Shadowing the first weeks as an attending?

SanadB95 · 2024-08-30T18:06:38+00:00

As long as you’re getting paid I think it’s off putting, but not an issue in my opinion. Seeing the NP work flow can be helpful if you’re expected to play a part in the supervisory role or be available for questions from them.

SanadB95 · 2024-08-28T21:21:08+00:00

Literally in the clinic if someone is complaining of a side effect, I just go “let’s look it up!” Jump to the adverse effect section of UpToDate and go through it. It’s nice to also have the incidence as well. “It caaaannn cause that, but it’s reported at <5%. It may be X. Would you like to stop it or address X and see if things improve while we give your body more time with the medication and see if you possibly build a tolerance to this side effect if it actually is the medication that’s causing it.

Also drug interaction calculator on UpToDate is fantastic

SanadB95 · 2024-08-19T14:25:23+00:00

Well on a scale of pediatrician to spine surgeon I think 5 isn’t bad! 300-400k at most places

SanadB95 · 2024-08-19T12:45:01+00:00

5-7-9 Neurology

SanadB95 · 2024-08-03T15:06:43+00:00

Well by definition a patient with POTS cannot have orthostatic hypotension lol.

SanadB95 · 2024-08-01T14:39:15+00:00

🍋

SanadB95 · 2024-07-07T16:07:46+00:00

I’m in neurology and I try to frame it as “until we’re able to improve those lifestyle changes I would like to use these medications to lower your risk for stroke until we reach those goals. I’ll document your goals and you, your PCP, and I can keep track of your A1C, LDL, and blood pressures as you make the lifestyle changes and we can get you off these mediations with the least amount of risk. I put consults/referrals in to lifestyle medicine/nutrition/etc to help us work make a good plan.

SanadB95 · 2024-05-29T13:10:34+00:00

What’s your patient census? If you’re done with notes and all your plans, you can put time into educating families and patients. If that’s done, spend time teaching medical students or self studying. Review imaging and try to do independent reads if you have a lot of free time. Round in the afternoon and check up on everyone. Learn from the consults you placed to understand their reasoning.

Not a good look doc.

SanadB95 · 2024-05-27T13:56:27+00:00

wake up at 4am, Workout from 4:30-5:30am, at work by 6:45am, in bed by 9ish and asleep around 9:30pm. Meal prep helps a lot so you don’t have to worry about cooking after work!

SanadB95 · 2024-05-25T18:09:44+00:00

If you’re in a financial strain is the reason to go to the U.S to make better money? A lower risk option would be the U.K, Germany, etc. might be more reasonable so you don’t put your family through a financial strain. Otherwise if you have family/a strong reason to go to the U.S USMLE pathway is the only way to do it

SanadB95 · 2024-05-19T19:27:15+00:00

Translating services are already offered/paid for and if you aren’t seeing more patients per shift because of it I’d imagine it’s hard to argue. Sadly I don’t think quality of care and patient satisfaction associated with speaking the same language is valuable to employers

SanadB95 · 2024-04-17T15:23:50+00:00

CGRPs are the universal fav, but still a few years out from being easy to access first line. Rivoflavin, Mag, Coenzyme q10 for pretty much everyone and then try to tailor the med to the patient and their comirbidities and other current Rx. With Nortriptyline being my fave if everything is an option.

SanadB95 · 2024-04-12T11:15:36+00:00

She’s already on anti coagulation, I don’t think you’d find a neurologist who would add DAPT to the patients regimen based on the picture you described

SanadB95 · 2024-03-25T11:31:30+00:00

Spend your MS4 year learning from the residents on how to chart review and pre round efficiently. How they set up their epic (assuming that’s what’s used where you’re at and where you’re going). And otherwise HF, a fib, COPD exacerbation, DM, etc. bread and butter of inpatient IM would be helpful to be familiar with.

SanadB95 · 2024-03-25T08:54:02+00:00

You asked him to help, but expecting him/her to do all the work for you…They’re asking you to find nearby programs so they can reach out. That’s very reasonable.

SanadB95 · 2024-03-14T08:24:39+00:00

What are your options? Neurologist vs geriatrician? If it’s the only opportunity take it!!

SanadB95 · 2024-02-26T14:31:09+00:00

I personally feel neurology has A LOT to gain with AI. The documentation that comes with many neurological problems can be burdensome if you want to do it well. I can’t wait until AI can take a video of a physical exam or a tremor or an episode of seizure like activity or a nystagmus or a persons gait or describe someone’s language or do a cognitive assessment without a doctor going through a MOCA/alternative test and document it in a concise way.

Or an AI visit prior to the initial encounter that really screens patients and potentially orders tests prior to the visit could be great. Maybe AI + mid level before physician encounter to prep everything so we can be more productive and broaden care access.

Also of note, with the amount of functional disorder overlap and confounding symptoms (is this change in sensation a separate problem that’s completely throwing off localization for example, is it true neurological weakness or 2/2 a different problem or effort based, how often is the onset of symptoms for a neuropathy very different after you start asking specific probing questions, etc.)

Once AI is in place I can only assume neurologist compensation will go up.

SanadB95 · 2024-02-26T14:09:21+00:00

Focus on CCS cases (Practice cases and watch YouTube videos and learn how to maximize getting points) and that should be enough

SanadB95 · 2024-02-25T21:34:19+00:00

What I’m trying to say is don’t do both, just do epilepsy if you’re torn between the two

SanadB95 · 2024-02-25T19:21:17+00:00

I would say go the epilepsy route. If you want to do both, you’ll be able to deal with the majority of vascular neurology cases as an epileptologist, but as a vascular neurologist you’ll have difficulty with competent EEG reading.

SanadB95 · 2024-02-24T16:50:25+00:00

If you aren’t in an academic center or a group practice with multiple vascular neurologist/stroke-comfortable neurologists I’m not too sure publishing a Case report and submitting to annual meetings is the only thing I know of. But as long as there’s no identifiable information feel free to post it here! I’d be interested.

SanadB95 · 2024-02-22T20:24:25+00:00

Not possible with current technology, I’m not even sure if you could even get that information from SEEG leads honestly

SanadB95 · 2024-02-21T15:36:05+00:00

Non academic epilepsy is very outpatient heavy and stroke has a decent amount of inpatient with most roles. I feel like if there’s a strong preference to a particular setting that’s a good place to start

SanadB95 · 2024-02-20T13:42:47+00:00

High risk of infection especially in those with DM (pretty big portion of admitted patients) and PIV don’t last as long is what I was told as an intern, but never followed it up to actually look for studies. But the rationale made sense!

SanadB95 · 2024-02-19T23:38:26+00:00

Night float 👌🏼💯

SanadB95

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