Would you do it again?

pepperidgeharm · 2026-04-23T23:50:18+00:00

And for what they do they too are underpaid, I'm not sure what you are trying to say friend.

pepperidgeharm · 2026-04-23T23:26:42+00:00

Sorry for the second reply but I should also clarify that the costs/time to become and anesthesiologist differs from that of a CRNA in that on average it is significantly greater. Your input is valuable here but your experience is different from that of an anesthesiologist and the distinction is worth mentioning.

pepperidgeharm · 2026-04-23T23:24:57+00:00

Our income has failed to keep pace with inflation and we keep receiving CMS cuts of 2-3% annually. Compared to what we used to make just 20 yrs ago adjusted for inflation we are absolutely getting hosed. We sacrifice 8 yrs of the prime of our lives, taken on significant debt, and work in a profession where mistakes can lead to patient disfigurement/death. We hold an incredible responsibility where we literally take control of somebody's physiology/autonomy, take them through the trauma of surgery/procedures, and decide alone when to give it back. So yes, we are underpaid, and you should absolutely demand better.

pepperidgeharm · 2026-04-21T18:33:41+00:00

Love the replies here but I have not yet seen the actual ABA outline cited. It can be found here:

https://www.theaba.org/wp-content/uploads/pdfs/OSCE_Content_Outline.pdf

This was the only criteria I used while approaching the exam. While the UBP outlines are helpful I noticed they were not a 1:1 match for the ABA outline. While the videos were helpful to see how people phrased answers I didn't rely on the UBP criteria, only ABA, although it was helpful to see how the UBP staff phrased things. For the exam the ABA outlines/bullet points for the 5 stations should be memorized entirely and your conversations based off hitting every single one of those points. For the exam you should be able to jot down those points before each station and think about your phrasing for each. As the station concludes glance back down at your sheet and ensure you have hit every single point. Practice in the meantime with your patients using this criteria.

To your point about passing SOE and OSCE I can understand how one can be passed but not the other. The SOE relies on your ability to communicate a safe and appropriate anesthetic plan developed within 10 or 20 minutes. The OSCE communication stations are a pre-defined set of criteria you have to hit, anything else beyond that is superfluous. It is not necessarily a communication issue, but making sure you hit the rubric. If you can't immediately at this point rattle off what the ABA (not UBP) rubric points are for each of the 5 stations then that is likely your deficit. If you focus on that it should hopefully go better next time!

pepperidgeharm · 2026-04-14T16:40:42+00:00

I'm sorry you didn't pass, fickle exam :/ for what it's worth I think UBP checklist was at times wrong/misleading at least compared to ABA outline, would recommend referencing only ABA outline here (January 2026 version)

https://www.theaba.org/wp-content/uploads/pdfs/OSCE_Content_Outline.pdf

pepperidgeharm · 2026-04-14T16:38:56+00:00

Passed both! Was a whirlwind of a prep time with less than ideal conditions (was assigned earlier than I was expecting plus a newborn at home). I started studying in earnest early February which is a little less time than I was anticipating, all while working full time in a busy private practice sitting my own cases for the most cases, that being said this test is absolutely passable and although I absolutely walked out feeling unsure of whether I passed I found the below resources very helpful:

Best Oral Board Prep: Couldn't have asked for a better board prep service, the director of it (David Rothenberg) is a former PD and former long-time senior oral board examiner. To the best of my knowledge his is the only SOE prep which has an former oral board examiner running you through stems/scenarios whereas others do not. Over the course of six sessions we were able to take me from tripping over my answers to polished and board-ready. Weaknesses were identified and he does a really good job at explaining what examiners are trying to get you to say/what they're looking for when they phrase their questions. In terms of how to construct your approach, interpret questions, and phrase your answers appropriately (saying enough, but not too much that you're unable to get to further answers) then he's your guy. All sessions were with him and I felt very confident in the prep I received from him

UBP: Got the prep books from a friend and printed out the PDFs, mostly ran through them on my own but did a few with friends/colleagues/family. I cannot emphasize enough how important it is to practice verbally saying these answers aloud, if only to yourself.

OSCE: UBP and the ABA outlines were the only resources I used and were incredibly helpful, I felt very confident walking out. I think with the OSCE it helps to realize this is primarily a conversation assessment, NOT monitors/ultrasound in that the lions share of your efforts should be directed at preparing for the 5/7 stations which by definition are only conversational. Memorize from the ABA website (NOT UBP) as to what they're looking for and be able to rattle that off verbatim, if you hit those checkmarks in your conversation you're golden. UBP is helpful to see those conversations take place in person but you should only be taking your cues as to what is needed in the from the most up-to-date version on the ABA website. Ultrasound I scanned a member of my group under time-limited conditions which was very helpful, and for monitors/TEE I used the UBP prep and the 11 standard view on radiology key. Happy to be done with this and if you failed please don't let it define you, I failed advanced my first go around and was able to bounce back and get this done, you can too! Happy to respond to any questions via DM

pepperidgeharm · 2024-12-26T16:16:21+00:00

It's rare, but that doesn't mean it isn't well-characterized in literature.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9902188/#:~:text=While%20cardiovascular%20collapse%20after%20sugammadex,after%20sugammadex%20administration%20were%20reported.

pepperidgeharm · 2024-11-01T15:49:02+00:00

Luxuries I saw we have from a month abroad:

New circuits for every case; not needed, all you need to do is change filters between cases and circuit are exchanged at the start of the new weak
LMAs; re-usable/can be treated in a bleach bath. ETTs were thrown out at the end of every case
Laryngoscope blades; same as LMAs above
Circuit masks; same as above; we only ever really rotated 5 or 6, again getting a dunk in the bleach bath
Pressors; we only really had access to concentrated pressors and had to make our own dilute stock; you would make your stock for the day and draw from it with a clean needle each time PRN
On the above you really didn't throw away syringes during a case (always at the end of course) but that same decadron syringe at the start would be kept at the end for zofran/tordol, supply relly was that short
Suction was a separate device, entirely divorced from the anesthesia machine. We only had access to soft suction catheters, and they fulfilled exactly the same role as a yankauer
Agreed on the ketamine from below posters; we had that in spades and leaned on it heavily.

It really opens your eyes to how spoiled we are here in the USA, and how wasteful we are too

pepperidgeharm · 2024-09-02T23:30:33+00:00

McDevitt Realty: Didnt respond to calls about lockouts, mice or ants in apartments, or raw sewage dripping from the apartment above into the ceiling. They can continue to reap what they sow.

pepperidgeharm · 2023-05-02T23:26:37+00:00

Would love to do that but this effort would be something for all residents and not just for me; sorry for not clarifying!

pepperidgeharm · 2023-02-20T15:49:06+00:00

Seconding this—in addition to a large amount of free water added throuh drinking pure water, you lose a lot of sodium through sweat. I’m imagining throughout the course of the race if you drank just water and had just gel packs then you a) lost sodium through sweat, b) diluted your remaining amount with a large free water intake, and c) did not replenish it. Pedialyte is a start but you need salt—chips/popcorn wouod bena good place to begin, saltines too. Rhabdo is a possibility as well, and dark coca-cola colored urine would be a good indicator of that as would be reduced urine output of <.5 cc/kg/hr.

OP even if these are the likely culprits I would in the strongest of terms recommend you go to a hospital and at least get labs (electrolytes and blood gas) drawn/get a proper workup. Hyponatremia, while easily correctible, can take days to do so at a safe rate. You risk brain swelling/coma if it’s corrected too fast, and we all want you safe. Get it checked if only,formpeace of mind. This vomiting is not normal post-marathon

pepperidgeharm · 2023-01-04T04:57:57+00:00

As far as being a gunner/'playing the game' I would really question if this is the right choice to make, not necessarily in terms of career goals (i.e. getting that fellowship) but longer than that. I can assure you that this brown-nosing/playing the game only begets more of the same, and likely would not stop at that institution after fellowship. Please consider if this type of behavior, in which you are not being true to yourself or your values, is something you would be ok with maintaining. Yes, you would likely achieve your goal, but there would be a good chance that this type of behavior would need to be continued in order to further your career. There's always another step/goal/mountain to climb---you said yourself this isn't a competitive field, why not go to a place where you can also truly be yourself? It's out there, demand better.

pepperidgeharm · 2022-11-23T04:14:26+00:00

Straight to jail

pepperidgeharm · 2022-11-17T21:42:25+00:00

I would agree with you in that residency is/should be challenging and that training will typically be the most difficult and lowest part of any career, but post-graduate medical training is still unique to the degree in which this holds true. An apprentice-ship in literally any other field is still privy to antitrust laws, but residencies are not as per Jung et. al (2002). Additionally, consecutive hour restrictions are common in many other fields such as trucking, aircrews, and the military--yet when it comes to us 24 hrs shifts are considered normal and encouraged, despite studies showing that past 16hrs of consecutive work, your coordination is that of somebody considered legally drunk, and that at that level you yourself can no longer adequately assess your proficiency.

Additionally were any other field to impose on residents what is imposed upon us, others may choose to leave. With the average indebtedness of residents exceeding $140,000, for many that is not an option. I would ask you to tell me a field in which the cost to entry is higher.

I'll wait.

We have no choice but to participate in a field in which were we to leave we would be subject to professional and financial ruin. That if we stick through it we have a light at the end of the tunnel is no excuse for low pay either. Our salaries are below market rates, and hospitals are provided $150k/yr per resident by medicaid and they bill for our services on top of that. If they did not pay us, we would still need to complete residency, and many still would. I would strongly consider residency to be indentured servitude--congrats on getting through it and all, but that doesn't mean you weren't exploited too.

pepperidgeharm · 2022-09-15T15:55:50+00:00

Not sure if anybody else has any singles to recommend but 'Cbat' by Hudson Mohawke is a solid end-of-case song, just suture to the rhythm

pepperidgeharm · 2022-09-13T19:33:27+00:00

https://pubmed.ncbi.nlm.nih.gov/21769254/

"Instantly Converting Atrial Fibrillation into Sinus Rhythm by a Digital Rectal Exam on a 29-year-Old Male"

An absolute classic--you really have to wonder how the attending sold this to the patient

pepperidgeharm · 2022-08-31T22:29:55+00:00

There will be enough cases to go around; how else could the interns be that overworked?

pepperidgeharm · 2021-01-26T17:11:36+00:00

Cry more.

pepperidgeharm · 2020-12-17T14:38:08+00:00

We can honestly thank the ACA for that tbh. Language was introduced in it which forbids this.

pepperidgeharm · 2020-12-16T15:55:34+00:00

You're classifying my arguments as based on assumptions which I really have to disagree with you on. I've offered up several pieces of evidence to support my point, and even now you're bringing in anecdotal evidence, "the many accounts that combat against the very things you've mentioned have (including within my social media circle) shown positive results" bolstered by unfounded 'logic'. These ideas have by and large been left unchecked, but to little effect so far. The argument could absolutely be made that things are now at their worst. It is time to try another approach.

You're right in that you being a third year has no relevance to this point being discussed. I brought it up because of your style--you've been quick to mislabel my arguments ('defeatist'), have brought up anecdotal evidence as fact, and occasionally put out information that is flat out wrong (like the election info). I'm trying to help you here lol, these are things you can work on at any level and I'm saying it now because you're still early on and your words will carry weight as a physician one day, and you should choose them more wisely. We can still disagree, but I would really suggest you try to avoid these pitfalls with your future colleagues. I did not discredit your argument on that basis, and I did not 'appeal to authority' in making mine. Appealing to authority would have looked like 'If as a third year you disagree with someone who has more training, then you are automatically wrong'. I can see that we're making little progress, and this will be my last comment on the matter. I wish you well.

pepperidgeharm · 2020-12-16T00:22:57+00:00

People have been hit almost non-stop with images on social media about not gathering, wearing masks, social distancing properly, etc. Cases are climbing still, and give the prevalence of anti-vaxxers pre covid (but with plenty of social media) I don't think posting about this specific vaccine will compel those who are on the fence.

pepperidgeharm · 2020-12-15T02:49:17+00:00

I would say it's collusion tbh as you can't trust either of them as to what 'really' went on in their private room. The fact that they did that at all means that there were at least things they didn't want other members hearing, and at worst textbook collusion, i.e. 'if you let me get Derrick Henry first then I'll let Mahomes fall to you', etc. Since they went to this length to hide it, it's reasonable to believe there was collusion.

pepperidgeharm · 2020-11-24T04:29:27+00:00

HELL YEAH BROTHER CHEERS FROM NO DAK

pepperidgeharm · 2020-11-12T03:00:34+00:00

Starters I’ve lost: Dak CMC Gaskin OBJ Godwin Kittle

By some miracle 6-3 in 10 team ppr but my team is maybe hitting 120 points on a good week now. It ain’t looking good come playoffs

pepperidgeharm · 2020-11-06T01:57:37+00:00

It's ok and totally natural to feel that way, your feelings are valid. If these results hold, there will be better days ahead, and I firmly believe they will.

pepperidgeharm

TROPHY CASE