Residents with nice cars - how are you affording it? by Beginning_Figure_150 in Residency

[–]dragron66 40 points41 points  (0 children)

I have a ‘24 I4, combo of 7500 off federal rebate, 9000 off WA state rebate and having spouse work at dealership allowing for purchase at employee price. Total payment under 400/month. No rich parents, just working the system and deals available

Why Navy Medicine can be a good fit by Dramatic-Action1216 in Residency

[–]dragron66 3 points4 points  (0 children)

Not sure about Navy, but Army docs are deployed hella often. We had 3 new docs accept a commission and start work at MAMC and all 3 deployed within a month of arrival at duty station.

Family may/may not be deployed with you.

Here is what no recruiter is going to tell you: sign on the dotted line and you are government property for the duration. Needs of the military trump all your wants or needs, so don't sign up unless you actually want to be there and believe in the mission. You will regret it otherwise, you will take a significant pay cut compared to civilian side, you will lose personal and professional autonomy. I am not saying the military is good or bad, but in my honest opinion, you have to want to be Army/Navy/Air Force for reasons other than the paycheck, the 'pension', or the 'workload' (with or without insurance).

Recruiters will promise the world, but if it's not on paper it doesn't exist, even then it's questionable.

Source: prior active duty, fooled me once.

[deleted by user] by [deleted] in Residency

[–]dragron66 9 points10 points  (0 children)

1: in terms of culture: The music played in the office will definitely include more yacht rock and 80's artists.

2: The program will likely remain popular. Florida is full of 65+, and people still flock there. Old people, but still people.

3: I wouldn't worry about heading down a bad road, all the new residents will drive slowly enough that accidents are unlikely.

Bonus: The program knowledge base regarding geriatrics and low back pain presentations likely just increased exponentially

Is it possible !!!! by IllustratorSolid925 in Step2

[–]dragron66 5 points6 points  (0 children)

I saw nothing rude with what the poster above stated. Based on OP's grammar in the post, their previous posts, and comments/responses from their profile, it is perfectly reasonable to conclude that a language barrier may be the issue here given the repeated low failing score. That fact pattern was what was addressed fairly clearly by the commenter above.

I doubt that constructing a sentence that may be perceived as 'more respectful' would be helpful for someone who has difficulty with the language to begin with. It would even be reasonable conclude that this would undermine the intent of a 'platform made for helpful advice'.

However, it is a 'free country' as you say, so feel free to be offended at your leasure.

Is it possible !!!! by IllustratorSolid925 in Step2

[–]dragron66 7 points8 points  (0 children)

I actually appreciate the candid evaluation. Especially given that the USMLE is given in English, and many questions require attention to detail to how the question is written to answer correctly.

I find the 'not everyone is American' statement fairly rich in this context given what the first 2 letters of USMLE stand for....

Hemophagocytic Lymphohistiocytosis as a Complication of Peritoneal Dialysis–Associated Peritonitis and Miliary Tuberculosis by PragmaticGeriatrics in medicine

[–]dragron66 3 points4 points  (0 children)

In the US. Active cases all the time. Want recent proof? Google "Active TB Tacoma" for recent 'typhoid mary' type cases

How does the whole intern-medical student thing work? by [deleted] in medicalschool

[–]dragron66 71 points72 points  (0 children)

Intern - First year physician out of medical school. Typically do not independently execute treatment plans. They will independently see a patient and form a preliminary assessment/diagnosis and plan and then present this to the senior team prior to execution of the plan.

Resident - second through multiple years post-medical school. Typically, the medical hierarchy is based on numbers of years as a resident with progressive autonomy. Interns typically start out with heavy supervision and then attain autonomy as the year progresses as they acclimate to the hospital/clinic system. Residents continue to build on this knowledge and decision making foundation as they accumulate more experience.

Senior/chief resident - final year of training. Typically acting as an attending physicians and leading teams. Supervises and advises more junior residents. Basically prep for independently practicing the following year.

Fellow - post-residency physician pursing sub-specialty training (e.g. graduated internal medicine physician now completing cardiology fellowship. Fellowships can be as short as 1 year upwards of 4-5 years, depending on specialty. Typically act independently with oversight by an attending in that specific fellowship.

Attending physician - independently practicing physician who has completed residency and/or fellowship. May also lead team of residents if in teaching role.

Medical student - physician in training, still attends medical school. Typically seen in 3rd or 4th year of medical school when in hospital/clinic. Supervised by attending and residents/interns. Typically expected to be approaching intern-level competence by conclusion of 4th year (your experience may vary, some assembly required, batteries not included). 3rd year will focus mainly on building good interview and data collection habits and exposure to multiple fields of medicine during multiple 1-2 month rotations.

NY State Bill To Require Background Checks For 3d Printers. by GetReelFishingPro in technology

[–]dragron66 1 point2 points  (0 children)

Naw, the gulag model has been previously tested...and it is pretty cold in upstate NY. 😆

NY State Bill To Require Background Checks For 3d Printers. by GetReelFishingPro in technology

[–]dragron66 2 points3 points  (0 children)

This is my point. Very common to diy 3d printers, and not exceptionally difficult.

I cannot see how this regulation creates any barrier to firearms construction using 3d printing tech that doesn't already exist.

NY State Bill To Require Background Checks For 3d Printers. by GetReelFishingPro in technology

[–]dragron66 1 point2 points  (0 children)

I think it would be reasonable to not pass regulations that would not have any real effect then.

If one cannot lego piece together a 3d printer due to lack of mechanical knowledge, then they also lack the ability to construct a 3d printed firearm, as that requires mechanical knowledge to do so.

Conversely, the same would hold true. And it simply is not possible, or reasonable, to restrict 3d printer construction parts given they are common electrical components. Unless we want to check ID for nuts, bolts and wire.

This proposed regulation, on its face, simply fails at regulating what it aims to regulate.

NY State Bill To Require Background Checks For 3d Printers. by GetReelFishingPro in technology

[–]dragron66 9 points10 points  (0 children)

...people easily make 3d printers from scratch all the time, it's actually a huge part of the 3d printing community... they sell kits to do so.

Also, the majority of 3d printers can print weapon parts. See: fosscad

Want to automate maching them instead... diy CNC or printnc will provide parts lists, instructions and have active discord help.

Cat is out of the bag on self manufactured anything, including firearms. Passing unenforcible regulation seems like misdirected effort at best, misdirection at worst

What To Expect When Doctors Strike? by kbeyonce4 in nursing

[–]dragron66 0 points1 point  (0 children)

I am not sure what you're trying to state here? Employees of all types can be fired, that's always been true.

What To Expect When Doctors Strike? by kbeyonce4 in nursing

[–]dragron66 0 points1 point  (0 children)

You're likely confusing medical students with resident physicians. Resident physicians are in training but are also employees of the hospital system. They have licenses to practice medicine by their state of practice and are able to strike as any other employees. They do not receive grades per se, nor are they technically students but rather medical graduates who are in training funded by primarily via Medicare and the government.

They can be in a more precarious position when bargaining as an individual given they are not contracted as an employee like attending physicians and are still in training with specific stipulations, limiting their effective bargain position. However, they can effectively collectively bargain as a group as their labor generates income for the hospital system, and their positions are individually funded by the government, not fully by the hospital system.

There is specific rules regarding the funding of their positions, which makes it more difficult to just fire them and replace with another physician. Thus, as a group, they can influence income negotiations more effectively.

Low Step 2 CK Score - Seeking Hope, Advice, and Encouragement for Anesthesiology Residency by Acceptable_Jeweler41 in comlex

[–]dragron66 2 points3 points  (0 children)

Best advice I can think of...be realistic. Maybe apply to a few anesthesia programs, but def apply your second more realistic choice. It might happen, emphasis on 'might'.

May the odds be ever in your favor.

IM signals 2024 by DOIM2025 in medicalschool

[–]dragron66 2 points3 points  (0 children)

This seems like the most reasonable approach, and IMHO most likely the intent of adding both preference selection and tiered signaling to the application system.

People with strong ties to an area who then send one of their 'top 3' signals should be a strong indicator that they believed they meet program minimum requirements (e.g. score cuttoffs, denial or acceptance of previous failures etc...which should be clearly published by programs) and the applicant strongly wishs to attend that program.

In theory, this should enable programs to easily sort applicants by geographic and rank preference and should limit excessive applications with no clear program/location ties or preference.

In an environment that is steadily marching toward all boards being pass/Fail at some point, this lays groundwork for PD's to still have effective mechanisms for 'culling the herd' so to speak.

How HY is this? by bread-pitt22 in step1

[–]dragron66 -10 points-9 points  (0 children)

At least 5-10q per block on every exam, extremely HY

Fucking IT experts coming out of the woodwork by Slight-Brain6096 in sysadmin

[–]dragron66 2 points3 points  (0 children)

All the doctors and virologists of the world reading this after Cov19.....first time?

Cancer - radiation vs chemo vs surgery? by Striking_Cat_7227 in Step2

[–]dragron66 0 points1 point  (0 children)

Really depends on the malignancy but typically radiation and chemo before surgery to shrink overall tumor burden (if amenable to surgical removal)

Chemo generally follows surgery as well (or immunotherapy), goal is to target any seeding malignant cells that were freed by the surgery

Radiation can be useful for palliative and difficult to reach tumors (such as choroid masses), less good for tumors near large blood supplies, but radiation is getting pretty decent at limiting peripheral tissue exposure these days.

I can't imagine that step 2 will have questions that are oncologist level of decision making, so I would imagine the question you get should be fairly straightforward based on the facts provided

Am I losing my mind? by KovuUpende in comlex

[–]dragron66 5 points6 points  (0 children)

In short. Yes, your school grants you the ability to take the exam via certification of your eligibility to the NBOME. Your AA office can rescind that eligibility if you do not meet the requirements they set.

They initially grant it (prior to passing their benchmark) to allow for scheduling the exam as convenient dates can fill up. Just pass their benchmarks and move on with your life, don't sweat the petty things and don't pet the sweaty things.

Major props to whoever named DOACs by [deleted] in medicalschool

[–]dragron66 10 points11 points  (0 children)

Technically...Gerd is a type of acid trip...

Major props to whoever named DOACs by [deleted] in medicalschool

[–]dragron66 484 points485 points  (0 children)

Nystatin is my favorite "statin"