Please upvote this post and help me lobby the mods to possibly pin this.

In the meantime, the folder link is in my profile description. If you can’t find it, lmk. Getting a metric buttload of DMs!

Pass it along -- thank you!

The folder includes the newest White Book, and:

• PDF on POCUS
• 2022 cardiology housestaff manual
• Heme/Onc manual

Does anyone else feel like internal medicine is just glorified secretary work? You’re essentially the case manager of medicine

Help me lobby the mods to approve my auto-removed post. How incredibly annoying

Test: https://www.dropbox.com/scl/fi/ciuhqvzs1b6olb4xnizfy/MGH-Housestaff-Manual-2024-2025.pdf?rlkey=hazf90wlhl9ygjlhw29ajmd6l&e=1&st=przhdhdv&dl=0

Your patient comes up to the floor from the ED? Are we supposed to be sending a message saying “hey doc., patient has made it to the floor.” Is that just annoying and redundant?

I just want to go deep into understanding the real basis of autonomy. Just want to get my moral axioms stronger.

I don't agree with most the thing he says, but I can get behind this. I've even seen cancer drugs like wtf ???? You want the patient to ask the DOCTOR if a certain med other then what they said is the right one to save there life cause they saw it on tv..... They do say even a broken clock is right twice a day 🤷🏽‍♂️

What prevents them from hiring the same type of staff that an efficient private clinic has?

I took step 3 today and day 2 was baddd. Only 2 of the CCS cases ended early 2 had negative updates until the end the others no update/good update but none ended early. I feel like I failed

pgy2 here (peds if it matters)

I’ve seniored 2 weeks and will be doing more soon. Overall I liked my interns, and when we all debriefed we all thought we worked well together. My first block senioring was nights which does include a lot of cross cover. At my program interns are first call for nearly everything from nurses and consultants.

One thing I found hard was figuring out how much I needed to ask/know.

Overall I felt like my interns and my nurses had decent instincts when to involve me along with the interns. But there were a handful of times they signed something out in the morning and I was like oh I wish I knew that, and I would have advised quite differently/ been more worried about certain pages.

I did tell them at the beginning to let me know about certain kids who were watchers, major changes in plan or status and anything they got paged on more than once because clearly someone was worried. Short of that what are some concrete ways to do better with this?

Watching the college football bowl games lately (one of the few times I’m exposed to a significant amount of cable TV commercials), I can’t help but feel a bit daunted by the quantity of disease modifying therapies for specific conditions in the form of -mabs that are rolling out. As a newish attending, there’s already a bit of a learning curve catching up on the fancy drugs that people who go to resident clinic and safety net hospitals generally can’t readily access. But it seems like every day there’s a new, brand-name drug out there with a unique MoA and side effect profile. I feel that as a doctor, I should know at least something about the medications my patients show up taking. Keeping up within my own specialty is a task, but it seems like things have gotten out of hand with the sheer volume of new drugs being marketed to people over stock footage of smiling, active people engaged in wholesome, fulfilling activities as a list of concerning side effects are read off.

I know these things can be looked up, but that can significantly hinder timely decision making in a busy ED or clinic vs common meds that are widely known. I hate the feeling when a patient mentions the brand name of their infusion I’ve never even heard of.

Another peril of direct-to-patient advertising, I know. But what are y’all’s thoughts on this? How do you navigate the surge of new niche meds?

Hey humans of Reddit.

I’m applying this cycle to FM residency, a very strong candidate for my region in which I’m applying. My story is complicated in that I don’t have family help/assistance, and I’m a single mom to a 5 year old. Custody is split 50/50, but kiddo’s dad’s girlfriend is having a baby some time in the spring, so shits probably gonna hit the fan over there, and I anticipate probably having him more often through the summer and fall.

Where I’m located and applied, I have really two options- hospitals close by (15 mins) with all their rotations in house, but bigger systems, more nights, more inpatient, arguably much better training. Secondarily- hospitals about 40 minutes away, lots of traveling to other training sites, smaller systems/probably less comprehensive training, but minimal nights and minimal call.

I obviously don’t want up in a situation where I’m not meeting the requirements of my residency program. I also want to be able to adequately support my son and know he’s well taken care of. I know I won’t be able to be at everything, but I’m struggling with navigating the nuances of a very unknown season.

Would love any advice for prioritization you did or did not do, or recommendations in hindsight that you have.

I'm casually starting to look into what programs I might want to apply to for fellowship. Whereas residency pages often had so much information about the program, the benefits, etc, and I usually could find comments online about the program from people who've rotated there or been employed there, that information seems harder to come by for fellowship. Where have you/are you guys looking? Anybody know of any programs in particular that are good or bad in some way for pediatric cardiology?

I’ve gotten the feedback a few times about being more thorough with my patients in terms of both asking them HPI questions and their chart.

Sometimes I feel weird asking them questions I should know (it’s already in their chart somewhere) and sometimes I just don’t know what to ask because I don’t know what’s relevant.

I also have a hard time digging through their charts. It’s often times overwhelming and too much information, so I don’t bother.

Any ideas on how to slow down?

My girlfriend will be sitting for IM boards in August and just curious if anyone has good study tips/ resources that they used to prepare! She is very much an overachiever and overthinker so any test scenario brings on a lot of “what if I fail and all of this was for nothing” 😬! TIA!

My buddy has a patient who is done with chemo in remission, but says they are in constant pain in the hip there bone Mets where. It was pretty big he told me I didn't see any patient identifying information ofc he just told me what i just told y'all lol.

I've been asked to revise the hospital Regulatory Education for our new residents. Topics include allegations, safety event reporting, legal document review, ect. Here's my question: how do you prefer for that Education to be delivered? Live? Video? Podcast? Webinar? Paper forms? Something else entirely? Any feedback is potentially helpful! Thanks!

Hi everyone, i know this sound weird but i don’t want criticism just advice if you were/is in my position. I would be happy to hear your opinion.So i am almost done with my interviews for peds for match 2025 season and i just found out i am pregnant due in September. And i don’t know what to do with matching season this year so do you think i should take the year off, or go ahead with rank order list . I would be happy if there is any one who has been in my spot before. Thank you in advance.

Hello, I am currently a PGY-4 fellow at a university program in Ohio. Due to family reasons and personal ties to Michigan, I am seeking someone interested in swapping positions with me who is currently training at a program in Michigan. Please DM me if interested.

Probably a major factor in bad inpatient outcomes as we continue to automate and systematize things within the EMR. At some point we gotta turn away from objective but incomplete data noise and just return to intuition

Please don’t flame me…I really need your honest opinions. My kid is a junior in college,giving up all of Christmas break to cram for the January MCAT, which is kind of an s show since she doesn’t take biochemistry until next semester. This is after missing all of her summers and weekends for 3 years to keep her grades up. Then I come onto this and other subreddits to see that you all feel like you’re in a dying profession and that midlevels have taken over. At this point, part of me wants to question all the sacrifices she and our whole family are making for her to become a doctor and advise her to just become a PA. There’s no one in our family that is in medicine, so I don’t have anyone to ask this question to. To be 100% honest, part of me feels like doctors have dug their own hole by making it so freaking hard to become a doctor but so easy to become a mid level. What would you say if this were your kid?

ETA:I fell victim to the Reddit echo chamber. Midlevels and AI are not taking over medicine and being a doctor is still a great career choice.

Basically the title. Genuine thoughts on pros and cons? Looking for: quality time together, family life, Kids