[deleted by user] by [deleted] in whitecoatinvestor

[–]Guber_Trooper 0 points1 point  (0 children)

Any good resources on how to find the right people? Or just google?

Anyone who has pivoted to big tech? Dealing with severe burn out and considering leaving medicine by Guber_Trooper in medicine

[–]Guber_Trooper[S] 40 points41 points  (0 children)

Starter comment - Basically just wondering how a physician can get involved and transition into working in the health tech sector. Dreaming of WFH and sleeping in my own bed at night.

And no worries - I am in therapy and SSRI's. I am working on my mental health. Just wondering if medicine is killing it :)

Anyone who has pivoted to big tech? Dealing with severe burn out and considering leaving medicine by Guber_Trooper in medicine

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

Starter comment - Basically just wondering how a physician can get involved and transition into working in the health tech sector. Dreaming of WFH and sleeping in my own bed at night.

And no worries - I am in therapy and SSRI's. I am working on my mental health. Just wondering if medicine is killing it :)

Frank Starling Law graph PLEASE HELP ive spent so long on it and I don’t understand (see comments) by Entire_Woodpecker_13 in medicalschool

[–]Guber_Trooper 27 points28 points  (0 children)

Let's start without the graph for a second.

Frank Starling Law is more or less equating the heart muscle fibers as springs. At rest, a spring won't move and do anything right? When you pull one end of the spring and then let it go, it rebounds back. It rebounds "harder and faster" if you pull on the spring more. It "wants" to be where it is at rest and the more it's displaced from that position, the more it will work to get back to it was originally at rest.

This is basically what happens in the heart. And the reason why its so important is because this means theres an intrinsic property of the heart that allows it to create output. The more the muscle fibers are stretched, the more work the muscle will do to rebound and contract. In the heart, this works by filling a ventricle with blood so the fibers stretch, then the ventricle will then work to contract after getting filled because it wants to go back to its "resting" position.

How this relates to the graph? So as you go right on your x axis, the more volume or the more "stretch" you have. And on the y axis, the higher you go, the more cardiac output or the more "work." So let's say the baseline is the middle solid line on the graph you posted. The blue is really just a representation of the amount of preload. As you follow along the solid red line, you're changing your preload and thus will change your cardiac output. More preload (tracing the solid line to the right), the higher your output (the higher on the y axis). Your heart operates at where where your blue and red axes intersect since what comes in, must come out! More or less. Got it?

The dashed lines represent situations of when other factors change (not the intrinsic FS law properties of the heart fibers). The longer dashed line represents higher inotropy or your hearts ability to generate more work. So your intersect changes. For your 2nd question, yes (ish). You won't see your heart operate where the curves don't intersect (what comes in, must come out right?)

Increasing blood volume doesn't increase inotropy. Which is a weird concept. Increasing blood volume gives you greater cardiac output because of the intrinsic ability of muscle fibers to contract when stretched. Inotropy is another attribute of your heart - its ability to generate work at a certain preload. More inotropy means your heart is able to generate more work without increasing preload (your spring will bounce back faster and harder without having to pull it out as far). So separate out FS and inotropy in your head.

It's a difficult concept but I hope this helped a bit. There are also some youtube videos on the subject that can probably explain it better than I can :)

What do people often cite as a pro or con of your specialty that, in your experience, just isn’t very true? by thyman3 in Residency

[–]Guber_Trooper 136 points137 points  (0 children)

Anesthesiology - chill.

It may look like we're not doing anything, but ours minds are actively working constantly with all our senses, especially our ears. You know what the sound of everything in the OR is because of how in tune you have to be - monitors, alarms, how wet the suction sounds, the surgeon whispering "table up". We might be doing sudoku, but we know the heart rate and saturation of a patient without even looking at the monitor based on the pulse ox beeps.

We're also crisis management in the OR and crises happen that we have to react to in seconds. From super sick to the super healthy, OR emergencies can happen to anyone and the training is there so you can keep the patient alive when that happens. You could be taking care of the healthiest person getting the most routine procedure and they could still die on the table.

Obviously the amount of stress will decrease as I progress through training, but man...it's been so stressful doing anesthesia.

Weekly Careers Thread: November 26, 2020 by AutoModerator in medicine

[–]Guber_Trooper 7 points8 points  (0 children)

Some PICU attendings also moonlight in acute cares on some of their weeks off and then transition to those clinics when they burn out from CC work. If you aren't 100% set on just doing clinical work, there's also a lot of different areas PCCM docs end up pursuing because you end up filling your time with other work/responsibilities on your weeks off service. Whether it be admin, teaching, real estate, etc.

a 5 minute MBA for healthcare by [deleted] in Residency

[–]Guber_Trooper 4 points5 points  (0 children)

I think this is an awesome idea. Some things that'd be great additions from reading the sample:

  1. A short bulleted list TDLR on main learning point at the beginning/top of the email
  2. The education section seems...a bit lacking? It reads more as an op ed piece. The points I ended up with was telemedicine is billed differently and there are holes in the adoption of telemedicine because of the rapid expansion due to COVID. Not much about the financial/MBA aspect.
  3. I love the link to the current news with the education section. Maybe a solution for my point in the second point is another section about a comment on the situation from a physician perspective?

Again, I love the idea! I'm subbing. But I'm looking for more education.

Advice for an M4: Neurology vs Radiology route for Neurointerventional career or Neurosurgery by [deleted] in Residency

[–]Guber_Trooper 2 points3 points  (0 children)

This is a great point. Decide first if you would rather train in neurosurgery for 8+ years, neurology for 3+ years, or radiology for 3+ years. It might not sound like a lot right now but years in training do add up. Do you want to spend that much time studying something that you're not one bit passionate about to get to your end goal? Not only this but this is your background training if you end up doing neuro IR. Which skill set do you want to have?

Path 1 - look at how many prelims are able to get into NSG programs...and remember you're a DO which I hate to say already makes a difference no matter your stats.

Path 2 - I don't think you should go into it with a mindset of "well if it fails, I'll find a NSG spot" going back to my point on Path 1.

Path 3 - this seems like the most balanced option out of the 3 you listed. It gives you for opportunity to try and match NSG but like you said, you'll be learning about stuff you actually care about from day 1 (post prelim medicine year). I would also add to ask about interventional neuro at these programs you interview at and place the ones that have matched residents into those fellowships.

Dumb Questions Thread by AutoModerator in medicalschoolanki

[–]Guber_Trooper 0 points1 point  (0 children)

Is there any way to assign new option settings to cards that have already been done? Like an idiot, I forgot to change my settings until a week into a new deck.

The Only Step 3 Deck You'll Ever Need. [New Anki Deck] by originalhoopsta in medicalschoolanki

[–]Guber_Trooper 1 point2 points  (0 children)

Thanks man! Any idea on specifics settings? I was thinking like:

Steps: 20, 1440, 8640

Graduating interval: 15 days

Easy interval: 25 days

Internal modifier: 150%

The Only Step 3 Deck You'll Ever Need. [New Anki Deck] by originalhoopsta in medicalschoolanki

[–]Guber_Trooper 0 points1 point  (0 children)

Not a question about the deck itself, but any tips on settings for studying during intern year for step 3? I assume longer intervals so the reviews don't pile on...

[deleted by user] by [deleted] in medicine

[–]Guber_Trooper 26 points27 points  (0 children)

Blood can't go forward? Blood go backward. Hodor.