Honestly, MD

Family Med PGY1

[thebootydiaries]

[itsagifnotagif]

It hurts how relatable this is

[caringintensely]

Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies

There has been enormous debate regarding the possibility of a link between childhood vaccinations and the subsequent development of autism.

A meta-analysis examining >1,000,000 children, “vaccinations are not associated with the development of autism or autism spectrum disorder.”

Over a million kids studied, vs. Wakefield’s false conclusions about 12. Do you think they’ll listen?

[ashleymd7]

“You may not become the best doctor in the world, or this country, this state or city. Hell, you may not even be the best doctor on your street, at your hospital or clinic, or the best doctor on a hospital floor or in a room at a given time. But when a patient comes to you, scared the headaches, the chest pains, whatever they’ve been having for months might be something worse, at that moment, YOU are their best chance for survival. You are that patient’s best hope, and proving yourself worthy of that responsibility is the only title you should ever care about winning.”

— A practicing physician for 40 years, and one who still hasn’t lost sight of what truly matters in this profession: the patients.

[onewillow]

This Autumn, let something die.

A worry, a relationship, a project that has run its course. Let go of anxiety over the future. Let go of guilt.

Let go of other people’s dreams for you. Let go of the fear that happiness or success or love or joyousness somehow isn’t for you.

Let go of feeling unwanted. Go outside, can you feel how deeply your presence is craved here?

Let go of the small and burdensome things. Gifts never opened. Keys without a lock. Broken earrings, old love letters, the ephemera on your fridge.

As David Whyte writes, “Anything or anyone that does not bring you alive is too small for you.” This Autumn, let go of all the clothes you have outgrown.

Let go of comparison.

Let go of doubt.

Let go of the feeling that you are somehow not good enough.

Because every imperfect apple that lays soft in your hands, and every ray of low Autumn sunlight that warms you through woolens will tell you a different story, a much truer story. The story that you are more, much more, than enough. That you bless this world simply by being alive.

[crookedlycasualwitch]

Y’all this hit me hard

[honestlymd]

This is something I really needed to read

[protego-et-servio]

The point of voting blue in 2018 isn’t to make the US perfect. We cannot accomplish that in one fell swoop. There’s gerrymandering, voter apathy, voter suppression, and generations of older party-line fucks we have to deal with.

Voting blue in 2018 is to make it less immediately threatening for PoC, LGBT+ people, the disabled, and any other marginalized demographic. It’s a stopgap against Republicans who are aligned with Nazis, white supremacists, and sexual abusers.

Correcting politics in the United States is going to take decades of new voters staying on top of politics and not falling prey to apathy, like our predecessors. 

People telling you not to waste a vote on 3rd Party this midterm aren’t saying “never vote 3rd party.” Republicans have united behind one utterly heinous front. We need to unite behind Democrats, for the time being.

[wellyfullofale]

I think next thursday is gonna be the best day of my entire life tbh

[thequeenofsunflowers-deactivate]

reblog for next thursday to be the best day of your life

[honestlymd]

First interview down

Flying out for round 2 on Monday morning. Interview season, here we go!

[honestlymd]

Interview Update

Applications: 28

Invites: 23

Scheduled: 18

Pending scheduling: 2

Pending cancellation: 5-6

Declined: 3

Completed interviews: 0

Estimate of interviews to be attended: 15 (still way more than enough, but so hard to narrow it down... might get closer to 12 as time goes on)

...and there’s one program near the top of my list I’m still waiting to hear from. I’m beyond humbled and grateful that I have more than enough interviews. However, let this be a cautionary tale. Do not over-apply. I should have listened to the match data that reported diminishing returns for greater than 19 applications or something for a family medicine applicant with avg scores or greater. Having to decide which to keep and which to cancel without visiting the program first is really stressing me out. I’m confident that I have some great programs to choose from, but what if one I cancel would actually be a great match? I want to make these decisions quickly to free spots for other deserving applicants. I never ever dreamed I would be in this situation, and all I want to do is make the best decision for my future career while being as respectful as possible to all of these programs and other applicants.

Anyone have advice for narrowing it down quickly? So far close-reading program websites just gives me more reasons to want to visit all of these places, which is not feasible for my time or wallet.

[honestlymd]

Anyone else not get a presidential alert on their phone today? I mean I’m not complaining that Trump doesn’t seem to have the ability to send me texts but...

[bottleoftonic-blog]

Most bang-for-buck things every intern should know before starting inpatient wards

Source. A collection of Meddit resources and advice on what bread-and-butter topics interns would most benefit from brushing up on/memorizing prior to the beginning of their internship. 1) Fluids. How and when to use them, dosage, timing and other pearls.

Review of fluids (not how to use them per se) by Dr. Strong /u/ericstrong

Maintenance Intravenous Fluids in Acutely Ill Patients - NEJM.

Pretty thorough review of fluid management on openanesthesia.org

2) Nausea. When to treat, how to treat and at what dose.

3) Standard pn orders: pain killers, sleep aids and antiemetics aka how to reduce nighttime calls from nurses by 25%

4) “Reflex” antibiotic choice for routine inpatient infections.

http://www.bpac.org.nz/Supplement/2013/July/antibiotics-guide.aspx /u/ChristianM and /u/ive_been_up_allnight

5) Initial work-up and treatment of dyspnea. (more realistic to approach by symptoms as, unfortunately, you first have to diagnose whats wrong. E.g. heart failure, pulmonary edema, embolism, COPD, pneumonia).

6) Initial work-up and treatment of oliguria/anuria.

7) A sensible initial approach to suspected ileus.

8) Blood. When, how, why to replace.

9) Pain. Optimal management without inducing narcosis.

Managing cancer pain: Frequently asked questions: CCJM

10) Potassium. When, why and how to shift or replace.

A review on both potassium and sodium disorders by Dr. Strong /u/ericstrong (Not reposted in 12) hyponatremia but applies there as well) https://www.youtube.com/playlist?list=PLYojB5NEEakXVIAapcSEleP4doUdHVtld

11) Hyponatremia. Most common electrolyte disturbance, commonly mismanaged.

12) Resuscitation aka commit the ACLS algorithms to memory.

Current ACLS guidelines. https://www.acls.net/aclsalg.htm

Would love a video series, interactive cases etc.

13) Basic EKG interpretation.

Whole EKG video courses

A whole free youtube EKG video review course by meddit’s own u/ericstrong

An alternative EKG course that takes you through all the basics. This however has no free version and costs 96$ a year. The quality is amazing. Here are 6 basic sample videos on youtube. The paid course is available on http://www.ecgteacher.com/

I have to admit I haven’t used this course personally but his free youtube videos are on-point and he seems like a good teacher. Also behind paywall. Free youtube samples are here. The full course can be found here https://www.ecgacademy.com.

EKG video cases

Amazing case-of-the-week emergency medicine EKG videos on youtube by Dr. Amal Mattu

– If you like Dr. Mattu’s cases (and you most certainly will) he is still posting every single week on his new site https://ecgweekly.com. It costs 4 starbucks coffees a year and is going to save someones life.

Practice EKGs with answers

Watching videos isn’t enough, you still have to grind out EKGs to keep your game strong. Visit http://ecgmadesimple.com and http://ecg.bidmc.harvard.edu/maven/mavenmain.asp for this.

EKG blogs

I recommend signing up for some kind of RSS feed (e.g. https://feedly.com/) and subscribing to the following EKG blogs:

http://hqmeded-ecg.blogspot.is (Dr. Smiths ECG blog)

http://www.ems12lead.com

http://ecg-interpretation.blogspot.is

http://jhcedecg.blogspot.is

EKG resource libraries

Life in the fastlane has a nice resource to look up a specific EKG finding, criteria or concept.

http://www.practicalclinicalskills.com/ekg.aspx /u/collidge

14) Know when to order ABGs and how to interpret them.

Almost too detailed video lecture series on ABGs and how to interpret them by Dr. Eric Strong (/u/ericstrong)

Practice makes perfect. ABG interpretation generator. https://abg.ninja/abg

Bonus 15) Basic CXR interpretation

CXR video lecture course

Again, Dr. Eric Strong has an excellent video course for free on youtube

Step-by-step guides to basic CXR interpretation

The Radiology Assistant: Chest X-ray - Basic interpretation

Radiology Masterclass step-by-step basic CXR

University of Virginia’s step-by-step basic CXR

All inclusive resources

The art and science of thoracic imaging All inclusive resource for all things thoracic! Jokes aside amazing resource.

UPenns CXR learning website

Loyola Universities excellent CXR Atlas Most outdated look but amazing content.

Checklist approach to CXR

Bonus 16) Overnight o-shit-what’s-that Head CT interpretation

Midnight radiology: Emergency CT of the head

University of Virginia’s guide to the Head CT

[sothisisnursingschool]

Hey, self: review before NCLEX. Xo, me.

[md-admissions]

Oh hell yes

[populationpensive]

For future reference.

[doctorkintsugi]

Must. Study.

[modernathenamd]

Scheduled to post right before intern year starts. Gulp.

[aspiringdoctors-blog]

Reblog to save a life. You got this, bbs.

[medicinasanguis]

we need it all

[honestlymd]

Future reference

[npr]

There are a lot of misconceptions out there about the flu shot.

But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.

“Flu vaccinations save lives,” Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. “That’s why it’s so important for everyone 6 months and older to get a flu vaccine every year.”

But many Americans ignore this advice. The U.S. vaccination rate hovers at about 47 percent a year. This is far below the 70 percent target. And college students are among the least vaccinated.

Think You Don’t Need A Flu Shot? Here Are 5 Reasons To Change Your Mind

Photo: Mary Mathis/NPR

[honestlymd]

Most exciting interview invite so far today! One of my top choices, which is also one of the most highly respected family medicine programs in the country. I’m absolutely floored that they would even consider me, much less send me an interview invite this quickly.

This interview season is shaping up to be a wild few months!

[honestlymd]

4 more interview invites today... starting to think maybe 28 programs was overkill. I honestly had no idea so many places would get back to me this quickly. But who knows, maybe things will calm down and I won’t hear from any more until after Dean’s letters come out? The unknown is hard. There are a few places high on my list I haven’t heard from and I don’t want to overbook myself

[honestlymd]

1st weekday after ERAS submitted...

TWO interview invites!! One scheduled for late October, the other hopefully sooner if I can get it. Still waiting to hear back. This is real now... I guess I should buy a suit?

[honestlymd]

Officially submitted ERAS today

It feels weird to say that. 28 programs and $400 later... it’s done. Now we wait!

[ithelpstodream]