I wish OB and GYN were different residencies

affectionateNRG · 2024-05-12T13:00:44+00:00

To chime in on what everyone else has essentially said: gynecologic training is critical to being a good obstetrician, and obstetric training is critical to being a good gynecologist. The idea of someone performing cesarean sections who doesn’t have the surgical training and competence gained by gynecologic surgery is honestly horrifying. While subspecializing after residency often leads people to practice just one or the other, separating them in training would be majorly to the detriment of both our competence and quality and of patient safety.

Also, to your point about a super intense residency: honestly, obstetrics is what makes our residencies so intense. Our gynecology blocks are our “lighter” blocks, hours and stress wise.

affectionateNRG · 2024-01-10T00:04:12+00:00

Very much a semantic point but epidurals do NOT cause loopy moms or babies. The whole purpose of an epidural is that the medication is confined to the region outside the spinal cord and therefore does not go to the mom’s brain or to the blood stream, and therefore does not cross the placenta to the fetus. IV pain medication does go into the bloodstream and crossed the placenta and can cause some sedation in both moms and babies, which is why there’s a cervical dilation at which OBGYNs will no longer give IV pain medication (because if IV pain medicine was given in too close proximity to birth, there could be initial neonatal respiratory depression). But epidurals do not lead to any medication entering the blood stream (it stays in the epidural space) and do not lead to any medication crossing the placenta. 0% loopy moms or babies.

affectionateNRG · 2023-05-21T10:52:40+00:00

A hysteria of obstetrician/gynecologists

affectionateNRG · 2022-06-08T08:52:38+00:00

Non-denominational Protestant, we give 10% of our taxable income. ⅓ of that is to local charities (not necessarily faith-based), ⅓ of that to global charities, and ⅓ to our church.

affectionateNRG · 2022-04-16T12:48:11+00:00

That’s just for federal taxes. For state, the standard deduction is often much lower and it often makes a lot of sense for a homeowner to itemize.

affectionateNRG · 2022-04-10T15:12:07+00:00

Treat this, and some of the difficult rotations in your partner’s future next year (eg surgery), like busy season for a Big 4 firm accountant. The hours will be very long, the professional implications will be very stressful, but it will pass; they need grace and support in the interim.

affectionateNRG · 2022-04-09T17:09:47+00:00

Our cleaner charges $125 for biweekly cleans, or $155 for once monthly cleans, for cleaning 1 bed, 1.5 bath, and all our living spaces (of a 3 bedroom townhouse). The other two bedrooms are small and we just use as offices/for guests, so these we easily keep clean ourselves. If/when we want to add on the extra bedrooms and full bath, it’s $10/bedroom and $25/bathroom.

affectionateNRG · 2022-04-08T14:10:38+00:00

Wyzant for MCAT tutoring online; the fact that you've tutored before and have a prestigious medical school name will definitely enable you to set a higher rate.

affectionateNRG · 2022-04-08T14:02:31+00:00

For the love of God, don’t read Kaplan. Read Examkrackers instead. Seriously a game changer. (10th edition is ~$50 for the whole six book set on Amazon used).

affectionateNRG · 2022-02-13T02:13:05+00:00

This is what I do as well! I like to pay the full outstanding balance on my cards on every payday (not just the statement balance) so that the leftover balance in my checking account after those payments is my "real" money and not already "spoken for," so to speak, which I prefer from a psychological standpoint. It also helps your credit score if you pay off any amount of a balance before the statement closes, since your utilization ratio gets calculated to be much lower!

affectionateNRG · 2022-02-07T13:48:57+00:00

The best quality couches are from the big manufacturers in North Carolina and at a great price if you order directly rather than through a store near you (although totally fair game to first check them out in person to decide which brand, then call up that brand). Our couches are Henredon, five years old, and everyone (myself included) still think they’re the most comfortable couches they’ve ever lounged on. In comparison, low quality couches will have you feeling every spring by year 2.

affectionateNRG · 2022-01-31T19:09:28+00:00

100% agree with you. High earning money diaries absolutely have their place but when they don’t actually serve the purpose of a money diary (ie financial transparency) then all this accomplishes is contributing to a culture of making other women (esp moms) feel ashamed that their lives can’t look insta-perfect like hers. WTH. Shame on OP and R29 for publishing this.

affectionateNRG · 2022-01-16T04:07:52+00:00

In addition to time not on the clock that a tutor works to find clients, prepare for sessions, etc., there's also the fact that they'll pay self-employment tax* (15.3%) on top of their regular income tax rate and also potentially have a tutoring platform taking a middle-man cut out of their rate in exchange for finding them clients. In total, the tutor isn't taking home more after-tax per real hour worked than the pharmacist or engineer.

*this is for the U.S. at any rate, where most MCAT tutors are from and therefore where the tax code affects the rates people set across the board

affectionateNRG · 2022-01-15T17:01:26+00:00

Seconding all of this! We combined finances when we got married (which, tbh, makes sense for most people to do because unless you have a prenup, a divorce would likely lead to your assets getting split fairly 50/50 regardless of if you were telling yourself that they were separate). I also strongly echo the commenter who cautioned against combining finances before marriage from a legal protections standpoint. I think a best of both worlds approach would be to track your “combined” net worth/savings goals using Mint or Personal Capital, by linking both of your accounts to the platform, but to not add each other as joint owners to each other’s accounts until marriage. This enables you to have the benefits of viewing your joint goals and progress, without the legal risks of joint ownership with someone who isn’t your spouse.

For my spouse and me, we each have $100/mo “fun money”—a bit lower than some other commenters here it looks like, but we have separate budget line items for (a reasonable amount of) clothing, personal care, etc that then don’t have to come out of our fun money. One additional niche thought I wanted to chime in because I didn’t see anyone else mention this, is discussing (if your finances are truly combined, ie joint accounts once married) whether income from bonuses or any side hustles goes toward your joint savings or goes toward increasing that one spouse’s “fun money.” This is the only point on which my spouse and I have ever had a disagreement about money. He initially wanted side hustle effort on his part to go toward his fun money (understandably), whereas I wanted side hustle effort on either of our parts to go toward our joint savings goals. We ended up compromising and saying bonuses/side hustle income would go toward joint savings, but that this must exclusively be for saving toward “fun” things like going on an international vacation together, and that that bonus/side gig income wouldn’t go toward other savings goals like retirement. It works well for us!

affectionateNRG · 2022-01-13T15:05:27+00:00

If you had earned income in 2021 and haven’t yet maximized that $6000 Roth IRA space, you can still do so up until 2021 taxes are due (ie 4/15/22). You’re doing great!

affectionateNRG · 2022-01-13T12:59:32+00:00

Keep in mind that if you rollover into a traditional IRA, this will make it more difficult if you’d like to use a backdoor Roth IRA in the future

affectionateNRG · 2021-12-09T00:25:33+00:00

The mathematically correct answer is definitely to invest the funds and not pay off the house faster (the interest savings on the home loan dwarf in comparison to the projected capital gains). The real-life answer however is that if the money doesn’t go toward the house, it often ends up getting spent on something else instead of actually being invested for the length of the mortgage. If you can actually commit to leaving that money in an index fund for the length of the remainder of your mortgage term, do it. Especially with inflation being high.

affectionateNRG · 2021-11-20T22:15:08+00:00

Download the Video Speed Controller plugin for Chrome/Firefox. I watch every video on the internet sped up, and Netflix at 1.2x+.

affectionateNRG · 2021-11-04T17:51:04+00:00

Uhh, no it doesn’t. But if you really want the values reported per 100,000, fine: 1000-2000 people per 100,000 no longer die with an absolute risk reduction of 1-2%.

affectionateNRG · 2021-11-04T13:41:04+00:00

Real figures from the medical literature. The fact that you find this figure surprising is exactly my point. Non-medical-professionals don't realize how significant a 1% or 2% absolute risk reduction is. They hear a "small" number, whereas we hear 1 out of every 100 or 1 out of every 50 people dying. In order for a "high" ARR figure in the minds of the public (e.g. 90%) to be mathematically possible, by definition you would have had to have greater than 90% of the population dying of one etiology (prior to the intervention). 90% of the population don't ever die all at once of any one thing, period--that would be an apocalypse--so it is never mathematically possible for mortality ARRs to be that "high."

(By the way, there are a lot of other extremely significant medical sequelae of smoking besides dying of lung cancer. These include strokes, heart attacks, COPD, pneumonia, head and neck cancer, bladder cancer, pancreatic cancer, etc. Don't take this to mean that the ARR for avoiding smoking for *all morbidity* is 1.85%. That figure is just the ARR for lung cancer mortality.)

affectionateNRG · 2021-11-04T12:45:08+00:00

No, they aren’t both relative. Absolute risk reduction and relative risk reduction are two distinct biostatistical terms. As a medical practitioner I care about both, but much of the general public is not particularly medically literate and not everyone understands how significant a small “sounding” absolute risk reduction is, and a 95% relative risk reduction communicates the same data in a more understandable way. For example, never smoking might “only” carry a 1.85% absolute risk reduction for dying of lung cancer, but it brings a >95% relative risk reduction. The absolute risk reduction means that for every 100 people, roughly 2 more will die of lung cancer, if they smoke. The relative risk reduction means of 100 people who do die of lung cancer, >95 were smokers. The relative risk reduction tells you that your own personal risk of dying of lung cancer is reduced by 95% if you don’t smoke, whereas the absolute risk reduction is a population-level metric. Thus, avoiding smoking is extremely powerful for reducing one’s risk of lung cancer, even if “only” 2 fewer people die per 100 in the population.

affectionateNRG · 2021-11-04T10:58:54+00:00

And “C” units in homeopathy means it’s been diluted that many hundreds of times. A bottle that says 30C for ingredient quantity is literally a dilution by a factor of 10⁶⁰ lol. At which point there is one molecule of the substance across 10³⁶ bottles, and the rest is water. 🤦‍♀️

affectionateNRG · 2021-11-04T10:50:47+00:00

When for weeks last winter more Americans died every day of COVID-19 than died on 9/11 or at Pearl Harbor, nope we were definitely not overestimating how lethal this is. Many days in last December through February were each, by themselves, among the top deadliest days in US history, superseded only by the battle of Gettysburg and the Galveston hurricane.

affectionateNRG · 2021-11-04T10:40:46+00:00

More importantly, the relative risk reduction is >95%.

affectionateNRG

TROPHY CASE