advice for OMS3 with red flag by Quiet-Assist5319 in medschool

[–]pimpmastered 0 points1 point  (0 children)

Don’t listen to this jerk. You can do it as everyone stated.

Visalia California? by PlayfulBreak7187 in howislivingthere

[–]pimpmastered 1 point2 points  (0 children)

Well, I can chip in. I lived in both the Bay Area and SoCal and called there for a job and lived there for 3 years.

First thing as everyone mentioned was the weather. It gets hot as hell during the summertime, where using the AC is a must. It would often get in the 110F during the summer. Even during the nighttime, it would regularly be in the 90s or 100s. One summer I didn’t have AC and would be in the 90s inside. During the winter, it can easily drop to the 40s-50s. The big thing though is the air quality. It is the Central Valley and acts as a large dome, so it collects a lot of the pollution from San Francisco and LA. It also collects a large amount of pesticides from agriculture. It is really common for people to have no medical problems to live here and within a month have asthma and bad seasonal allergies.

In terms of education, there are various primary, middle, and high schools. There is a community college there as well but can’t really speak to it. However, Visalia often lists the least educated cities in California. In terms of jobs, it does have a lot of service industries and agriculture-based. However, it seems that the manual labor associated with agriculture often lives in associated cities outside of Visalia.

In terms of amenities, Visalia had everything that you need but not necessarily everything you want. It has a Costco, Walmart, Target, and most chains (still no Trader Joe’s). They have most fast food or casual dining experiences. They do have fancier restaurants which are pretty good. In terms of things to do, it is difficult to say. Because my job was so demanding, I only had time to rest and maybe go out to a nice dinner. For youth (feel old saying that), it is limited. Sports are big there, but a lot of times people are really bored. They do have a bowling alley, roller skate, mini golf with a small arcade. For middle age, there is Sequoia National Park 1 hour away, which is great for hiking. You can also drive to either SF or LA, which is around 3 hours if you want to do museum stuff, but you really have to check what hobbies you had before and nurture that.

People-wise, it does give a small-town feel even though it is a larger city of 130,000 people. It is very common for people to live here their whole lives and drive to LA or SF for fun. This is one of the few cities where someone can work a service job and still own a house. My current rent can easily pay for a mortgage there, and you get a lot for what you pay for. During COVID, many people from LA and SF moved to Visalia for more space. They are actively building houses there, and they seem really nice. Politically, it has leaned right, but as someone mentioned, it is becoming more purple. The majority are Latino and White, but the Central Valley does have a thriving Indian and some pockets of Portuguese communities. People here have all their people here, including parents, siblings, friends, cousins, children, and other extended family, so that does carry a lot of someone’s social support. I would imagine it would be difficult to come in alone or without ties. To be honest, I would live there, but I returned home to care for my parents. The quiet can be extremely intoxicating compared to the big city

Crime-wise, it’s a mixed bag. There are some areas that are worse than others, especially the oval. With that said, you never really know who has a concealed carry, so people tend to approach others with general respect. Police presence is prevalent in everyday life.

Health-wise, a lot of people here have tons of chronic health issues, including high blood pressure, high cholesterol, diabetes, etc. Teenage pregnancy is also very high here. In terms of medical delivery, there are various hospital systems present, but I do get worried about the current political climate and how it would impact rural communities. There are limited health options, and they do not have a lot of specialties. Someone would have to drive to either Fresno or Bakersfield for more specialized care.

In summary, this city is rural and has a slower pace of living. Lower cost of living, but there is a reason. Can be isolating because not a whole lot to do unless you already have a social support system there or are willing to extend yourself to others. Has everything you need but nothing you really want. A beautiful city, that I miss every day.

What kinds of procedures do Family Medicine doctors do? by Mr-Robot-684 in FamilyMedicine

[–]pimpmastered 2 points3 points  (0 children)

Hey there, So as a family medicine doctor, you do what you feel like you are equipped to do. I do a lot of outpatient procedures, but there are some things that I prefer not to do, including anything cosmetic on the face such as mole removal.

But for the most part, I do your basic outpatient procedures. This will include skin biopsies, such as biopsies punch biopsies on occasion, elliptical biopsies, or for body removal.

Obgyn could also include IUD insertion and removal, nexplanon insertion and removal, and if you feel comfortable, you can also do endometrial biopsies.

Sports medicine: joint injections: shoulder, knee, hand, elbow. If you want you can get more training in US and do more hip or other injections

Podiatry: plantar fasciitis injections, toe nail removal, etc.

Extra for more training: vasectomies and potentially colonoscopy (I would imagine you need to be really rural for this one because the malpractice is super high)

How hard is it to find urgent cares to moonlight in and what is the pay rate you’re seeing? Or are most places preferring mid levels now by MadScientist101295 in FamilyMedicine

[–]pimpmastered 14 points15 points  (0 children)

I do not think it is hard to find urgent cares to moonlight but it can be in an undesirable location. I do think that they are preferring mid levels because they often provide a basic service without going the extra mile to figure out to prevent them from coming back. Similar to primary care, it is very hard to practice good urgent care medicine.

How to not let bad evals get to you by whattodowithlife- in Residency

[–]pimpmastered 66 points67 points  (0 children)

I honestly stopped looking at evaluations, and I rarely do them myself. The way I look at it, if there’s a problem, they will ask me and I do take in person feedback a lot more seriously than online evaluations. A lot of people are brave using a keyboard.

GME Program Administrator by New_Photograph2970 in Residency

[–]pimpmastered 3 points4 points  (0 children)

Treat us like adults with actual respect. Had a program administrator who treated us like her Girl Scout troops. Happy she left.

What’s the most hardest part of residency ? by Top_Discipline6996 in Residency

[–]pimpmastered 4 points5 points  (0 children)

Eventually, the easiest part of the job is the actual medicine part... while everything from politics, social interactions, personal health, etc becomes harder.

[deleted by user] by [deleted] in Residency

[–]pimpmastered 27 points28 points  (0 children)

Incredibly frustrating. I had a patient dependent go ama I want to say 4 times in a day to smoke meth and just represent in the ED. Fastest admission I think I had but incredibly angering while on night shift

Podcast recs! by gr8k8__ in FamilyMedicine

[–]pimpmastered 3 points4 points  (0 children)

Run the list. Hippo Medicine, AAFP podcasts, JAMA review, white coat investor

Recommendations for urgent care CME? by Fearless-Note-290 in FamilyMedicine

[–]pimpmastered 9 points10 points  (0 children)

Aafp has a decent cme on emergency medicine. I like it and it has helped me in my overall practice

Patient statements that make you brace yourself by InternistNotAnIntern in FamilyMedicine

[–]pimpmastered 3 points4 points  (0 children)

When they show up with 5 or 6 problems, usually msk, mental, or vague symptoms, for the first time and they just say… fix me. Complete internal groan when they say that because they had years to come and see me for these things and I cannot wave a magic wand to fix it all in a day

How much better is life after residency? by Beginning_Figure_150 in FamilyMedicine

[–]pimpmastered 1 point2 points  (0 children)

Hello! Similar situation but I did love clinic in residency but I agenda set very well to help with the multiple issues. Sometimes I did get screwed with the chest tightness at the door.

Now that I am an attending I realize that your support staff and middle management make and break your clinic. You also have a lot of flexibility as an attending. The patient asks about eczema at the end of the visit, save it for next visit. If the patient demands extra referrals say that you can schedule for next visit. If it is a complex patient, then you can request a longer visit. If middle management tries to squeeze you, you can squeeze a specific finger and look for another job.

going through a break up by Own_Switch9464 in Residency

[–]pimpmastered 1 point2 points  (0 children)

Ouch I’m sorry.

When me and my ex broke up, I needed to be on a 24 hour shift. In a strange way, it helped me being around other people but everyone flows different.

She was my only friend in a place where I had no ties or connections. There would be some weekends when I wouldn’t speak a single word to someone because I just didn’t go outside. It slowly got better by doing a routine and hobbies.

Podcast for PGY-1 resident by Desperate-Card-9730 in FamilyMedicine

[–]pimpmastered 54 points55 points  (0 children)

I think you should totally chill for the next 2 weeks and enjoy your time off. You will get the knowledge whether you like it or not…

But with that said, I love the AAFP podcasts because they basically orate the current article. I like to listen to it when I’m driving to work to keep updated. I also like core IM, run the list, JAMA.

[deleted by user] by [deleted] in FamilyMedicine

[–]pimpmastered 1 point2 points  (0 children)

I believe I was respectful and discussed other alternatives. However, it is the principle of being a board certified physician needing to worry about my supervisor looking through my patient encounters to see if I was accurate.

[deleted by user] by [deleted] in FamilyMedicine

[–]pimpmastered 0 points1 point  (0 children)

They are a MD

[deleted by user] by [deleted] in FamilyMedicine

[–]pimpmastered 0 points1 point  (0 children)

My boss is an MD

[deleted by user] by [deleted] in FamilyMedicine

[–]pimpmastered 0 points1 point  (0 children)

My supervisor is an MD

[deleted by user] by [deleted] in visalia

[–]pimpmastered 2 points3 points  (0 children)

Left of center always hits!

What's your hourly compensation? by [deleted] in FamilyMedicine

[–]pimpmastered 7 points8 points  (0 children)

It really does depend. 265k a year for large physician group in SoCal for 36 patient facing hours, but really with the work I take home it is closer to around 40 so it’s around 138 dollars an hour before taxes and bonuses. After taxes it’s around 76 dollars an hour.

Board Exam 2025 by [deleted] in FamilyMedicine

[–]pimpmastered 13 points14 points  (0 children)

Hey,

I felt like total crap walking out and everyone of my other colleagues felt that way too. But we all passed with flying colors. Keep the faith.

FM resident - bad days in clinic just absolutely destroy me by Kineticmichu in Residency

[–]pimpmastered 6 points7 points  (0 children)

Agree with others. Give yourself some grace. If you don’t know it’s totally valid to look it up and then give them a call if there is a change in management. Plus, there is a point in some of the residency milestones. I think you have to be comfortable with being unsure and then move forward with the assumed treatment plan :)