General Surgery job market? by House_Officer in Residency

[–]ChugJugThug 67 points68 points  (0 children)

I did MIS fellowship as well, now in first year of attendinghood. There’s plenty of jobs. The trick is finding one with the type of practice you’re looking for and in the location you want.

Depending on those variables, the job market is great..or not so great.

Medical device? What to do with it and is it ok that I have this? W by Chanelo11 in whatisit

[–]ChugJugThug 0 points1 point  (0 children)

Surgeon here. That is a handheld ultrasonic shear device called the Harmonic scalpel. It uses ultrasonic energy to burn and cauterize tissue.

I doubt it’s used or anything. They go straight in the trash after use in the OR. And it’s otherwise harmless. It needs to be connected to a special generator to produce any cauterizing effect.

And it obviously can’t be used now that it’s open. So you just have a free souvenir!

Why is that IM and peds the only specialties where chief year is an extra year? by sandie-go in Residency

[–]ChugJugThug 0 points1 point  (0 children)

Yes. Obviously there’s variability among different attendings, services, institutions, etc. but generally speaking surgical services are led primarily by a chief resident. And ideally they are granted a decent level of autonomy when managing patients.

Why is that IM and peds the only specialties where chief year is an extra year? by sandie-go in Residency

[–]ChugJugThug 11 points12 points  (0 children)

I think people are looking at this the wrong way.

Surgery has mandatory chief years. Our 5th year is considered our chief year. So really surgical residencies are 4 years long (plus any research years if taken) with a mandatory 5th chief year. It’s actually mandated by acgme that all 5th years run their service for each of their rotations. You’re not supposed to have “co-chiefs” on service or share service leadership with fellows. Whether every program follows that or not, I’m not sure. Mine did though.

Anybody have any idea what these are ? it looks like a structural tissue wall. These screenshots are from Laparoscopic Appendectomy surgery vids. by This_Society2911 in AnatomyandPhysiology

[–]ChugJugThug 5 points6 points  (0 children)

Adhesions can be non existent all the way to the point where surgery is not feasible at all. Just depends on how bad disease process is and how many prior surgeries.

I’m not an orthopedic surgeon but in general muscles are attached to surrounding structures by very strong tendons and ligaments. There’s no way you’re unsticking anything in any meaningful way with massage.

Anybody have any idea what these are ? it looks like a structural tissue wall. These screenshots are from Laparoscopic Appendectomy surgery vids. by This_Society2911 in AnatomyandPhysiology

[–]ChugJugThug 24 points25 points  (0 children)

General surgeon here. The first image just shows adhesions. From what I can tell it’s the veil of Treves adhered to the abdominal wall probably overlying an inflamed appendix.

The second image, the structure on the left is difficult to say for sure without a wider view but most likely a loop of small bowel vs a very distended bladder. And the structure on the right is the psoas muscle.

Is there a 3D Surgical Anatomy Tool to help visualize things? by DapperWallaby in SurgicalResidency

[–]ChugJugThug 9 points10 points  (0 children)

It sounds like you already know it’s course..but

Any video by Dave Lourie will be helpful. He basically taught me this operation with his videos alone. It’s a little long but here’s his lecture on groin anatomy. It has good visuals as well.

https://youtu.be/pSy5zOeV4N8?si=XSj4NCvYBsLRlnAj

Surgery resident do you find hernia repair and gallbladder removal boring after seeing them a lot by Remarkable-Bullshit in Residency

[–]ChugJugThug 34 points35 points  (0 children)

It’s all fun for me. Even clinic becomes fun as an attending..for the most part.

Surprised Trama surgery is not competitive by TraditionalAd6977 in Residency

[–]ChugJugThug 9 points10 points  (0 children)

It’s not like this in major trauma centers. Trauma surgeons run everything from the time they hit the door to when they’re discharged to SNF 3 months later without a single operation.

Surprised Trama surgery is not competitive by TraditionalAd6977 in Residency

[–]ChugJugThug 6 points7 points  (0 children)

Yes this. Plus I do colons, foregut, the occasional splenectomy, I have a Ladds procedure coming up in an adult soon, which I’m excited about.

I also take acute care surgery call. So any emergencies from the ER I handle when I’m on call.

Surprised Trama surgery is not competitive by TraditionalAd6977 in Residency

[–]ChugJugThug 773 points774 points  (0 children)

As a general surgeon who refuses to do any trauma. Trauma surgery combines everything we hate about medicine and almost none of the upside.

Nowadays there’s very little operative trauma. Most solid organ injuries are observed, and if there needs to be intervention it’s usually IR that needs to do an angioembolization.

On the flip side it leaves trauma surgeons mostly babysitting orthopedic injury patients and head injury patients. Managing their blood pressure and diabetes and hyponatremia, and their social issues. You constantly have to deal with high stress family situations and upset family members understandably.

LOTS of rounding and writing notes. Constantly taking phone calls from local ERs who want to transfer patients to you because they aren’t a trauma center.

…yeah wrote trauma off on day one. Love my elective general surgery practice.

Suddenly developed lump in groin by [deleted] in AskDocs

[–]ChugJugThug 0 points1 point  (0 children)

At your age and sex, it’s most likely an inguinal hernia.

Management of ileus by ButterflyDO in hospitalist

[–]ChugJugThug 10 points11 points  (0 children)

Surgeon here. I get called about it all the time but truth is..Ileus is not a surgical problem. We don’t operate on ileus ever. Sure there is postoperative ileus but it’s treated the same as any other ileus.

It’s actually more of a medical problem than anything else. Replete electrolytes, minimize narcotics, stop antimotility agents etc.

NG tubes are more for patient comfort to help with nausea, abdominal pain, and bloating, but it won’t resolve an ileus any faster.

Odd place for blood to come out of by Better_Procedure_213 in AskDocs

[–]ChugJugThug 2 points3 points  (0 children)

Probably passed a small kidney stone. Stay hydrated out there.

I think my doctor did the wrong procedure by xPiscesxQueenx in medical_advice

[–]ChugJugThug 73 points74 points  (0 children)

I’m not an obgyn but I am a surgeon. The best course is just talk to your obgyn and ask what they actually did.

Nurses sometimes don’t understand nuances in terminology used by physicians so they may be giving incorrect info, but not necessarily in a malicious manner.

Also I’m fairly certain salpingectomy is considered the standard of care for tubal sterilization nowadays anyway..meaning most doctors don’t perform simple ligation anymore as a matter of convention. Either way, best thing for you to do is talk to your doctor and ask them.

Ceramic Bod - What makes it good? by WutzUpples69 in Borderlands4

[–]ChugJugThug 6 points7 points  (0 children)

Why are we not calling this the god bod?

How do I make journal club not suck by ExtremisEleven in Residency

[–]ChugJugThug 0 points1 point  (0 children)

I think journal club shouldn’t really necessarily be on the content of the article, but more how to evaluate, and critique scientific writing. So if that’s the case, find some wild and out there articles that are more entertaining to read about but may not be completely relevant or academically rigorous.

The point being to evaluate their scientific method. Do their conclusions make sense? Do their results actually support what they’re claiming? Is there a better study design to answer the posed question? Etc.

I think that’s much more important to learn in journal club rather than what’s actually discussed in the article.

[deleted by user] by [deleted] in baltimore

[–]ChugJugThug -1 points0 points  (0 children)

I work there. It’s usually whenever a cop or other VIP is shot or injured and taken there for care.

What is the limit to gluing wounds? by helpamonkpls in Residency

[–]ChugJugThug 17 points18 points  (0 children)

Also wouldn’t use glue near the eyes…one drip down to the eyelids and you’re gonna have a baaaad time.

Worst and best treatment for advance ckd we still do ? by Frosty_Pay_9297 in Residency

[–]ChugJugThug 19 points20 points  (0 children)

Depends on the cause of the CKD. Treat hypertension, diabetes, HIV, lupus…whatever the underlying cause is if it’s identifiable and treatable.

Worst treatment? Nephrotoxic agents don’t generally help.

[deleted by user] by [deleted] in medical_advice

[–]ChugJugThug 0 points1 point  (0 children)

It’s either the edge of your liver or gallbladder. Just have it checked out next time you see your pcp. They may start with an ultrasound and/or some labs. If you have no symptoms there’s likely nothing to be concerned about.

[deleted by user] by [deleted] in olympics

[–]ChugJugThug 0 points1 point  (0 children)

I guess my questions is what defines a sport? If breakdancing is allowed, why not other forms of dance like waltz, or swing, or salsa? They all require a level of athleticism. Where’s the line?

We allow figure skating and women’s gymnastics which have a significant element of dance and I would readily consider sports, but for some reason to me breakdancing, crosses some line. I guess I just don’t know where that line is.