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UGoLong last won the day on January 11

UGoLong had the most liked content!

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About UGoLong

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    Physician Assistant

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  1. UGoLong

    Post interview tips

    Notes are nice when you are interviewing a few people for one position. It is essentially meaningless when you’re interviewing a few hundred people for an incoming class. We interview, fill out some paperwork, and move on to the next. A nice thank you at graduation, on the other hand, is very nice and deeply appreciated! Sent from my iPad using Tapatalk
  2. UGoLong

    Best Laptop for School?

    My advice: talk with the students in your program. Many programs assign you a "big" to give advice as to where to live, what books to buy, etc. Given the differing software environments, there may be some local pros and cons to consider. If you don't have a "big" assigned to you from the class ahead, call the program and ask if there is a student you could talk to about things like this.
  3. I was not a fan of being around blood and shied away from medicine as a career when I was younger. When I was assigned to the ED as a hospital volunteer, I was reluctant. Eventually I came to enjoy being there, and went on to 33 years in EMS and became a PA. One thing I noted is that having a job to do at a scene totally changes one’s reaction. I hate gory movies and still do. On the other hand, eating a pizza after dealing with a motorcycle wreck: no problem. Watching is way different from having a job to do. Feeling helpless to do anything makes you focus on the gore. Sent from my iPad using Tapatalk
  4. I'm sick of this topic as well. Until we're replaced by machines, we are here to apply some judgment, whether anyone else likes it or not. I do enjoy your posts, Ventana, and I hope your next workday goes better.
  5. I really don't want to defend a provider who leaps right to a cath and then screws up the patient. That's like doing an exploratory lap before a CT in a stable patient. But there is a big difference between saying that you've done enough by the guidelines and ignoring that nagging voice in the back of your head that says "look farther, grasshopper." (Maybe the voice should add "But don't be a cowboy about it.") guideline noun [ C ] us /ˈɡɑɪdˌlɑɪn/ › a piece of information that suggests how something should be done. ACC/AHA Guidelines generally define themselves as follows: Intended Use: Practice guidelines provide recommendations applicable to patients with or at risk of developing CVD. The focus is on medical practice in the United States, but guidelines developed in collaboration with other organizations can have a global impact. Although guidelines may be used to inform regulatory or payer decisions, they are intended to improve patients’ quality of care and align with patients’ interests. Guidelines are intended to define practices meeting the needs of patients in most, but not all, circumstances and should not replace clinical judgment.
  6. I'm hoping that was a while ago! We seldom go directly to an elective cath these days. Docs who do lots of caths with patients who seldom actually require intervention are looked at fairly closely these days.
  7. UGoLong

    Am I Setting a Good Example...

    I personally think that each box of Thin Mints is a unit dose.
  8. I hear what you're saying and I too do not see a reason for an in-hospital nuc stress test for the particular patient you described. And there is usually little reason for a stress test to clear an asymptomatic patient who already gets to 85% of the max age-predicted heart rate (220 - age) in his or her normal life. If they can't do that, then a stress test may be indicated for surgical clearance for the riskier surgeries. If a patient is not able to exercise (perhaps because their hip is getting replaced and it hurts too much to move), then a nuc can actually be an easier and faster test than the alternative: a dobutamine stress echo. Screening guidelines to release someone from the ED by ruling out ACS are great and unclog your department without excessive risk. But it's not the same thing as what a cardiologist may decide to do on follow-up, nor should it be necessarily. That's why you have them follow up in the first place. And let's not ride our own horses too high. I certainly don't endorse the behavior of everyone working in the same specialty that I do. On the other hand, for most of us, it's not an issue of "selling your morals" but of evaluating a given patient's risk. I wouldn't assume everyone is trying to overbill. No one wants to be the one that blew off a symptom and didn't investigate further if that was called for.
  9. Find some contacts, make some calls, send some emails/letters, line up some informational interviews, save up some money and then visit for a week or two for reconnaissance. Don't just "up and move there." Many years ago, one of my uncles wanted a job in the LA area. He had been stationed there during World War II and loved it. It probably had 1/100th the population then that it does now, little smog, and wonderful weather. What was not to love? He thought about this heaven on earth often. So, in the mid-1960s, he sold his business and house, and headed out there with his family, their belongings following in a truck. Kind of the central New York state version of the Beverly Hillbillies (an old TV show; look it up on NetFlix). Mind you: my uncle had never been back to California since the war, he had no job lined up, and his family had never been there before. As soon as they hit the San Bernardino County line, my asthmatic cousin went into status asthmaticus big time. He ended up in a hospital for an extended period. My uncle realized that LA had changed in 20 years and not for the better. The family returned to New York and he was a broken man for the rest of his life. Bottom line: Follow your dreams, but do some research first. (Hence the opening paragraph of this post.)
  10. UGoLong

    Ws on a transcript

    I don’t believe a W is an F. You should check that out further. Sent from my iPad using Tapatalk
  11. Many new grads don’t know very many working PAs, other than the ones they shadowed or had as preceptors. And PAs for the most part don’t mind helping out the newbies, After all, someone probably helped them once upon a time. There is nothing wrong with politely asking for help or advice, especially from former graduates of your program. It may initially feel weird to you, but don’t let that stop you. The worst thing that can happen is that the stranger won’t help you, which is exactly what happens if you don’t ask. And, when the time comes when someone asks you for help, remember how you are feeling right now. Good luck! Sent from my iPad using Tapatalk
  12. I work in cardio and see a variety of behaviors in other practices. That said, people drop dead without risk factors and we’d understandably really don’t want that to happen on our watch. A 51 yo man with unexplainable chest pain that subsides with negative troponins is probably going to get a cardiac workup. If no other risk factors, our practice would likely recommend an outpatient stress test. If the patient is reasonably active, it would probably be a treadmill or treadmill stress echo. Just as you wanted to rule out an MI, a cardio practice wants to rule out ACS or ischemic heart disease. That’s one of the things we do. Sent from my iPad using Tapatalk
  13. Still with the same practice and specialty (cardio) that I started in 12 years ago. Only now part time while I teach part time as well. Sent from my iPad using Tapatalk
  14. I don't get paid for it (nor does our practice). I generally have a PA student or 3rd/4th year med student with me most days that I round in hospitals. I really enjoy the students, though the day usually runs longer than when I round alone.
  15. UGoLong

    Poem for personal statement?

    I personally wouldn't recommend it. The goal is to give a slice of yourself, not so much a performance. I think it would be like sending a video of you doing an interpretive dance. The PANCE folder for each individual is large and full of numbers. The only things that the reviewer see that presents a slice of what the applicant is like are the essay and the letters of recommendation. Your poem, though entertaining and heart-felt, doesn't give me enough of a view of who you actually are.

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