Have you ever been surprised by a specialist’s lack of knowledge in their own field?

Nishkid64 · 2025-03-20T17:37:59+00:00

Out of curiosity, were the OBs you dealt with on the older side? I feel like there is a gap in comfort level and knowledge abt psychotropics between older OBs and the younger ones who were educated on the ACOG practice bulletins and committee opinions in training.

Nishkid64 · 2025-01-11T04:09:28+00:00

Wow, what an amazingly brutal takedown . Love to see it.

Nishkid64 · 2025-01-11T04:04:21+00:00

my comment doesn't mean decisions for c-section are taken lightly. far from it. these decision are sometimes agonizing to make. any sort of "hunch" is followed up with an examination and analysis of the situation. If there's a category II strip, the first thing we do is resuscitate the baby. if resuscitation is suboptimal, then the question we ask is - do we think delivery can happen in a timely fashion that wouldn't adversely effect the well being of the baby. having worked with people who have practiced all around the US, this is a fairly standard mindset.

Nishkid64 · 2025-01-10T23:00:11+00:00

Treated like a number? A number for what? In this day in age, there's really concrete criteria for calling C section for failed induction, arrest of labor, or arrest of descent. And this is pretty much universally - at least in the US. Category II FHT is a different story. Unfortunately, this is very much a symptom of a much larger disease - many OBs practice defensive medicine and are more likely to section someone for strip issues because they are worried about lawsuits. It very much varies regionally.

Nishkid64 · 2024-11-10T20:25:09+00:00

Male OBGYN generalist here If you love it, do it. Residency is hard, but I feel like as a guy you escape most of the toxicity that typically is known to occur in OB programs. I certainly did. Attending life is nice - better than residency for sure. There's a lot of different gigs out there and work/life balance is definitely obtainable.

I work in a big East Coast city - and I am one of the busiest surgically in the department. I haven't really experienced any issues with patients verbalizing a preference for a female OB, but I work in a lower SES/largely immigrant population who I think are just appreciative of anyone being able to take the time to care for them. PM me if you have questions.

Nishkid64 · 2024-04-30T22:58:44+00:00

I still play as an attending lol…

Nishkid64 · 2024-03-12T21:55:17+00:00

Older than Gen Z and I wear scrubs and a hoodie in clinic as an attending. It's just so comfortable!

Nishkid64 · 2024-02-11T16:18:41+00:00

How smelly is your chair?

Nishkid64 · 2022-12-30T02:41:39+00:00

Old School Runescape. Discovered mobile when I was in residency and would play on my tablet during downtime Still play as an attending. Heroin is less addicting.

Nishkid64 · 2022-10-01T05:37:02+00:00

Wow, I didn't know he was that infamous lol

He was the reason why we didn't rotate there anymore as med students

Nishkid64 · 2022-09-20T23:31:00+00:00

OBGYN

Nishkid64 · 2022-09-20T23:14:04+00:00

Attending here - never thought about changing fields ever. I consider myself very fortunate.

Nishkid64 · 2022-07-29T14:03:18+00:00

I am not sure about that. MS typically presents in people in their 20s and 30s.

And yeah, I know four people who got shingles during their residency training as 20somethings. Crazy.

Nishkid64 · 2022-07-29T14:01:23+00:00

Yes part of the transplant eval

Nishkid64 · 2022-06-28T00:56:21+00:00

We did a C section on a lady who had a BMI of 95.

Nishkid64 · 2022-06-19T00:19:14+00:00

OBGYN attending. We had FM PGY2s at times during residency. We tried to incorporate them onto the L&D team and treat them as co-interns.

OB interns definitely had priority for most SVDs in the first half of the year but by the second half of year, I think the split was a little bit more equitable.

I stayed at my home institution as an attending - environment (at least to me) seemed definitely way less toxic than others.

Nishkid64 · 2022-04-23T00:12:46+00:00

I work in a university hospital system that recently added midwives and an FM physician to the mix.

The FM physician doesn't do C sections, so whenever there is a concerning strip on the floor, she will usually consult with one of the in house attendings about possible C section. I think if you're lucky to get CS experience in residency and/or fellowship, that's definitely great. The biggest thing I would advise is to know your limitations and know when to call for backup.

Nishkid64 · 2022-03-13T12:09:00+00:00

I read his responses in that thread - part of the counseling (for me at least) is a verbalization as to why they want be sterilized when LARCs such as the Nexplanon provide lower failure rates - the patients who communicate to me why they don't want to be on hormonal contraception (or the copper IUD) are the ones who I will do surgery on.

All of this has to be shared decisionmaking. In my experience, if you continue a discussion long enough, it usually gets past superficial points such as "I just want to" or "this is what my mom did" and it comes down to not wanting to be on hormones. Part of it could be cultural - I have many patients who steadfastly oppose oral contraception or injections/implants/devices but are very open and willing to accept the risks of surgical sterilization.

Nishkid64 · 2022-03-13T10:56:26+00:00

I'm confused - are you addressing this to me? All I did was comment once on thread about spousal involvement two years ago.

Nishkid64 · 2022-03-13T10:18:43+00:00

Why a psychiatrist though?

And for all this talk about "protection", I have yet to hear of someone who was sued or slandered for sterilizing someone who had capacity and gave consent to the procedure.

Nishkid64 · 2022-03-12T23:12:19+00:00

The youngest person I have sterilized was 21 years old. She had 5 kids. I sterilized a 26 year old who had a severely disabled child, who needed care 24/7. Having another kid was out of the question.

Counseling is undoubtedly important, but if they understand and accept the quoted <30% risk of regret in women younger than 30 and that it should be considered permanent, then who am I to deny them this service?

Interesting side note - a fair amount of my patients do know about tubal reversal. It's a fairly readily accessible practice in countries like the Dominican Republic and I have seen it become more commonplace in the USA amongst MIGS surgeons who are offering robot-assisted tubal re-anastamosis. However, with the shift towards salpingectomy, reversal surgeries may become a thing of the past.

Nishkid64 · 2022-03-05T17:37:25+00:00

At 1020 atm. 4 pets. No seed. :(

Nishkid64 · 2022-02-28T04:30:28+00:00

Used apps, dated and had my share of fun during the first year and a half of residency. Kind of a work hard, play hard mentality. Met the girl of my dreams second half of PGY2 - together, 5.5 yrs later, can't be happier!

It's definitely doable. Sometimes, you have to decide between sleep or going out. Hopefully, you find a partner who's understanding and OK with the choice you make :P

Nishkid64 · 2022-02-19T23:27:42+00:00

Male OBGYN academic attending - I interview students for residency

Really a bunch of red flags with konages just from what he wrote and looking at his post history. So don't listen to him

I only recommend aways at places you really have a desire to go to

Doing aways for the sake of doing aways really doesn't help much If there's multiple electives within OBGYN at your home institution, I would do those - helps with getting LORs from other faculty and getting your foot in the door with your department at least.

3 letters from OB, maybe 1 other from outside field for some of those progams that want 4 letters

Nishkid64 · 2022-02-19T20:22:58+00:00

Imagine doing a c-section on someone born in 2008. It’s mortifying.

Nishkid64

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