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About MikeyBoy

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    Physician Assistant
  1. Looking forward to following and discussing with you guys!
  2. Bad year so far. Had a handful of Flu A+ patients end up on ECMO last month, and we rarely refer patients for ECMO. This past week we have been having steadily more patients testing +. Critically ill, waiting on the viral panel= I start tamiflu. No question about it. Even if >2-3days.
  3. Just wrote them a letter as well. Shameful stuff, and I normally enjoy the NYT.
  4. Medscape just focused on a great study to help prevent burnout on a long term basis- basically by focusing your mindset on the good that happens in the day, not the bad Duke WISER Research. I work in a MICU, otherwise known colloquially as the graveyard to my colleagues in surgery/IM. I am constantly burnt out. But I love my job and I know I make a difference and take care of myself after I leave work. I could go work at Patient First, make $20k more and have less overall stress, but why would I do that? (no offence to anyone). I often think when driving home from work "HOLY
  5. Have you found a good link to email them at (besides the comment section)? Can't find it on a quick look through their website.
  6. My advice- always know backwards/forwards anything that can kill a patient in a few minutes. You won't have time to look it up. Use the online Mass Gen Hospital Housestaff Handbook (you can find the 2016 pdf online for free) for quick refreshers. UptoDate for anything you have time to look up. Marino is a great baseline read. I found FCCM very basic, just read through a used copy. Agree with ultrasound- read up on free resources, then have your job pay for you to attend the CHEST bedside course in Chicago. Also, please do not read that latest and greatest in cr
  7. I agree with everyone else and wanted to highlight what you said- you admit your presentations are disorganized, how could someone give you a glowing review? This is critical care, where there (often) is not time to hand hold. Would you feel better if he gave you a canned positive review? Now that [that reality] is out of the way, I'll share you my experience. I did fantastic in my ICU rotations (I did 4 months during PA school)- but when it came down to applying for a job there, was I ready? HECK NO. Did it hurt? HECK YEAH. But, I worked med-surg/telemetry at night for the next 4
  8. 5 years. Community Hospital MICU--->Large academic center MICU. Left to get a new experience, burnout/overworked, etc.. Definitely don't regret it! :)
  9. I am in the reactive DDAVP camp. Mainly due to our diligent interns/students to keep on top of the q2h whole blood Na's coming in fast. Great topic, here's the link to the blog for others; https://emcrit.org/pulmcrit/taking-control-of-severe-hyponatremia-with-ddavp/
  10. I'll advocate for critical care, my experience in the MICU :) 1.Autonomy: Day time, a collaborative experience. At times, like the attending-fellow experience, otherwise, general autonomy depending on the level of comfort per attendings. Night time, full autonomy. 2. Salary: Should be higher given the amount of procedures, in-patient billing, and high stakes of critical care. 3. Stress: At work? High. Out of work. None. I'll say this balances to a moderate level. 4. Work/life: Easy balance, but depends on the hospital system (on-call, 24h shifts, etc), but, generally as #3 was alludi
  11. Hopkins offers an October-October residency. Usually 4 residents, who work through the various ICU (SICU/CVSICU/Neuro/MICU/CCU) and elective speciality rotations. Working 60-80 weeks, you get what you put into such an experience. I think if you are a gunner and highly motivated, these are great experiences. If your timid and not willing to step up to get experiences (run codes, grab procedures) your going to have a tough time getting a fantastic experience since PA residents have to fight it out for procedures with interns/residents. Note: I never have done a CC residency, only have se
  12. Quick update, So I ended up accepting a position at a large academic center. I'll have a good deal of autonomy, which was my main concern voiced at the interview, along with educating residents and rounding on their patients as well, and research opportunities. Hours, salary, all improved. I'll still be doing the same, if not more, of the current procedures I do now. Definitely still feels like a leap of faith, but, as my current boss put it, I'd be an idiot to turn it down at this point in my career. Thanks for all the kind words and encouragement, really excited.
  13. Yeah I already do this, along with all the new internal medicine hires we take under our wing during hospital orientation. It is a breath of fresh air, especially with the motivated, smart PA students when they are first learning about critical care. Great points. With a few interviews coming up, autonomy within a resident team is definitely a concern of mine, and something I'll have to tactfully ask about. I think it's a balance. At my current hospital I have a mix of autonomy- sometimes on my own at night (intensivist avail by phone) vs scutting along during the daytime with very a
  14. Thanks gbrothers. Yeah I think there is that fear in me, that if I stay where I am for another 6 years, I'll never really grow into the clinician I could be. I would just be treading water where I currently am; comfortable, but still about the same clinician I am at 28. Thanks Maverick, good luck with your move!
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