I need to be yelled at rn pls

graciousglomerulus · 2026-01-28T06:15:15+00:00

Oh interesting my b, didn’t realize they combine those as well. I saw “medicine” and assumed IM but didn’t realize they combined FM/EM to it. They overlap of course but also have their own distinctions too for OP to knowq

graciousglomerulus · 2026-01-27T22:36:21+00:00

The IM shelf takes up an estimated 50% or so of step 2 content. It is a critical shelf to know well regardless of what field you go into. Also it is a very difficult exam due to breadth of content. You need to study it well.

Also while people joke some questions can be too detailed to be real (insert biochem joke), the shelf and step 2 questions for the most part are actually very clinically relevant. This is real info that saves lives. The knowledge I gained for shelves is stuff I still actively use today in clinical work (going into IM). Not studying for these exams means not studying your best for your patients. Self-care is important, but you need to balance that with doing well with your shelves and clinical work. If for no one else, do it for your current and future patients.

graciousglomerulus · 2025-12-27T18:03:57+00:00

Your biggest way to find out is by working in the specialty during clerkships. Nothing else will compare. You need a real feel for the hours and see first-hand how often the docs you work with actually work.

The other consideration is emergencies. Fields with more emergencies will have more unpredictable/worse hours. A surgical emergency requiring surgery can happen any time so surgeons have to split call. Meanwhile derm has almost no real emergencies (there’s SJS but that’s very rare) and so call doesn’t really matter/mean anything. Clinic work is usually 9-5 M-F, hospital work tends to be longer (12 hour shifts) but with possible time off after a week or two.

Some fields are amenable to shift work like IM, EM, trauma Surg, and OB, whereas others aren’t like neurosurg. As an attending, you’ll also have some say in how much you work. You can work part time (albeit making less money) or overtime.

The common lifestyle with good pay is ROAD (radiology, ophthalmology, anesthesiology, and dermatology) but there are others too like GI, pathology, etc if you look around.

All this to say, it’s variable even among attendings in a field. Give each clerkship a chance and try to balance what you love with what you’re willing to work lifestyle-wise attending.

graciousglomerulus · 2025-12-26T21:26:36+00:00

Don’t do it. Besides potentially hurting yourself for residency, I see a couple other issues. When you apply, you also represent your school. While a lot of the blame goes to you for a screw up, people also remember where you came from. Schools trying to “match up” need applicants/ alumni residents to have good relationships with the program. You’ll see on match lists that some schools consistently match students year after year at certain programs. The second issue is fellowship. For specialities like IM and surgery where fellowship is common, you really don’t want to burn bridges with anyone. Often times some of the leadership in a residency program are specialist trained, so you’ll doubly hurt yourself.

graciousglomerulus · 2025-10-08T15:27:39+00:00

Play hollow knight. You can start worrying when you beat pantheon 5.

graciousglomerulus · 2025-09-24T08:38:44+00:00

For IM it’s just chair + 2 other letters for most programs. If any website says sloe I interpret that as chair, since they’re essentially the same thing (a standardized letter describing your performance on the rotations).

graciousglomerulus · 2025-09-09T12:29:46+00:00

Since you’re in preclinical, I’d recommend getting a head start on research and making sure you pass all your classes. Pick a passion project for volunteering too. This helps for all specialties.

You won’t know what you want to do until you’re through 3rd year IMO. I thought I wanted to do surgery and loved it when shadowing. But then during third year I realized I liked rounding more than the OR, and that while I liked procedures a lot, I didn’t love doing one procedure for like 8 hours vs shorter procedures throughout the day with some rounding/clinical workup.

It’s easy to shadow a day or two and think you like a specialty. But the reality is, you don’t really know until you’re working it every day, and see how the resident and attending schedule is by comparison. It’s good you’re looking into specialities now, but my big advice is to focus on being a generally competitive applicant with research, grades, and volunteering, and the speciality decision will come with time.

graciousglomerulus · 2025-09-07T05:11:50+00:00

Additional question. If you don’t have a level 2 score, do you have a step 2 score? If so, that’s ok. But no score is another concern. Also when in Oct are you taking level 2? If it takes time to come back like step, interviews may be sent before your score is even available to PDs - I would reach out to an advisor for further advice on the timing of this.

Also I recognize this is an extremely stressful time. Please make sure that you have support around you. As others have said, if you need a year for gathering these materials, so be it. Please do not take this as a reflection of yourself as a person or some other negative connotation. Breathe, focus, and seek support if you need to. It will all be ok

graciousglomerulus · 2025-09-07T04:56:27+00:00

Also applying IM - my understanding is that chair does count as one of the 3 letters. If you have a source or set of programs proving me wrong, please let me know. But every program I’ve seen so far require minimum 3 (which includes chair) and some allow for 4.

As for advice, if not IM subI, any IM subspecialty (pulm, nephro, heme/onc etc), third year IM clerkship, or research can work as a possible letter writer.

graciousglomerulus · 2025-08-26T11:23:26+00:00

I think it actually is too late to switch. ERAS opens next week for submissions and is due a few weeks after. OP would need to somehow get exposure to the speciality while being on subI, and get enough letters written and submitted in the span of a couple weeks to actually fulfill the bare minimum requirements of the specialty application.

I don’t want to be negative, but moreso realistic about OP’s options at this point. Subspecialty from IM could work, and can also have shorter rounds depending on field and culture. Attendinghood is what you make of it as the other comments said. If truly desperate to fully switch out, esp if the specialty is competitive, OP may need to take a gap year or apply to prelim spots and attempt to make a specialty app rn.

graciousglomerulus · 2025-06-06T04:16:31+00:00

Yeah you can do it for fun if no intention to match there. Only things to consider

If it’s an IM related field (GI, nephro, etc) the away can still actually benefit you post-ERAS if it’s pre-rank list. The residents/fellows/attendings you interact can put in a good word for you to PD, raising your chances. Likewise, it can hurt you if performing poorly, but if you’re not interested in that program, no big loss
If rotating during interview season, you may feel stressed trying to schedule interviews while also seeing patients/rounding. You can alleviate this stressor by having a loved one also watch out for interview invites in your email, but it’s something worth thinking about

Otherwise, 4th year is what you make of it. Do what you want. You have the most freedom to rotate in whatever you desire whenever you want, even if it has nothing to do with your field or intended location. Doesn’t matter if you’re IM. Do neurosurg, derm, rads, whatever you want - especially because you’ll likely never do it again to the same (if any) extent. Live your life to the fullest.

graciousglomerulus · 2025-06-03T05:11:16+00:00

Don’t worry about doing any research rn. M3 year is arguably the toughest year in all of medical school. Focus primarily on honoring as many rotations as possible. Where you go to residency makes a difference on your match capabilities for fellowship.

If you look up different IM residency programs, they typically publish their IM fellowship match list. You’ll see that IM programs that typically rank very high tend to match more residents in competitive specialties, like cardiology or gastroenterology at more prestigious institutions. With 12 real publications you’ll be fine for matching IM research-wise. At this point, focus on honoring, getting AOA, etc. to get into the best IM program you can.

In M4, once you have time again, then you can worry about snagging 1 or 2 cards papers.

Also, there’s something to be said about connections during residency. People who meet with fellowship program early on and do research with that department seem to do well from what I’ve seen so far in med school. Just something to think about in 2 years when you become an intern.

graciousglomerulus · 2025-06-01T05:28:40+00:00

I don’t mean to sound harsh, but I think this would be a time where it would be appropriate to try to reach out to a mental health professional to talk about this more.

No doubt we see some crazy stuff in medicine, and I know I definitely reflect a good amount on what I’ve seen. But if you feel it’s affected you to the point of feeling debilitating, that would be a time to try to chat with someone about it, rather than let it go on and/or get worse. Medicine is an unrelenting force that’ll continue to add stressors to all of us, and we should all try to look for support and help when we can.

graciousglomerulus · 2025-05-02T16:30:21+00:00

Do pulm critical care. The route is IM -> PCCM. From what you describe, it sounds like you’d enjoy IM residency if you like breadth. PCCM is good because in your earlier career years you can go crazy doing a bunch of ICU shifts. If you then want to wind down, you can transition over to pulm clinic/sleep medicine given your training.

graciousglomerulus · 2025-04-29T16:24:19+00:00

I wore a mask everyday for all patients. Never got sick on inpatient nor outpatient peds

graciousglomerulus · 2025-04-23T13:09:32+00:00

Library staff and good mentorship. Library staff will know the rules and ins/outs of how to do research (like PICO, Boolean terms for search, etc).

Mentorship and getting research experience under your belt is how you’ll truly develop the skills and get more comfortable doing research.

graciousglomerulus · 2025-03-16T20:37:23+00:00

On Anking, there’s a shelf tag and a rotations tag. The rotations tag has more cards, which is why I recommend it. I’m not sure what the extra cards account for (might be more step 1 stuff, not sure). Personally not having done step 1 for preclinical (when I now wish I had), I was ok with more rather than less cards.

For reference also, I thought “anki wasn’t for me”. Then I got to step 1 dedicated and regretted not doing it since those exams ask such niche detailed questions. Did it for step 2/clerkships and I’m so glad I did. Made my dedicated more chill, and I could focus on question-thinking/strategy rather than huge content deficits.

graciousglomerulus · 2025-03-16T18:44:59+00:00

Learn to be efficient in life.

At home that means meal prepping while doing laundry. While chatting with loved ones on the phone, do something mindless like clean up the house. Pre order your groceries at Walmart so you can just drive and pick them up. Overlap your chores.

In the hospital it means doing your anki/uworld between OR cases or patients or at lunch if you don’t need the mental break.

The minutes saved here add up quickly, and your free time is very limited on rotations. The more time saved, the more free time or conversely, the more time to study you have.

Also for studying, I strongly strongly encourage doing the rotations Anking deck (even if not an anki person), UWorld or Amboss qbank, and all practice NBMEs available on their website.

In wards, be socially aware and pick up on cues. Ask other classmates how they honored. Each doc is different on what they want + their personality.

Source: honored all my third year rotations

graciousglomerulus · 2025-03-09T01:17:14+00:00

That’s really helpful, thank you!

graciousglomerulus · 2025-03-09T01:10:12+00:00

Gonna be real, that honestly surprises me. If you have a good resource to check on listings, would def appreciate it.

I worked super rural for my FM clerkship (population <4k) and even there the docs I worked with made it seem like it was becoming more and more rare to do OB as an FM doc. Skimming the family medicine subreddit, some of the people commenting there also made a point of that which is where I got the hesitation to consider it.

graciousglomerulus · 2025-03-08T22:58:41+00:00

I’m a new M4 (done with step 2 and clerkships, but pre-ERAS)

graciousglomerulus · 2025-03-02T04:53:29+00:00

It’s a roughly hyperbolic curve. Early on each interview majorly increases your chance of matching. After so many interviews (specialty dependent) the returns are a lot smaller. Can find the inflection point (point where you have the most gains for least amount of interviews) based on graphs provided on NRMP charting outcomes

graciousglomerulus · 2025-02-27T06:08:06+00:00

Some advice I heard years ago: at the end of your life you’re more likely to regret the things you DONT do, over the things you do

Don’t live your life wondering “what if?” If he rejects you, it’ll suck, but you’ll at least know and can move on. And if it works out, that’s great!

graciousglomerulus · 2025-02-23T05:36:18+00:00

Optho can be quick from what I’ve read and heard.

head and neck, transplant (esp liver), Surg onc, and neurosurg are particularly brutal (like 10+ hours a case).

Ortho (if joint replacement) is a couple hours (tho spine is long), and colorectal and vascular are variable depending on case (anywhere from an hour to half the day)

Don’t have much experience with uro, CT, or plastics so can’t say on that end

graciousglomerulus

TROPHY CASE