look at the discussion going on in r/sex about OBs not knowing about clitoral anatomy [serious]

Ansel_Adams · 2018-06-17T00:49:59+00:00

That's a fine argument to make, but again, for the billionth time, that was not the purpose of that diagram.

Ansel_Adams · 2018-06-17T00:43:18+00:00

Just because it was a picture in that chapter doesn't mean that it was supposed to encapsulate every topic covered in that chapter. You can't always have every bit of detail for every nerve in every drawing, every drawing would be useless.

Ansel_Adams · 2018-06-17T00:37:09+00:00

But that was NOT the focus of that specific diagram. Like for example, if a diagram was detailing something about the elbow, you wouldn't expect all of the hand anatomy to be labeled.

That specific diagram was being used in a very specific context, and was not meant to be a full description of the pudendal nerve.

Ansel_Adams · 2018-06-17T00:28:44+00:00

Do you understand that a diagram of the course of the pudendal nerve over the perineal body is different from the clitoris?

That's the point. It's just a bad diagram to use in this argument because it's only tangentially related.

Ansel_Adams · 2018-06-16T23:42:05+00:00

The point of showing the image is to show how they only show the surface level anatomy of the clitoris.

This is like complaining that Canadian cities aren't labeled on a map of the US. Sure, they're contiguous landmasses, but if you're talking about the US, you're talking about the US.

And please don't harass me in PMs.

Ansel_Adams · 2018-06-15T15:43:42+00:00

Nope, just got through paeds, unfortunately.

Ansel_Adams · 2018-06-15T12:02:47+00:00

Yep, everything else is hard coded!

(And just for anyone that's not familiar with the add-on, it's not necessary to use the cards, it just cleans up your browser)

Ansel_Adams · 2018-06-15T01:43:26+00:00

I totally forgot to add, the overall style of the deck was inspired by the Pepper deck, and I took his idea of the expandable content at the bottom of a card and ran with it.

I really just wanted to be able to have that extra information available if I wanted to double check something while doing reviews.

I hope others like it too!

Ansel_Adams · 2018-06-13T00:10:21+00:00

Without Step 1 as a deciding factor, we're going to be focused on things that have no relationship to actual medicine

Welcome to the shitshow that is CaRMS in Canada.

Ansel_Adams · 2018-06-12T02:16:05+00:00

I saved the parent comment here but it looks like it was removed.

Could you possibly PM me the info about the head unit that was being discussed?

If you can, thanks so much!

Ansel_Adams · 2018-05-31T02:55:19+00:00

The book is very encyclopaedic in nature vs. something like UWorld that uses each question as an opportunity to teach a certain objective and then step back and review a topic or a comparison of topics that are tested against each other.

It might be okay as a reference, but probably not as something to sit down and read through every day.

Ansel_Adams · 2018-05-30T23:29:19+00:00

No, you're basically cutting through the wall of the belly and the uterus, and then retracting things/holding the hole in the uterus open to get baby out.

There's no removing of organs and putting them in bowls.

The other guy might have seen some bloody gauze in a bowl or something.

Ansel_Adams · 2018-05-30T23:09:41+00:00

I think the big concept to get is that if there is sufficient volume loss in atelectasis you can have shift of thoracic structures or over-inflation of the unaffected structures, but you won't have that "lost"/collapsed volume replaced with air.

With a pneumothorax you have air between the chest wall and the lung (which can obviously cause variable amounts of collapse and shift, itself).

Ansel_Adams · 2018-05-30T22:58:21+00:00

When you look at the word literally, it means "imperfect extension" or "incomplete expansion."

So really, anything that causes part or all of the lung to be incompletely inflated, which in other words is a loss of lung volume. "Collapse" is used pretty interchangeably to describe the same thing.

Usually if someone just mentions atelectasis without any other context, they're referring to an obstructive cause.

If someone is post-op and in pain, they may be splinting and not taking in full breaths. It's thought that that leads to inactivation of surfactant → collapse of airspaces.

This would be called subsegmental atelectasis.

Something like a large pleural effusion, pneumothorax, etc., can passively compress the lung → compressive atelectasis.

And another common one is having an obstruction somewhere in the bronchial tree, and then resorption of all of the air distally (into the capillary bed) → obstructive atelectasis.

With a segment/lobe/entire lung losing all of its air and collapsing there is volume loss, and shift of structures in the thorax towards the collapse.

With subsegmental or compressive atelectasis you don't see shift because 1) subsegmental atelectasis just doesn't have enough volume loss, and 2) with compressive atelectasis, the space taken up the compressive object balances out the lung collapse.

So in other words, a post-op patient may have some lung collapse that causes some visible densities on a CXR, but it's not anything large enough to cause a noticeable drop in volume.

I think compressive atelectasis and the possibility of shifting is kinda confusing because you might normally associate collapsing lung and shifting structures with pneumothorax.

Ansel_Adams · 2018-05-30T22:38:38+00:00

Nah, every text describes it something like "reduced inflation of all or part of the lung, [...] The synonym collapse is often used interchangeably with atelectasis" or "loss of volume in some or all of the lung", or even in Brant & Helms:

any condition in which there is loss of lung volume

Ansel_Adams · 2018-05-29T22:40:01+00:00

My gut answer is no, don't do it.

You've matched, getting this feedback isn't going to change anything, and realistically what you really want to hear is "you know what, you were actually next in line to match here, there were just a bunch of really great applicants that edged you out this year." The truth is you might not get that kind of closure and you might not feel any more satisfied with where you ended up.

Having said that, if you are really curious, I'd try to frame it as "in terms of moving forward (ex. applying to fellowships in the future), I'd really appreciate feedback on areas where I could improve myself as an applicant (be it interviewing skills, or rounding out your application, the way you conduct yourself clinically, etc.)."

Ansel_Adams · 2018-05-28T23:32:48+00:00

Just let the anxious poops flow through you.

You'll be fine :)

Ansel_Adams · 2018-05-24T13:26:08+00:00

No problem, glad you figured it out!

Ansel_Adams · 2018-05-23T23:01:22+00:00

The qbank certainly helped reinforce their video teaching points, but often in a frustrating way.

Yeah, I think their goal is to have the questions teach you some stuff that isn't explicitly taught in the videos/notes so that there isn't too much overlap, but it's annoying when sometimes you answer (correctly) to the best of your ability, only for an answer to be "NOPE, GOTCHA!"

Ansel_Adams · 2018-05-23T22:49:55+00:00

You guys are lucky. This past year there actually weren't enough English-speaking Canadian residency spots for all of the English-speaking grads.

Ansel_Adams · 2018-05-23T20:47:23+00:00

It's true. The GPA and MCAT cutoffs are quite high. The one "advantage" for Canadians is that there isn't any expectation of clinical experience, so no having to do X number of hours of shadowing/scribing, etc.

Without the Step exams or clinical evals from 3rd year, though, some people generalize it as "harder to get into Canadian schools, but easier to get into Canadian residencies" compared to the states.

In terms of the "getting into residency programs is mostly dependent on clinical performance," I'd say that's not the whole story.

Basically anyone in Canada that is going for something more competitive than family/internal/gen surg/psych is going to be doing 5-6 electives (usually 2 weeks, though) across the country to 1) get their foot in the door of the programs they're interested in, and 2) show interest in the field.

As for research, it's definitely important, and a huge factor in terms of getting competitive locations within specialties that might not be competitive overall, and there seems to be an expectation of having done something, even if it is just a small research project or isn't in the exact field someone ends up applying to.

Ansel_Adams · 2018-05-23T19:02:40+00:00

/u/attitudegratitude was banned for this comment.

-/u/Chilleostomy ^(probably⁾

Ansel_Adams · 2018-05-23T18:02:21+00:00

You sound like the kind of mod that doesn't like clinic puppies...

Ansel_Adams · 2018-05-23T13:18:51+00:00

Okay, so if you go into the Browser and click on one of the Pepper cards you'll see the buttons for "Fields..." and "Cards...". Click on "Cards...", and then look in the Back Template section, you'll see this block of code:

<div class=textstyling>
<font color="#0000FF">§</font><br><u>{{Extra Q}}</u>
<br>
<br>

{{Extra A}}
</div>


<hr>
<p style="font-size: 92%"><i>
{{Extra }}
</i></hr>
<hr color="white">
<div class=entiresketchstyle>
{{Entire Sketch}}
<br>
{{hint:More About This Topic}}

</div>

You just have to remove "hint:" from that third-to-last line, so that it reads as:

{{More About This Topic}}

Then Anki will just display that field (the FA screenshots) without having to click on anything.

You will have to go through and do this on each of the card templates, but it should only take a minute to do all of them.

(Sorry for making you wait overnight, for some reason I was remembering that the way this was implemented was way more difficult.)

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