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

[RobParks2M]

Yea that's basically it.

I could probably spin one of my hobbies into it somehow. I used to be a fine dining chef and I/we used a lot of tweezers to plate. Might be a reach but it's one of my strongest characteristics

lmao bruh I might leave that out if I was you. I don't think surgeons would take kindly to you comparing using tweezers to move chit on a plate to your affinity to surgery but das just me

[sam212]

More questions for y'all as I'm approaching the start of my first semester...


for those that actually lift, were you/are you guys able to bulk properly (eat enough food) with your loan money?


Is there anyone here who didn't do any research in med school? If so, what specialty are you in/ planning on getting into?

You’ll be fine, I’m no power lifter or anything, but I did go through 2 bulk seasons in med school.

[sam212]

It’s good to see this thread. I have been here a long time but only visit sporadically. First year ortho trauma attending. Hang in there guys, it’s worth it.

[WeekndOrNah]

Holy fuk this NP student has more word finding difficulty than 90% of our psych patients. Dude can barely read off the record or his own notes and my attending (nicest guy ever) is visibly impatient and annoyed after two weeks of giving him feedback lmao

How the fuk and this dude already been working as an rn

[fitnessdoc2020]

It’s good to see this thread. I have been here a long time but only visit sporadically. First year ortho trauma attending. Hang in there guys, it’s worth it.

This is very encouraging to hear as someone nearing the end of 3rd year. Hoping to see you on the other side one day!

[CaliSuperSport]

What kind of specialties are MD's here in? Any advice on what led you to that specialty?

I've been on the Pre-PA track for a year, but a couple PA friends are begging me to just do med school (they both work in emergency) and are complaining about fresh doctors pulling rank on them.

Thing is...I was content going for Orthopedic PA - I'm not sure I have it in me to be an Orthopedic Surgeon. It's quite competitive isn't it? I'm the type that will struggle with a challenging task if my heart's not fully in it.

If I do go the med school route - I'm not sure what I'd choose. Feels like I'd have to "find myself" all over again to decide what I want to do. /deardiary

[muscle beast]

What kind of specialties are MD's here in? Any advice on what led you to that specialty?

I've been on the Pre-PA track for a year, but a couple PA friends are begging me to just do med school (they both work in emergency) and are complaining about fresh doctors pulling rank on them.

Thing is...I was content going for Orthopedic PA - I'm not sure I have it in me to be an Orthopedic Surgeon. It's quite competitive isn't it? I'm the type that will struggle with a challenging task if my heart's not fully in it.

If I do go the med school route - I'm not sure what I'd choose. Feels like I'd have to "find myself" all over again to decide what I want to do. /deardiary

IM here, applying to cards. Didn't know what I wanted to do, just now decided because it's fun, makes sense, makes money, and gives me an excuse to not be around my annoying kunt of a gf.

And the bolded up there is a red flag (srs). There's going to be lots of times in med school and residency where your heart is not in it but you have no choice but to push tf on.

Pulling rank? You have to ask yourself whether you're comfortable not being at the top of your field. If you are okay with riding shotgun the entire trip, then go PA. But if you're like most of my colleagues, there's no way you're handing over that steering wheel (unless you're a sl00t tryna have babies)

TLDR; we're all gonna make it

[CaliSuperSport]

IM here, applying to cards. Didn't know what I wanted to do, just now decided because it's fun, makes sense, makes money, and gives me an excuse to not be around my annoying kunt of a gf.

And the bolded up there is a red flag (srs). There's going to be lots of times in med school and residency where your heart is not in it but you have no choice but to push tf on.

Pulling rank? You have to ask yourself whether you're comfortable not being at the top of your field. If you are okay with riding shotgun the entire trip, then go PA. But if you're like most of my colleagues, there's no way you're handing over that steering wheel (unless you're a sl00t tryna have babies)

TLDR; we're all gonna make it

Thanks dude. I'm guessing I'll have to think hard about it. I've got another 2 or so years undergrad to talk to some more PAs and doctors.

I always thought working in Ortho/Derm would be more collaborative and less toxic than a big hospital, but I don't know for sure.

[sam212]

What kind of specialties are MD's here in? Any advice on what led you to that specialty?

I've been on the Pre-PA track for a year, but a couple PA friends are begging me to just do med school (they both work in emergency) and are complaining about fresh doctors pulling rank on them.

Thing is...I was content going for Orthopedic PA - I'm not sure I have it in me to be an Orthopedic Surgeon. It's quite competitive isn't it? I'm the type that will struggle with a challenging task if my heart's not fully in it.

If I do go the med school route - I'm not sure what I'd choose. Feels like I'd have to "find myself" all over again to decide what I want to do. /deardiary

I’m a first year ortho trauma surgeon. Thank the good lord everyday for giving me the opportunity to do what I do. Wouldn’t change anything. But I realize it’s not for everyone. Ortho is very competitive, I got in 7 years ago, probably wouldn’t have gotten in today.

Ortho PAs do well, I know some that make more than PCPs. But they work very hard. If you just want to chillax and work 730 to 4, you’ll be just like any other PA. The downside of being a PA is that you’re stuck in a junior resident role for the rest of your life. When your friends say that they had some young Drs pull their rank on them, they probably meant that there were decisions made that were above their pay grade by young physicians. On ortho, PAs don’t make any decisions, even as little as post op pain medication and dressing changes. Take it for what it is though, you do what you’re told, so you’re not resposnsible for anything either when **** hits the fan. You don’t have to stick around when 4pm hits. It’s got its upsides and its downsides.

[MakeABanana]

What kind of specialties are MD's here in? Any advice on what led you to that specialty?

I've been on the Pre-PA track for a year, but a couple PA friends are begging me to just do med school (they both work in emergency) and are complaining about fresh doctors pulling rank on them.

Thing is...I was content going for Orthopedic PA - I'm not sure I have it in me to be an Orthopedic Surgeon. It's quite competitive isn't it? I'm the type that will struggle with a challenging task if my heart's not fully in it.

If I do go the med school route - I'm not sure what I'd choose. Feels like I'd have to "find myself" all over again to decide what I want to do. /deardiary

Currently a diagnostic radiology resident with plans to do a body imaging fellowship. I enjoy doing the diagnostic side of medicine without the BS that comes with having to see patients (meaning the paperwork, not the patients themselves, per se). Also, dealing with dumb people can become grating. As a radiologist, you more often deal with slightly less dumb doctors, PAs and NPs. I get to sit or stand at my station and look at all the different types of pathology coming through to a practice or hospital. If a case is interesting enough, I open up the chart and read through the visit. It's a field that requires a wide breadth of knowledge to get good at, as you need to know what each specialty is looking for or trying to rule out when they order an imaging study.

Additionally, a lot of radiology subspecialties can do procedures, not just interventional radiology. Depending on the practice, body imagers can do biopsies, fluid collection (e.g. abscess) drainages, tumor ablations ... and some other places even allow them to do percutaneous cholecystomies, biliary drainages, and nephrostomies.

[incomingbrOMS]

What kind of specialties are MD's here in? Any advice on what led you to that specialty?

I've been on the Pre-PA track for a year, but a couple PA friends are begging me to just do med school (they both work in emergency) and are complaining about fresh doctors pulling rank on them.

Thing is...I was content going for Orthopedic PA - I'm not sure I have it in me to be an Orthopedic Surgeon. It's quite competitive isn't it? I'm the type that will struggle with a challenging task if my heart's not fully in it.

If I do go the med school route - I'm not sure what I'd choose. Feels like I'd have to "find myself" all over again to decide what I want to do. /deardiary

IM resident here as well. Deciding between pulmonary/CCM vs. cardiology then abbreviated CCM+advanced heart failure.

Do you want to be calling shots or not? Do you want to be the one people look for when **** is on the fan or the one looking for the people?

If you wind up not feeling strongly about your answer to those questions, PA route will give you an awesome career taking care of patients.

[kovalchuk71]

Currently a diagnostic radiology resident with plans to do a body imaging fellowship. I enjoy doing the diagnostic side of medicine without the BS that comes with having to see patients (meaning the paperwork, not the patients themselves, per se). Also, dealing with dumb people can become grating. As a radiologist, you more often deal with slightly less dumb doctors, PAs and NPs. I get to sit or stand at my station and look at all the different types of pathology coming through to a practice or hospital. If a case is interesting enough, I open up the chart and read through the visit. It's a field that requires a wide breadth of knowledge to get good at, as you need to know what each specialty is looking for or trying to rule out when they order an imaging study.

Additionally, a lot of radiology subspecialties can do procedures, not just interventional radiology. Depending on the practice, body imagers can do biopsies, fluid collection (e.g. abscess) drainages, tumor ablations ... and some other places even allow them to do percutaneous cholecystomies, biliary drainages, and nephrostomies.

Banana, serious question here: How do you deal with sitting in a dimly lit room and staring at a bright computer screen all day? I shadowed a radiologist before I got into medical school and my eyes were cooked after 6 hours or so. I couldn’t imagine doing that for 9+ hours a day.

[CaliSuperSport]

Currently a diagnostic radiology resident with plans to do a body imaging fellowship. I enjoy doing the diagnostic side of medicine without the BS that comes with having to see patients (meaning the paperwork, not the patients themselves, per se). Also, dealing with dumb people can become grating. As a radiologist, you more often deal with slightly less dumb doctors, PAs and NPs. I get to sit or stand at my station and look at all the different types of pathology coming through to a practice or hospital. If a case is interesting enough, I open up the chart and read through the visit. It's a field that requires a wide breadth of knowledge to get good at, as you need to know what each specialty is looking for or trying to rule out when they order an imaging study.

Additionally, a lot of radiology subspecialties can do procedures, not just interventional radiology. Depending on the practice, body imagers can do biopsies, fluid collection (e.g. abscess) drainages, tumor ablations ... and some other places even allow them to do percutaneous cholecystomies, biliary drainages, and nephrostomies.

Thanks dude. Radiology is something I only recently looked into after learning how many of my classmates are considering sonography/radiology tech.

I’m a first year ortho trauma surgeon. Thank the good lord everyday for giving me the opportunity to do what I do. Wouldn’t change anything. But I realize it’s not for everyone. Ortho is very competitive, I got in 7 years ago, probably wouldn’t have gotten in today.

Ortho PAs do well, I know some that make more than PCPs. But they work very hard. If you just want to chillax and work 730 to 4, you’ll be just like any other PA. The downside of being a PA is that you’re stuck in a junior resident role for the rest of your life. When your friends say that they had some young Drs pull their rank on them, they probably meant that there were decisions made that were above their pay grade by young physicians. On ortho, PAs don’t make any decisions, even as little as post op pain medication and dressing changes. Take it for what it is though, you do what you’re told, so you’re not resposnsible for anything either when **** hits the fan. You don’t have to stick around when 4pm hits. It’s got its upsides and its downsides.

Awesome man thanks for the insight. ATM, being an ortho surgeon seems like a large leap for me. It's not like any of my fam were surgeons or I've wanted to be one for years. It's literally based off of "yeah, I wouldn't mind being the boss and making almost 500k/year and getting in-depth knowledge of orthopedics."

But I'm also a pretty agreeable person as long as I get a basic level of respect. If physicians consistently chastise mid-level clinicians - that might wear on me. The biggest deterrent for me was the long residency as well. I really need to do more soul searching I think.

IM resident here as well. Deciding between pulmonary/CCM vs. cardiology then abbreviated CCM+advanced heart failure.

Do you want to be calling shots or not? Do you want to be the one people look for when **** is on the fan or the one looking for the people?

If you wind up not feeling strongly about your answer to those questions, PA route will give you an awesome career taking care of patients.

Yeah my response is "it would be nice but I don't need to be the boss" provided I'm not going to get punked constantly as a PA. Definitely going to think it over some more though.

You guys are quite advanced in your careers compared to me (still in undergrad) so I'm going to do my best to educate myself and explore the field some more.

[Berkush]

MS3 (soon to be 4) applying to plastics this upcoming cycle. Any plastic residents/attendings here?

[MakeABanana]

Banana, serious question here: How do you deal with sitting in a dimly lit room and staring at a bright computer screen all day? I shadowed a radiologist before I got into medical school and my eyes were cooked after 6 hours or so. I couldn’t imagine doing that for 9+ hours a day.

A few tricks:
- don't be in too dark of a room. A good backlight does wonders to relieve eye strain. Contrary to what a lot of people think, you don't need a near pitch black room. Pitt's reading rooms, for example, are very well lit.
- look away from the screen periodically, or better yet, take frequent breaks. If you colleagues in the reading room, use that time to chit-chat, catch up, goof around within reason, etc. Better yet, take a quick stroll, grab some food/coffee, or sit outside for a bit and get some vitamin D.

[SwiftRick]

Can't decide Psych Vs Gas

Hold me brahs....

[Dr. Horse]

Can't decide Psych Vs Gas

Hold me brahs....

not sheriff?

[SwiftRick]

not sheriff?

Sheriff as deputy.

Both specialities appeal to me. I truly enjoy the pathophys and medicine behind both. I enjoy reading new research and articles about them and I can truly see myself doing it for the next 30+ years. Psych has better work life balance, anesthesia is more procedure based and less notes.

Any input would be good.

Can't wait for MS3 to be done. Biggest #wastehistime2019

[sam212]

Sheriff as deputy.

Both specialities appeal to me. I truly enjoy the pathophys and medicine behind both. I enjoy reading new research and articles about them and I can truly see myself doing it for the next 30+ years. Psych has better work life balance, anesthesia is more procedure based and less notes.

Any input would be good.

Can't wait for MS3 to be done. Biggest #wastehistime2019

You’ll have more independence in psych and more options. Anesthesia (without pain fellowship) will always be associated with some sort of hospital. I’d still probably do anesthesia because I can’t just sit for hours and talk. Psych has very low liability. You can really fuk people up in anesthesia. Psych is better lifestyle and low stress, probably less money in the beginning but the ceiling is probably higher in psych if you want to hustle and have your own practice. Anesthesia will start you with high pay, but lower ceiling.

[chestenvy]

Can't decide Psych Vs Gas

Hold me brahs....

Psych residency is probably much more chill than anesthesia, but as someone finishing anesthesia residency this month it really isn't bad. Although my comparison is mostly surgical friends. Psych seems like a lot of talking and not much instantaneous gratification. Anesthesia is about the opposite of that. I talk to patients for a brief period before any of them could actually bother me and then they are asleep. I do multiple satisfying quick procedures a day. There are lots of great jobs right now too. Most feel they are compensated fairly and it's also not unusual for jobs outside academics to have 8+ weeks vacation. It has its share of issues including CRNAs, thankless job, frequent inhouse call etc. But there is honestly no other type of physician I look at and think wow I should have done that instead. I'd be happy to answer any of your questions.

[RobParks2M]

You’ll have more independence in psych and more options. Anesthesia (without pain fellowship) will always be associated with some sort of hospital. I’d still probably do anesthesia because I can’t just sit for hours and talk. Psych has very low liability. You can really fuk people up in anesthesia. Psych is better lifestyle and low stress, probably less money in the beginning but the ceiling is probably higher in psych if you want to hustle and have your own practice. Anesthesia will start you with high pay, but lower ceiling.

Can confirm. local psych doc here does looney med swaps on patients- one of which was a coworker of mine. this individual got committed and when this person got there doc said "we see a lot of local psych doc's handiwork in here unfortunately". They reported this provider to the board and somehow nothing came from it. This doc does things like diagnosing bipolar disorders within 10 minutes of a visit despite no obvious mania or other things important for a dx. Proceeds to load said patient on 3-4 meds including lithium, quetiapine, olanzapine, and in addition decided to help treat ADHD so threw some ******** in there too. 2nd appointment decides to completely change all 3 meds. Told this person to get a 2nd opinion because that is nuts(at this point they got committed). Since that happening I've noticed other patients with similar big changes in psych meds from same doctor. I have started to probe these people and see if they felt uneasy about these big changes particularly when they didn't have anything other than an antidepressant before seeing this provider. I've had 2 people thus far get seen by other psych doc's and thank me for saying something because they don't walk around feeling like a zombie anymore and take half the meds. Psych patients are some of the few that I feel really benefit from pharmacist counseling. Lots of these drugs have minor interactions that can cause unpleasant side effects.

[SazabiBrah]

Any med students/ former students here that DIDNT do research? If so, what specialty are you in/plan on going into?

[Berkush]

Any med students/ former students here that DIDNT do research? If so, what specialty are you in/plan on going into?

I know some friends that did not do research who are applying Medicine/EM. The friend who is doing Medicine was encouraged strongly to get involved in research if he wants to match to a top 15 program. The friend who is doing EM has Steps >270 and all Honors and a ton of leadership and service and the Dean/her program director said she is good and does not need to do research since her app is strong otherwise.

But I found research helped me choose what I want to do because I actually liked doing it in the field I'm going in to, whereas I can barely read a paper in other fields without doing something else

[danglingfruits]

Back. Deferred for a year due to disease, but I'm good now. My only regret is that the class above me has much better looking students.

[incomingbrOMS]

Any med students/ former students here that DIDNT do research? If so, what specialty are you in/plan on going into?

I didn't do any in medical school. I did bench research in undergrad, don't care for it. Focused on leadership roles and UGME in med school. I'm more interested in medical education and clinical research when able but I don't initiate too much of it myself, just not my main interest.

IM resident going to critical care either via PCCM or cards, haven't decided entirely. Certainly for top research institutions in many fields it is going to be expected that you churn out significant research. For most fields though a few case reports and a few IRB projects on top of that is probably sufficient for a decent subspecialty interview list in an IM world assuming you are otherwise a good candidate. Some university programs want to train physician researchers and some want to train clinicians. It's not a knock on one pathway or the other, just know what fits you and what to do with that knowledge. I.e. if Cleveland Clinic wants to train predominantly clinician cardiologists and you have 37 papers on cardiac remodeling at a molecular level being effected positively by spunk they might be impressed with your resume but if you talk like a miscer in the interview you probably wont fit the program.

[ModernSlave]

Awesome man thanks for the insight. ATM, being an ortho surgeon seems like a large leap for me. It's not like any of my fam were surgeons or I've wanted to be one for years. It's literally based off of "yeah, I wouldn't mind being the boss and making almost 500k/year and getting in-depth knowledge of orthopedics."

But I'm also a pretty agreeable person as long as I get a basic level of respect. If physicians consistently chastise mid-level clinicians - that might wear on me. The biggest deterrent for me was the long residency as well. I really need to do more soul searching I think.

Yeah my response is "it would be nice but I don't need to be the boss" provided I'm not going to get punked constantly as a PA. Definitely going to think it over some more though.

Based off your replies, an option that you may consider is going the PA route and doing a PA residency in whatever specialty (only 1 year for 99% of them). I don't really much care to be running the shots, but am definitely mirin the extra years of experience/education docs get. It's a nice compromise between just PA school and the whole med school/residency route imo. Although you still won't be as proficient as most competent doctors, that extra year you take to do a residency will put far ahead of most new grad PAs and especially NPs.

Every PA I talked to who has done a residency has recommended it and would 100% do it again. From what I've heard, your scope of practice vastly expands with a residency under your belt (especially in ER and any surgical specialty), allowing you to do procedures and see complex cases that most PAs won't ever get to. Yes, PA residents get similar trash pay to MD residents, but the year you sacrifice in income you'll make up with your first job as you'll be a highly attract applicant and can pretty much ask for and get 10-20% more than a new grad.

PAs are pretty well respected in the hospital system (large teaching hospital) attached to my school and don't get undermined simply because they are a PA. However, respect is still definitely a factor in some places, specific states as well. Don't think it's really an issue as long as you ask the right questions when interviewing and shadow before you accept a job offer.

[dxw]

MS3 (soon to be 4) applying to plastics this upcoming cycle. Any plastic residents/attendings here?

in

a few more weeks until PGY3/6

[SazabiBrah]

Fuark, can't believe I move out of state next month for med school.

[wildabeest]

Based off your replies, an option that you may consider is going the PA route and doing a PA residency in whatever specialty (only 1 year for 99% of them). I don't really much care to be running the shots, but am definitely mirin the extra years of experience/education docs get. It's a nice compromise between just PA school and the whole med school/residency route imo. Although you still won't be as proficient as most competent doctors, that extra year you take to do a residency will put far ahead of most new grad PAs and especially NPs.

Every PA I talked to who has done a residency has recommended it and would 100% do it again. From what I've heard, your scope of practice vastly expands with a residency under your belt (especially in ER and any surgical specialty), allowing you to do procedures and see complex cases that most PAs won't ever get to. Yes, PA residents get similar trash pay to MD residents, but the year you sacrifice in income you'll make up with your first job as you'll be a highly attract applicant and can pretty much ask for and get 10-20% more than a new grad.

PAs are pretty well respected in the hospital system (large teaching hospital) attached to my school and don't get undermined simply because they are a PA. However, respect is still definitely a factor in some places, specific states as well. Don't think it's really an issue as long as you ask the right questions when interviewing and shadow before you accept a job offer.

Midlevels calling whatever year of training they do as "residency" is a fukkin insult and slap to the face of real residents, GTFO with that poverty bullchit

Doing 1 extra year of fake residency does not prepare a midlevel to expand their scope and "see complex cases" and doing so is reckless and dangerous for the patient

If you want to be a physician go to medical school and real residency

[Hardlifter9]

Midlevels calling whatever year of training they do as "residency" is a fukkin insult and slap to the face of real residents, GTFO with that poverty bullchit

Doing 1 extra year of fake residency does not prepare a midlevel to expand their scope and "see complex cases" and doing so is reckless and dangerous for the patient

If you want to be a physician go to medical school and real residency

This. what is this bs they pull to attempt to equalize themselves.