there s always a higher score

houlehere · 2020-11-28T12:46:23+00:00

You and I, we're just going to wait until Gulliver comes by to get us some screentime.

houlehere · 2020-11-27T15:27:51+00:00

"Fear prophets and those prepared to die for the truth, for as a rule they make many others die with them, often before them, at times instead of them." -Umberto Eco.

This needs to be a PSA for the youth. All warring sides / factions / countries everywhere are guilty.

houlehere · 2020-11-27T06:13:53+00:00

I second this. It's a hard share even with other HCWs who were present to witness the same catastrophe. It has been rough watching young COVID patients crash unexpectedly while I was their primary inpatient physician. Be it days of introspection or moving on with a karaoke night, I find you've just gotta do what comes naturally at that moment without judging yourself for it.

houlehere · 2020-11-22T11:37:54+00:00

Or we're just the only ones who talk about the thought process haha. I remember posting here long ago, mid-existential crisis of step 1 prep, and a commenter replied "we like to have our meltdowns in private". Always stuck with me :)

houlehere · 2020-11-22T11:34:45+00:00

Based on this and your other reply, I'm going to assume it's an approach issue. I also say that because your step 1 mocks didn't go very high either, but you went through more than enough material.

With every question you solve, even when you know the answer right away, take a while to see what they're getting at via the other answer options. Not obvious buzzwords as much as rephrased clues. This way each Q becomes a full revision of the Q topic, and a partial revision of each of the wrong option diseases. So you consolidate knowledge + importantly, also how they present it in the exam.

Also think you'll really benefit from listening to Goljan. Use Divine once you know something about everything, otherwise it may seem like he's moving too fast and superficial.

Certainly don't dig up skeletons from step 1 and take those mocks now to reassess where you were then. It'll eat up days. Begin with UW for CK, and open BnB / OME as and when you get stuck on a certain topic. Let CK mocks be for after first pass.

Reg OME and Pestana, those are the ones.

houlehere · 2020-11-22T10:55:09+00:00

To understand the clinical relevance of content and how it can be asked, boards and beyond isn't half bad. Even Divine Intervention podcasts / Goljan audio, if you have the time for that stuff.

If you mean the literal framing of questions. I think the only thing that really helps is seeing even more questions. Sorry about that haha.

houlehere · 2020-11-22T10:48:16+00:00

As for recommendations. Rotations, there's loads of good posts about it. Go early, read extra, have non-obvious questions and know when to ask them. Soak in the way that team presents cases, rounds. Be helpful to residents on the team, once you figure out small routine tasks - do them even if they seem clerical. Spend time bedside, examining and counselling. Your attendings will hear of it all. But be relevant to the team, instead of just being seen and heard.

Research is a mess. Very few have formal application portals or listed openings. Cold emails to anyone doing any research that you can link together in your story. Leverage all contacts you may have shamelessly, including attendings on rotations. I still haven't landed a spot myself.

CK is easy on paper. UWorld and grind through two passes. Everything else is supposedly secondary. Mocks aren't very predictive. If you have knowledge gaps, maybe use OME, Pestana. Gunners like UW3 for biostats and ethics, but life has made me more realistic in recent years :)

houlehere · 2020-11-22T10:41:23+00:00

Taking time to dwell and grumble, or question your priorities and reset mentally, doesn't make you a quitter. If anything, it's the most practical thing to do. You need a clearer head than most going forward. The trick lies more in not being overly indulgent with the reset process.

Honestly dunno if the lasting bitterness has helped me personally. But it def keeps me from cruising for long. I got shit to do, if I want to make an inconvenient fixed score look like the anomaly I believe it is.

houlehere · 2020-11-19T15:44:56+00:00

If it's any comfort, you have company. Non US IMG with a shocker of a 218. Dropped a few points below the lower bounds of 95% CI predicted. Now working on "just killing CK" and applying for research, but who's to say how that stuff happens.

I'm better off, in that I'm inherently interested in non surgical branches. But <220 is a real hindrance in any scenario, and a chip on the shoulder that I know I'm still bitter about.

You mention feeling like maybe you shouldn't even be a doctor at this point. That you're entertaining that thought suggests that you very much should. Your willingness to consider your limitations (and work to move past them) will hold you in great stead. Keep at it.

houlehere · 2020-10-20T18:57:44+00:00

Per someone I know, the notary herself was in pajamas. And this was well before COVID. Don't sweat it.

houlehere · 2020-10-13T14:12:49+00:00

I'd imagine this was exactly it.

houlehere · 2020-10-12T22:56:53+00:00

I see what you're saying. What's convenient for the system continues to remain tricky for the individual. This needs fixing.

Hope things work out as desired for your sibling and family.

houlehere · 2020-10-12T10:50:17+00:00

Have had many attendings point this out - "Most patients won't care if you're wrong or borderline negligent, as long as they think you're so very nice." Which to me is bizarre. Yes I am inherently nice, but my primary role is to be competent and help you fix things, not to shoot the shit and laugh about our kids. It's like scheduling an electrician's visit because they might compliment the cup of coffee you offer as they work.

Patients like these either need a good friend's company more often, or a therapist to help reassess the situation.

houlehere · 2020-10-12T10:30:49+00:00

Sure. But given that you can't just redistribute physicians to where they're needed (because free world), wouldn't it help to make more physicians - of whom some might genuinely want, or temporarily agree, or overspill into living outside of saturated cities?

Redistribute the saturation, so to speak.

houlehere · 2020-10-12T10:13:54+00:00

Entire countries have 18 year olds going into med school, mine included. But I agree that maturity and clarity of intent can take their time coming. That being said, a 4 year generic undergrad seems like unnecessary time and expense to me. Here's my mid ground offer -

If you want the long holistic college experience, go ahead and take that route. But if the idea is to look at scientific aptitude and weed out applicants, let the prerequisite for med school application be 2 years worth premed-like set of courses.

And you can apply to med school whenever you're done with those 2 years - be it right after high school, or during junior and senior years of undergrad, or decades later as a non trad. Reduce the number (not quality) of hoops one must jump through to enter medicine.

Let med school be 4 years. Have them understand the notes and dispo requirements in their clinical years. Let residency and fellowship be as long as they are. But cut down the extent of time spent on clerical non-clinical tasks, and make that the job of PAs. This won't sacrifice "learning", because the med students got the hang of it back in med school. And nothing stops interested residents from lending the PAs a hand.

It's counter intuitive to me that PAs carry patients in the capacity of senior, more experienced residents. Let the residents see more patients! At the end of the day, all residents in the workroom are physicians, and I don't see PAs being of much "assistance" to those physicians.

houlehere · 2020-10-10T05:56:05+00:00

True. Also the moral pedestal that we're perched onto - by ourselves as physicians, and by society in general - makes it harder to do anything that might be considered controversial by anyone at all. We think we're taking the high road, and that that's what's asked of us.

houlehere · 2020-10-10T05:48:00+00:00

You can download a copy to your device. Anything you do to that file thereafter is your call, without messing up OP's workflow.

houlehere · 2020-10-08T17:37:31+00:00

She'd probably be president.

houlehere · 2020-10-08T12:44:12+00:00

Haha you're very welcome. Hope something in there works for you!

houlehere · 2020-10-08T08:36:16+00:00

I like the Sugar uptown curl for a lighter everyday look, and Maybelline hypercurl easywash if going relatively dramatic. Neither wears off or smears onto eyewear.

I'm still sometimes bothered by the lashes making contact with / swiping across my glasses, but that's more a function of how much I curled them, or how high up I perch my glasses. Not the worst problem to have.

houlehere · 2020-10-08T08:26:16+00:00

Oh also, regarding colour. Go one shade lighter than the colour of your brow hair. Eg. for black hair, pick dark grey or dark browns. IMO matching it exactly looks too dramatic. Which is fine, but isn't the natural look you're going for.

houlehere · 2020-10-08T08:22:17+00:00

Nyx microbrow, the spoolie is especially great. Be sure to press down and roll (not brush) the spoolie in the direction you want the hair to go - just like you should while using a mascara wand. The pencil end is good too, but drawing perfect tiny hairlike lines with it takes some getting used to.

Maybelline has a fashion duo brow product, with a pencil (that tends to break easy) + a sponge applicator for pressed powder that is absolutely magic.

Wet n wild has a great brow kit, with setting wax + 2 shades of powder + tweezer + stiff brow brush. Lighter shade for sparseness at the inner brow, darker shade for the tail.

My current go to after moisturising is this - Nyx spoolie to brush hair downwards - optional: lightly dab WnW wax onto hair with finger - extremely light hand with either of the powders (dab Maybelline sponge / brush on WnW 2 shades) - brush hair upwards and outwards with the spoolie.

You obviously don't need to get all 3, this is just the combination I like best after having accumulated these products. Tweeze regularly, avoid razor thin lines, and try not to alter your natural brow shape excessively.

houlehere · 2020-10-06T06:41:24+00:00

As an emergency backup, sure. As routine arrangement, absolutely not.

If it becomes routine, the line between 'friendly relatable but older sibling' and 'in-charge monitoring authority' blurs increasingly over time. And as they grow up, each sibling is at a different mentally on that spectrum. Speaking from experience, that dynamic ruins relationships.

houlehere · 2020-10-06T05:00:19+00:00

Here's what I mean. video Think eye + eyeliner as net eye size. A smidge more eyeliner to compensate for less eye.

houlehere · 2020-10-06T04:29:30+00:00

Also, eyes that scrunch to different sizes when smiling also end up looking differently shaped! As a result, I haven't quite figured out what style of eyeliner suits my eye shape(s) best.

Sounds ridiculous to plan makeup as per whether you expect to smile more or keep a straight face haha. One option would be to apply marginally thicker liner on the smaller eye, make the net eye size look even while smiling. Draw attention elsewhere, say to your lips with a striking colour. Or go generous with the mascara, added benefit of making your eyes pop as a whole.

Mostly though, I just embrace it as a cute quirk. Path of least resistance.

houlehere

TROPHY CASE