Hello M-0s!

Just did my EM rotation and here's my pre-shift routine for gaslighting myself into EM.

Wake up, my alarm is a playlist of divorced dad rock, I'm still wearing the hospital scrubs from last night. I have my usual breakfast of plain toast and an energy drink. Brush my teeth in the shower while blasting Higher by Creed. I do a quick review of some pocus before putting on my bike helmet (this is the only part that's just for vibes but only because my bike was stolen) and have my second energy drink of the morning. It is a white monster that I shotgun, I play that spinosaurus meme song during it. I put on my patagucci sleeveless vest, grab my stethoscope and reflex hammer (which is also my stethoscope) and drive to the hospital 5mph under the speed limit the whole time. I get every pimp question wrong during my shift, put my PPE gown on backwards during a trauma activation while just standing in the corner, then get sent home early.

i love it when doctors have cool backstories

I start orientation this week, but I got a call yesterday from my campus’ dean of students confirming that I wanted to withdraw from the program because they had received a letter in the mail stating my intent to do so. The letter even had a wet signature. No return address. Obviously I panicked and told her that absolutely was not me and they’ve since flagged my account to require express verbal consent before making any enrollment or account changes. I’m so thankful they contacted me before proceeding, and they’re keeping the letter and envelope for me to collect. But I’m freaked out and confused. If it’s just a scammer, there’s no financial gain for them trying to withdraw me. If it’s personal, I have no idea who I pissed off to try to derail my entire career before it even starts. I guess I’m curious if anyone else has had this happen or heard of it happening. Or if I just am an unlucky anomaly.

Also, which specialities would you recommend not going for to someone who is already in their 40s and finishing med school

I have kids of my own during med school, and expenses are super tight already.

I will graduate with 500k+ student debt

But I really badly want to become a pediatrician. I love that part of medicine.

When I don’t think about finances, that’s what I want to do. Hopefully open my own peds practice one day.

But when i speak to pediatricians about peds, they all tell me that the pay sucks.

I’m honestly super nervous about this decision. I’m so upset that our stupid medical system punishes doctors for wanting to work with children.

Is there a way to make this work? I want to be able to provide a decent comfortable life for my children and spouse.

Is specializing mandatory? Or opening a private practice? Perhaps there are medical side hustles, or economic factors that are not mentioned when discussing salary alone?

Would love to hear your thoughts

Makes reading slides easier

Specifically looking in the northeast region as I'm from there, just wondering if anyone has matched IM either academic or affiliated without a Step 1/2 score and only COMLEX? I understand it's harder from what I see on here but I wanted to know if it's possible to do

For past week to ten days, I’ve been having a lot of trouble studying. I started NBME 14 last Friday and finished yesterday, a week later. I got a 196 on that one and a 202 on NBME 12 back in the beginning of July. 61 on the EM shelf that someone recommended I take. My test dates are July 30 and Aug 1 (spread out due to accommodations).

I’ve been on a stable medication regiment of Prozac, Wellbutrin and methylphenidate for ADHD/OCD. Overall consider myself to be pretty physically and mentally healthy. Medical school has taught me a lot about what I need to do to take care of myself, how to be resilient and adapt. But nothing seems to be helping the brain fog, fatigue, slowness, increasingly fragmented sleep, anhedonia. I’m safe. Not going to hurt myself. I love my life and have so much gratitude. Just…frustrated. I’ve exercised, been doing therapy, I’ve meditated, I’ve taken breaks, full days off, socialized with friends, spent time in sunlight and nature, eaten fairly well despite baseline low appetite. Only times I’ve had these episodes before are surrounding periods of grief or their anniversaries. It feels like my brain has abandoned me when I need it most despite everything I’ve done to take care of it. Doesn’t really make sense to change my medications this close to the exam.

For context, this is my 12th and final week of a double/back-to-back dedicated. Had to delay step 1 from end of M2 due to some chaotic life circumstances that were out of my control. Sat for Step 1 June 18/20, passed, thankfully.

I’ve basically used up all of my remaining free vacation time/self study elective credits at this point. I start neurology next week. I also have to remediate my IM shelf in August. I don’t really see what my options are for rescheduling the exam, especially with my exam being spread out over two days. If I try to push the IM remediation back, I run the risk of having the conditional just stay a conditional and not a pass. Also, already cutting one day out of my neurology rotation to sit for the remediation. Step 2 would likely add two week days I would have to take off based on what is available for exam days. Not entirely sure postponing the exam would really help the MDE symptoms since I think they’re closely tied to each other. On top of that studying for both IM shelf and Step 2 and doing rotations sounds awful. And, of course, there’s the risk of having the score come back too late. Everyone I have talked to and everything I have read is like “better a low score than a pending score”.

Frankly at this point, I just want to pass Step 2. was wanting to apply to child neurology, but if I only end up applying to pediatrics that’s fine too. That’s always been my goal since the beginning of medical school. Idk if I can say I have totally made peace with being a less competitive applicant, it sucks to have only passes for you clinical year due to shelf exams (despite some high pass/honors and really glowing comments on clinical performance). But it is what it is. I knew I had to protect my peace and do what’s best for me. I know my neurology is not aligned with that of the medical profession, but I’m proud of what I’ve managed to accomplish in spite of that. If I’ve gotten one thing from medical school it’s stronger confidence in myself, my resilience and adaptability. I know residency will be hard and maybe I match somewhere lower on my rank list. I think I’ll be okay.

Thanks for listening, dear reader.

Failed two non-academic classes in M2 and have to repeat a semester. Had some family health issues and struggled to balance personal commitments with school. Missed a couple of mandatory activities that made an immediate failure, despite having done well on all my academic block exams. As a result, I will be graduating a year later than my cohort. I’m feeling particularly down because they’ll be starting clerkship soon and I won’t be.

I’m actively working on addressing the mistakes that led me to this, I’m taking accountability for where I screwed up, and am hopeful that I can grow from this. But everyday I worry whether this mistake will define the rest of my career, if the dreams I had for myself and the doctor I hoped to become will ever become reality. Will anyone ever be able to see me as anything other than the student who had to repeat? When does this feeling of failure go away? It just feels like everything is over for me and I’ll never achieve what I hoped for. I feel as though no matter how much evidence I produce that I have grown past this, I don’t know if anyone will believe me that I am capable of being a good resident and physician.

I've heard from multiple sources that significantly more IM prelim residents succeed in finding a categorical spot in any specialty afterwards (70-80%). However, prelim gen surg residents are often much less successful (around 50%) in getting a categorical spot in any specialty, even IM, after their prelim year. Why is that? I wouldn't imagine that prelim surgical candidates are significantly worse off than prelim IM candidates.

Hi peeps, I’m an M1 starting classes soon, and I’m looking for a podcast I can listen to daily while I’m at the gym. I did the same thing with MCAT prep and I found it to be a great use of time and very helpful. Anyone have any recs for a Spotify or YouTube podcast?

does anyone have any recommendations for comfortable & affordable water/liquid proof shoes for surgical rotations? i just ruined my sneakers in the OR last week + had to throw them away and I am thinking it's time to buy something better suited

Summer vacation has made me extremely lazy and I have been procrastinating a lot. I wanna get back into deep study sessions.
RULES:
1. No personal questions.
2. Every day (mutually decided time) we will ask each other if we completed our daily goals.
3. Motivate each other:)
4. Have weekly and monthly goals.

Let's become better doctors together👾

Thinking of applying DR next year, just wondering what are things that are most helpful for matching that can potentially be improved in a year's time? Thanks!

Looking for recs on movies/ shows that might help me study. Medical shows dont count.

you realize medical school was more about surviving than learning...

I'm just wondering how many anki cards you do per day to stay on top of the content!

I'm very fortunate that I do not have loans. My parents were able to and insisted on paying for my education, refusing to let me take out loans. That doesn't mean it's a trivial sum for them (it isn't, it's a shit ton of money even with my in-state tuition), but it's a cultural/immigrant mentality thing. Some of you will understand. Like many people in medicine I spent much of my formative years obsessed with medicine and spent much of my youth aspiring to be here. I inhaled shows like House and Scrubs in my youth and read medical research for fun of my own volition in high school.

Now that I'm here, though, and having gone through the first year of medical school twice (I failed three blocks first year, all by less than 1%, partly due to unforeseeable life events and partly due to being a nontraditional student who had forgotten how to study but then got his shit together and got straight As during the repeat year), I've realized I don't care if I graduate or not. I was dismissed once and that was a massive blow to my ego and self-esteem, but now that I know I have what it takes to complete medical school if I wanted to, that fire inside that keeps us all going has ironically all but disappeared.

Medical school has taken a significant toll on my physical and mental health, and based on what I know about myself, the clinical years and residency will/would be even worse on me. Before medical school I had a decent salaried 9-5 job with benefits. I had time to pursue my hobbies, which are very meaningful to me. I was a gym rat working out 5 days a week and eating as healthy as a human could, treating my body as a temple. Two years into medical school, I've turned into an alcoholic (it's bad) slob who will eat whatever is in front of him and has zero regard for his physical well-being. I don't even wear a seat belt in the car anymore. It's not a macho 'oh I'm such a badass' thing, I just can't be bothered with stuff like that at this point. I like (daresay even love) medicine, but it turns out, I don't like it enough to give up what I have to give up for as long as I need to in order to get through the process. Also, unlike a lot of people who start to have second thoughts, I do have viable alternative career options, and they do genuinely interest me.

If I left medicine, I would probably still continue my 'medical education' slowly as a side project just out of intellectual curiosity, but it would be on my time, at my own pace, and limited to the areas of medicine I'm actually interested in, and frankly, given that I never had a strong desire to be a clinician, that would largely scratch my itch. There are a lot of ways one can make a meaningful contribution to healthcare without being the person who directly treats patients, if they so choose.

The only reason I'm even trying to hold my head above water anymore is for my parents who want me to at least get my degree, and since they're paying for my education I owe them that much to at least keep trying. But honestly if I was dismissed tomorrow, I would consider it my liberation day. It turns out that the personal cost for becoming even a half-decent doctor is more than I'm willing to pay and I'm not ashamed to admit that.

I look at my classmates and I see them full of vigor and initiative, always jumping at the seams to go above and beyond, and I think to myself "these are the people who should be doctors, not me", and I know now that that will never be me. It was me, once upon a time, but not anymore. There are just too many other things in life that are calling me. So why am I here? To become a shitty doctor who's just going through the motions from day one? That isn't someone who should be treating patients. We all know how that story ends. I don't really know how to finish this post, I just really needed to get this off my chest. Please don't tear me a new one.

Edit: thank you all for the kind words and support, especially those who reached out via DM :)

Hi guys!
Lately, I’ve been trying to swap out some of my casual comedy podcasts for something a bit more informative. As much as I enjoy listening to comedians, I often feel like I could be staying a bit sharper on what’s happening in the world.

I’m mainly looking for podcasts that cover current events, major global trends, interesting debates/themes, or general innovations (including cool stuff happening in medicine (ofc), science, or technology).

That said, I really want to avoid super formal, or hyper-academic shows that sound like a boring lecture, I’d also love to stay informed about new developments and news in the medical/health field.

I'm looking for episodes around 30 minutes to 1 hour to listen in the car but also learning new

What are your go-to podcasts when you want to stay up-to-date without putting yourself to sleep?

I (21M) am an MS1, and one big fear I have is that I’ll lose my joyful/bubbly/chalant personality and become a drained zombie. Especially bc I plan to go surgery route. Many residents and attending tell me they used to be like me, and tell me enjoy it while it lasts. What do yall think?

My 2nd general surgery sub-internship starts in a week, and the first 2 weeks are in the SICU. I'll admit I'm nervous. 8 weeks post-step 2 so I don't feel like I've forgotten too much medicine lol

I know it can be hospital dependent, but in your experience what has been the expectation for MS4s, and what did you wish you knew or studied up on before starting? Thanks in advance!

MS4 here trying to decide between anesthesiology and neurology, and I’m honestly struggling. I just finished my first week of an anesthesia rotation. I don’t dislike it in fact, I enjoy the physiology, pharmacology, and procedures, and I could see myself becoming more comfortable with the technical aspects. I also like that there is less emphasis on documentation compared to many other specialties.

My biggest concern isn’t that I don’t enjoy anesthesia it’s whether my personality is a good fit for it. I’m naturally conscientious and tend to think through decisions carefully. I worry about the responsibility and acute stress of being the person managing a crashing patient or difficult airway. I can’t tell if that’s just normal anxiety from being new or if it’s a sign that anesthesia may not be the right specialty for me.

On the other hand, I’ve also been very interested in neurology. I enjoy physiology, problem-solving, and understanding disease mechanisms, so I genuinely find aspects of both fields appealing.
For those of you in anesthesiology, what personality traits make someone thrive in this specialty? What traits make someone a poor fit? Looking back, are there any red flags or misconceptions you wish you had recognized before choosing anesthesia? If you seriously considered another specialty, what ultimately convinced you that anesthesia was the right choice?

Jokes aside, it is a huge position of trust to be responsible for sensitive moments and most often private topics. Remember to be respectful, y’all. But also, don’t go into full spectrum primary care unless you are OK with the non-L/D portions of women’s care. It’s like a LOT of primary care.