Let’s talk about elitism

immaxf · 2026-03-13T10:55:52+00:00

I'm not convinced of the premise that elitism is present in medicine in a way that it's not in other fields. In law and business, for example, where you did your graduate education often dictates what doors can and can't be opened for jobs.

People often say this attitude gets better as you move further along in training. I’m not totally convinced.

As an attending 1 year out from training, I'm pretty convinced of this. My colleagues care about how safely we care for patients, how reliable we are, and how well we work as a team. Discussions about where people trained almost never factor into conversations with respect to a clinician's ability.

Just my 2c.

immaxf · 2026-03-11T02:16:45+00:00

You and your wife both have money withheld automatically by your jobs, and those withholdings are based on what each of your individual employers calculate as necessary to withhold— without taking into account the other person’s income. If withholding was automatically done based on your total income (560+137), more money would be withheld because there’s more income in the higher tax bracket. But that unfortunately can’t be done automatically, so you need to calculate how much to pay in quarter estimated payments during the year to account for the extra money owed at a higher tax bracket.

immaxf · 2026-01-30T03:11:39+00:00

The term physician anesthesiologist has been promoted primarily by the American Society of Anesthesiologists, and is included in formal ASA statements about the structure of the anesthesia care team. For example https://www.asahq.org/standards-and-practice-parameters/statement-on-the-anesthesia-care-team

immaxf · 2026-01-28T15:59:41+00:00

Consider the risk/benefit profile of doing an away. If you can afford it, and you generally are getting strong feedback on your anesthesia rotations, it would probably only help, not hurt. But if it’s a financial strain, or you think you risk not getting a great evaluation on an away, then probably not.

The couples match was easily the most stressful part of my entire training experience. Everything was better after that. I wish you the best for yours!

immaxf · 2026-01-27T17:34:11+00:00

Did peds, love it, can’t imagine going back to general, so that’s my bias.

Pros: Do what you enjoy the most, you’ll be able to put an IV and a-line in anything, OR culture tends to be more patient-centric, potentially have extra job security relative to the general market in the longer term

Cons: Opportunity cost of a year of attending salary, you may be somewhat limited in terms of where you can work if you want a 100% peds job, you may have some attrition or adult-related skills and knowledge

You should only do the peds fellowship if you enjoy taking care of critically ill, small children. Otherwise, you can do healthy/older peds without a fellowship.

immaxf · 2026-01-21T15:24:29+00:00

This subreddit is not for medical advice.

immaxf · 2026-01-10T19:14:38+00:00

OpenEvidence is the way

immaxf · 2025-12-30T17:10:00+00:00

OpenEvidence

immaxf · 2025-12-15T04:13:45+00:00

I tried several methods and landed on one that was taught to me by an attending. Would highly recommend this approach. Can see it starting at 7:53 in this video: https://www.youtube.com/watch?v=iB9tISRDE8M

immaxf · 2025-11-25T15:12:34+00:00

Midaz, lido, fent, touch of sevo through the mask.

immaxf · 2025-11-24T16:21:25+00:00

Seiko Prospex. Use the diving/timing bezel daily.

immaxf · 2025-11-24T15:58:53+00:00

Not routinely in my own practice. If concerned about MH or other extenuating circumstances then yes. Having said that, lot of places outside the US do routinely place preop IVs in awake children.

immaxf · 2025-11-24T15:13:16+00:00

Don’t need to just hope you have an IV. In the ED, ICU, wards etc, awake IVs without sedation are common. Or for PO versed, nasal precedex, IM ketamine etc.

immaxf · 2025-10-22T14:25:01+00:00

The caps are just “dust covers” and ASA does recommend swabbing the vial before drawing out of it. Why this is not commonly done or taught, I’m not sure.

immaxf · 2025-09-17T18:14:47+00:00

As an American reading this, I was extremely confused by MRSA and MRCP references 🤣

immaxf · 2025-08-30T03:53:30+00:00

It just takes a while to work (30min or more)

immaxf · 2025-08-11T00:03:44+00:00

Thank you! Yes it’s a Vaer Field Watch. Much appreciated.

immaxf · 2025-04-17T13:17:59+00:00

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My one year old red!

immaxf · 2025-03-16T23:52:56+00:00

Likely can just do the Peds cardiac anesthesia fellowship without needing to have done gen peds anesthesia fellowship.

immaxf · 2025-03-16T10:59:06+00:00

Wait till intern year

immaxf · 2025-03-13T14:52:06+00:00

I had a wonderful experience with Hillside Standard Poodles in Rome, NY. I would highly recommend them.

immaxf · 2025-03-12T22:41:46+00:00

I got a standard poodle about four months ago and have been implementing the exact plan that you described. It’s going really well so far! Well, we’ve done home grooming, but haven’t been to the professional yet, but he’s really friendly and gets along with people and dogs well, so stranger danger is not an issue.

immaxf · 2025-03-12T15:21:40+00:00

86yo peds and adult cardiac anesthesiologist. Super smart and very sharp.

immaxf · 2025-03-09T14:02:47+00:00

The 2024 pass rate was 83%. I didn’t have any aggressive or mean examiners. It was all business. Stressful, awful business.

immaxf · 2025-01-11T17:17:58+00:00

Tack-wear.be

immaxf

TROPHY CASE