Michael Hofkamp, MD, FASA
@HofkampMichael
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(He/him) Dad, husband, OB anesthesiologist, golfer. I tweet about #OBAnes , #MATCH2025 , golf, wine, & cooking. đłïžâđđłïžââ§ïžally. Tweets donât represent employer
Round Rock, TX
Joined April 2020
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Pinned Tweet
PUBLISHED: The peer reviewed manuscript of our
#anesthesiology
PD survey study in JEPM, the peer-reviewed journal of
@SEAnesHQ
. Make sure to read this if you are applying to anes for
#Match2025
!
@trpender
@FutureAnesRes
@jwolpaw
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@jfitzgeraldMD
Seems like I spend half my time as an OB anes on L&D helping pts through the childbirth process and the other half in the main OR helping to fix the uro-gyn ravages of childbirth. I know many happy couples my age w/o children and there is nothing wrong w/ not having children
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@londyloo
Apparently one has to be a North Carolina or South Carolina resident to qualify so this wouldnât help the out of state students who dream about going to Duke but canât afford it
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@fuzzymittens
It has been my observation that there is an inverse relationship between airway management skill and ego about said skill. The day I stop fearing airways is the day I will need to retire from anesthesia
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@dig_deeper1
Couples that started off poor and become rich together tend to have bank accounts together.
Couples that were rich before they became a couple tend to have separate bank accounts.
I donât see a problem with either đ€·đ»ââïž
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@TheBlondeRN
Yup!
Its:
-8h for fatty meals (cheeseburger)
-6h for light meals (toast, cereal)
-2h for clears (water, black coffee)
Some places make pt NPO after midnight so they can call them in early if there is a cancellation (again, convenient for everyone but pt)
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@MileHighBecky
Hospitals should be giving loyal staff RNâs retention bonuses right about nowâŠ
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@dansolomon
Friend of a friend has a huge commercial real estate empire. During pandemic, he said âmom and popâ types worked out deals when couldnât pay rent. Big corporations? It was their âbusiness strategyâ to avoid paying rent but they would end up paying once he threatened legal action
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@TPP_MD
A good upper level resident wouldnât have put an intern in that situation to begin with đ€·đ»ââïž
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@studentdrdemon
There is a uro-GYN at my hospital who is about to retire and he insisted upon being there at induction so he could hold his pts hand as she fell off to sleep. Surgeons who are present for induction tend to have smoother running rooms too
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@WFJimMulligan
@londyloo
I believe what she is saying is that 200 students from NC & SC who were accepted to Duke come from families who make less than $150K and will benefit from this new financial aid. Observation: the family one is born into has an outsized influence on college admissions
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@dremilyportermd
We were homeschooling in TX before pandemic and go 9-3 every day w/ a rigorous curriculum taught by my wife who is a PhD level psychologist (no longer practices). Thereâs homeschooling and then thereâs homeschooling
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@lealuo
Completely agree. I donât have a problem w/ Elon Musk making billions dreaming up new inventions but I do have a problem with healthcare CEOâs extracting millions of dollars of salary (often from non-profits) on the backs of nurses and physicians
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@blondemedSJW
Some of the scariest anesthetics I have ever done have been on pts w/ infected teeth who present at midnight w/ trismus w/ no mouth opening. Most often due to lack of access to a dentist
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@TPP_MD
A good upper level wouldnât have had that reaction to an intern doing one of their first lines đ€·đ»ââïž
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@kathryniveyy
As an anesthesiologist, I would have ZERO expectation of vecuronium being stocked in a drug dispensing machine located in MRI. When we do anesthesia for MRIâs, we bring our own drugs. Crazy that the system that put vecuronium there in the first place not held accountable here
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Iâm a 45 y/o attending and am 16 years removed from residency. I still do overnight shifts and provide anesthesia services at 3 am.
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@MamaDoctorJones
Risk of aspiration for any laboring pt: 30% cesarean rate*5.6% GA rate*0.15% aspiration rate reported by Mendelson = 1:38K
Thatâs a lot of starving pts to prevent one aspiration
Imminent cesarean is one thing, but many are NPO w/o benefit
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When LIV adds a slate of new golfers, someone needs to interview the ones they are displacing. Ask them if they regret signing w/ LIV, what they are going to do now w/ their career, etc. Iâm looking at you
@AlanShipnuck
(although Iâm sure LIV has this stuff wrapped up with NDAâs)
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@Keitheveson
Iâm not going to lie - doing the anesthesia for the procurements is hard, but seeing this picture puts everything into perspective
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@jjfitzgeraldMD
3 yrs is a LONG fellowship. I think we also need to pay the fellows more along with increasing the number of training spots
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Iâve done the anesthesia for pts who choose to deliver fetuses w/ lethal anomalies at term and for those who end those pregnancies early on. Neither choice is easy for the pts. Compelling Ms. Fox to carry her Trisomy 18 fetus to term is a special kind of state sponsored cruelty.
BREAKING: Late tonight, the Texas Supreme Court temporarily halted a lower court ruling that would have allowed Kate Cox, our plaintiff with severe pregnancy complications, to have an abortion to protect her health and future fertility.
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@GeorgeChristanz
M1 year was my hardest year in medicine. It took 5 years after residency before I felt like a ârealâ attending and 10 years after residency before I felt mastery of my specialty. Donât pay attention to the pretendersâŠ
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ATTENTION
#Match2024
ANESTHESIOLOGY APPLICANTS:
A 𧔠on gold and silver tokens.
Last year, the anes world was upended w/ 5 gold tokens. This year, there are 10 additional silver tokens.
Whatâs an applicant to do?
@trpender
@FutureAnesRes
@Inside_TheMatch
@jbcarmody
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@VipsMDMEd
Some things can be handled over the phone but if in doubt, Iâve never regretted going to the bedside but Iâve regretted NOT going to the bedside
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2012 match: EVERY one of my students from Texas A&M matched into anesthesia, even the ones I was really worried about. In recent years, applicants I would bet $100 to match are starting to not match. Donât be so hard on yourself if you donât match into anesthesia.
#Match2024
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Applicants: donât lie like this b/c consequences can bite you later on
PDâs: maybe the term âranked to matchâ should only be used when a candidate is in top 10 if you are matching 10 and NOT when candidate ranked 11-25 if you <usually> go to 25th spot to fill your class of 10
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Every article that describes the fentanyl epidemic occurring in US communities should also include the sentence âWhen used by licensed professionals in a clinical setting, fentanyl provides excellent pain relief with a proven safety profileâ
@nytimes
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After the birth of our first born, my wife felt like she was âlied toâ b/c ppl sugarcoated the difficulty of caring for an infant. For many, this leads to feelings of inadequacy. Yes, about 5% of the time the baby will do âcuteâ things youâll love, but 95% of the time is drudgery
Iâm tired of hearing theâŠ
âYouâll never sleep againâ
âYour travel life is overâ
âSay goodbye to your weekendsâ
My first baby is joining us in the next 3 weeks and Iâm excited, nervous, anxious, and grateful.
Iâd love to hear your favorite parts of having a newborn/baby/kids
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@ohJuliatweets
It varies. My wife has a PhD in clinical psychology and homeschools our children. We do a lot of virtual courses w/ independent teachers fed up w/ school system. Homeschooling in Texas means we can teach LGBTQ and âCRTâ issues. There are certainly those who abuse it though
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@MamaDoctorJones
This Twitter anesthesiologist (me) agrees w/ you that low risk pts should be able to eat easily digestible foods (toast, pasta, pancakes, lean protein) during labor. Itâs an uphill battle to change society (ASA, SOAP, etc) and hospital guidelines
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@sasstronomical
Sometimes we assume that healthcare workers (or those who aspire to be one) are completely stoic and at ease when receiving medical care as a patient but some of the most scared, vulnerable patients I have taken care of have been healthcare workers
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I believe that reporting the use of anesthetic adjuncts adds clinical context to the general anesthesia rate for cesarean delivery. I present data from a community hospital within my system
@emilysharpe
@MariaSheikhMD
@bagchisubha
@RobertGaiser1
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As an anesthesiologist, I obviously canât work remotely from home (the patients are at the hospital đ€·đ»ââïž). I fully support all efforts for remote work b/c it makes my commute easier/safer.
And besides, if we take all of those people off the road, it makes a safer and more enjoyable commute for those who can't be remote.
Moves money to small towns where otherwise nobody would live.
Lots of stuff.
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ATTENTION
#Match2024
APPLICANTS: 𧔠on personal statements
There are many things you can NOT control during the application cycle
Your personal statement is something you ABSOLUTELY have control over.
@trpender
@FutureAnesRes
@Inside_TheMatch
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ATTENTION
#Match2024
ANESTHESIOLOGY APPLICANTS: A 𧔠on how to pick a residency.
With tokens, WHERE you apply has become a high stakes event. In this đ§”, Iâll walk you through how to choose which programs to send your applications
@FutureAnesRes
@Inside_TheMatch
@trpender
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My advice (when asked) for my female med students:
1) donât make rank list decisions w/ your partner w/o a ring
2) if marriage is what you want out of a relationship (and you have communicated that), move on if he hasnât proposed after a year of dating
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@allisonoconn
Gross anatomy lab was one of my least enjoyable experiences of medical school. At the same time, I was grateful for the sacrifice/gift of the cadaver and the opportunity to learn. I donât think this experience can be replicated in any other way
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@thanh_neville
It has been my observation that family members who have had healthy relationships with the terminally ill pt have a much easier time letting go than family members who have had a rocky relationship
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@IDdocAdi
7th yr of MD/PhD after realizing classmates from M1 yr are now attendings
@transplnt_mdphd
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Anesthesia pro tip: looking at a prior well-documented airway note is like a professor letting you use the answer key to take an exam
@AirwayMxAcademy
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@MissKayeW
@jfitzgeraldMD
Pregnancy and childbirth are traumatic experiences for the body and we as a society severely sugarcoat their long term effects. Pts should absolutely have agency to decide whether to stay pregnant when they find out they are pregnant.
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@ashtroid22
Mandates work. I know several RNâs who were on the fence but got the vaccine once it was required. I think Biden has to treat these holdout healthcare workers like Regan treated the striking air traffic controllers in the 80âs - let them resign/get fired and move on
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@alextatem
graduated from med school in 04, can count on one hand the times I have been mistaken for anything other than a physician. Also not above helping out and most frequent task is helping people to the bathroom in day surgery. Completely agree this is a huge problem for female MDâs
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@LouStagner
If he played an easier course, he could have a scoring average of 72.0
Breaking 80 is fun, but an 81 from the tips at Sawgrass is a whole lot better than shooting 79 at your typical muni. Lots of players donât get this đ€·đ»ââïž
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@demoncouncil
âHeâ wasnât really into the woman he dated for 5+ years and didnât have the guts to end it sooner
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@paulaalorenaa
Iâm sorry about your Step 1 result. I know several excellent physicians who failed board exams. The skills needed to pass these exams are not the same skills needed to be a great doctor
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@MaxJordan_N
Yup. In 2016 (at age 38) had an exercise stress test for âheartburnâ that gave me a NSTEMI. 95% occluded RCA that was subsequently stented. It absolutely happens to people in their 30âs
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@anxiouscatmom
My GYN colleagues will selectively bring some pts to OR and weâll do deep sedation for IUD placement. Someone w/ your history deserves this option
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@WhyamIhereb
When I was a med student, my PhD prof rewrote my work.
When I was a resident, my attending rewrote my work.
As a young attending, my work I could call my own often was rejected.
As a senior attending, I now rewrite my mentees work
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@_consistentgolf
At my club you can book a tee time as a single but it is understood that other members can book the remaining three spots
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@vlamers
My 9 y/o gets her first shot today. My wife gets her booster today and my 13 y/o is fully vaxxed. Iâve spent the pandemic intubating dying COVID ptâs. It blows my mind that people have bought into the disinformation and will not get themselves/their family vaccinated
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@EpiEllie
The first statement implies that there is an association just not enough statistical power to prove it. The second statement leaves the question of association open
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@sheologian
I would say that it has already collapsed. Hospitals are struggling to get to prepandemic staffing levels and every wave/surge makes it worse
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@SarahColando
@ASALifeline
@FutureAnesRes
Iâll be there! For residency fair, pick out 6-10 programs ahead of time. It can get really crowded. It might take 10-15 minutes of patiently waiting to talk to someone at a booth. Many residencies (including mine) document who makes contact and this can help w/ IV invites later
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Can ChatGPT intubate? đ€
ChatGPT has passed:
- United States medical license exam
- The Bar Exam
- MBA operations exam
Knowledge workers should be very worried
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@mominmedicine
Sweet! Dual applying to integrated peds cardio thoracic w/ anesthesia as a backup. I like it!
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@thatgirl409
A few years ago there was an outbreak of chlamydia at the high school in Stephenville (TX) and the superintendent was quoted in the news as saying he had no idea how the outbreak occurred given that the school district had implemented an abstinence based sex Ed curriculum
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@sarahshulist
@ZJAyres
Yup. When I got my first request to review a paper I had NO idea what I was doing. The best âtrainingâ I received for being a reviewer was reading the reviews of my own submitted manuscripts.
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@Eldricks_hoes
My neighbor used to be a F&B manager at a mid-tier club and they figured out it was cheaper to put free iced tea, lemonade, and snacks at the turn compared to paying someone to stand out there to sell it đ€·đ»ââïž
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@RodGerardo
I once rescinded a LOR for a med student when I found out that he was asking to go home at NOON on his fourth year elective/audition rotation!
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For medical students applying to residency, objective metrics like class rank, a useful Deanâs letter, and Step 1 scores have disappeared. Presenting a project at a national meeting is a big line on the CV for ERAS.
@FutureAnesRes
@Inside_TheMatch
I encouraged my students to go to a conference to build their CV - which cost hundreds of $$ to attend - for them to present to an audience of 2 people. Why? Countless hours of work and hundreds of dollars⊠for a line on their CV?
@AcademicChatter
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@AlanaKinrich
I donât think anyone expects an EM doc to do a perimortem C/S. In a perfect world, OB would be at the bedside if a parturient was in cardiac arrest but this is only possible at the most resourced hospitals
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Two observations:
1) a medical school canât recruit a diverse class w/o a great deal of intentionality - free tuition alone wonât do it
2) free tuition wonât induce students to pick primary care - higher salaries for primary care will
âRelieving the burden of student loan repayment does nothing to address the link between wealth and medical school admissions in the United States.â
Read more from me and
@Jared_Boyce
via
@statnews
here:
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When seconds count, physician anesthesiologists are on the front lines, ensuring patient safety & optimal outcomes.Â
#PhysAnesWk23
#AnesthesiaTwitter
Â
#MedTwitter
@ASALifeline
@asagrassroots
#txlege
@CRCook1978
@udaya_bhaskar49
@emilysharpe
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@theRNbiologist
If we donât have a circulating nurse, we canât do the case
If we donât have a PACU nurse, we canât move on to the next case
If we donât have floor/ICU nurses, we have no place to move our ptâs out of PACU
Yup, nurses are pretty essential
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@MBurt34
My neuroanatomy final during M1 year was on my 23rd birthday. It still hurts as a 43 y/o
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@PollyannaRN1
@GRGirl8
@EPNurse10
In Texas there is something called âsafe harborâ and a nurse invokes it in writing when he/she feels they are given an unsafe assignment. It is a BIG deal administratively and there is not âsupposedâ to be relation by the employer
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@Eldricks_hoes
Completely agree! Like I said in my other post, if you canât afford to pay for your guest to play in your member-guest, you canât afford to play in your member-guest!
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@ashleythakurrr
During residency, an attending accidentally paged me complaining about me when the page was meant for another attending
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Almost 1 in 5 US MD seniors did NOT match in 2023 and 2 in 5 US DO seniors. I think itâs important to take an honest appraisal of your application if you are thinking of applying to anes this cycle. Better to get actionable feedback now vs October
#Match2024
@FutureAnesRes
Wow - look at the difference in preferred specialty match rate for ONE YEAR of
#Anesthesiology
applicants. (Pink was 2022, Fuschia was 2023)
Source: NRMP
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For
#Match2024
, anesthesiology applicants will have 5 gold tokens and 10 silver tokens. If you apply to a program and donât send a token, you are stating they are at best 16th preference. My advice is just to apply to 15 programs for anesthesiology and save your money
Rising M4s -
These are 2023 fees, so they may change come September.
As you prepare and estimate the number of programs you intend to apply to, you should estimate what it will cost you.
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@pedsmd2b
One of my rising M4âs going into anesthesia is a 47 year old former dentist who was an officer in the army. Even the med students who have gone âstraight throughâ deserve not to be infantilized.
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@AdrianaaPerez
I think you have to set professional boundaries and not feel bad about holding your ground. Many hospitals require even native speakers of languages to get certified to obtain consent. Itâs not as simple as saying âhey you, Iâve heard you speak ____, can you interpret for me?â
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For anes, once you cross 230/240 for USMLE Step 2, you have already demonstrated a high probability of passing ABA exam. When I see a 270+ score, I look at the rest of the ERAS/CV to see what opportunities that person gave up to get that score
@FutureAnesRes
@trpender
#Match2024
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Fun fact: when an insurance company actually pays for care they call it a âmedical lossâ. Like any business, they are incentivized to minimize losses and go to great lengths to do so
It's absolutely infuriating that insurance companies collect ridiculous premiums, refuse to provide coverage, and then accuse the DOCTORS of robbing patients when they need to be paid for their work.
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