MCW Class of 2010, Part 3

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Xandie said:
You guys doing presentations and the exam and all that fun radiology stuff?
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Yup.

My presentation will probably leave a little to be desired.

Motivation = zero.
 
My presentation was awesome: imaging in pregnancy. I was all gung-ho and stuff back then... ha.

But on the up side, emailed my top programs yesterday and got good responses from two. Excellent. Happy day today.
 
So my "small group session" today turned out to be me in the STAR center with an M4 and a standardized patient, and I was expected to walk in and do a full physical (no history, and no breast/female exam) in 12 minutes. Hey, not like they warned us we'd be doing this or anything. I felt like an idiot as I'm remembering what the cranial nerves do. I'd have made a little question sheet in advance if I knew what we were doing....

I really hope that doesn't count for a lot of points.
 
TheProwler said:
So my "small group session" today turned out to be me in the STAR center with an M4 and a standardized patient, and I was expected to walk in and do a full physical (no history, and no breast/female exam) in 12 minutes. Hey, not like they warned us we'd be doing this or anything. I felt like an idiot as I'm remembering what the cranial nerves do. I'd have made a little question sheet in advance if I knew what we were doing....

I really hope that doesn't count for a lot of points.
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What the heck was that session for?
 
akpete said:
What the heck was that session for?
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Come on now, you should know that CER sessions don't need to be FOR anything. It's a part of the Clinical H&P session, not to be confused with the Physical Diagnosis Workshop or the Presentation & Reasoning or the Independent Study Block, which is completely different from your lectures and the small groups that go with those. And it's separate from the History OSCE and the physical findings....

I don't know how Dr. Mitchell doesn't realize this class is WAY too complicated. Maybe one day, every other week, we should have small groups. On the same day. Our schedule has at least 5-10 CER components on it each week, and you have to figure out which one you're going to.
 
You know what? Second year sucks.
 
TheProwler said:
So my "small group session" today turned out to be me in the STAR center with an M4 and a standardized patient, and I was expected to walk in and do a full physical (no history, and no breast/female exam) in 12 minutes. Hey, not like they warned us we'd be doing this or anything. I felt like an idiot as I'm remembering what the cranial nerves do. I'd have made a little question sheet in advance if I knew what we were doing....

I really hope that doesn't count for a lot of points.
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So, after 8 20 minute CER sessions you aren't able to do a full physical in 12 minutes?
 
I'd like to thank our school bursar for not including a number in box 1 of my 1098-T. Why can't they figure out how much they received rather than being dumb and saying how much they billed? I'd rather not add up all my separate loans. 🙄
 
Ah, clinical H&P. I heard it sucks if you have to do the Star center for that. I went to St Joes and saw actual patients. Would do a full H&P and would take as much time as I wanted.

If I remember right, the physical exam OSCE at the end gives you 30 minutes.

For step 2 you have much less time. 12? min for focused H&P.
 
Yeah, 12 min for the full thing, and then ten (I think) to write the note.
 
No, and I know very few people who did have trouble with the time. Remember, by the time you're taking CS, you've had more than a year's worth of practice. It's a pretty broad history, sort of focused, but still all the different parts, and a focused physical... but still, I can probably do an admit (read=full) H&P (the patient part, not the note part) in 15-20 minutes. Fellow fourth years, any time estimates? I haven't done one in a while.
 
I see oasis gives me the option to "drop" my psych/neuro clerkship.

Touchy feely tuesday goes to touchy feely september. ugg.

Did anyone do anything in interventional radiology?
 
indo said:
Did anyone do anything in interventional radiology?
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I just finished a full elective month in IR. Great attendings, great fellows (although they'll be gone by the time you would get to them). Overall a very good month, especially if you're into minimally invasive procedures and practicing gaining central access with ultrasound. You also have no exam, just a 20-30 minute presentation at the end of the month on whatever topic you choose that can be linked back to IR in any way (almost anything is fair game).

IR was already on my top 5 list of specialties to consider and this month moved it up to the top 2. Let me know if you have any other questions about logistics or what kind of stuff you can expect to do.
 
Also, if you don't have an IR elective, you can also get a decent amount of exposure to the field with vascular surgery.

IR is probably in my top 5 specialties, but I haven't actually had a rotation in it.
 
DoctorFunk said:
IR was already on my top 5 list of specialties to consider and this month moved it up to the top 2. Let me know if you have any other questions about logistics or what kind of stuff you can expect to do.
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It does sound interesting to me. I like the idea of procedures. What kinds of things did you do? And what else did you watch?
 
TheProwler said:
It does sound interesting to me. I like the idea of procedures. What kinds of things did you do? And what else did you watch?
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They really worked at giving me practice gaining access to veins via ultrasound, and then allowing me to place long-term central access lines. I hit the int. jugular but had trouble hitting the basilic or brachial, but after they helped me get access I would finish up putting in the lines essentially independently (which was nice). So those are the procedures that I did pretty much on my own.

The attendings will let you scrub on anything coming through the doors (and you are sometimes first assist), so I got to see things like endovascular AAA repair, kyphoplasy and vertebroplasty (injecting bone cement into the spine), biliary stenting, renal artery stenting, iliac stenting, carotid artery stenting, an embolization of a life-threatening gastroduodenal a. bleed, TIPs procedures, CT-guided chemoembolization, CT-guided viral vector gene therapy for cancer, fluoro-guided chemoembo, g-tube placements, chest tubes, all sorts of angioplasty (they let you run the inflation device) etc.

They also do some cool procedures infrequently that I didn't see, like uterine fibroid embolizations. Unlike some other hospitals in the country where cards, vascular surgery, and neuro/neurosurg is encroaching on their procedures, the IR group here is really robust and has maintained control of a lot of procedures, and has a really good relationship with vascular surgery at the same time. I think this is probably one of the better IR programs out there.
 
TheProwler said:
It does sound interesting to me. I like the idea of procedures. What kinds of things did you do? And what else did you watch?
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Oh, oh, oh, I forgot one of the coolest things I heard about all month. Two of the attendings were asked by some perinatologist OBs to intervene in a case where a fetus had a large AV malformation that was shunting too much blood from their developing lungs and potentially threatening viability outside of the womb. I wasn't there, but they were actually able to embolize the AVM while the baby was still inside the womb! I guess things went great and it sounded like the baby was doing much better and was likely to be born without further problems.
 
DoctorFunk said:
They also do some cool procedures infrequently that I didn't see, like uterine fibroid embolizations. Unlike some other hospitals in the country where cards, vascular surgery, and neuro/neurosurg is encroaching on their procedures, the IR group here is really robust and has maintained control of a lot of procedures, and has a really good relationship with vascular surgery at the same time. I think this is probably one of the better IR programs out there.
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Any idea about the long-term prospects of other fields moving in on it? And it's a pretty competitive residency, isn't it? Is it entirely separate from a radiology residency? It sounds pretty cool because of the variety of other disciplines that it works with and the variety of procedures it entails.
 
TheProwler said:
Any idea about the long-term prospects of other fields moving in on it? And it's a pretty competitive residency, isn't it? Is it entirely separate from a radiology residency? It sounds pretty cool because of the variety of other disciplines that it works with and the variety of procedures it entails.
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I'd say that the field will be in flux over the next 20 yrs or so as the aforementioned specialties hedge in on some of the peripheral vascular work and procedures like carotid stenting. The nice thing about IR is that they pretty much innovated all of these procedures and will likely continue to be on the cutting edge of any new procedures coming down the pipeline. So I think that although the field may look different in the future (probably less stenting and more targeted cancer therapies if I had to guess) it will probably still be a vital specialty. When I asked one of the attendings about this issue in comparison to say interventional cardiology which has been very aggressive in incorporating IR procedures into their practice he replied that he likes to think of IR as having a very diversified "stock portfolio" that will enable it to adjust as innovations come down the pipeline.

You can get into the field via the traditional path, namely the 5 year radiology residency followed by a 1 yr IR fellowship. That would make you a board certified radiologist who is also certified to do IR procedures. There is also a newer training model that is operating under provisional acceptance by the national rads association. This one is called the DIRECT pathway and it entails a total of 6 yrs of training. Your first two yrs is clinical training in something like a transitional year and a prelim surgery or medicine year. Then you do 27 months of diagnostic radiology mixed in with 9 months of IR (total of 3 yrs). After that you can sit for the rads boards (so you essentially compress what most radiologists learn to take boards in 48 months into those 27 months--better be a good test taker!) Then you take the final year of straight IR fellowship, so you get almost double the IR exposure as you normally would in the traditional pathway.

Talking to Dr. Rilling, who heads the educational board for the Society of IR, he made it sound like it was very likely in the next 5-10 yrs that IR will be an independent 5 yr residency straight out of med school. Essentially he indicated that more and more people want to do straight IR without mixing in any diagnostic sidejobs and this would better train them to do this. Sounds like a sweet deal to me--I only wish I would graduate after that went into effect.

Overall the competitive bottleneck to get into the field is the diagnostic radiology residency, which is pretty competitive. Once you get in there the fellowship is actually not very competitive at all because most people don't go into radiology residency with the idea of working a ton with patients and the lifestyle of IR is a little more intense call-wise than regular rads (although not nearly as bad as surgery).
 
DoctorFunk said:
I'd say that the field will be in flux over the next 20 yrs or so as the aforementioned specialties hedge in on some of the peripheral vascular work and procedures like carotid stenting. The nice thing about IR is that they pretty much innovated all of these procedures and will likely continue to be on the cutting edge of any new procedures coming down the pipeline. So I think that although the field may look different in the future (probably less stenting and more targeted cancer therapies if I had to guess) it will probably still be a vital specialty. When I asked one of the attendings about this issue in comparison to say interventional cardiology which has been very aggressive in incorporating IR procedures into their practice he replied that he likes to think of IR as having a very diversified "stock portfolio" that will enable it to adjust as innovations come down the pipeline.

You can get into the field via the traditional path, namely the 5 year radiology residency followed by a 1 yr IR fellowship. That would make you a board certified radiologist who is also certified to do IR procedures. There is also a newer training model that is operating under provisional acceptance by the national rads association. This one is called the DIRECT pathway and it entails a total of 6 yrs of training. Your first two yrs is clinical training in something like a transitional year and a prelim surgery or medicine year. Then you do 27 months of diagnostic radiology mixed in with 9 months of IR (total of 3 yrs). After that you can sit for the rads boards (so you essentially compress what most radiologists learn to take boards in 48 months into those 27 months--better be a good test taker!) Then you take the final year of straight IR fellowship, so you get almost double the IR exposure as you normally would in the traditional pathway.

Talking to Dr. Rilling, who heads the educational board for the Society of IR, he made it sound like it was very likely in the next 5-10 yrs that IR will be an independent 5 yr residency straight out of med school. Essentially he indicated that more and more people want to do straight IR without mixing in any diagnostic sidejobs and this would better train them to do this. Sounds like a sweet deal to me--I only wish I would graduate after that went into effect.

Overall the competitive bottleneck to get into the field is the diagnostic radiology residency, which is pretty competitive. Once you get in there the fellowship is actually not very competitive at all because most people don't go into radiology residency with the idea of working a ton with patients and the lifestyle of IR is a little more intense call-wise than regular rads (although not nearly as bad as surgery).
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Sweet! A brand new, highly concentrated sleep-aid! Thanks Funk!
 
Agent Splat said:
Sweet! A brand new, highly concentrated sleep-aid! Thanks Funk!
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You're just jealous that you spent the whole month bored as hell because you were too big a pansy to step up with the big boys of IR. Hope you learned a ton about barium enemas.
 
DoctorFunk said:
You're just jealous that you spent the whole month bored as hell because you were too big a pansy to step up with the big boys of IR. Hope you learned a ton about barium enemas.
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Bah! I learned valuable career skills I can take with me no matter what field I enter. That, and after I helped with barium enemas I got to go home at 3pm.

IR is for people that wish they could be surgeons and have the attitude of surgeons, but are too afraid to do some serious cutting. Pansies!!! :hardy:
 
Boys, above the belt, please.
 
Agent Splat said:
IR is for people that wish they could be surgeons and have the attitude of surgeons, but are too afraid to do some serious cutting. Pansies!!! :hardy:
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Correction: IR is for people who would rather avoid the morbidity/mortality associated with brutish surgery and prefer more elegant methods towards intervention. It also attracts people who are too busy to waste hours dissecting down to anatomical sites of interest or closing up layer upon layer of adipose.

By the way, who's the one commenting on a surgeon's attitude? We both know that you are a far cry from a surgeon in mindset towards patients, you Patch Adams looking goofball.

Xandie: How's that for above the belt? 😉
 
I think you boys are cycling together. Go have some chocolate and a good cry and you'll feel better soon.
 
Mmm... Godiva.
 
how does anesthesiology compare to IR regarding procedures?

I wish sports/spinen was available in December. It would have made a sweet third choice.
 
also Godiva makes chocolate liquore for a nice chocolate martini.

2 shots vodka and 2 shots Godiva and coat the glass with hersheys... You are in business
 
indo said:
also Godiva makes chocolate liquore for a nice chocolate martini.

2 shots vodka and 2 shots Godiva and coat the glass with hersheys... You are in business
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And how. I love a good martini.
 
I love alcohol. Just sayin'.
 
Off my man, there... them be fightin' words.
 
Bump. Hee hee... that's 4 MCW threads at the top of the list... hee hee. I'm feeling really weird tonight. Has anyone ever taken Lyrica? It makes me feel happy.
 
achybrachy said:
Bump. Hee hee... that's 4 MCW threads at the top of the list... hee hee. I'm feeling really weird tonight. Has anyone ever taken Lyrica? It makes me feel happy.
Click to expand...

does it work the same as several lines of cocaine? if so i'm so there.






(not really)
 
stupid university of toledo college of medicine
 
I saw TWO SDNers today. Pretty impressive, since I only saw like five students today.
 
Little bit irritated at the class of 2010 right now for blowing off the board review session tonight.

Only two of you showed up. Thirteen 2008ers showed up.

Nice.

😡
 
donnyfire said:
Little bit irritated at the class of 2009 right now for blowing off the board review session tonight.

Only two of you showed up. Thirteen 2008ers showed up.

Nice.

😡
Click to expand...

The what?

(that's half the problem)
 
Fixed for me.

Oops.

Props to 2009.
 
Props to Marc for saying that I looked good. Ten points for you, munchkin.
 
It only works once, m'dear. I'm fresh out of balls.
 
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