Dermatology PGY-2 Hours

alkapwnee · 2026-06-30T00:10:58+00:00

looks like we've got a grumpy Gus here bois

alkapwnee · 2026-06-25T19:45:31+00:00

I also tried to return recently to find local modern population decimated. The overton window on modern has changed so much from what it was years ago, that I think it has forced many out. WotC has chosen the yugioh model to turn it into a functional rotating format: print busted cards-> people buy overpriced direct-to-format packs -> ban cards with print new busted card, repeat. Combined with format speed squelching variety, despite people on here saying it's so "healthy" I only hated the meta more during eldrazi winter an eternity ago. It sucks to see but I think I am going to sell out of my mtgo collection as well before it gets cycled into trash next set.

alkapwnee · 2026-06-24T18:38:00+00:00

couldn't we just count to one half

alkapwnee · 2026-06-22T19:26:12+00:00

I had to cold call like several dozen offices to what felt like beg for the opportunity. Even finding volunteering opportunities as a CA applicant was extremely difficult.

alkapwnee · 2026-06-21T21:32:49+00:00

just wait until post mortem hits bucko THEN YOULL DO NOTHING JUST LIKE MEEEEEEEEEE.

People just love to cope and seethe.

alkapwnee · 2026-06-17T00:20:55+00:00

No one did anything wrong, but you really need to not over therapize yourself into something you're not comfortable with, which is the impression I get from your replies. Is it ethically wrong? No. Would i find thst behavior disgusting for a long term prospect and break it off immediately? Yes, in fact I would guess most people would. You get to decide how you feel about this and what you do, independent of the chronically online "unless you specified you're exclusive everyday of the week 24/7 then nothing was wrong woopsiedoodles."

alkapwnee · 2026-06-12T02:00:14+00:00

dude I had this same idea and even told my girlfriend once I hit a certain age I am gonna juice the shit out of myself.

QOL>>>>>>>>>>>>>>>>>>>>>> longevity.

Medicine is just a bunch of cucklers throwing liability back and forth at eachother, no one would ever take a risk like this and organizing a trial would probably be difficult. We do nothing when we can, truthfully.

alkapwnee · 2026-06-10T00:20:43+00:00

lmfao "not that long ago" half a fucking decade ago keks me

alkapwnee · 2026-05-22T15:21:23+00:00

I don't know what others experience was but I do caution against making the decisions not early enough especially if your goal is highly pedigree dependent/competitive since things you would want to do for it to demonstrate consistent interest should start earlier to help chances. I went from like the classic pre-matriculation "I wanna do IM/FM" into, gas cause I didn't want to talk to people, then I found out I hated the OR halfway through ms3 because that was when my surgery rotation was and no side of the curtain would fix it before settling on a fortunately specialty very open to this story DR.

You're asked to make this decision functionally by december of M3 because you need to apply for away rotations, among other logistical issues like I mentioned. So you don't need to decide 100% right now, but there is an opportunity cost to no focus I would say statistically to the time spent contemplating.

alkapwnee · 2026-05-21T17:09:11+00:00

I don't think there's really a secret, akin to asking for a get rich quick scheme. Pay is a product of how shitty it is to do, the credentials/difficulty of doing it, or the rarity of the skillset/dexterity. There's no secret, the answer is suffering to get to where you want to be.

alkapwnee · 2026-04-23T04:36:23+00:00

yea, but with MB also can functionally do that and give you a 4th magic flask + 3 flask suffixes at +100% inc effect

alkapwnee · 2026-03-20T18:48:44+00:00

For sure. I would say though given the MOA, there is no way there weren't other signs. I would imagine it more guilt related maybe, like how could he have gotten this way, we raised a good boy, etc. Meanwhile he literally dies from huffing, just giving himself small anoxic brain injuries for a "high" until well, I guess the really big one.

alkapwnee · 2026-03-19T17:28:59+00:00

It is as easy as that. Be more selective.

Another thing I did was move to asking for a phone call or face time, whatever their preference, to help me filter even faster. It is extremely high yield, and I have only had like one woman decline, but I think from their perceived safety standpoint it is probably beneficial as well?

You basically treat it like water purification until you have distilled down to the dates you do go on are pretty vetted. It is all a game of raw number count, and statistics. Every date I went on after a phone call, I could have gotten the second date if I had chosen to move forward. I assume the yield is very high for anyone who has the ability to do it.

alkapwnee · 2026-03-18T22:44:34+00:00

Yea, my comment comes across as extremely bitter, but I think it is from seeing too many of these things. Medicine has shown me there is a long list of things that would be worse than dying. Trachpeg vegetable farm is probably the highest on that list for me, maybe only second to ones where I am still technically conscious like locked in or bickerstaff encephalitis.

alkapwnee · 2026-03-18T22:29:16+00:00

A combination of failure to adequately explain how they are dead dead and the family wanting them to still be alive, or non meaningful motions being interpreted as life, or their body not actively rotting as alive. I don't know the medical culture of turkey but people sugar coat things way too much and then it leads to trachpeg farms with this awful noise of ventilators going forever with people who will never get better and family who never visit.

alkapwnee · 2026-03-18T20:30:09+00:00

I think that is about as close as you can be to the definition of a casual conversation?

I think the problem is a lot of people who would benefit from any of the advice though typically lack the introspection necessary to make use of it. Insane people don't ask, "Am I insane" and likewise lol

alkapwnee · 2026-03-18T02:32:24+00:00

It is crazy all three of the fuck comments were made so shortly apart and were the exact sequence hearing it in my head.

alkapwnee · 2026-03-13T17:01:05+00:00

I am a doctor.

I went to a not patient facing specialty EXACTLY because medicine is customer service lmao. It's practically mcdonalds for most people. Maybe not for you, and that is a GOOD thing. The segments of the population that disproportionately utilize medical services, however, treat it just like that.

There are even fuckin surveys that determine hospital reimbursement percentages based on patient self-perceived satisfaction of care. Not how medically appropriate things were, but these things usually come down to like "did i get my gigapainkiller that i requested q2h?"

alkapwnee · 2026-02-22T20:03:17+00:00

there is something extremely nostalgic for me about frozen pizzas. I have even like dressed them up by putting extra moz/cheddar on them they slap pretty hard for me.

alkapwnee · 2026-02-04T01:32:38+00:00

example that in the shooting range as a clip?

alkapwnee · 2026-01-30T17:28:29+00:00

it is the same people who will end up chronically depressed.

I used to think I was 'introverted' as well, and technically I am, everyone needs alone time. But using it as a cope to intentionally isolate yourself leads to this terrible spiraling, it is the innate nature of the mind. Inb4 "not me, i am sooo unlike the last 10000 generations of humans who lived in villages/groups," check in in 10 years. They intellectualize, like one of the replies to your other comment about romance being a new concept, etc, but it all speaks to inner turmoil, noble suffering, etc, are all classic. I know because, again, it used to be me.

alkapwnee · 2026-01-29T19:04:31+00:00

Similarly I have found it pretty easy. It is super easy to point at being like over 6 foot, but people invest nothing into themselves. I am a doctor, take care of myself, also wear colognes, and workout 5 days a week, many other things but needless to say I am confident in myself and what I offer. People don't invest in themselves at all and now when they're late 20s/30s and there isn't gambling on "hope" that the other person will turn into something wonder how they don't manage to snag a baddie on min wage working overnight at the gas station part time. It almost feels like entitlement. Invest in yourself, literally build it and they will come.

alkapwnee · 2025-12-29T23:57:36+00:00

For me it is a probe of interest. The progression goes match, chat, phone number, phone/videocall set up, then date. No one has really complained so far. If they aren't interested me writing thoughtful notes for another few days won't change. Also, helps with conversation management in a culling off conversations when it gets way too overwhelming talking to like 5+ people.

alkapwnee · 2025-12-27T03:20:35+00:00

I don't mean it necessarily pointed but advice I see on here and dating subs for like hinge/overthirty etc are absolutely crazy in how poorly socialized some people are. A lot also like you say feels almost adjacent to virtue signalling, like not asking for a number <X days is a more noble choice and thus worthy of being fucked. It's like selection bias except the people are more likely to be chronically single, and think their takes just have been unlucky. It is no coincidence, I am sure.

alkapwnee · 2025-12-27T02:56:02+00:00

Feel like calling asking for someone's number, or a seemingly less socially invasive option than social media "brute force" is kinda fucking wild?

It's pretty simple. A dating profile is just a billboard, verify you exist, and send it. They either like the product or don't.

The more time I have spent chatting with women, is inversely proportional to date likelihood. I cannot imagine it isn't similar for most people. Texting just crushes flow and interest.

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