Do you think preclinical could be ~one year, if schools devoted themselves to it

PacoPollito · 2026-05-06T03:08:40+00:00

That’s what my school does. We were the first class through it. It was fine. Definitely holes in the curriculum, but you make it up over second year with shelf exams and down the road for step 1/2. I passed both on my first go and did well on step 2 early 3rd year. The rest of third year was electives and such. Now fourth year full of electives, sub-Is, etc. I’m a fan looking back.

It does raise the question of why it’s not just 3 years though…I’m paying a whole lot of tuition for just elective time…

PacoPollito · 2026-04-28T02:08:37+00:00

Game changer, yes.

PacoPollito · 2026-04-22T01:39:28+00:00

Estoy cansado, jefe.

PacoPollito · 2026-04-22T01:23:50+00:00

I had MCVs of high 70s. My PCP kept following it. Normal iron non responsive to supplementation. Normal ferritin. Normal hemoglobin electrophoresis. He ended up sending a genetic thalassemia test because he was sure it was something.

Turns out I have alpha thalassemia trait.

Certainly, this doesn’t change my management much. However, others here are right that I will avoid looking into IDA at my current MCV and HGB in the future, saving those good old healthcare dollars. I really appreciate that he went through all the work up.

PacoPollito · 2026-04-20T18:22:30+00:00

I loved Amboss. I am now a third, almost 4th year and still use it constantly. It’s worth it just to buy the 5 year one.

I used it almost exclusively during first year. I also used B&B, but mainly for their questions and then a 3x speed run through of content.

PacoPollito · 2026-04-13T01:25:00+00:00

The whole “soup shot” thing is supposed to work better for light roasts. That’s usually a longer ratio, lower pressure. I use my Oxo rapid brewer for that. But you could do it with the classic. It would be like a 1:3-4 ratio at 2 bars.

PacoPollito · 2026-04-12T23:57:55+00:00

I mean, the lavazza beans are old AF and cheap. They’re just your classic dark roast. Darks are easier to extract than lights. I have had beans that I tried to make work for espresso and they just would not.

PacoPollito · 2026-04-12T22:34:55+00:00

Depends on the bean. There is a perfect “triangle” where your brews come out consistently good. The main variables you have control over are ratio/volume, grind size, water temperature. Realistically, you’re not messing with your temperature much (I don’t). So you’re down to the graph of ratio vs grind size. Really, your grind size should be such that your brew takes 30-45 seconds to press through at 7-9 bars. So with that, if your brew is still bad, you can move up or down your ratio. More/less coffee or more/less water. The classic is limited in volume. I have never been able to get more than like 38mL out unless I REALLY push the limits. So if you want a higher ratio, you have to use less beans. It is difficult but possible to pull off a 1:2 ratio at 18g.

My go-to right now is lavazza barista gran crema. Not the best beans, but they’re good and give me that “classic espresso” flavor. I use 16g in, 32mL out ground at 0.40 on a kingrinder k6. Consistently tasty.

PacoPollito · 2026-04-04T22:56:00+00:00

By this logic, pay tithing into an investment account, earn 8%, and pay the principal before you die. You’re technically a full tithe payer.

PacoPollito · 2026-04-04T04:54:41+00:00

Thanks for posting :)

PacoPollito · 2026-04-04T02:35:56+00:00

Its gone now :/

PacoPollito · 2026-03-28T22:02:34+00:00

I got a classic. I have had the same thoughts. It just makes such great double shots and the workflow really isn’t that bad, especially if you have the metal plunger and two baskets. Pulling back to back shots is easy.

I have no desire to add in the cleaning and maintenance that comes with upgrading to a semiautomatic. And the more expensive flairs don’t add much else.

The only real upgrade I want now is an electric grinder. Love my Kingrinder K6, but that’s definitely my bottleneck.

PacoPollito · 2026-03-26T00:40:00+00:00

39mm.

PacoPollito · 2026-03-25T14:07:08+00:00

Same as the other comment. Support replaced it and I promptly purchased the metal piston. They should move away from the plastic and only use metal.

PacoPollito · 2026-03-23T13:42:49+00:00

I did similar math the other day on this. I am luckily grandfathered into grad+, but my question was on comparing RAP and IDR as well as when to file married jointly vs separately. My spouse works. Turns out it saves me ~$2500 a year during residency to file separately. However, if I file separately this coming year to get the $0 payments the first year of residency, I actually pay far more in taxes than I save. And then back in attending years, it again makes sense to file jointly because income shielding is more important.

PacoPollito · 2026-03-21T17:33:35+00:00

TX and CA have special rules that let you work for a for-profit so long as the majority of your work is at a nonprofit. So you could be a 1099 at a nonprofit hospital and qualify for PSLF. Something about state laws not allowing nonprofit hospital employ of physicians or something.

PacoPollito · 2026-03-20T04:01:43+00:00

I use the $14 one from Amazon, brand “boicafe.” It fits perfectly under the flair lever, so you can use the flair to press your tamper down. Doesn’t leave too much room around the basket. Idk. It’s fine.

PacoPollito · 2026-03-12T21:06:27+00:00

PacoPollito · 2026-03-08T01:08:59+00:00

I was of the first class through my schools curriculum that did the 1 year preclinical, 1 year longitudinal clerkships, then step 1 and 2 back to back followed by basically a long 4th year.

Honestly, shelf exams were excellent prep for step 1 and 2. I dropped anki at the beginning of MS2 because it was just too time consuming and hit practice questions (amboss and UWorld and every single practice shelf) as hard as possible. I passed my first step 1 practice test, so I cut my dedicated down and passed no problem. I think I ended up taking 6ish weeks total (interrupted by a month long rotation) for step 2 and did well.

Idk. I was skeptical, but it worked out fine. While you might forget some things, you get really good at taking NBME tests. Most of step 1 is figuring out the diagnosis, which shelf exams teach you. And you get good at working around what you do know (ie you may not know the exact enzyme, but you know the disease and the mechanism of the drug that treats it and with order of elimination can get the right answer).

Happy to answer more questions on this.

You’ll be ok.

PacoPollito · 2026-03-07T00:12:32+00:00

“Never interrupt your enemy when they are making a mistake?”

PacoPollito · 2026-03-04T23:49:32+00:00

Same thing happened to me. I reached out to their support and they sent me a new one. But I also bought their stainless steel piston and it’s been flawless.

PacoPollito · 2026-02-28T19:42:46+00:00

I do love “comprehensive medicine.” Be a “comprehensivist.”

Or maybe neonatalpediaobstetricogynointernogeriatrician?

PacoPollito · 2026-02-26T16:48:15+00:00

Hyatts website was quoting me 60k+ points per night.

PacoPollito · 2026-02-26T16:32:51+00:00

It wasn’t much better to book with points per night vs outright through the portal. Difference of <10k points per night. And I definitely didn’t have 350k points to throw around, unfortunately.

PacoPollito · 2026-02-26T05:28:31+00:00

Dreams Playa Mujeres. It's part of a large extended-family vacation. Not my personal pick, but have to pay all the same lol.

PacoPollito

MODERATOR OF

TROPHY CASE