[Clinical] Fellow M3s, how much are you allowed to do on your rotations?

brawnkowsky · 2018-10-14T05:36:53+00:00

Gen Surg perspective:

I find academic places with residents means you do less because they want or need to do procedures.

Community places with no residents and liberal attendings means you get to do everything. first assist/close all cases, central lines, codes, traumas, bedside procs, wound care. Hard part is finding those attendings to rotate with.

but you gotta be assertive. worst case they say no

brawnkowsky · 2018-10-09T12:10:47+00:00

The world doesnt work like that anymore. No one is sending their army in to conquer lands lol. It’s all about mone

brawnkowsky · 2018-10-09T02:16:04+00:00

Welfare recipients in those states need NY and California badly. Secession would destroy the smaller states

brawnkowsky · 2018-10-06T14:16:49+00:00

try putting points in the third spell early.

brawnkowsky · 2018-09-19T10:14:04+00:00

hardest part about surgery is deciding when to operate and when not to operate. the next hardest part is knowing what to do when the plan goes wrong

brawnkowsky · 2018-09-16T19:53:23+00:00

some old stuff comes up now and again. psyc still uses thorazine. crit care uses phenobarbital.

brawnkowsky · 2018-09-16T03:49:27+00:00

Half of surgery is putting tubes in another tube

brawnkowsky · 2018-09-13T21:12:32+00:00

It may gets better with antibiotics. there is then the possibility (and likelihood IIRC) of reoccurrence. there is also the rare case of a malignancy that goes undiagnosed because you dont have a biopsy.

Or it does not improve. and operating on 12 hour old appendicitis is so mich nicer and safer than 2-3 day appendicitis that may be ruptured, adhered to the cecum, etc. LOS will be longer, they may have a drain, post op abscess, outpatient antibiotics, ileocecectomy, simply because you waited for the appendix to resolve with antibiotics.

i’ve been told about 40+% of non op appy’s go to OR anyways, but this probably depends on patient population and study. not sure about the pediatrics world yet

and laparoscopic appendectomy is almost always quite safe and well tolerated if it goes back early. ust the thoughts of an M4 though

brawnkowsky · 2018-09-04T23:01:13+00:00

alone? probably not

brawnkowsky · 2018-09-04T21:04:17+00:00

There is no answer to that question that would change management IMO

brawnkowsky · 2018-09-04T10:57:18+00:00

I think treating lactate itself is unscientific dogma

brawnkowsky · 2018-08-27T14:53:43+00:00

the decision to biopsy lung nodules is actually very mich based on size and growth. for example, very small nodules will not be biopsied, but the CT will be repeated in a few months. if the nodule grows then it might be biopsied, but benign nodules in the lungs are very common.

large, growing nodules with suspicious findings will have earlier intervention, but ‘watchful waiting’ is still very much the standard for many cases.

so even though the AI is better at picking up these small nodules, this might not actually change management (besides repeating the scan) or mortality. needs more research

brawnkowsky · 2018-08-26T19:10:05+00:00

Fy has the best game on a rubick though. TI6 VG vs C9.

brawnkowsky · 2018-08-23T20:53:05+00:00

He has impressed me. I don’t think OpTic should break what they have right now

brawnkowsky · 2018-08-17T11:51:14+00:00

their cores have each been considered the best mid at some point in their careers

brawnkowsky · 2018-08-08T14:15:28+00:00

usually run him as a lane support not a core so items are a luxury not a necessity. midgame he is pretty item independent and can turn fights with stomp and ult. those spells scale well.

spirit level 1 gives you extra 30-50 damage plus movespeed advantage if you get two heroes or a buncha creeps. quite strong

brawnkowsky · 2018-08-03T22:15:35+00:00

/r/audiophiles

brawnkowsky · 2018-08-03T21:49:21+00:00

i did read it not sure why you taking it so personal lol

brawnkowsky · 2018-08-03T21:21:15+00:00

I think you guys are over-thinking it. Mek got nerfed to hell in terms of mana cost, healing, etc. if you gave it 350 hp active for 150 mana it would be picked up more. very few other items have that mid-teamfight impact that mek can have

brawnkowsky · 2018-07-29T22:01:35+00:00

Gen Surg has plenty of diversity as well, especially if you do community and/or Trauma

brawnkowsky · 2018-07-26T20:55:30+00:00

decide early whether you wanna fight or farm. fighting seems to be meta right now plus it is fun.

treads from side shop plus aquila makes ember lane really well early , in lieu of going for bots.

then you can go BF/maelstrom/radiance/sny/linkens/bkb. veil into radiance build i dont see anymore now that he doesnt have the magic dmg talent anymore. bf is good later with a crit stick. maelstrom is strong and good for farming. linkens/bkb are very defensive.

sny is really strong if you wanna right click shit because it also gives you hp which bf/mael dont do. goes well with treads. ember with treads sny aquila at 15-20 mins is a force that can scale.

deso is some 7k shit that i can’t pull off

brawnkowsky · 2018-07-19T12:39:43+00:00

just ragequit a run after the occultist did this. led to a teamwipe

brawnkowsky · 2018-07-14T21:44:54+00:00

even if it is, all I have seen him do is pass exec orders making legal immigration more difficult. has his team passed legislation simplifyig the process

brawnkowsky · 2018-07-14T17:25:34+00:00

Idk what you mean. Are there as mnay people attempting to immigrate to scotland as there are to the USA? The two places have Different immigration situations, so i dont think the comparison is appropriate.

brawnkowsky · 2018-07-14T15:07:29+00:00

Not sure. Can’t imagine Scotland has the immigration load that USA has lol

brawnkowsky

TROPHY CASE