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NLengr

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  1. Like
    NLengr got a reaction from MK. in Surgical specialties with good job prospects?   
    Our division head during residency had an MBA and a passion for administration. He started doing a couple half days a year on business topics (incorporation, finances, practice set up etc) which were well received. But that involves someone having to take the initiative to do those kind of lectures and unfortunately, all programs don't have such a person. 
    Personally, I think the RC and CCFP need to step in and require X amount of business training per year (say 6 hours or something). Then leave it up to the programs to figure out how to supply it. 
    As for the lack of human resources knowledge, part of it is probably due to the fact that the academic programs and universities are the major players in allocating residency seats. First, they have no major interest in making sure our human resource supply meets our needs. Second, academia does a terrible job of putting people with business type skills into leadership positions. At my residency university, the main criteria for getting promoted in the administration was publications and research. It was so bad, our division head had to fight the university to get promoted to the leadership position, despite an MBA, experience creating and running a journal and experience leading our national specialty organization. But he wasn't churning out esoteric research papers, so the university couldn't see how he would make a good leader. You end up with guys who are really good at research being put into leadership roles for which they have little to no skillset (or interest in developing that skill set) and as a result, the leadership is ineffective much of the time.
  2. Haha
    NLengr got a reaction from PTPTPT in Dating Profiles   
    I usually emphasise that I'm a surgeon and put at least one full line of dollar signs. 
    /$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
  3. Haha
    NLengr got a reaction from zoxy in Dating Profiles   
    I usually emphasise that I'm a surgeon and put at least one full line of dollar signs. 
    /$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
  4. Like
    NLengr got a reaction from MK. in Surgical specialties with good job prospects?   
    If you are looking at large centers, there are no surgical specialties with good job prospects. Competition for jobs in big cities is intense. Even if you do a fellowship, lots of research and an advanced academic degree, luck stil has a huge role in landing a position. You need to be lucky to have a spot open up when you are entering the job market. Those spots don't open up all that often. You also have to be lucky enough the group gets along with you. You could be the best kind of person but if you don't mesh with the group dynamics at the time, you won't get a look in. Plus there will be multiple other people like you who want the job. 
     
    My advice with choosing a surgical specialty (or any specialty involving lots of hospital resources) is to make sure you would be happy doing that specialty in a community job ANYWHERE in the country (rural NL, Northern Saskachewan, Northwestern Ontario etc.). If you more value a location (urban center, specific city etc.), pick a specialty that can exist with minimal affiliation with a hospital (family, psych, general internal etc).
    Think very hard about your priorities because once you match, it's hard to change your path in life.
  5. Like
    NLengr got a reaction from medhopefull1984 in Carms Results 2016   
    Politicians couldn't give two shits about physicians, medical training or the healthcare system in general. Every decision they make is made from the point of view of "how does this help my re-election?".
  6. Haha
    NLengr got a reaction from PirouetteCacahuete in Dating Profiles   
    I usually emphasise that I'm a surgeon and put at least one full line of dollar signs. 
    /$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
  7. Like
    NLengr got a reaction from Edict in Surgical specialties with good job prospects?   
    If you are looking at large centers, there are no surgical specialties with good job prospects. Competition for jobs in big cities is intense. Even if you do a fellowship, lots of research and an advanced academic degree, luck stil has a huge role in landing a position. You need to be lucky to have a spot open up when you are entering the job market. Those spots don't open up all that often. You also have to be lucky enough the group gets along with you. You could be the best kind of person but if you don't mesh with the group dynamics at the time, you won't get a look in. Plus there will be multiple other people like you who want the job. 
     
    My advice with choosing a surgical specialty (or any specialty involving lots of hospital resources) is to make sure you would be happy doing that specialty in a community job ANYWHERE in the country (rural NL, Northern Saskachewan, Northwestern Ontario etc.). If you more value a location (urban center, specific city etc.), pick a specialty that can exist with minimal affiliation with a hospital (family, psych, general internal etc).
    Think very hard about your priorities because once you match, it's hard to change your path in life.
  8. Haha
    NLengr got a reaction from MK. in Neurosurgery vs Peds General Surgery vs Orthopedics Lifestyle   
    Well if you want a job and/or a life, I would forget about neurosurg right now. 
    Ditto for ortho if you want a job in Canada. 
    Peds surgical specialties are awful unless you like spending 50% of your time negotiating with kids. 
  9. Like
    NLengr got a reaction from FifthCycle in Dating Profiles   
    I usually emphasise that I'm a surgeon and put at least one full line of dollar signs. 
    /$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
  10. Like
    NLengr got a reaction from pinkneuron in Neurosurgery vs Peds General Surgery vs Orthopedics Lifestyle   
    Self reported stuff might not be that accurate. There is probably lots of recall bias etc.
    I'm a busy staff surgeon and I am able to spend time with my family. You just need to prioritize what's important to you. Most of the people I know who never see their families are like that because, honestly, they don't really want to see them and don't put the effort in. It's the same in any profession. 
    Honestly, you are best off just shadowing and asking various staff. 
  11. Like
    NLengr got a reaction from RichardDegrasseSagan in IM vs EM?   
    IM: Spend 3 hours debating a sodium value.
    EM: Look at abnormal sodium value, call medicine.
     
    As a side note, surgical specialty: What's a sodium value?
  12. Like
    NLengr got a reaction from Docmcstuffins__ in U of T medical student convicted of rape   
    Welcome to medicine. A huge number of physicians are nacsassistic, empathyless, unprofessional a-holes. 
  13. Like
    NLengr got a reaction from jnuts in Surgical specialties with good job prospects?   
    Thanks BUUUUUUUUUUULLLLLSHIT imo. I always wondered fool would agree to that? You work damn hard for that money and they're fleecing you for half a million dollars or more after spending a decade treating you like a slave (med school, residency +/- fellowship). Stockholm syndrome at it's finest......
  14. Like
    NLengr got a reaction from FrannieLydon in What To Do Summer Before Med School If Considering Derm   
    Drink beer and hang out with your buddies. 
  15. Like
    NLengr got a reaction from zxcccxz in Can't keep up in medschool   
    Speak for yourself. I was recently called in the middle of the night for a trauma patient with life threatening intra-abdominal bleeding. Luckily I have memorized the entire Krebs cycle. It was the only thing that saved his life..
  16. Like
    NLengr got a reaction from winston87 in specialties that make 1 mil per year   
    Agreed. There are many times I wish I had done family.
  17. Haha
    NLengr got a reaction from jnuts in Are surgeons allowed to have facial hair?   
    Next time I have a beard, I'm gonna braid it into multiple braids and put flaming matches in the end like Blackbeard. That way, the patients will know I mean business and be too terrified to ask questions.
     
    I have included a helpful illustration:

  18. Like
    NLengr got a reaction from Caribbean Med in Neurosurgery vs. Radiology   
    Don't make me choose between them!!!
  19. Like
    NLengr got a reaction from LostLamb in American Board of Radiology just cancelled/postponed their oral exams due to COVID-19   
    Hang in there. It's an awful year and now complicated by an awful situation. You will get through it.
    Like my grandfather used to say to my dad, my dad to me and now me to my own kids when everything looks bleak: "This too shall pass".
  20. Like
    NLengr got a reaction from ChemPetE in COVID-19 Impact on Electives and Clerkships   
    Honestly, once/if the volume starts to increase it will be all hands on deck if needed. Both the resident and the staff will be seeing different COVID patients. 
  21. Haha
    NLengr got a reaction from 1D7 in Neurosurgery vs. Radiology   
    Don't make me choose between them!!!
  22. Thanks
    NLengr reacted to rogerroger in Stethoscope not picking up bowel sounds   
    There is a lot of historical rubbish taught as gospel in medicine. Bowel sounds is one such thing. 
     
    Back before Med school I did a history of medicine project looking into the history of “bowel sounds”. I tracked all the references about bowel sounds back to their 19th century source. Cozy up kids, let me tell you a story. 
     
    In the early 19th century a physician named Leannec in France invented the stethoscope. It was in part intended to prevent awkwardness when listening to female chests. It also happened to improve auscultation. As you can imagine Leannec hit a gold mine with this invention. Published a bunch of things on auscilating the chest and received praise and fame. 
     
    Like all good academics, Laennec had a salty academic rival. He initially published a bunch of things basically saying the stethoscope was non-sense. This line of thinking clearly didn’t catch on. So if you can’t beat them in research, join them. This rival started publishing all these things about auscilating the abdomen. High pitch sounds mean this or that. Frequency of bowel sounds means this and that. It was all this guy’s opinion. Not actual evidence. 
     
    As far as I could tell, all papers citing the usefulness of auscilating an abdomen have their source in this paper. Zero solid evidence. Just some 19th century academic trying to carve himself out a niche in the rough and tumble world of academic medicine. This 19th century opinion has been parroted in various forms for over 150 years. 
     
    The last time my stethoscope went below the diaphragm was during Med school when it was a silly check box on an OSCE.  
     
    Some other day I will tell you about the “story” of FOBT in the acute care setting...
  23. Thanks
    NLengr reacted to Thunderbirds in Stethoscope not picking up bowel sounds   
    Bowel sounds literally have zero clinical value. Their presence or absence means nothing. Just skip it. 
  24. Haha
    NLengr got a reaction from LostLamb in Stethoscope not picking up bowel sounds   
    Mine doesn't pick up anything but a Lub and a Dub for the heart.
    Not because the thing is faulty. It's because every other sound is made up by cardiologists to protect their turf. Hahaha
  25. Haha
    NLengr reacted to rmorelan in COVID-19 Impact on Electives and Clerkships   
    PGY5 level of salty. 
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