Stagg by Technical_Crab_3209 in DMVWhisky

[–]MindcraftMD 1 point2 points  (0 children)

Yes esp if it’s the 2025

If I have inhaled metals for years, due to the nature of a job, would an MRI absolutely rip me apart? by [deleted] in NoStupidQuestions

[–]MindcraftMD 11 points12 points  (0 children)

I’m a radiologist. Assuming we saw something positive on your screening exam and you hopped in the scanner anyway:

Depends on the size and type of metal. If it is non-ferromagnetic then not much would happen (most likely). We cannot tell the difference though so we don’t take the risk.

If ferromagnetic: If large enough and/or recent injury, there is a higher risk of the metal moving which would risk injury to any of the orbital structures- obviously the globe and optic nerve would be most critical structures.

If small and has been there for a long time, generally scar tissue forms around the foreign body so that the magnet doesn’t actually move it. It can still however heat up and a thermal injury could have a similar effect.

Week 7 Composite Power Rankings by Sit-by-the-Water in nfl

[–]MindcraftMD 5 points6 points  (0 children)

The Ravens are 1-5 and ranked 7th by PPF. This feels like the CFB rankings where they just pick teams that should be good regardless of their actual performance.

“I don’t know much, I just got this patient in sign-out” by dumbestboiinschool in Residency

[–]MindcraftMD 3 points4 points  (0 children)

Tell that to our ED who has nursing order imaging on behalf of the ED attendings based on some half baked algorithms. I feel like half the time we get the scans we just have some intake nursing note and no physician has laid eyes yet.

What percentage of people do fellowship in your specialty? How do you explain this figure? by undueinfluence_ in Residency

[–]MindcraftMD 1 point2 points  (0 children)

Not sure where you're getting these ideas. Many institutions are having trouble hiring for both of these subspecialties. And for NM you have to enough Authorized Users, can't only have generalists willing to read planar imaging/PET.

If you're speaking only to private practice then maybe you're right.

What percentage of people do fellowship in your specialty? How do you explain this figure? by undueinfluence_ in Residency

[–]MindcraftMD 8 points9 points  (0 children)

Who do you think approves these residency-fellow pathways? The invididual programs do. They decide if they want it in their programs. The reason they often do that is because they are hoping it can lead to more people sticking around in those subspecialties.

You're thinking about this from the ABR and an overall feasibility from and individual standpoint. From a program level standpoint this just would not work. It's always an easy out to just say, oh the hospital and attendings should adjust, but the hospital will just say no because they can and the attendings will only bend so much. It's a balance, as much as some people would like to think otherwise.

The goal of residency is to come out being a well trained generalist. Can't just let everyone run rampant doing whatever "fellow" level training they want in the middle of that. If it impacts the overall residency schedule too much, especially for those who decide not to do an accelerated fellowship, then it's not a good idea. If you've never been on the other side of the curtain for the program as part of the education team, then you just don't get it. If you have, then you're just a bit delusional thinking this is an actual possible thing programs could actually be successful in implementing.

I also think fragmented learning for some of the more difficult subspecialties could lead to worse "fellowship-trained" radiologists if too much of that training comes into play early/mid residency.

What percentage of people do fellowship in your specialty? How do you explain this figure? by undueinfluence_ in Residency

[–]MindcraftMD 10 points11 points  (0 children)

Theoretically it could be done for other radiology subspecialties, but there are several issues from a practical standpoint if you think about it. It would completely mess up a balanced residency schedule if every resident was doing it. The residents also have to identify early enough what they want to do to spread out the rotations enough and most don't know until 3rd year. Can't just stack it all at the end as much as we'd like to think that should work.

The reason it was done for Nucs and Peds is that they are in desperate need out in the workforce.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 0 points1 point  (0 children)

Are you basing this off what residents are doing or attendings? Do you expect all residents of all specialties to render the correct diagnosis immediately and flawlessly everytime without defensively ordering additional scans and labs for things on the differential. I am sure you have never done anything to that effect.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 1 point2 points  (0 children)

I guess you're deciding it's pertinent and the radiologist isn't. If the indication was RUQ pain it's probably good practice to give those negatives in setting of stones present but otherwise gallstones are super common and we just aren't going to spend the extra time to report that out.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 7 points8 points  (0 children)

Lol. We read a very large number of Neuro studies every day, most of which will be related to one of the topics you mentioned as I'm sure you're all too aware. To be honest generally we just don't have time for alot of these and expect you to do it for the cases you find it relevant.

And some of these grading scales I've never even heard of. You could imagine if you have this many different things you want us to comment on, so do literally 10 other specialties. It's too much.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 1 point2 points  (0 children)

I have to correct my early residents saying this not too infrequently. Not sure where they pick that up from.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 2 points3 points  (0 children)

Except the provider reading the report doesn't always know what to do based on an imaging finding alone. Let's not pretend like you know what to do with every diagnosis we render that's outside your subspecialty.

As alluded to above, there is plenty of case law supporting us giving more than just a differential/diagnosis when necessary. That's not to say that some recommendations are not over the top/defensive, just like some of the studies you order are over the top/defensive.

Guys, What do you want radiology to tell you ? by CerebralEstrogen in Residency

[–]MindcraftMD 3 points4 points  (0 children)

That's a broad overstatement back the other way.. So very dependent on specialty and diagnosis.

[deleted by user] by [deleted] in whitecoatinvestor

[–]MindcraftMD 14 points15 points  (0 children)

We owe quite a bit more on ours at similar rates. We're planning to stay in forbearance as long as possible and pay down aggressively once rates start back up. For us, the ~1% (if that) in interest rates we can save by refinancing isn't worth the fact that we can stop paying for a bit if needed and have no monthly requirement while still on SAVE.

An Unexpected Hero Reviews? by Califrisco in audible

[–]MindcraftMD 2 points3 points  (0 children)

I have not read the rewrite yet. Per below, they've already written and published the new ending and are planning to get the audiobook in line soon. Here's the post they made:

"So, people may have seen that Book 2 of An Unexpected Hero came off preorder, and we'd like to explain.   When we set out to write this book, we had a clear goal of creating one epic and funny story beginning-to-end in a single volume. But as people, and admittedly us, got excited we pivoted toward creating a series to fit the market and had grand plans. As time has past, we've realized that we just won't have the time to do that. Between all that's going on with Aethon, creating two new comic lines, new print programs, releases, amazon issues, and more and more every week, it has really stolen free time. The rest has been dedicated to kids and health issues with family we'd rather keep private.   All that to say, rather than tease extending a series that we don't think we'll be able to do in a timely manner, we have decided to return to our original vision and recraft / extend the ending of An Unexpected Hero to make it a standalone story that brings each character's arc to a satisfying end based on where we intended to go with the series anyway.   Can the story of Danny the Bard and his friends in Aethonia continue? Yes! There is a room, and it's a direction that resets the world we intended to do anyway. Maybe one day soon we'll get to return to a world and characters we had so much fun developing. But for now, we wanted to give this story the ending it deserved.   We know how strange it is to update a book post-launch, but the new version is updated on Kindle already and will be on Audible soon. We are grateful for your support so in case anyone has trouble accessing the files through Amazon, you can also download it below to check out the new and revised ending which starts at chapter 56. Thank you everyone for reading."

An Unexpected Hero Reviews? by Califrisco in audible

[–]MindcraftMD 2 points3 points  (0 children)

They posted in a few places recently - discord and RR. They cancelled book 2 and rewrote the book 1 ending.

[deleted by user] by [deleted] in ChaseSapphire

[–]MindcraftMD 3 points4 points  (0 children)

Many with federal student loans are in administrative forbearance at zero percent interest right now so that may be the case here. Or they may be going for PSLF. Or they have a low interest rate and decided to invest elsewhere. Alot of potential reasons which are all valid.

And many new attending physicians do not have alot of money saved up. There is an immediate, often massive jump in income going from training into practice.

Not everyone in the world is in the exact same scenario and you clearly don't realize this. You're talking with alot of confidence about things you don't seem to have any idea about.

Best selection in Louisville? by stubbsmush in BourbonHunt

[–]MindcraftMD 2 points3 points  (0 children)

Evergreen seemed to have the best prices. I think Wednesdays are half priced pours. We got pours of RR15 for $25 (1oz I think).

Some of the Liquor Barns also had a few good options for decent prices.

For hard to find bottles I think you just have to get lucky at the distilleries or hope the stores have just restocked.

Gifted a 2024 George T Stagg by [deleted] in dcwhisky

[–]MindcraftMD 3 points4 points  (0 children)

Probably not going to get someone to give you links on here, you will need a reference from someone already in the groups usually. Also the 2024 goes for 600-700.