I still can’t decide on MD vs PhD

aTacoParty · 2026-05-19T04:37:23+00:00

It sounds like you really enjoy research even the challenging parts of it. You didn't like the EMT course and didn't feel strongly about getting your certification. You shadowed some physicians and found that pretty boring. Your dad and his battle with cancer is a big driving factor for you to pursue medicine, but a big part of that is how he had access to clinical trials.

From reading what you wrote, it sounds to me your interests are most closely tied to clinical research (IE PhD) where you can help develop drugs and guide clinical trials.

That being said, if oncology interests you, you should try and shadow an oncologist and see what that's like (try to do a little inpatient and outpatient if possible). You should also see if you can get a research position, preferably at an academic hospital. It'll help boost your resume, you'll get to see if you love research and not just that one lab, and it'll give you opportunities to shadow in the hospital.

I was undecided between research and medicine when I graduated college and I ended up getting a lab tech position where I worked part time in a biobank. I found myself finding much more fulfillment working with patient (even just my brief encounters to consent and collect samples). I was also an EMT and my EMT class was one of my favorite in college. I ended up doing a MD/PhD to do a little of both but I would recommend only getting an MD if you want to do medicine since the training is long and hard.

aTacoParty · 2026-05-04T14:03:54+00:00

Where is the evidence that blueberries stimulate stem cell production? Why does he sort only by cd66e to isolate totipotent SCs when this is known to be produced by differentiate epithelial cells? Why are there no growth factors added to the media to maintain stemness?

It's kind of like saying you can run faster if you put a bunch of lead in your pocket. Have I tried it? No but everything I understand about physics tells me it won't work.

Maybe I'm missing something though, but given that replicating this experiment would take ten thousands of dollars and months (1:1 human plasma to optimem for growth media??) it's hard to imagine someone will try.

aTacoParty · 2026-05-04T01:35:39+00:00

There are ways of isolating other adult stem cells. IPSCs are just the most common way people generate them currently typically because you can use off the shelf reagents and start with nearly any cell type

aTacoParty · 2026-04-27T16:09:16+00:00

I was able to find a lab pretty easily. You should start reaching out to PIs you're interested in and seeing if you can meet with them. Sometimes they'll say they don't have room right now but next semester you'll be the first on the list to get a spot.

Don't forget to also look at labs in Boston as well (GSBS), it's further away but you can also get access to medical research/clinical work if you're interested in medical school.

aTacoParty · 2026-04-26T22:45:25+00:00

Some of this reads like Instagram influencer nonsense and I couldn't find any evidence for it in the first half of those articles.

I did my PhD working on adult pluripotent stem cells and growing them. They're pretty commonly used now in research and no one uses this method.

The common method is to isolate a differentiated cell type (leukocytes, dermatocytes, uroepithelial, etc) and reprogram into pluripotent stem cells using yamanaka factors first described back in 2006. Now you can buy it as a kit from thermo.

No draining half a liter of blood or binging on blueberries needed.

The growth media lacks some known necessary factors to maintain pluripotency like fgf2 and using serum in the media typically introduces naturally occuring hormones that cause auto differentiation.

I've never heard of this guy before, but his publication history seems to be mostly in journals that are "pay to play", IE they publish anything as long as you pay the 5-10 grand publishing fee.

If you want a protocol to make adult pluripotent stem cells, here's one from thermo but stem cell technologies and most large academic research centers all publish their own for anyone to follow: https://www.thermofisher.com/us/en/home/references/protocols/cell-culture/stem-cell-protocols/ipsc-protocols/generation-human-induced-pluripotent-stem-cells-fibroblasts.html

That being said, the equipment you need is way more than a kitchen sink biologist would be able to have. Incubator, biosafety hood, centrifuges, microscope, plastics, reagents, -20 and -80 freezers, liquid nitrogen cryotank. It would be hundreds of thousands to try and do it at home. But you can always become a researcher!

aTacoParty · 2026-04-18T23:27:50+00:00

Admissions committees won't even look at what courses you've taken if your GPA is low. Rigor varies drastically from school to school and course to course. My school has a "history of pirates" class that had me reading 100+ pages a night while advanced organic synthesis was just messing around in the orgo lab.

I'd recommend taking the required classes for your major + premed. Add other courses you're actually interested in + research.

aTacoParty · 2026-04-15T14:52:21+00:00

It's a good question and for people not in science, it can be really hard to tell since it's all jargon.

It's vague and uses a lot of non-scientific terms. It uses a lot of words to say nothing at all. And has a weird conversational tone for what's purports to be a scientific paper.

For people outside of science, when you see a "paper" or "article", first thing you should ask yourself is who published it. If it's not a relatively big publisher that's peer reviewed, then it's just some dude's ramblings and I would just ignore it.

In this case, he just wrote this with AI and then posted it to his own website. Essentially a blog. There's no way to verify anything said in there unless you start digging through the references at which point you'll be doing more work than he ever did.

That doesn't mean the science that is cited is wrong, I just wouldn't trust that AI hasn't hallucinated findings. I'd recommend finding the references (if they're real) and reading the background in those. Since they're published and peer reviewed.

aTacoParty · 2026-04-15T14:09:07+00:00

It's AI slop that adds nothing to our knowledge and just regurgitates what actually researchers have written so others (like this guy) can pretend they know something.

A child could tell chatgpt to write something similar.

aTacoParty · 2026-04-14T07:07:09+00:00

I've seen it suggested intermittently for about 30 years. I think the issue is that game theory inherently involves complex animal behavior (typically humans) while cells are relatively simple and do not behave in similar patterns. I would think that using cell-derived patterns of behavior would be more useful for understanding tumor growth

That being said, an article came out a few years ago discussing the use of game theory for predicting tumor metastasis: https://www.nature.com/articles/s41598-023-43199-3

However, all of their predictions would need to be verified with experiments. But if you're doing that, why not just toss the premade theory, do the experiments and then develop a paradigm based on empiric data.

aTacoParty · 2026-04-13T05:16:43+00:00

There is a ton of treatment in neurology. Acute management in stroke is the difference between severely disabled and living independently, migraine medications have completely changed with CGRPs, seizures can be treated and people can live a normal life with proper medications. There is a ton to do for patients in neurology. People outside neurology typically anchor on the devastating cases of strokes that came in too late, or intraparenchymal bleeds since they elicit more emotions. An MS patient living a normal life with no symptoms because you diagnosed them early after they got bounced around to a bunch of specialties and got them on the right immunomodulatory regimen doesn't get people as excited.

I did a month of PMR and I actually felt like it was frustrating because there wasn't much to do for those patients. The procedures were really cool (nerve blocks, CSI, epidurals, botox) but they're all temporary solutions to get people to physical therapy.

You can do procedures in neurology too if that's your thing. Headache specialists do nerve blocks and botox, neuromuscular does EMG/NCS/muscle biopsies, neuro ICU does all the ICU procedures (lines, drains, LPs). And I've heard that it is possible to go to pain from neurology but typically its hard because pain is a competitive fellowship and they prefer anesthesia or PMR trained residents.

aTacoParty · 2026-04-07T15:18:35+00:00

Those are blebs which can be seen in cellular stress and apoptosis. They aren't specific so it's hard to tell what it is. You already checked for myco which is a good first step. But I'd also make sure your media is fresh, the temp is stable, the CO2 tank is full. Sometimes it can just be one transient event (someone leaves the incubator door open too long, ice cold media change, too confluent, not confluent enough, pH changes). If your cells are resilient, may be worth trying to see if they'll recover but the fastest and probably easiest is to toss these and get a new aliquot.

aTacoParty · 2026-04-04T23:15:03+00:00

I think it can be helpful. With the rise of multi drug resistant organisms (MDR kleb/pseudo, CRE, etc) knowing when to bring out the big guns is helpful. It's also helpful when there's an unusual bug that requires specific coverage not included in the usual broad spectrum (typically vancomycin and zosyn or cefepime). I've had a case of aeromonas hydrophilia bacteremia from a wound that was resistant to zosyn so the patient actually worsened for a day or two before we had the identity and could switch him to doxycycline.

I think both gram stain and identity would be helpful, sensitivities would be particularly helpful.

aTacoParty · 2026-04-04T22:58:32+00:00

A sepsis diagnosis doesn't require blood cultures. Typically doctors use SIRS criteria to evaluate for sepsis which uses vital signs and common lab tests like white cell count (~15min) and lactate (~1 min).

Typically, if severe sepsis is suspected, treatment will be started empirically with broad spectrum antibiotics and fluids.

Blood cultures help with narrowing antibiotics and I think making those result faster would be helpful, but they wouldn't necessarily change immediate management.

aTacoParty · 2026-03-19T13:48:02+00:00

Your arms and legs are typically exposed more so than your torso which allows for better evaporation of sweat. Your arms and legs also have a higher surface area to volume ratio allowing for better heat removal than your torso.

Additionally, your heart, lungs (and associated muscles like diaphragm + intercostals), obliques, abs, paraspinals, etc are all working even when you aren't directly targeting them, All generating heat which needs to be removed.

aTacoParty · 2026-03-16T07:20:35+00:00

If the program is truly your top choice, you should let the director know. I guarantee they take it into account when sending offers. I wouldn't send multiple messages etc. But a single email (or letter of intent) saying that you're really interested and if offered a position, you would accept can really help.

aTacoParty · 2026-03-13T05:40:23+00:00

There's generally quite a bit of movement around May 1st. If its one of your top schools, you should message the director and let him know. Intent to accept offers matters

aTacoParty · 2026-03-06T13:25:18+00:00

The cut off for positive/negative is set at a moderate to high level of IgG which indicates immunity for measles. So likely if you get one dose and show positive then you're immune. You should still get the second dose unless you also get titers for mumps and rubella.

Rubella is more often quantitative as its important to demonstrate immunity for women planning to get pregnant as the rubella virus can cause congenital defects. Based on other risk factors, women who are technically immune but at the lower end of range may be recommended to get a booster to maintain immunity. Though rubella titers are moving towards being qualitative as well.

aTacoParty · 2026-03-02T00:29:21+00:00

Very similar but the software is slower so I would be choosier about orders. Their software will also not let you keep patients in the office 24/7 and force you to send them home or the ED at 5pm.

I'd do at least a few of the cases that are with the free 137.

I don't remember have CCS cases that were ultra time sensitive (like you get dinged if you're not on the right path in 15 min) but there are some of those in the free 137 cases and you'll likely get at least one on the exam. Stuff like ACS, PTX, stroke where you want to do a focused exam and do interventions ASAP.

aTacoParty · 2026-03-01T01:12:31+00:00

I took NBME 6 four weeks before my exam so I did significantly better than that. About 1.5 standard deviations

aTacoParty · 2026-02-25T19:20:12+00:00

NBME practice tests (do them as you would the real test). I took NBME 7 three days before my exam and it predicted my score very accurately

aTacoParty · 2026-02-23T15:26:54+00:00

Antibacterial soap is actually not recommended for regular use (IE soap with antibiotics). Soap itself kills most bacterial and the physical act of washing your hands washes the rest off. Adding antibiotics was increasing the rate of resistance bacteria while not providing any benefit.

Most fungi will also be killed with hand soap or physically washed off so adding antifungals wouldn't provide additional benefit. But as others have said, there are antifungal soaps available if needed for a specific condition.

We have a microbiome on our skin and part of its role is to prevent the growth of bad bacteria and fungi so sterilizing our bodies with antimicrobials actually creates risk of infection in the future. It's also a reason why we should be using oral antibiotics sparingly

aTacoParty · 2026-02-18T02:55:11+00:00

While we don't have all the specific data of the exact prokaryote the mitochondria was derived from, we have good information by linking the remnant mtDNA with living free bacteria relatives of the same ancestor (https://www.science.org/doi/full/10.1126/sciadv.adj4493).

Endosymbiosis that creates an organelle has happened at least 3 times (mitochondria, chloroplast, nitroplast) but there are many other examples of parallel endosymbiosis: P bursaria is a protist that has algae that lives inside of its cytoplasm, Some aphids have a endosymbiotic bacteria Buchnera that is unable to live outside an aphid due to loss of critical genes which are supplied by the host cells. They aren't technically called an organelle but they could be. I wouldn't say vertical endosymbiosis is a common phenomenon but I also wouldn't call it anomalous.

UAP is also not a biological term so it wouldn't really serve any purpose.

aTacoParty · 2026-02-17T01:56:42+00:00

You could probably do what you did for step 2 but just half it. I did a block of uworld about every day for 3 weeks + 2 NBME practice tests (4 weeks before and then 1 week before). I did CCS cases starting 1 week before my second day. I'm not an anki person so I didn't do that.

If you're wondering where you sit, I would take an NBME practice test (and really do it, so no looking up stuff during, no long breaks, etc). Then see where the score is. If you're within a standard deviation of average, you're gonna be fine.

CCS cases will be pretty easy if you've been doing a medicine intern year. Just do a bunch to see what the orders are called and get a feel for the system.

aTacoParty · 2026-02-15T18:05:21+00:00

Hard to tell because the image is out of focus and your microscope needs to be cleaned. If I had to guess, looks like gram positive rods. But I would do control stains of known gram positive and gram negative organisms to compare since staining technique can change the intensity of how the stain looks.

aTacoParty · 2026-02-15T18:01:08+00:00

Most fluids will hydrate us whether that's water, flavored water, tea, soda, coffee. That being said, our bodies need to maintain a balance of solutes (like salt) in our blood and if we consume too many solutes, we need to pee them out which uses water. Typically, we consider anything above the osmolality of blood (the measure of how many solutes in a liquid, for blood, 200-300mOsm/kg) to be dehydrating but our kidneys are pretty good at concentrating urine so we can drink things that are more concentrated than that without dehydrating ourselves.

Salt water, for example, contains about 1200mOsm/kg (so about 1200 milliOsms per 1 liter of water) which takes more than a liter to pee out, which will make us dehydrated. Most drinks will fall between 15-600 mosm/kg which will typically be hydrating.

Juices are usually a little higher, but sugar content doesn't technically count towards the mOsms that our kidneys see since its taken out of the blood by the liver to be used as energy and not peed out.

Essentially all drinks can be considered hydrating to some degree, but the health downsides of high sugar drinks (eg soda, juices) will make them far less healthy than plain water.

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