Devpriyo Pal

@aditya_gan3500 @DrAditya2935 You are incorrect. You wanted to be a neurologist from your internship - you just did not know it yet. 😛

@DrAditya2935 Same for all batches I should probably win a medal I knew that I wanted neurology from my housestaffship Did exactly that

When we joined AIIMS, as all of them will - we were asked what we wanted to be. 50%-70% I think said Neurosurgeons/CTVS. I remember saying Ophthalmology. 2 people from batch did Neurosurgery. No CTVS. 1 quit. (From neurosurgery) I of-course didn’t do Ophthalmology. No one said Radiology. 7 did. (Out of 70)

@DrShauryaGarg This is funny to me because I both agree and disagree with you. I have read Guyton as a “story book” and enjoyed it more than Ganong at the time but will not recommend this to anyone else because in retrospect feels like a waste of time.

I like how confidently dumb some of them are on these platforms. Just because you can write “senior” consultant after doing a DNB CTVS doesn't mean you've actually opened a textbook or have reading comprehension. Exhibit A:

@DrAditya2935 100% agreed. London (and much of Europe) is built for heat retention (Victorian/Edwardian build), and is struggling to deal with this atypical climate whereas Delhi is optimised for its weather. Humidity is more too - I’d say Kolkata feels even worse at 35 degrees personally!

@drdevrad Is 35C in Say London more intolerable than 35C in Delhi? That’s true right?

@DrAditya2935 Hydrocoele is one of the many problems with that particular structure!

Kolkata - Hydrocele Messi. Patagonia - Elephantiasis Messi.

@DrAditya2935 @mohan_boll82842 New town is also my favourite part of the city these days. You sound like someone who has spent a fair bit of time there!

@mohan_boll82842 Hospitality of India in general is good :) Food was nice. From food and hospitality perspective- I like Kolkata but the city in general is dirty af. (Except new Town)

Have travelled to many cities in India- it’s been a long time since I was impressed and felt hopeful. Vizag made me that hopeful. Last was Kochi (but then even it had occasional pockets of disappointment) Major metropolitan hubs (Delhi/mumbai etc) all are hellholes. Thanks all for the recommendations - apricot delight was great.

@Aspirin150mg @thenerdnxtdoor2 Finney and Thomas? That was one of my favourites too.

@thenerdnxtdoor2 Thompson or Tolstoy? I think it was thompson or something

@DrAditya2935 I find the outrage a bit tiring because it rarely translates to meaningful change in practice. It trends and then fizzles out and/or people are distracted and do silly things like blaming social media and the apparent dearth of “pathology grind” in medical education system…

I’m no way defending Sejal or her words. But this right now is full blown mass hysteria. Bharat ek outrage Pradhan desh hai.

A medical student admits to doing something shameful, and soon, modern medical education itself is on public trial. This tradition is very old. Every generation of doctors is the worst ever trained. Apparently, previous worst-ever generation somehow trained them anyway.

@DrAditya2935 I have no need for this anymore in my life but I really like how easy this is to remember. 🙌

Milestones You can try to read revise and remember them 20 times and you’ll forget them 25 times. But for gross motor milestones - a simple stick figure can help you figure out everything. See the stick figure given below. Just remember - 3,6,9,12. 3 months - Neck control 6 months - Trunk control - Sit with Support 9 months - Knee Control - Stand with Support. 12 months - Feet control - walk with support. A child would be able to stand with support only once it gains ability to sit without support. So sit without support comes one month earlier - at 8 months. Similarly- you’ll only be able to walk with support - once you’re able to stand independently. Hence, stand independently comes at 11-12 months. In Toto, this becomes 3 - NECK control 6 - Sit with support. (Trunk control) 8 months (9-1) month - Sit without support 9 - Stand with support (knee control) 11 months (12-1) - Stand independently 12 - Walk with support. (Feet control) That’s it - you’ll now never forget Gross motor milestones for 1st year.

@aditya_gan3500 @Dr_S_Arora To perform guided aspiration 💉

@Dr_S_Arora Pyogenic spondylodiskitis? Why CT?

Diagnosis? #radiology

Can anyone predict at what point will people get tired of these terrible predictions?

@FergusCafferty @SeanLangenfeld That was terrible. Med student picking up increased medial clear space and correcting a radiologist - SO realistic 🙄

@SeanLangenfeld The one and only time a radiologist was featured in the show, they missed a subtle xray finding that a medical student then schooled them on. ED is the top source of radiology consults for imaging in hospital medicine, but you wouldn't guess that from the show.

TV is going to glorify any specialty. Make a show about surgery and you'll see the same hyperbole. The only time I'd really be annoyed is if the EP's competency came at the expense of others, ie he/she saves the day from an incompetent surgeon/internist/anesthesiologist, etc. My bro is an EP, and has done 99% of the described procedures. Also it's a TV show.

@aditya_gan3500 Unfortunately despite multiple checks by different peoples (doctors, nurses), consent forms, WHO checklists, never events still happen in every system. In my practice, where laterality is important, my final check is asking the patient for the last time while skin-marking.

Apocryphal story from UG days The boss hands a big shot in UG with several gold medals and class assistantships a patient's file with an ECG paper in it 'Interpret it' He tells him Brimming with theoretical knowledge the guy interprets the f**k out of the ECG [It was a complete heart block = something that even a UG student should be able diagnose] Then he hands it back expecting a congratulations The boss smiles back at him 'Congratulations! You failed' He is shocked His batchmates are shocked Turns out He didn't read the name on the ECG It was from a different patient and not from the file Correct diagnosis but wrong patient Massive error Most important lesson of the day Always check the patient particulars before taking a history, performing an exam, reading a lab report or performing a procedure This is a never event = res ipsa #MedTwitter #NeuroTwitter #MedicalEthics

Overall solid advice - Tailor it to your specialty and specific life goals. If you are confident in your skills and satisfied with training, you need to crack on and build a practice. If you want to learn more/subspecialise, think about how much time you need as an SR.

Quick rules question on Jumla @zainmemon_ : if we play this Conspiracy card, can it be used at the start of our turn so we earn resources from the extra Ideology card, or does it only activate during turn actions (meaning no resources that turn)?

@Drpoojadutta @drpraveenpsy I fail to see why him reminiscing about what he personally considers a period of struggle in his life prompts you to defend something that he does not criticise in the first place. Let’s stop here before it gets silly. Well done on realising your American dream. Have a good day.

@drdevrad @drpraveenpsy lol, more than US health care system you should be concern about doctor’s mental health and safety. In that context I would choose US health care and that’s my reflection.A shoes, jacket and snow I didn’t find graceful statement when people have sold their land for American dream

I first saw snowfall in Chicago, USA, and it remains a bitter memory for me. I was in Chicago to take the USMLE Step 2 CS exam. By then, I had already spent almost six months in the US doing electives and research. I had cleared Step 1 and had decided that I wanted to return to India and prepare for the PG entrance, as I did not like living in the US. My only motivation to appear for Step 2 CS was fear. I was worried that if I failed, people would mock me and say that I returned to India because I could not clear the exam, and that not liking the US was just a sorry excuse. I was also anxious about starting afresh for Indian PG entrance exams after spending more than a year pursuing the USMLE route and investing a substantial amount of money. I was struggling to sleep with so much going through my mind and was forcing myself to study. Snowfall started while I was in Chicago. My winter clothing was completely inadequate, mostly jackets suitable for a Delhi winter. I did not want to spend money on buying proper winter clothes there, as they were expensive. So I wore all three jackets that I had brought with me and tried to hide the collars so that people would not notice. The roads were completely snow-covered, and my shoes were not suitable at all for walking. As a student, I could not afford taxis. The kind of shoes people wore there were expensive, and I had already decided to go back. The entire time I was walking, I was terrified that I would slip, injure my knee, and that there would be nobody to help. I walked extremely slowly, constantly anxious. Thankfully, I stayed there for less than a week, completed Step 2 CS, passed the exam, and took a flight back home. All this happened in December 2010, and the memories still remain so fresh.

@Drpoojadutta @drpraveenpsy The post is a personal reflection on @drpraveenpsy experiences and challenges. It offers no recommendations or warnings. Interpreting this as a critique of the US healthcare system is not only disingenuous but also serves to invalidate his lived experiences.

@drpraveenpsy These are very small struggles which you have mentioned!I passed my step 3 USMLE newyork with in far worse conditions!India has no comparison with US health care system and doctors wealth!India is not even close so just because you didn’t choose US please don’t discourage juniors

@aditya_gan3500 I agree wholeheartedly, but I didn’t think colorectal cancer was considered rare anywhere.

This is American data. But many Indians have a Western diet now. Be very careful. Unusual GI complaints. Don't ascribe it all to entitities like IBS too quickly. Colorectal malignancies kill people. Take the history, examine the GIT and obtain the testing. Rare diagnoses are not rare. They are rarely diagnosed. A missed diagnosis of cancer will kill the patient and the doctor. #MedTwitter #NeuroTwitter #GITwitter #OncoTwitter

Recent? This millennial has one too! It’s my favourite lab coat that comes with a flood of nostalgia every few years when I come across it.