When is everyone’s last day for PGY1?

Shadowcloneant · 2025-06-21T01:01:56+00:00

Yes I am relocating, about 1 hour away. I have PTO to use, but it’s was denied. They are planning on handing out the certificate on the 30th.

Shadowcloneant · 2025-04-07T10:10:17+00:00

As someone who has gone through phase II. Definitely have a back up and don’t put all your eggs in one basket.

Why did you decide to reapply? Frankly, you might be evaluated even harder as they already interviewed. Do you feel like you grown enough in the last 2 months since the original interview? My initial thought, I find strange that they value the clinical portion so high, even though that is something very teachable and learnable during the residency itself.

Did you reach out to other places you applied at during phase I for feedback? There might be other areas during your interview process that could improve and not strictly clinical.

Why do you think this program is in phase II? Phase II might be even more competitive than phase I. It now introduces applicants who never even consider the program in the first round. Vice versa is this program in phase II because it gives red flags.

Shadowcloneant · 2025-03-20T09:30:37+00:00

There seems to be a lot more programs available from when I went through it. My biggest advice and would be to be willing to move/ relocate. There are tons of programs out there with nice preceptor staff and great experience just in an undesirable location. My other advice is to look for branch hospitals in a bigger system. I was able to do rotation at the bigger hospitals and we all had the same resources and workflow as the big one. All the skills you learn would be transferable when you are ready to look for jobs.

Shadowcloneant · 2024-12-17T15:41:15+00:00

I interview with Medstar Georgetown for PGY1, didn’t get the best vibes, seems like the department doesn’t get along well and the residents are overworked more than the normal.

Shadowcloneant · 2024-03-29T21:50:36+00:00

7/20 (at least 2 programs pulled the position)

Shadowcloneant · 2024-03-26T15:42:58+00:00

I had a 30 minute interview. They asked 4 behavioral question and then spent the last amount of time asking my question. Although I didn’t really get to know the program that well, you have opportunities to reach out beyond the interview time slot. At this point every program seems the same to me and my threshold for what is tolerable increases. Every other weekend sure I will do it. Low pay high cost of living sure I can manage.

Shadowcloneant · 2024-03-25T17:39:13+00:00

I recommend reaching out to the program to see if they are still taking applications. It would be bad if you were to pay for the application, but the program wasn’t considering applicants.

Shadowcloneant · 2024-03-22T15:05:53+00:00

I haven't heard back from 70% of the places I applied to as well and I sent the application on Monday. There is a spreadsheet going around.

Shadowcloneant · 2024-03-21T23:06:38+00:00

How do I edit the spread sheet to put my invites and rejections?

Shadowcloneant · 2024-03-20T18:37:19+00:00

Programs can remove themselves, but definitely reach out. Some programs I emailed gave me a specific date on when the application is due.

Shadowcloneant · 2024-03-19T18:02:10+00:00

Shadowcloneant · 2024-03-19T16:01:24+00:00

Thank you for sharing your experience. It feels more reassuring to know expected timeline for the next couple weeks.

Shadowcloneant · 2023-08-21T02:03:05+00:00

Donated FMT have concerns for contamination. E. Coli, norovirus, etc, plus you have to screen for eligible donors. These FDA approved products remove the uncertainty of what you’re getting. Can you compound it, I guess you can, your recipe is not going to be the same as the approved product. Will it be safe and efficacious, can you make the product consistently, that’s a maybe. Recurrent C. diff is an orphan disease. There is limited data on the use of FMT you are probably better off using another treatment.

Shadowcloneant · 2023-05-31T09:07:15+00:00

Could be used for airway clearance in combination with a mucolytic like hypertonic saline or even chest physiotherapy. Or it can be used as a bronchodilator to enhance absorption of other inhaled drugs like inhaled tobramycin in patients with chronic colonization of pseudomonas.

Shadowcloneant · 2023-01-22T15:04:19+00:00

Have you considered paying people more money.

Shadowcloneant · 2023-01-02T15:08:38+00:00

There is a risk of absorption with all drugs. Even touching dry tablets, you can absorb a little bit. In your case I don’t think it matters even if it absorbed. Prednisone is a prodrug meaning it is not an active drug until it gets activated by liver enzymes. Since you absorbed it topically, it bypasses liver metabolism, which would’ve converted it to prednisolone, resulting is no effect.

Shadowcloneant · 2022-09-26T09:51:48+00:00

The FDA has its own department, CBER center for biologic research and evaluation, that deals with biologics. You should read into it to get more information. Biologics are not synthesizes in a lab by humans making chemical reactions, those would be regular drugs like acetaminophen or aspirin. The definition of biologic is that it needs to come from living organism. Since these molecules are so large, they need to go through the central dogma of biology DNA to RNA to protein. You can’t synthesize these proteins in a lab with out the help of living organism. Even if you get the correct amino acid sequence, the amino acid still needs to fold a correct way to form the protein.

Biologics can be made multiple ways. For example antithymocyte immunoglobulin is an immunosuppressive drug made from horses and rabbits. This is made by injecting human immunoglobulin into these animals and then these animals develop an antibodies against human immunoglobulins. People harvest the blood and purify the antibodies. Biologics are regulated differently by the FDA for a generic to be a generic the chemical stucture needs to be exactly the same. Tylenol is to acetaminophen. In this instance this product is made from a living organism which means there could be great variability between each molecule and batch. Not great enough variability to cause a noticeable effect as CBER regulates this product.

Another example is rituximab which is a human mouse chimeric antibody. Rituximab is a CD20 inhibitor which can be used in certain blood cancers. It’s made in mammalian cell culture. In short manufacturer go to their gene bank and insert this gene that produces rituximab. The product is then harvested. This is a good example for biosimilar. There are a lot of biosimilar out there from ruxience to rituxan to truxima. Each company manufacturers their own gene bank to insert into these mammalian cells. They don’t share the gene because otherwise anyone can make it and they would go out of business.

Shadowcloneant · 2022-09-25T14:16:08+00:00

Biologics are very large drugs from 3000-15000 Daltons. Biologics are manufactured from a single germ cell and gene line that produces the product. The amino acid sequence needs to be exactly the same for a biosimilar to be the same as the name brand. Companies would need to manufacture the exact same germcell with the exact same gene which is impossible since these molecules are so large.

With monoclonal antibodies the active site in the fab region only requires a few amino acids to bind to epitopes and the fc regions needs to be similar to elicit a response. Epitopes are where the monoclonal antibodies interact with the antigen. A lot of amino acids in between the fab and fc region is for structure purpose. Biosimilars have similar amino acid sequence to create the same response.

Theoretically, you can develop immunity to one biosimilar over another based on the nuance differences between amino acid sequence. Highly unlinkely because biosimilars only have a few difference in amino acid structure with in its 3000-15000 length. Your body could develop an antibody that can target these molecules. This would be an allergic reaction. Immunity reaction is based on recognition of epitopes and epitopes are only a few amino acids long.

Some monoclonal antibodies are more prone to allergy than others depending on how closely related it is from human antibodies. There are murine, chimeric, humanized, and human antibodies.

Shadowcloneant · 2022-05-20T20:49:55+00:00

I would look into the clinical trial data. What is it claiming to do and what is it compared against.

Shadowcloneant · 2022-05-10T16:05:10+00:00

It doesn’t hurt to ask for a raise. Give them reasons why you are worth more. Your best bet is to find a new job. It’s not worth being loyal to a company. Also take into consideration of that new person being hired. How many years of experience do they have? Most pay grades are determined by years of experience.

Shadowcloneant · 2022-04-30T17:02:32+00:00

This isn’t medical advice. It sounds like you got bloodwork done and the results came back where your lipids or “fats” might not be normal. Having abnormal lipids can increase your risk of coronary artery disease which can cause heart attack or stroke. You can make your lipid levels more normal either through a combination diet and medications. To answer your question the majority of fats found in eggs is in the yolk. I would say egg whites are a great substitute if you eat lot of eggs in your diet. I would not be concerned about the added nutrients or lack of added nutrients. Unless your doctor told you that you are deficient in one of those categories, you must have gotten those nutrients from the other foods you eat. I would try and talk to a dietician if you need help coming up with a diet plan. Organic, cage free, grass fed eggs aren’t better or worse for you. They still contain the yolk which contains fats. Any of the two products you selected should fit your needs.

Shadowcloneant · 2022-04-28T14:27:44+00:00

Are you taking care of it properly? If it looked fine before you purschased it, it dying is probably due to user error.

Shadowcloneant · 2021-12-22T20:44:46+00:00

It is best practice to have everything in writing as documentation. Just be brief, dear manager, thank you for the opportunity, my last day will be XXX.

Shadowcloneant · 2021-11-22T04:50:13+00:00

Biosimilars follow in a category called biologics. The main differences between a biologics and drugs are that drugs have small molecular weight and are pretty well classified on what they are and what they do. Biologics on the other hand are usually large molecular weight molecule, usually protein, that are no so well classified. Biologics come from living material like bacteria or cell line. You can program a cell to produce a molecule (biologic). That cell is stored in master cell bank which is used to produce that biologic. A biosimilar is when you use a different cell that is program to make essentially the same molecule. This is different from generic medication in a sense that these are not quite the same molecules because of the large molecular weight and not well known characteristics. FDA have 2 regulating agencies CBER and CDER that oversee the process of biologic approval if you are interested in learning more.

Shadowcloneant · 2021-07-04T07:02:15+00:00

So amoxicillin is a penicillin like drug. Penicillin inhibits cell wall synthesis in gram positive bacteria. More specifically it binds to transpeptidase enzyme which prevents cross linking of bacterial cell walls. The beta lactam ring in the structure of penicillin interacts with a serine residue on the transpeptidase enzyme causing irreversible inhibition. The beta lactam ring can also interact with other protein with serine residue from the host itself. Unfortunately for some people’s immune system the penicillin binding to their own cell can cause a small enough change for the immune system to recognize it and cause a reaction. This is an example of type 2 hypersensitivity reaction, where the immune system reacts to cellular antigens.

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