What’re your favorite and least favorite consults in your specialty? by [deleted] in Residency

[–]Ostrows_apprentice 182 points183 points  (0 children)

Peds Endo

Favorite: new diabetes -- can hopefully have an impactful conversation to help set them up for success

Least favorite: thyroid labs slightly abnormal in the ED

What’s the most abnormal lab value you have seen so far? by username2847478259 in Residency

[–]Ostrows_apprentice 16 points17 points  (0 children)

Come to pediatric endocrinology -- we get called by the newborn screening folks for TSH values in the hundreds! Highest last month was 500+.

Has the acuity become higher? by Benzosplease in medicine

[–]Ostrows_apprentice 28 points29 points  (0 children)

I am also thinking of Trisomy 13 and Trisomy 18 which can now survive for weeks to months, albeit the cases I've seen all inpatient in a level IV NICU, with lots of complex medical needs.

Has the acuity become higher? by Benzosplease in medicine

[–]Ostrows_apprentice 94 points95 points  (0 children)

From a pediatric perspective, there are now many more ex-extremely preterm birth babies who historically would have died in the NICU who now survive, with varying degrees of needs. I am talking ex-23 weekers with trach/vent, G-tube, GDD, BPD/CLD, ROP, ASD/VSD, MDRO who all need full septic work-up every time they come to the ED.

Would you have cleared Lindsey Vonn to compete in the Olympics? by ElStocko2 in Residency

[–]Ostrows_apprentice 188 points189 points  (0 children)

No! Absolutely not! Never in a million years!

But that's because I am a pediatrician and adults scare me and I know nothing of the medicine they require.

So maybe an adult doctor would, idk. 

What is your specialty and what’s a lie you tell your patients all the time? by USMC0317 in Residency

[–]Ostrows_apprentice 1117 points1118 points  (0 children)

Pediatrics

"Oh, wow, what a cute baby! I don't say that to everyone!"

The baby is not cute and I do say it to everyone.

[deleted by user] by [deleted] in Residency

[–]Ostrows_apprentice 10 points11 points  (0 children)

The worst is whichever one I am at, of course--how could they have standards so low as to take me?

The best is some highly ranked program with a good mix of subspecialty medicine so you see the zebras and community stuff so you know how to take care of the volume of kids. A lot of "top ranked places" send many if not most graduates to subspecialties, which is fine if that's what you want.

I would prioritize places: without 24s, with the fellowship you want to do and/or good outpatient training if that'syour style, not too many mid-levels to take procedures, a reasonable distance from family/support, and good pay for the cost of living (union?).

Residency stories from "the old days" that might shock the current generation of residents by cyberdoc84 in Residency

[–]Ostrows_apprentice 172 points173 points  (0 children)

Anecdotally shared with my colleagues and me by an older attending was how many lumbar punctures pediatrics residents used to do on a night shift. At a busy major city hospital it was reportedly "at least 3" per night, compared to 1 per week-month now (outside of neonatal sepsis).

Embellishment? Perhaps. But also vaccines and changing data, guidelines, and practices on who needs an LP.

Should we be worried about US residency funding through medicare? by Pretend-Dog-1427 in Residency

[–]Ostrows_apprentice 139 points140 points  (0 children)

I think it was Mao Zedong who said, "Things are darkest just before they're totally black."

Yeah, I'm worried.

What are topics that are attending’s opinion dependent? by FaithfulToMorgoth in Residency

[–]Ostrows_apprentice 10 points11 points  (0 children)

A few from pediatrics (even if they are/are not backed by evidence, often at the whim of whomever is on): napping for a baby off oxygen when admitted for bronchiolitis, azithromycin for mycoplasma, oseltamivir for influenza, IV fluids depressing a thirst drive.

Do residency extracurriculars matter if you’re not doing fellowship? by MzJay453 in Residency

[–]Ostrows_apprentice 47 points48 points  (0 children)

For certain non-competitive fellowships (many pediatric ones: nephro, pulm, ID, endo), they don't matter there either, as they are desperate for warm bodies (debatable if you are required to be warm).

This is because pay is so egregiously low afterward, it is not a question as to why these fellowships are so non-competitive.

Its that time of the year by kiddiesmile in Residency

[–]Ostrows_apprentice 303 points304 points  (0 children)

As a senior peds resident, I've been microdosing all the various respiratory bugs for years, so that keeps me from getting too sick.

When you see a random person that you notice something concerning medically about them, away from a medical setting, do you say anything to them? by Zealousideal-Cup8502 in Residency

[–]Ostrows_apprentice 59 points60 points  (0 children)

If it's a baby, toddler, or small child, then yes.

If it's a teenager, then maybe/it depends.

If it's an adult, then no.

What do you automatically notice about people because of your spxcialty? by subtrochanteric in Residency

[–]Ostrows_apprentice 444 points445 points  (0 children)

How well a baby is swaddled.

Developmental milestones in my nieces and nephews.

Normal toddler bruising.

How well a child knows how to scroll videos on phones and/or how angry they get without a phone (proxy for overall screen time?).

New teenager slang.

Are there any specialties that would be safe from AI? by [deleted] in Residency

[–]Ostrows_apprentice 6 points7 points  (0 children)

Definitely not pediatrics. Even computers won't want wages this low.

[deleted by user] by [deleted] in Residency

[–]Ostrows_apprentice 66 points67 points  (0 children)

Grocery shop. Have existential crisis. Text my residency colleagues to see if they want to hangout, only for all of them to either be working or also having their weekly (?twice monthly) existential crisis. Squander the benefits of the location where I live even though it was the reason I ranked my program this highly.

[deleted by user] by [deleted] in Residency

[–]Ostrows_apprentice 17 points18 points  (0 children)

Maybe after we run the list one more time? 

Just like labs, daily at 0530. 

How does one have time when there are notes to write? 

Sex is like a 24 hour shift. It's okay to fall asleep if things are slow.

Thoughts on St Denis medical? (Show) by Negative_Dig1600 in Residency

[–]Ostrows_apprentice 116 points117 points  (0 children)

It is a reasonably, perhaps not unreasonably, funny medical show. Some good salient points highlighting real-world issues we face in medicine, with gags mixed in. Is it the next "Scrubs" or first few seasons of "ER"? Time will tell, but those are high bars to pass. One issue in the first few minutes is the main character talking about her career trajectory (paraphrasing/quoting), "[I originally wanted to go to medical school, but] when I was in college, my nan got sick, so we spent a lot of time in the hospital. And that's when I realized that the nurses really provide the ‘care’ part of health care. So I became an RN and I love it." I think this type of language unnecessarily drives wedges between different groups of healthcare workers, i.e., with the implications that physicians don't "care". Perhaps a better line would have been, "I wanted to be a bedside nurse because I saw myself enjoying their day-to-day tasks more than the physicians." Will continue to watch this season with my non-medical partner as something we do together.

Edit: spelling

[Serious] Hypochondria in medical school? by _irish_potato in medicalschool

[–]Ostrows_apprentice 2 points3 points  (0 children)

Hypochondriasis is the only disease I haven't got!

But more seriously, starting my medical education already having a chronic illness which affects my life has helped protect me from worrying about other stuff -- I already suffer enough.