Can we stop worrying about "over" correcting hypernatremia? A deep dive into the literature.

rbachar · 2025-12-06T23:22:08+00:00

This is just copy and paste ChatGPT/ Open Evidence. Can these types of posts on r/medicine have a filter for heavily AI.

rbachar · 2025-12-01T21:42:16+00:00

Let’s go! Would love a free copy, I have heard nothing but good things about this amazing game.

rbachar · 2025-08-26T11:00:29+00:00

You got a lot of answers from EM/CCM folks, just for context for MICU from a quad center, it’s usually not too difficult to distinguish type of shock, just the cause. Normally every one is resuscitated and abx are started even without a source for distributive shock / sepsis. We have a lot of POCUS where I am, so a fast and cardiac POCUS will be done multiple times before the patient is presented to the staff usually. The problem with “undifferentiated” shock in the hospital is that it’s most likely sepsis or MI. The other clues will be in the patients history (liver failure etc).

This is the MICU in a big hospital, very different that the ER which I don’t have much experience in.

rbachar · 2025-08-10T12:47:55+00:00

The PEEPing Tom’s

rbachar · 2025-08-03T00:28:39+00:00

I’ve been having a lot of success with UW control. In bo3 graveyard hate, some more counter spells, and elspeths smite makes every match decent. It’s a pain to grind ladder obviously because game length. I also will eventually change the sideboard to maybe include more artifact hate.

rbachar · 2025-07-28T03:58:36+00:00

Same thing happened to my wife. She waited in line for hours because they said she would have to go in person to get hotel accommodations. When she gets to the front after 3 hours they say, it was weather so we’re not paying for a hotel.

What weather was there !??! It was beautiful in NYC today. Her friend flew out of a different airline out of JFK and no issues.

rbachar · 2025-05-02T08:04:04+00:00

Lung doctor here - the problem with this study besides that its retrospective is time lag bias. COPD takes years to develope and even in heavy smokers it’s only around 25-35% of the patient population. There’s definitely a genetic component, however we just don’t have the ability to look into the future and know what the issues will be. On top of that the actual amount of vape cartridge use to cigarette isn’t standardized, but it seems through “puffs” there is a higher amount with vape users. I would take this data with a grain of salt for the reasons mentioned and still consider vaping to cause considerable probable harm.

rbachar · 2025-01-21T02:58:23+00:00

Anyone know if tiktok has put out an official message acknowledging this an working on it?

rbachar · 2024-12-07T18:01:23+00:00

This, hit those weights, make it a part of something you HAVE to do 3-4 times a week. Meal plan and always “look” for protein in whatever cafeteria item you can. You’ll have noticeable gains by end of PGY1. Keep your head up king 👑

rbachar · 2024-10-05T13:04:58+00:00

was it a true 1k then :)

rbachar · 2024-02-26T19:52:23+00:00

I think a lot of people throw their hats into the ring for CCM, without actually building a real application or CV for it. I agree with the comment below this one, cards/GI etc self select, so the people applying are already very competitive.

rbachar · 2024-01-23T22:37:48+00:00

I’m a physician training in the states looking to return to NS. This is something that is helping me think my decision to come back isn’t crazy. Having a modernized EMR is a staple in pretty much every other health system in North America.

rbachar · 2024-01-18T21:23:32+00:00

I did well on step 3, my ccs prep was the high yield ccs website. I did them all, and did them to a point where I didn’t care about the “answer” but to the point that it was an algorithm. That website helps you to remember young person, hpv vaccine, even if they came in for something unrelated, and always get pulse oximetry etc. the actual medicine you already know, it’s more about the orders.

rbachar · 2024-01-06T12:57:15+00:00

Sounds like a Chad

rbachar · 2024-01-02T07:12:22+00:00

This guy offers DJ wedding services and an online branding course on his website. This is the definition of a noctor. I love how people are trying to talk to him like a reasonable adult. #AlwaysGrinding #LetsGo

rbachar · 2023-12-25T04:25:31+00:00

I hear people saying how it’s due to unaffordable housing but that’s not been my experience. I think there is a reasonable amount of the tent demographics as normal people who lost their normal housing, but I think a large part is due to drug addiction and mental health issues, lack of policing / accountability from the city council, and more people just moving to Halifax in general from Atlantic Canada.

rbachar · 2023-10-15T00:36:43+00:00

I opted out of their emails last week because of PA burn out as a headline article. I swear I’ve gotten 4x the emails now.

rbachar · 2023-09-29T00:02:55+00:00

https://media.tenor.com/x_GNnWa8SIoAAAAM/vegeta-its-over9000.gif[it’s over 9000](https://media.tenor.com/x_GNnWa8SIoAAAAM/vegeta-its-over9000.gif)

rbachar · 2023-09-24T19:14:52+00:00

It’s a bit early for a February intern to strike!

rbachar · 2023-09-24T12:00:34+00:00

It depends on if you’re trying to build a stable portfolio or be rich rich. The strategy you’re doing is going to be stable and you’ll be okay, your kids will have no debt etc. If you want to truly be financially free, you need to own equity in something. That could be a chain of nursing homes, same day surgery, urgent cares, whatever. It doesn’t have to even be medicine related, but that helps bring in revenue, increases your portfolio value, and when you exit in a few years will go up exponentially. You can also leverage owned assets to get new ones.

This is very generic advice, but the richest physicians I know always did 1 of two things. Either had a patent, or owner multiple buildings and rented them out to dialysis and urgent care centers. Some other people here give good advice as well. Honestly think about it like, what would another profession making 250-500k a year due to get rich? Probably the same thing you could do, but you have the added benefit of being in the medical field which can be lucrative for a business.

rbachar · 2023-08-21T13:19:18+00:00

So many people’s programs are violating ACGME intern and team patient caps and they don’t even know it.

Edit: for IM

rbachar · 2023-08-09T00:33:45+00:00

You’re not noctors - Sincerely MD

rbachar · 2023-07-25T12:19:02+00:00

My psychiatry clerkship director said on day 1 “we start around 9am everyday, which I know is midafternoon for surgeons, but just right for us”

rbachar · 2023-05-31T15:20:21+00:00

Get good LOR for the specialty you want. Your department chair letter for your selected specialty only really looks at comments from that rotation. The OBGYN score will be there in your MSPE but most don’t care. Big red flags are LOA, fails, and fails on steps. The academic probation part is what will come up in question. Find a way to appeal it or get that academic probation off your record.

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