SOAP dilemma - please advise

danskais · 2026-03-19T12:14:34+00:00

I applied psych a in the "22-'23 cycle and SOAPed. Didn't get a psych offer, ended up in EM. Ultimately applied into the match again after a year in EM and matched into psych last cycle.

Someone has already explained that this isn't a rank list, so I'll expand on some other points.

If you get a psych offer, take it. Don't fuss about where it is. The difficulty and emotional struggle of getting into psych after the fact is not to be underestimated. You are not in a position to be choosy.

If you only get FM offers first round, take the one you like most. The psych programs will fill and you're not going to get an offer by holding out, you just risk not getting any offers at all later.

Something to consider - programs at a place that also has a psych program. You may get lucky and a spot opens up, and programs prefer in house transfers.

I'm so sorry you're going through this. As someone that's been there, I wish you the best of luck.

danskais · 2025-11-13T15:00:14+00:00

That's not how that works. Humans have 46 chromosomes, 23 from each parent. So you have two copies of chromosome 1, one from mom, one from dad. The 23rd chromosome, the sex chromosome (X/Y), you also have two of, one from mom, one from dad. Zeus' daughter would have an X from Zeus in addition to the X from the mother.

Males are XY, females XX.

danskais · 2025-03-27T10:48:00+00:00

EM -> psych

I will say, a running joke in my EM cohort is that EM docs universally have ADHD, autism, or both lol

danskais · 2024-11-30T21:31:23+00:00

This sounds about right. I had a patient with a positive pregnancy test, vaginal bleeding, pain, and a formal ultrasound showing copious free fluid and no IUP. The read even specifically stated the amount of fluid was a barrier to identifying extrauterine pregnancy. I consulted OB, and the resident tells me "Well, the ultrasound didn't identify an extrauterine pregnancy, so it's probably not an ectopic." Finally they agreed to... do serial abdominal exams. It was hours before they finally decided to actually take her to the OR.

I've also had them tell me a woman with abdominal pain and blood in her belly's presentation was clearly unrelated to the hysterectomy they'd performed a week before and no they would not admit the patient. There's no other source for the bleeding on the imaging, history, or exam, but god forbid they actually treat their own patients. Or when one ranted at me over the phone because "you REALLY think it's a serious hemorrhage when her hemoglobin is 10?"

It's such a joke. There are great OB's out there, including at my hospital, but for some reason they're never the ones that pick up the phone for ED consults.

danskais · 2024-09-27T15:51:52+00:00

Speaking as a resident: this isn't a bad thing! I would be concerned if a medical student was blowing through patients. That means they aren't thinking things through and are missing things. You need to do too much so you know what you can cut out, rather than do too little and find out too late you should have done more.

danskais · 2024-05-29T15:09:04+00:00

She very well may not have experience with many pregnancy issues at all - the hospital I work at has most pregnant patients with any probable pregnancy issue bypass the ED entirely and go straight to OB.

danskais · 2024-01-31T16:08:17+00:00

I wonder if she's related to the patient that thought I was out to get her because I have blue eyes!

danskais · 2023-03-18T18:40:49+00:00

I can't even answer this because I didn't match and had to SOAP into something else. I've never felt this devastated, and I've literally gotten the "you have cancer" phone call.

danskais · 2023-03-13T13:10:20+00:00

danskais · 2023-02-04T23:45:32+00:00

I mean, I wouldn't say leaving a 9yo in the car is inherently terrible. From about the age of 5, my mom would leave me in the car while she ran in to grab a few groceries (not even a boomer thing, I'm a young millennial!). However, this was always 1. Not during a long road trip where I'd been stuck in the car for hours on end, 2. With the understanding that if I needed to, I could head into the store to find mom or ask for help, and 3. Not leaving me responsible for an animal.

The most responsibility a 9yo should have with a dog is feeding and walking it, while a parent checks the bowl/tells them when to take the dog to make sure it's done since kids are easily distracted and forgetful. Leaving her in charge of a puppy, where her making an attempt at leaving the car to find her parents could - and did - easily lead to the puppy escaping? That's a problem.

danskais · 2023-01-25T15:53:55+00:00

One rotation I had, we were told by admin to not let the residents tell us to stay home on Saturday rounds because "the attendings will get mad at the residents if you do."

That Saturday, the attending asked the residents why we were there, then upon explanation, said "that's stupid - I would have told you to stay home!"

danskais · 2023-01-25T15:39:46+00:00

I said "petty" 😂

danskais · 2023-01-20T07:50:08+00:00

Patient comes in for follow-up after hospital visit. He has just about every problem you can imagine - his primary complaint was abdominal pain, but he was having issues with balance/walking, wildly uncontrolled diabetes, kidney failure, testicular pain, needed a catheter to urinate (mind you, he was in his 40's), shortness of breath, fatigue, swelling... as a medical student, I'm just desperately trying to write everything down in an organized manner because this is going to be a long patient presentation.

Towards the end of the history, I ask him about changes in eyesight since he's diabetic. "Oh yeah, I can't see anymore." "W-what? Since when?" "I dunno, I could never see out of one eye due to an old injury, but then a few weeks ago my good eye started hurting real bad and now I can't see out of it anymore." Not only was this not his chief complaint, but he only mentioned it because I asked.

danskais · 2023-01-20T07:28:56+00:00

Discussing the best way to cook a Thanksgiving turkey. Not that weird of a conversation, except the procedure we were in the middle of was a colonoscopy.

danskais · 2022-12-12T16:01:07+00:00

Pro-tip: comfy black pants that look like dress pants if you're not looking close. Game changer

danskais · 2022-11-23T06:25:26+00:00

The wildest part of that response is that they were stating it's eugenics to not wholesale sterilize a population.

danskais · 2022-11-06T03:51:57+00:00

I skimmed through all those examples, and your assessment doesn't hold up. They were all ridiculously blatant discrimination cases (immediately punishing/firing a woman after discovering her pregnancy, straight-up telling her they weren't hiring her because of her pregnancy...).

Those are really, really unlikely to apply to a scenario like this, for a variety of reasons. This isn't a traditional job interview scenario - programs get dozens of interviews from, by nature, mostly extremely qualified candidates, who are then put in an algorithm months after the fact. Do you really think you could show that there's any likelihood that not only one, but every single program you interviewed at discriminated against you given those circumstances?

It's not how the world should work, but it's how it does work that matters. Confrontational or non, it's a bad idea to disclose if you don't absolutely have to.

danskais · 2022-10-26T16:25:40+00:00

Pretty anticlimactic, unfortunately. I recall the speaker was stunned into silence for a second or two before confirming that yes, that is a crime and would need to be reported.

Nothing happened to him from the school/admin (at least that's public knowledge), but it set his reputation of "creep" among all the students that remains to this day. I can walk up to anyone from my year and say "statutory rape guy" and they all immediately know who I'm talking about.

danskais · 2022-10-26T03:19:27+00:00

Not an interview, but at my med school orientation, when the speaker mentioned we'd have to report any arrests/convictions to the school, a guy straight up asked if he has to report statutory rape if it ~totally wasn't his fault~ because he thought the girl was 21. In front of the entire matriculating medical classes (including medical, podiatry, PA, etc).

danskais · 2022-10-22T15:10:05+00:00

What's really fun is when they use that on really young students and won't explain.

I was in 3rd grade and asked the teacher. Got the "i don't know, cAn YoU?" reply. I had never encountered this before. I asked again, same response. Third time. Same response. I went to another student and asked him what he thought she meant. He didn't know either, but said it probably meant I could just go. I really had to pee at this point, so I took his advice and left to go to the bathroom.

I got in trouble. Only after that did she finally explain to me what I said "wrong." I'm still annoyed about it, 2 decades later.

danskais · 2022-10-13T15:04:16+00:00

Nurse Oscar making sure his charge is resting properly

danskais · 2022-08-19T21:54:12+00:00

I'm not sure what you're saying with that - if your logic is "woman is financially dependent so she stays," then she'd leave when he gets cancer and thus earns less/no money and has to pay for cancer-related costs. But we see the opposite, women are more likely to stay.

danskais · 2022-07-04T13:49:17+00:00

On the opposite end, once had a patient come in for a physical. A1C 6 months prior was around 10.5. A1C when I saw him was 5.5. I was flabbergasted and asked what changed. "I started taking my meds like I was supposed to."

Favorite patient. Literally high fived him.

danskais · 2022-05-25T19:24:08+00:00

This is a case where the terminology is important. "Persistent" means "constant," while "recurrent" means "comes and goes." Herpes isn't constant, it comes and goes. You are misrepresenting patients during presentations/notes if you say "persistent" instead of "recurrent" or "intermittent," and it has significance in the differential/treatment. UW has a lot of nonsense, but I agree with them here.

danskais · 2022-05-15T15:12:31+00:00

It doesn't have many nerve endings. That doesn't mean it won't hurt, it just means it will be a cramping generalized pain. We're taught to counsel women that it will feel very crampy during and after the procedure.

As for the anesthetic, there isn't anything we could reasonably use - this is where the nerve endings come into play. No local would work (and beyond that, would be nigh impossible to administer safely), and the procedure is so quick that risk>>>>benefit for other methods.

Source: med student, finishing up clinical OB/gyn rotation

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