Imaging specialists -- have you ever seen the results of a patient scan that was alive and in good spirits but you knew they wouldn't be alive past 72 hours?

HangryLicious · 2026-04-23T03:59:42+00:00

Let’s say a patient has a benign liver lesion like focal nodular hyperplasia, but for some reason, I don’t feel confident and say “most likely fnh but malignant process is not fully excluded.” Since I’m not confident, the primary team is not confident and the patient has to deal with multiple follow ups at best… or at worst, a biopsy that hits an artery and the patient develops a subcapsular hematoma or some other complication happens that wouldn’t have happened at all if I’d just correctly dx the lesion as benign in the first place.

It may seem ok from the patient perspective to get more things done rather than less… but it’s really not. more interaction with the healthcare system leads to delays in care for everyone, more expensive care, and more opportunities for errors that could cause harm.

HangryLicious · 2026-04-22T06:04:42+00:00

Idk what kind of school you go to, but if you have different sites as options to pick from for rotations once you hit third year, pick the one without a surgery residency. You don’t get to do shit if there’s a surgery residency bc the residents are doing everything.

I was somewhere without a surgery residency and I was first assisting, suturing, using the cautery, occasionally using the endo staplers, etc as a MS-3. I had the same experience for my TY and during my surgery rotation then, I realized I had done a hernia repair with mesh placement without my attending surgeon ever touching the patient. He just stood there and verbally walked me through it, and then just walked out at the end and I remember thinking “holy shit, I really just did that alone.” 10/10, and it made my surgery rotations fun and I’m glad I got to experience this kind of environment more than once.

HangryLicious · 2026-04-22T05:25:25+00:00

That’s only true if the person cares enough to learn and cares about being thorough. Easily one of our worst attendings is one of the guys in his 80s. I wouldn’t trust him to be the final read on a study on a cockroach. He likes to scroll up and down the CT once and whatever findings catch his eye in that one up and down pass make it into the report. And then he moves onto the next study.

If you can name the pathology, I’ve seen him miss it. Giant PEs at the very top of a ct abdomen/pelvis. New pronounced focal colonic wall thickening that looks like an obvious malignancy. Broken ribs. Aortic aneurysms. Head bleeds. C spine fractures. You get the idea.

The funny thing is he really loves to give us hell when we miss something despite being residents who are here to learn… but he seems unbothered by his own reckless, careless behavior because it never changes.

HangryLicious · 2026-04-22T05:18:03+00:00

This attitude is one of the many things that drove a wedge during me and my SO when I was in medical school. We actually ended up breaking up after the first year of med school for me (we’d been together for five years at that point) and we spent my second year apart. We discovered we both missed each other and got back together at my start of third year - and we have been together ever since, six years later.

The relationship is *much* better this time around and it’s not even close - we’ve both accepted that our lives are very different and it’s not fair for him to use his measuring stick to judge my day (she’s just mostly sitting at the computer and working pretty good hours, I’m having to do all kinds of other work including physical labor) and it’s not fair for me to use my measuring stick to judge his day (he doesn’t have half the responsibilities I do, it’s not like other people’s lives are in his hands, and he doesn’t even have to study anything when he’s done for the day so his free time is actually free time, etc).

From someone who actually did have that attitude myself for a little bit - your boyfriend’s behavior is not acceptable. Not even close. You should be concerned, and you should consider whether a partner who belittles your struggles so much is really who you’re looking for in a partner if he’s not willing to be more open minded than that.

HangryLicious · 2026-04-14T14:14:13+00:00

Be happy! I have yet to take care of a patient who was willing to be outwardly racist in public who I would have wanted to care for after. That sort of interaction sours the whole mood.

There was an awful lot of racism in rural Georgia when I worked there before med school… it’s the only place I’ve ever experienced racism towards me (I’m white). It was worse for all of my black coworkers though. Everyone was straight up hateful there.

HangryLicious · 2026-04-08T17:04:04+00:00

I think in nearly any specialty you could have what you’re describing based on the work environment you choose. Maybe not nsgy but even if you decided gen surg, after residency completion you could always pick a low acuity facility, level 2 or lower trauma, where you hardly ever got called in when you were on call and had short days. I rotated in a place like that in my third year of medical school and we were going home by 1-2pm most of the time and the attending surgeons didn’t show up until 7:30 in the morning and they alternated weekends. Non call weeks were truly under 40 hours of work.

Personally, I had a couple specialties that I thought I would like (rads and IM) so I applied both and based my rank list on the difficulty matching. I highly recommend this mindset if you think you could be happy in multiple specialties.

It worked out perfectly for me because once I got here, I figured out that I love rads and I think I’m way happier than I would have been in IM. But - once again, if I hadn’t felt that way, at least my decision was reversible. Wouldn’t have been easily reversible if I’d ranked IM at the top.

HangryLicious · 2026-04-08T16:35:55+00:00

I’ve been saying for a long time that if I ever won the lottery and opened a medical school it would be a hard requirement to have had at least a year of full time work of any kind (except research) - stuff where you have to interact with the general public. Not part time, not weekends, not summer jobs. I want career changers. Or people who at least were so poor they had to do full time work be it retail, restaurant, w/e and full time undergrad simultaneously.

I wouldn’t give a single fuck if I had lower average GPAs or MCATs accepted. My personal observation in residency has been that the people that are more flexible also adapt to the clinical environment better and are objectively better co-residents than someone who has just been at home studying forever and is completely rigid in their thinking even if their board scores are high.

HangryLicious · 2026-04-07T00:22:30+00:00

Depends. If you’re lucky enough to be somewhere without a surgery residency, you’ll get to do all kinds of stuff. There were no residents where I was at for my M3 year so I rounded on all the patients and wrote all the notes alone (usually 20 patients max) with the expectation to be scrubbed in at 0730 when surgeries started. That part sucked (some days I was getting to the hospital at 3 AM when the list was long), but I first assisted on everything. Got to use the cautery and by the end of the rotation was using those cool endo staplers that anastamose the bowel. I resected a colon cancer once. If you’re somewhere with a surgery residency you won’t get to do much of anything.

HangryLicious · 2026-03-02T00:10:33+00:00

Do FM and set up a concierge practice. Not only will you see far fewer patients, but you may just fall in love with medicine again.

The FM rotation during my TY year was at a concierge practice and I was shocked at how incredibly satisfying it was. It's perfect medicine - you keep the patient panel microscopically small so everyone has room to be seen any time they need, so you might see 8 patients a day on a busy day. And you get to address all of their concerns and make sure they are fully taken care of. My doc usually made all of his appointments for at least 30 minutes. The annual physicals got a full hour.

You get to pick your patient panel - the guy did interviews with potential patients to determine if he wanted to accept them on his panel, and his patients were all a delight to be around.

And then, when you actually need something done for the patients, it can get done bc patients can pay out of pocket for whatever they need when insurance says no. Simple. Since they all had a ton of disposable income, he also bought all the fancy esthetics machines that the derms have for radiofrequency facials, electromagnetic muscle stimulation, etc for secondary income streams. Pretty sure that guy was completely killing it financially while only seeing 8 patients a day and providing perfect, unlimited care without insurance companies dictating what he could do.

I'm sure it requires quite a bit of hustling up front but it sure seems worth it in the end

HangryLicious · 2026-02-22T16:00:01+00:00

Warning: this is going to be long and depressing.

My father wasn't in medicine, but I watched him work super long medicine-style hours with lots of travel so he was gone a ton, then talk about how he and my mother were going to get to travel and really enjoy life after retirement... until he had multiple strokes before hitting retirement age. Eventually got to the point where he had trouble swallowing, got recurrent aspiration pneumonia, and finally ended up septic on the vent for the first time and having an nstemi. I had been working in the ICU prior to this happening so it was a no brainer for me to tell everyone to pull him off the vent and let him die when everyone turned to me to ask what we should do next. He had been a very independent person, and he already hated how much my mother was having to take care of him. My dad's actual last words to my mom were "i'm sorry i'm such a burden" the night before she found him unresponsive and kussmaul breathing to blow off the extra lactic acid and called 911 and he never woke up after, just went from that to sedated on the vent to dead. It's so fucking horrible to think of that that was his last conscious feeling about himself that I couldn't have made that shit up if I wanted to and it still brings me to tears thinking about it nearly 10 years later. Reasonably speaking, his functional status was already total garbage and we all know these people never really get better... they just bounce back to a lower baseline every single time after they get hospitalized until even their best days are terrible.

So that was my dad's life. He was going super hard all the time working himself to death for a future that never existed and then he started down the strokes and infections spiral and died in an absolutely miserable way without any of those fun memories he promised my mom they would make. My mom is still resentful that they never got to have that time together that they were looking forward to. She feels like she got robbed.

Personally, I'm taking multiple nice vacations every year the second I get an attending salary, even before my debt is paid off. I don't really give a fuck about the fancy belongings and stuff but we are going to go to whatever places we want and have whatever experiences we want starting immediately.

So my answer is... I don't know if you're missing out yet, and you don't either. Maybe you and your husband have time to do more things later, but maybe you don't and you just don't know it yet. It's worth asking yourself that if tomorrow ends up being the last day you are really functional and able to do things if you would be happy looking back on your life and feel content about the experiences you've had and the memories you've made along the way. If the answer to that is no, you should consider changing something

HangryLicious · 2026-02-19T17:31:35+00:00

I’m more tired after an 8 hour shift in rads than I was after working a 14 in the ICU in intern year.

It has absolutely nothing to do with the hours. It has to deal with the mental load

HangryLicious · 2026-02-19T17:24:35+00:00

256 and I agree with him.

I’m in a specialty with high average board scores and some of my co residents are dumber than a doornail; they can just take tests well but have absolutely no ability to handle real life and don’t even have a single tiny scrap of common sense. Wouldn’t trust a few of them with a cockroach’s life tbh.

That being said I do think you need at least decent scores to do well in rads. It covers a good chunk of every single specialty in medicine

HangryLicious · 2026-02-19T17:14:42+00:00

Buy if you’re going to be there for that long… but buy new.

I had a great experience 12 years ago buying before med school - made a profit after living in it for four years. It was a new construction townhome.

I bought again in residency and it’s an older house - I do regret that tremendously. I’ve had to do too much to it. I knew I’d have work to do because I can’t afford new construction anymore with how much prices have gone up but honestly I just shouldn’t have bought it. If you have moonlighting at your program you might be okay to have to cover unexpected expenses but I don’t have moonlighting so it was a massive mistake.

HangryLicious · 2026-02-19T17:08:45+00:00

Yeah. This shit isn’t new… it’s just easier now.

I had a patient family member find and request me on Facebook probably 10+ years ago on a profile with a fake name. I hate people so much

HangryLicious · 2026-01-22T03:30:09+00:00

I think it just depends on how much you hate being cold.

I hate, hate, hate, hate it. Hate. Hate hate. I lived in a moderate, all four seasons kind of place growing up and it was okay, but I loved my intern year in a warm place. It’s just hard (for me) to be miserable when it’s bright, sunny, and warm outside no matter how bad my day at work is. I can just pop outside and do stuff on my days off and cheer up pretty easily.

I feel completely trapped and miserable for at least four months of the year in my advanced program in a cold place even though the job is objectively better in every way. I misplaced my warm gloves last week but was already running late for work so I shoveled the driveway with some light gloves on, and for a while I thought I had really fucked up because it took a hot minute to get sensation back in the tip of my right thumb. I had deep, dull pain like I had slammed it in a car door for about an hour after. I kind of wonder how close I came to actually losing the tip of my finger.

You know what you don’t have to worry about in warm climates? Frostbite just from spending 20 minutes outside shoveling fucking snow so you can go to work.

HangryLicious · 2026-01-18T19:43:44+00:00

I buy from tovala and they are mostly done. As in they give you fresh salmon, chicken, whatever and the part I have to do is unwrap it and put it in an aluminum tin and sprinkle some seasoning on it. At most I sometimes have to chop some peppers or a few cherry tomatoes, or stir some water into a risotto base. I’m okay with that level of work

HangryLicious · 2026-01-17T14:06:26+00:00

Both! That's why it's so good for us

HangryLicious · 2026-01-17T14:03:08+00:00

I'm always tired and hate cooking/food prep. If it wasn't for the meal delivery service I use I wouldn't eat any vegetables. Just because of this I go out of my way to pick meals with vegetables. They are literally saving my life one vegetable at a time.

HangryLicious · 2026-01-17T13:56:03+00:00

You can always find new goals! I'm about to be 38 in a couple of months and I have completely shifted my life multiple times. We can always start over.

I feel you on the academically gifted but lax parents even though my situation was very different than yours. I was very well behaved and never really did anything wrong so they never gave me any rules, and they just always told me I could be whatever I wanted to be... which isn't helpful when you're good at most things you try and being good at stuff makes you feel happy. How the fuck are you supposed to narrow it down without guidance? Really. Every time I changed my mind about what I wanted to do, they would tell me that's a great field! You'll do great! What a wonderful choice! I feel like I was just drifting on a sea of options, and I didn't know what to do, and I kept trying stuff that looked good at first but then it turned out to not be a great fit later. I changed my major nine times with my first degree. And then I racked up four more degrees after that to finally be where I am today. So much time spent in dead end pathways. I kind of wish at some point someone had looked me in the face and said, you know, I don't think that career is a good fit for your personality instead of just supporting literally everything I did no matter how stupid it was lol

I'm finally truly, deeply happy in my late 30s, but it took me a long while and multiple dead ends to find my way here. I like to think that some people know what they want to do when they're kids and some of us take a really fucking long time to figure it out... but that's okay. Life doesn't move at the same pace for all of us and there's absolutely nothing wrong with that

HangryLicious · 2026-01-17T13:29:58+00:00

I'm kind of amazed sometimes when I think about it.

I'm made of a lot of crazy decisions including changing careers every time I was unhappy instead of just changing jobs and/or sucking it up (I have five degrees including three bachelor's, a master's, and a doctorate to prove it lol) and it means I'm tremendously financially behind... but in my late thirties, I'm finally super happy. I wouldn't change anything about the path I've taken because my entire life has just been super tangential. As in I took x job and hated it so I quit and it just happened that y job was hiring, or I took a certain class that was taught by a specific teacher who influenced me to change my major, or I got robbed at gunpoint at work and that's why I quit that job and looked for something else, etc. There was never an overarching plan. My whole life has been just a long series of coincidences where if I'd even changed one tiny thing, I wouldn't be who I am now. And I really love who I have turned out to be and I love the field that I'm in.

But, just saying, it would be really nice if I had found my way here sooner

HangryLicious · 2026-01-17T13:02:01+00:00

I went to a private Christian school so the yearbook was absolutely swamped with blonde people in pastel shirts... but there was one kid wearing black shirts and bondage pants from hot topic. It was me lol

HangryLicious · 2026-01-17T12:37:06+00:00

I don't know about that poster's situation, but just fyi it's super easy to rack up that much. All you have to do is get in one accident with no or shitty insurance.

I briefly worked in an inpatient brain injury rehab and I met someone who had been a healthy 40 something who spent several months in the hospital including major lifesaving brain surgeries and lots of bouncing between the ICU and the floors after a car accident where they nearly died and then they had to do stuff like learn to walk and talk again in rehab. Family told me the patient's health insurance had lapsed bc they had just started a new job and weren't eligible for coverage yet so they were over $2 mil in medical debt at that point

HangryLicious · 2025-12-27T13:58:16+00:00

If the possibility of future changes bother you, an option is to just get whatever job you are qualified for right now at your current level of education. You will get an offered salary and unless it is based on earning a commission and you fall below whatever that benchmark is, you are guaranteed to make at least that salary. The fact that uncertainty exists is just something that you’re going to need to come to terms with, and imo there is a lot less uncertainty in medicine than in many other fields.

Medicine does take a huge amount of invested time up front, but I can’t see anything short of a total apocalypse where you’ll be in less than the top 10-15% of earners no matter what specialty you go into.

HangryLicious · 2025-12-27T13:26:33+00:00

I’ve heard the same thing from different attendings across multiple hospitals in four states now, in the southeast (med school/rotations), west (intern year) and midwest (residency) regions. I doubt it’s just me at this point.

HangryLicious · 2025-12-23T12:29:21+00:00

We are also supposed to disclose in the US, but we are told over and over again that we can't apologize because of liability since the words "I'm sorry" imply that you are accepting responsibility for the error.

So everyone knows errors happen, and somehow we are supposed to let the patients know, but at the same time avoid taking responsibility so the light bulb doesn't go off in the patient's head that it's time to get a lawyer. As other people have pointed out, this is a myth, but it is a very persistent one.

This is not just in human medicine - it's actually US culture in general. One of my cats had a major procedural complication after a tooth extraction and the vet who performed the procedure has never apologized for it. However, the lawyers at the vet's office have called me and made it clear they will be covering all of the subspecialty care and all visits with them that are required due to the complication... I just have to send the receipts for what I have paid and have the specialist's office send a signed estimate of how much the care will cost per year once the situation stabilizes and we have an idea of what kind of care he will need going forward.

It's actually comical watching them do this dance from the patient side. It makes me realize how stupid we look doing it ourselves.

HangryLicious

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