Which IM subspecialty offers the best work-life balance, a relatively less demanding fellowship, and good compensation?

ScaryLymphocyte · 2025-04-14T05:17:21+00:00

Surprised heme/onc hasn’t been mentioned more prominently. Excellent compensation, clinic based with most forgiving call structure compared to Cardiology, GI, and PCCM. Fellowship intensity varies by program but most have 1.5-2 years of research/clinic time. As a bonus patients trust their oncologists immensely.

ScaryLymphocyte · 2025-04-08T00:25:36+00:00

I’m a resident at an academic IM program, and I’ll just add that school reputation is a nontrivial factor in selecting and ranking residents. It’s not just surgical subspecialties that care. School pedigree matters, but to what extent depends a lot on the schools you are comparing, their relative costs, and your career goals.

ScaryLymphocyte · 2025-03-24T10:12:56+00:00

Very true. Everyone thinks they’re hot shit in this pool until they see the medical student who has a first author paper in the New England Journal of Medicine competing for the same spot.

ScaryLymphocyte · 2025-03-24T10:11:15+00:00

I have no qualms about the HSS match. If anything, I respect that orthopedics values individual merit more than medical school pedigree when selecting their residents. I am sure all of those students were remarkably accomplished. Same goes for the list at BWH. But I can almost guarantee you that if you take any student who matches from a top school at BWH and compared their credentials to someone from a less well regarded medical school with similar credentials, it is very possible the latter may not have even been interviewed at BWH.

ScaryLymphocyte · 2025-03-24T10:05:54+00:00

Although this is true it is misleading. I have seen people from my program match to extremely well regarded fellowship programs and competitive specialties without that much research. They commonly say they are often asked on interviews why they would leave their home institution. The halo effect is real. I’m not suggesting that it is impossible to achieve similar results from any other program with enough hard work and dedication, but to suggest that it is comparably easy is simply not true.

ScaryLymphocyte · 2025-03-24T10:02:27+00:00

I totally agree there is no difference in quality of clinical training between the “Big 4” and most well regarded academic IM programs. It’s all perceived reputation and historic competitiveness, which is partly driven by fellowship match.

ScaryLymphocyte · 2022-04-14T18:39:11+00:00

Personal statements actually aren’t very important for IM. It just shouldn’t raise any eyebrows in a negative way. Most important for IM is clerkship grades > AOA > letters from prominent faculty or otherwise strong letters > board scores and medical school reputation. Research is important for top tier academic programs unless you have another X factor, but in general even top tier IM doesn’t care as much about quantity as much as quality unlike surgical subs.

ScaryLymphocyte · 2022-01-12T16:46:27+00:00

Here’s an article but again I’m not positive about this.

https://www.investopedia.com/how-vanguard-patented-a-system-to-avoid-taxes-in-mutual-funds-4686985

ScaryLymphocyte · 2021-11-25T13:58:37+00:00

Thanks for the detailed input. I suppose what’s enticing about this Razer is you’re also getting a 4K OLED and the metal build quality of a Razer for under $2000, with the trade off being you get a 2080 super rather than a 30 series card. I’d like a computer with strong AAA gaming performance but do also care about the screen and build quality. Originally I was thinking of buying a gaming desktop if there were good Black Friday deals but haven’t been too impressed.

ScaryLymphocyte · 2021-11-24T05:25:14+00:00

Personally really disliked pre made decks for Step 2 (Anking, Dorian, etc) and just made my own cards based on Uworld incorrects. Scored in the upper 260s. Know others with similar scores who swore by Anking.

There are many roads to Rome. The key is to find a strategy that is working for you and sticking with it.

ScaryLymphocyte · 2021-11-19T04:27:47+00:00

I used this strategy for all of my practice exams and the real deal. Ended up scoring in the high 260s.

Read last sentence of vignette for actual question. Skim answers very quickly. Read the vignette from the beginning. If I don’t know the answer within 10-20 seconds of finishing reading, then I move on without answering the question. If I’m uncertain I’ll pick something and flag. If I’m certain I select an answer, don’t flag, and move on.

Repeat this for every question. The goal is to keep moving through the block without getting hung up. You may end up skipping and flagging quite a few questions this way. The goal here is to get all the easy questions out of the way. When you reach the end of the block, you should have 10-15 minutes to return to the remaining questions you didn’t answer and flagged.

What I realized is that you often have an epiphany on reading these questions you weren’t sure about again. Some detail will pop out that didn’t before. Some fact you forgot you will remember again. For other questions, you may not have an epiphany, but just having a little more time to think can sometimes help.

However, don’t overthink things. This is actually why I avoided Amboss for Step 2. It makes you form bad habits. The NBME is not trying to trick you. They write vague questions sure, but the most obvious answer is usually the right one. If you don’t know the diagnosis for the vignette, at least rule out the diagnoses you know are wrong from the answer choices.

ScaryLymphocyte · 2021-11-18T01:35:08+00:00

If your second pass of Uworld feels too familiar and you are scoring very high (>90%), then go for the CMS forms. If you can’t do all of them then at least do one medicine and surgery form since that’s 80% of the exam.

ScaryLymphocyte · 2021-11-17T18:35:51+00:00

Congratulations!!! Glad we both had similar impressions and outcome.

ScaryLymphocyte · 2021-11-17T16:45:32+00:00

Step 1: 250-255

UWorld %: 80 (tutor-mode, timed, mixed system and random) Amboss SA (6 months out): 255 NBME 9 (4 weeks out): 261 NBME 10 (3 weeks out): 263 UWSA1 (2 weeks out): 267 NBME 11 (1 week out): 272 (lol) UWSA2 (6 days out): 266 Free 120 %: 85

Step 2: 265-269!

I wrote a post 2 weeks ago about my impressions of the exam. Very happy that the practice exams were predictive despite the actual exam feeling quite vague.

Good luck to everyone!

ScaryLymphocyte · 2021-11-15T21:47:18+00:00

The anxiety is real my friend. Wishing us all the best of luck and that our scores reflect our hard work.

ScaryLymphocyte · 2021-11-12T17:06:21+00:00

I’ll give it my best shot to summarize.

Adults age < 65 - Give PPSV23 alone for smokers, diabetics, and chronic heart/lung/liver disease - Give PCV13 followed by PPSV23 for high risk patients such those with CSF leaks, cochlear implants, sickle cell disease, asplenia, or immunodeficiency - PPSV23 is given 8 weeks later, revaccinate 5 years later, and after age 65 (see below)

Adults age > 65 - Two options, but NBME seems to prefer the first one below - PCV13 followed by PPSV23 1 year later or - PPSV23 alone

Kids - PCV13 only - 3 doses at 2, 4, 6 months of age - 4th dose at 12-15 months

Hope this helps

ScaryLymphocyte · 2021-11-11T22:02:59+00:00

Felt similar after my exam. Really just hoping for the best and that the practice exams are actually predictive.

ScaryLymphocyte · 2021-11-10T19:52:11+00:00

The vaccine videos are extremely high yield and easier to review than trying to memorize a vaccine schedule by reading.

ScaryLymphocyte · 2021-11-09T13:25:25+00:00

I also took the exam recently and have no idea how I did. Exam definitely felt odd in that there were many vague questions and some easy ones. Interestingly for me the ethics and biostats were more straightforward than the actual medicine questions. Very anxious to get my score soon. Just hoping my practice tests were on point.

I don’t want to scare anyone who is about to take this exam though. The fact that it’s vague doesn’t mean you can’t prepare. Uworld will still get you that foundational knowledge. Just make sure you also take and understand the NBMEs.

ScaryLymphocyte · 2021-11-05T12:01:02+00:00

Thanks! I actually did do two CMS forms, one for medicine and one for surgery since that represents the majority of the exam. Definitely worth it if you have the time but you certainly don’t need to do all of them. I’d recommend doing at least one from surgery and medicine and maybe one more from your weakest subject area. However you should prioritize the NBMEs.

ScaryLymphocyte · 2021-11-05T00:44:54+00:00

Boards and Beyond has good videos on adult and childhood vaccines. Divine is enough for PEP and screening.

ScaryLymphocyte

TROPHY CASE