u/espressofloat

I'm sorry, another "should I do fellowship" post, truly looking for honest advice. I am very grateful to anyone who reads and offers their opinion.

I am a CA-2 at a large academic program. We have all ACGME accredited fellowships and some non-ACGME fellowships in-house. I have scored very well on exams, published/presented research, and am overall a good fellowship candidate. Generally interested in academics post-residency, PP not out of the picture though.

Since starting residency, I have wanted to do fellowship. I have been driven by the desire to be an expert in a field and to feel solidified in my career with the mid-level explosion. Currently, I am very stuck. I generally could see myself enjoying parts of every ACGME fellowship, as well as being content without fellowship. I do feel scared for the future of being a generalist, I understand this is highly debated, but I don't want to be stuck in 15 years feeling like I need to find a fellowship when programs are more competitive than ever, and then having to take a step back for a whole year.

One big important part to this all is my desire to return to my hometown. Since leaving for med school 6+ years ago, I have been on a journey of trying to return home and haven't been able to. Currently, only peds and pain fellowships are offered by programs in my hometown. Even one more year of not being able to go home doesn't sit the best with me.

Going to list my feelings on each ACGME fellowship below.

Critical Care: Initially my goal/main interest coming into residency. I love being able to expand my horizon past anesthesia. I feel competent and confident from the skills I obtain while working in the ICU. I just feel like the pay differential upon getting out of fellowship will undoubtedly push me towards working anesthesia after graduation, and I may just end up losing my skills and not practicing CC after all. Only interested in CC if I can pursue split practice between OR and ICU. No fellowship option in my hometown.

Cardiac: I really like cardiac cases. By far the most engaged I have ever been in the OR. I love the active participation in the case with the surgery team. What I don't like are the very early mornings and the supreme effort that every case demands. I'm a bit concerned that the stress/effort will feel burdensome when the pay differential is small. I also like time flexibility. I like to be able to take 2-3 weeks off at a time. I feel like the reduced cardiac pool will squander this chance. Also no fellowship in my hometown.

Peds: I enjoyed peds cases a lot, but I didn't love the tiny babies. I felt almost useless, as my interventions were unlikely to change the tides significantly. Most neonate cases I was just praying nothing went wrong lol. I'm not the best with kids but I didn't feel like it made much of a difference during my peds months. To me, without a pay differential, it doesn't seem like a worthwhile endeavor.

Pain: Pharm is my favorite part of medicine, so I could see myself enjoying pain, especially with new medications and uses of old medications. The procedures are pretty cool overall. I didn't like my clinic time much as a resident, but it's also because it was filled with lots of downtime and I didn't have much decision-making power. Because of my time as a resident, I never really considered pain much. I'm sure as an attending, it would be much different. I like the aspect of leaving the OR for a bit. I would probably still want to do per diem anesthesia, but from what I understand, you generally need to dedicate yourself to pain practice coming out of fellowship in order to make this work.

Feel free to call me out where I'm wrong and provide any opinions or advice. Thank you so much for taking the time to read this.

Hi everyone, I could really use some help as I have ongoing AT issues in my 2013 Outback 2.5L after valve body replacement.

Background: Driving one day, christmas lights on the dash, valve body codes, etc. Bought a valve body from Djtrans on ebay and replaced it without issues. Went to shift and the car immediately stalled. Redid my installation, same problem. Found out that they sent the incorrect valve body and had the correct one sent to me.

Today, I installed the new, correct valve body. Initially, the car wouldn't start, but it seemed as though the battery was discharged (old and testing poorly). After a jump, the car started and I was able to drive. Immediately I noticed a few things:

• All dash lights and transmission codes were initially gone
• Car idles lower than usual (~650 RPM) and feels like it is nearly going to stop running upon ignition
• Won't shift out of first gear

After driving around my neighborhood a bit, the lights reappeared. I performed a scan after these new lights came up, and I'm getting a P0730 error now, but no solenoid error (as I was previously).

I also have some electrical errors appearing, however these may be related to the battery (B101, B102, B103, B104, and U1201).

I wasn't able to test the solenoids on the new valve body, only because I don't know the reference ranges/numbers to use to ensure that the solenoids are working correctly. I wasn't able to find this information online, unfortunately.

During the install, I did have some issues. The clip piece to remove the brown harness on top of the valve body broke off when I was reinstalling it last time, so I wasn't able to remove that harness for installation. I covered it in some paper towels and secured it with a twist tie above the valve body, allowing the installation to proceed. This and all other harnesses that I had to remove and reattach for the job seem to be well attached. The screws for the black heat protective cover also broke within their respective holes, so I'm not able to secure that in anymore except with tape or some other janky method.

Please let me know if you all have any ideas or suggestions. I really appreciate it.

Anesthesia resident, just started my 3rd year. Will be doing fellowship (at least 3 years left of lower income) and interested in academics, so PSLF is a possible option for me. I lost 2 years of PSLF eligibility though being on SAVE forbearance for my first 2 years.

• Current income ~80k, will be around that for 3 years, then likely 400k+ after
• Total loan burden at this time is $282k.
• Engaged and will likely get married within next year or so. My spouse makes about the same.
• RAP and IBR have largely the same monthly payment ~$450.

I'm leaning towards RAP for the interest accrual help. Per loan simulator, if I do PSLF, I will pay less with RAP. If I don't do PSLF, I will pay significantly more with RAP. I'm on the fence about PSLF, I'd like to do it, but anesthesia jobs are somewhat hit or miss with eligibility, and I've already lost 2 years. To me, it makes more sense that RAP would help reduce my loan burden given the monthly excess interest forgiveness. However, the cap on IBR payments makes sense to me as a safer option long term.

All thoughts and help are very much appreciated.

Anesthesia resident, just started my 3rd year. Will be doing fellowship (at least 3 years left of lower income) and interested in academics, so PSLF is a possible option for me. I lost 2 years of PSLF eligibility though being on SAVE forbearance for my first 2 years.

• Current income ~80k, will be around that for 3 years, then likely 400k+ after
• Total loan burden at this time is $282k.
• Engaged and will likely get married within next year or so. My spouse makes about the same.
• RAP and IBR have largely the same monthly payment ~$450.

I'm leaning towards RAP for the interest accrual help. Per loan simulator, if I do PSLF, I will pay less with RAP. If I don't do PSLF, I will pay significantly more with RAP. I'm on the fence about PSLF, I'd like to do it, but anesthesia jobs are somewhat hit or miss with eligibility, and I've already lost 2 years. To me, it makes more sense that RAP would help reduce my loan burden given the monthly excess interest forgiveness. However, the cap on IBR payments makes sense to me as a safer option long term.

All thoughts and help are very much appreciated.

Hi all,

My wife's 2013 outback 2.5 premium at around 105k had multiple lights pop up (brake light, oil temp, check engine) mid-drive today. She scanned after pulling over and the code was P0700. She went to a chain service place and (after $220, RIP) reported P0700 and P2793, and quoted her $5k for a new transmission. We took it home. She said that there wasn't much of a noticeable difference with driving.

After a lot of research, it seems like problem requires at a minimum, a solenoid replacement, but ideally a valve body replacement. I am comfortable doing either repair, but the fill/flush and relearning would need to be done elsewhere as I don't have the equipment.

Does this seem like the appropriate diagnosis given the codes? It seems like the solenoid-only repair is risky as they tend not to last.

This car burns oil as well (from prior research there was a class action lawsuit about this years ago that the prior owner missed) and popped a P0420 code a few months back suggesting catalytic converter problems. I just cleared the code and the car performance hasn't changed (and the code never returned), but I'm unsure about emissions status. She took the car in for maintenance soon after and nothing was mentioned about this.

She loves the car, but I'd love to hear opinions on if it's worthwhile even chasing this transmission repair given the potential catalytic converter issue that may be at play. All help is appreciated.