. even if the mw can't help you, she might be able to point you in the direction of someone who can. and keep trying. the right mw is out there for you.

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#137 of 1527 Old 01-20-2009, 08:42 PM
 
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in regards to finding support for a UC I would call and ask. Yes- it would mean risking not fining someone by being honest, but there are many midwives who are open to providing support to UC mamas, and it would be a great situation if you could find one. Or maybe you can find a m/w who will be hands off enough for you to be comfortable with, while DH still feels the security that a professional brings. Many midwives will stand back and watch, so long as you talk about it up front, and then you could have a built in photographer, etc.
I agree with being honest and when I start practicing would have no problem providing prenatal care to a client who plans to UC. As long as they are up front about it.

I spent the day watching the inauguration coverage. In between bawling sessions, I googled local midwifery organizations again because I forgot to bookmark them yesterday

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#138 of 1527 Old 01-21-2009, 08:44 AM
 
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okay; i've been offered another job attending a birth in Thailand (seems I'm getting a rep as the only mw around crazy enough willing to come all the way to southern thailand to attend births ).
sounds like a dream - all expenses paid trip to Phuket for 6 weeks, and DD can come with me, I get to visit my friends, and attend the birth (and the mama is really sweet too). I feel crazy not to take it.
But I'm not 100% sure I feel like going away from home for so long atm (we just moved into a new house). not to mention going on a 9 hour flight
still, it would be good experience for me, and I'd love to be in Thailand again... mmmmm... thai food

so, what do you all think? WWYD?

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#139 of 1527 Old 01-21-2009, 11:02 AM
 
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wow... it sounds really cool, a very unique opportunity. But if you feel unsure about it then don't go. It would be really hard to be away so long with all those doubts.

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#140 of 1527 Old 01-21-2009, 11:11 AM
 
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That sounds wonderful, I'd get a house sitter and go.

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#141 of 1527 Old 01-21-2009, 11:40 AM - Thread Starter
 
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Well, I'm selfish and want to see you again if it would work out, so of course I'm going to say to come. And the mama is very sweet.

BUT if you just get a sense that it's not right, then don't do it. (And she does have other birth options BTW - heck I told her she could birth at my house)

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#142 of 1527 Old 01-21-2009, 01:28 PM
 
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That's a tough one. It seems like such a wonderful opporunity but, that is a long time to be away from home.

Have you made a pros and cons list? That helps me sometimes.

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#143 of 1527 Old 01-21-2009, 05:47 PM
 
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Does your partner get to come with you? (sorry can't remember if you are married)

I would totally do it if DH could come too.

Will it interfere with your other clients? If so, I probably would not go.
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#144 of 1527 Old 01-21-2009, 07:48 PM
 
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I say that if you can take DD then GO FOR IT! : What a great opportunity (and all expenses paid!!).



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#145 of 1527 Old 01-22-2009, 12:00 AM
 
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thanks everyone. I will admit that visiting mammarabbit is a huge one securely on the pro side

my DP is overseas for work for most of that time anyway (in israel), and there's a chance he'll be able to come there on the way home (his flight goes through bangkok).

there are loads of Pros: experience of attending a birth, getting a trip to thailand, visiting friends, the all-you-can-eat sushi buffet nearby to where the mama lives...
cons: just the vague idea that I don't really feel like travelling atm.

I think I'll just talk to the mama about it again.

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#146 of 1527 Old 01-22-2009, 04:38 AM
 
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okay, thanks again for the responses everyone, and sorry for hikacking the thread to my own personal dilemma...
I started typing an email to the mama saying how I'm feeling, and just before I clicked send, she called
we had a bit of a chat and...



mamarabbit, keep some free days in late april! I'm coming to visit :

I think I stopped weighing the pros and cons, and started feeling into how I would feel to *not* go. there was a little relief there, but mostly disappointment. so there was my answer.

anyway, it always helps me to get other's opinions; helps me to clarify how I'm feeling in myself, so thanks

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#147 of 1527 Old 01-22-2009, 05:14 AM - Thread Starter
 
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Yeah!!!! Can I be your assistant? J/K no way I can be down there for that long! Though if I could catch a quick flight as soon as she's in labor... nah I'm dreaming, what would I do with my 3 other kids LOL

Anyway, what great news and you'll have fun and get a great birth experience.

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#148 of 1527 Old 01-22-2009, 07:08 AM
 
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oh that would be so cool if you could come down too. if only you could bring the whole fam.
anyway, she is going to book my flights to stop in bkk for 2 days on the way back so i can drop in on you

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#149 of 1527 Old 01-22-2009, 03:41 PM
 
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Hey Mamas, I'm wondering how much money I should budget per month for gas for my car during the 2.5 year clinic piece (*IF* I get accepted to the program)?

Majikfaerie

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#150 of 1527 Old 01-22-2009, 04:33 PM
 
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how far from your house is it? It would be hard to say... b/c gas prices can go anywhere, ya know? Plus gas milage can very, etc.

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