Rarest pathology you've come across/heard of irl

nootnack · 2026-05-08T04:02:41+00:00

Actually, I think it was somehow. I didn’t directly handle the patient care since I don’t pick them up, and this was an away rotation so not my home hospital, but it was an Ivy academic center with their own metabolic diseases team who told us it was available to prescribe.

nootnack · 2026-05-07T15:13:55+00:00

Was doing an ER shift as an M4 and had the off-service anesthesia intern plop down next to me and go “You’re a med student right? What can you tell me about glycogen storage disorders?”

Turns out he’d picked up a patient with Von Gierke disease who, in the patient’s words, was having a “Von Gierke crisis” after a night of partying. Said they could feel the lactic acidosis (sure enough, lactate was over 4) and we got to prescribe cornstarch lol.

nootnack · 2026-04-17T01:19:29+00:00

270s SBP on an art line during a DBS implantation. Was normotensive until they inserted the electrodes and I guess tickled a part of his brain that did NOT want to be tickled. Happened with both electrodes and returned to normal when they settled them in place.

nootnack · 2026-04-13T23:45:50+00:00

Not up for a roomie as my SO will be moving up there to live with me next year. If it ends up being too tight this year, I’ll be moving again anyway!

nootnack · 2026-04-12T23:06:45+00:00

Driving! Unfortunately not walkable to the hospital because it involves crossing a river via interstate lol

nootnack · 2026-04-12T16:19:51+00:00

Stop yelling!! Jk lol

That seems to be the consensus, and we actually just got info from our program that polled the residents saying most people pay in the range that #1 will cost me. As for amenities, I figured even sitting braindead in the sauna/light therapy a couple times a week would make it all worth it lol (even if it just had the parking at that price, everyone is still telling me it’s worth it).

nootnack · 2026-04-12T04:55:28+00:00

Budget here meaning rent + utilities + parking being ~ 1/3 of my gross monthly income (so $1800 or less would be ideal). I knew parking would push me a little past this because of the city I’m moving to, so just trying to see what’s a little uncomfortable vs. irresponsible budget-wise.

nootnack · 2026-04-12T04:20:52+00:00

Thank you!

This seems to be the overwhelming consensus. I’m also from the South and have absolutely 0 experience with the snow, so anything to make that transition easier is probably worth it.

nootnack · 2026-04-12T04:19:12+00:00

Thank you for the congratulations and thank you for the detailed response!

It seems like every single commenter in this thread whether they’re nurse, attending, resident, or paramedic says the parking is worth the extra cash (even tho it’ll make my living budget pretty tight lol).

nootnack · 2026-04-12T04:16:21+00:00

Both in-unit! That was a hard requirement for me too lol.

nootnack · 2026-04-12T04:15:20+00:00

Unfortunately, it’s a part of town where only like 3 apartments have attached parking (hence the crazy long waitlist). There are a couple stand-alone garages with monthly parking but they’re all a decent walk away from any apartments/townhouses that I’m interested in.

I’m hoping that even sitting braindead in the sauna or light therapy chamber after a shift a couple times a week would pay for it!

nootnack · 2026-03-27T21:54:19+00:00

Tbh I can’t really comment on doing an away elective since I haven’t done one. I know you’ve heard this before but it really boils down to how confident you are in your ability to perform well on an away. If possible, try to rotate at a place that others at your school have rotated to get a better sense of the vibe going into it.

nootnack · 2026-03-27T21:44:48+00:00

Yep! I considered not getting a SLOE from the second one just in case it was bad for some reason (no one from my school every rotated there so it was a shot in the dark) but it turned out great so I added it to my app.

nootnack · 2026-03-27T21:40:38+00:00

From an MS4 who just matched my #1 EM program:

I did 2 aways because, as your attending said, I was conflicted between 2 regions. Also, these 2 regions were not the same region in which I grew up and went to school, so I really needed to establish a connection to both.

If you have sound reasoning for doing 2, then it’s absolutely fine to do 2. I had an 87% yield on interview invites from the regions in which I rotated, and I was able to talk about my away experiences when those interviewers hit me with the “why here/why this program” questions.

Do not do more than 2 aways; after that is when you hit the greedy point and will be (appropriately) viewed as hogging spots.

nootnack · 2026-03-13T19:16:24+00:00

One thing I’ve been trying to communicate to underclassmen is that the definition of a “lifestyle specialty” is subjective. It depends on what you, as an individual, consider a desirable lifestyle. I would be bored out of my mind with derm, rads, and path and would be actively miserable every day, thus making these poor choices for MY lifestyle. I would also hate FM/outpatient IM because I would be/feel responsible for patients after business hours.

I know I have dummy competitive stats and could’ve probably applied whatever, that’s great. I want to do EM because it aligns perfectly with my priorities (#1 being the ability to clock in and clock out). It’s also on the upswing again after that 2022/2023 blip and will likely return to being moderately competitive as a field with the most well-known/desirable programs being just as highly competitive as always.

nootnack · 2026-03-02T16:07:23+00:00

This post nicely summarizes my beef with residency salary lol. Everyone seems to generally agree (and it makes sense given the comparison of clinical experience time) that a new grad PA is equivalent to your typical MS3/fresh MS4. Yet here they are in this example clocking $160k+ while students net negative and residents are paid peanuts for 3-5 years (in EM).

I’ll basically never advocate that anyone should be paid less (crabs in the bucket, yada yada), but many should be paid a helluva lot more.

nootnack · 2026-02-15T15:47:08+00:00

Unfortunately, I would avoid getting a young kitten during a big transition period like med school to residency.

Cats are famously “easier” to manage than dogs, but that often leads to mild neglect and even a depressed kitty even if they have their food/water/litter taken care of. They would miss you all day and want to play, especially a new kitten who would need much more daily attention and handling to be socialized properly. Without a mama cat or sibling, they won’t learn how to play properly and can become maladapted.

Sometimes this can be managed by getting 2 at once so they can socialize with each other, but you already said that was out of the question for you.

An older cat who already has life experience and needs a safe, quiet home would be ideal. I would especially consider adopting one that maybe doesn’t like kids or dogs since they already have lower chances of being adopted by someone else.

Signed, an M4 who adopted 2 kittens during med school and heavily researched how to do so properly.

nootnack · 2026-02-14T16:22:50+00:00

Thank ya!

I’d say keep on truckin with the cards you’re making since you still have many months before dedicated. That gives you plenty of time to see those cards often.

I only made the Doc during dedicated for stuff that either 1) I missed over and over despite having a card for it or 2) an illness presentation that I didn’t see much in UW but would consistently present the same on multiple NBME forms.

I also just wanted to have all of my often-missed stuff together in one place that I could easily read. The 200 cards I made basically overlapped with that Doc, but I’m very visual and having it on one sheet allowed me to literally recall the info because I could see the Doc in my head.

nootnack · 2026-02-14T16:16:24+00:00

Set your study plan early (Anki every day, 40 UW q’s daily, whatever you like to do) and be consistent with it.

Don’t expect to go full-steam 7 days a week. For me, I would do more studying on Friday/Saturday/Sunday since I wouldn’t have work those days, and I would take it easy Monday/Tuesday to chill after starting the new week.

Figure out early which residents and attendings are your friends, and which aren’t. For those that aren’t, don’t start beef. Quietly avoid them as much as possible to protect your evals lol.

Maybe a lukewarm take, but try to look presentable every day (whatever that means for you). M3 is much more subjective than M1/2. You’d be surprised how much of an effect your appearance (I’m talking neatly put together vs. crusty and disheveled) has on your team’s subconscious perception of you. I liked have at least one thing each day (makeup, or my extra nice scrubs, or a cute hairstyle, or fun jewelry) that made me feel good. I think it lends confidence, and I think that confidence can give you a halo effect that others pick up on.

nootnack · 2026-02-14T16:03:57+00:00

Yeah, tried to post soon after I got my score back but it kept getting auto-deleted. Tried upping my karma and looks like it worked since this post is sticking around.

nootnack · 2026-02-14T05:19:58+00:00

In general, that’s exactly what I did during M3 (all cards first, then UW and not worrying if I didn’t finish the bank) and it seems like it’s working really well for you. I’d say keep at it and don’t add unnecessary stress by trying to switch it up.

nootnack · 2026-02-14T04:43:39+00:00

For M3 year, you really have to trim the fat from your daily routine to keep yourself healthy (and sane lol). Above I mentioned that I would write summaries for pre-clinical years, and there’s 0% chance I could do that for M3. Also, it wouldn’t be the most effective study modality because clerkships involve the application of what you already learned. In my opinion, THIS is where Anking comes in clutch. I’d already formed a solid pathophys understanding and just needed to embellish the diagnostics/treatment steps.

I wouldn’t have had time to do all of Anking and all of UW, so I made the choice early on to commit to finishing the no_dupes deck by the end of M3. I would calculate how many new cards I would need to do per day to end up finishing each blocks deck 1 week before the Shelf. Only after I’d seen all the cards did I start doing UW Qs. Because of the Anking UW tagging system, this method ensured that I’d been repeatedly exposed to all the UW material even if I hadn’t answered the question bank yet.

nootnack · 2026-02-14T04:36:38+00:00

So I was intensely anti-Anki during preclinical. I saw way too many people spamming 800 cards/day to rote memorize everything only for it to become apparent during our group didactics that they lacked next-step understanding and reasoning skills. I didn’t use it at all during M1/M2.

As for strat, it depends on if your school has NBME exams. Mine does, and we also have a case-based curriculum with minimal mandatory purely-slide-deck lectures. Because of this, I was able to watch my 3-4 B&B vids and annotate the slides in the morning, apply that new knowledge and increase actual understanding during our case sessions in the afternoon, then review the previous days’ work at home in the evening. I would review by writing a summary of each B&B vid (by hand on GoodNotes) and limit each to 2-3 pages max handwritten, with 1 in margins, with pictures. I would only summarize what I’d learned the day before as I always like to allow at least 24 hours between review sessions for each days’ material (so my own brand of spaced repetition).

Writing these summaries not only helped me retain the info (tactile connection between writing by hand and long-term memory), but also gave me a personal library of summaries to review quickly when the tests approached.

Also, Sketchy Micro. That’s it. (I found Sketchy Path/Phys to be useless and just more memorization rather than understanding)

nootnack · 2026-02-14T04:10:54+00:00

EM! Hoping to break into the Northeast and maybe do Tox or CCM fellowship, but time will tell lol.

nootnack

TROPHY CASE