Josh McGough, MD

Josh McGough, MD Father | Husband | EM Doc | Trying My Best

08/20/2026

Just say SOMETHING. It’s ok to be wrong - I’m wrong all the time. We just want to make sure there are GEARS TURNING in that head of yours!

08/18/2026

Replying to Great question. OWNERSHIP is the difference - any M2 can walk in and ask 100 questions and read it off a paper.

We work as a team in the ED - if you can show me that you care about your patient, relay updates to the team, and help lift up our colleagues (RNs, RTs, SW…) you’re good in my book.

Keep the questions coming!

08/17/2026

Evergreen things to say as a med student on an audition rotation - what else would you suggest?

08/15/2026

Medicine does a good job at making you believe there is NEVER a reason to slow down.

08/13/2026

Explain medical topics like a regular guy: pericardial effusions

It’s often the SPEED the fluid comes more than the amount. If you have CKD, cancer, or are old, you may have fluid slowly accumulating for years! That’s often ok.

If you are young, small fluid gained fast can be BAD.

New to POCUS? If IVC smol, it’s not tamponade. If IVC big, check pulse pressure. If pulse pressure smol,check for diastolic collapse on M mode. Don’t know how to do that? Call an adult or google it!

You’re doing great.

08/12/2026

I’m sure it was well intentioned to make results immediately available. But they’re often not helpful, and often not even relevant to the visit you came in for. A K of 3.4 and a K of 7 both flag red. The color tells you nothing about which one matters.

08/08/2026

Walk your patients - people should be able to do things as they LEAVE the ER as they did when they enter!

Can you walk, eat, and p**p? You should continue being able to do that when you leave!

08/06/2026

We have so little training for some of life’s most devastating moments.

Just acknowledge it - say NOTHING, “wow can we pause for a second?”, etc

I’m not asking for anything huge, just give it an extra 15-30 seconds. Your patients will respect you more for it, or at a minimum feel like you care!

08/06/2026

You’re not gunna make it, and other things that may be “true” but certainly aren’t the kindest way to say things.

We learn a lot in training how to DO things, but not to SAY to people. To grieve with them. To pick up on their facial expressions, that they have no idea what we’re alluding to, and stuff like that.

Those are the things I love to talk about.

08/03/2026

ABG vs VBG

1. Do you NEED an A stick? Are they not oxygenating their tissue? Methemoglobinemia? CO? Post ROSC? Trying to risk stratify for ECMO?
2. CO2 can be reliable from a VBG, consistently 4-6 higher than ABG
3. Same goes with pH
4. Follow your institutional guidelines for stat chemistries!
5. If you need MANY ABGs, consider an A line

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Stony Brook, NY

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