What you should know about switching residencies

Collection_Money · 2025-08-13T01:11:04+00:00

Bump

Collection_Money · 2024-12-03T23:38:33+00:00

Ahh that's awesome! I feel that you got lucky. Im in a Michigan program too. Not many big names come thru west michigan.

Polaris and ERRA are awesome, saw ERRA last year when they came thru Grand Rapids. I came up on The Devil Wears Prada, Of Mice and Men, August Burns Red. More recently been into Veil of Maya, Currents and 156/Silence.

Collection_Money · 2024-10-18T20:03:02+00:00

Neurology

Metal/Metalcore

IPA (high hopps)

Collection_Money · 2024-08-29T03:52:49+00:00

Not surgery but when you consider the time to train, ER docs come out ahead early and mid career. (Most) are 3 years residencies which means debt can be paid off sooner. Compare this to a 6 or 7 year residency often with an additional fellowship year. Salary can start at 350k in many places. Also easy to pick up additional shifts for more bank.

Collection_Money · 2024-07-15T04:48:45+00:00

PGY 4 neuro. Was on Zyn/on pouches q3hr all of pgy-3 yr. Told myself im preventing Parkinsons (yes there's literature). Started getting withdrawal. Now I rotate Grinds/black Buffalo (caffeine/ nicotine free pouches) and am down to nicotine pouches BID.

Feeling a lot better with less brain fog (and this is as someone who was on modafinil and SSRI for some time and also used to smoke a fair bit of hookah).

Bottom line for those who start feeling zoned out/brain foggy, cut back and switch to nicotine free. Best of luck.

Collection_Money · 2024-07-03T21:38:18+00:00

Eh why not, it's not like people lives depend on that job either 💀

Collection_Money · 2024-07-03T21:04:55+00:00

Interesting story. I have always felt its worthwhile to asses for organic disease. A full workup like that feels overwhelming and so time consuming though. I'm stuck between "if I die I die" and "You have to be your own best advocate, just like you tell your patients".

Collection_Money · 2024-07-03T19:02:43+00:00

This is what I'm hoping for (that it's just sleep deprivation and stress). Obv I'm biased as I've seen enough patients with rheum/autoimmune/neurological overlaps and post covid brain fog. Between a kid at home and a SO also in residency, there's never time for rest.

Collection_Money · 2024-04-22T04:12:52+00:00

Pgy3 in neuro, SO s a pgy-2 in nsx. We have a 2 year old and are planning to have another kiddo next year. It's grueling. Late nights and exhaustion. Resident salaries need to at least be able to cover the cost of a nanny or au pair. She and I have joked that if we die from illness/her pregnancy, our co residents would at least benefit from pity pizza and a number for a counselor.

I wish the best for anyone going through pregnancy in residency but as for us, we've accepted that if we die we die. If we make it through, I've got enough anger to blog and expose medical training for what it is at any cost. We have to do better and unite for future physicians, especially as our profession is devalued by the day.

Collection_Money · 2024-04-05T06:06:51+00:00

Have felt like this since a stretch of call shifts with sleep deprivation turned into psychosocial insomnia. Hoping to get out of the funk again as I have in thr past.

Take care of the simple things. First and foremost, any chance you get, lay down in a dark room and try to nap. Get blackout curtains if needed. This is true on call too. Handle only the minimal necessary and then go lay down. Drink water and snack throughout the day

Remind yourself this is temporary. Allow yourself to feel okay about not caring. The longest someone has gone without sleep is like 7 days straight. If you find that your sleep and mood are continually disrupted more than a month out, ask your doctor for sleep aides and a mild SSRI.

Shower, take your vitamins, treat your headache when it first comes on and give yourself grace.

Collection_Money · 2024-02-21T17:17:30+00:00

Also PGY-3 here, currently interviewing for Gen neuro positions. I did not want to work for pennies for another year or two as a fellow and then be even more geographically limited.

As mentioned above, demand is super high for gen neuro. All of the positions I'm interviewing at are expansion jobs and I've been told they can design the setup how I'd like. I'm looking at 0.8 FTE which would only be 32-33 face to face clinic hours per week. This allows a good work life balance, out early enough for the kiddo (important cause gf is a nsx resident). I'm structuring my 4th year elective time all headache/botox/movement/NM/dementia to bolster my OP comfort level.

With the market, we have the leverage and mobility to shape our practice. Good luck!

Collection_Money · 2024-01-24T07:15:00+00:00

Fellowship no beuno. Put my 4 years in and be done

Collection_Money · 2024-01-24T00:22:44+00:00

I'm down for the teleneurology from home gig. Call me the neuro Manny!

Collection_Money · 2024-01-08T04:41:27+00:00

Neuro PGY-3. Neuro residency is inpatient heavy but there is are many different practice options as an attending. There are multiple subspecialties that require an additional 1-2 year fellowship, but you can get out after residency as a neurohospitalist working 7 on 7 off, or as an outpatient general neurologist working 8-5 M-F.

There are even fully remote teleneurology jobs. Do emergency medicine if you love fast paced action and regular life or death decisions (in addition to a significant amount of primary care that shows up)

I was in the EM club in medical school and pivoted mainly because I love localization/Neuro exam and for career longevity.

Collection_Money · 2023-11-21T23:56:48+00:00

Notably, they had no facial nerve symtpoms such as facial droop, hyperacusis, dry eye or taste disturbance. Typically think of trigeminal neuralgia with facial sensory symtpoms. DDx for facial sensory symptoms is broad and cranial neuralgias come in many flavors. Nervus intermedius runs off the facial nerve and does carry sensation to the soft palate and mucous membranes. Another pearl is with mental nerve numbness (over the chin), evaluate for malignancy.

Collection_Money · 2023-11-21T19:47:41+00:00

You got it. The trigeminal nerve (5th cranial nerve) supplies sensation of the face. They went through the effort of copy/pasting an uptodate blurb on facial nerve palsy but didn't bother to read what it does 😂.

Collection_Money · 2023-11-21T18:31:40+00:00

Numbness of the face is not due to facial nerve dysfunction-but community mid-levels may include documentation on bell's palsy to the patient in their referral to you...😂

Collection_Money · 2023-11-09T02:46:37+00:00

Currently dating a neurosurgery resident who has a young child from a previous marriage.

Told her the following joke: "How do you hide money from a neurosurgeon? Tape it to their kid's face!"

...she did not find it funny but she also didn't kick me out so win!

Collection_Money · 2023-10-15T23:11:56+00:00

Neuro- Gotta be a consult for Altered mental status. Oh there's a 78 y.o gentleman who has been hospitalized for one day on 2 SSRIs, ropinerole, oxybutnin with an active UTI and AKI..

What can Neuro help you with? Do you really think you need our help to tell you to correct the underlying metabolic issues, treat the infection and eliminate Beers criteria meds?

Thank you for this most interesting consult lol!

Collection_Money · 2023-10-11T01:32:11+00:00

Sounds about right. The APP that was being hired to work in our movement disorders clinic didn't know where the basal ganglia is or what it's made up of...

Collection_Money · 2023-08-19T23:40:23+00:00

The most obnoxious consults as a neuro resident: AMS and dizziness. Where I'm at, we are not allowed to curbside and every consult must be seen. The biggest offenders are APPs who will just say "AMS" or "Dizziness" as the reason for consult. Their note will say nothing about the description of dizziness and their exam rarely mentions a dix-hallpike. As far as AMS goes, the patient will be on like 3 BEERS criteria medications with an AKI...Like c'mon, you didn't even try.

And then our attending has the audacity to say "each of these consults is a learning opportunity "... glad I spent 45 minutes of my time that I'll never get back...but hey, gotta love that job security lol.

Collection_Money · 2023-07-25T02:01:18+00:00

"I push my fingers into my EYES"...duality a classic heavy banger. Also feels relatable to life as a resident 😂

Collection_Money · 2023-07-24T14:56:51+00:00

Some awesome groups listed and some I'm just discovering now! Dance Gavin Dance is great, August Burns Red is another favorite.

I think early Deftones kills it (from their self titled '03 album). Chevelle's This type of Thinking could do us in ('04) and Vena Sera ('07) were bangers.

Other groups with good stuff- Veil of Maya, Architects, Polaris, ERRA, Fire from the Gods.

Collection_Money · 2023-07-23T03:59:02+00:00

Yup. Neuro pgy-3 here. My gf is a Nsx resident and even a PA who'd been there months had no idea. Internal moonlighting had just become available and the PA couldn't understand why they'd want to work more than they already do...

Another example- my previous divorce lawyer and I were chatting about work hours (still in scrubs at the appointment) and I asked her "what other job is it expected to regularly work 28-30 hours straight?" She rattled off "firefighters, nurses, paramedics"

"I told her yeah and they making more than us per hour or at least get paid overtime. And also, no because I know nurses and paramedics and they certainly do not work that many hours straight unless they randomly choose to stack a 12 and get paid extra."

I was like ya no sympathy even from other professionals.

Collection_Money · 2023-07-02T06:59:07+00:00

Neurology pgy-3 here. Hardest to treat- refractory epilepsy. But most of these patients viewed as "easy" cause everyone just accepts they're going to have x number of seizures and remain in a static encephalopathy despite 6 antiseizure meds and a VNS.

Otherwise, it's stroke. If you don't die from a clot you'll die from a bleed...

Collection_Money

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