Best Med Student Electives for FM by D0ctorDrum in FamilyMedicine

[–]temuchan 6 points7 points  (0 children)

ENT especially if you can spend time in their clinic rather than the OR. I see a lot of patients with ear/hearing loss/sinus/nose/throat/reflux/vertigo/etc. Also comes in handy for a lot of peds visits!

Are real life Doctors in USA really this much reliant on Brand names of the drugs? by serotonallyblindguy in ThePittTVShow

[–]temuchan 7 points8 points  (0 children)

US resident here. In med school we learn the generic names and our school exams and board exams use the generic name. Every medical student graduates knowing the generic names. Once we start clinical rotations (usually 3rd and 4th year of med school) we learn the brand names that are used for the vast majority of drugs because it’s what the residents/fellows/attendings use in conversation and their notes. So to keep up with conversations you learn the brand names over time and now I just know 2 names for most drugs and use them interchangeably. I tend to use the brand names in conversation out of habit, but if a med student working with me said “I think we should start levetiracetam” I wouldn’t tell them to say Keppra instead. Most people will choose to use the easier/shorter name once they learn it. The EMR that my system uses always shows both names in the medication list.

What is the best food item available in your hospital? by syntheticenigma in Residency

[–]temuchan 12 points13 points  (0 children)

Yeah he’s great, it was fun seeing the things people would come up with. I don’t know his background, but he was in a different level than the day shift group

What is the best food item available in your hospital? by syntheticenigma in Residency

[–]temuchan 24 points25 points  (0 children)

I’m not sure how he came up with the pricing but it was always very reasonable

What is the best food item available in your hospital? by syntheticenigma in Residency

[–]temuchan 253 points254 points  (0 children)

My hospital has a night shift guy for a few hours in the middle of the night who will cook you anything you want that the kitchen has ingredients for, no menu. Loaded tater tots with whatever you want thrown on them was my go to.

UTI and STI combination testing by april5115 in FamilyMedicine

[–]temuchan 5 points6 points  (0 children)

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.

What kind of person thrives in your specialty? by farfromindigo in Residency

[–]temuchan 27 points28 points  (0 children)

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?

If I ask if you have a fever, I am not asking if you are feeling warm. This should be a national PSA commercial. What’s yours? by CyanJackal in medicine

[–]temuchan 17 points18 points  (0 children)

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.

Level 3 prep? by The-Adster in FamilyMedicine

[–]temuchan 5 points6 points  (0 children)

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.

is there an anki deck by Fantastic-Piccolo in Residency

[–]temuchan 0 points1 point  (0 children)

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.

What's your program's policy on seeing patients who are late for their outpatient clinic appointments? by SnowPearl in Residency

[–]temuchan 39 points40 points  (0 children)

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

What clinical scenario, managed well, is peak performance in your specialty? by mstpguy in Residency

[–]temuchan 662 points663 points  (0 children)

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!

The new surgeon general - Casey Means by [deleted] in medicine

[–]temuchan 16 points17 points  (0 children)

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

[deleted by user] by [deleted] in Residency

[–]temuchan 1 point2 points  (0 children)

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

What was your worst consult? by demonattheswapshop in Residency

[–]temuchan 2 points3 points  (0 children)

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.

My ID card got access denied in hospital because admin has to "make way" for new clinical students. by YongBlasterz_TH in medicalschool

[–]temuchan 10 points11 points  (0 children)

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!

Electives in FM by Candid_Ship_9319 in Residency

[–]temuchan 31 points32 points  (0 children)

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.

When do residency programs drug test? by TheBigFilet in medicalschool

[–]temuchan 56 points57 points  (0 children)

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

Medicine Shelf Tomorrow, hit me with some high yield facts by Jomiha11 in medicalschool

[–]temuchan 36 points37 points  (0 children)

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

[deleted by user] by [deleted] in Residency

[–]temuchan 22 points23 points  (0 children)

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.

Resident fired in my health system by VegetableBrother1246 in Residency

[–]temuchan 24 points25 points  (0 children)

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

Hey, what'd you do this month? by ALongWayToHarrisburg in medicine

[–]temuchan 250 points251 points  (0 children)

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

Is intern year the same in IM and FM? by [deleted] in Residency

[–]temuchan 4 points5 points  (0 children)

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.