Leaderboard

Congrats to all those who were accepted so far. I am a current student in the cohort so feel free to reach out to me if you have any questions regarding housing, curriculum, documents needed, etc. For those still waiting to hear back, good luck to you all. Remember the faculty members who are reviewing your apps are also practicing clinicians on top of being professors as well. They are very busy and it is a very busy time for them right now. My class is about to find out our clinical site rotations for next year, so they are working on that and we have a lot of events going on around the community that many of the staff are actively involved in as well. I know its hard, but be patient and try to remain positive. *For context, most of my class did not hear back until mid Jun - Late July last year

Patient was tachy, so getting a D Dimer to start the PE workup would be a good idea. I never do a CRP, but I always check a BNP, to eval for heart strain, e.e. from PE. Consider demand ischemia, but those trops are higher than I would expect if that was the case. How was the pt's kidney function?

These clinics were a bad idea from the start. Large portions of their customer population are in lower socioeconomic brackets, and most likely have poor insurance or no coverage; these are the same pts we see in EM who have multiple concurrent health issues and utilize the ED as their PCP. Now imagine those same pts going to a Walmart clinic to have all those issues managed, often by an overburdened supervising attending supplemented with undertrained NPs ( and sometimes PAs) addressing several comorbidities in an improperly resourced environment. It borders on predatory behavior, because these pts don't have the wherewithal to set up with a PCP and our legislative bodies view "some healthcare" as better than "no healthcare" (which paradoxically leads to more problems). Anecdote: A Peds nurse that worked in our ED did her NP coursework on overnight shifts (telling as to how busy they were), got a job in Pain after graduating and transitioned to a Walmart clinic. No experience in primary care whatsoever, no experience with adult pts managing bread-and-butter conditions. We also have several ED nurses in NP school who are looking at PCP jobs, and don't even know about Choosing Wisely or the USPSTF. This is what corporate bodies like Walmart look for.

I think it's as simple as people don't trust Walmart with their health

I've been getting more into education. How I did it was just apply broadly to positions near me. Just kept searching and applying and eventually got a "part time - temporary" position as course director for pathophysiology, which has led to me being a regular guest lecturer now on topics that I'm more of an expert in. After this I applied for a full time remote teaching position for a DMS program. They didn't want me for full time, but also made me course director for a singe course, I think really as a trial. I've seen lots of friends get teaching jobs at their alma mater if they stayed local to it. That seems to be much easier since they know you a lot better. Some relevant information about teaching: Being "part-time" but course director is grueling. It's essentially having 2 full time jobs, it just lasts for a semester. For live teaching, I was given old lectures to work off of, but if you have a perfectionist personality it is still grueling. I was spending at minimum an 8 hour day every week modifying lectures. Then I had to re-write questions based on what I taught. Writing questions and multiple choice answers that are just the right degree of difficulty and not making an error that throws students off is a bit of an undertaking. Guest lecturing is a lot better, but I've found I've rarely been given the amount of time I felt needed to adequately cover a topic, which is frustrating. Plus the pay is terrible and really only do it for the passion. Per hour worked, I really feel like I'm making elementary teacher pay. Plus managing your clinical schedule to work around the student class schedule is a real pain. For remote teaching, it sounds great on paper, but in practice is as much work as live teaching and doing a commute. For me, I found I was not nearly as good of a lecturer recording my class as I was live speaking off the cuff. Lots of time spent editing recordings. Remote teaching, at least for doctoral programs, requires a LOT of discussion assignments, which you have to moderate, further the discussion, evaluate proper citations, etc. It's like grading several essays every week, which is not an insignificant amount of time, especially when you are working full time clinically. Plus you never really get those student "ah-ha!" moments that are rewarding in live classrooms. I've decided being the course director is really not for me, at least not while working clinically full time. I do it again since it got me into guest lecture work that I enjoy, but boy was I burning the candle at both ends during that semester both live and online courses. Unexpected bonus to teaching: I learned so much from teaching pathophysiology. It made me a better clinician and a better preceptor having to go back and relearn it all to teach, basically reading all of Rubin's Pathology.

I hade an old friend who was a program director at a well respected program for many years. He grew the program from new to a couple of hundred students a year with great pass rates and good boards. They got a new dean in his department and he was replaced by the deans buddy for no reason. Another beloved teacher in the same program was removed after years and years of teaching because someone reevaluated his PhD and it wasn't accredited by an organization the program approved of. Academic centers can be viper pits full of climbers that will step on your neck for a promotion.