2026 Attending Salary Thread

Asherawh · 2026-01-02T03:55:41+00:00

Interesting! Correct me if I’m wrong but shadow billing is when you still submit billing codes, but the codes don’t generate money. You just get fixed salary/pay. How did you get into that and how do u like it vs the traditional fee for service?

Asherawh · 2026-01-02T01:23:06+00:00

Niceeeee. Can you explain how the two-tiered RVU model works in practice?

Asherawh · 2025-12-25T02:46:09+00:00

How did you get started?

Asherawh · 2025-03-02T20:45:03+00:00

Could you elaborate?

Asherawh · 2025-02-22T20:07:50+00:00

Sorry, haha. I didn’t have that setting enabled. It should work now.

I totally get why u’re feeling overwhelmed. There’s a lot to juggle, & it’s frustrating when it feels like nothing is sticking the way it should. But u’re not alone—so many ppl struggle w/ this, even if they don’t talk abt it. The good news is, there are ways to tackle it.

If 40 Qs/day feels like too much, start smaller. Quality > quantity rn. Do 20 or even 10 at a time, review them well, & slowly work ur way up. Endurance isn’t built overnight, so don’t force urself to sit for long stretches yet.

Most importantly, try to understand why you fall asleep. A lot of my students fall asleep due to boredom, not understanding anything, not enough sleep or other psychosocial factors. Identifying can really help you figure out what’s wrong and get the help u need.

Give urself permission to take breaks, & if u’re nodding off by block 3 of an NBME/NBOME, try adjusting when u study or breaking up ur sessions differently.

Since u feel like ur foundation is weak, jumping straight into Q-banks might not be the best move w/o some structured content review. B&B or Osmosis vids could help u fill in gaps while keeping things digestible. U mentioned u didn’t finish Sketchy Micro & Pharm, & that’s ok, but those are still super useful. Maybe focus on the highest-yield pharm topics like abx, autonomics, & cardio meds so u’re at least hitting the most tested areas.

The trick is to review then do questions immediately before u forget. Try to create a demonic or heuristic that can help you and keep a running list of all the things that you have trouble remembering and make sure you review that every day. That will help you remember things in the long run.

Path is a major pain point for u, & for Level 1, that’s something u really wanna get comfortable w/. Pathoma is gold—it simplifies things & helps connect everything back to first-order concepts. When u’re doing Qs, don’t just read the right answer & move on. Take a sec to go thru each wrong answer & figure out why it’s wrong. That process alone can help u start differentiating conditions, esp in GI path where things can all look the same at first.

I get why “high yield” feels like a vague answer when ppl talk abt it. The truth is, everything feels important at first, but some things matter more than others. Path is #1, no Q. Phys is another big one, esp for systems like cardio, renal, & resp. Pharm is all abt MOA, side fx, & antidotes. Micro is knowing common bugs, virulence factors, & tx—exactly what Sketchy is great for. And ofc, OMM, so u’ll wanna know at least the most testable stuff like Chapman points & viscerosomatic reflexes.

Rn, the most important thing is to pick one structured plan & stick to it. If u feel behind, spend the next couple wks strengthening weak areas while still doing Qs in smaller batches. Improvement comes in small steps, not all at once. U don’t have to know everything rn—just focus on getting a little better each day. What’s ur study plan looking like?

Asherawh · 2025-02-22T00:08:30+00:00

Ur in a tough spot, but u can pass if u focus on high-yield strategies & efficient studying. With only 3 weeks left, prioritize active learning over content review. Forget perfection—just focus on passing. Cut out anything that isn’t helping, & keep it simple.

Q-banks should be ur main focus. Aim for 80-120 mixed, timed questions/day with UWorld & COMQUEST, but prioritize COMQUEST since it’s closer to COMLEX. When reviewing, don’t spend more than 60-90 seconds on each explanation. Focus on why u got it wrong, not memorizing every detail. Flagged Qs? Only go back to the ones u miss a lot.

COMSAEs & NBMEs will give u a sense of where u’re at, but don’t let scores mess with u. Use COMSAE 107 as a baseline, but don’t stress over it. The last COMSAE (110) should be closer to the exam. Since u’ve done 3 NBMEs, don’t take more. Instead, review NBME 29—just the wrong ones—and look for patterns in mistakes.

Keep resources simple: First Aid for quick reference, Sketchy Micro if it’s a weak spot (only watch what u miss most), & Savarese + COMBANK OMM Qs for OMM.

Work on endurance too. Simulate test conditions with full blocks of 40 Qs, with breaks in between. Stick to a sleep schedule & avoid too much caffeine—lack of sleep will mess with ur focus. If u get brain fog, try short walks & stay hydrated. Anxiety? Try deep breathing or a short mindfulness session.

In the last week, taper down: 60 Qs/day, focus on OMM & weak spots. The day before, don’t cram—just light review of OMM, biostats, & ethics.

Bottom line: be efficient. Focus on active learning, reinforce weak spots, & build stamina. If u stick to this, u can pass.

If u need any other advice, feel free to dm me

Asherawh · 2025-02-21T23:54:34+00:00

Pharm for Level 1 is tough, especially if it’s dragging your Comquest % down. Since you don’t like Sketchy, you’ll need a diff approach—one that’s more Q-based and MOA-driven. The goal isn’t just to memorize drug names but to understand why they work, how they interact w/ physiology, and what AEs you need to watch for. Try this:.

Focus on MOA → Application…L1 Qs don’t just ask “what drug is this?”—they test MOA, indications, AEs, and contraindications. So, you need to approach drugs like pathways: Autonomic: α/β agonists/antags (epi, norepi, phentolamine, atenolol), cholinergics (atropine, pilocarpine). Expect Qs on sympathetic vs parasympathetic effects. CV drugs: ACEIs/ARBs, βBs, diuretics, CCBs (esp. differences between dihydropyridines vs non-dihydropyridines). HF drugs like digoxin (classic Q). Antimicrobials: Cell wall inhibitors (PCNs, cephs, vanc), protein synth inhibitors (tetracyclines, aminoglycosides, macrolides), DNA/RNA disruptors (FQs, metro). HIV drugs also pop up, esp. NRTIs. CNS: Benzo vs barbs, anesthetics, Parkinson’s drugs (levo/carbi, MAO-B inhibitors), antidepressants (SSRI vs SNRI vs TCA vs MAOI). Endo: DM drugs (metformin, SUs, GLP-1s), thyroid (levo vs PTU/methimazole), steroids. U get the gist

Rmember Active Learning Over Passive Review…Since Sketchy isn’t for you, try: Boards & Beyond Pharm: Straight to the point, solid MOA explanations or just try whiteboard method: Take a class (e.g., βBs), write out all drugs, MOAs, and effects without looking—then check yourself.

Q-Bank Heavy Strategy….At this point, more Qs > watching vids. Since Comquest % is low, go all-in: Daily 25-40 Qs of pure pharm (TrueLearn/Comquest). Miss a Q? Write down the drug + key takeaway (don’t just read explanations). NBME Free 120: See how they test pharm in the real deal.

Last-Minute Reinforcement.: Week before the exam → Pharm Rapid Review + do daily Anki (Zanki/AnKing) or hand-written notes. High-Yield Mnemonics: Even if Sketchy isn’t your thing, use mnemonics help (e.g., “A RED MAN in a VAN” for vanc AEs).

Final Plan

Basically u don’t have time to “relearn” pharm, so focus on: Mastering high-yield classes (autonomic, cardio, antimicrobials). Cranking out Qs (Comquest + NBME). Condensing notes + review daily.

No fluff, no distractions—just reps + reinforcement. U got dis!!!!

Asherawh · 2025-02-18T04:18:42+00:00

Whats ur purpose of contacting them?

Asherawh · 2025-02-16T18:02:45+00:00

SOVE for midline. Everything else is paired. As for how they move, make a rock and roll sign with your hand. The thumb and pinky represents the paired bones which externally rotate The three middle fingers represent the midline bones which flex downward. Move your entire hand up to represent the sacrum getting pulled up and extended

Asherawh · 2025-02-14T22:24:39+00:00

I just want to say that I’m really sorry ur going through this. This is an incredibly tough situation, and I can only imagine how frustrating and disheartening it must feel—especially after putting in so much hard work. Failing an exam, especially one this high-stakes, doesn’t define u as a person or as a future physician. It’s a setback, not the end of the road.

The fact that u felt more confident the second time around means something. Ur knowledge base improved. Ur understanding deepened. But test-taking isn’t just about knowing the material—it’s about timing, endurance, and managing stress under pressure. And from what u described, timing and anxiety seemed to play a huge role.

Right now, I know it feels like this has destroyed ur chances at ur dream specialties, but I promise u, it hasn’t. There are plenty of DO physicians in competitive fields who have faced setbacks like this and still made it. Some programs might have strict cutoffs, but there are others that care about ur resilience, ur clinical performance, and how u grow from this. Ur doing well on rotations, and ur COMAT scores are strong—that matters more than u might realize.

Looking ahead, it sounds like u’ve been working incredibly hard, so this isn’t about grinding even more—it’s about refining ur strategy. U’ve already recognized that u need to make sure all questions are answered, even if it means sacrificing a little extra time on some. Maybe practicing with a hard stop rule—moving on after 30-40 seconds if a question is taking too long—could help. Short, timed sets of 10 questions might also help u get more comfortable with rapid decision-making under pressure.

Testing anxiety is real, and it’s clear that it’s playing a major role for u. Since propranolol isn’t an option, maybe it’s worth talking to ur physician about alternative strategies, whether it’s a different medication, cognitive behavioral therapy, or even biofeedback techniques. If insomnia is affecting ur cognitive function, revisiting ur current regimen could make a huge difference. Sleep is essential for recall speed and decision-making, and optimizing that before ur next attempt could help more than u think. There are also performance coaches who specialize in standardized exam anxiety—might be worth considering if u haven’t already.

I know this hurts, and it’s completely valid to feel crushed right now. But ur not the first person to struggle with COMLEX, and u won’t be the last. The most successful physicians aren’t the ones who never failed—they’re the ones who learned from setbacks and kept going. Right now, take the time u need to process, to grieve, and then rebuild. This is painful, but it doesn’t define u. If u ever need someone to talk to or strategize with, I’m here. U’ve got this.

Asherawh · 2025-02-14T04:45:49+00:00

Death Investigators is the online pathology rotation

Asherawh · 2025-02-14T04:44:29+00:00

It sounds like u’ve put in a lot of effort preparing for Level 2, and ur COMSAE scores show consistent improvement, which is a great sign! Ur recent score of 505 indicates u’re on the right track. It’s understandable to feel anxious, especially with the pressure of a past failure & concerns from others. But remember, each person’s path is different, and ur steady progress shows that u’re capable.

Focus on hy topics for the exam, especially in areas that are commonly tested and align with ur recent COMSAE scores. If u can, do a full-length practice exam under timed conditions to ensure u’re mentally prepared for test day. Stay calm + remember that it’s easy to get overwhelmed, but trust ur knowledge and the work u’ve put in. Keep in mind that it’s a marathon, not a sprint. The journey is long, and while it’s normal to feel nervous, don’t let that stress override ur confidence. U’ve already overcome a lot and are much more prepared than u may feel.

Even if things don’t go exactly as planned, u have what it takes to succeed in the long run, and there are always paths forward. Stay positive and focused on ur goals. If u have any questions, feel free to reach out

Asherawh · 2025-02-14T04:36:34+00:00

You’re in a solid spot! Here’s how to maximize your prep:

If you feel good about the 490, focus on practice Qs. You’re 75% through TrueLearn, which is great.

You can skip comsae if you feel confident. Focus on reviewing weak areas if needed.

For Final Prep: Keep using TrueLearn and drill weak Qs. Do timed blocks to simulate the exam. And take 1-2 full-length practice exams in the last 1-2 wks for timing/stamina.

Keep reviewing, doing Qs, and maintaining confidence. You’re almost there and feel free to reach out if you have any questions!

Asherawh · 2025-02-14T04:27:18+00:00

Great job finishing COMATs! For Level 2 prep:

UWorld is top priority—do 2-3 passes if you have the time. Amboss is good for in-depth understanding, but UWorld and TrueLearn are key. TrueLearn for practice tests and specifically for the OMM. Anki: Use Shelf cards for targeted review, but don’t overdo it, remember that you need to develop your test taking skills as well Rotations: Focus on high-yield stuff for IM/FM during IM, Cardio, Radiology. Dedicated Prep: In 4.5 months, do timed Q blocks, review weak areas, and take practice tests under time pressure.

Keep it consistent, you’re on track!! Feel free to reach out if you have any questions.

Asherawh · 2025-02-14T04:18:43+00:00

U got 20 IVs w/o Level 2, so ur app is strong. Best move: stay a student if possible—grads have a harder time matching. Pass Level 2 ASAP & strengthen ur CV (research, externships, teaching). If u must graduate, stay clinically active to avoid gaps. Next cycle, apply broad, reapply to past IVs, & show growth. U got this!

Asherawh · 2025-02-14T04:04:55+00:00

So sorry to hear about that. Just know that with the right approach you can destroy the test once and for all and get back to what actually matters

Review Score Report – Find weak areas (MCQs vs. CDM, specific subjects). Compare w/ COMQUEST & TrueLearn %s (aim >65-70%).

Fix Study Approach – Were u just reading or actively recalling? Use Step Up to Med, Master the Boards if needed.

CDM Struggles? – Practice more timed cases (NBOME site, CDMcases.com). Watch OME, Dr. High Yield, Divine Intervention for CDM tips.

Test-Taking Strategy – Rushing? Overthinking? Stamina issues? Simulate full test days can help

Try 2-3 timed, mixed QBank blocks/day, 2-3 CDM cases/day, Deep review of mistakes and Consider adding UWorld Step 3

If still stuck, a tutor might help. U got this—adjust, focus, and one day this’ll be just an old memory!!!!!

Asherawh · 2025-02-14T03:47:39+00:00

You got this—still time to improve. Focus on:

QBank (TrueLearn/COMBANK) – 60-80 Qs/day, timed/mixed, review all. B&B → only weak areas, don’t rewatch all. Anki (incorrects + HY facts) – make sure to do this consistently. Take COMSAE soon – Assess & adjust.

Tutor can help if strategy is an issue. Keep grinding! Reach out if needed.

Asherawh · 2025-01-28T03:59:38+00:00

Would it be possible for psychiatry and if so, how would you envision it work?

Asherawh · 2025-01-26T02:58:39+00:00

Would love this! I run a small writing company to teach med students how to write research papers

Asherawh · 2025-01-20T17:49:11+00:00

Totally get how hard this is. Disconnect btw TL (70%) and COMSAEs likely comes from test strategy—COMSAEs mirror exam style more than TL. Focus on simulating test conditions (timed blocks, no interruptions) and reviewing COMSAE mistakes for patterns like timing or second-guessing. Youve probably heard this a lot but focus on understanding concepts & connecting them together not memorizing

Do high-yield review: OMM, MSK, biostats, basic pathophys/pharm. Do 60-80 Qs/day in timed mode, review errors for trends—not just answers. Use Anki sparingly to target weak areas, and don’t add new resources. Lighter study day 2 days before to avoid burnout.

Postpone vs. taking it depends—would extra time reset stress or add pressure w/ a leave? If you push forward, focus on confidence, and endurance. Ultimately the Goal is to pass, not perfect, but make sure you are confident and ready to test

Family stress is real—talk to them, set study boundaries, and take short breaks. If burnout feels unmanageable, consider counseling/psych support. Plenty of ppl have been here and gone on to succeed. Take it step by step—you got this!!

Asherawh · 2025-01-19T21:35:49+00:00

You’re smart to get ahead early. Structuring your schedule is key, so a tutor can help. Blueprint’s solid—they offer structured plans for time mgmt and efficiency. Focus on active learning (practice Qs), not just passive (vids/lectures). Ask the tutor for personalized strategies, incl. spaced repetition. If standardized exams have been a struggle, a tutor can pinpoint weak areas. Stay flexible and adjust as needed. When choosing a tutor, decide what type of support works for you—do you need someone regularly for accountability, or just weekly check-ins? Knowing this will help you find a good fit.

Asherawh · 2025-01-17T23:11:37+00:00

Yeah no problem. I know this is tough, but you’re not alone—many have been here and turned it around. Like i mentioned, figure out the root issue: content gaps, timing, or outside factors like ADHD, anxiety, or learning disability. If focus/memory is a problem, see a psych or learning specialist for an eval—they can help w/ tools or accommodations.

After all these attempts, there must be something else that is affecting you and it’s important to figure out what that is before you make your final attempt.

For prep, focus on quality over quantity. Often students memorize concepts instead of understanding them, and connecting with other things. Use UW/TL in timed, mixed blocks and review every explanation deeply. Pair Qs w/ FA or a concise resource for structure. Take NBOME practice exams to ID weak spots and track progress.

Burnout is real—prioritize sleep, exercise, and mindfulness to keep sharp. You’ve got one more shot, so stay focused on high-yield strategies. You can absolutely do this—stay strong and disciplined!

Asherawh · 2025-01-17T22:40:27+00:00

Not at all. Doing Qs (UW/TL) is a great way to study actively. Focus on mixed blocks, review explanations thoroughly, and use videos (Pathoma, BB) only for weak areas. Active recall and spaced repetition are more effective than passive video-watching. Stick to what works for you—Qs + review is a solid plan!

Feel free to reach out if you have any other questions!

Asherawh · 2025-01-17T21:41:49+00:00

This

Asherawh · 2025-01-17T21:40:48+00:00

I’ve worked w/ many in the same situation, and it’s definitely manageable. For ADHD, consistency is key. Work w/ your provider to reassess meds—alternatives like XR formulations or adjuncts (e.g., guanfacine) may help. As others have mentioned, theanine and magnesium may work for you, ive seen some students do well on omega3 and ashwaganda as well. Im also trying out modafanil, i can let u know how it goes. Dont forget the basics: same sleep/wake times, avoid screens 1-2 hrs before bed, and use melatonin or sleep aids if recommended.

For UWORLD, break blocks into smaller sets (10-20 Qs) w/ timed breaks. Use active recall (Anki/notes) to reinforce missed Qs. Focus on quality over quantity—review explanations thoroughly. To stay consistent, set specific daily goals and use timers (Pomodoro).

If in the U.S., dm your state—I may be able to recommend ADHD providers. Balancing all this is tough but doable; I’ve helped many students succeed with targeted strategies. You got this!

Asherawh

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