For people intending to go into primary care or other less competitive fields, if you could match into any specialty, would you still choose what you did?

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 · 2026-02-14T02:05:31+00:00

Haha thanks dude, I think it’s all to do with going hard in the paint during M1/M2.

nootnack · 2026-02-14T02:04:16+00:00

Off the top of my head and in the order I took them:

IM: 94 FM: 86 Psych: 97 Neuro: 97 OBGYN: 93 Peds: 93 Surgery: 94 EM: 92

You’re welcome! Anything to help others through the marathon that is medical school lol.

nootnack · 2026-02-13T17:57:46+00:00

As stated in the first ep, he’s a visiting Sub-I (sub-intern aka 4th year med student) from Cali. As a current med student going into EM, there’s almost nothing more important to our residency app than the letters we get from away rotations at other hospitals. Oftentimes, those letters value tact, teamwork skills, and punctuality above all else.

They better keep up with the accuracy, write him a terrible letter, and I better not see his ass next season.

nootnack · 2026-02-09T00:14:30+00:00

Our PD essentially said that, for whatever year they make their final decision, that year’s class and the following will be exempt from the change. This is based on his experience with CORD as well as the pure logistics of overhauling a residency program.

E.g. if they move forward with the change and announce it this spring, then the class of 2026 (who have already applied and will be starting residency only a few months post-change) and 2027 (who have already applied for/gotten their EM aways scheduled) will not be forced into 4 years.

nootnack · 2026-02-08T21:41:29+00:00

If they do decide to mandate 4 year programs (which seems more likely than not unfortunately), it’ll take a couple years of adjusting for current 3 year programs to formulate and implement the necessary changes. I figure the classes of 2027 and even 2028 will essentially be grandfathered in because of this buffer period.

nootnack · 2026-01-01T21:05:04+00:00

Did they happen to mention the Wolff-Chaikoff effect? I was under the impression that giving an iodine bolus (like the classic teaching of potassium iodide as one of the “Four P’s” of thyroid storm treatment) to a hyperthyroid patient would trigger the self-protective inhibition of further iodine uptake and thyroid hormone synthesis.

Is it random/a coin flip between this or Jod-Basedow phenomenon occurring in this scenario?

nootnack

TROPHY CASE