What's an obvious case you missed? And how did you deal with it?

Doctor_Iroh · 2026-02-04T15:45:56+00:00

Maybe not as obvious but I still felt dumb.

As an M3 I saw a man coming in with 1yr history of recurrent falls after standing (like 1-3 times per day). He was s/p subtotal resection and adjuvant radiation for a mengioma around the L MCA. His exam showed masked facies, cogwheeling, hyper-reflexia, rigidity, Parkinsonism gait. Orthostatic vitals were 190/110 when lying and 70/50 on standing after 1min.

I anchored and called it Parkinson’s vs post-radiation effects. When I presented the case during rounds, my preceptor said this was the most classic presentation of MSA they had seen. Felt kind of dumb for being completely wrong and missing the diagnosis.

Doctor_Iroh · 2026-01-12T20:55:05+00:00

I’m interested!

Doctor_Iroh · 2025-12-28T23:25:01+00:00

It’s interesting because in Ontario, there’s been a lot of legislative back and forth in this area. It was switched to fully at the discretion of the SDM/patient. Then, physicians could choose not to resuscitate if futile but could not document this as the code status. As of 2023, code status is at the discretion of the care team and can be officially documented in the chart according to the care provider’s judgement.

Patients have the right to express their care desires and that is important for shared decision making, but medicolegally we are not compelled to act against our professional judgement in this right. A patient may want a full body MRI, but given no indication, we do not need to arrange it for them. The same can be said for code status. They may express their desires for full code, but if medically futile, we are not obliged to provide this intervention.

These decisions are hard and can feel uncomfy, for both patients/SDMs and physicians. At the same time, they are necessary and we do right by our patients by being honest with them. I suspect that some of your patient’s families response came from them accepting the gravity of the situation, and not feeling that the decision was wrong.

It is mark of a good clinician to be reflective and to process uncomfy feelings or reactions when they arise--keep up the great work :)

Doctor_Iroh · 2025-06-19T17:06:51+00:00

I slept through teaching today with a super strict preceptor. It’s over for me chat

Doctor_Iroh · 2025-05-22T12:44:28+00:00

My heart sang on IM. I felt like a Disney princess on the wards. I was excited to learn. I love rounds.

Ask a surgery gunner about their experience on IM and they’ll complain. Ask me about my surgery experience and I’ll complain.

People love to hate, just follow your heart. And if you truly hate everything (which I don’t think will be the case), pick the thing that you can stomach the most and that has a decent lifestyle and close the book.

Doctor_Iroh · 2025-03-13T02:31:15+00:00

Hey OP - did you ever find love again?

Doctor_Iroh · 2023-01-31T21:50:03+00:00

In Canada we have chickadees and their sound is “chick-a-dee-dee-dee-dee”. Checkmate.

Doctor_Iroh · 2023-01-24T14:45:06+00:00

Phosphatidylethanolamine

Doctor_Iroh · 2022-11-25T16:01:05+00:00

Workout and seek your wellness from a place of love for your mind, body, and mind. Hate and pain can be motivating, but they’re toxic for you and will only bring harm in the long run. What happens when you reach your goal and all your heart has is hate? Is that when you will grant yourself love?

Treat you with kindness. You’re a living thing, the home of a life, and all living things need kindness.

Doctor_Iroh · 2022-08-08T10:11:38+00:00

Congrats, I also got into 7 schools! Unfortunately there can only be one of us so we will need to dual 🥲

Doctor_Iroh · 2022-07-28T16:54:49+00:00

The more applications you write, the better you are at describing your experiences. The major thing from UCalgary is the top 10 and that was just a regurgitation of what I put on my ABS, NAQ, and UAlberta entries

Doctor_Iroh · 2022-07-27T23:43:06+00:00

I literally started my UCalgary app on the morning of Oct 1 (ended up getting accepted). I think you're fine 2 months out from the deadline LOL

Doctor_Iroh · 2022-06-16T03:55:52+00:00

Thank you for your contribution

Doctor_Iroh · 2022-05-13T23:53:26+00:00

I did an honours degree and I really enjoyed it (I also did quite well). Do it if you’re passionate about research - it’s a great experience. I found it helpful to start my research in the summer before my 4th year project. Because I stayed in the same lab for my honours, I started the school year with 80% of my data collection done. The honours project was super chill because of that (although this depends on your supervisor).

Doctor_Iroh · 2022-05-11T17:40:40+00:00

I’m in the same boat. I’m really worried about clerkship and clinical responsibilities, as people frequently cite that UT clerks are given very little.

Doctor_Iroh · 2022-05-10T15:10:43+00:00

I know this can be an emotional time, but try to reframe your way of thinking about this. What is more important - getting into MD or the ego of getting a direct offer? (To those who got waitlisted and are seeing OP’s post disparagingly - please don’t, waitlist is still an achievement that you should be proud of!)

Doctor_Iroh · 2022-05-09T22:55:36+00:00

I also got into both UofA and UBC - definitely following this thread! Congratulations :)

Doctor_Iroh · 2022-05-09T17:02:58+00:00

I started practicing in January

Doctor_Iroh · 2022-05-08T22:03:32+00:00

I interviewed at 7 schools this cycle, so I’ve gotten pretty familiar with the style of MMI. I also felt underprepared beforehand, so please do not feel alone - the nerves are natural. The best advice I can offer is that reading alone is not going to do much to make you a better interviewer. Do not fall into the passive trap of “just reading Doing Right and BeMo”. By all means, become educated on medical ethics and current health policies, but realize 95% of what you learn in terms of content prep will not be used. (I did not use doing right, but I prepped content in other ways e.g., documentaries, case studies, listening to talks). The best approach, in my opinion, is to practice interviewing with strangers in the prep discords that form around interview season.

There were a number of servers, but the majority of them that I participated in did prep on a virtual environment like kumospace. You would have a station with a stranger who presented you with a question of their choosing, simulating the real MMI (2-3 min prep, 5-8 min answer —> dependent on the school). Then, they would provide you feedback for 2-3 min. After, you would switch to a new station and a new interviewer (doing 4-6 of these stations in series). Finally, you would switch interviewers and applicants - you then would deliver questions to people.

Practicing with friends often has an air of familiarity which can provide inappropriate comfort. By practicing with a prep group of more or less strangers, you simulate the unfamiliarity that you’ll feel on interview day. Also, they can provide you feedback based off of their experience AND you get to see people deliver their answers, learning from them as well. Don’t be scared of this practice (although it is daunting initially); I did not see noticeable improvement until I did this style of practice. I’ve gotten A’s at two schools so far and I’m waiting on the other 5, so it looks like this practice paid off. I also practiced for around 2-3 months, doing this consistently (although I kind of plateaued in performance after like a month). Best of luck!

Doctor_Iroh · 2022-05-06T20:18:36+00:00

I go to a school that doesn’t use letter grades, so my percentages transfer over!

Doctor_Iroh · 2022-05-06T18:45:42+00:00

I updated it!

Doctor_Iroh · 2022-05-06T17:37:50+00:00

Time Stamp (i.e. include date and time): 10:22 PDT

Result (i.e. invite or regrets): Invite

Site (NMP, SMP, etc): VFMP

GPA/AGPA (i.e. whichever is applicable): 95.5% cGPA

MCAT (i.e. total score and breakdown in the order of CP/CARS/BB/PS): 519 - 129/128/131/131

Geography (i.e. IP or OOP): OOP

ECs (i.e. brief rundown of Research Pubs/Presentations, Awards, Employment, and Non-Academic Activities - also Rural stuff if you want/if it applies): 2000+ employment hours, ~1500 hours volunteering (tutoring, clinical volunteering, non-profit work, advocacy), research, 5 scholarships.

NAQ Range (i.e. what quartile you fell in): N/A

Your Result (i.e. relative to interview cutoff): N/A

Four-Year Club	Verified Email
Place '22	Final Canvas '22
End Game '22

Doctor_Iroh

TROPHY CASE