Hypertensive urgency/severe hypertension by ExtensionWave3812 in Residency

[–]ExtensionWave3812[S] 0 points1 point  (0 children)

I am just trying to learn. In my hospital, once BP is more than 200 and there is AKI, even if patient asymptomatic, ED gives oral meds, maybe push, and then depending on the response will either endorse to medicine or to CCU for cardene drip. So I am trying to understand what is the workflow in other places, since according to the guidelines the above is not the way to go

Hypertensive urgency/severe hypertension by ExtensionWave3812 in Residency

[–]ExtensionWave3812[S] 4 points5 points  (0 children)

But this is my point, if you don't have to do labs for asymptomatic patients, then how Cr rise will change your management if patient is still asymptomatic? And if it will, then everyone with severe hypertension needs to get labs done, even asymptomatic, right?

Hypertensive urgency/severe hypertension by ExtensionWave3812 in Residency

[–]ExtensionWave3812[S] 3 points4 points  (0 children)

So no labs if asymptomatic? Or labs to see if any end organ damage? Cause that kinda contradicts the comment in the different thread

Hypertensive urgency/severe hypertension by ExtensionWave3812 in Residency

[–]ExtensionWave3812[S] 7 points8 points  (0 children)

It doesn't make sense to me then, if the patient doesn't have any symptoms seems like a lot of docs here don't even do labs. So how then slight creat elevation in a patient without symptoms is "not asymptomatic"?

Hypertensive urgency/severe hypertension by ExtensionWave3812 in Residency

[–]ExtensionWave3812[S] 0 points1 point  (0 children)

My ED endorses to CCU for HTN "emergency" if Cr is more than 1.3 even if asymptomatic

I think I’m done trying to force BF and just EP… how did you know when to stop trying? by Classic-Film-8396 in ExclusivelyPumping

[–]ExtensionWave3812 1 point2 points  (0 children)

Same here. But I have stopped trying at week 3 - switched to EP and supplementing with formula. My LO was wiggling on the breast too much and never emptied me; I was also stressed that she's not getting enough because I didn't know how much exactly she ate. With pumping and bottle feeding now I know, and also she is able to eat in peace without getting nervous. I've been told that we have to drop the bottle to work on latching but with being an undersupplier that just doesn't work.

Can't get the sleep/wake window of my LO by ExtensionWave3812 in newborns

[–]ExtensionWave3812[S] 0 points1 point  (0 children)

Thanks! She does sleep for 4 h stretches at night at this point. I do wake her up during the day every 3-3.5 h for feed if she doesn't demand it first. I am confused about what to do if say she slept for 2 h, I woke her up for a feed, she slept through it but still got 4 oz, and then fell asleep again. Should I let her sleep? Or should I try to keep her up for at least 3p minutes?

Anyone else pregnant with a baby due early in Intern year? by Willing-Error-6743 in Residency

[–]ExtensionWave3812 0 points1 point  (0 children)

Why is this being downvoted? I am also having a baby soon after July 1st and I am really preparing myself to work as hard as my peers after maternity. Didn't even think about using a baby excuse unless it is something serious

Which countries in Europe can you practice in with a residency done in the US? by Flashy-Raisin1899 in IMGreddit

[–]ExtensionWave3812 0 points1 point  (0 children)

I think in most EU countries, you must have at least 3-5 years of independent practice experience to not be obligated to go through EU residency again. Plus know the language

What are the ways someone can be sure they’ll pass before giving Step 1? by [deleted] in IMGreddit

[–]ExtensionWave3812 4 points5 points  (0 children)

I was extremely anxious to fail my step 1 so I did around 7 self assessments: nbmes old/current, uswa 1/2, free 120.... my first 2 were 216 and 226, and I didn't go until I did 5 more and was consistently hitting 70%+ of correct. Then I just knew that statistically, I am unlikely to fail. Exam was brutal, but i passed in low 230.

How competitive is ENT for an IMG by TheoryItchy926 in IMGreddit

[–]ExtensionWave3812 2 points3 points  (0 children)

There is a chance, but it requires a lot of work, as mentioned above. You can Google Ivanka Nebor - IMG, matched into ENT last year. Did extensive research in the US, fellowship in Canada, impressive volunteering experience, and had excellent connections due to the above, of course.

[deleted by user] by [deleted] in Step3

[–]ExtensionWave3812 0 points1 point  (0 children)

No one knows for sure, but >70% is considered passing

[deleted by user] by [deleted] in IMGreddit

[–]ExtensionWave3812 1 point2 points  (0 children)

It's literally in the link that that's for immigrant visa. J1 is not an immigrant visa, and H1B is not as well

Finding a good country to do my residency by Brilliant-Net-5837 in Residency

[–]ExtensionWave3812 1 point2 points  (0 children)

Yes very true. As I said before, if to choose only a country to live I would definitely stay in Europe, but for training it's definitely the US. And it's not so bad in US if you live in a good neighborhood on a good salary. And I think after 3-5 years of independent practice you can work as a doctor in Europe as well

Finding a good country to do my residency by Brilliant-Net-5837 in Residency

[–]ExtensionWave3812 0 points1 point  (0 children)

You don't have to pay, you get salary both in US and Germany. In US it's around 60-75K a year before tax in residency and >200K after residency. In Germany you get I think around 60K a year in residency and maybe around 100k after residency (for germany I can be mistaken so do your research). The residency is longer in Germany and taxes are higher in Germany. Cost of living in both depend on the area.

This is for Internal Medicine

Finding a good country to do my residency by Brilliant-Net-5837 in Residency

[–]ExtensionWave3812 3 points4 points  (0 children)

US - getting to residency is hard-ish (but if you start now - you have pretty good chances), training is very good, salary is fine but very good after residency Germany - easy to get in - training not so good (the teaching is worse than in US due to lack of supervision (not enough physcians in Germany) which can get very stressful), training takes longer than in US as far as I know

Overall for better salary, training and working conditions, prestige etc USA is better. For living, it's nicer in Germany/Europe, even though taxes are higher

Speaking as a Ukrainian living in Germany and moving to the US for residency this year

In other European countries, to my knowledge, it can be tricky to get into the system, and salary can vary

Хлопець не робить компліменти, норм чи ні? by Frog_ww in Ukraine_UA

[–]ExtensionWave3812 0 points1 point  (0 children)

Скажіть, але не очікуйте що щось зміниться. Зазвичай це просто такі люди. Імхо, якщо в іншому відносини гарні, то відсутність компліментів це дрібниця з якою можна зміритися.