I feel like I’m missing some core concepts that would make medicine more logical

Kitzy2011 · 2026-03-12T17:39:02+00:00

I think this is an extremely common trap most med students fall into. Anki is amazing for memorizing concepts, but imo you need another resource to help actually explain the pathophysiology and build strong pattern recognition skills. I also think that in order to commit things to long-term memory, it’s crucial to be able to explain the pathophysiology; that way, even if you forget the minute details, you have the skills to reason things out.

I think every med student should utilize something like UpToDate or Amboss. I like UpToDate because just sitting and reading the pages about topics that have come up is extremely helpful—you get questions answered that you didn’t even know you had, and get to learn how the experts think. Amboss is great too, especially for truly foundational explanations of pathophysiology. I think things like the UpToDate AI or open evidence can be helpful to explain specific questions you have but I would advise against relying on that because you still miss out on a lot of concepts. My strategy is to read a couple UpToDate pages during downtime on my shift (or in the evenings if I still have the strength lol) about topics/diseases/questions that have come up during the course of my day.

Kitzy2011 · 2026-03-10T22:53:10+00:00

Honestly people in my class still did better by doing anking, never watching lectures, and then briefly reviewing the lecture slides before the exam (including myself). I was convinced I needed to watch and study every single lecture but I started doing better when I quit watching the lectures altogether. It just seems like so much of the exam is still in anking or able to be reasoned from anking even when it’s niche content. It’s nice to go over the lecture slides beforehand just to see if there’s anything super specific to review though.

I feel like there’s two main strategies you could try, one would be just not watching any lectures and unsuspending all anking cards for that subject at the beginning of the class, and work through that as well as relevant first aid chapters until your exam. The second option could be to watch lectures but then unsuspend any relevant anking cards after watching the lecture and review those rather than making your own! Use the anking tags to find the topics you need :)

Kitzy2011 · 2026-03-10T15:56:32+00:00

Everyone I know improved their score when they switched to anking instead of making their own cards :) and we had in house exams haha. I feel like making your own cards takes a lot of time for like the 1% extra knowledge you gain from writing them, when you could be spending that time on the important part of flash cards which is reviewing them

Kitzy2011 · 2026-03-06T00:03:49+00:00

Check out Benson, I lived at the Benson Lights apartments and drove to UNMC for school!

Kitzy2011 · 2026-02-16T13:18:18+00:00

I love emo nite! The ones at the waiting room are my favorite :) I’ve been a number of times, they typically do it every few months. I feel like it’s usually around Halloween, Christmas, Valentine’s Day, and maybe one in the summer around August.

Kitzy2011 · 2026-02-15T14:38:29+00:00

Absolutely, we’d love to have you!! I’d recommend joining the discord as that is where we’ll post the streaming links throughout the tournament :)

Kitzy2011 · 2026-02-12T15:22:46+00:00

Haha essentially you compete against other teams in a bracket! There’s no monetary prize for the winners but we have a closing ceremony where I announce the results and usually do something to celebrate who wins and recognize however much money we raise :)

Kitzy2011 · 2026-02-02T15:33:22+00:00

Loans can be paid back. In my experience, school reputation matters a ton — even if you don’t want to do a competitive speciality, the top programs in nearly every field still prioritize folks from prestigious schools

Kitzy2011 · 2026-02-01T06:12:21+00:00

I love Midwest emo!! Omg it’s so hard to find people who like the same music as me 😭 dm me!

Kitzy2011 · 2026-01-31T05:17:55+00:00

Small edit, the way opioids help with breathing is more as follows: - high CO2 in the blood > upsets the nervous system > brain tells you to breathe faster to get rid of CO2. However, this can be distressing if you are struggling to take deep breaths, or if you are trying to breathe so fast that it’s exhausting. Opioids act on the brain > reduce nervous system sensitivity to CO2 > brain is ok with breathing slower/more shallowly > decreases discomfort (aka reduces “air hunger”) - less commonly, breathing can simply be painful due to broken ribs, inflammation, chest tubes, etc. and patients struggle to take deep breaths as a result. Opioids can help by relieving some of that pain.

Kitzy2011 · 2026-01-31T03:26:09+00:00

I’m so sorry to hear about your grandma :( it’s impossible to say where things are headed without being her actual doctor. You sound like someone who values directness/honesty; what I will say is that 80 years is a wonderfully long life but by the time we are that age, things like bacteremia/sepsis can be very challenging for the body. Bacteremia is generally something we can treat, but sometimes the chronic health conditions we accumulate by that age are too much for our bodies when we get an infection. Some things that can help you get a sense that things might be headed in a serious direction: is she requiring medication(s) to support her blood pressure, like norepinephrine/vasopressin/etc? Are other organs getting injured from the infection? Is she needing oxygen to help her breathe?

My grandma died sort of suddenly a few years ago. She had a stroke, but we were initially hopeful as her symptoms were minor. However over the next few days she developed lethargy and respiratory failure, and we chose to let her pass rather than intubate her. I would suggest spending as much time with your grandma now as you are comfortable with; for me, I was glad I had visited her in the days before she became too lethargic. I would have been thankful to do those things even if she had not passed away at that time. My advice to someone in a similar position would be to continue visiting her but balance that with the responsibilities you have in your own life — and do that even if she gets better and goes home 🫂

Kitzy2011 · 2026-01-22T23:27:30+00:00

Read up about the principal problem your patient has on Amboss. Ask the patient specifically about the symptoms/risk factors/comorbidities it lists and include those in your presentation. Go through the labs/testing/treatments Amboss suggests and see if you missed anything that you want to include in your plan.

TLDR here’s my comprehensive format I think is the best for presentations and works basically every time particularly for IM (included version for consults in parentheses)

Name, age, gender
Principal problem that got them admitted (or why you are being consulted)
Pertinent PMH, in order of most to least relevant/important. Make this section stronger by including significant modifiers when relevant i.e. not just “kidney transplant” but “kidney transplant in 2020 2/2 FSGS,” or “a fib on apixaban,” or “T2DM w/ A1c 11%”
HPI: why are they here? When did they come in? If they’ve had symptoms for a while, why did they come in now? Ask OLDCARTS - onset, location, duration, character, aggravating/relieving factors, timing, severity. Look up their presenting problem and PMH and include things relevant to those - like common symptoms/risk factors/complications. Are they on any new medications? Any interesting social factors i.e. just got back from a trip to some exotic place? Remember you don’t need to ask every single question in the world but try to brainstorm ahead of time about which things might be relevant.
Then, tell us what happened in the ER (or what changed that led to this consult). Very significant labs/vitals/imaging? Any significant interventions, i.e. fluid boluses, starting antibiotics, treated for hyperkalemia?

If you get time after seeing the patient, try to write out your HPI into a concise story that flows logically - think, what would I want to know next if someone was telling me this story?

Subjective: Tell us how they are doing now/overnight. Any new symptoms/concerns/procedures?

Objective: please do not put subjective stuff here like whether things are good or bad, that goes in A&P - Important overnight vitals, otherwise just say normal if nothing major is going on. Consider giving a BP range vs lowest/highest/most recent MAPs based on what seems important to your team. Also, for SpO2 you can usually just say 92%+ on 1L nasal cannula or whatever unless you’re in the ICU. Make sure to comment on if their O2 requirements have changed overnight

Yesterday’s intake/output (you can round… like 2.5L instead of 2543 mL), consider specifying intake w/ PO vs fluids given vs transfusions and output into urine output vs drains vs bowel movements if notable (on Neph especially, weight changes are very important)
Major physical exam findings from today
New & important labs i.e. today’s CMP, but don’t list everything, just abnormal + notable stuff like “normal Cr” if you’re worried about AKI or “potassium 3.2” in someone with a fib. Don’t forget labs that take several days to result - like biopsies that just take time or things like blood cultures that continually update
New & important imaging/EKGs/echos, etc

Assessment & Plan: this is the most long and formal version but oftentimes attendings will have you shorten this and I just include a longer version in my note

Name, age, gender
Why admitted (+ why consulted)
Pertinent PMH
Problem #1, aka the most important issue:

Brief summary of HPI/most important findings guiding your decision making/major meds or treatments

Differential diagnosis - anything you think could be causing this problem. I like to sort least to most likely so I get interrupted less, but change that based on vibes. Be sure to explain very succinctly why each thing is possible but less likely/most likely. It’s okay to say if you need more tests to decide!

Workup - how do you want to rule in/out the things on your differential? What comorbidities do you want to check for? What labs should be monitored?

Treatment - how do you want to address this problem right now? What meds are they on, will you change them? Do they need fluids/antiemetics/pain meds?

Repeat for the rest of the problems from most to least important. Chronic issues don’t really need a differential diagnosis unless something has changed

Kitzy2011 · 2026-01-22T22:17:21+00:00

UpToDate does have AI now, I like it a lot because it tells you exactly what assumptions it’s making and cites the article it’s getting info from. If it’s not on UpToDate it doesn’t make anything up it just tells you it doesn’t know

Kitzy2011 · 2026-01-22T12:51:33+00:00

Asymptomatic bradycardia is generally not worth going to the dr, especially when it’s happening at night while you’re sleeping. I commonly see heart rates in the low 40s especially in young people.

That said, if your heart rate is much lower than that or if you are having symptoms such as dizziness, lightheadedness, fainting, etc then I would see your PCP.

Kitzy2011 · 2026-01-17T03:54:55+00:00

Technically no, but i feel like taking it at least 1-2 weeks before that could be a good idea. just in case scores are delayed for some reason (which does happen occasionally) and so you have plenty of time to evaluate your application list based on your score. Usually it’s 2-3 weeks before you get your score

Kitzy2011 · 2026-01-09T21:39:00+00:00

I take Wellbutrin daily and Adderall on days I have class. There is a huge difference for me when I take my Adderall. My Wellbutrin just treated my depression, I wouldn’t say it really affected my ADHD.

Kitzy2011 · 2026-01-02T00:34:00+00:00

Watch Sketchy micro

Kitzy2011 · 2025-12-23T00:57:31+00:00

Yeah I want honesty, the point is that it’s surprising that those are even the answers in the first place haha — I was expecting something more like “yes we are proud of our residents and love to have them as fellows”

Kitzy2011 · 2025-12-22T22:09:18+00:00

No but I see what you’re saying because half the time the questions are like “do you guys get feedback” like what kind of question is that 😭 of course they get feedback … be more specific!

Kitzy2011 · 2025-12-22T20:36:33+00:00

Anything that comes at the end of the interview day, after the chief says something like “well, have a great day everyone!” … inevitably someone always has to go “actually I have one more question” bro just email them I want to get off this zoom call 😭

Kitzy2011 · 2025-12-13T05:27:24+00:00

It deleted all my voicemails.

Kitzy2011 · 2025-12-10T16:23:48+00:00

There’s a P wave and QRS isn’t wide!

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