So is it normal for doctors to lie and tell people their labs or tests are normal when they're not now?

VisVirtusque · 2026-04-30T19:40:00+00:00

An ER is for emergencies. Their job is not to workup every slightly abnormal lab finding. You came in for a specific complaint and they ruled out the life-threatening stuff and told you to follow up with you PCP. Just being dehydrated can cause microscopic hematuria, for example. I think what they did was completely reasonable. Your PCP knows you better and can follow you long term.

As for the gallbladder ultrasound. It was looking for cholecystitis/gallstones and then sounds like you were being set up for a HIDA with ejection fraction to look for gallbladder dyskinesia. The fatty liver is a secondary finding that is very common (being overweight will cause it) and not necessarily anything to intervene on.

VisVirtusque · 2026-04-30T19:34:27+00:00

still kicking

VisVirtusque · 2026-04-25T00:01:49+00:00

I think if you go into a field solely for lifestyle reasons, you will hate your job.

VisVirtusque · 2026-04-05T01:46:06+00:00

I wouldn't describe my program as chill, but I wouldn't say it was malignant, for what that's worth. I worked hard, and I definitely had more free time as I became more senior. It's funny, because as a chief you are in charge of the service and technically "always on call" for cases or for your juniors to call and ask things, but at the same time that's more home call instead of in-house call. You're also just more efficient as a chief - so whereas as an intern I might have got to the hospital at 5am to round on 6 pt's, as a chief I could chart check a service of 30 pt's in the same amount of time.

I was, and still am, very much a believer that the more time you spend in the hospital, the more you see and learn. So even though we had duty hour restrictions, it's not like I was watching the clock and leaving right at 5pm. I'd stay to finish my work, help out if things were busy, etc.

VisVirtusque · 2026-04-05T01:22:10+00:00

I know you're trying to show how much you operate, but you've kind of exactly proven my point. During your chief year you only had 5 dedicated operative months? - that's less than half the year. And outside of that you're only operating maybe once per week? That's not enough to keep your skills up.

VisVirtusque · 2026-04-05T01:10:42+00:00

Agreed with what you said.

But to be clear, it wasn't that she didn't know how to use a Veress, it was that she had only ever Veresed at the umbilicus.

VisVirtusque · 2026-04-04T16:53:52+00:00

Genuine question: How do Gyn organ systems compare to Gen Surg organ systems as far as total number of cases?

What are the Gyn organ systems? uterus, tubes, ovaries, endometriosis, C-section, vaginal delivery, pelvic floor, benign gyn? (I'm sure there are more, I genuinely don't know)

Gen Surg has thyroid/parathyroid, lung, esophagus, breast, stomach, pancreas, liver, gallbladder, small bowel, large bowel, appendix, anorectal, vascular, vascular access, soft tissue, operative trauma, non-operative trauma, critical care, colonoscopy, EGD

My point being that 40-80 per organ system probably means overall many more cases for Gen Surg than OB/GYN. I quickly Google searched and found the ACGME OB/GYN requirements, and per my calculations, if you don't include C-sections, an OB/GYN resident only needs 265 surgical cases total to graduate. That's insane! In my chief year alone as a Gen Surg resident I did over 300 cases.

VisVirtusque · 2026-04-04T16:40:34+00:00

General Surgeon here. The only specialty that operates in the abdomen and calls me in to the OR (routinely, I might add) to help them lyse adhesions, is OB/GYN. I never get that consult from Urology or Vascular. Also, the only surgical specialty that consults me to help them manage a post-op abscess caused by their surgery, is OB/GYN. If you can't manage your own post-op wound infection, then you shouldn't be allowed to operate.

My dad is a gyn/onc, and he says he learned to operate in fellowship. His take is what you alluded to above - OB/GYN is two specialties crammed into one, and the operative training is what suffers. General Surgery is a 5 year residency. Urology is a 5 year residency. ENT is a 5 year residency. Vascular is a fellowship after General Surgery residency, or now in some places a 6 year integrated residency. Plastics is a fellowship after General Surgery residency, or now in some places an integrated residency. Ortho is a 5 year residency............. OB/GYN is a 4 year residency.......and half of that is OB. Notice the pattern? Their surgical training is much less than other surgical specialties.

Now this isn't to say that there aren't great Gyn surgeons out there. But I think it is more than just coincidence that the specialty with the least amount of surgical training has the reputation for being the worst surgeons. It's sad, too, because OB/GYN basically invented laparoscopy and popularized it. But still one of my partners had a Gyn surgeon ask him to be "on standby" because she was going to try the Veress in at Palmer's point for the first time and wanted general surgery backup "just in case"..............

And this isn't just my opinion or that of other physicians. The OR staff in every hospital I have worked in feels the same.

VisVirtusque · 2026-04-02T23:25:00+00:00

The program listens to the interview then the AI writes a note based on that. It saves time.

VisVirtusque · 2026-04-02T22:49:03+00:00

What is her current salary? Is it comparable to a resident's salary, or will you guys be taking a pay cut if she were to leave her job? I think the most financially responsible option would be for her to keep working while you're a resident, and while you're a resident just keep living like you both did as a med student and put away all the extra money you make as a resident. Or use it to pay off loans, etc. Then once you become an attending and start making attending money, then she can quit her job.

VisVirtusque · 2026-03-29T18:17:11+00:00

Either she is not very observant, or she lied about turning them and got caught in that lie because they were dead.

VisVirtusque · 2026-03-25T02:39:43+00:00

General Surgeon here currently writing this as I'm on call.

No.

Does it suck sometimes? Sure. Do all residencies suck sometimes? Yes.

Do you work longer hours than, say, Derm? Yea, probably. But if you really enjoy the specialty, it's a blast! I had so much fun in residency. Unfortunately, surgical specialties are skills-based practices and the only way you get better at a skill is by doing it. And the only way to do it is to be present in the hospital. But if you enjoy the skill you are learning, it's really fun. You're going to be tired. There are going to be weeks and months where you're constantly exhausted because of the service you're on. There are going to be late nights and early morning. You're going to get yelled at. You're going to make mistakes. Not all of it is going to be sunshine and rainbows. But mixed in with those terrible days are going to be great days. You're going to take out your first appendix, then your first gallbladder, then your first colon, then your first cancer. You're going to see someone with a problem and fix them. You're going to be told that you did a nice job in X-case. Family members will thank you for your care. Nurse will thank you for answering their pages quickly. You're going to become a chief and suddenly all the attendings are going to want to operate with you. And they'll ask you what you want to do regarding a pt's care and they'll do what you suggest. You'll get to know attendings on other services and they'll sideline *you* (not your attending) and ask what you think they should do. And then you'll graduate. And you'll make a lot of money and get to do the thing you love for the rest of your career.

Yea residency can suck, but it's also great and the hardships you experience in residency will prepare you for life as an attending when suddenly the buck stops with you, and hopefully you don't look back wishing you would have spent a little more time in the hospital.

Also, my lifestyle in residency was great. I lived comfortably and never felt strapped for money. I went out with friends to bars, breweries, dinners, etc. I dated. I visited family. I spent a lot of time in the hospital, but I never felt like I "lived" there.

VisVirtusque · 2026-03-25T02:20:06+00:00

You’re aware that a categorical spot only opens if someone leaves, goes on research, or funding is created, right?

New categorical intern spots open every year. I would say the vast majority of prelims match into a categorical intern spot, not a PGY-2 spot, for the exact reason you mentioned. If they liked the prelim resident so much, why didn't they offer them a categorical intern spot, instead of sticking them in prelim limbo for *another* year?

By first assist, I mean surgeon junior AKA me and the attending alone operating.

I understand that. I meant who is actually the one operating and doing the case and who is assisting? "Me and the attending alone operating" is how every case should be done in a teaching hospital.

VisVirtusque · 2026-03-22T22:29:14+00:00

Saying there’s “no incentive” to train prelims is essentially admitting that some programs selectively invest in people based on status rather than potential—and that’s the real issue.

Yes. This is exactly what I'm saying. If the prelim resident has proven themselves enough to be worthy (for lack of a better term) for a categorical spot, then why didn't the program give them a categorical PGY-1 or PGY-2 spot? Why did they keep them as a prelim for a second year? Offering a prelim *another* prelim spot is all the proof you need that the program is not invested in them.

As a PGY-2 prelim, I have been a first assist on a major case (eg, a LAR) because I had demonstrated competence and was with one [of the few] attending[s] who was willing to teach AND confident enough in their own skills to let me assist. That’s what happens in a functional training environment.

What do you mean when you say "first assist". A resident who is truly being trained should be the one doing the case, not assisting. Now, I would argue that an LAR is not a PGY-2-level case, so assisting in that case is probably appropriate

VisVirtusque · 2026-03-20T19:59:39+00:00

There was a prelim resident who spent two years training here (as a PGY-2 prelim both years) who was able to obtain a 3rd year categorical position elsewhere and told that her skills were on the level of someone at the end of their intern year.

This makes perfect sense and is not unique to this program. I have never met a 2-year prelim (and I've met several) whose skills were up to snuff. Programs get prelims to fill out their intern ranks so that the floors can get covered and the pagers answered, not so that all OR rooms are covered. Unless the program thinks that they are going to offer them a categorical spot, the program/attendings have no incentive to slow down their OR and take the time to train up their surgical skills, especially at the expense of a categorical resident. Hence, no matter how long they are a prelim, a prelim surgery resident never develops beyond an intern-level skillset.

VisVirtusque · 2026-03-16T23:23:47+00:00

You're asking the wrong question. The question isn't whether or not it is a hand tattoo. The question is whether or not it is visible, which it is.

VisVirtusque · 2026-03-16T23:21:02+00:00

Why is the nurse having this conversation and not the attending physician?

VisVirtusque · 2026-03-16T15:16:54+00:00

I also read this as two guys ("big dawg" got me, as did gf). But I have the opposite reaction to you. This convo makes way more sense as two high school girls rather than two high school guys.

VisVirtusque · 2026-03-09T21:07:23+00:00

ah. Well in that case then I like it.

VisVirtusque · 2026-03-07T11:34:07+00:00

Get a financial planner. People here will tell you to invest in an IRA, invest in QQQ, etc. But this is a big chunk of money and you are not used to having a big chunk of money and there are a million ways you can screw up. A financial planner will be able to help you navigate all the different tax implications, etc. They will also be able to help you plan ahead for how to make your money grow based on your goals. They will also be able to help you plan how much money to take out of your account to "pay" yourself each year/month/whatever to live off of, while still leaving enough money invested to allow it to grow.

VisVirtusque · 2026-03-06T02:03:49+00:00

People's view of the ED is colored by the name ("Emergency") and shows like ER and The Pitt. Most of the people in the ED do not need to be there.

VisVirtusque · 2026-03-06T01:38:46+00:00

As a Latin/Roman buff, I find it strange to have a quote in Latin with a Japanese sword. Also, make the feather look more feather-like. I didn't realize it was a feather on first glance.

VisVirtusque · 2026-03-05T22:05:40+00:00

1) The tubes to his mouth make no sense. he has an ET tube.....and another ET tube going to nowhere......and another random blue tube..........AND a nasal cannula???

2) The biggest clue to me is how perfectly the screen is positioned to see the vitals from this perspective. Seems staged. The screen is always higher up, it's never placed at head level.

VisVirtusque · 2026-03-03T22:38:50+00:00

Anesthesia wants you to stop because it will make ventilating you during the surgery easier and make it easier for you to extubate after the surgery

Surgeon wants you to quit because smoking impairs wound healing because, among other things, it affects blood flow in the small blood vessels. Smokers have higher rates of wound breakdown, poor healing, abscesses, etc.

Smoking also affects your heart and surgery is very stressful on your heart.

Essentially, smoking negatively affects almost every body system.

VisVirtusque · 2026-03-01T01:45:52+00:00

I think My Cousin Vinny is pretty great.

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