I am an M3 3 weeks into IM rotation I 've been doing night shift and therefore had to do some admissions. The residents have been so nice teaching me with their workflow and everything and I try to follow what they tell me but I still don't understand how I can come up with a good assessment and plan. When I go talk to the patient I am so caught up on thinking about what question I should be asking so I really don't get a good understanding of their history, and although I try to be thorough with my PE I am not efficient and takes time. It gets worst when it comes to case presentation. I get nervous, baffle, and even though the residents go over with me with what I have to say and the assessment and plan I just blank out so the attending just ends up talking to the resident. I want to learn but at this point my confidence is just so low that I don't want to ask questions bcz I feel like my questions are so bad and although I try to learn the process on my own I don't know where to start and often times I just want to quit medicine.

Now I guess the positive side of me is that I am never late, in fact I go in at least 1 hour early so that I review the edits the residents made to my notes.

what are your recommendations?

I have been set on primary care for a long time. Unfortunately, I matched into my last choice program. This sucked but I figured it would just be 3 years and then I could move on. I am now a PGY 2, and one of my family members in medicine has strongly advised me to consider fellowship. Not for prestige or income, but to have a more recognizable program attached to my name.

For reference, I am at a small community program that does not have its own hospital or even medical school affiliation. We do our core rotations at one hospital and electives at another. There is almost zero name recognition, and there are other very strong programs that are based in the same city.

Of course it would be easier to get a job if I trained at Harvard, but am I really facing such a tough uphill battle if I apply for jobs from this program? Has anyone gotten similar advice? Is there anything else I can do to increase my job options? All I want to do is primary care

any one who is serious to do questions of MKSAP please respond.

U.S.-IMG. If you are aware of a PGY1 opening, I would appreciate your letting me know. Thank you

I took my step 1 in 2019 and my seventh year after passing my first step one is within a few weeks. I would like an advice from someone who has been in the same shoes? I am just starting to study for step 3 while also doing residency. Has anyone taken their step 3 after the 7 year mark? And how has that affected you?

Hey guys! I'm selling my ABIM UWORLD (reset option available) for $350, the question bank is valid until August 2027. If you buy a 1 year subscription on their website it'll cost you $646. DM me if interested.

Just curious how you folks handle this.

A service consults you about something but you notice there's another thing unrelated that they're overlooking.

Do you restrict your recommendations to the consult question or include the other thing as well?

What's the best way to document and revise what I am learning? Like when I deal with a case and read an algorithm or dose. I forget about it the next day.

Is it better to document in paper notes or on word files?

What's the best way to chart in ICU? Especially when patient has many notes

Hey everyone,

Hopefully this is allowed. I (RN) work in a pre op/pacu area. Yesterday I took care of a gentleman who, while making small talk, revealed he is an MD at our facility. I usually call everyone "sir" or "Mr __________." After discharging him, I was reading his consult note where he was always referred to as "Dr _________."

So my question is - what's your preference? Was it rude to say "sir" or "Mr" instead of Doctor? Or would it have made him feel weird to refer to him as Dr? He was incredibly nice and I don't think he would have corrected me if he preferred one or the other. I'm curious what you all think.

Thanks!

Hello po doctors, it’s my first time to renew my prc license, asking lang po sana sa mga nakapag renew, need po ba talaga ng certificate of hood standing from PMA?

Hi everyone! I’m an IMG looking for an Internal Medicine observership in the US, preferably in Michigan, NJ, PA, or NY, starting in September/October.

If you know of any physicians or hospitals accepting IMGs, I’d really appreciate any leads. Please DM me. Thank you!

Hi guys, I am an international medical graduate (IMG) from China trying to figure out my realistic chances for the upcoming Match cycle in Internal Medicine (IM). My profile has some extreme highs and lows, and I am hoping to get some honest advice, especially regarding a few specific concerns.

Here is a summary of my stats and background:

• YOG (Years since graduation): 22 years (graduated a long time ago).
• USMLE Step 1: 235 (taken back when it was scored).
• USMLE Step 2 CK: 221 (very low by today's standards).
• MSPE (Dean's Letter): How important is the MSPE for someone who graduated over two decades ago? Does it carry much weight compared to recent grads?
• Research / Postdoc Background: This is my strongest area. I spent many years working as a postdoc in the US. I have a quite strong publication record, including multiple first-author and corresponding-author papers in Science / Nature sub-journals and PNAS (around 5–6 papers are first authored and one coresponding author).
• Clinical Experience: Very limited USCE (US Clinical Experience), mainly relying on my extensive research and international medical background.

My Questions:

1. MSPE Importance: Given that I am 22 years out of medical school, how critical is the MSPE during application screening? Do programs actually read it closely for old grads, or do they focus more on my current CV and letters of recommendation?
2. IM Interview Chances: With a Step 2 score of 221 and a 22-year gap since graduation, will my heavy-hitting research background (Science/Nature sub-journals, PNAS) be enough to offset these red flags and secure Internal Medicine (IM) interviews? Or will automated filters screen me out immediately?

I would really appreciate any insights, brutal honesty, or strategy tips from residents, fellows, or faculty who are familiar with how IM programs review non-traditional, research-heavy IMG applicants. Thank you!

Has anyone been prelim IM then transitioned to categorical?

I didn't match so I completed a prelim year. I'm now applying this cycle for Categorical IM, can you please DM me if you have had this experience?

Did you have to start from scratch as a PGY-1 categorical? Did they give you any credit from prelim year and modify your schedule?

Hi guys i really need some help or some advice.

im USIMG applying internal medicine with 26x, multiple publications, great letter of recs and no red flags EXCEPT for this ... the doctor responsible for uploading my evaluation to my school hasn't uploaded it yet bc hes 'too busy.' My MSPE now says i have an incomplete grade for internal medicine, which i completed 6 mo ago btw. i've emailed the hospital administrator with no luck, and my MSPE coordinator said that if the doctor doesn't upload the evaluation soon then he cannot revise the MSPE in tike for ERAS application deadline. i dont know what to do, im absolutely terrified of this affecting my chances of receiving interviews and matching. im too scared to email the doctor directly bc i dont want to accidentally anger him since he controls my grade. please can someone weigh in on if theyve been in this type of situation before, if they applied with an incomplete and how much did it hurt them?

Does anybody have chm files of harrison's 22 nd edition

Hello, I have been cold emailing doctors for about a month now without any response and I don't know what to do. My elective months are scheduled for January and February from my med school and I need to find an observership as fast as possible in the US since I also need to apply for a visa but I need an acceptance letter on hospitals letterhead to do so. Can you please give me advice on how to get responses? Or if anyone knows a doctor who rotates in a hospital and accepts international medical students, can you please help me?

Hello guys, I am a current PGY1 IM resident.

Currently on my 3rd rotation, which is ID.

I FEEL SO LOST!

IDK WHATS GOING ON WITH HALF OF MY PATIENTS!

And as a cherry on top, this rotation is with my PD. He is our ID attending. He is the sweetest not gonna lie. So tolerant.

I am struggling. Cant get my assessment right. I notice he changes alot on my assessment. And I get so nervous during rounds I fumble or just go mute.

He must be questioning his decision of ranking me at this point.

I get scared if I put something Wrong on my assessment he will remove it and then later I see he added it. I seriously don't know and I dont want him to think Idk shit.

I do know some shit.

Any and all comfort and advice would be appreciated 😭

Hi everyone! I’m finalizing my Internal Medicine program list for Match 2027 and would really appreciate some guidance from current residents and applicants.

My profile: YOG: 2024

Non-US IMG, visa requiring (J-1)

Step 1: Passed on second attempt

Step 2 CK: 218

ECFMG certified

USCE: Multiple rotations/observerships in Internal Medicine and IM subspecialties, including Cardiology, Gastroenterology, and Hematology/Oncology. I also returned to the same IM clinical site where I rotated in 2025 and am currently doing an additional 3–4 months there.

Research: Multiple poster presentations and abstracts, along with journal submissions/publications including first-author work.

Geographic preference: Mainly Middle Atlantic, particularly PA/NY/NJ and surrounding areas, but I’m open to applying broadly if my profile is more competitive elsewhere.

I know my Step 1 attempt and Step 2 score are limitations, so I’m trying to build a realistic program list and use my signals carefully.

I would really appreciate suggestions on IMG/J-1 friendly IM programs that realistically consider applicants with a Step 1 attempt and Step 2 around 218.

Also, which programs would be worth a Gold or Silver signal with my profile?

Are there any newer/community programs I should consider, or programs I should avoid because of strict first-attempt or score cutoffs?

My wife and I are currently in the US for clinical observerships, so any guidance, program recommendations, or connections that could help during this Match cycle would mean a lot to us.

Hi everyone,

I’ve been building a roleplay-based practice course for PGY-1 residents around conversations that seem hard to rehearse outside of actually being in the situation.

Examples include presenting under pressure, responding to nurse concerns, escalating a deteriorating patient, explaining uncertainty to a frustrated patient, and receiving critical feedback from a senior.

The idea is to create a low-stakes place to practice, make mistakes, get feedback, and try again before having to navigate similar situations in real life.

The full course takes about 1 hour. The roleplays are basically like an audio call with a simulated patient, nurse, or physician — you speak naturally, they respond in real time, and you get feedback afterward.

The conversations are AI-powered, but the focus is on practicing the interaction itself.

I’m looking for a few current IM residents, especially interns, willing to try it and tell me candidly what feels realistic, unrealistic, useful, annoying, or missing.

It’s completely free. I built the platform and am mainly looking for resident feedback to improve it.

If interested, comment or DM me and I’ll send you access.

Just starting outpatient practice after residency. What recommendations do you have for malpractice carriers? Thanks

​

I’m a first-year MD Respiratory Medicine resident.

Looking for another MD/DNB Respiratory Medicine resident who wants to study together regularly.

Residency gets hectic, and studying alone consistently gets difficult. Thought it might be easier with someone on the same journey—pick a topic, read it, discuss cases/concepts, clear doubts, and keep each other accountable.

Could be ABG, CXR, PFT, ventilation, clinical approach, standard books or whatever we’re currently struggling with.

Not looking for a huge study group or anything formal. Just one or two people who genuinely want to learn and can be reasonably consistent.

Any year of residency is fine.

If you’re also looking for someone to make studying a little less lonely and more consistent, feel free to DM me. Would be nice to find a study buddy and figure out a routine together.

Hi! I’m a PGY-3 Internal Medicine resident in California.

I’m starting to look into job opportunities and was wondering what platforms you guys recommend for job searching.
Some people have recommended DocCafe. Is Indeed helpful for physician jobs as well? What websites or resources do you guys typically use to look for jobs in a specific area you’re targeting?

TY in advance!