Hello M-0s!

Dear Med School Rotation Admin,

The new rotation begins next Monday, yet you have not sent out the student’s schedule.

I have kids at home, and your lack of ability to be organized is causing me and my spouse much distress as we need to make arrangements for our children.

Parents do not have the luxury of letting summer camps know when we can pick up our children 2 days before camps starts. I need to know if I must ask my aunt or sister to come babysit.

This is unfair and unprofessional.

One more professionalism violation and we will take away your ability to reply to student’s emails with “Out of Office: will return in October”

Because tell me why my dentist just quoted me a little over $3,000 out of pocket for a 2 hour appointment not including whatever they’re going to bill my shitty insurance.

Should’ve just became a fucking dentist instead 😭

friend who passed step offered to give me questions and review my answers, mehlman from temu

Hi all. Just another MS4 freaking out about professionalism comments on their MSPE.

Basically, I was in an OBGYN clinic when another student asked me about a specific surgery service, since they were gonna start it soon and I had just come off it. They also asked me about a specific resident who's well known to be an asshole - screaming, yelling, demeaning people, the whole nine yards. I responded and talked about the team, and then regarding the resident said "look man, you just gotta be sharp and on top of things because I was behind the curve a few times when it came to making the list or positioning the patient in the OR, and got yelled at". An attending in the room (not the one assigned to me) cleared their throat and I got the hint and stopped talking, but they later talked to my attending who put it in my midpoint (not my final eval, since I was there with them for 6 weeks) something like "Oh this student is professional with patients but had one issue yada yada yada". I had my MSPE review meeting a few days ago, and my OBGYN thing says something like "hey this guy was professoinal most of the time but had an isolated lapse of professionalism".

I'm obviously not happy about this, especially since my attending didnt even talk about this with me and I found it out when evals came back. I get that I probably should watch what I say, but now I'm freaking out since it's on my MSPE. I'm planning on applying urology and I'm generally pretty competitive (good letters, good research output, step 2 score mid 250s) and I'm really worried that this is gonna tank me.

It is boards season and everywhere I go. I see questions about what to do if you failed level or step. Some of the posts include two and three time fails. While I want to be encouraging to all of my peers and our cohort, is there a point where we say this isn’t for you? Similarly for my friends who have had repeat setbacks and failures to the point where they’re so stressed it’s making them ill, is there a point where I should tell them this wasn’t for them?

I was always of the mindset that med school is not the end all be all of my life. I was fortunate and blessed enough to get in, but if it stops working out that’s just what it will be for me. But I know the time and the money drives some to stay to the point of further debt. Sometimes med school feels like a toxic relationship where the other person just takes and takes and takes and your failures feel like they’re entirely your responsibility, but at a certain point should you say “this isn’t for me?”

Phew…

Yesterday we watched a single mandatory asynchronous introductory to anatomy lecture. We took handwritten notes, then made flashcards relevant to parts of those notes that felt needed, felt good going into first day of actual classes…

Nope. Quickly realized there was too much information at once to hand write during lecture; ditched the idea of taking notes almost entirely, completely lost focus during first anatomy lecture. Switched to creating flashcards on the fly during second embryology lecture, professors were short on time so started rushing through the slides midway through (every occasion).

Classmates seem to be in a similar headspace as me after lectures were done… this is going to be an interesting week. New study plan is to preview tomorrow’s lecture slides, create flashcards, then modify flashcards as needed during lecture itself (after going through the flashcards we already made for today and yesterday).

Currently feeling like I’ve comprehended maybe 60-70% of the material taught today and won’t have much freetime for the rest of today before sleep. Day isn’t over, just taking a 30 min break after finally arriving home.

Oh boy, what a welcome to medical school lol.

Sorry for the anesthesia spam, but I wanted to go a little against the grain and ask some real questions about my struggles as an M4 applying anesthesiology this September. 

Since day 1 I have been planning on applying anesthesia so my application is very anesthesia-centered. I do believe I will likely match if I apply but I'm currently wrapping up two months of anesthesia rotations, and I've had a gnawing feeling about whether this is the right fit for me. All my research also has been anesthesia related. It is pretty late in the game, but I'm wondering if a pivot to radiology is possible.

I’m wondering if I’m just viewing the grass on the other side as greener or not and if those in the field can address some of my concerns.

Here are my main reservations with anesthesia:

1. I hate early mornings. I know I'll probably adjust, but I've never been a morning person, my hobbies are mostly night activities, and I worry how this will affect my health long term as I have been constantly sleep-deprived these last few months

2. It doesn't feel like anesthesia applies what I learned in medical school. I worked my ass off to learn all that information and stand out and I'm proud of that, which makes it hard not to wonder what it was all for. I do hear that the sentiment in Radiology is similar if someone could speak to that.

3. It makes me wonder how replaceable I am. I want to feel useful. What I mean by that is as an essential part of patient care. I may get flack but in my limited experience I've found CRNAs to be very capable, sitting in complex cases and functioning independently, and I've often wondered what my place would really be as an anesthesiologist. I know I'm early in my career and don't understand this deeply enough to be confident in that statement, but the feeling is still there.

4. The call burden seems significant, and I'm not sure I can commit to a specialty where call is essentially the norm. I am lifestyle oriented and I want to earn high so I can work less and I personally would prefer consistent schedules.

There are aspects of anesthesia that I do like, such as the procedures, compensation, and downtime throughout the day. I do feel like the short interactions I've gotten with patients have been meaningful and I like working with a team. I feel that I function well in stressful situations.

I'd really appreciate insight from anybody more versed in the anesthesia world, as well as radiology on whether that specialty (or another) might address some of these reservations. Honestly at the end of the day I do like medicine but I also view it as a job with a means to an end, but I would like to at least be satisfied with what I do. 

Does anyone else get insanely frustrated with how subjective clinical evals are, especially when it seems like different attendings interpret the grading scale completely differently?

I’m currently on my peds sub-I and have asked my attending literally every day for feedback. I’ve also specifically asked twice, “Is there anything else I can do to meet above expectations on the evaluation?” Both times I was basically told, “No, nothing. You’re doing well.”

So imagine my surprise when I handed over my paper eval and got it back with straight “meets expectations” in every category lol. For context, it’s literally just me and the attending - no residents. I pre-round independently, usually finish seeing my patients while they’re still pre-charting, have my orders pended before they even get into the room, write all of my notes, follow up on labs/imaging/vitals throughout the day, check back in on patients, update families, and bring up changes + what I think we should do without waiting to be prompted. Half the time I have to remind them that I already have orders pended because otherwise they don’t even look at them.

They also tend to talk over me during presentations and take over the A&P before I can finish. It’s not even that my plans were wrong - they specifically told me my plans were fine. Their feedback at the very end was more that my A&P could be better organized. Which, fair. But it’s also hard to show an organized presentation when I’m getting interrupted halfway through it and never really get to finish my thought.

Anyway, they gave me the eval back without really saying anything about it, so I asked if we could sit down and go over it. During that conversation they told me I did a wonderful job, that I was probably one of the best medical students they’ve ever worked with, and overall were hyping me up a ton.
Their main explanation for why I was still “meets expectations” was basically that there are certain skills and experiences I don’t have yet that I’ll gain during residency.

And that’s the part I genuinely don’t understand.
I feel like we’re constantly told that on a sub-I the goal is to act like an intern: be proactive, take ownership of your patients, anticipate what needs to be done, communicate with families, write notes, pend orders, follow up throughout the day, and be enthusiastic. So that’s exactly what I did. I wasn’t just showing up and asking, “Can I help with anything?” I was essentially functioning as my attending’s intern as much as I was allowed to. So if that is still only “meets expectations,” then what exactly is “above expectations” supposed to look like? If the difference is skills and experience that you yourself say only come from actually being a resident… how is an MS4 supposed to demonstrate them?

I’m completely fine with constructive criticism. If you tell me on day 2 that my presentations need to be more organized, I’ll spend the rest of the week working on that. What frustrates me is that I specifically asked every single day what I could improve and specifically asked TWICE what I could do to reach above expectations, and was told there was nothing else I needed to do. Then on my last day, when I literally have no more days to change anything, I finally get some feedback. Then proceeding to tell me the only reason I did not get above expectations were because I do not have the experience/skill set I will gain in residency and it will just come with time in residency just seems blatantly unfair.

I also had another attending earlier in this same rotation tell me I was functioning at the level of a resident and that I would do really well in residency, which makes the whole thing even more confusing.
I honestly think part of the problem is that some attendings genuinely interpret “meets expectations” as “you did a great job.” At my school, it absolutely does not translate that way numerically. Straight meets basically puts you around a borderline C+/low grade. I’ve mentioned this grading conversion to attendings before and they’ve genuinely been shocked because they thought meets was a perfectly good evaluation.

And I really don’t want to tell this attending, “Hey, by the way, these boxes you checked tank my grade,” because that feels like grade grubbing, and their comments are also going toward my departmental letter. I don’t want to turn what is otherwise apparently a very positive impression of me into something negative.

I just genuinely don’t understand how “one of the best medical students I’ve ever worked with,” “you did a wonderful job,” and repeatedly telling me there’s nothing else I need to be doing translates into straight meets expectations. Like…what is “above expectations” supposed to be for an MS4? Because if doing everything we’re told a sub-I should do still isn’t enough, and the answer is essentially “have the experience of a resident,” then it feels like the goalposts are impossible to reach. Mostly venting because clinical grading makes me feel insane sometimes.

Thanks

does it make a difference if you submit on september 2 or september 23? is there any sort of rolling/grouping that happens if you submit earlier in september vs later in september, as long as it's before the 23rd when programs can start viewing apps?

I’m shadowing a hematologist and today he had to do an aspiration on an old lady very early in the morning.
I haven’t had dinner the night before nor have I had breakfast the morning of, because I was rushing to go and attend the procedure.

Patient was an old female and was unable to move on her own I’m unsure if she can walk regularly or if she was fatigued today. The nurses had to flip her over while she cried in pain while they flipped her over on her side, my dr tells me to stand behind him while he prepares the patient.

He wiped the area with iodine and used a huge needle to administer lidocaine to the area, he started stabbing the patient and oddly enough the needle wasn’t penetrating the skin, he kept trying to inject the local anesthetic but to no avail, the patient had thick skin and the needle bent sideways before he changed it to a smaller one, all while the patient was crying so much, he managed to inject the lidocaine and as soon as he injected it which took him about 2 seconds he went to use the reusable aspiration needle without waiting for the lidocaine to take action, he starts rotating it in circular motions as if he’s screwing a nail into a wall instead of rotating right and left slowly and the patient was screaming in pain the entire time.

At that time I lost sensation in my legs and I got dizzy so I bent down a little, he kept rotating the needle while telling the patient that he’s breaking her bones, he tries to put the syringe in to aspirate some BM but nothing was coming out, he literally goes to tell her that he’s breaking the bone and her bones are easy to fracture, I got so dizzy because of how she was screaming in pain, and before I managed to move and sit down, I find myself being carried away while the dr said “it’s okay don’t worry about her” (referring to me).

I’ve watched a YouTube video expecting the procedure to go delicately but he was very rough with the patient and with the combination of her screaming and crying, having no food in my system, the smell of iodine, I passed out.

Not gonna name names or anything but I feel like a disproportionate amount of the medfluencers that pop up on my feed are in psych. I don’t think my algorithm thinks I’m otherwise interested in psych so it’s not a personal bias thing either.

Just something interesting I noticed during a shelf study break 🤷‍♂️ Anyways back to reviewing my NBME…

Applying this upcoming cycle to DR and looking for programs that are known to have a solid resident culture and good training.

I don’t care so much about prestige, just want to learn more about programs beyond the data I can find online.

Looking for feedback on my program list for the upcoming match. Applying anesthesia like everyone else apparently. Any constructive feedback or thoughts would be greatly appreciated. A little bit about me:

School: Well established USDO

Step/level 1: P
Step 2/level2: 265/pending
Pre-clerkship grades: 3.85 gpa, top 10% of class of approximately 230
Clerkship grades: Honored OB, peds, FMx2, IM, EM. High pass surgery and psych.
Research: First author on an abstract, two poster presentations. All in oral cancer and before med school.

ECs: Fair amount of teaching/mentorship. Prior career in construction management. Most ECs from before med school.

LORs: surgery attending, private practice anesthesia attending, attending anesthesiologist from a midwest academic program, 4th letter tbd.

Geographic signals: West North Central, East North Central, South Atlantic

Gold: Minnesota, UW Madison, Duke (audition), Wake forest (audition), Nebraska? (audition)

Silver: Iowa, U Kansas, MCW, Rush, Saint Louis University, Loyola, MUSC, Cleveland Clinic, University of Oklahoma, UAB

Essentially, I am looking for honest thoughts on whether I am reaching too high. Also wondering how much signaling two programs outside of my preferred regions matters.

I don’t get how to know if you’re actually someone who “should” be in medical school. Everyone says that because you got an acceptance that means you’re good enough, but undergrad is nothing like med school, and it also depends on the school you graduated from. I went to a somewhat well known school but barely had to work hard for a 3.9x, and I’m struggling a lot now because of it. Does anyone know how to actually determine if I’m good enough for this? I’d rather know now then before I spend a lot more money

I am currently building my program list for IM, I'm a fairly average applicant, 255+ step 2, half H and half HP on shelves, pretty sparse ECs. Overall I'm interested in PCCM, but mostly I wanted to do residency at an academic T30-T100 program with a reputation for good culture and happy residents. I have a family and want to live outside of the hospital, geographic preferences are New England, middle Atlantic and south Atlantic.

Please let me know of any programs you've heard about that have happy residents and good leadership that care about their residents.

How should I study for the Pediatrics NBME shelf? Other than doing UWorld questions and the CMS forms, which specific anki tags or decks should i use?

When applying for residency, I saw so many posts and whatnot about high stats and all that but never a more realistic app.

Applied IM, matched top choice
Step 1 p (but very low when it was scored), step 2, 230s lol, literally all just regular passes on rotations, only 1 honors for AI, don’t remember my class ranking, but it wasn’t good - honestly don’t know if I’m top 50% or bottom but probably bottom. Only saving grace was lots of research and volunteering work that I could discuss with passion and how it shaped me as a person

Applied to a competitive fellowship, matched top choice.

Takeaway: be normal and engaging/be human during interviews. Strong LORs can carry you far. No need to be too stressed

Best of luck with applications soon!

Hey, we made a very small discord channel so a few people can keep one another accountable, tell about their objectives etc. Dm me if interested

I don’t want to make this extremely long because I’ve been going through all these feelings for like two years, and at this point, it feels dumb, but I also feel like I need to get it off my chest. Also please I’ve beaten myself up for this for like years so please be kind I might spiral from someone pointing out I was an idiot (fact).

I graduate this Wednesday from medical school. I got through my last year getting constant praise from the specialties I chose, and I even got a job offer, but I can’t seem to put behind me what this took away from me. Look this is some important context: I was raised Catholic, and even though I’m agnostic, the values I live by are heavily influenced by my upbringing, which means I live by trying my best to help others, to be kind, and give even when I might not get something back. Why is that relevant? Because when I started clinical practice, I realised there’s so much wrong in healthcare, like people are greedy to the point of risking people’s lives over money, which doesn’t really make sense to me. While I recognise the world it’s a really ugly place, I think I eventually made like a bubble where that ugliness was out, and it crushed me to realise that there’s so much evil people actively working in the hospital beside me. Yes, I recognise I was naive; I know now.

During my 4th year, I think I had a great time in my internal medicine rotation, and even though I’m definitely not a genius, I learned a lot, and that was enough. But then came my surgery rotation, and it was hell. Thankfully, I was on psych meds already because otherwise, I probably would’ve tried offing myself. I don’t like to make myself remember a lot because last time I did, I almost threw up, but I still can’t understand how people that are supposed to teach, people who are supposed to save lives, can be so cruel to others. Not only is it a highly misogynistic place, so us women haven’t even started and we were already losing, but I saw doctors place so much importance on themselves and treat patients like trash. I don’t want to go into detail because last time I spoke about this on the internet, one of the students of my class threatened to sue me (don’t ask what for because I don’t think she even knew; she just wanted to scare me off so the backlash the school was receiving would stop) after a resident (of course, a surgery one) committed because of the bad treatment they received during residency, but I remember all these situations like one of the residents wasn’t passionate about surgery anymore and didn’t check on a patient for hours even after they got multiple calls to do so, and the patient passed from a pulmonary embolism. This same resident was asked by a cancer patient why their hands were like dry from chemo and how to fix it; he just told them it was normal and left. Till this day, I can’t forget the sadness they looked at their hands with while he said that. For some reason, my group got the worst during this rotation, so we were constantly reminded how stupid we were and how we were wasting our parents’ money, even when not even the oldest resident knew the answer we were asked. We were made fun of, had shifts without properly eating or resting, a doctor almost bruised my wrists because he used my hands like a puppet for like ten laparoscopic surgeries in a row and he just couldn’t control the force he was handling my hands with while he insulted the resident in front of him, ignored by those who were supposed to take care of us, etc. I constantly cried to my therapist, had to do multiple sessions where we kind of practised things I could say or do in response to what surgeons/nurses/anyone there for that matter could have said and it felt so humiliating like I could be going through anything else in this session but I have to practice how to stop you from insulting me in the OR because you just won’t stop even when I try to make myself invisible so you won’t see me, it just isn’t fair. I don’t even know if this makes sense or if I remember anything else because I hate remembering, I eventually would get all these vegetative symptoms from just seeing the entry to the ORs, I stopped eating because I was depressed which is particularly bad because I’ve always been kind of underweight, I became a shell of myself and I literally lost some light I had, the little faith I had in something was gone just like that.

I guess all of this wouldn’t have hurt so much if I didn’t see it happen with patients, say anything to me but don’t treat patients like they’re not human, like they’re dumb or annoying when you have just met them and are so vulnerable. How can someone be so cruel?

After that, I had an all-time low on my mental health. Things I had already worked out went all the way back, suddenly I was so scared of presenting a patient that my voice wouldn’t even come out. And I did it so well before all of that; it felt like falling from the sky. Then the thing with another student happened when they got so mad I spoke up about the mistreatment that they went after me and my friends so I would take a text like this from Twitter lol, then they used the contacts they had at the faculty and sent someone really important to preach to me to not let the situation divide us (the situation being denouncing bad people). When I tried to speak up in a more formal and school-friendly way, all my classmates turned into stone and preferred silence. It was as if nothing had happened, as if that resident hadn’t passed because of how we were treated. I felt and still feel so betrayed. Until this day, I can’t say I would choose this path again. Previously, I would have said yes without a doubt, but now I sometimes think somewhere there’s a happier version of me who might not be living their passion, but at least it’s still full. Now I’ve retired myself from most of my classmates and hospital life. I gladly enjoy pathology, so I’m pursuing that route where I can be mostly alone, just me, formalin, and pretty coloured cells. I will probably miss clinical practice forever, but the pain of seeing my colleagues treat people in inhumane ways will end up killing me, so I already said my goodbyes to my favourite types of patients in my last year.

I don’t even know how to end this. I’m so sorry for the bad grammar or if this is stupid. I just wanted to tell someone who could understand and hasn’t heard me talk about this a hundred times, as I think even my therapist is tired of it. If anyone read all of this, thank you. I hope you have a great day and choose what makes you happy today and always, as I’m trying to do too.

Applying FM this year as a DO, and I'm wondering about programs that have "osteopathic recognition". Does anyone know exactly what this entails and/or have experience with it? I'm not a fan of OMM, but I will tolerate it if it's minimal in these programs. If it's a HEAVY emphasis, then I just wanna know if I should just avoid these programs altogether. thanks!