Congrats! I’m excited for you!! Best of luck!

Eddy, I just seen you are coming to our University to give us a talk. I heard your talk on Impella @ SCCM 2024 but couldn’t say hello because of too many people around. Will look forward to meeting you in person this time.

Good luck! Glad I was able to help 👍🏼

Good luck!!

Awesome! Let’s me know how I can help. Surgeons do some funny things in the SICU. Always remember that 2+2=4 and 3+1 also =4. I say that bc it’s a different style but also good outcomes.

Thanks for the sub! Glad to share my thoughts if it’ll help someone. Thanks for sharing the international take on the speciality. I’m also a big fan of Farkas. I need to actually talk to him instead of silly back and forth on Instagram and Twitter. I think he does great work and is a smart smart dude. I didn’t know he only did CCM and left the Pulm behind. The solution of being in academics is a good one. I’ve thought about it. I was offered several academic gigs but turned them down for my private practice gig. Need to make a video on why I did that. Thanks for checking out my videos! If you have any ideas let me know.

haha! you should've just asked me in person! by the way, have you left yet? I need to buy you a beer/bourbon/something.

I leave Sunday! Ready to crush this first semester.

Damn dude. I’m out of town until Friday and then on nights. The departure date came on quick. Sooooo happy for you

Thanks for sending me in that direction. I had never heard of that podcast. I’ll reach out to Dr. Gray. 👍🏼

Thanks, Eric. To do trauma-CC you need to do a surgery residency (5 years) + a trauma fellowship (I think 1 or 2 years). To do EM-CCM you do 3 years of EM residency and 2 years of CC.

@@eddyjoemd I am a bit confused because for the EM-CCM I thought it was 4 years of EM residency then 2 years of critical care.

@@eddyjoemd also what board certifications do you get from the EM-CCM residency vs the EM PCCM resideny

Yeah I had the same exact question.

There are many routes to ccm in the US. At the end of ccm training, I'd say people are more or less the same in terms of ccm knowledge and skills. The real differences are in things not directly related to ccm as a specialty such as job market. For example, if you want to work in the community and in the MICU, it's mainly IM/pulm/ccm, hence it's an advantage to be IM/pulm/ccm. Hospitals and private groups will often want you to cover inpatient pulm consults as well as the ICU as well as see outpatient pulm patients. Granted, much of this is changing, but that's traditionally been the case. In private practice, anesthesia/ccm tends to go back to anesthesia since doing straight anesthesia usually pays a lot more than mixed anesthesia and ccm. Again, this is changing too, but that's traditionally been the case. Otherwise anesthesia tends to find academic work (which usually much pays less than private) doing anesthesia and the sicu where often surgeons are the ones in charge or want you to do things their way. Again there are increasingly exceptions to everything I've said. I'm just giving a general answer. Hope that helps.

@@pattube thanks a lot! This is very helpful

Thanks!!

I’m not a good person to teach ABG or acid base interpretation. I do it so often that I just run all the shortcuts in my head and can’t explain it without skipping steps. I even wrote a lecture to make a video but it flat out sucked. I wasn’t good at it. Wish I could help, though. Now I just look at the ABG, BMP, and what’s going on with the pt and figure it out 9 times of 10 in just a few minutes. I’m not bragging, it’s just routine.

Ahmad, academic activities are important but some institutions are more research heavy than others. I didn’t have anything published when I started my fellowship but I’m definitely not the standard. Locums is a great way to make some good money but you need to think that a lot of those institutions that offer locums positions are because they can’t keep staff. There’s usually a reason for that that’s unfavorable to you as a clinician. Poor ancillary staff, unfavorable equipment where the chances of liability are high. Terrible EMR’s. No consultants. I’ve thought about picking up some weeks here and there but haven’t pulled the trigger. Also, when you’re first practicing on your own, you want to be at a place where you’re going to almost immediately feel comfortable. Somewhere where your partners can show you the ropes rather than just get thrown into the fire.

It’s something I think about regularly which is why I have backup plans in the works. Burnout is real. Two years in and I’m fresh but I can’t speak about how I’ll feel after 10 years.

@@eddyjoemd Can Critical Care Docs go back to being internist/hospitalists FTE? If they experience burnout or can they be part time in CC and hospitalist?

I actually think that there's more burnout for hospitalists. I don't have the data to support that. Also, I don't think seeing the pay cut from CCM to Hospital Medicine helping out the burnout sensation. Lifestyle creep is real. Some people who do Pulm/Critical Care shift more to the Pulm side of the world when burnout happens. I am working on several strategies to mitigate burnout as well as lifestyle creep. Earning money through KZfaq is a seed I'm planting that perhaps could earn me a certain amount of passive income if I do it right and do it long enough. Let's see. What else can I help you with? Also, you'll very likely have to do nights with CCM.

You’ll realize that you won’t want to do hospitalist work once you’re brain is fully trained in Intensivist mode. Their work is still hard, just different.

My pleasure! 3 years of EM and 2 years of CCM. 👍🏼

I know some people who are trying to do that. My question is how well is your knowledge base going to stay after a decade? Are you going to be able to keep up with the Pulm literature and new therapies with so much cool stuff coming out over the decade? I wouldn’t trust myself. I can’t even keep up with the primary care stuff anymore.

I’m 5 years in and am not burnt out at all while doing the 7on/7off. I’m working on several side hustles that could potentially supplement my income should I get burnt out. To be honest, though, it’s not as mentally demanding once you have sufficient experience. It could potentially even become mundane to some.

We can talk offline about this because inevitably someone will misconstrue my words, but it is multifactorial and the landscape is changing. I appreciate your support.

Is there a way I can DM you?

Email me: eddyjoemd@gmail.com. It may take me a bit to get back to you 👍🏼

I’m bias and I would say IM. Either is fantastic, though.

@@eddyjoemd thank you , you are doing a great job

also, critical care is the dream, so more exposure, more rotations in icu sounds so much better!

no, but he can suction mucus from the lungs! (so basically he does what a nurse does, just goes a bit deeper)

No critical care. A 2 year fellowship rather than 3.

Due to the high burnout rate, the market has accommodated jobs with schedules such as mine for critical care work as well as hospital medicine. Every job I interviewed for had between 155-182 shifts. No more.

@@eddyjoemd Thanks!

My pleasure. Thanks for checking out my videos!

Yep! You definitely can. 👍🏼

I believe Mayo-Rochester is one example of pulm only.

Yep. But you’re going to lose a year of your life and a significant financial opportunity cost.

Yep. But you’re going to lose a year of your life and a significant financial opportunity cost.