Misc. Med Thread Vol. 3: caribbean diabetus strikes back

[knot4reel91]

Thanks for the tip brah srs. Can you enlighten me though on which Step 1 subject is the most difficult/the one most people need to study "extra" for?

Why do you even care about this now? gtfo and go relax. You're not studying to learn, you're studying because you're amped up that you got into med school. chill out, it's a marathon

[WeekndOrNah]

I can only speak to IM, since I interviewed there. Nashville is, well, Nashville. It's an awesome city. The program is based out of St. Thomas Midtown hospital and St. Thomas West. Both are decent-sized places with a lot of private attendings. Don't think the acuity is that great, since Vanderbilt is right across the street (literally). Residents seemed happy, and most go on to become hospitalists. Fellowship match is pretty poor, and ranked it super far down my list for that reason.

Appreciate it. Seems like a solid program but ultimately boils down to “not quite Vanderbilt”

[knot4reel91]

Appreciate it. Seems like a solid program but ultimately boils down to “not quite Vanderbilt”

Ain't even close to Vandy. I will say that the residents seemed SUPER happy. Probably the happiest bunch I saw on the trail.

[wildabeest]

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

[RobParks2M]

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

Huh? I thought NP are more or less unsupervised? Also, OG Jack3d strikes again

[WeekndOrNah]

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

ho lee fuk

would love to see more of these lawsuits (not more harmed patients tho). getting real sick of midlevels misdiagnosing chit.

[knot4reel91]

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

That's ****in' disgusting. Any M-2 should be able to diagnose that **** without even needing a scan. It's disgusting what they're allowed to get away with. They do nothing but pat themselves on the back every chance they get. If you want to practice like an MD, then shoulder the same responsibility and get your ass sued for malpractice.

[WeekndOrNah]

Yall use AirBnB for a full month when you did your aways if you didn't know anyone in the city?

[JCTWP46]

Yall use AirBnB for a full month when you did your aways if you didn't know anyone in the city?

Yes. On 2 separate aways. Wasn’t cheap but worth it.

[WeekndOrNah]

Thoughts on going to a formerly DO general surgery program?

HonorHealth Scottsdale residents all DOs except for 1. All the faculty are MDs. They just offered me a SICU audition rotation. I'm also dumb bc I didn't realize it wasn't Mayo-affiliated until now. Have a week to reply, I'm only really waiting on George Washington to reply at this point which I would def take over this now

[muscle beast]

Thoughts on going to a formerly DO general surgery program?

HonorHealth Scottsdale residents all DOs except for 1. All the faculty are MDs. They just offered me a SICU audition rotation. I'm also dumb bc I didn't realize it wasn't Mayo-affiliated until now. Have a week to reply, I'm only really waiting on George Washington to reply at this point which I would def take over this now

Why do you feel the need to go to a DO gen-surg program? The point of aways is to go to places where you think you'd be a long-shot on paper, and to absolutely crush it in person (assuming they rank away rotators).

[kovalchuk71]

Why do you feel the need to go to a DO gen-surg program? The point of aways is to go to places where you think you'd be a long-shot on paper, and to absolutely crush it in person (assuming they rank away rotators).

Ouch. My inner AT Still is weeping.

[WeekndOrNah]

Why do you feel the need to go to a DO gen-surg program? The point of aways is to go to places where you think you'd be a long-shot on paper, and to absolutely crush it in person (assuming they rank away rotators).

I went full potato and thought it was Mayo but it's not. lmao

[MakeABanana]

Reading these shoulder MRIs and everybody and their mommas got glenoid dysplasia.

Prevalence is around 20% according to the literature. I probably have it, too.

https://radiopaedia.org/articles/gle...plasia?lang=us

[WeekndOrNah]

Locked down both of my aways. Basically going coast to coast in one weekend between the two, so I think I'm going to have to Uber everywhere and rent an AirBnB extremely close to both hospitals instead of taking my car lol

fuk that's gonna be expensive

[WeekndOrNah]

Looks like I won't be taking my car on my two aways so I'll be ubering everywhere lmao

EDIT: I basically have to drive coast to coast in one weekend if I do take my car, so no thx jeff

[incomingbrOMS]

Ouch. My inner AT Still is weeping.

lmao

Looks like I won't be taking my car on my two aways so I'll be ubering everywhere lmao

EDIT: I basically have to drive coast to coast in one weekend if I do take my car, so no thx jeff

welcome to 4th year. I was driving back and forth halfway across country and all over state med school was in in between flying all over the country. Pepper your credit care. If you can handle your credit well, consider getting an airline card srs. I got 2-3 interview flights paid for round trip by using one fourth year.

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

One of our residents recently referred to an APP that was with a consult as Student Doctor XYZ on rounds with the rest of the physician team. The butthurt is growing nationwide at the expansion of powers.


EDIT: read one of the depositions by an expert witness physician in the trial and while clearly that poor girl received poor care I really fuking hate reading attorneys try to practice medicine in the court room. They so clearly don't understand diagnostic reasoning and try to paint the picture that the only think that rationally could have caused her shortness of breath was PE and while obviously somebody should have gotten that angio, it sounds like the girl converted from submassive to massive PE at some point during transfer to the university hospital and did get lysed but other than super egregiously delayed detection it's hard to say that she would have benefitted from treatment initially. All the outlying hospital would have done is started heparin and transferred her in sooner. As someone who gets these admissions all the time it sounds like she didn't really have any indications to be lysed until she arrived at the university hospital so I mean you can argue that sure if she would have gotten there 8 hours earlier with a high-risk submassive at her age someone probably would have done CDL or vacuum or something but all in all thats just a really ****ty case. 1000% should have been recognized and scanned immediately but I wonder if the outcome would have been much different.

We recently had a similar type case that happened in our own center last year that resulted in the code response residents/cardio faculty crashing the patient onto VA ECMO mid-arrest, this stuff can happen anywhere. Ours was a case of anchoring bias rather than poor diagnostic reasoning. I like reading these cases but they make me feel more defensive.

[Monty522]

oh holy **** i can post in here.

rapping up OMS-1 crew.

[Monty522]

Hey y’all, I know prestudying before med school is frowned upon but I’m doing it anyway... I’m not killing myself studying, I just read about 30-60 minutes of material from a Step 1 prep book I bought off amazon.

Right now I’m going through dermatology and endocrinology because I find it the most interesting.

What subject should I start studying to help prepare me the most for med school/ step 1 (I.e what’s the most beneficial/difficult subject I should start preparing for)? Anatomy? Cardiology?

Wait you didn't even start and you're worried about step1 already? Man...study balance and living. You've prob been overworked and studying your whole life. Take the time to actually go out like your business major friends. Meet new people, work a job, travel....do things you can't do when school starts.

[SazabiBrah]

Do you guys think $1500 a month would be too much in rent to live by myself? That’s pretty much the minimum rent in the city where I’ll be moving... the alternative is getting a roommate, then I could get the payment down to $1200 or so

[muscle beast]

Ouch. My inner AT Still is weeping.

Do you guys think $1500 a month would be too much in rent to live by myself? That’s pretty much the minimum rent in the city where I’ll be moving... the alternative is getting a roommate, then I could get the payment down to $1200 or so

As someone in a high COL area, I feel your pain. It sucks to have to pay that high of rent, but personally I'd rather live by myself than save $300/month to live with a roommate. If i were saving maybe a $1000/month, maybe. Do you what you gotta do man.

Now, if you can get a spot with a co-intern (4 of my co-interns did this, without knowing each other prior) and it's worked out well

[MakeABanana]

Do you guys think $1500 a month would be too much in rent to live by myself? That’s pretty much the minimum rent in the city where I’ll be moving... the alternative is getting a roommate, then I could get the payment down to $1200 or so

That's how much I pay in NYC. Is there any on-campus or program-subsidized housing? Some of the studio offerings here subsidized by my program are around $900/month.

[Monty522]

Do you guys think $1500 a month would be too much in rent to live by myself? That’s pretty much the minimum rent in the city where I’ll be moving... the alternative is getting a roommate, then I could get the payment down to $1200 or so

Are you solely living off loans?

[vik66]

Thanks for the tip brah srs. Can you enlighten me though on which Step 1 subject is the most difficult/the one most people need to study "extra" for?

brah just stop

Ain't even close to Vandy. I will say that the residents seemed SUPER happy. Probably the happiest bunch I saw on the trail.

Most programs at Vandy are malignant. IM work very very hard, and frequently break work hour restrictions. Not worth it IMO. We had people match there this year and last.

Locked down both of my aways. Basically going coast to coast in one weekend between the two, so I think I'm going to have to Uber everywhere and rent an AirBnB extremely close to both hospitals instead of taking my car lol

fuk that's gonna be expensive

ok brah so I did an away in Denver and one in San Diego. I would highly recommend getting on rotating room and trying to find a place. Also reach out to the program coordinator to see if any of the residents would be willing or have a room to rent out. Also, learn the public transpo in the area you are going to and USE it. Also look into turo for renting a car, it is very cheap. Good luck brah. Also look into biking

[wickedman]

Why do you feel the need to go to a DO gen-surg program? The point of aways is to go to places where you think you'd be a long-shot on paper, and to absolutely crush it in person (assuming they rank away rotators).

I actually went against the grain, and used them for middle of the road options so I could potentially crush it and then have a hopefully securish spot. But it would depend on how competitive an applicant you thought you were for what you were applying I suppose.

I hate how most EM attendings have to supervise midlevels

Midlevels dont know what they dont know and phuck chit up and its on the physician. Then these midlevel *******s want independent practice. phuck this chit

https://www.oscn.net/dockets/GetCase...QxP0bqXWYQRUmM

TL;DR College female has chest pain and SOB and syncopizes and is taking OCPs. BF calls 911 and they get taken to the ED. NP working there orders utox, gets pos meth and anchors on it super hard and says its just drugs despite the fact BF saying pt does not use drugs and is an athlete. NP cancels the CTA chest and admits pt. After talking to another unknown medical provider 8 hours into the visit the NP finally orders the CTA chest but fails to order it stat. CTA chest finally gets done and shows massive PE. Pt dies

But of course the off site supervising physician was only named in the lawsuit and the NP is still working in the ED

Don't think I would have even ordered a tox.

[SazabiBrah]

Are you solely living off loans?

Yeah for the most part. For my first semester I’ll be able to use the rest of my GI Bill

[WeekndOrNah]

brah just stop



Most programs at Vandy are malignant. IM work very very hard, and frequently break work hour restrictions. Not worth it IMO. We had people match there this year and last.



ok brah so I did an away in Denver and one in San Diego. I would highly recommend getting on rotating room and trying to find a place. Also reach out to the program coordinator to see if any of the residents would be willing or have a room to rent out. Also, learn the public transpo in the area you are going to and USE it. Also look into turo for renting a car, it is very cheap. Good luck brah. Also look into biking

Appreciate it brah, Rotating Room seems clutch even tho both of my programs aren't on there I can at least use it for the same city.

I actually went against the grain, and used them for middle of the road options so I could potentially crush it and then have a hopefully securish spot. But it would depend on how competitive an applicant you thought you were for what you were applying I suppose.



Don't think I would have even ordered a tox.

Yea I actually don't mind this rotation, it's grown on me. All MD faculty and in a top city destination for me (in b4 you'll only experience it looking outside of the hospital windows anyways), and it's my first away which can prepare me for my audition in Nashville that I care more about (if I had to pick one).

and yea I wouldn't have ordered a UDS either


EDIT: ending 3rd year with psychiatry. 5 of my 8 weeks are on Geriatric Psych where I work 2 hours a day tops. feelsgoodman.jpg

[kovalchuk71]

Appreciate it brah, Rotating Room seems clutch even tho both of my programs aren't on there I can at least use it for the same city.



Yea I actually don't mind this rotation, it's grown on me. All MD faculty and in a top city destination for me (in b4 you'll only experience it looking outside of the hospital windows anyways), and it's my first away which can prepare me for my audition in Nashville that I care more about (if I had to pick one).

and yea I wouldn't have ordered a UDS either


EDIT: ending 3rd year with psychiatry. 5 of my 8 weeks are on Geriatric Psych where I work 2 hours a day tops. feelsgoodman.jpg

Damn bro, what's your vendetta against DOs?

[Hardlifter9]

Damn bro, what's your vendetta against DOs?

Lol this. The profession is under attack by midlevels and we still have intra-specialty and MD DO fights? NPs and PAs mobilize and function as one unit to push their agenda. Doctors do the opposite and get wrecked as a result.

[memcop]

Sooo if anal bead doesnt pop out with the rest should one wait for it to "pass" naturally or dig it out with a grapefruit spoon?

Asking for a friend, dont read into it.