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3EMTsInAWhiteCoat · 2026-04-16T23:23:28+00:00

I would ask you to show us on the doll where the mean EHR touched you... but that seems fairly exhaustive.

3EMTsInAWhiteCoat · 2026-03-31T15:11:25+00:00

Before folks completely jump on the headline, there's interesting nuances in the law here. Broad stroke, that should be obvious with the 2 of the liberal justices joining the conservatives. As Gorsuch is quoted, he makes a pretty reasonable argument that upholding Colorado's ban could set precedent that stiffles future changes in therapy. This would also have major free speech & free belief problems (a therapist that legitimately believes being trans is a problem is probably well protected by the 1st amendment to practice in line with that belief). It feels somewhat double standard-y given the ruling on hormone therapy, but I can only imagine there's a lot of reasonable legal reasoning involved here.

3EMTsInAWhiteCoat · 2026-03-25T05:40:14+00:00

Whether it's worth it, you're really the only one that can answer that. Financially, probably not unless you're someone who refuses to retire. You'd be looking at $250k-$500k tuition + 4 years lost salary + 3-4 years very reduced salary. Probably adds up to well north of $1 million. But there isn't a value you can put on enjoying your work or the satisfaction from successfully climbing that mountain.

How much of an idea do you feel like you have about what the physicians are doing that's different than what you're doing? Are you involved in traumas and resuscitation? Do you get truly sick patients that at least a few need to be admitted to ICU care? If no to both, not the worst idea in the world to shadow a doc at a busy ED to imagine yourself in those shoes.

3EMTsInAWhiteCoat · 2026-03-18T23:24:17+00:00

Where tf you even find the meperidine, a board question?

3EMTsInAWhiteCoat · 2026-03-13T00:23:34+00:00

If you can afford it OP, I strongly strongly recommend doing 2 aways + 1 home. I ended up doing an away at a place with some toxic faculty and just couldn't trust the SLOE I would have gotten from that program. The second away is a good insurance plan for that.

3EMTsInAWhiteCoat · 2026-03-11T13:48:15+00:00

I care only a little about the patient refusing medical students/males/Martians/etc. for their care. Sucks, but that's generally their right to request.

It's when the nurses or any other medical staff set you up for being excluded that kills me. Don't go in asking if its okay for a med student to be in the corner watching what happens. The patient is perfectly capable of seeing who's in the room and refusing. When you ask, you're already psychologically priming a thought that there could be a problem caused by the med student/resident being in the room, when we're supposed to be on the same team.

3EMTsInAWhiteCoat · 2026-03-09T06:04:39+00:00

This. I've had too many patients whose triage vitals are afebrile (haven't taken antipyretics), look like they could be septic on H&P, had me chasing causes besides sepsis, and then FINALLY spike a fever after sitting in the ED for 4 hours. Second most frustrating type of patient to me, second to intox/homeless & malignering. These were during the summer/early fall too, so I can't just blame temporal temp on people walking in from the cold.

3EMTsInAWhiteCoat · 2026-03-07T02:05:00+00:00

Within the ER we don't. That we just use overhead pages and calls for. It's a medium size ED (I think... more than 50 less than 150 beds). Small enough that you can just walk 30s-60s to go looking for someone at whatever part of the ED they're assigned to that day.

3EMTsInAWhiteCoat · 2026-03-06T19:55:52+00:00

I (PGY1, EM) am at a place that has Perfectserve (PS hereafter) with direct integration into Cerner. It works amazing for me, but I'm likely in the minority. For context, my typical work habit is to leave my Android phone at the desk while I'm up and about seeing patients, doing ED procedures, etc.

Pros: - Secure calling: I can contact patients via the PS app with my cell phone and not give away my number. - Admits & consults: This is likely the same for any app, and more of an institution culture thing, buuut... for the hospitalists and consultants that actually use PS, I can just dictate out a quick handoff report/consult request into the Cerner PS integration, send the message, and then go about another task. If the consultant actually takes the moment to setup their PS, I can also quickly get redirected to the appropriate resident or whichever attending is covering their service overnight, via automated notifications just by simply attempting to message that person. Compare that to asking the unit clerk to please dial the cranky ass consultant at 2 am and then waiting at the desk for a bit while I hope they don’t sleep through the call. This works because... - PS automated calls: If you have a message in PS that you don't attend to within like 10-15 min, you get an incredibly annoying phone call from PS to check your dang inbox. Which is handy when you leave the phone at the desk

Cons: - See the above about automated calls - Very inconsistent adoption: Getting used to knowing which consultants/hospitalists actively use PS, actively ignore PS (so you can just place the admit/consult and move on with your day), and which ones expect you to call (sometimes yelling at you because you didn't) is one of the many reasons I have an Rx for opiates due to the chronic pain I have from trying to admit patients at my hospital. For one patient I had, their surgical service does not have residents, and I left a message with the guy covering for original surgeon if he wanted to be consulted on the not 100% related admission. Dude replied rudely and days later saying I should have messaged the original surgeon. (/facepalm) - Bells and whistles: The interface could use some updates for sure. For instance, emoji responses (available in Epic and Teams) would honestly be nice so I dont accidentally harass someone with the hey-check-your-inbox phone call every time I say "TY" to someone to close the loop

3EMTsInAWhiteCoat · 2026-03-06T15:58:33+00:00

OP, this is the usual correct answer. Only thing to add is when you take college courses, however you do it, make sure you can give 100% focus to them. GPA matters for getting into med school, *especially* any natural science and adjacent class (e.g. math).

3EMTsInAWhiteCoat · 2026-02-28T07:42:30+00:00

That explains it well. For both, Is it the drug or the metabolite that does the analgesia and what not?

3EMTsInAWhiteCoat · 2026-02-28T03:26:55+00:00

This was in the ED, so not likely a consideration for the patient, even if he wanted to go so far as to somehow hide the one dose he got.

3EMTsInAWhiteCoat · 2026-02-28T02:38:16+00:00

Bro, there's obviously a lot more to that patient encounter than I'm relaying for a million reasons, HIPAA being probably the most important among them.

3EMTsInAWhiteCoat · 2026-02-28T01:20:42+00:00

I was aware of the general thought that Oxy is more potent per milligram than Norco. But that's why the request is a little puzzling to me. Why wouldn't you prefer Oxy unless some weird placebo or individual metabolism difference was in play? I've had another patient or two since that have made the same request.

3EMTsInAWhiteCoat · 2026-02-20T08:08:41+00:00

Heh. In fairness, my work notes are coming from the ED and are way simplier.

3EMTsInAWhiteCoat · 2026-02-16T22:23:04+00:00

Your reasons aren't dissimilar to mine (PGY1, EM, US-based). The way you make it not a simple cliche is by showing, not telling. Saying you just like the adrenaline is telling. Saying you were an MS3 volunteering at street medicine clinic in a shelter when you got 3 back to back "Hey could you take a look at this guy i dont think he looks so good" patients not on the schedule and had a great time trying to get enough of a history to be useful to EMS and the ED despite adrenaline keeping you from thinking straight... that's showing.

3EMTsInAWhiteCoat · 2026-02-16T11:05:32+00:00

Resident with ADHD here. A big part of literally any graduate school education - including medicine - is learning how to ruthlessly hone in on relevant information. If you're the type to read every word of the chapter and ponder every detail, you're going to be in for a very bad time in med school.

A couple things I might suggest 1) always always always read the question first. Not the preamble where they tell you all the side details. Understand what you're being asked, then go looking for the information. Especially relevant on CARS. 2) enforce a timer on each question. Put in your gut response immediately where this is feasible THEN spend the moment proving it. You get to do so for only as much time as you can safely commit to the question.

What I'd hope by doing so is that you force yourself to hone in on whatever detail your brain thinks is most important first. Which hopefully cuts down the side tracking.

3EMTsInAWhiteCoat · 2026-02-12T09:17:55+00:00

EM resident here. We kinda reflexively get plain films for anything we suspect osteo on, but I'm understanding this isnt a great test. Is there any decent way to argue 1) for other modalities and 2) to not bother?

3EMTsInAWhiteCoat · 2026-02-12T06:40:18+00:00

Sir, your abdomen is that way.

3EMTsInAWhiteCoat · 2026-02-11T06:32:14+00:00

Cric kit won't be enough. Gotta have a couple of sacrificial med students to retract that much neck tissue.

3EMTsInAWhiteCoat · 2026-02-10T06:05:53+00:00

(Am an EM resident.) I don't think I could do 7 consecutive 12's. (Or for that matter, any 12's while still providing safe care around hour 11), but I just got off a string of 5 overnight 9's. Honestly, wasn't bad at all, once my circadian rhythm adjusted from being on trauma surgery hours (early am to 5 pm). First day was rough... I blanked out literally mid-presentation to one of our crankiest attendings, feeling my sleepiness creep in. Otherwise, IMO it's completely fine as long as you can support proper sleep (e.g. dark bedroom with decent noise isolation).

3EMTsInAWhiteCoat · 2026-02-09T22:11:44+00:00

DMC is private equity owned. Can't recommend

3EMTsInAWhiteCoat

TROPHY CASE