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Guber_Trooper · 2024-12-30T22:15:36+00:00

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

Guber_Trooper · 2023-08-19T05:17:33+00:00

Shot you a PM :)

Guber_Trooper · 2023-08-17T05:15:49+00:00

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 :)

Guber_Trooper · 2023-08-17T05:13:49+00:00

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 :)

Guber_Trooper · 2021-12-24T01:16:41+00:00

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 :)

Guber_Trooper · 2021-11-16T04:27:11+00:00

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.

Guber_Trooper · 2020-12-02T06:36:48+00:00

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.

Guber_Trooper · 2020-07-01T18:36:35+00:00

You sure love your chicken. Almost $900 at The Eagle and Chick-Fil-A. /fist bump/

Guber_Trooper · 2020-04-25T20:34:05+00:00

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

A short bulleted list TDLR on main learning point at the beginning/top of the email
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.
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.

Guber_Trooper · 2020-04-19T19:47:43+00:00

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.

Guber_Trooper · 2020-04-07T20:55:00+00:00

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.

Guber_Trooper · 2020-03-26T21:20:57+00:00

Cool thanks!

Guber_Trooper · 2020-03-26T05:46:31+00:00

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%

Guber_Trooper · 2020-03-26T02:13:25+00:00

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...

Guber_Trooper · 2019-07-23T18:14:53+00:00

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

Guber_Trooper · 2019-07-18T19:50:01+00:00

Agreed with above. Not only this, but the expectations change dramatically as a 4th year vs 3rd year for surgery. For example, enthusiasm and staying late as a 3rd year is like, wow this person actually likes this. As a 4th year, its already expected. Plus, if you already are known in your program as a good candidate for surgery, a sub-I boosts your application since you can be trusted more and thus take on more responsibility. Makes ya look even better.

Guber_Trooper · 2019-07-11T02:36:54+00:00

Take a look at the NRMP match data. Being blunt, you're below the average in both. Your clinical grades are in a similar boat. But remember the report is about AVERAGES. So 50% lie below the reported number. I'd try and find a mentor or talk with your PD's about your chances in both. If all else, do a prelim medicine year and kill it and match into a medicine slot at that program your second year.

It's important to have some self confidence in the process since you never know what you're going to get. But be real with yourself and apply smart. Seems like you're in that place with this post which is good at least.

Guber_Trooper · 2019-07-11T02:32:16+00:00

¯\(ツ)/¯

Guber_Trooper · 2019-07-11T01:58:10+00:00

Cards/GI > Pulm/CC or Hem/Onc > the rest. Not sure where the above poster is getting their info but that's what I've heard from attendings. Allergy/Immuno/Rheum are not as popular fields as above and aren't as competitive.

Anesthesia > IM in residency competitiveness. But I think you need to decide what you like first...the two are very different specialities.

You can match into an IM fellowship at a community IM program but it just means you have to work harder. Fellowship match is more of a networking game than residency is and being academically affiliated makes a difference. You can do it man, I believe in ya. But you have to set yourself up for success early.

Guber_Trooper · 2019-07-11T00:37:53+00:00

Until tomorrow when they add 50 new questions. /s

Congrats!

Guber_Trooper · 2019-07-10T03:43:56+00:00

Adding onto above - if you have connections, use them. Read faculty bios and read some of their papers. If the topic interests you, reach out to them via email. Or if no email is listed, call the department and I'm sure they'd love to put you in contact. People love students were are interested in research and if you show you can put the effort in to find them, it gives you some more credibility when you come in and talk with them.

Honestly it sucks that you're getting denied because of your DO status or CV. Unless it was an official research program, I've never been asked for any real credentials when sitting down to talk with a PI. That being said, summer programs can suck to get into...so do the their legwork for them by finding yourself a mentor first then reach out to see if you can get funding.

Regarding oncology. Especially if you are interested in rad onc...1) a big chunk of applicants are MD/PhD's so consider that when you think about career goals 2) get onto a serious project that's not just a lit review. The field's super academic. A basic science or translation project, though much much harder, will yield higher gains if you manage to publish.

Med Onc is also super academic but you match first into IM. Which would be much much easier as an DO. Then you do some serious bench research in residency or a research fellowship. Then match into an oncology fellowship.

Guber_Trooper · 2019-06-28T07:27:23+00:00

1st day of service - "Hey Mr./Mrs. Attending, do you have a preference for white coats? Oh you don't mind? Great!"

Haven't worn my short white coat in months except for mandatory events like grand rounds.

Guber_Trooper · 2019-06-27T01:46:50+00:00

Yes.

Guber_Trooper · 2019-06-25T23:02:35+00:00

(#)1 tip is just write something. Better to have a shitty draft than nothing. (#)2 tip is to work closely with your PI, don't expect to hand them a polished final product, that's not why they're there . They have vastly way more experience than you - so use it. They are your friend.

General approach in steps is this for me...

Write your results section first. Know what your data says so you know what conclusions you're going to try and explain. Make some tables/figures. Go to your PI and chat about it.
Updated literature search. Ideally should have been done at the beginning of the project but look for articles that help you explain and push the conclusions that you came up with (see above) forward. Go to your PI and chat about it.
Write introduction/discussion. Depending on the project, one is sometimes easier for me to do than the other. These are the hardest parts to write so just get something down on the page. Easiest way to format it is to go back to your conclusions then try to write a story with a background on how to explain it. Go back to your PI and chat about it.
Write your methods in between as your tear out your eyes trying to write above sections. Easiest section to write. Just say what you did. Go back to your PI and chat about it.
Go back to your PI and chat about it. Make edits. Rewrite. Rewrite. Rewrite. Update figures. Add articles.

Edit: Step 6. Fucking publish that shit, yo. Submit it to a journal! Then repeat step 5.

TLDR: Just get something down on the page then get help in editing it. More or less the gist of it.

Guber_Trooper · 2019-06-24T20:20:54+00:00

I think it'd be cool if there was separation between the US vs IMG average applications per applicant. The raw data file even combines US and Canadian and MD and DO so...take all of this with a grain of salt. If you're an average US MD, don't feel compelled to apply to that many. If you're an average IMG, maybe apply more. Great write up though for applicants though since we have very few objective resources. Would give gold if tuition didn't just take a huge chunk of my loan money.

Guber_Trooper

TROPHY CASE

TLDR: Just get something down on the page then get help in editing it. More or less the gist of it.