gamerEMdoc
@GamerEMDoc
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EM program director. PGY18. Pittsburgh Steelers, SF Giants, #Medtwitter , Golf, Video Games. GNR fan. Opinions are my own and do not reflect those of my employer
Joined December 2010
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#EMBound
4th years, here is a compilation of a lot of past advice 🧵s to get you ready for your upcoming AIs to hopefully net you great sloes, write your PS, what programs look for, and more! DMs are always open for advice along the way. Let’s get it!
#MedStudentTwitter
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It’s been like 1 shift since I examined an eyeball in someone not wearing pants.
#EMforlife
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When a bunch of docs and nurses quit and a hospital is about to collapse, please, everyone, before you leave that hospital…
Make sure to send 🍕 to admin. Finding staffing is hard. They need to know they are the real heros.
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It’s amazing to me that the public perception is that hospitals are overwhelmed with COVID when the reality is, inpatient cases are easily manageable now, but hospitals are overwhelmed bc a huge portion of the workforce died or quit and theres noone left to take care of anyone.
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A tetralogy of fellows
Never seen this many cardiologists in one room.
What do you call a group of cardiologists?
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We give our residents holiday gifts, but I think the most unique thing we do this time of year is give all our residents a 6 day holiday break. No need to take vacation time. Just a free 6 day block off for the holidays to rest, recover, and see their friends or family.
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Shorten med school to 3 years, eliminate step 1 and get rid of all the repeat basic science stuff from college, then add 1 year to all residencies. Shorten residency work hours. Everyone graduates in the same amount of years, but med ed would be just a better place.
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Nevermind, our staffing is fine, we don’t need any more nurses, thanks!
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Hey
#MedStudentTwitter
, want to learn how to quickly master reading rapid rhythm ECGs ahead of your EM elective? Here is how to look like an all-star. All the images in the tweets below were taken from a google image search, credit goes to whoever posted them originally.
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So... did we eradicate influenza just by masks? Its mid January and I STILL havent seen a case. Also the first winter I didnt have a respiratory virus or two in ages.
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Emergency Medicine: What happens when the nerds from high school realize they are the coolest people in medical school…
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Hear me out. A yoga studio for med students. But where you just have 2 drinks and then lay in childs pose for 30 minutes while an attending leading the class tells you its going to be ok.
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Hospitals always are like “Happy Labor Day to all of the HCWs who keep the hospital running so the corporate aspect of medicine can continue to rake in billions in profit. Here is a $5 free coffee card redeemable only today from 1-2pm.”
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Ive seen some weird shit in medicine, but having a conversation with someone with a HR of 12 is definitely up there.
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I paid my debt to med school by serving 4 yrs in the Navy, loss of autonomy, deploying, 1/3 of a normal EM salary for 4 years; I still support student debt relief even though Im debt free. Just bc you paid off your loans doesn’t mean others need to suffer rising education costs.
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When a patient takes the news of their critical diagnosis well, but then starts crying bc they are being admitted to the ICU and they will be bankrupted by the healthcare system in the US, it really makes you realize how far we have fallen as a nation.
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Two people with zoom interviews no-showed. No cancellation heads up. Just didn’t come. It kills me people care so little about other applicants they aren’t willing to cancel in ERAS or email so those spots could go to others.
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Most specialties: I hope we match the students with the highest step scores on our list.
EM: I really hope we match the mountain climber guy, microbrewery fangirl, the former chili's waitress, the dude that played college baseball, and that standup comedian.
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Whoever named 3 rashes that look alike rubeola, rubella, and roseola... fuck those guys. 🖕
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CDC announced today that the 10 second rule will now be raised to the 20 second rule for HCWs who eat food that drops on the hospital floor.
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Do we choose to work so hard in medicine because we are naturally hard workers or because we are uncomfortable with being alone with our own thoughts when we have no work to distract us?
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Did every floor nurse in America quit this past year? Good lord these nursing shortages are never ending. Everyone I talk to at different hospitals, it sounds like the same story. No floor nurses, tons ED holds. This is not sustainable.
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Attendings should have to take step 1 every few years just to demonstrate to med students how unimportant the material on that exam is to actual medical practice.
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Breaking news: Republicans will be offering their thoughts and prayers and Democrats will be adding stern calls for change before forgetting any of this ever happened by next week.
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No you didnt match by accident. Yes you will be ready. No you didnt forget everything in the last few months of 4th yr. Yes everyone feels this way. No you don’t need to study ahead of time to prepare for intern year.
(Plays this on repeat for the next 3 months…)
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Trying to remember from elementary school, if a nuclear bomb drops, I just crawl under my desk and Im fine, right?
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Sometimes when doing holistic review you uncover an absolute gem of a candidate on paper that you just know a ton of places are going to overlook bc they don’t have a cookie cutter application and it completely validates why you should read every app.
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4 years ago I voted for Hilary begrudgingly. I watched election night on shift and one of my residents had a mini-meltdown as Trump won. I reassured her, saying honestly, the President really wields little power, how bad could it get. Man was I a fucking idiot 4 years ago.
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Got through med school after growing up blue collar poor. Worked up to 30 hrs without sleep as a resident. Navy OIF/OEF Vet with a Naval Achievement and Commendation medals. Works on the frontline of a global pandemic. Please Mr Cruz, remind me how tough you are? 1/5
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I havent seen studies on this but my assumption is that all IM docs sort their laundry before washing them and all EM docs wash their clothes all together in one big pile.
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Ok, as promised, here is my personal statement of why I do EM 15 years later. I wrote this post night shift this AM, so excuse my grammar (and swearing). I hope this gives people insight into both EM as well as my career and why I do what I do.
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I miss the good old days when an attending could punch a student in the face if they got something wrong on rounds. Students these days have no commitment to medicine.
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I understand some peoples hesitancy about getting vaccinated. I dont agree but I do get some concerns. What I dont understand is HCWs who literally believe FB memes over randomized control trials. It’s honestly embarrassing how scientifically illiterate many in medicine are.
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Grover is 68 but still working bc he’s been divorced twice and now has a 2 yo at home with his 3rd wife. He questions why everyone is obsessed with ultrasound, which “is a fad that adds nothing to a good quality exam”. And he believes we will never recover from step going p/f.
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Tons of back and forth about disinterested students on my timeline. Disinterested med students are often those that aren’t allowed to get involved and have zero autonomy. If you find that many of your students are disinterested, look hard at your rotation experience.
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How do I go about winning the Nobel Prize in Medicine as an average doc who really doesn’t like doing a bunch of research? Would they consider a case report?
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Good morning to everyone whose fate has already been sealed in a matter of seconds by a computer but that will be kept from you for two weeks because of... verification.
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Does anyone know anyone who got COVID, was symptomatic, and got completely better in 5 days? Many of the people Ive seen return at 10 days over the past 2 years are still coughing.
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ERAS: Hey where are you from?
Every Med student this year: My hometown is Brooklyn, NY, Pittsburgh, PA, Dallas, Tx, San Diego, CA, Boise, Idaho, Portland, Oregon, Miami, Florida, the moon, Newark, NJ, Salt Lake City, Utah, and Pheonix, Arizona.
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Biden deploying 1000 members of military medicine to hospitals to help staffing is ludicrous. That wouldn’t make a dent in one state. Deploy the entire military. We need security, transport, environmental services, 1:1s. Healthcare staff shortages just isnt docs and nurses.
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Texas is trying to figure out when a fetus transitions from a gift from God to not their goddamn problem and it appears to be around 5 years old.
Abbott said Wednesday that Texas would consider challenging a 1982 Supreme Court decision requiring states to offer free public education to all children, including those of undocumented immigrants.
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Really wish the mRNA vaccine actually would alter my DNA. I think Ive gotten as much out of my current DNA as I can.
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Holy shit. Got this residency review on FB from a graduates mother and I’m just at a loss for words. 😭
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ED doc sided with residents who petitioned admin for hazard pay, and protected their anonymity when admin pressed her for a list of names. Then allegedly was fired on a trumped up complaint thereafter. I hope she takes home all the money!
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Why are studies being done on professionalism looking at social media of young trainees, and not focusssing on predatory behavior of attendings toward female residents, students, and nurses? Or on explitive laced tirades just for being consulted to the ED?
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We can study science and medicine for 8 years and work for 15 years in a specialty and people will still go to Joe Rogan for medical advice. Or believe facebook memes over us. The public doesnt believe us. The govt doesnt give a fuck about HCWs or actual medical reform.
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Im going out on a limb here, but Im taking a firm stance that we probably shouldn’t have teenagers armed with semiautomatic rifles roaming the streets to live out their vigilante fantasies.
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Stop treating a virus with antibiotics and ivermectin. Please. Stop. We have a CDC. They make clear recommendations of what drugs to use and when to use them. I assure you, you are not smarter than the CDC and have not read more literature. Follow. Guidelines.
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I think one of the more unique things about our residency is all the residents get a week off over the holiday without having to burn vacation time. 🎅🏻 🎄
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If you never tried to study while intoxicated, did you even go to medical school?
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Couldn’t sleep so I looked at apps until my eyes could no longer focus. 100% will finish these in the next 10 days. Cant grant everyone an interview, but Im at least going to be able to sleep at night knowing I looked at every app you all paid ERAS for.
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Can we get a study that shows doctors who are normal people and live lives like normal people are the best doctors because they arent judgemental fucking assholes?
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Wait times? No, fellow patriot. You just get to experience trickle down inpatient beds in the greatest healthcare system in the world.
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CDC’s loss of limb policy on going back to work…
(Please tell me some of you are old enough to get this reference)
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@olsonplanner
“Money is not my main concern, but I value my self-worth. I value my skills, my time, and my expertise. And I know how much those bill for and how much an organization profits off that. So while I dont care about the dollar figure, I do care about being taken advantage of.”
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If you want to gauge where you should be at interview wise, by the end of today you should have zero interviews. Take a deep breath.
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NBME: We canceled step 2cs forever...
NBOME: How are we gonna spin this... 🤔
NBME: ... just cancel ...
NBOME: By passing comlex 2 PE, DO students will now have a leg up on MD candidates by showing their clinical proficiency to future programs for ONLY $1300!!!
NBME: 😞
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There needs to be a Step 4 exam to practice in 2022. One single question. Fail, you lose your license.
The question: Should you prescribe steroids and a z-pack for mild covid?
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Tip for 4th year students tomorrow: Make sure you aren’t blocking incoming calls from unknown phone numbers tomorrow. Chances are your new program will likely want to reach out and congratulate you!
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Me: Doctor, runs an EM residency
Also me, staring at the ceiling at midnight: I’m halfway through life and have accomplished nothing.
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Every year I get asked by students for tips on how to look good on their EM sub-I's. So, here you go, here are my tips on little things you can do or not do to make a good impression. Go earn those good SLOEs...
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Somehow got the EMRA Presidential Leadership Award… Im both confused why I deserve it but also incredibly thankful to folks at EMRA for recognizing the value I provide in my little corner of the world. Thank you so much
@emresidents
I truly couldn’t be more honored.
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The White House saying that if you are vaxxed “it’s totally ok to travel and keep your holiday plans” may not look too good in retrospect a month from now. They 100% are more concerned about the airline industry and economy than they are about lives lost and hospitals.
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Me this AM: Still nervously hopeful the match goes well, I really want to match a great class.
Me tonight: I’ll settle for 8 people that aren’t predators
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I just love when programs are like:
We are DO friendly, please apply!
Minimum Step 210
Minimum COMLEX 800
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How do I get more mitochondria? My cells seem to be running low on powerhouses.
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But by always saying “there’s no beds” people arent grasping the healthcare system is collapsing bc of manpower, not physical space. We need to tell people the truth, “there is no one left to care for you”
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Why subject yourself to injecting industry sponsored MONOCLONAL antibodies for COVID? See your doctor today about how to build all natural immunity by making your own organic antibodies with a simple shot.
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Gotta love a country where if a doctor misdiagnoses you, despite the best of intentions and knowledge, you can sue for a fortune. Yet a politician can literally make the choice to sacrifice thousands to a gruesome death and the worst that can happen is they get voted out.
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I slept 12 uninterupted hours today, waking up at noon. Did some yoga. Golfed by myself. Will spend the evening by the pool and in my hot tub. Im literally living my best introverted life.
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I will not rest until my teenagers grow up, get a job in healthcare, join medtwitter, follow me, and talk to me and think I’m funny without knowing I’m their dad.
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There are med schools that dont have a match day ceremony… 🤦🏻♂️. People are paying like 40k/year in tuition alone and schools cant find an auditorium, some envelopes, and some food?! 😡
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After 2 months of patiently waiting on legal/admin to work their magic, my contract is now signed and Im officially under contract as a PD. 🎉 🥳
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When you submit your list, no matter what happens, be proud of the fact you accomplished this. 4 years of med school is hard. Interview season is hard. This whole process is filled with self doubt, anxiety, and the unknown.
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Blessed that we filled all our spots. If anyone didn’t match and needs my help this week, please reach out, my calendar is now wide open.
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Does anyone find it odd, that despite being in a once in a lifetime global pandemic, with healthcare being on the forefront of the news daily… that the government has been radio silent with regards to the healthcare staffing crisis in America?
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Step 1 P/F is a slap in the face to all the people who memorized every detail of every glycogen storage disease in order to match into Orthopedics.
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Im staying in shape until I get to 90. Once I get there Im going to retire from eating healthy, bc I will have won. Then I’m eating cinnamon toast crunch for breakfast everyday. Burger and fries for lunch. Pizza for dinner. Beer and nachos as snacks. I may start smoking.
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Im babysitting one of our residents newborns at the moment. Can I add this to my CV?
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Rented out a bowling alley / arcade / laser tag arena for the morning for our first all vaccinated residency fun day conference since covid.
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People always seem amazed when they are told that the reason there are no beds isnt bc there arent beds. There are no nurses. No techs. Nothing. Beds are not in short supply. Professionals to take care of the people in them are.
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My 91 Grandma passed away this AM on hospice at home. She had mesenteric ischemia a week or so ago, so it was expected. While she was still with it in the hospital, I had a truly long conversation with her for the first time in years.
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COVID is exposing many DO schools and how they rely on students to find and schedule all their 4th-year rotations as opposed to providing them a site to do so. To pay tuition to a school that then doesn't even provide you a site to rotate at is absurd.
😢 Reading this really hurt. So sorry that this is happening to you. You have worked so hard, and you don't deserve this. The system is failing you, failing us - we are all in this together. Wish I could help.
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Not gonna lie, the “greatest country on earth” would probably give a shit if 3000 of its citizens were dying every day.
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I always love when people ask me, an EM veteran at this point, “are you going to specialize”...
Chaos is a specialty damnit!
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Always have been open and honest about the app process from my end, so I wanted to explain how I approach apps and handing out interviews before we get there, if anyone is interested in a 🧵 on the process…
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I don't know what new EM PGY1 needs to hear this, but there are 328 million people in the US. There are about 900k active doctors (0.2% of the population). About 40k board-certified EM docs (0.01% of the population). You are not an imposter. You are the ELITE.
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No residency can appeal to every applicant. Not everyone wants an above market salary, a low cost of living, 6k in free food a year, a 5k moving stipend, no call, friendly attendings, free parking, a free onsite gym, and reasonable work hours.
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No matter where you end up, your first or last, just remember. Someone wanted you in their program. They found value in you as a candidate. And somewhere someone celebrated that you were on their list yesterday. You are not an imposter no matter where you match.
#NextGenDocs
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Saw multiple people in the airport, and two people on my plane, in scrubs. Why in the world would you wear your scrubs to the airport?
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Maybe this variant we’ll consider better masking, actually do contact tracing, or make rapid testing more accessible.
Hahahaha. Noooooo. Jk. We’ll just keep on hoping COVID ends soon.
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I came home 2 hrs late because of a code that came in before shift change. Had apple cinnamon wine and apple pie for breakfast. 3 hrs sleep. Now up for turkey (wife/kids only) so I can nap before going back to COVID central. And Im still Thankful I get to do this, truly.
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Given all the open spots in EM this year, I feel extraordinarily grateful we matched ours. Idk how, but grateful nonetheless. 🙏🏻
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