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lkth487

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lkth487 last won the day on June 29

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About lkth487

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  1. I am supportive of a lot of what people want in this thread, but experience is different than training. I can't work in a practice and assist a surgeon who does appy's for 15 years and then sit for the general surgery boards even though I have a MD after my name. Formal training with specific training and didactic requirements are important. This is why I think PA residencies are vital, especially if some body comes together and creates formal training requirements for them.
  2. There are ~30,000 allopathic residency spots per year, with less than 20,000 graduates. The overall number of US grads who end up in a residency is likely ~99%. Though some of those may have to scramble. The people who are feeling the squeeze are the graduates of foreign medical schools.
  3. This is a horrible idea for physicians. It will create an incentive to increase med school spots without a corresponding increase in residency spots. It's not hard to get into a residency right now, but it might eventually.
  4. I never shadowed anyone prior to medical school (I was not a PA either). I did some admissions committee stuff for a med school, and that was primarily an issue to make sure you know what it is like and that your only experience was not from Grey's Anatomy (or House). If you're a PA, you will be more than fine.
  5. There are other (nicer) reasons to pick med school :)! Plus, these days, the whole status thing is very much overrated.
  6. lkth487

    em photo quiz( occasional series)

    Fair enough! That makes sense.
  7. Was it 5% higher than <30 days, or 5% higher overall? The former may not be all that significant clinically given all the other factors involved. If you're talking about the chance of death going from 10% to 10.5% - it may not be significant given the limitations of the study (retrospective, not much standardization given use of a national database, etc), vs going from 5% to 10%, which is likely significant.
  8. lkth487

    em photo quiz( occasional series)

    Why didn't they want to pace? That's a long ride....
  9. Do you have the same opinions about MDs teaching/precepting PA students? To this day, the one single person who taught me the most about my field is an older PA, back when I was a new resident. I would hate it if PAs could only teach PAs, or NPs only NPs or MDs only MDs. I think we'd all be poorer for it. When I read EMEDPA's posts about a clinical topic, I always learn something new about emergency medicine. I think that's great. I don't know. I'm old fashioned - if you have knowledge to share, you should share it freely. I think it's an important part of our profession (and part of most version of the hippocratic oath). I think you can advocate and fight for the advancement of your profession but also be open to teaching people if they want to learn.
  10. lkth487

    PT to PA?

    You live once. If that's what you want - do it. With your PT background, I'm sure you will be highly sought after if you wanted to stay in a related field (ortho, sports, rehab, pain, etc)... Or during your rotations, you may fall in love with neuro-oncology, who knows? Life is too short. You're just starting out and you have time - I'd make the jump!
  11. I'd want it done in the next five minutes. But that's not the point is it? If it was my kid, I'd love for everything to happen immediately, from that MRI for a MSK injury to the dermatologist appointment for eczema. I might want my kid to be the priority in the ED for a cold compared to someone else who has a head bleed. But as a provider, your job is to decide on the priorities of things since all things can't be done immediately with the resources that are available. Obviously there is a lot of patient anxiety with having to live with a known melanoma and you should expedite the removal as much as you can - hence my point about getting them in as soon as possible. But from a medical perspective, the evidence shows that it doesn't seem likely that you will have a worse outcome if you have to wait three weeks. If I was the surgeon, and I was booked, I may try to see if I can fit this in earlier, but I wouldn't necessarily move heaven or earth (e.g put off someone else's surgery) in the absence of other medical factors that would necessitate an earlier removal. But this is not my field and I'm happy to be corrected if anyone can find some evidence to the contrary.
  12. No. If I remember correctly, the recommendation is 4-6 weeks but even longer times have not been associated with poorer survival. Get them in as soon as you can, but I do not believe a 3 week timeframe has been shown to be dangerous. Sources: https://www.ncbi.nlm.nih.gov/pubmed/12100184 https://www.ncbi.nlm.nih.gov/pubmed/19095097
  13. Culture negative sepsis is the bane of my existence. I hate it. Not that I would do anything differently, but it's so unsatisfying. We don't use procalcitonin as much in babies, though there are some studies that are coming out now showing it may be useful. The problem is that oftentimes it's raised in things like RSV - I think it's made in the respiratory epithelium in times of stress? - so it can be elevated. In Europe, they use procal as one of the criteria for working up a febrile infant. But it hasn't really caught on here. For the adults, do you guys use PCT to initiate abx or more to trend it to know when to stop abx?
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