u/PrecedexNChill

We are a dual income but single physician income family. Looking at jobs in the bay in my speciality, I expect our combined take home to be somewhere in the range of 550-650k pretax. Current income is around 250-270k depending on how much moonlight. I am currently a fellow. We have no student debt. We are renting and maxing out our 403bs, IRA and contributing to a 529. Looking at homes in the area, even a basic starter home is anywhere from 1.5-3 million depending on location. It seems much more financially sensible to just rent indefinitely. Is anyone else just planning on renting indefinitely? Did anyone purchase a home in the Bay Area recently on a single physician salary income?

I did most of MkSAp and did ok on it (80% first pass) but I think it’s ridiculous for boards and probably uworld is a better use of your time. I took the test today and it was mostly focused on diagnosis and first line management. Here’s one example of mksap being absurd:

Patient with cteph undergoes surgical PEA but on follow up visit still has residual pulmonary hypertension, what is the next best step in management? The answer was obvious to me because I’m a PCCM fellow but this is an absolutely absurd question to ask a general internist. In reality, not even general pccm attendings are going to be the ones managing this situation it’s going to be a PH specialist likely at only a few centers in the entire freaking country.

If a patient comes for a new PH evaluation and the referring physician ordered a v/q scan I’ll be impressed.

wtf is MKSAP doing man.

Curious to know when people start to care about hyponatremia enough to do something about it. I start to care when it gets below 125. If they have chronic heart failure, cirrhosis, ckd I started to care as a resident when it got below 120 because our attendings often would make us consult nephrology or icu even if there was nothing to do about it. As an PCCM fellow now I don’t care what the level of sodium is unless they are symptomatic.

IM and for me its “You have to fill the tank” (patient has RVVO and confluent b lines) for patients in septic shock.

Hey starting pccm fellowship in a couple of weeks. I’m a little concerned about the CCM aspect because it’s a mixed ICU and PCCM are the minority of fellows and attendings even in the MICU. I also noticed a lot of of the third years in my program are scheduled for anesthesia rotations. Why would you want to intubate in the OR as a third year fellow unless your airway experience sucks? We also have very little actual required time in the icu. Obviously the role is different but I will have done 9 months of icu (most of it as a senior pgy2/3 with no fellow) as a resident and will probably do about 9-10months as a fellow. Any thoughts on what I should do? I am thinking I am just going to prioritize getting airways on all of my ccm rotations because I have done 150+ lines as a resident and we also independently manage vents and pressors at our community site as residents and run codes at all training sites so I feel like my ccm fundamentals are good.

What is the cheapest stethoscope that will not break immediately that I can buy for fellowship next month. I lost two of my stethoscopes during intern year and never bothered buying another one. I have to at least fake it for Pulm clinic (even though I will have a HRCT, V/Q scan, Echo, RHC, PFTs) for my patients.

Sitting at 70-80% for most sections (did way better on cards, pulm, renal) than random shit like neuro crit because I’m IM. Is this good enough to pass ccm boards?

Don’t have much to offer sorry. Let me know if anyone is feeling generous

Anyone have any good resources for CTICU for IM residents like a crash course or bootcamp series that is online/free? I’m going to be moonlighting in a mixed med/surg icu with some cabg patients although generally lower acuity with no ecmo or anything like that.

I think this game was subjected to a lot of hate and controversy but I have nothing but positive things to say. I am a new VGC player (I started with blue version when I was 7 back in the early 2000s) and played until emerald. I have a busy job (resident physician- we work a ton) and a family but have still been able to get a fully meta team (sneasler, gambit, chomp, etc) with only the starter pass in like a week and a half. Mainline Pokemon games are way too time consuming and I don’t find the single player experience engaging unless it’s a kaizo/ rom hack. Just want to give the team behind the game props and the fremium model is not really too greedy and actually really easy to keep up with