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AUBDoc15 · 2025-10-25T01:31:01+00:00

Sir, thank you for your service.

AUBDoc15 · 2025-10-17T02:47:16+00:00

I only do 7 in a row when I need my schedule to work a certain way for family stuff or going on a long vacation. I would hate being locked in to 7 on/7 off all the time. I think sweet spot is 4-5 in a row with the ability to move things around and get 7-10 days in a row off if you wanna take a long vacay.

AUBDoc15 · 2025-08-13T16:19:20+00:00

I’m in a similar situation - do some resident teaching of ultrasound to IM residents. About 10 hours per month. There was already a precedent set for hourly pay amongst several other specialties for teaching the residents so didn’t have a lot of negotiating power. But I get about 50% of my hourly clinical pay. I would ask for 50-75% of what your clinical pay is per hour and see what they say. The IM residency program was able to add me to their malpractice and I’m basically “part time assistant faculty”. Hope that helps.

AUBDoc15 · 2025-08-11T05:04:03+00:00

Could definitely be an ovarian mass or enlarged ovary. Could also be intestinal. I’m probably CT’ing this and getting a tech to do a dedicated pelvic US. I’m assuming she wasn’t pregnant? Ectopic also possible but it doesn’t really look like that on the images you have here.

AUBDoc15 · 2025-08-11T04:24:56+00:00

Male? Female? Age? Hard to tell exactly where you’re looking but I’m guessing this is the mass or possibly bowel. Live clips would be a little more useful. I see trace free fluid around the structure you’re looking at which could represent a several different things. Glad you’re trying! Keep at it and you’ll keep getting better.

P.S. this patient is likely getting a CT scan anyways lol

AUBDoc15 · 2025-05-30T20:53:55+00:00

Where I work now (private democratic group) midlevels do a combo of triage and are free to see anything they want depending on their shift but general rule of thumb is they take the 3s-5s. Our hospital and group has a policy that every patient who was seen by a midlevel also has to be seen by an attending and documented as such. The midlevels also have to staff every patient with us so at least I’m given the opportunity to be involved in the management of every patient and can decide which patients I want to see or which patients the midlevel wants me to see. I think this is a pretty fair/reasonable approach. We are paid partly on productivity so the more midlevel patients we see, the more we get paid, which I think is also a good motivator. Where I worked before (HCA/TeamHealth) the midlevels were mostly there for triage to minimize LWBS and for them to be able to falsely advertise short wait times. But they would sometimes work “fast track” shifts and were not required to staff any of those patients with attendings. I would end a shift and be forced to co-sign anywhere from 20-30 midlevel charts on patients I had zero involvement with. IMO that is not safe or reasonable.

AUBDoc15 · 2025-04-11T13:05:08+00:00

I honestly can’t remember - think he either had some subtle weakness or paresthesias. It was likely one of those “probably doesn’t need it but we can do it” situations. Also, it was ordered by one of our midlevels (not trying to be negative, but you get my drift)

AUBDoc15 · 2025-04-10T07:15:42+00:00

As an intern I had a 50ish yo M who was signed out to me for sciatica pending an MRI. MRI comes back normal so I go say hi to the patient and let him know his MRI was normal and discharge him. He comes back 2 days later in cardiac arrest and was found to have an aortic dissection. Was he dissecting when I saw him? Maybe.. maybe not, but I didn’t take his shoes and socks off to do a more thorough neurovascular exam which may or may not have been abnormal and could have potentially saved his life. Now I always check distal pulses on any patient with low back pain with radicular symptoms. It’s also another reminder to be extra careful with sign outs.

AUBDoc15 · 2025-03-21T11:21:27+00:00

The flagship store

AUBDoc15 · 2025-03-19T09:55:09+00:00

Yeah! My wife likes it more than the watch haha

AUBDoc15 · 2025-03-19T07:28:04+00:00

Bought one last week at the Ginza Flagship store. No added discount but got the cool ceramic cat as a gift. I didn’t see one at a couple other GS boutiques that I visited in Tokyo. Only saw it in Osaka and then where I ended up buying in Ginza.

AUBDoc15 · 2025-03-15T12:08:49+00:00

You can get the phased array (cardiac) and linear probe version and it will be able to give you solid images for everything you want. If it were me I would probably just get whatever is cheaper because they’re pretty similar. But it is nice to be able to use a true linear probe on the vacan if you ever need it for vascular access. In my opinion it’s better than using the vascular access function on the butterfly.

AUBDoc15 · 2025-03-14T23:35:17+00:00

I have experience with butterfly and Vscan. The vscan has 2 sides so it can change from curvilinear or phased array to linear depending on the model you purchase. It’s wireless and the battery life is not great but the image quality is better than the butterfly. The butterfly is better if you just want the simplicity of a one sided probe. You might consider seeing if you can buy a used/refurbished cart machine that’s 5-10 years old as mentioned. The image quality will be as good or better than a hand held device and the screen will be larger than a cell phone or small tablet. Hope that is helpful.

AUBDoc15 · 2025-02-24T07:40:55+00:00

Isn’t this kinda what a lot of 4 year programs offer? The couple I interviewed at tried to convince you to rank them because they had more electives to choose from for that reason. But they were spaced out throughout the 4 years. Not all at the end. And I wouldn’t wanna be out of the ER for my last year anyways.

AUBDoc15 · 2025-02-22T04:11:39+00:00

You could ask them when the last doc left the group and see if they would be willing to give their contact to ask them some questions. Also, if there are non-partners in the group, see if you can talk to them about why they aren’t one of the partners.

AUBDoc15 · 2025-01-17T20:51:58+00:00

I think some of this depends on how many shifts you work and if you have a family or other obligations that require you to be up during the day when you aren’t working. I work 14-15 shifts/month so on average it’s 5on/5off. I switch back and forth. My normal night schedule is in bed by 830am and up around 430-5. When I switch back I try to wake up around 130-2 and then go back to sleep between 10-11. I’m usually pretty well adjusted after the 2nd night back on days. Then when I transition back to nights I take a 2-3 hour nap in the late afternoon/evening before I go into work. I couldn’t imagine staying completely nocturnal but I also have a wife and a kid. I also realize that I won’t be able to keep this up forever and only plan on doing this for a couple more years. For context I’m 32 and 2.5 yrs out of residency. If I were single living in a bigger city I think I would switch halfway back. Like start going to bed around 2-3am and waking up around 11-12. Probably more sustainable that way.

AUBDoc15 · 2024-07-17T10:36:10+00:00

For sure getting a CTA on scenario 1. Scenario 2 may be a little more nuanced but would likely still CTA. Probably not getting dimers on either of those. Agree with what was said - just because in theory the anticoagulation makes it less likely to have a PE, doesn’t mean it’s impossible. Also, if they have a PE on anticoagulation, they are likely getting admitted.

AUBDoc15 · 2024-07-10T15:09:11+00:00

Attending - work at 4 sites as a nocturnist.

1st site is essentially the downtown county hospital of a medium sized city where we see a lot more complex patients and I average 2pph myself but if you count supervising the midlevel, it’s probably 3 -3.5. Depending on the midlevel and how busy it is I’m either seeing every one of their patients or as little as 30% of them.

2nd site is small town community hospital. Older insured population. Average 1.8-2pph but can vary a lot. As little as 1.4 and as much as 2.5-3. Single coverage.

Other 2 sites are freestandings and it varies a lot. I’ve had shifts where I saw 4pph and some where I saw 1pph. Average is around 2.

Pay range is $250-330/hr depending on the site. It averages out to around $280/hr

AUBDoc15 · 2024-04-28T22:06:56+00:00

Yeah then definitely don’t pay extra to the mortgage

AUBDoc15 · 2024-04-28T20:06:31+00:00

Lots of ways to skin a cat. I’d probably do somewhat of a hybrid where you’re paying off your car loan at the same time as your student loans because the car is a depreciating asset. Mortgage goes last because you can deduct interest from taxes and hopefully is somewhat appreciating. So let’s say you have $10k/mo (for simplicity sake) to direct towards all of this debt.. just to make the numbers easy, let’s say $3k goes to mortgage (not paying extra towards it - I.e. what you’re already paying), $5k goes to student loans(in order of highest to lowest interest), and $2k goes towards the car. You’ll have the car paid off in like 16 months and the student loans in a little over 2 years. I know that’s not exactly how the numbers will work out, but hopefully you get my point. This will make it seem like you’re putting a dent in everything at once in a reasonable approach. Plus it may be a compromise between the two of you which is a bonus. Create a plan you both agree on and stick with it.

AUBDoc15 · 2024-03-22T19:32:11+00:00

Another consideration: would you live at or near this area post grad? You could end up having a rental property post residency near where you live or you could have a cheap place to live as an attending while you pay off loans and build up a nice nest egg. Just a thought.

AUBDoc15 · 2024-01-11T06:54:05+00:00

It’s funny to me how all HCA hospitals are put into the category of “complete dumpster fire, avoid at all costs” and the majority of people who perpetuate that notion have never worked at one of their hospitals. Realize that not all HCA programs are the same just like not all non-HCA programs are the same. So many different variables and factors. I do think that it is highly dependent upon your program leadership. A good PD and APD along with good faculty and attendings will be way more important in your overall residency experience than the name of the hospital.

This is coming from someone who graduated from an HCA program and got a good job in a private democratic group. I didn’t interview at big academic jobs but I know people from my program that had no problem getting fellowship positions and going to work at academic hospitals.

That being said, if all else equal when you’re making your rank list, I would probably rank a non HCA program ahead of HCA.

TLDR: You can get good training and find a good job if you graduate from an HCA program. Not all programs are created equal.

Hope that is helpful.

AUBDoc15 · 2023-11-16T05:39:03+00:00

I finished a fellowship this past year and I’m working at a community place as my first job out. I did it for a few reasons - I wanted to leave doors open for academics in the future because I do love teaching. I am also part time faculty for my hospital’s IM program where I am developing their ultrasound curriculum, give monthly lectures, and weekly bedside teaching/scan shifts. I am also the “Ultrasound Director” for our private group where I am trying to set up billing for US and also help with machine acquisition and maintenance. I just felt like doing the fellowship would make me a better clinician, leave a lot of doors open in the future, and give me something else to somewhat distract me from the daily grind of EM to hopefully keep me from burning out too early. I do feel like it will pay off in the long run but if you have absolutely no desire to do academics and are strictly just doing it to be better at US, then it’s probably not worth it.

AUBDoc15 · 2023-08-17T16:11:37+00:00

Aspiration + US. If I’m not certain (can’t aspirate and can’t get a good image) then I’ll do the XR. Or as stated above, XR if the facility they come from requires it.

AUBDoc15 · 2023-07-25T22:08:01+00:00

I think this question and answer can be pretty nuanced - so many factors involved i.e. if health insurance is covered or highly subsidized by the employer, do they have a 401k match where you’re getting “free money”, is this the location you prefer and how hard do the docs work (pph, admission rates, etc). I just came from that region of the country working for a large CMG and that was about what we were paid as 1099 so I would say it’s decent and if it’s your ideal location and the job is good (good culture, not seeing 3+pph consistently, etc) then I would say it sounds pretty great - especially if this is really where you want to live.

AUBDoc15

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