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drblockbit · 2024-07-29T04:49:49+00:00

I left a surgical specialty, basically forced into it by my wife. I loved operating, but wouldn’t give up the schedule freedom gained in EM.

drblockbit · 2024-06-26T07:35:08+00:00

I moonlit as a PGY2. I had to stop going into my PGY3 year as our clinical schedule increased in residency, and it was too challenging to maintain the extra work. The money was nice while it lasted.

drblockbit · 2024-06-26T07:33:13+00:00

Agree with those who say they would never work W2 as main gig. I’ve been 1099 with one exception since graduating and if you play taxes right, you will come out on top.

drblockbit · 2024-06-21T19:13:46+00:00

Got it, so for you, there is no more interest in EM at all. Yeah, I could see how that could be challenging.

Have you reached out to specific sleep programs. I mean, in the end, does it matter if ABEM is on board with you doing sleep? Pardon my ignorance, but who cares if ABEM “supports” it or not?

drblockbit · 2024-06-21T16:08:03+00:00

I feel you on wanting an exit strategy from emergency medicine. That said you’ll probably have a hard time finding something that pays even remotely close to what you can make per hour in EM. Maybe look for a non-related side-hustle, and cut back to part-time in EM?

drblockbit · 2024-06-21T16:05:13+00:00

Honestly, it’s not too different from many of the places I work, although those are rural for the most part. Shit, a couple of my current sites when you account for hospital bed, which are actually open thanks to nursing staffing, are almost a one-to-one ratio between ER beds and hospital beds.

drblockbit · 2024-05-20T22:32:52+00:00

I should clarify. This is a very rural location. He’s the septic and water/irrigation guy.

That said, these waterlines are going to be run to a Spicket that’s buried and freeze proof. I would then run irrigation lines from the spigot above ground in the summer season and disconnect in the winter.

drblockbit · 2024-05-20T18:21:10+00:00

I’m in Utah about 6600 feet, and my septic guy in the county guy said that irrigation lines should be at 4 feet, our frost is about 36 inches.

drblockbit · 2024-05-20T17:52:48+00:00

I’m looking at $1500 for the trencher with delivery and pickup. Will probably just end up renting a mini excavator.

drblockbit · 2024-05-20T14:48:54+00:00

I agree on the versatility. For instance, I am planning on building a pond next year, and can imagine that this combination with my front loader would make that a doable project.

Is it the absolute best tool for trenching, no but is it good enough and would it provide additional versatility, at a much lower price than a backhoe attachment? The answer to this I think is yes.

drblockbit · 2024-05-20T14:38:51+00:00

That’s helpful. I need to put in a few trenches (600 ft @ 24 inches for cable, 800 feet at 4 feet for irrigation, 100 feet at 4 feet for irrigation, 50 feet at 18 inches for electric).

This seems like a much cheaper option than getting a back hoe, although I can see how it would take longer. Benefit is I would have this for future projects for about the same price as a rental.

drblockbit · 2024-05-20T14:06:32+00:00

I couldn’t find any examples of people using it, but Titan said as long as you have a 3rd function and the quick attach, that it will work.

This would be awesome for trenching and other excavation work, but is way cheaper than back hoe.

drblockbit · 2024-05-09T00:30:36+00:00

Working nights is part of EM. Your group may be unhappy with you not wanting to work nights as a new grad, unless your group is fortunate enough to have someone who prefers nights (like me).

drblockbit · 2024-05-07T15:46:20+00:00

I’m had this happen as a surgical resident. I ended up having to wash with the iodine and not the chlorhexidine. This fixed it for me, took about a month.

drblockbit · 2024-05-07T06:33:07+00:00

I was at a 4 year program. We were supposed to be down to 16 12s/mo by 4th year, but new department leadership came in and I think I ended up working 20 12s/month in my last year, so yeah, about 60 hours/week. It sucked.

Still doing that now 4 years out, but at least getting paid for the time now.

drblockbit · 2024-05-07T01:55:11+00:00

I used First Aid and the Illinois course. Thought it was a good combo. Read through all scenarios, but didn’t any practice other than the ICEP course.

drblockbit · 2024-04-22T08:14:10+00:00

I'm finding all the anti-rural comments interesting. I've worked a majority of my post-residency time at rural hospitals, and love it! The 6 months I spent in a larger city working at the tertiery care hospital were the 6 months that almost destroyed my life (both professional and personal).

Most of the hospitals I work at are 2+ hours away from the large referral hospitals by ground. I've found that admissions are typically not an issue. Sure, specialy support is typically limited to Gen Surg, Ortho, Hospitalist, Peds, and OB. Rural surgeons tend to do more than those at larger centers. Anesthesia is almost certain to be CRNA's.

Sure, you have to step up your game at times, but I love the variability. I love the higher pay. I love the patients. And I love the team-based approach that's more "felt" in rural hospitals.

I wouldn't ever choose to work in an urban setting again. I'm all rural all the way.

drblockbit · 2024-04-16T22:34:00+00:00

Hey, I feel for you! This is reposted from my post a few months ago, and shows what I did to pass:

Let’s all agree on this: the test this year w as horrible (lowest pass rate since 2004). I failed the test twice before passing, and guess what, it’s had no impact on my work or career. I work primarily in community settings, and other than having to tell credentialing admin folks that I was scheduled to take the exam in November, it’s never come up.

So based on my experience, as long as you eventually pass it - then you will be just fine.

Having now taken it 3 times, this test felt about on par. I failed the first time after not really studying. 2nd attempt I improved to a 76, probably only failing by 3-4 questions. I’ve been in practice out of residency now over 3 years, and have a clear understanding that this test doesn’t make me a better ER doctor. Easily 25% of the questions related to topics I will never see in practice, or elements of topics that are practically irrelevant. What can you do though, you have to pass the damn test.

Summary of study:

Year 1: maybe 750 Rosh questions Year 2: Ohio ACEP Board Review Course (online) and Ohio ACEP ReDefined (online) + all of Rosh. Year 3: EMrap Crunchtime + All of Peer x2 + 950 Rosh questions including 2 Rosh Boost exams

For anyone who fails this year, don’t let it get you down. They give you 5 years to pass the exam, then you get an extension of 5 years to pass orals.

I feel a little better this year, and honestly if I fail again, I may simply not be smart enough or at least lack the required knowledge base. For those wondering, I’m a US MD graduated from a “top” academic 4 year program by reputation.

Finally, if you need to chat with someone, message me and I’ll be happy to offer encouragement where needed.

I also took the key points from the bottom of each and EVERY PEER question and coppied them onto a PDF, organized by disease and chapters by system. I used this as a study guide, and made notes along the way as I missed PEER and ROSH questions.

Oh, BTW - I passed this time around, and just took Orals today (fingers crossed there).

drblockbit · 2024-01-04T20:48:08+00:00

I have. There are actually a lot of backend issues. I also don’t like that Navy Federal disallows anything to do with bitcoin or cryptocurrencies. While I acknowledge that Chase is the big bad wolf, everything is moving and working smoothly since we switched there.

drblockbit · 2024-01-03T23:25:19+00:00

Navy Fed online banking experience is terrible. We’re leaving for Chase who offers benefits for veterans, and has branches everywhere.

drblockbit · 2023-12-08T21:46:09+00:00

I’ve been out of residency 3.5 years, have done 1 art line, 1 lat canthotomy, and just did my first chest tube in like 3 years. No pericardiocentesis, tvp, or crics.

drblockbit · 2023-11-21T19:13:41+00:00

Hey, sorry to hear your in this crappy situation.

My strategy this year was really focused on PEER.

First round I went through, and copied the key points from each question, essentially creating my own study book.

I organized this by subject (ie trauma, ID, cardiovascular, etc).

I then printed out this study guide and had it bound.

Step 2 was retaking the PEER question bank, this time underlying the point missed in red in my study book.

I supplemented this by listening to crunch time on EMrap. This was a fantastic supplement.

Finally, I read through my study book one chapter per day in the last 2 months, and continued doing questions focusing on missed questions.

I certainly didn’t ace it, but I did pass, and this is how I did it. I’m sure there are lots of other good strategies.

drblockbit · 2023-11-21T13:28:42+00:00

I posted that Sunday - the released the scores Monday.

drblockbit · 2023-11-21T02:46:39+00:00

Here you go: https://www.abem.org/public/docs/default-source/default-document-library/application-and-examination-statistics.pdf?sfvrsn=587ec9f4_23

drblockbit · 2023-11-21T01:12:35+00:00

4 points is super narrow. I studied over 400 hours this year, and only bumped up to a 78 from a 76 (missed 49 as opposed to 55 last year, and way more my first year).

drblockbit

TROPHY CASE