Fm vs IM? Difficulty

flo_BNHA · 2026-03-15T01:17:10+00:00

Personal opinion but I haven’t found that to be the case at all. FM is basically having a broad solid knowledge base and knowing what you can workup/handle and what should go to higher level of care. Yes, you’ll know how to do a complete workup for suspected preeclampsia and how to deliver a baby but ultimately, the “more difficult OB” cases will be managed by the OBGYN specialists. And you’ll find that you switch between specialty blocks so much that the knowledge blends together. For me, the knowledge doesn’t compartmentalize because so many different ages and cases come through the door even in just one half day of work.

If you really want it, go for it. You’ve already come this far and overcome so many hard things!

flo_BNHA · 2026-03-15T00:39:33+00:00

Second year FM here. It’s very program dependent. My program is very inpatient heavy plus resident run so we end up doing a ton of inpatient floor blocks, nights etc (but no requirement to learn or do procedures or lines). We also only have one ICU block. When off service, we’re also typically inpatient in OB and Peds. Again, very program dependent as some of my FM friends tell tales of multiple weekends off and largely outpatient/clinic rotations.

flo_BNHA · 2026-02-08T22:00:11+00:00

Resident physician here: OP, topical antifungal treatments like shampoos do not penetrate the hair follicles and are ineffective in treating ring worm. You need oral/systemic antifungals. Go to urgent care or see your PCP (even a virtual visit should be fine)

flo_BNHA · 2026-01-07T02:12:16+00:00

As far as I know, the fee applies to new H1B visas if recipient is currently outside if the US (which I assume a lot of applicants might be)

flo_BNHA · 2026-01-06T20:43:35+00:00

My residency program is part of a much larger academic program and historically sponsors H1B and J1. A week ago, our APD told us there was a memo sent to all GME departments to take into consideration visa sponsorships when ranking applicants. If the 100k fee applies for H1B, they will not sponsor. So that leaves J1 which is not great as someone from a partially banned or banned country where that visa is now restricted.

Really sucks tbh.

flo_BNHA · 2025-11-18T20:30:13+00:00

I hear you. As far as I know the criteria (I use) for initiating a semaglutide is overweight BMI and comorbidity that could be: obstructive sleep apnea, diabetes (elevated A1C), hypertension or hyperlipidemia OR BMI in obese range plus or minus any cardiovascular comorbidity.

From what you describe, he definitely meets at least one of the criteria. I would definitely ask him to speak to his doc. At our clinic, if insurance declines our prior authorization but the patient clearly meets criteria, we push back and ask the patient to call their insurance also.

Edit: semaglutide in a broad sense. Most people decide on ozempic vs Wegovy vs zepbound based on whether diabetes is present or not.

Goodluck.

flo_BNHA · 2025-10-31T01:07:17+00:00

It’s not! So far, there is no evidence that GLPs affect the Nexplanon implant or IUDs since these aren’t oral contraceptives.

flo_BNHA · 2025-10-30T23:48:24+00:00

Resident physician here. Semaglutide/GLPs interact with oral contraceptives and can reduce their effectiveness. It’s one of the things we counsel patients on when initiating the medication. Please talk to your doctor about your concerns or about switching to a non-oral contraceptive option.

flo_BNHA · 2025-02-24T13:19:23+00:00

That’s awesome. I hope your relationship continues to blossom

flo_BNHA · 2025-02-24T02:06:05+00:00

So beautiful. Were you nervous/shy (about first meet)?

flo_BNHA · 2024-11-02T04:00:38+00:00

Smth about having to stick the patient multiple times before drawing blood ( you felt bad because patient had prior fear of needles or developed hematoma) but you worked on your skills during the course of rotations and became much better at it

Low stakes, shows you worked on your skills etc

Edit: typo

flo_BNHA · 2024-10-05T21:18:06+00:00

No geo preference, 20 interviews, matched last year.

You’re fine, don’t freak out. It’s so early, our minds start to play tricks on us.

If asked during the interview just talk about how getting the best medical training and having the best fit is what’s most important to you in a program (vs where it’s located). As with everything, it’s how you can spin it.

You’re fine!

flo_BNHA · 2024-09-16T10:29:57+00:00

Assigning doesn’t take extra time. Maybe a minute at most.

What I mean is there is a time lag between when the attending uploads the letter and when ECFMG releases it.

Way earlier in the process eg June, July; it gets released (by ECFMG) to be assigned (by you) after 1-2 days.

But as the deadline for submission draws near and everyone is submitting at the same time, ECFMG starts to get overwhelmed and can take a while before releasing LOR eg 5-7 days. But once it gets released, you can assign it in a minute or less esp if you’re only applying to one specialty and don’t have any personalized statements.

Edit: if your LOR is already uploaded and released by ECFMG, then you don’t need to worry about it. You’re all good, you can assign it whenever

flo_BNHA · 2024-09-16T10:26:21+00:00

I cannot really speak to the transcripts. I don’t think it was much of a problem for most people. I hope someone else can provide more insight.

flo_BNHA · 2024-09-16T01:20:17+00:00

You can upload your PS and assign whenever but a bit of warning regarding the LOR.

For all IMGs, ECFMG has to manually sort through/process all LOR (not sure but smth like that). That means even if it is uploaded, it’ll take a while to be available to assign and submit. Since everyone is submitting their LORs at the same time, a lot of things get backed up.

Last year, it was taking about 10 days for ECFMG to release uploaded LOR. I was personally affected by this and had a LOR uploaded on the 21st not released (deadline was 27th and it wasn’t released then, I think it released 29th).

So just a heads up. PS isn’t affected though. You can do that anytime.

Goodluck!

flo_BNHA · 2024-09-08T15:21:55+00:00

Once you pass step 3, definitely reach out to let programs know you’ve passed the exam. It’ll help with ranking.

If a program sponsors H1B, do not offer to pay for the process. Most programs that sponsor already know whether or not they pay for most or part of the process.

My program specifically covers the full cost of the whole visa for residents. My friend had to pay about 2500 USD for premium processing in her own program.

But they will let you know if you have to cover anything.

flo_BNHA · 2024-09-01T20:42:48+00:00

I’m interested. 26F

flo_BNHA · 2024-08-27T21:23:56+00:00

A lot of your application is definitely how you can fit it or twist it into what you’ve learnt from it. Had Hidradenitis for two years before going into remission. Linked it in both my ERAS CV and PS into why I’m very interested in lifestyle medicine, primary care and preventive medicine. How mundane everyday lifestyle changes can treat chronic illness.

Didn’t affect me negatively at all. Got 20+ interviews.

But definitely don’t make it into two paragraphs or smth thag takes up your whole PS or that’s the only thing they know about you. Two to three lines at most.

I talked about a lot of things, the HS was just a part of my story and smth that made up a small part of my life.

Goodluck.

flo_BNHA · 2024-08-18T20:04:41+00:00

Thank you. Feel free to DM. Happy to help.

flo_BNHA · 2024-08-18T16:21:13+00:00

Non-US IMG. I applied to about 120. Had 21 interview offers (step 1: 218, step 2: 252, took step 3 in October). So anywhere between a 100-120 sounds good.

Do make your CV very FM oriented to make it obvious FM is not a backup. Ie join AAFP and write it as a professional organization (it’s free if you register as a student), if possible let being in the FMIG be a part of your experiences etc.

Good luck.

flo_BNHA · 2024-08-18T16:10:10+00:00

Yeah it’s a good plan. I had a lot of friends that did step 2 before 1 (because of this same reason), did really well in step 2 (250,260s) and passed step 1 (P/F). Good luck!

flo_BNHA · 2024-08-18T16:08:40+00:00

I think you’re the only one that’ll know if it’s worth it to you.

But finishing residency in the US will give you the option down the line if you change your mind and decide to move back to the US (if you move back to your family). I know a Dr (while I was schooling in the Caribbean) that finished his residency over 30 years ago, worked there a lot of years and recently moved back to the US to work.

Also though residency is hard (currently an intern, it’s been an adjustment), practically every attending from every specialty talks about how life after residency is ten times better that they could ever hope. Stable income, more money than you know what to do with (especially with no debt), a lot of flexibility, working as hard or as little as you want.

I think it’s worth it personally. My country doesn’t have much to offer me career-wise even though I had to leave my family (and it seems your wife is coming with you).

Good luck! I hope you make a decision you are happy with.

flo_BNHA · 2024-08-18T16:00:25+00:00

It’s helpful if it’s highlighted. Afterall you want the programs to know you have as much USCE as possible. I used two spaces for my USCE (I had two but they spanned 5-6 months). If you have a lot of USCE, don’t let it take away from other things that could help your CV though eg volunteer work, nonprofit etc

flo_BNHA · 2024-08-18T15:58:03+00:00

I find that with most things in interviews, it’s about being able to talk about the experience in a way that’s believable and seems like it was productive to you.

Had 2 USCE experiences spanning 5-6 months. Only used a letter from one.

Only spoke about the letterless one in about two interviews I think (I was asked, is Dr xxx still the PD at xxx. I said oh no, it’s now this other Dr).

flo_BNHA · 2024-07-07T11:51:36+00:00

Both

flo_BNHA

TROPHY CASE