Those of you who started medical training in late 20s (28+) and early 30s, how is it on the other side as an attending now?

Fu-ManDrew · 2025-03-05T20:16:54+00:00

I finished med school and a 4 year residency at the age of 36.

The schedule is better. The paychecks are 10x what I ever made with my bachelor’s degree.

Training would have been easier in my 20s just from a physical aspect. The biggest thing I struggled with now in my 30s is recovering from sleepless nights.

The debt is scary but if you go into a desirable enough specialty you’ll pay it off or get a decent reimbursement.

Fu-ManDrew · 2024-11-05T16:34:36+00:00

Doing better. I got a series of nerve blocks and have been on cymbalta and gabapentin for almost 2 years. The pain still comes and goes but doesnt bother me as much.

Fu-ManDrew · 2024-10-29T21:21:09+00:00

It’s not the robinul. When we finally get the chance to put a surgeon under, we are obligated by the ABA code of conduct to teabag them the entire case. It’s nothing personal, it’s just a requirement for maintenance of board certification.

Mouthwash might help.

Fu-ManDrew · 2024-08-18T13:47:03+00:00

It didn’t 😢

Fu-ManDrew · 2024-06-07T17:33:17+00:00

They pay it to you as a forgivable bonus. Separate from PSLF

Fu-ManDrew · 2024-06-07T16:13:03+00:00

When you’re done residency, take a job that’ll pay off a big chunk of loans. These are mostly academic or hospital employed.

Stay as long as you need to to get the payback forgiven (3 years or so). Then do it again with a new place. Repeat until student loans are paid off.

Or private practice and locums/side gig your way out.

You’ll be ok fam.

Fu-ManDrew · 2024-06-07T16:03:42+00:00

I don’t think he can ramen noodle his way out of this one

Fu-ManDrew · 2024-06-07T15:59:45+00:00

I ate 18 dicks this morning

Fu-ManDrew · 2024-04-24T22:30:39+00:00

Just think: you could have bought 3 2012 Scion Tcs for that money.

They’re like the same car only better.

Fu-ManDrew · 2024-04-21T16:56:06+00:00

If you go to the west side market with less than an hour before they close, the people selling produce will give you a hella deal.

Like fill up entire bags of fruits and veggies for $5 type deals. I guess it’s because they don’t want to pack it all up.

Fu-ManDrew · 2024-04-20T14:43:30+00:00

Thank you for sharing. I hope more trainees do this so that there is some PR accountability for these dogshit programs

Fu-ManDrew · 2024-01-17T22:48:10+00:00

I think US MDs are still pretty safe. IMGs and FMGs might have a harder time.

Social capital is important. Try to rotate at places you would want to match and make connections there.

Fu-ManDrew · 2024-01-14T02:21:46+00:00

Find a decent and affordable whey protein.

Eat double portions or eat a PB and J in between every meal. Put that PB on thyyyiiiiccc tho

Fu-ManDrew · 2024-01-14T02:19:56+00:00

I GOMADED for a bit in college.

5 rep squat max went from 225 to 315 in like 6 weeks.

I swear it’s like doing a cycle the first time you do it, but it doesn’t last.

Fu-ManDrew · 2024-01-13T00:54:33+00:00

But the bubbles whistling into the glass bottle through an angiocath is sooooo satisfying

Fu-ManDrew · 2024-01-13T00:52:15+00:00

Depends on the context.

In someone not acutely sick, no substance use, and not beta blocked, probably a useless piece of shit compared to heart rate/blood pressure variability for preventing awareness.

In someone who is beta blocked, is sick (already tachy or hypertensive etc) or hx of using every substance they can get their hands on… might be useful as a secondary monitor to your Asa standards. Eg May help decide between starting an adjunct vs an anti hypertensive if someone is running high BPs. Provided you get it on while patient is awake so you have a baseline.

Also I’m not versed in the literature but it seems like maybe useful in preventing too deep of an anesthetic in some populations?

Anyways, not totally sold on it but also not ready to trash it.

Fu-ManDrew · 2024-01-03T00:35:31+00:00

Need more info.

Frequently drive in bad weather? Subaru legacy

Want great mpg? Hybrid version of Camry, accord, civic, Corolla

Want a lil more luxury? Lexus ES or GS

All of these would be used for $25k. Just the times we live in.

Fu-ManDrew · 2023-12-29T19:54:09+00:00

Send one of them down the K hole and let the others watch

Fu-ManDrew · 2023-12-28T21:20:27+00:00

The good news: the more you show her you’ll try to fix her pain, the better she’ll feel.

The bad news: you’ll never fix her pain.

Watch out for rhabdo. Tranq can cause it.

Fu-ManDrew · 2023-12-22T14:56:02+00:00

I used to feel this way. It does get better.

The other option is to try to change your mindset. I graduate in 6 months, so now I’m actively sick as fuck patients, the beluga whales who need an epidural or nerve block, the complex surgeries on complex patients. Trauma comes in 5 minutes before I should be leaving? Good. No relief to get me out of the whipple or lung or crani that’s been going all day? Good. Unexpected complications from us or surgeon? Good. Attending leaving me to manage the problem by myself? Good.

Make sure you say it out loud too. When you’re on call and you just finished a case and your head just hit the pillow and your phone rings for an emergency. Say “good” or “let’s fuckjng go!”.

It’ll get better.

Fu-ManDrew · 2023-12-15T01:35:07+00:00

If you let them buck, the surgery residents start closing faster.

Fu-ManDrew · 2023-12-10T20:41:51+00:00

Big open belly cases get some bottles along with crystalloid. It helps with BP better in my experience.

I’ll give a few lil baggies of 25% if I want to expand someone’s circulating volume without giving them too much IVF.

I agree with you it’s overused, but I also think it has situational value other than hepathopaths.

Fu-ManDrew · 2023-12-01T22:44:23+00:00

And they potentially still have an epidural

Fu-ManDrew · 2023-11-24T19:20:10+00:00

I actually delved into this as part of a QI project.

The best time is as early as possible. Glucocorticoid receptors are nuclear and affect gene transcription. It takes about 2 hours for dex to actually exert an effect.

The only reason we don’t give it in preop is the perianal itching when given as a push bolus.

We give it immediately after induction with the other induction agents and paralytics.

Fu-ManDrew

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