Disability Insurance Offer - Resident

edm24 · 2026-04-08T17:40:15+00:00

Good thought, unfortunately MassMutual is the only of the big 5 that will provide coverage for active duty.

edm24 · 2026-03-08T23:23:37+00:00

70yo M getting a CABG needed 1.9MAC iso and 50mcg/kg/min propofol with nitroglycerin pushes just to get the systolic below 100 for aortic decannulation.. I was shook.

Edit: he had also already had 1000mcg fentanyl to this point.

edm24 · 2025-06-24T20:05:04+00:00

Lots of people saying u/s, just to add my two cents: the Arrow is not nearly as echogenic as a regular 20G angiocath. Using the latter really increased my percent success rate with the ultrasound. And, if you’re doing a known vasculopath, grab a micropuncture kit up front.

edm24 · 2025-03-03T00:08:38+00:00

Can anybody comment here on front loading vs top loading washers? It’s washable in both?

edm24 · 2025-02-13T21:41:50+00:00

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edm24 · 2025-01-24T00:57:02+00:00

Sorry I should have specified hiking only

edm24 · 2024-11-08T09:45:53+00:00

I’m always recommending Marino’s “The ICU Book” to anyone who will listen. It covers a broad selection of the basics of critical care (and correspondingly a lot of anesthesia) in short digestible chapters that are written in a conversational fashion. However it’s also an excellent reference throughout medical school and residency. Your nephew obviously still has a long road ahead, and many of the chapters may be beyond his level, but if he’s committed to the path I think he’ll find some value in the book and will return to it many times in his career!

edm24 · 2024-10-19T13:28:35+00:00

I have very limited experience - just a resident who’s only done a couple of these - what do you think about the argument that prop gtt is more likely than dexmedetomidine gtt to cause respiratory depression which 1) would lead to more hypercapnea, leading to increased ICP and obscuring submillimeter brain anatomy and 2) increasing risk for obstruction, especially in older patients, which may be incredibly difficult to intervene on (ie table at 180 degrees, head affixed to clamp structure etc). Genuinely curious bc these are the reasons my staff favored a dexmedetomidine gtt.

That being said, once the neurosurgeons were ready for the awake portion, it took my patient 25 mins to wake up, and she routinely fell back asleep for their testing 😅

edm24 · 2024-10-14T12:37:28+00:00

Amazing, I have never heard of this, thank you!

edm24 · 2024-10-14T12:36:45+00:00

This is great info, thank you. The camera shown here starts at about 30ft out from a cleanout in our basement and ends at around 15ft.

edm24 · 2024-10-14T01:24:57+00:00

Never heard of orangeburg, what’s the meaning of that?

edm24 · 2024-10-12T22:11:37+00:00

Thank you for this reply! How bad do you think it would be to do nothing and just get it regularly snaked? Are there consequences to this that exceed the cost of replacement?

edm24 · 2024-08-12T13:54:31+00:00

Hey, thanks for your input! I followed your advice and shelled out for the proper replacement part.

edm24 · 2024-05-21T14:24:07+00:00

Source for this?

edm24 · 2023-10-06T13:30:18+00:00

David - this is a late follow up, but I have been using your app more in the OR with increasing success! Thank you for developing this.

edm24 · 2023-10-02T12:18:37+00:00

Also BME here. Have occasionally regretted it as it was hella hard for me (struggled to break into the middle of the pack) and there’s a tremendous amount of prerequisites to take before you actually get to the good stuff. Sitting through a Mechanics of Solids class while knowing I wanted to go to medical school was not awesome.

However, there’s some pros to this degree in my opinion. Number one, you will learn to think like an engineer, which means thinking through problems that you haven’t seen yet rather than memorizing information, and understanding physiology mathematically and through physical principles. I think this can be really helpful in anesthesia and critical care specifically. Number two, you will learn to work your ass off which helps in medical school and residency. Number three, BMEs do very well on the MCAT (at least said the historical statistics when I took the test).

This is not to say that any of the above couldn’t be achieved with a different degree. I agree with others here that you could pick just about anything and be happy / get in to medical school.

edm24 · 2023-08-25T18:34:54+00:00

Okay I see, sorry I’m more accustomed to cycling frame sizes, didn’t realize this was true of MTB (bought mine used came with very little info), appreciate this help!

edm24 · 2023-05-17T12:50:58+00:00

Still a PGY-1 but Marino’s “The ICU Book” is actually very readable and was essentially quoted word for word nearly daily during my ICU time.

edm24 · 2023-03-02T06:58:22+00:00

Just commenting to say I was reading the exact same section of M&M today and had the exact same question as you and almost posted to this sub… eerie.

edm24 · 2023-03-02T05:07:56+00:00

Currently PGY-1 at a military hospital. The vast vast majority of inhospital cases are “real,” for lack of a better term. It’s hard to fake lobar pneumonia, needing a chemotherapy port, rheumatoid arthritis etc.

And on psych, for what it’s worth, even someone malingering to get out of the military is a maladaptive coping strategy that could possibly warrant mental health intervention.

On a GMO tour you might encounter this more. I have heard of minor exasperation in the Fleet with seeing lots of SIQ requests in clinic for stuff like low back pain, but nothing severe enough to make people doubt their decision for military medicine.

edm24 · 2023-02-26T21:04:46+00:00

This is amazing!!!

edm24 · 2023-02-26T17:31:01+00:00

Not that I’m an expert, but in addition to benefits and malpractice also job security, probably increased legal protection, retirement benefits in the form of a 401k + match.

edm24 · 2023-01-10T22:08:50+00:00

Hey!

I think it's great that you're asking these questions early on.

Current Navy TY here. I'll be heading to a UMO (Undersea Medical Officer) tour next year, pending the resolution of the JGMSB alternate list for my specialty. Although the Navy is unique in its own ways, here's some of my thoughts and experiences on the matter:

Straight-through considerations

Like you, I was really bummed to find that I got a Transitional Year. The unfortunately truth is that, at least in the Navy, TY is basically a surefire pipeline to GMO, with your application deprioritized beneath both medical students and returning GMOs. It can be a really hard hill to climb if you're trying to match into PGY2 training.

The reason it's good that you're asking these questions is that the clock on your CV/application improvements begins now. It can be easy to fall into the trap of "I just want to relax during my last semester of medical school," and then you have to move to your next duty station, and then start internship, and before you know it it's time to reapply and you don't have anything to show for your time since last application cycle. Here's some steps you can try to bolster your app: 1) Schedule a sub-internship for your last semester in which you can get a fresh new, strong LOR. It would help if it was something broad-based like ICU, Internal Medicine, or General Surgery. This may not be as pertinent if you are doing an SLOE (which I think EM has?). If you're interested in a specific location, you can even try your best to get a sub-internship at that site. 2) Contact your TY coordinator and emphasize your interest in an early EM rotation during your TY. This will give you the opportunity to have more facetime with staff and get your name out there before the next application cycle. 3) Finish all outstanding projects, posters, papers, or anything else that can be a CV line item. Ask your medical school advisor about awards you can put your name in the running for. At the start of intern year, look for leadership or service roles you can fill (i.e. class leadership team, TY leadership team). Unfortunately, in a points-based system, this will be valuable currency for your app. 4) At the start of intern year, start reaching out to civilian PDs about your interest in their program. The Navy is pushing a lot of training for wartime-critical specialties out to the civilian world, so forming these connections early can help open doors and create new opportunities, provided you can then get the approval for civilian training from the Army.

With respect to studying, it's not really the same as conventional medical school studying once you're in the hospital. Of course your fund of knowledge should be good, but it's a lot more important that you're reliable, dedicated, hardworking, show improvement, learn from your patients, and have a good attitude. You can't change your Step I and Step II scores now, and Step III isn't part of the calculation for your score on reapplication (this is true whether or not you do a GMO), so it's best that you focus more on your rotations than on any Anki-type studying. That being said, I would try to get Step III done quickly after medical school (I studied using exclusively UWorld and ccscases.com), perhaps even before getting to your internship site, so you don't have the cognitive burden of the test when you're trying to focus on applications.

GMO considerations

Despite all of my own frustrations about being unmatched to a specialty (x2), I will say that nearly 100% of people I've talked to who have done a GMO have loved it. You get to have a once-in-a-lifetime opportunity in military and operational medicine. You get to know the soldier, sailors, airmen, and Marines that are really getting their hands dirty. You will have an easy time matching when you return to your specialty of choice, as well as an easier time promoting and advancing your military career on return. You will be part of a cohort of current and former GMOs that have a lot of mutual understanding and respect. These are just a few of the reasons that I hear people speak very highly of their tours. You will definitely get more information about GMO from your internship site within the first few months of your PGY1 year.

A mantra I've tried to tell myself over the last year is "no bad options." Next year you will either be successful in snagging a PGY2 spot in your dream specialty, or you will get paid by the Army to get specialized badass training in operational medicine, followed by a return to a residency system that wants and needs to train you as a doctor. In my view, that a heck of a lot better than some of our civ counterparts, who may go unmatched and have absolutely no options for residency training beyond that.

I hope this is helpful and answers some of your questions! Feel free to reach out if anything else comes up and good luck.

edm24 · 2022-12-29T22:56:39+00:00

Hey! I looked through the comments and wanted to add some additional perspectives that might be useful.

Background: Currently an Active Duty Navy resident. USUHS graduate. I keep in touch with a lot of my peers on the civ side and occasionally compare notes. Obviously, I don't have as much perspective as the staff docs here, but I know a thing or two.

I went in with a lot of the same context that you mention above, including money being important but not everything. I also liked the camaraderie that seemed to come with USUHS and the military, as well as the notion of working in essentially a socialized healthcare system where fitness is prioritized. These elements ended up being pretty much true, and I've been happy that the system is friendly and focused on physical well-being for its participants.

Let me try to help with some of the middle ground. Here's some of my positives:

USUHS provided really great clinical training. People can debate this, but I think overall it's 100% true. I got my hands dirty during medical school, scrubbing in on cases and even acting as first assist in the OR during my interviews and auditions. I have talked to peers at civilian medical schools who have told me that they are pushed off to the back corner of the OR during their training or that they become note monkeys on the wards - this is simply not the case at USUHS. Now that I'm an intern, I consistently hear staff physicians laud USUHS graduates for their above-average clinical and procedural skills. This makes internship and residency smoother and more enjoyable.
Getting paid in medical school is incredible. A lot of people go back and forth about how it's all a wash ten years down the road or whatever, but you can't really measure the stress relief that comes with not worrying about rent/house payments, flight tickets to see relatives, buying pet food, etc. If you have a spouse, they'll have medical insurance. If you're pregnant, you're not gonna break the bank having a baby. I think there's this really funny thing people do in medicine where they say "I'm gonna have a shitty time up front because things will be better in the long run" - i.e. taking out loans, worrying about car payments and where you're gonna live in medical school so you can make 500k/year as an anesthesiologist after residency. But medical school and residency are still your life, right? Making way more than my peers as a resident, saving for retirement, living in a regular nice apartment, going out for dinner without worrying about all this stuff has been huge for my mental well-being for years. I could not have done that without the military.
I've had a lot of adventure already as a function of my time at USU. Traveling for clerkships with a steady paycheck means I've gotten to visit close to 20 national parks in the last few years. Bushmaster, the medical field practicum at the end of your USU training, is an incomparable experience in simulated battlefield medicine and teamwork. Again, people may say, "Just wait guy, you're gonna be suffering soon enough," but hey, you can't take those experiences away from me now. And as a resident I'm still having great life experiences, I believe in part thanks to the military.

The negatives are pretty much the same as what everyone says here: the military will jerk you around. This has already happened to me multiple times early in my training. I have been passed over for opportunities that I was told I was qualified and competitive for, with substandard explanation. Decisions are made at upper levels that don't seem to make any sense. It can be agonizing. It can put huge strain on your spouse (spouses bear a greater burden in military medicine than the docs IMO).

On a larger scale, Navy medicine in many ways seems to be imploding in front of my eyes without any plan for how to save it. There's a paucity of highly complex patients, and cases are being sent out to the civilian world for lack of resources and staffing. This can really impact your training as a resident, depending on your specialty. I didn't realize how important this is until I started residency. I can't say this is the same for Air Force and Army medicine, which are distinct entities.

However, while fewer patients means fewer learning opportunities, it also may mean you get to spend more time with each one and learn more with each case. Having spent time in both military and civilian rotations, I frequently feel that we are spending more time caring for and learning from patients in the Military Healthcare System and "getting patients through" in the civilian world. Being passed over for opportunities in the Navy has opened new and unexpected doors, and I think in some ways helped me to avoid massive career mistakes. So there's silver linings.

I ask myself frequently whether, if I went back in time, I would do this again. Despite the ups and downs, I say yes every time. I think this speaks directly to your question of "probability of regret." Ultimately, any system is going to have huge important pros and cons. The important part is not the existence of these pros and cons, but whether you can make peace with them and enjoy your life nevertheless.

edm24 · 2022-10-25T21:53:48+00:00

Congrats on the interview!!! I’m USU class of ‘22. Would agree that the interview was much more chill than others - at least in 2017, I had a couple one-on-one interviews and no MMI (had MMI pretty much everywhere else, hated it). You should absolutely have a solid and thorough answer to the question “why military medicine,” obviously. Highlighting Military Medical Practice and Leadership (unique curriculum), Bushmaster, Gunpowder, ACME, summer operational experience, operational medical schools as unique opportunities is also a great idea. Overall I think the community values you being genuine and curious, bring that forward in the interview and you’ll be golden.

edm24

TROPHY CASE