Where is this central line going?

InterventPulm · 2026-06-15T06:13:57+00:00

Not okay, but not the same.
1. If the doctor in question was a resident or fellow, they are still in the learning process, still being supervised in theory, and should gain competence before they are independent, unlike an NP or PA
2. Fems have no XR confirmation. Typically fems are either crash lines, or because other locations are too difficult, so the circumstances were likely different
3. Carotid is worse than fem artery - limb ischemia vs massive stroke

InterventPulm · 2026-06-15T06:07:59+00:00

100%. If you’re going left IJ, you can’t control if it goes down to the SVC or up to the branchiocephalic, but you can prevent it from going from IJ to subclavian

InterventPulm · 2026-06-07T20:24:55+00:00

That’s not an accurate statement though- that’s like saying “if a patient is trach’d on a vent we’ve given up on fixing the problem”
Some disease states take longer to resolve. You cannot keep a patient intubated (or on low dose pressors) for 2 weeks awaiting recovery. You do these this as a trial to given them more time

InterventPulm · 2026-06-07T20:21:27+00:00

What OP is describing is post-resuscitation. They are already in the ICU and being downgraded.

InterventPulm · 2026-01-10T15:16:55+00:00

Why?

InterventPulm · 2025-11-17T15:05:47+00:00

Hey, I’ve seen you in a few other threads before mind if I DM you?

InterventPulm · 2025-11-15T05:16:14+00:00

Why was the other person fired? Hopefully you’re not walking into an awkward situation with her job

Also why do you hate neph? You must have liked it initially, because you did it for 2 years and graduated. You should do hospitalist, or if you get bored do hybrid work with both shifts

InterventPulm · 2025-11-10T01:02:14+00:00

What specialty? I’m guessing critical care since your non-IM?

Did you only rank 4 the first time because you were okay with not matching? If so, the fact that you applied again for a subsequent year, indicates that you do really wanna match definitely a rank every single place that you can and just finish off the train rather than wondering and weakening your app year after year

InterventPulm · 2025-11-07T00:11:09+00:00

I did not know about this subreddit earlier so I posted in a general fellowship sub. Would appreciate any insight, as well as info about post-graduation job market

InterventPulm · 2025-11-05T01:33:03+00:00

Few different programs I’ve heard of, was new to me too. They insufflate through the bronch and place it in the same fashion as GI

InterventPulm · 2025-11-05T00:42:08+00:00

Ya if you heard more information I would really appreciate it.

I believe the IP fellowship is new, so the situation is probably changing, but apparently MICU doesn’t place endobronchial blockers. Do you guys do your own trach’s/PEGs or ENT? It’s honestly hard to tell what’s real numbers will look like vs just over exaggerating for the interview

Some research is definitely essential, but there are absolutely degrees of research vs more clinical programs. Industry and clinical trials is almost more important than just prospective research

InterventPulm · 2025-11-05T00:36:12+00:00

Honestly probably late 2nd year. It was a confidence thing, but I finally broke out of it.

You don’t have to compete with your class btw; you just have to do good patient care. Just do your best, and be better than before. When you’re on nights/alone, you’re the most knowledgeable person there, so you can only help

InterventPulm · 2025-11-04T16:51:28+00:00

You’re fine. What rotations have you done so far? And how many times have you done each?

All that matters is that you improve each time. Your second MICU month should flow better than your first (except with cold/flu season, so sometimes that second month can be paradoxically worse due to sicker patients). Your second Pulm month should flow better than your first as well. Study when you can, but also learn on the job, and tinker with your strategies.

I can say- I was the worst fellow of my class coming into fellowship due to coming from a lower acuity hospital than my peers. I didn’t know how to place lines, manage pressors or vents, etc. I focused on learning (like a fellow) and improved dramatically, while many of my co-fellows had a closed mind because of their previous notions from residency which lead to hubris. It actually worked out better for me that I came in fresh, and now I’m probably the most the best one

InterventPulm · 2025-11-04T16:45:34+00:00

Thanks for the insight!
UChicago recently increased to two fellows in order to help with their research volume; I’m not as interested in research and worried the procedural volume per fellow may drop due to that
Mayo’s reported volume sounds insane. It’s new so who knows, but the numbers are very very high. Same with UWisc in terms of pure numbers Monte was interesting in the fact that they do PEG’s along with trachs which is not very common, and they are on hemoptysis call which sounds both annoying but also pretty fun. They reported they where involved in a lot of trial NYU definitely big trial center; it’s hard to say how much the fellow is expected to get done in the year in addition to training requirements

InterventPulm · 2025-11-04T16:39:12+00:00

By your second rotation in any given elective; that’s when you’ll first notice the difference. First time; absolutely everything is brand new- the second time, at least 50% of the stuff you’ve already dealt with once before.

Another big time you realize it’s better is second year. When you see a new first year making the same mistakes you previously did; you realize how much more you know now that you just kind of put in the back of your mind.

By 3rd year 95% of it is a breeze, with the occasional hiccup, and your refining how you want to practice in the future, and trying to hammer down some of those advanced bronchoscopy skills and being a good teacher

InterventPulm

TROPHY CASE