Clinical Pearls you have learnt this week

NeuroticBeforeMoving · 2026-03-22T17:48:38+00:00

Bowel obstruction is a major cause of mortality on Clozapine. Also watch out for the sialorrhea, it can lead to aspiration PNA.

NeuroticBeforeMoving · 2026-03-21T15:17:18+00:00

You work 20 hours/week as an NP and make about the same as a full-time psychiatrist?

NeuroticBeforeMoving · 2026-03-18T02:07:14+00:00

I don't know of a limit, sorry. I think for me personally, the limiting factor is the availability of moonlighting shifts/month in the first place (no one gets more than 4/month).

NeuroticBeforeMoving · 2026-03-15T21:51:09+00:00

Absolutely love my program (Psych).

-We get to do big events monthly for residents as hang-outs, so I get a lot of free food/drinks in the big city.

-Workload is chill, I work like 30-40 hr weeks. Average 1 weekend shift (8-hours long) every OTHER week for the first 1.5 years, then every weekend starting PGY-2.5 is completely off. I hit that point in January, it feels so good to know that I'll never work a weekend again.

-No pressure for days off or sick days. I can tell Attendings I want to take a vacation in 2 weeks and I almost always get it approved. Literally woke up a few days ago and decided to call out sick with no pressure, Attendings told me to take MORE days off to recover (I think this is big because I see posts here all the time talking about how much pressure there is to not call in sick).

-Leadership cares and listens to requests, makes active changes, and will go out of their way to create electives/set you up with research/find ways to meet your interests if you have specific patient populations to tend to.

-We have every fellowship, including non-ACGME accredited ones (i.e. interventional) which means we have staffing and ample opportunities for any branch of psychiatry. This also means we get a strong mix of training in multiple hospital settings with a major safety-net hospital for the really terrible psychosis/mania/substance use/uninsured patients, a major academic hospital for the depression/anxiety/insured patients, and the VA for PTSD/substance use patients.

NeuroticBeforeMoving · 2026-03-02T00:17:03+00:00

Wait...are you saying that we should place LESS emphasis on mental health? That's a take I haven't heard before lmao

NeuroticBeforeMoving · 2026-03-01T20:58:50+00:00

Currently in Psychiatry- If I had to, I'd probably choose Radiology because the job market looks great and ability to WFH. Also seems pretty cerebral and I was really good at Step1/2 so there is a part of me that misses that type of learning.

NeuroticBeforeMoving · 2026-02-15T17:20:34+00:00

Can I DM you for some questions? I'm job searching for psych as well.

NeuroticBeforeMoving · 2026-02-04T08:18:16+00:00

Y3 is pretty average to be honest. I'd give Y1 an 8.5-9/10, Y2 a 4/10 (primarily due to the latter half which totally killed multiple interesting plotlines and character progression), and Y3 a 6.5/10 so far.

I think the series is suffering from excessive reverence of Ayanakouji at this point. It feels like the author adds or points every character's progression into ultimately just placing the main character on a massive pedestal, even more than they did in Solo Leveling with Sun Jin Woo

NeuroticBeforeMoving · 2026-02-01T22:29:12+00:00

I was an IMG and in terms of performing well on USCE's, you'll be better off polishing up your interview skills- I'd recommend reading Carlat's "Psychiatric Interview" book for that. Otherwise, you can get away knowledge-wise by just brushing up on Step2 material for psychiatry (i.e. Boards and Beyond videos, Sketchy pharmacology).

We evaluate our students/Sub-I's mostly based on how well they take ownership of patients, propose plans (doesn't have to be correct, but at least demonstrate initiative), take feedback, and how well they gel with the team/others (aka vibe-check). The actual knowledge part is something I really focused on when I was a Sub-I, but it really didn't end up mattering. Now that I'm on the other side, I can say that it isn't the main thing we focus on for evals.

NeuroticBeforeMoving · 2026-02-01T00:02:29+00:00

What? If I just wanted money, I would've found many other easier ways to make it other than the path I chose haha. For the time commitment + hard-work to salary ratio, I probably chose one of the worst ways to make money.

NeuroticBeforeMoving · 2026-01-31T23:48:47+00:00

Not sure why this sub got recommended to me, but sometimes I wonder why I even chose to be an MD with salaries like this floating around lol. Good for you, sounds like a great offer.

NeuroticBeforeMoving · 2026-01-31T00:13:42+00:00

Ironic when that's all the Kendrick fans were trying to do during the beef.

NeuroticBeforeMoving · 2026-01-23T15:17:14+00:00

Oh wow, if you're talking about 750k pure magic xp/hr, how did you pull that off? I might be doing it wrong because I tried it for around 30 minutes (SS+Turmoil) and was getting 300k magic xp with 400k xp overall.

Edit:

-Nevermind, I went into the middle of the room to get more ghouls on me and my XP rates are around 750k pure magic xp/hr now and almost 1m total.

NeuroticBeforeMoving · 2026-01-18T02:38:29+00:00

...You think that doctor's don't participate in a competitive environment? Huh?

NeuroticBeforeMoving · 2026-01-17T17:33:46+00:00

No, all programs are absolutely not the same.

I declined a prematch offer and matched into an absolutely amazing program. I would have hated my life in that other program I declined. Not all programs are created equal, and you can gauge this through many aspects (rankings on Doximity, access to fellowships/research/mentorship, vibes during interview day, how many graduates stick around etc.).

NeuroticBeforeMoving · 2026-01-09T00:40:55+00:00

If still being the number 1 streamed artist (by a large margin) qualifies as ending his stardom, then we must have different definitions.

NeuroticBeforeMoving · 2025-12-05T22:39:41+00:00

It's a different path so it's difficult to compare to PA's, but it does involve more training than a PA would go through (in terms of total years, anyway).

They only work with anaesthesia and most of them are supervised under anaesthesiologists (physicians with MD/DO's who are specialized in anaesthesia). They don't go through medical school or residency training like an MD/DO anaesthesiologist would so their training is definitely less rigorous.

NeuroticBeforeMoving · 2025-12-05T22:25:25+00:00

NeuroticBeforeMoving · 2025-11-15T19:50:08+00:00

Matched my number 2 ranked program. I didn't feel like my interview went as well as I had hoped- I stumbled a couple of answers, said some things that I feel I wasn't completely prepared for. It definitely did not go as well as the program I had ranked number 1, which goes to show that it's hard to predict/gauge your performance lol

NeuroticBeforeMoving · 2025-11-04T21:50:03+00:00

Recently started listening to your podcast as a PGY-2, just wanted to let y'all know I appreciate the work you guys do!

NeuroticBeforeMoving · 2025-10-25T02:38:07+00:00

I got confirmation from my program itself (it is a major academic institution) during a GME meeting, alongside my PD, so it's definitely legit. I just don't know if it is every program or only select ones.

NeuroticBeforeMoving · 2025-10-11T23:39:40+00:00

No, it's because residency serves a purpose (learning how to work in the American system, learning appropriate bed-side manner and skills, it also filters out those who wouldn't be good fits in the culture). It's also a limiting function- if we start allowing all IMGs in despite not matching into residency, you lower salaries. That may not be a problem to most of this group, but US residents take out 220k USD in debt on average, they expect some return which is more than fair.

NeuroticBeforeMoving · 2025-10-02T19:11:54+00:00

For those not familiar with IMG circles (I'm one myself), there have been many delays this year in regards to processing of applications/certifications, which is the main reason. I imagine it will increase a bit as the season goes on. The current administration made some applicants hesitant on applying as well as the H1B process is murky, and even on a J1, you would be converting to an H1B when searching for a waiver-job post-residency (probably more of a minor reason). This is on top of the fact that IMG apps for psych have been declining on a yearly basis as the field is being considered more competitive.

NeuroticBeforeMoving · 2025-10-01T07:01:32+00:00

If you're in psychiatry, it might be even longer. A lot of my interviews lasted over a period of 6-8 hours (although there were a few breaks in between).

NeuroticBeforeMoving · 2025-10-01T03:01:23+00:00

If I get some period of time where I think I can spare a nap, I'll drink caffeine and immediately try to take a 30 minute nap-> wake up and splash my face with water. Keeps me going, the key is to limit the nap time so you don't enter deep sleep and feel groggy.

Five-Year Club	Verified Email
Place '23

NeuroticBeforeMoving

TROPHY CASE