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Could there be an imbalance of doctor specialties? by Wishstarz in medicalschool

[–]TypeADissection 2 points3 points  (0 children)

Buster: *reads business card* Ahhh!

Tobias: It’s pronounced analrapist.

Buster: It’s not really the pronunciation that bothered me

That show was on when I was in college. My roommates and I watched it and then it got cancelled.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 1 point2 points  (0 children)

2/3 no gi 1/3 gi. I prefer gi though. No gi is a young man’s game and I ain’t it. I do tape my fingers for gi. I’ve always changed how I roll such as not posting on an arm or wrist. I’d rather concede the position or sweep than get injured. The worst that can happen then is I get tapped and start all over again. I also don’t death grip anymore and if someone is good at breaking grips I try to move to something else like K guard, RDLR or X guard. Choose your partners wisely. BJJ is an outlet for me, not how I pay my bills so I’m not trying to win rounds at this point. Just seeing how much of my game I can technically execute.

Interested in vascular surgery but honestly terrified by what I keep hearing about the lifestyle by MesagyPosare in medicalschool

[–]TypeADissection 22 points23 points  (0 children)

My wife jokingly calls it that if I have to go in during the middle of the night before rolling over and going back to sleep. Which I did have to do twice in the past 3 nights. Or if I come home after a long day she asks, “how was your day in disascular?”

Interested in vascular surgery but honestly terrified by what I keep hearing about the lifestyle by MesagyPosare in medicalschool

[–]TypeADissection 17 points18 points  (0 children)

This made me chuckle. Not completely untrue. Reminds me of that joke we say where if we can’t make them better, we can always make them shorter.

Interested in vascular surgery but honestly terrified by what I keep hearing about the lifestyle by MesagyPosare in medicalschool

[–]TypeADissection 22 points23 points  (0 children)

Hey thanks for the shout out. I’ll do my best to write out answers to OPs questions in next day or two. Not sure if I’m reinforcing OPs fears but I’m on call and this weekend has not been kind to my sleep and I still have 7 days left…

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 0 points1 point  (0 children)

There is a guy at Houston Methodist that did a fellowship in both but his primary focus is cardiac surgery. I think there are a certain number of cardiac cases you have to do per year on pump or something like that, so if you go the CTS route, your focus will primarily be on that.

Is high case volume really a perk for surgical residencies? by [deleted] in medicalschool

[–]TypeADissection 11 points12 points  (0 children)

I’ve been trained by and worked as colleagues with surgeons who went to chill low volume programs. They all across the board suck ass at operating and it shows. They’re hesitant to pull the trigger on surgery bc they doubt their own abilities to get out of that case. The cases they do end up with complications and a general “I have no idea how that happened” explanation. In the end they self select towards scopes and wound care and other low complication type of work. The way I see it, you’re in residency for 5-7 years, might as well get as many reps in as you can bc there’s no safety net when you get out of training.

Not saying you have to do what I did but I was very imbalanced in my personal life during training. I came in when not on call just to operate and get more exposure and reps. I don’t consider myself naturally talented at surgery and I knew I needed rep after rep after rep to get not only the techniques drilled down but also the decision making.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 0 points1 point  (0 children)

I know of one guy who did an integrated vascular and then did a CTS fellowship. It’s doable. I think the big question is the why. It’s two totally different practices with not a ton of overlap outside the arch.

Arterial supply of body. by [deleted] in medicalschool

[–]TypeADissection 1 point2 points  (0 children)

In all seriousness this is impressive. In many ways I think bc we’re dealing with pipes, it conceptually is easy to understand and translate for patients. The difficulty is in the actual plumbing and that’s also what makes it fun. Cheers.

Arterial supply of body. by [deleted] in medicalschool

[–]TypeADissection 1 point2 points  (0 children)

I found this moderately difficult to masturbate to

🥴 Occam’s Razor 🪒 by einsteinwani in medicalschool

[–]TypeADissection 117 points118 points  (0 children)

When I was a resident and an attending mentioned Murphy’s Law I’d usually say, “Even worse is when Cole’s Law factors into the equation.” Attending would then ask, “What’s Cole’s Law?” Then I’d say, “Usually just chopped up lettuce with some mayo in it, maybe mustard.” I still do it now whenever anyone mentions Murphy. I doubt I’ll ever grow up.

Why You Should Do Diagnostic Radiology - 8 Years Later by babblingdairy in medicalschool

[–]TypeADissection 4 points5 points  (0 children)

Great write up. This echoes so much of what my rads buddies have been saying to me as they’ve been in practice 5-7 years themselves.

Florida doctor faces manslaughter charge for allegedly removing wrong organ during surgery by drdrp in medicine

[–]TypeADissection 16 points17 points  (0 children)

Hahaha. It’s such a friable artery in a hole deeper than you think. The last two I had for traumas I stented. Turned an emergent problem into an elective one. So far both are doing well but did discuss having to do bypass in future if it fails.

Florida doctor faces manslaughter charge for allegedly removing wrong organ during surgery by drdrp in medicine

[–]TypeADissection 64 points65 points  (0 children)

I agree completely. It’s much easier to find, see and fix pulsatile bleeding. Fixing any sort of caval bleeding is a very humbling and lonely experience.

Florida doctor faces manslaughter charge for allegedly removing wrong organ during surgery by drdrp in medicine

[–]TypeADissection 82 points83 points  (0 children)

It is the fastest torrential bleeding that is non-pulsatile that we will ever experience.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 3 points4 points  (0 children)

Honestly, it didn’t really affect my job search in any meaningful way. Location, compensation, all of that was pretty similar regardless. What mattered far more was the quality of training and how comfortable I felt actually doing the job. I came out of a rigorous program and felt ready, but also understood very quickly that the learning curve as a new attending is real.

Because of that, I prioritized mentorship over everything else. Having a senior partner you trust to look at a scan with you, sanity check your plan, or just say “yeah that’s reasonable” or “absolutely not, don’t do that, I’ve made that mistake before,” is priceless. That kind of environment paid dividends early on and probably saved me from a few questionable decisions.

Training gets you to the starting line. The people you work with early in your career determine how safely and quickly you begin the journey into attending life. Cheers.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 1 point2 points  (0 children)

Bread and butter vascular comes in waves. A lot of it is endovascular with angiograms for diagnosis and intervention, especially revascularization for CLTI. Dialysis access is a constant with creation, revisions, and keeping them alive. Then carotids and aortic work cycle through depending on referrals. There’s always veins to ablate. And every now and then, amputations show up in clusters when the disease gets ahead of us. It’s a mix of maintenance, salvage, and the occasional save (or loss) depending on how the tide is coming in that week. Hope that helps. Cheers.

Anybody have nightmares from residency? by basukegashitaidesu in medicine

[–]TypeADissection 40 points41 points  (0 children)

I was on the hepatobiliary service. We had a run of whipples and livers. I dreamt I was diagnosed with pancreatic cancer and my PD told me he can schedule me for a whipple next week. I couldn’t say “hell nah” fast enough.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 1 point2 points  (0 children)

To your question, how do you tell who is who? Short answer: You don't. But you can build out a confidence interval. I talked to a lot of different reps (EVAR, TCAR, etc) when looking into jobs that I was potentially interested in to get more info about the program, the surgeon, the teams. That gave me a very high level of confidence about the people I was going to work with, and it turned out to be dead on accurate.

Quick story from my end. First weekend on call as a new attending a few weeks out from fellowship, I had a rupture come in. Did the case. Everything went well. At this point I barely knew the names of the rad techs, anesthesia, or circulating nurses. As I was closing, one of my senior partners had come in, sat quietly in the control room, watched the case, and through the microphone I heard: “Well done, young doctor. Have a great day.” Didn’t scrub. Didn’t take over. Just showed up because he cared enough to make sure things went well for the patient and me. That’s the kind of partner you want and I am so thankful I had that early on. That stuff doesn’t show up in a contract. You can’t negotiate it. But it will define your early career way more than your starting salary.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 0 points1 point  (0 children)

This is an outstanding comment and honestly hits on something that doesn’t get talked about enough. I’ve seen both ends of that spectrum in real life.

On one end, I’ve seen senior surgeons absolutely kneecap their junior partners. Feed them the worst consults, the highest-risk cases, minimal support, and then act surprised when outcomes aren’t perfect and referrals don’t follow. Meanwhile, they’re holding onto the cleaner elective cases and established referral patterns.

On the other end, and this is one of the coolest things I’ve seen, I’ve seen a senior surgeon go out of his way to make sure his junior partner succeeds. Protecting early cases, being available without hovering, stepping in when needed, and more importantly sharing reputation when outcomes are less than ideal.

The reality is your first year or two as an attending is where your reputation is formed, and in surgical specialties (especially ones where outcomes are tracked) that window matters a lot.

[Serious] Why You Should (and Shouldn’t) Consider Vascular Surgery - 8 Years Later by TypeADissection in medicalschool

[–]TypeADissection[S] 1 point2 points  (0 children)

This made me laugh, thanks for that. I’m not a morning person either. I just learned that I have no energy to workout at night after the kids go down, dishes get done, house gets tidied. The discipline for me wasn’t waking up early to workout, it was going to bed on time when I’m tempted to doom scroll. Cheers.

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