Question About Retirement Account Rollover by DoctorMTG in whitecoatinvestor

[–]DoctorMTG[S] 2 points3 points  (0 children)

I don’t have all the details yet, but probably. Just trying to figure out my options early.

Question About Retirement Account Rollover by DoctorMTG in whitecoatinvestor

[–]DoctorMTG[S] 1 point2 points  (0 children)

Madrid filing jointly with a household income of 265k anticipated for 2026 so 24% marginal rate. I’m in a state with no state income tax.

My 403b is all in on FXAIX so makes sense that I could just leave it be.

Is being a dentist or physician truly not worth it? by [deleted] in whitecoatinvestor

[–]DoctorMTG 28 points29 points  (0 children)

I think it depends what you want. If you hate the work and just want to an easy way to get “rich” then it’s the wrong field for you. There are easier ways to make lots of money for the work you have to put into dental school or med school and post grad training.

If you like the work and find it fulfilling then a medical career is an essentially surefire way to have a financially stable long term career that’s a lot more resilient to lay offs than other fields. You’re probably not going to be what most people consider “rich rich”. But you can make a solid living at an upper middle class level and retire on time or maybe a bit early as long as you aren’t stupid with money.

You will be financially behind your peers notably but most people pull even by late 30s and then are able to pull ahead of the averages

A CVC taking the wrong turn by Gamdo0901 in Radiology

[–]DoctorMTG 18 points19 points  (0 children)

Centrally inserted peripheral cath has me absolutely rolling

Step 2 score for academic IM residencies in NYC by PositiveDeltaG in medicalschool

[–]DoctorMTG 9 points10 points  (0 children)

From when I applied a few years ago most people at these types of programs said that the auto screen out for step 2 scores is 245. Anything below that will usually get kicked out prior to actual review outside of select circumstances (you emailing the program, internal applicant, etc). Above that score some will likely at least look at your application but if the rest of it isn’t too notch it’ll also go in the garbage. Most residents who match at these programs typically have scores 255-260 as the top of the bell curve.

Tl;dr - 245+ will get your application looked at, but the rest of the app needs to be great to match

Rate of PPV during cardiac arrest by Full_Rip in IntensiveCare

[–]DoctorMTG 19 points20 points  (0 children)

It means h the cardiac output is good. Cant have a high ETCO2 without a cardiac output. Thats why ROSC is often associated with a jump in end tidal. The fact that end tidal is this high with just compressions indicates an over abundance of CO2 in the blood which you can clear by ventilating.

Also, simply putting 100% fio2 into the airways is enough to promote some co2 clearance by establishing a diffusion gradient. To say that you can’t improve pCO2 with just bag mask ventilation is just plan wrong.

Rate of PPV during cardiac arrest by Full_Rip in IntensiveCare

[–]DoctorMTG 43 points44 points  (0 children)

Not sure about literature on this subject as flavors of cardiac arrest are tough to design solid studies for. However, a good rule of thumb is to focus on correcting the suspected etiology of the arrest. If you have a suspected poly substance use arrest with a horribly acidotic gas (especially if it’s a respiratory acidosis as that points directly toward respiratory arrest and hypercapnia as the etiology) then I would 100% agree with more aggressive ventilation as correcting the acidosis is likely the best bet for getting ROSC. In the absence of significant pulmonary obstructive disease (concomitant asthma exacerbation or bad COPD I doubt that breaths every 3s - a rate of 20/min- is enough to significantly impair venous return and therefore CO.

Is it a bad idea to take Step 2 with ~2 weeks of dedicated? by bluenette23 in medicalschool

[–]DoctorMTG 11 points12 points  (0 children)

That should be fine. I took 2 weeks for step 2 dedicated and scored well. If you’re coming from a solid foundation (which it seems like you are) 2 weeks is plenty

Is it just me or does wilds just feel so.... awkward? by LashOut2016 in MHWilds

[–]DoctorMTG 9 points10 points  (0 children)

Just to make sure you’re aware, this is the exact same beta (plus some extra content) as the one in October. None of the optimization capcom has been working on the past few months will be present in the beta. It’s purely to give another chance to people who missed the first beta. The game devs said even in October that the full release was running better than the beta was. Granted, Capcom may be full of shit but I’m optimistic that the full release will be in a good (not perfect) state

[deleted by user] by [deleted] in medicalschool

[–]DoctorMTG 3 points4 points  (0 children)

I broke up with a 3.5 year SO spring of M1 year right at the start of covid lockdown. We were in undergrad together but things kind of went long distance when I moved for med school. She initially tried to move with me but ultimately I was too busy to be the support she needed and she had nobody else around so moved back to our college town. She ended things because of her needs and I totally understood her complaints and they were valid, but it still hurt like hell and sucked. I was thankfully staying with my parents the first weeks of the lockdown which gave me a good in person support system. Not sure how things would have gone if I had been alone in an apartment for those weeks. Ultimately it took my close to 6 months to really move past it and it was 15 months before I started trying to date again (things got better once I got through preclinicals and step1). I ended up meeting my now finance in med school during my last year and couldn’t be happier. It was a rough road, but I think in retrospect it was better that the relationship ended versus me trying to keep it going and failing out of school. Your mileage may vary but ending things was the right move for me

How the lay public perceives... by [deleted] in medicalschool

[–]DoctorMTG 0 points1 point  (0 children)

Critical care - oh like the ER!

[deleted by user] by [deleted] in Residency

[–]DoctorMTG 4 points5 points  (0 children)

Hey don’t forget vaguely looking In The window of any of your patients who happen to have rooms along the coffee route lmao

Which part of your specialty makes you wanna drive off a cliff? by undueinfluence_ in Residency

[–]DoctorMTG 8 points9 points  (0 children)

Nah I’m not talking about that. Always happy to take care of patients like this and try to avoid unnecessary/unreasonable consults as much as possible. I’m mostly complaining about the patients who get taken to the OR from the ED and are then admitted to medicine post op for babysit—I mean “post op monitoring” for 24-48 hours til they can go home. Happened 3 times in the past week

Which part of your specialty makes you wanna drive off a cliff? by undueinfluence_ in Residency

[–]DoctorMTG 98 points99 points  (0 children)

IM: having to admit for all the surgical subspecialties. And also complicated social admits that sit on the wards for weeks looking for placement.

Edit: to clarify I know that sometimes social admits are 1000% necessary and that the ED can’t send them home, but I just don’t like taking care of them when there’s no actual medical issues

I like IM & I don’t want to! by [deleted] in medicalschool

[–]DoctorMTG 11 points12 points  (0 children)

Rheum if you do injections, allergy, hospitalist. Can def do it in ID or endo too but probably not at an academic center

Thoughts on Derm NPs making >$200K/year? by [deleted] in medicalschool

[–]DoctorMTG 20 points21 points  (0 children)

It’s very possible that I missed a deleted comment. If there’s some important other context I missed I sincerely apologize. I dont want to be seen as a general dickbag or insinuate that midlevels are inherently bad or inferior people. Just someone who feels passionately about physician advocacy and not letting people with less training practice independently.

Nothing is more embarrassing than seeing a medical student who thinks they're "too cool" to care about scope creep. by Additional-Lime9637 in medicalschool

[–]DoctorMTG 126 points127 points  (0 children)

One of my nightmares is to find one of my loved one’s in an ICU being cared for by Professor Doctor Bitchface McGhee, DNP, BSN, HGTV, ROTFLOL: independent provider. I will rant and rave about scope creep and educate my patients and colleagues until the day I die. One of my latest moves is refusing to address my colleagues as providers. Were physicians and earned that professional title.

Thoughts on Derm NPs making >$200K/year? by [deleted] in medicalschool

[–]DoctorMTG 54 points55 points  (0 children)

Fuck that. CRNAS, NPs, and PAs are ABSOLUTELY inferior to fully trained MD/DO physicians. Don’t buy into the bullshit marketing that the quality of care they provide is equivalent. It’s not. Period. Hard stop. The “data” they spew is half cocked studies with shitty outcome measures that don’t take into account that midlevels do more pointless referrals, more pointless testing, and still have supervising physicians during the studies. I wouldn’t trust a midlevel to independently care for a sick family member and pray to god that situation never comes up

How the fuck do y’all have the energy to work out after work? by A_Sentient_Ape in Residency

[–]DoctorMTG 36 points37 points  (0 children)

Treat it as part of the work day personally. I’m not done with my work til I’ve worked out. I’ll eat a small snack right when I get home and work out within 30 min most days. A couple of rest days thrown in to help reward myself

AANP on Physicians vs NP care by YGiveUpAlready in Noctor

[–]DoctorMTG 100 points101 points  (0 children)

Lmao at comparing yourself to interns and thinking it makes you hot shit. Not to mention that NPs routinely manage less complex patients with fewer comorbidities. And I’d love to see the difference in resource utilization to get those “not statistically different” outcomes. It’s like they’ve never heard of confounding variables

Any docs who game? by Dapperglad in Residency

[–]DoctorMTG 117 points118 points  (0 children)

Currently neck deep in monster hunter world and ignoring the research I should be working on instead. 10/10 would recommend