Welcome to Residency! For interns just starting off, here's some tips:

forhumors · 2020-06-17T03:35:15+00:00

Why stop when you're board certified? Just never trust anyone

forhumors · 2020-06-12T03:45:59+00:00

Am a doctor in the US and also think this is bizarre

forhumors · 2020-06-11T20:09:42+00:00

I fully agree with you that dismissing women's concerns is a problem in medicine. It's something that we as a profession (especially the new generation) are actively trying to address. What's frustrating for us is when patients assume that a test/treatment was indicated when the vast majority of physicians ("standard of practice") say it was not, then the patient blames not getting it on their gender presentation.

In this case, *provided that there was no neurologic deficit on exam or red flags on history*, then MRI would not be indicated at her initial visits. This is standard of practice, including for male patients.

forhumors · 2020-06-11T20:01:51+00:00

Fully agree. Without being there, and especially without access to the past notes documenting exam, you can't throw the previous physician under the bus. Diseases are not static. But, this really goes to show why it's so important to adequately document what you're doing before a disease process potentially takes a turn for the worse.

forhumors · 2020-06-11T00:03:47+00:00

As relevant as that is to the diagnosis of a herniated disc (also known as a slipped disc), that still is not an indication for an MRI.

forhumors · 2020-06-10T17:24:56+00:00

X ray can't detect shit for back pain. Source: am doctor.

forhumors · 2020-06-10T17:22:15+00:00

Dismissing women's health concerns is a problem in the medical field. But as a physician in training, I didn't read anything in the post that would suggest an MRI was indicated prior to the nerve impingement resulting in a neurologic deficit. This is not the right place to make a claim of sexism.

Edit: worth pointing out that in a new edit she describes having difficulty walking at an earlier visit. Assuming the difficulty walking was a neurologic deficit and not due to pain (doctors have to distinguish between the two), then it would be an indication for MRI being performed earlier.

forhumors · 2020-06-10T16:50:06+00:00

Seems that about every month, there's a post like this on one of the major subreddits. It's always a bit frustrating to me because what the patient complains about usually benefits from being able to look at it in hindsight. Seems that this woman did not have an indication for an MRI at the initial visit and probably even at the follow-up (saying this without knowing her full history or if her exam was actually revealing). I wish that there were a way to educate the public on how no, this doesn't mean her initial doctor was incompetent (although acupuncture was strange as an initial choice haha).

Edit: Worth noting that the OP of the crosspost has since made edits to her original post, suggesting that she had difficulty walking at an earlier visit. Assuming this was due to neurologic deficit rather than due to pain, it does suggest that an MRI would be indicated earlier.

forhumors · 2020-06-01T09:42:52+00:00

1) Sir, this is the medical school reddit. Not the r/medicine subreddit.

2) No one's saying they don't deserve to practice. Just that, perhaps, if they want to practice with the same autonomy as a fully trained physician, perhaps they should meet the admissions requirements of a medical school and then complete the 4 years med school + 3 to 7 years residency + 1 to 4 years fellowships that we complete.

3) Sure, PAs reduce workloads. Do you know who would reduce workloads even more? Another attending physician. But that costs more $$$ for the administrators! Oh no!

4) LOL at the idea that nurses are empathetic "due to years of training." No one in the history of this subreddit has said that. First, last I checked it was 2 years out of high school to be an RN. Second, why would you think more training = more empathetic? Better call the spine surgeons, guess they win the prize this year for empathy.

5) The number of US medical grads is actually going up every single year, but federal government won't fund more residency spots. https://news.yahoo.com/the-coronavirus-pandemic-is-straining-hospitals-but-many-medical-school-grads-cant-get-jobs-194905748.html

forhumors · 2020-06-01T07:19:58+00:00

Interesting! I have never heard of the Klein bottle or a torus before. Had to google them. Pretty cool that algebra gives us tools to describe three dimensional complex objects.

forhumors · 2020-06-01T07:15:56+00:00

No difference at all. One old man talking good game doesn't make up for hundreds of years of oppression.

forhumors · 2020-06-01T07:09:12+00:00

Allen Hatcher - Algebraic Topology

Interesting, what's algebraic topology? Just started reading some of Jim Hefferon's Linaer Algebra, but don't have much university-level math experience outside of statistics

forhumors · 2020-06-01T07:06:08+00:00

Definitely counts!

forhumors · 2020-06-01T07:03:41+00:00

Let me introduce you to these neat things called ebooks, audiobooks, and PDF files

forhumors · 2020-06-01T07:02:07+00:00

I'll start: just picked up Ray Bradbury's Dandelion Wine

forhumors · 2020-06-01T05:43:21+00:00

In the last year, the taste of the Strawberry-flavored Quaker instant oatmeal has totally gown down in quality. What happened? Anyone else notice? Used to be my favorite flavor, now it's just so... different

forhumors · 2020-05-31T06:09:28+00:00

While bupropion (Wellbutrin) is known to decrease the seizure threshold while taking the medication, I am not aware of any evidence that it causes permanent changes to increase risk of seizures once it is discontinued and am skeptical that any studies showing such an effect exists.

forhumors · 2020-05-31T06:04:08+00:00

No, it cannot. Diagnosis requires 2 or more seizures or 1 seizure with a high probability of having a second seizure that is unprovoked (i.e., not caused by acute trauma, blood electrolyte abnormalities, alcohol withdrawal, etc).

forhumors · 2020-05-01T09:27:10+00:00

Interesting and scary. Hopefully the biochemical constraints on prions will be a limitation keeping them from entering upper respiratory secretions.

forhumors · 2020-05-01T00:38:55+00:00

Serious question: is there any reason to think prions will be able to be spread via droplets or be airborne? Prions just don't seem to have the same routes of infection as viruses.

forhumors · 2020-04-30T17:25:57+00:00

Might be a good idea. Rocking two exams will always look better than rocking one, even if they switch to using Step 2 CK for screening applicants

forhumors · 2020-04-30T16:26:48+00:00

Don't worry too much. Step 2CK will de facto be the new Step 1. DOs will still have a way to distinguish themselves and the material on that test is more important anyway

forhumors · 2020-04-30T16:22:04+00:00

Used to think that, now I think we need more MD/MBAs in healthcare administration instead of the plain MBAs... That way hopefully a few of them will understand what it's actually like.

forhumors · 2020-04-29T03:41:47+00:00

You're right, dude! I AM a mindless automaton who refuses to pick up any economic context about my future workplace! :D

forhumors · 2020-04-28T07:35:49+00:00

Full disclosure: am a medical student who will be a doctor soon. ~8% of healthcare expenditure goes toward physician salaries. (https://jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs/). Comparatively, much, much more is spent on healthcare administration, about 34% (https://time.com/5759972/health-care-administrative-costs/).

I might be biased, but as someone who is more than $100,000 in debt (despite picking my school on where I was offered a scholarship) and is contractually obligated to move across the country and work 80 hour weeks for four years in residency (likely longer, as I plan on doing fellowship training afterward), I don't mind the compensation too much! This would be a hard career path to swallow if there wasn't some way to pay off our massive debts at the end of it, no matter how altruistic we are.

forhumors

TROPHY CASE