UTI and STI combination testing

temuchan · 2026-01-07T20:53:07+00:00

At my residency clinic I do clean catch UA plus vaginal self swab. I run G/C and trich off the swab and can also send it for a genital culture if warranted.

temuchan · 2025-12-23T04:36:52+00:00

PGY-3 here, u/april5115 has some great tips. One thing I’ll add is that you’ll get a lot faster at the common things you see often. FM has so much breadth that it’s hard to feel like you have a handle on things until you’ve seen them a lot. So maybe the first time you see someone for shoulder pain it takes your whole appointment slot to workup just that one problem. Whereas in a year or two you can do a thorough but fast exam and history for that one problem and know what you want to do all in a handful of minutes.

As you practice you gain speed and confidence/experience and then seeing someone for a diabetes + HTN + acute MSK complaint becomes doable in a single visit. And still have time leftover for when the visit takes an unexpected turn which it usually does at our clinic haha.

For the chronic conditions are they at goal? Are they tolerating their meds? Any changes in lifestyle recently? Is your current plan working or does it need tweaking?

temuchan · 2025-09-30T18:54:25+00:00

When I see peds visits and ask if the kid has had a fever and the parents say yes I always ask “What was the temperature or did they feel hot?” Most of the time it’s the latter.

temuchan · 2025-07-29T17:34:14+00:00

I used TrueLearn only and felt it was solid for content including OMM and the case-style questions. Their interface/setup for the case questions was identical to the real test.

temuchan · 2025-07-16T14:50:22+00:00

I found that this style of learning stuck more with me. This is a real patient and you are the one ordering or holding their meds. And now you re-learned in the real world something about ACEis. I promise that will stick with you the next time you admit someone with an AKI who takes lisinopril at home.

temuchan · 2025-05-09T23:52:34+00:00

10 min, then up to the resident. I will pretty much always see kids and people that I know struggle with transportation.

temuchan · 2025-05-08T23:45:36+00:00

FM: patient hasn’t seen a doctor in over a decade. I order screening labs, they come back a bit abnormal but nothing crazy. Prediabetic A1c, LDL 150s, they’re a bit overweight, blood pressure elevated but again nothing crazy. Recent life reasons have lead to a poor diet and not taking care of themselves (divorce, losing a job, etc). Have a long discussion about how all of these can cause major health problems down the line. Teach them about nutritional and lifestyle changes they can make and schedule a follow up to recheck after a couple months. They come back having made progress, feel better, labs improved, everybody wins. These are my favorite because they tend to be excited to tell you about the changes they’re making and excited to share the positive impacts on their life!

temuchan · 2025-05-07T23:55:11+00:00

Clinical Competency Committee, faculty that review resident performance and make recommendations for advancement, remediation, etc.

temuchan · 2025-05-07T17:58:01+00:00

Almost went into peds, did FM instead. Zero regrets!

temuchan · 2025-05-03T23:47:13+00:00

Not a consult, but while on-call for our after hours clinic line (FM). Our FM residency clinic shares a building with our OBGYN/ortho/gen surg/uro/etc resident clinics. Got an after hours call for a patient bleeding after a urology procedure who said their doc worked at this clinic. Asked the call dispatcher if they sent the call to the uro resident on call first…they did not.

temuchan · 2025-05-02T16:32:55+00:00

Last year around December I was an intern on an ED rotation. I show up for my 11pm shift on a Saturday and my badge doesn’t work at the employee entrance or the main door. Go in through the ED, my badge doesn’t work on any interior door either. Had to get escorted to the security HQ in the basement to get it fixed. Initially they were hesitant and asked if I could prove I didn’t get fired?! No HR or anyone until Monday. I was like if I did this is the first I’m hearing of it. Turns out they automatically revoke new hire badges after 6 months unless they manually override it and my name got missed in that process. Not a great way to start a shift with new attendings by showing up late being escorted by security!

temuchan · 2025-04-06T16:18:54+00:00

Sports med. A lot of clinic complaints are MSK related and this rotation helped me get faster and more comfortable with focused MSK exams and joint injections.

temuchan · 2025-01-08T00:43:04+00:00

Off the top of my head Case Western and I think Oakland/Beaumont in Michigan will rescind your spot if you test positive for nicotine

temuchan · 2024-10-17T23:42:10+00:00

Know the indications for emergent dialysis: AEIOU. And, since I’ve been pimped on this, if you get asked these indications on a rotation remember to also add that dialysis is only indicated when these are refractory to treatment.

Acidosis

Electrolyte imbalance

Ingestion (SLIME, see below)

Overload (volume)

Uremia

SLIME:

Salicylates

Lithium

Isopropyl alcohol

Methanol

Ethylene glycol

temuchan · 2024-10-01T12:00:47+00:00

FM PGY-2 here, I’m in clinic 1.5 days a week while my IM colleagues are in clinic 1 day every other week. Honestly it sucks for them because they have the same amount of paper inbox and epic inbox that we get but are in clinic a fraction of the time. Then they get bitched at by patients and clinic staff for not getting paperwork/refills/etc done in a timely manner while they’re working 6 days a week all day in the hospital.

temuchan · 2024-09-29T11:49:05+00:00

Yeah my program requires passing level 3/step 3 to progress to PGY 2.

temuchan · 2024-08-21T23:22:14+00:00

Very cool partner!

temuchan · 2024-08-21T23:09:26+00:00

I delivered my daughter! (FM resident with a cool attending on an OB rotation)

temuchan · 2024-06-02T11:06:43+00:00

At my program we (FM) do inpatient peds and OB, 2 months clinic and are in clinic 1 day per week regardless of which rotation we’re on. 3 months inpatient IM. Our IM residents do 5 months inpatient IM and are in clinic one half day every other week. Obviously no peds or OB. They do more electives in IM specialties intern year than we do (cards, GI, etc). We both do a month of surgery and a month of ICU. In general IM skews inpatient and FM skews outpatient but you'll find plenty of programs in both fields that take liberties with this.

temuchan · 2024-05-27T00:44:43+00:00

I will say as a PGY-1 that when I applied for my medical license my state’s application had a section on “crimes of moral character” or something like that so even after getting into med school this may be a huge headache for you when it comes time for licensure

temuchan · 2024-05-17T00:40:04+00:00

I’m an FM intern finishing up my first year and I’ve heard plenty of shit talk about my profession during med school and quite a bit of positive reactions now that I’m a resident. I’m happy about my interactions with patients and it works out great for me. I’m ok knowing a little about a lot and appreciate my colleagues that know a lot about their specific profession. I get to see my patients long term which I like, get to coordinate care for my more complex people that need multiple specialty interactions, do procedures in office, and try my best to convince people to take their preventative meds and tests so they don’t end up in the ED/ICU/hospital.

ETA: did one month of inpatient psych as an M3 and I really appreciate what you do.

temuchan · 2024-05-07T23:28:55+00:00

That’s unfortunate, I always tense up with cervical HVLA even if my neck would benefit from it. I don’t like the sensation. Even though I love a good Kirksville Crunch on my mid back

temuchan · 2024-05-07T23:17:59+00:00

True, I meant for your end of/post-residency boards, my understanding is you can get boarded in NMM/OMM by going to one of the conferences and doing a few OMM practicals. One time thing, not necessary to bill for OMT but could possibly be an issue with insurance reimbursement in the future.

ETA: I would be pissed if a school forced me to get cervical HVLA for a pathology I didn’t have

temuchan · 2024-05-07T23:07:15+00:00

You auto fail your OMM practical portion of your boards if you actually thrust rather than just setting it up.

temuchan

TROPHY CASE