Ryan D'Souza, MD
@Ryan_S_DSouzaMD
Followers
2,345
Following
851
Media
259
Statuses
1,673
Pain physician/Anesthesiologist @MayoClinic | #MedEd | Research Mentor and Coach to 100+ med students, residents, and fellows | Educational threads🧵👨⚕️👨🏫
Rochester, MN
Joined July 2015
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Southport
• 533350 Tweets
Rebeca
• 412862 Tweets
Simone
• 357205 Tweets
julia
• 229182 Tweets
フランス
• 206391 Tweets
Hezbollah
• 200394 Tweets
Beirut
• 193627 Tweets
É BRONZE
• 192367 Tweets
flavia
• 143414 Tweets
Prisca
• 140956 Tweets
لبنان
• 131470 Tweets
#AkatsukiJapan
• 122727 Tweets
Flavinha
• 115239 Tweets
Jade Barbosa
• 91089 Tweets
#GinasticaArtistica
• 81000 Tweets
Daiane
• 50825 Tweets
ファール
• 49128 Tweets
Green Day
• 42917 Tweets
男子バスケ
• 37542 Tweets
Suni
• 32185 Tweets
Jordan Chiles
• 29436 Tweets
#الضاحيه_الجنوبيه
• 28743 Tweets
Mourinho
• 27225 Tweets
Krunic
• 18727 Tweets
İsmail
• 17423 Tweets
ブラジル戦
• 16154 Tweets
Lille
• 16066 Tweets
ファウル
• 14692 Tweets
八村退場
• 13200 Tweets
アンスポ
• 13072 Tweets
オーバータイム
• 11442 Tweets
Dzeko
• 10796 Tweets
ホーキンソン
• 10273 Tweets
Pinned Tweet
This thread is for those starting residency and intern year. As I reflect back on my journey and these tips, I didn’t follow many of them myself and wish I had. Below I provide my perspective of residency and survival tips. 🧵
22
165
1K
#MedStudents
,
#Residents
,
#Fellows
, and
#Research
Trainees - I recently had both a resident and fellow ask me how I got involved in research and published when I was a
#trainee
. I thought I would share my tips and advice in this thread.
#MedTwitter
#ACGME
#MedStudentTwitter
8
91
271
Greetings
#MedTwitter
Interviews are nerve-wracking! Fellowship
#interviews
are happening, so I wanted to give tips in this thread (applies to any
#interview
)
Disclaimer: I’m no expert, these are my views only
#MedEd
#Resident
#MedStudent
@Inside_TheMatch
@IMG_Advocate
🧵
12
49
166
Extremely proud of my brother for matching into his top choice at VCU
#Neurosurgery
. Let’s go!
Congrats and welcome to our newest
#Neurosurgery
residents, Shawn D’Souza and William Mualem. 🎉
We look forward to all the great things you'll accomplish!
#MatchDay2024
1
2
39
6
1
144
Thrilled beyond words! 🎉 My brother just matched into
#Neurosurgery
! 🧠🏥 So proud of his hard work paying off. Huge congratulations to him and others embarking on this journey! 🌟
#Match2024
#ProudSibling
4
1
141
Behind every successful person is a network of mentors who believed in them, supported them, and helped them overcome obstacles. Don’t underestimate the power of mentorship in achieving your goals.
1
35
132
Good luck to fellows starting their
#pain
#fellowship
!
Here are some tips in this thread 🧵
Hope you find this helpful. At the end, do what works best for you!
@SMoeschlerMD
@nasir418
@MayoAnesRes
@NANSRFS
@ASRA_Society
@MayoPMRRes
@MayoPainMed
@KohanLynn
@TrentDEmerick
9
35
101
1/The reality of residency - it is a wild 🎢 ride. It’s not just about medical knowledge and patient care—it’s about resilience, adaptability, and maintaining work-life balance. But, it’s more fun than med school!
2
3
106
Interesting RCT (RESTORE Trial)
Compares PRP vs placebo injection for knee
#osteoarthritis
-No difference in knee
#pain
scores at 12 months
-No difference in medial tibial cartilage volume
Should we reconsider offering this to patients?
#Physiatry
#rehab
7
21
96
Our Research Scholar
@MariamElSaban
presented TWO President’s Choice Abstracts at
#ASRAFALL22
on spinal cord stimulator outcomes. Just absolutely amazing! 👏
#Anesthesia
program directors - she is going to be an amazing anesthesiologist!!
@MayoAnesRes
@IMG_Advocate
#Match2023
8
9
95
2/Patients will teach you more than any textbook. Take notes from unique real-world learning cases. Consider publishing rare case reports.📝
2
1
84
Truly honored and humbled to receive the Early Career Rising Star award
@NANS_ION
. My gratitude overflows for the mentors who guided and shaped my journey. This award is a testament to their wisdom and support. Excited to dedicate my life to advancing
#neuromodulation
🙏
12
3
81
Interested in learning/reviewing all commonly used analgesics, as well as less common analgesics (LDN, CBD/THC, alpha lipoic acid, acetyl carnitine). Consider reading this
#MedEd
#research
#MedStudentTwitter
#pain
7
15
80
🎉 Exciting news! Our team just completed a monumental three-year journey, dedicating countless hours to craft a comprehensive guideline on systematic reviews/meta-analyses in
#regional
#anesthesia
and chronic
#pain
. 📚 We aim to elevate the quality of SRs/MAs in the field
8
30
77
Deeply honored and humbled to receive the Teacher of the Year Award from
@MayoAnesthesia
pain fellowship. Grateful for the unwavering support and inspiration from my colleagues. Thank you to the pain fellows for allowing me to be a part of your educational journey.🙏😊
#MedEd
13
0
78
‼️Anesthesia residents‼️- this thread shows my tips for studying for
#anesthesia
boards and in-training exams. Hope you find this 🧵 helpful!
2
23
76
7/Stay organized. Use planners, apps, or whatever works best for you to keep track of your tasks. I developed a daily habit/To-do list: (1) logged cases into ACGME log, (2) read a textbook chapter, (3) did 10-20 qbank questions
1
1
73
3/The first time you handle a critical situation on your own is terrifying and exhilarating. That’s where true learning happens. To this day, I recall running a code without an attending during my intern year
1
4
72
5/Socialize and get to know your co-residents. They will be part of your family and support system. You lean on each other during tough shifts and celebrate victories together. Volunteer to cover their shifts when they are sick or unable to make their shift.
1
0
72
Tweetorial 🧵 on becoming a ⭐️mentee
Mentoring
#residents
&
#fellows
in
#research
is rewarding! It's not just about teaching, but also witnessing their growth🌱
Having mentored >50 trainees, I provide advice on how to be an excellent
#mentee
and seek
#mentoring
opportunities💡
5
21
68
Interested in learning about
#neuromodulation
? here are some video links that may be helpful in getting introduced to the basics of spinal cord stimulation, DRG-S, peripheral nerve stimulation:
@ross_barman
@RushnaAli6
0
21
67
4/You’ll make mistakes, and that’s okay. Every error is an opportunity to improve and provide better care.
2
4
67
Congratulations to an amazing group of graduating fellows from
@MayoAnesthesia
Pain Fellowship! So proud of all of you!
3
3
65
Been a rough and busy month, but taking a break to travel to Virginia tonight to celebrate my brother's graduation from med school! ✈️🎓 Incredibly proud of his hard work and dedication. Can't wait to see what the future holds for him as a neurosurgeon.
1
0
63
I’m sharing these slides on spinal cord stimulation and
#neuromodulation
that I presented at
@ASRA_Society
Hot Topics webinar. Here is a thread and brief presentation of some slides.
#pain
#residency
#fellowship
#MedEd
#MedTwitter
#MedStudentTwitter
1
22
61
12/Treat everyone the way you would want to be treated. This includes your nurses and support staff. Remember that you are part of a team. They will have your back when you need it most! Trust me!
3
4
62
8/Don’t be afraid to ask for help. Don’t pretend to know something that you don’t know. It is OK. This is the purpose of residency - to learn things that you don’t know.
1
3
61
Heard of Torg-Pavlov ratio?
It’s the ratio of cervical canal diameter to cervical body width; <0.80 indicates cervical stenosis. It’s used as a universal indicator of cervical canal stenosis despite differences between gender and race
#MedEd
#MedStudentTwitter
#Spine
#Physiatry
1
11
58
En route to New Orleans for the
#ASRAFall23
Conference! Excited to connect with incredible minds, indulge in delicious cuisine, and absorb knowledge from
#pain
experts. ✈️🔍🤝
@ASRA_Society
4
4
60
Deciding author order in a manuscript is crucial: credit should match contribution, not clout. Ethical authorship respects effort over fame. I still remember being unfairly bumped lower on projects I poured hours into as a trainee. Let's honor hard work in academia.
1
8
60
We propose this treatment algorithm for managing painful diabetic neuropathy. Options in figure with an asterisk are FDA approved for PDN.
@ross_barman
@jonhagedornmd
7
19
59
Guideline on writing systematic reviews/meta-analyses is finally published in
@RAPMOnline
and featured on the front cover! 🎉📚
👉🏾Part 1: (FREE ACCESS)
👉🏾Part 2:
@sites_brian
@nasir418
@saraamaralMD
@alopipatelmd
@JayKarriMD
3
23
59
6/Balancing personal life and residency is challenging. It’s important to find time for self-care and to connect with loved ones. Prioritize mental+physical health. Exercise, eat well, and make time for activities to help you relax and recharge.
1
2
59
A good mentor doesn't just impart knowledge; they inspire, empower, and guide their mentees to reach new heights. Be the mentor you wish you had.
0
10
54
Amazing people, conference, venue, and weather at
#AAPM2022
Met some incredible people, learned new things, made friends, and hope to continue collaborating and seeing them in the future.
@SMoeschlerMD
@ross_barman
@SchappellMD
1
5
53
I really like the change to “ASRA Pain Medicine” to be inclusive of acute pain + chronic pain. Since starting chronic pain, I’ve often felt detached from my anesthesia colleagues. But this is the right move to increase ongoing
#Collaboration
. Excited for future of
@ASRA_Society
.
2
7
50
9/Find a mentor (clinical, research, or work/life balance coach, etc) who can guide you through residency. Their experience and advice can be incredibly valuable.
1
2
51
Pain fellowship
@MayoAnesthesia
is the best! Love working with these people!
@DrCwoods314
@jonhagedornmd
3
5
51
📰 Exciting News! 🌐 Our latest paper is out
🩹 Diagnostic block ≠ superior pain relief at 3/6 month post PNS implantation
🔍 Diagnostic block may predict short-term relief with temporary PNS
❌ Diagnostic block relief ≠ relief from permanent implant
#Neuromodulation
4
10
49
Taught my fellow how to do a celiac plexus block w/ one-needle technique and made his day. Never seen a fellow that excited before. Yes… the needle was that curved to get it exactly centered. Good technique if aorta is adhered to left vertebral body
#Meded
#MedStudentTwitter
3
3
47
Just finished presenting to fellows at
#ASRAFall23
discussing
#Neuromodulation
for Chronic Neuropathic Pain. Covered topics on patient selection, FDA indications, and surgical tips. Educating the next generation of
#pain
experts is rewarding! 💡🧠
@ASRA_Society
0
13
49
Congrats to those completing med school and starting intern year soon. Always remember why you chose this path. Reflect on your goals and the impact you want to make. Keep pushing forward—you’ve got this! Hope this 🧵 was helpful.
2
3
47
I was never a mnemonic person, but this helped me in
#pain
#anesthesia
training when treating acute+
#chronicpain
.
STAN-TT-NO-LAG (Think of Stan’s Audi TT having no lag…cuz it’s fast)
I created slide/thread.
#MedStudent
#Residency
#Fellowship
#MedTwitter
#MedStudentTwitter
1
14
47
Q&A: As graduating residents are prepping for
#pain
#fellowship
, what textbooks to use?
I swear by “Practical Management of Pain” by Benzon and “Atlas of image guided spinal procedures” by Furman. Read both from cover to cover
4
7
45
Hard to keep track of what is
#FDA
approved.
Here is list of approved treatments for painful diabetic neuropathy
Meds: pregabalin, duloxetine, tapentadol
Topical: Qutenza patch (distal to ankle only)
Intervention: 10-kHz spinal cord stimulator
#pain
#diabetes
#neuropathy
#MedEd
6
9
45
📢 Exciting news! The
#ASRAFall24
Chronic Pain Meeting is in
#LasVegas
on Nov 21-23, coinciding with the F1 event! 🏁 Mark your calendars, and snag those early bird registrations! Let's make it an unforgettable weekend! 🎉
@ASRA_Society
4
19
45
18/Question every medical decision. Why this treatment, and not that one? Why this diagnostic test, and not the other? Oftentimes this will lead to engaging discussions with your attending (sometimes they may not know the answer either)
2
0
45
Y’all know I like offering low-dose naltrexone for pts w/ refractory neuropathic
#pain
.
Here is a double-blind, crossover, RCT () showing similar efficacy+superior safety vs amitriptyline for painful
#diabetic
neuropathy.
#LDNforPDN
(it rhymes😀)
4
14
45
Grateful to have
@Ropivacaine
as our Grand Rounds speaker
@MayoAnesthesia
. Thank you for sharing your expertise with us!
2
4
44
Studies are all over the place on side effect rates from spinal cord stimulator placement
Here are pooled rates you can share with pts on hematoma risk
👉🏾Neuraxial hematoma: 0.32%
👉🏾Pocket/subq hematoma: 0.59%
👉🏾Total risk of any hematoma: 0.81%
#MedEd
1
9
44
Good luck to all applicants interviewing for
#pain
fellowship!
I want to share my thoughts on the Mayo Fellowship Program (Rochester) led by
@SMoeschlerMD
I am biased, but I loved every moment of fellowship and want to inform candidates as to why.
🧵
@MayoAnesthesia
@MayoAnesRes
1
6
44
Do spinal cord stim “holidays” work?
👉🏾~19% had loss of efficacy from habituation
👉🏾After “holiday”, ~30% pain relief
👉🏾Responder rate ⬆️ from 0% to 57.5%
Bottom line: don’t abandon SCS if habituation occurs; consider SCS holiday
1
8
43
Our article in
@JAMA_current
on the Hara et al paper comparing SCS vs placebo.
We critique some flaws in the manuscript – lack of washout period, different waveform paradigms used in trial vs implant, protocol violations.
@NANS_ION
@nasir418
@VwaireO
2
12
42
13/Many academic programs will have free educational resources (e.g., with access to many free textbooks, UpToDate, etc). Make sure to ask the librarian or residency secretary for these resources.
2
0
41
10/Develop good documentation habits and find ways to optimize this (e.g., using smartphrases). Clear and concise charting can save you time and prevent errors. Expect your attendings (and your patients) to read your clinic notes.
2
0
42
We should place more emphasis on pt
#satisfaction
as a PRIMARY outcome in
#research
+
#clinical
care. At the end, that is what we strive for in
#pain
medicine - “are you satisfied w/ ur care”
Great team effort on this article w/
@jonhagedornmd
@JoshuaRomeroMD
@ChrisHaDO
0
4
40
11/Always make time to stay updated with the medical literature. Get an app that provides a summary/abstract of up-to-date articles.
3
0
41
I always counsel my mentees and trainees that there is no need to seek validation for academic accomplishments or clinical work. Just keep trying your best and importantly believe in yourself. That’s what counts.
1
5
40
Picture speaks for itself.
Vaccines work.
Great to collaborate on this publication in
@IARS_Journals
#COVID19
#MedEd
#MedTwitter
#Vaccine
@alvie_barr
1
11
39
Sedimentation of lumbar nerve roots is normally seen dorsally on supine MRI
In patients with lumbar spinal stenosis, sedimentation is rarely seen (positive "nerve root sedimentation sign")
1
8
40
'Diagnostic' block prior to peripheral nerve stimulation is a good 'diagnostic' tool, but is not a good 'prognostic' tool. Our study shows that diagnostic blocks don't predict long-term relief
#neuromodulation
@SMoeschlerMD
@nasir418
@JayKarriMD
2
10
39
Dr. Dare Olatoye giving an amazing and enlightening talk today on Racial Disparities in Pain Medicine at the SIS Conference in Washington DC.
#race
#bias
@MayoAnesthesia
@SISPhysicians
0
5
39
Remember, as clinicians, your time and energy are precious. It's crucial to say no to academic requests that don’t align with your goals or values, even if they come from powerful figures. Prioritize what's best for you and be selective. Your future self will thank you.
4
6
38
15/If you are planning to apply to a future competitive subspecialty/fellowship, consider starting early to boost your application (e.g., seeking research opportunities, networking with subspecialists, etc)
1
1
38
For those who missed the Basics to SCS webinar by
@NANSRFS
, here is the YouTube link:
@RushnaAli6
@VwaireO
@BrandonSmith_MD
@Dr_Ankur_Patel
@MayoAnesRes
@MayoPMRRes
2
11
38
Important work from
@DrCwoods314
and his team
Disparities and inequities among racial and ethnic minorities is prevalent in pain medicine
#Race
#Pain
#MedEd
3
13
37
😭😭😭I’m back in Rochester MN after spending two weeks in Maui… Never thought I would say I’m freezing in 40 degree weather. Until next time Maui.
4
0
38
11. There are many peer-reviewed articles out there that can guide you on how to write your first paper:
Here are some examples👇👇
1
12
38
Lumbar spinal stenosis is prevalent! We demonstrate that only 4 of 199 pts (~2%) who underwent MILD and/or Superion procedure needed lumbar spine surgery when followed for two years.
#pain
#spine
#surgery
@jonhagedornmd
@doctdeer
@abhishekyadavmd
0
9
36
Our latest paper is a FREE open access resource providing updates and treatments for Complex Regional Pain Syndrome
#CRPS
Here is the link:
1
10
36
Mentor Tip: Celebrate your success, but don't forget to celebrate your mentee's success even more! Their achievements reflect your guidance and support. Lift them up, cheer them on, and revel in their victories.
1
2
36
⭐️ Resident Dr. Jennie Eller presenting on
#pain
and analgesic use in medically underserved areas
#ASRAFALL22
Congrats on being selected for “President’s Choice Abstract”
@NarouzeMD
@MayoAnesthesia
@MayoAnesRes
2
4
36
#Residents
#Fellows
in anesthesia, PMR, neurology, and neurosurgery passionate about
#neuromodulation
, consider applying for leadership positions in
@NANSRFS
Openings for Vice Chair, Mentorship Liaison, Research Liaison, and Diversity/Equity/Inclusion Officer!
@Dr_Ankur_Patel
0
15
33
🗓️The FIRST spinal cord stimulator was implanted on March 24, 1967 by Shealy
💡 I propose that we call March 24 National Neuromodulation Day.
... And let all pain physicians and neurosurgeons have that day off as a holiday
0
3
35
I am thrilled for the upcoming
#ASRAFall23
conference! 😃 Grateful to be part of a society that warmly welcomes and embraces early career physicians. Can't wait for the knowledge and connections that await! 🙏
@ASRA_Society
Have you registered for
#ASRAFALL23
yet? Hear from
@Ryan_S_DSouzaMD
why this meeting is not to be missed! With hot topics like AI, precision medicine, and DEI, this will surely be a memorable event. Early-bird ends Thursday, September 28! ➡
0
8
28
0
8
35
17/Just try your best and don’t compare yourself with your other co-residents. Everyone has their own strengths/weaknesses and different training backgrounds
1
2
34
14/Network early with professionals in your field such as during conferences. Building connections can open doors to opportunities (e.g., research collaborations, job openings, etc).
1
1
34
Pro-Con Debate on Perioperative
#Methadone
!
I chose the pro side and present my views in this Article of the Month
@IARS_Journals
Free access along with link to podcast recording below:
Fun debating with
@LKDunnMD
0
12
34
Excited to announce my new role as Social Media Editor for
@RAPMOnline
🙏Huge thanks to
@sites_brian
@dr_rajgupta
@ESchwenkMD
😀Thrilled to collaborate with Editors
@blockergirlMD
@alopipatelmd
in the journey ahead!🚀
4
1
34
Congratulations to those who matched today! To those who did not match:
👉🏾it's not the end, but a new beginning! 🌟
👉🏾The SOAP program offers a second chance to find a match.
👉🏾Stay resilient, hopeful, and keep pushing forward. 💪
Medicine is life-long learning
#SOAP
#Match2024
0
3
34
Has anyone read the FIRST case report on spinal cord stimulator implantation by Shealy/Mortimer/Reswick? The article is free and very cool. They even tell you the date/time stimulation was started.
Link:
#neuromodulation
@nasir418
@JayKarriMD
@RushnaAli6
4
4
33
Thrilled to be on this panel w/ Dr. Christy Hunt
@JayKarriMD
@nasir418
@DoctorSivaMD
at the “Big Data in Neuromodulation” session! As we navigate the future of neuromod, harnessing large datasets is pivotal for groundbreaking research. 📊🧠
#NANS2024
#BigData
#Neuromodulation
0
6
31
Grateful for the opportunity to volunteer and serve
@ASRA_Society
🙏
It’s an honor to contribute to such a premier organization dedicated to advancing pain management and regional anesthesia.
As
#NationalVolunteerWeek
comes to a close, we wanted to give one last shoutout to all the volunteers that make
@ASRA_Society
possible! From committee members to SIG leaders, mentors, researchers, and more - thank you!
0
10
16
0
3
32
Are you a med student, resident, or fellow who has never done a meta-analysis/systematic review? It’s never too late. If you want to learn how, check out 👇
Part 1
Part 2
Both are free. My mentees have used it as a guide to publish
0
9
32
🎉 Thrilled to share that my incredible research mentee and future pain fellow, Tyler West, received a prestigious research award during residency graduation for his outstanding academic accomplishments in research and publications!🌟Congrats Tyler! 🚀👏
#ProudMentor
@MayoAnesRes
0
0
31
The more I work in pain medicine and grow older, the clearer it becomes: our greatest impact lies in educating the next generation. Can’t wait to work with the next resident/fellow class.
1
3
31
16/All residency programs have an in-training exam (with a percentile score). For those applying to competitive subspecialties, these scores can be important so I recommend to start studying early
1
0
31
🌈 Still a believer in Low Dose Naltrexone
#LDN
for generalized pain! Recognizing it's not a one-size-fits-all, as responses vary among patients. 🔄 Here are some exciting analgesic outcomes in our study highlighting potential of LDN! 📚💊
FREE access:
1
8
30
⚠️I often feel like CRPS and cluneal neuropathy are overdiagnosed. I see neuromodulation companies pushing these indications especially PNS for cluneal neuropathy.🚫 Precision in diagnosis is crucial for effective treatment
@nasir418
@JayKarriMD
@VinnyFrancioMD
@MateuszGraca
4
1
31
Success often attracts criticism. It’s human nature. Don’t let it derail you. Focus on improving yourself and meeting (or surpassing) your own expectations, not others’ expectations. Stay true to your path and keep pushing forward. 💪✨
1
4
31
Simply put, most meta-analyses on spinal cord stimulation are POOR quality
We discuss the statistical and methodological quality of existing meta-analyses
Link to free article:
@nasir418
@JayKarriMD
@Royce_Copeland1
@MayoAnesthesia
#Neuromodulation
🧵
10
12
30
Reminder: It's easy to get caught up in comparing ourselves to others, but staying true to our own journey is where real growth happens.
3
1
30
Our own Dr. Pingree representing
@MayoAnesthesia
in his talk about real world outcomes using
#PNS
with sustained efficacy of ~50-60% at 24 months in responders following 60 day treatment with
@sprintpns
.
#ASRAfall21
@SMoeschlerMD
0
4
28
Thanks
@RAPMOnline
for the feature. My responses to questions on how to get involved with editorial work, impact of RAPM, tips for submitting authors, and my proudest career moment can be found here:
2
2
30
Had a blast💥at
#SanFrancisco
! Fun catching up w/ friends + learning updates in
#pain
. Thank you 🙏
@magedguirguis1
@MagdaAnitescuMD
@dr_tinadoshi
@meredith_barad
@eckmann_max
@DElmofty
@AmyPearsonMD
@KohanLynn
and other co-chairs for organizing an amazing
#ASRAfall21
conference!
1
3
30