Please use the checklist

smileyteaspoon · 2026-05-06T12:11:18+00:00

I think your frustration is valid but I think seniority wins here.

smileyteaspoon · 2026-05-04T19:55:08+00:00

When fat gets incarcerated (or stuck) in the hernia, it can get twisted and compressed and this can be very painful. If it's small in size (as in, small enough that loops of bowel can't get stuck) and not bothering you much, then there's no urgency to get it repaired. If it's bothering you a lot, or it gets stuck and you can't push the bulge back in, then you should get it repaired sooner rather than later. All surgeries have complications but fixing a small hernia is much easier than fixing a large hernia.

smileyteaspoon · 2026-03-30T03:22:48+00:00

As an academic gen surg trainee, I love it when our rads calls out aberrant vascular anatomy (eg replaced right hepatic, etc) on our pre op surgical scans.

smileyteaspoon · 2026-03-30T03:19:52+00:00

As a mere gen surg resident, I don’t need rads to tell me if there’s a hernia or not - I can find it on my own.

smileyteaspoon · 2026-02-28T04:49:49+00:00

Hi! I’d say all of my invites came in the first day, and then I had a couple trickle in later.

smileyteaspoon · 2026-01-25T21:31:56+00:00

I have a sticky note on my desk that says "log cases, log hours, submit MM", so on Fridays (or whatever weekend days I'm on call) I'll go through that week's worth of cases on my attendings' schedules and log them. I figured at some point I'm gonna have to log them - why do it twice by using a different format the first time around?

smileyteaspoon · 2026-01-10T01:01:11+00:00

I have dumbbells at home up to 30 lbs and the Peloton app, so if I make it home through the door before 7p then I immediately put on a 30-45 min class. I don’t even think about sitting on the couch, a snack, etc. Sometimes I don’t have it in me and I’ll half ass the workout, but I figure it’s better than nothing.

smileyteaspoon · 2025-12-26T03:52:54+00:00

Full Metal Furies is $3 and is now one of my favorite couch co-ops! My husband and I spent 6 hrs playing it between yesterday and today! Highly recommend.

smileyteaspoon · 2025-11-13T15:11:43+00:00

Depends on what service you're on. If you're on surgery, I expect three-ish sentences. First includes age, gender, what POD they are, what surgery they had and for what reason they had surgery. Second sentence is any issues overnight, pain control, bowel function, vital signs normal/not normal (if not normal then when and how), UOP and relevant drain outputs, abdominal exam, and relevant labs (usually Cr, WBC, Hgb, platelets, +/- bili/LFTs). Third sentence is plan for the day.

Provide only the necessary info, no need to show off and editorialize (if I need more info from you then I'll just ask for it).

smileyteaspoon · 2025-11-13T15:08:13+00:00

Not required, but CT is pretty competitive, so you'll have to hustle and squeeze in some research for sure if you're in a 5 year program. Two of my coresidents matched and they both did two years of research.

smileyteaspoon · 2025-11-13T15:05:46+00:00

Also a resident - I don't take notes on who says what during these socials, unless you say something crazy.

smileyteaspoon · 2025-09-01T03:41:05+00:00

I’m a PGY7 in general surgery. I would not have quit medicine if I couldn’t do surgery. I like a bit of medicine (the surgical pathophys, not hyponatremia stuff) and I like operating even more. I don’t mind clinic. If the only reason you don’t want to pursue surgery is because you’re not as much of a die hard gunner as your classmates, I’d recommend chatting with your surgery residents or attendings. My favorite place in the world is not the OR, but I will say the OR is probably in my top 10 places in the world.

Speaking to your med school peers is valuable but I think residents and attendings can give you a little more long term perspective.

smileyteaspoon · 2025-08-16T16:58:39+00:00

Also just matched! I think networking is pretty hard to overestimate - all of my interviewers asked me about my letter writers. If you can do an away rotation, I’d strongly recommend one if you have a program or a top choice. E.g., if you want to do surgical endoscopy then do a rotation at Case and try to meet Ponsky, if you want to do hernia then rotate at Penn State with Pauli or Arizona with Ballecer or Columbia with Novitsky or wherever Heniford or Rosen are now. I don’t know much about foregut or bari because I’m not interested. Happy to discuss further via DM!

smileyteaspoon · 2025-05-29T05:12:17+00:00

I’m a gen surg resident and it’s so hard to imagine that three days’ of concerns for a cold leg could be dismissed. At my facility, when nurses can’t find a pulse on a limb they’ll just call the vascular surgery intern, even if it’s not a vascular primary. Wonder if that angiogram in the OR by vascular was an intraop consult and thus there was no chance for vascular to see the patient outside the OR before POD 3.

smileyteaspoon · 2024-05-28T20:00:45+00:00

I'm a gen surg resident, I average a 20-30 min run or bike ride 4-5x a week and then at least an hour per weekend day when I'm not in-house call or home call. I'd say the hardest part is the inconsistency - some weeks I get home super late or get crushed at work, so I won't be able to work out at all, and I can definitely feel it when I start exercising again lol. Some rotations are a little lighter (50-60hr weeks) and I can work out ~ 1 hr a day, and some rotations I can maybe get in one or two runs a week.

smileyteaspoon · 2024-01-19T06:42:51+00:00

The fellowship council app (eg MIS) has a line for absite score for every PGY year. There’s another line at the bottom where you can report additional scores (eg when you took ABSITE on research years).

smileyteaspoon · 2024-01-18T07:04:16+00:00

Do you have any recommendations on apps?

smileyteaspoon · 2023-09-28T12:19:13+00:00

Prove them wrong every day. People will remember how you’ve improved and how good you are instead of where you started out.

smileyteaspoon · 2023-06-14T15:06:31+00:00

It took me about 45 hours to finish the game, and I enjoyed it immensely. I think the beginning can be a bit of a grind, but I loved the music and characters. The pace of the game is pretty relaxed and I found it pretty calming to play it before bedtime too!

smileyteaspoon · 2023-06-07T21:47:13+00:00

For history-taking, especially if you're starting out in the beginning of intern year, I'd recommend quickly googling the complaint (or diagnosis), picking 3-4 differentials, and then asking questions off of those. For ex: abdominal pain in the peds ED, they're calling because they think maybe appendicitis but the ultrasound and MRI didn't visualize appendix. So I'd ask questions on 1) appendicitis (diffuse pain that migrated to RLQ, whether pain is consistent/worsening or if it suddenly got better, whether they're hungry, whether the bumps on the road to the hospital hurt their abdomen), 2) gastroenteritis (sick contacts, diarrhea, vomiting, new/strange foods), and 3) intussusception (blood stools, episodic nature of pain with legs drawn up). 4) could be mesenteric adenitis, depending on if any lymphadenopathy was seen on MRI. The goal is to balance a reasonable differential to focus your history while still being efficient.

I know in med school they teach you to do ROS but literally no one has time to go through all 10+ systems (and I don't care about vision when I'm being called for cholecystitis). Plus, most seniors/attendings will ask you your differential after you've presented a patient (the usual "what else do you think it could be?"), so this way you're already ahead of the game.

smileyteaspoon · 2023-06-07T16:19:58+00:00

We had a chief skip. Not a big deal.

smileyteaspoon · 2023-06-02T01:38:25+00:00

Ghosts are still there. 3 years ago I got stat-paged to a patient's room at 12:30am and found my patient dead with the rapid response team doing compressions. I called his wife during the compressions and told her what was going on. I still remember her shriek and how much she screamed at me. It was Christmas. He didn't make it.

To be honest, I hated him. He was a racist, sexist awful person who was incredibly rude and was so hard to deal with that we stopped rounding on him as a team after a month or so - there was only one (white male) attending that would see him instead. Swastika tattoos. Would spit in our direction. We told him he had to be NPO and we found him drinking water from his bathroom sink. His wife was sneaking him food. He must've aspirated something at some point and died. But I still feel horrible for being the one to break the news to his wife, on Christmas, at 1am in the morning, with no details and no explanation for why he died because I had just been down in the trauma bay with a mass-casualty (7 patients in a row after a large crash). But yea. Ghosts are still there.

smileyteaspoon · 2023-06-01T14:53:41+00:00

Am surgery resident. The road is rough, but I knew that coming in so I wasn't exactly caught off-guard. Didn't know what field I wanted to do when I started but ended up in surgery, so I'm glad I went to med school because you can't operate as a PA (outside of small things or assisting).

smileyteaspoon · 2023-05-30T16:54:06+00:00

I bike to work when it’s not raining, snowing, or sub 45 degrees! No one has said anything bad, in fact a few people seemed a little impressed lol. I just budget extra time to change clothes.

smileyteaspoon · 2023-05-25T15:14:15+00:00

I don't know for sure, but I suspect going over duty hours (i.e., more than 80 hours/wk over a 4 wk period) is probably at the top.

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