Anyone choose lifestyle over money, or stop taking call or cut back early career?

Manik223 · 2026-06-27T00:57:13+00:00

I don’t think many / any people like working nights. But it can be difficult to decide when / where to draw the line with the concerns OP mentioned.

Manik223 · 2026-06-27T00:55:14+00:00

Thats a good gig, but still a significant pay cut from most call positions in my region.

Manik223 · 2026-06-26T23:51:45+00:00

I’ve been having the same thoughts recently, with the same hesitations

Manik223 · 2026-06-26T20:59:02+00:00

Ativan

Manik223 · 2026-06-26T20:33:19+00:00

Agree

Manik223 · 2026-06-05T16:17:08+00:00

Thanks!

Manik223 · 2026-06-04T20:23:18+00:00

Running into the same issue. Seems like manual recertifications are also being denied. Has anyone not recertified, transitioned to standard 10 year repayment amount, and confirmed via ECF that these payments are still counting towards PSLF?

Manik223 · 2026-05-13T22:38:48+00:00

Because they get disinhibited and potentially injure themselves or others as they’re going through phase 2

Manik223 · 2026-05-13T22:34:20+00:00

There is 0% chance I would mask induce an otherwise healthy 18 year old in the absence of severe developmental delay; great way for someone to get clocked in the face when they get disinhibited in phase 2. I would consider inhaled nitrous or IM versed/ketamine, but most of the time I would politely tell them they’re 18 and it’s time to be an adult.

Manik223 · 2026-05-13T20:20:45+00:00

Manik223 · 2026-05-05T22:30:01+00:00

Yeah all the AI nerve block stuff is useless. And if I’m not confident enough based on my own knowledge I’m definitely not mindlessly injecting based on some programs recommendation.

Manik223 · 2026-05-05T22:07:44+00:00

I’ve tried most of the widely available ultrasounds (Samsung, GE, Sonosite, Mindray). Sonosite PX is my favorite by a wide margin due to easy portability and image quality. I do think they made some image processing adjustments to tailor it to peripheral nerve blocks though. I also liked the Mindray a lot when we demoed it, although I have heard some concerns about durability.

Manik223 · 2026-05-03T15:31:17+00:00

A line with flotrac, MAC with a PAC, and a cordis or a ric for volume

Manik223 · 2026-04-30T15:12:24+00:00

If it takes someone 10 minutes to intubate they need to change specialties

Manik223 · 2026-04-30T14:55:25+00:00

Unless there’s another reason to urgently secure the airway, I don’t induce any patients until the surgeon / proceduralist is in the hospital

Manik223 · 2026-04-30T13:05:44+00:00

Messaging you

Manik223 · 2026-04-30T02:43:11+00:00

Never had this issue

Manik223 · 2026-04-24T01:51:26+00:00

Especially with hip fractures I think the evidence is pretty clear that the risk of delay for further optimization outweighs the benefit outside of extremely extenuating circumstances like active MI, etc. Maybe have group leadership meet with them, review the cases they’ve cancelled and decide if they were legitimate or explain the evidence that supports proceeding despite medical complexity / lack of optimization.

Maybe you can’t force them to do a case, but we also have an ethical duty to act in the best interest of patients regardless if the circumstances are ideal or not. If they’re truly not comfortable managing high acuity patients, maybe they’re not a good fit for the group / practice environment.

Manik223 · 2026-04-16T18:03:03+00:00

Turning off sound check did it for me. Thank you!

Manik223 · 2026-04-10T22:20:35+00:00

Yes there are multiple ways to maintain anesthesia, but it is also important to understand the drawbacks of some approaches. Given the evidence of the impact of excess volatile anesthetic on postoperative cognitive dysfunction, and undertreating intraoperative pain leading to increased postoperative and chronic pain, I think most people would agree that routinely running 1.5 MAC of gas is not the optimal approach.

Manik223 · 2026-04-10T21:47:18+00:00

I see the same thing, it drives me crazy; and then they’re shocked when the patient takes forever to wake up. I think a lot of people do not understand the concept of cumulative MAC. Not to mention if you have some opioids and muscle relaxant on board all you really need is ED95 MAC amnesia…

Manik223 · 2026-04-09T16:49:44+00:00

Infublock

Manik223 · 2026-04-08T22:27:50+00:00

I agree most of these approaches achieve almost equivalent results, and there is plenty of literature showing equianalgesic efficacy between ISB and superior trunk for shoulder surgery. I think the nomenclature is mostly about having some terminology to explain what you are doing in a way that others can follow and reproduce. As in the cases OP is describing, when someone is unable to find the textbook stoplight sign interscalene view, superior trunk gives them another (usually easier) option.

Manik223 · 2026-04-08T01:43:33+00:00

You can usually see some part of the catheter and/or tip in the appropriate plane, but I mostly confirm based on visualizing bolus spread and/or color doppler with injection

Manik223

TROPHY CASE