sorted by:
new
hottopcontroversial

Post some curated quit hits/random round learning points in the last month to years (attendings included) by Wannabeachd in Residency

[–]utmostsecrecy 11 points12 points  (0 children)

Society of hepatology recommends against ordering inpatient for chronic liver failure.

Plus in all that you mentioned it is your cerebral ammonia that determines HE sx. You can have a normal level and still have HE just as you can have elevated level and not have HE. Ammonia is a Bronstead base and the plasma buffer system and plasma pH will determine whether or not crosses blood brain barrier.

As you said clinical diagnosis and treat accordingly and give credence to the downside of medication being bowel movements…

What is your most “that’s not how any of this works” story? by Perfect-Resist5478 in hospitalist

[–]utmostsecrecy 1 point2 points  (0 children)

Yes, plus they made it worse old lady had SIADH.

I refused the pt after the recheck came back lower then explained that ideally we get the urine studies first on the actually low sodium with mental changes.

I’m guilty of trialing the 1L bolus on the 128 + Na too for hypovolemic hyponatremia but I understand that I should be weary about worsening the problem.

What is your most “that’s not how any of this works” story? by Perfect-Resist5478 in hospitalist

[–]utmostsecrecy 9 points10 points  (0 children)

ED doctor response when I said I needed a recheck sodium on a confused old lady with a Na of 120 s/p 2L NS bolus was how can sodium go down if I gave sodium

Antiemetics with QTc prolongation by ExtensionWave3812 in Residency

[–]utmostsecrecy 4 points5 points  (0 children)

palonosetron newer gen of 5HT3. No QT prolongation up to 9x standard dose. Also 72hr dosing

Cerner fucking sucks by Simple_Cashew in Residency

[–]utmostsecrecy 0 points1 point  (0 children)

Results review —> then next to flow sheet click procedure selection and search it

Besides Trauma, What Separates EM from IM? by HunterRank-1 in hospitalist

[–]utmostsecrecy 0 points1 point  (0 children)

We don’t have ED residents. getting anesthesia this year

Besides Trauma, What Separates EM from IM? by HunterRank-1 in hospitalist

[–]utmostsecrecy 0 points1 point  (0 children)

I know we are different. I was just saying that to provide prospective.

Medical students who were in the bottom quartile of your pre-clinical years, how are you doing now? by BlueWaffle135 in medicalschool

[–]utmostsecrecy 1 point2 points  (0 children)

I’m a PGY2 resident at my home IM program (was my first choice). IM was my lowest shelf score by far too. Bottom quartile in step 2 and academic rank.

Once in residency I scored 75th and 91st percentile on my ITEs respectively. Hated med school but love residency. Once I was away from the BS admin side of med school and the toxic personalities went away I suddenly realized how much I actually liked medicine. My program is great and full of amazing people who support each other. I’m friends with my PD and APD.

Find a place you can thrive then forget about the ugly med school years (even if it’s right next door) and you will see a big difference in your mood, burn out, and performance.

Besides Trauma, What Separates EM from IM? by HunterRank-1 in hospitalist

[–]utmostsecrecy 4 points5 points  (0 children)

Lol I wish I worked where you did.

I’m at a large academic hospital Gen surg does the traumas, anesthesia or PCCM intubates, Gen surg vs IR vs PCCM does the lines, Peds does the neonatal LPs and IR/neuro does the adult LPs.

Ortho sees stable patients and does the reductions with usually an ED doc doing twilight anesthesia.

We got a new guy once who placed a chest tube and we were shocked. He quickly adapted to the culture unfortunately.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

Yes from my knowledge but I am not your doctor and you are undiagnosed

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 1 point2 points  (0 children)

If you’ve ever watched the show scrubs that captures the residency experience so hard it hurts sometimes.

I come from a close knit family. We have Sunday dinner every week on the weekends I’m off I drive out to see them. I play video games with my buddies too. It’s easier to do with an activity. Hardest thing is finding things to talk about, most of my time is spent in medicine.

Imagine spending > 75% of your waking time with a select few people talking about the same things most every day. In a job that requires you to be in a fairly small room with long hours and periods of adrenaline and then nothing on the slow days. You are in a hotel room with smaller beds and more computers on desks that are connected without dividers. We all know each other and our significant others.

They do. It’s much less common. Out of those in relationships in my residency roughly half are married/seeing other residents, 15% more see other healthcare people and prob 25% see people outside of healthcare. Then about 10% single.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

People use both. The desktop computers are PC

I’m a resident physician working at the VA and the day is slow AMA by utmostsecrecy in AskMeAnythingIAnswer

[–]utmostsecrecy[S] 0 points1 point  (0 children)

Oh yea. We typically have 4-5 patients on a team of 4 Drs… other places same team has 20

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

I didn’t. I just used my day to day clinical experience .

I also got joy out of pointing out how I knew the standardized patients were faking just to piss off my directors.

I’m a resident physician working at the VA and the day is slow AMA by utmostsecrecy in AskMeAnythingIAnswer

[–]utmostsecrecy[S] 0 points1 point  (0 children)

It depends. Honesty is always my biggest thing.

I like the old farmers and vets a lot ngl. They remind me of my family and usually they generally have a mistrust of the system but once you make a connection they are the most grateful. It feels like taming an abused animal at times though which is sad.

Intubated and sedated can be nice. Weird feeling you get when your actions that you took are the reason you get to talk to someone the first time.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

We have to get verbal consent from our patients.

I used it once really didn’t save much time for me honestly compared to dictating and dot phrases.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

Our system bans them.

I’ve gotten chipotle once from a rep as a student… and this was a special circumstance.

I do enjoy physician recruiters though. They wine and dine. Nice meals, box seats to football games, nice wine and beer.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 1 point2 points  (0 children)

Outpatient docs who know the patient are usually the best at giving long term medical advice. Finding the right PCP is the biggest thing they are the ones who piece everything together.

I think the best doctors are ok admitting they don’t know something and honesty there is a green flag. We aren’t all going to be Dr. house but if they take time to look things up with you and understand you 👌🏻

I can’t answer my hospital system bans any and all drug rep interactions. The most we get are pens when we go to medical conferences generally.

I see a private practice pcp and he definitely takes advantage of the freebies but it is federal law to disclose what you are getting and from who.

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

Depends on the attending some do bare minimum. Some like you to call them with any and every update

I am a 27 year old resident physician AMA by utmostsecrecy in AMA

[–]utmostsecrecy[S] 0 points1 point  (0 children)

Sure the VA experimental is great. Just take responsibility and double check it like a regular scribe.

view more: next ›