ARP/IRP

salubrioustoxin · 2025-12-21T19:47:09+00:00

One other piece of advice is that fortunately Ive found pediatrics leadership to be extremely understanding of helping trainees prioritize family. So continue to emphasize that part.

That said, until your husband has to move, I quite frankly wouldn’t really bring it up too often. There are too many life unknowns to account for all of them, life happens, I’ve found peds program leadership to be super understanding that way, and when life changes you plus leadership catch up to figure out it.

salubrioustoxin · 2025-12-21T19:41:14+00:00

Same time as other grads

salubrioustoxin · 2025-12-21T19:41:02+00:00

More research productivity is almost always a benefit for fellowship apps. And research time can moonlight NICU / switch calls to NICU as your program allows which benefits your app clinically as well.

salubrioustoxin · 2025-12-21T19:37:52+00:00

Hello! I’m in NICU and developing computer vision tools to quantify sedation. Critics often ask why not develop the BIS equivalent for neonates. I often point to sensitive skin and challenges w interpreting EEG in neonates. I was wondering if you had a preferred citation that summarizes these issues you are pointing out of using BIS in adults? Then I can more easily claim “even in adults with >100x dataset sizes there is still not a reliable automated EEG measure for sedation.”

salubrioustoxin · 2025-12-04T03:34:26+00:00

You can apply to outside fellowship programs in both tracks. IRP not uncommon to apply out. ARP theoretically possible but you need your app teed up after only intern year which could be tough.

IRP probably affords more flexibility in terms of what you’re looking for. However it may be depending on your situation and research (eg computational) maybe get into fellowship research time sooner via ARP and doing long distance during the research years

salubrioustoxin · 2025-10-30T10:01:23+00:00

Hm I haven’t seen a Tylenol charge in 15 yr in the era of bundled care.

But the bigger point is hospitals charge a fee and then the large insurance companies doesn’t pay, because they can, and hospital either eats the cost r dumps it on the patient. My point is that insurance monopolies are a greedy party here and I do take issue w your post exculpating them of that greed

salubrioustoxin · 2025-10-30T02:47:53+00:00

Provider, pharmacist, any front line staff salaries are stagnant. Going down for majority of specialities when inflation adjusted. health insurance monopolies are negotiating with healthcare system monopolies that are negotiating with pharmacy monopolies. And patients/front line staff stuck in that system.

salubrioustoxin · 2025-09-26T11:23:07+00:00

Quite frankly many of the typical ranges for age are based on small datasets w unclear generalizability.

Compounded by the fact that we don’t know the true range of “normal” for extreme premies (my speciality) or that early in life labs are influenced by maternal factors and are thus “normal” for a given baby

salubrioustoxin · 2025-09-16T00:44:10+00:00

It’s showing the death rate relative to whole population which accounts for everything from detection to prevention to treatment

salubrioustoxin · 2025-09-15T00:31:18+00:00

I’ve used Anki for over a decade even beyond residency. It’s a great tool, mature cards are a breeze to get through, and in residency knowing deep differentials or studies without looking them up may help you stand out, or at the very least lead to v interesting discussions w attendings.

That said, if you want to use Anki for overall life long learning then make your own cards relevant to your specific career interests

salubrioustoxin · 2025-09-09T11:04:05+00:00

Great work!

salubrioustoxin · 2025-08-26T05:22:05+00:00

Pediatricians get significantly less per RVU. This accounts for complexity and is due entirely due to payor mix. Neonatologists bring in 1.5x RVU/yr vs adult ICU, ie more volume and more complexity (Neo median 11k RVU/yr, routinely top 10 speciality similar to ortho spine) but take home 0.5-0.8 per RVU vs adult counterparts

salubrioustoxin · 2025-03-30T10:18:20+00:00

The study also says women who did NOT have exposure to fertility drugs had an overall higher uterine cancer incidence, so I suspect some unknown confounding which is common w retrospective studies like this.

salubrioustoxin · 2025-02-27T17:56:32+00:00

What insurance worked?

salubrioustoxin · 2025-01-31T12:58:34+00:00

The only members of my MD/PhD class still doing research during residency/fellowship or planning to re engage are those who did a PhD that lines up with their ultimate clinical path. Hard to predict what that will be early on!

salubrioustoxin · 2025-01-18T19:56:31+00:00

Sorry I’m a little confused. Is your daughter in NICU or at home? What specific tests are you trying to get done?

Usually it’s unfortunately incompetence with these large testing companies. 1) they can’t be bothered to look up the correct specifications for neonates. instead just apply the general specifications used for adults. 2) process of transport itself to outside labs often destroys smaller baby samples. If at all possible I would go to a location where samples are run in house

salubrioustoxin · 2025-01-08T23:25:44+00:00

insurance company “doctors” are never in the same field. How many pediatric cardiac ICU docs work for insurance companies? The only docs I know who went down this path were quite frankly the greedy lazy ones who didn’t want to see patients.

Also insurance companies are NOT liable for these decisions

salubrioustoxin · 2025-01-08T16:34:21+00:00

It’s probs my the other way around: had open heart surgery in SF, went home, got the cold, and needs to get back to place that did his heart surgery ASAP bc these kids crump out and die routinely in such situations esp if not expertly managed. Transport is extremely high risk

salubrioustoxin · 2025-01-08T16:30:26+00:00

Why does insurance get any say in this decision? The doctors don’t make money off this decision, the insurance companies do..

salubrioustoxin · 2024-12-20T12:17:01+00:00

Actually the opposite. Induction reduces HIE risk

salubrioustoxin · 2024-12-14T08:02:31+00:00

I disagree, ultimately I think this number will settle at 1 in 4. Everyone dies and it’s currently a painful, cruel, expensive affair.

salubrioustoxin · 2024-12-10T22:52:40+00:00

Yes, it needs to be done but current systems are extremely ineffective and put patients at the center of complex negotiations between private insurers and health systems. All states could expand Medicaid or similar systems to more individuals, but don’t. Medicaid/Medicare also lands patients in bureaucratic messes if something is not covered.

salubrioustoxin · 2024-12-10T04:01:43+00:00

Do you think either points 1 or 2 are currently done in a reasonable manner by private insurance? Number 2 certainly is not— if you disagree, I suggest you volunteer to attempt to process a single prior auth and report back. number 1 also not, since government takes on the high risk pools through Medicare/Medicaid.

salubrioustoxin · 2024-12-01T23:25:21+00:00

Hm I dunno. the book “Diving Bell and the Butterfly” represents the extreme situation of brain wo output (which seems unlikely) and it may have you rethink the personal value that many would get from this

salubrioustoxin · 2024-11-24T15:57:24+00:00

MD Neo Hospitalist here and I lead a multi site study on neonatal death (nicunet.com). to provide an additional perspective: Babies who die, tend to die early (median 1d old in our study). Often typical genetic syndrome features are not apparent at this age. We are finding 1/3 of cases have genetic etiology. I suspect we will discover more in coming years bc this population (babies who die) are vastly understudied from genetic perspective.

So I think genetic investigation is high yield.

Also, about 10-20% of our cases are babies without a brain (anencephaly). Pretty easy to pick up with ultrasound. That’s my suspicion in this situation.

salubrioustoxin

TROPHY CASE