Anyone thought they performed terribly but ended up matching there?

I don’t have anxiety usually but my body involuntarily exhibited all signs of anxiety and panic prior to interview: palpitations and stuttering in speech, etc.. I liked the program.

Not my best performance. But anyone still matched there despite not their best performance?

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u/Every_Lifeguard6224 — 13 days ago

Some self reflection

I learned a lot about myself during the medicine journey, particularly hospitalist journey.

Medicine, particularly hospitalist, would be best for someone who is not particular about whether things being done right or wrong or a particular way. A person who is mentally/emotionally malleable and moves frictionless in a work place that is bound to have mistakes and failed plans thrives better than someone who wants things done a particular way. If you’re happy as long as things work, then you’d enjoy medicine in this country. Maybe this is an obvious observation for yall lol

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u/Every_Lifeguard6224 — 2 months ago

What the fuck is multiple medication intolerance syndrome?

And can we fucking stop telling patients they have this.

This is a uniquely middle age white woman syndrome who have no real problems in life so they latch onto bullshit like this. I’m afraid to tell patients the truth cause it hurt their feelings. Patients here go to the board directly if they are unhappy, it fucking sucks.

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u/Every_Lifeguard6224 — 2 months ago

Hate to say it… but American culture is not meant to allow affordable healthcare.

The excessive and toxic obsession with privacy, the over-litigious lawyers that prey upon massive malpractice capital, lack of effort to own their own health yet still demanding the best possible care for something that doesn’t require to come to hospital, the need for red-tape … so on and so forth.

It has all the risk factors needed to make healthcare more expensive than it needs to be..

I could be wrong. Have worked in different parts of the world and that’s just my perspective

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u/Every_Lifeguard6224 — 2 months ago

Unpopular opinion: nurse practitioners should get independence. This is good for physicians.

  1. This is a tax on the nurse practitioner and the hospitals. Increases more liability for the hospital.
  2. There will be more NPs leaving hospital medicine as a result.
  3. Consultants do not want to get consults from NPs.

Many more benefits.

Edit: this is good for hospitalists*

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u/Every_Lifeguard6224 — 2 months ago

New alcoholic hepatitis guidelines

Are you guys starting NAC with steroids in severe alcoholic hepatitis? Defined by MELD greater than 20, MDF greater than 32.

Our gastroenterologist didn’t recommend it, but just wondering how the practice is on your guys end

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u/Every_Lifeguard6224 — 3 months ago

First business

Trying out a vending machine with a friend.

27k for a vending machine. Can make 75 burgers a day. Each burger 5$. Costs 2.5$ to make. Can put whatever we want in the items.

Any suggestions? I’m doing this to learn. Ok to lose money to learn. Thanks.

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u/Every_Lifeguard6224 — 3 months ago

Stand alone ED admitting directly to floors.

I don’t place admissions orders for my own ED patients without seeing them. I hate these stand alone EDs trying to admit directly to floors and then they are a shit show. What the fuck

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u/Every_Lifeguard6224 — 3 months ago

Applying for fellowship.

Anyone here applied and matched or thinking of applying this year?

My application is not competitive. < 10 publications with good scores. IMG. No visa required. Applying for hemonc. I legit decided June 30th.

Maybe wasting money but shooting my shot.

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u/Every_Lifeguard6224 — 3 months ago

Emtala

I work in a community hospital, been here for a year and half doing nights I got a transfer request from a hospital for a service. We are a small as fuck community hospital that’s two hours away from this transferring ED and there is a tertiary transplant center just an hour away for them (that the patient is already established with)

When I heard the sign out, I had a feeling this patient is too complex for this hospital. My chief of staff said patient is too complex for us and needs to go to higher level of care. The ED doc said he wants to know my chief of staff name because he suspects this is EMTALA. Will I get in trouble for listening to my chief of staff? In EMTALA, are individual physicians liable or will it be hospital as a whole?

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u/Every_Lifeguard6224 — 4 months ago

Strokes/seizures on 40s or 50s female on tizanidine, dicyclomine, and psych meds are almost always fake news

A uniquely American problem. Don’t these middle aged white women got nothing better to do than get attention?

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u/Every_Lifeguard6224 — 4 months ago

Culture of discharge summaries

Why is it that progress notes make sense when written as assessment and plan but somehow when writing a discharge summary, it’s taboo to write it as assessment and plan? Do we become dyslexic to read it as A&P in a D/C summary as opposed to progress note?

If elaborative or paragraph is better for people to understand the hospital course and treatment plan, should we just stick to that for progress notes too?

Essentially, I hate writing a d/c summary in paragraph form. Just read the god damn notes from before. The more emphasis you place on the culture of doing notes, the more your job is reduced to simply doing the notes.

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u/Every_Lifeguard6224 — 4 months ago

Alcohol withdrawal.

How long does it take to get physical dependence on alcohol? If a patient was detoxed 7 days ago and started drinking 3 days ago, can they still get physical dependence to get withdrawals?

I didn’t find much studies.

Edit: petition to remove headache in CIWA protocol. If I haven’t had coffee in the morning and climb the stairs, I’d be scored 9ish on CIWA and nurse would spam that Ativan

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u/Every_Lifeguard6224 — 4 months ago

How important is discharge before 11

In the past year, I’ve discharged the most of my group and 100 patients more than the next hospitalist but my discharge before 11 is shit. How serious is this shit? Will they fire me this?

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u/Every_Lifeguard6224 — 5 months ago