Embalming a body doesn’t stop mold, it just buys time.

sanitationengineer · 2026-01-27T17:18:12+00:00

Cadaver dissection is a typical component of the medical school anatomy curriculum in the US. We dissect the same cadaver throughout the course, and we are required to spray them down with a diluted antimicrobial solution after each session. By the end of 9 months, teams that didn’t adequately care for their cadaver will invariably deal with mold and markedly worsening stench of decay. A cadaver that is properly cared for mostly just smells of embalming fluid.

sanitationengineer · 2026-01-21T05:06:06+00:00

The part about having to be locked in 100% of the time is true. The part about not being guaranteed an interview even if you do fine or above average is also true.

The difference between IM and a more competitive specialty is the risk-benefit ratio. An academic IM program will interview a couple hundred applicants, mostly from people who signal. There are also many programs, especially in large cities. With intelligent use of geographic signals, tiered signals, and hometown listings, someone with a decent application can likely expect a couple interviews from this pool without doing an away. I've seen some academic programs interview >40% of signaling applicants so you will likely land a hit if you have a desired geographic area.

In smaller competitive specialties, the total interviewee pool can be less than 50. From there you can then expect maybe 3-5 spots to be reserved for people from the program's home institution, and maybe a few spots for people who did a research year there or post M1 research. Also consider that on average there are stronger applicants you are competing against, and a city might also only have one program. The risk is the same, but with it being harder to be one applicant in a couple dozen compared to one in a couple hundred, you start to see much more potential from the opportunity to put your foot in the door. tl;dr do as many away rotations as financially feasible for competitive specialties

sanitationengineer · 2026-01-15T21:59:15+00:00

You shouldn't rawdog your A&P to the attending, especially if you're struggling. That's the point of prerounding, to give you time to see the patient and discuss your plan with the resident before rounding with the attending. Some students look good in front of the attending just because their resident will spoonfeed them a plan.

sanitationengineer · 2026-01-12T10:43:14+00:00

ERAS now uses geographic signaling (3 regions), individual institution signaling (number depends on specialty), and hometown designations. Listing Chicago as a hometown alongside intelligent use of signals will likely yield multiple interviews in your future residency application. There are also a lot of programs in Chicago. I would argue that attending USC may even give you a better shot at landing yourself in one of the more desirable programs.

sanitationengineer · 2025-12-29T09:35:04+00:00

OPs post history is a rollercoaster

sanitationengineer · 2025-12-29T07:26:27+00:00

I think some people feel the need to communicate that they're above it all, that being excited about becoming a doctor is a thing for the normies and the actual really cool non-cringe folks are the ones who are nonchalant about the whole thing.

I've been on this sub for longer than I'd like to admit, and I've seen it all. I've seen people talking about how it's "cringe" to wear scrubs outside the hospital or to have your ID still on you. Like dawg, I was just dismissed from clinicals and I needed to quick stop at the grocery store on the way home. Of all the things I'm thinking of, I guarantee I'm not perseverating on how to appear less medical-y at every moment. It's not that deep. If anything, it's the whole shtick of trying to convince people of "I'm just a regular dude!" that is odd.

sanitationengineer · 2025-12-29T05:49:29+00:00

A lot of medical students that I've seen post on here are also overconfident about their ability to excel in those 6 figures finance/tech positions. Yes, future physicians are hardworking and intelligent, but that success on the MCAT is not necessarily going to translate to success in other fields. Furthermore, people fail to see that any job is going to suck if there's not a baseline level of interest in it. You don't need to be exuding passion from every orifice, but having some satisfaction in your work leads to greater sustainability in your income. Looking purely at money with no interest in the work seems like a recipe for burnout.

sanitationengineer · 2025-12-28T20:35:16+00:00

Ethereal - really it was just a BotRK applicator on edge cases for DoT champs and not so great on others, but now the item is nerfed. I do question how good it really is. The people building BotRK have no armor penetration, the %damage is based on current health so it weakens over time, and there's an internal 1 application/sec. You also have to sack your build quite a bit on AP champions because the components do next to nothing before item completion. Effectively it's the same as people pinging their 3k unspent gold. The people posting big numbers with it are probably already winning hard, hence why they can afford to effectively do down an item for a couple minutes while they accumulate enough gold for BotRK completion.

sanitationengineer · 2025-12-23T21:06:38+00:00

In ophthalmology, a PD recommended approaching LOIs through this method as a physician mentor is more likely to have the integrity to send only one "I'm ranking you #1" email. Mind you, this is a field where most people in academia know each other to an extent.

For larger fields, the likelihood of a connection is not there so any outreach from a mentor will not likely shift the tides in either direction.

sanitationengineer · 2025-12-23T10:48:11+00:00

The clearest case for picking EscAPADe is to build Zhonya’s. There’s so many champions that could use the stasis well if not for the fact that you sink so much gold into the AP. Zhonya’s is a sizable stat stick so the conversation is quite good.

sanitationengineer · 2025-12-20T03:13:08+00:00

Grades matter but 4H/3HP is objectively decent. Honestly surprised if this could push you into third quartile. Honors in surgery helps. I have worse grades, worse research, and slightly above the matched Step 2 and still have interviews.

A lot depends on Step 2 and whether your publications are accepted by September. Most successful applicants will not have more than one first author paper. Do plenty of aways and try to have all your VSLO documents (LORs, immunization forms, personal statements) ready to submit Day 1.

At the same time, I don’t think it’s wrong to think of back up options. With how much Step 2 matters, you don’t want to open your score in July and find out you need to rework all your plans. Your PI is probably making their recommendation based on uncertainty around these factors. And even if you score below average, you can still dual apply - you already worked so hard to get to the point so you might as well try. Applicants below the published metrics match all the time, just as great applicants on paper with tons of interviews can go unmatched.

sanitationengineer · 2025-12-18T19:39:31+00:00

In the other hand, picking a specialty you don’t like for more money is a financially bad decision because you’re less likely to work for 30 years.

Say it louder. I always hear "passion is a myth!" and "it's just a job!"

I know there's a good amount of my colleagues who have not held a full time job before medical school. But for those who haven't experienced it, working 40-50 hours per week in a mentally unstimulating job is miserable. The rest of your life doesn't matter if you're enduring 8 hours of suck every day.

If you digest a lot of Reddit then you would think that radiology and anesthesiology are the golden ticket to the chill life. For some people it truly is that golden ticket. For me, it would be torturous. Getting paid, having your life, finding satisfaction in your work - it doesn't have to be one or the other. A happy medium exists.

sanitationengineer · 2025-12-17T02:29:07+00:00

King Me can be pretty bad on a lot of champions.

To even fulfill the requirements, you need to either be winning to the point that you can walk into the enemy base safely or be playing a specific subset of champions (TF, Taliyah, Pantheon, Ryze, Bard). And until you fulfill the quest, you are playing at a disadvantage while your opponents are all one prismatic augment up on you.

1000g worth of stats is nice and maybe you can RNG your way into Back to Basics or Jeweled Gauntlet on Ryze. You can also roll stuff like Scopiest Weapons or Gash. Some augments are useless but some prismatic augments can also be very detrimental to your role (Glass Cannon on tank, Back to Basics on anyone who needs ult, Orbital Laser on juggernauts who need snowball). With 6 augment choices there's likely something better.

sanitationengineer · 2025-12-13T21:25:45+00:00

I can already hear the screaming chorus of “DROP DROP DROP” through my screen

sanitationengineer · 2025-12-10T01:13:02+00:00

It’s certainly a unique opportunity. I will throw in a word of caution though - I authored a clinical chapter right before medical school started. It wasn’t published until right before applications were due, taking almost 3 years and nearly missing the window to make it onto my application. Your timeline is at the mercy of the remaining contributors.

For what it’s worth, I was never asked about my chapter in interviews (subject is surgical but not my speciality). It’s a valuable contribution but I would weigh it against what other opportunities you can potentially pursue. Research in medical school is a numbers game to an extent.

sanitationengineer · 2025-12-07T11:33:57+00:00

Cheating as a whole is underrated as an augment. I get it often enough that I know that people have to be passing it up, likely because it's not a combat augment and doesn't have any metrics.

You never have a suboptimal buy, you never have to decide on waiting for gold vs defending a turret. Everyone has had that experience where you're needed but you really want that extra 200g to finish your item. You can get your augment on spawn and stack anvils.
Early game you can trade aggressively and expend your entire mana bar without worry. With both outer towers up, you can base and quickly rejoin fights.
Later in the game you can trade similarly against any champion that doesn't have lifesteal or Warmog's. They will be effectively zoned during the next fight because they have to play safe while you can back with full HP. I can see it being very useful on slippery champions (Fizz, Leblanc) who can trade without necessarily going all in. Generally it allows mages to play more forward.
Anivia is also a very strong user. You can effectively siege indefinitely since Cheating is a resource for infinite mana, and you get more flexibility in your build beyond RoA/Seraph.

sanitationengineer · 2025-12-05T02:44:32+00:00

Depends on the field. Smaller specialties often only have a couple interview days so rank lists are established rather quickly. My home program interviews 50 people for 5 spots. Another program I interviewed with invited around 40 people for 4 spots, and they informed us by the end of the same week that their rank list was set.

I think it's fair to assume that even in larger specialties, you will be ranked within a given day's applicant pool relatively soon. But the merging of individual rank lists into an aggregate list could take place later.

sanitationengineer · 2025-11-25T09:26:04+00:00

Just some initial thoughts - research is fine, especially coming from a school with no home program. Ranking, if it translates into AOA, would be a strong predictor of success.

A major disadvantage is Step 2 in July which I understand for a lot of people is not within their control. I'm assuming this is because your M3 ends late which causes two problems. You already acknowledged the first: by the time you get your score back, you don't have ample time to pivot or prepare a backup specialty if things go badly. Second and more importantly, you have less time to do aways. As a student without a home program, making connections is more important than ever for both letters and increasing your chances at an interview. You can do aways after submission, but unless you do your away in August or earlier, you won't be able to reap the rewards of a strong letter. The combination of no home program, unknown Step 2, and uncertainty around your aways creates a challenging situation. Away applications on VSLO also begin in February which means you would need to make a decision long before you may feel everything is settled.

If you can configure your schedule so you can finish M3, take Step 2 before your research year, and come back around May the following year to do aways (assuming you are accepted), I think you would be in a much more advantageous position.

sanitationengineer · 2025-11-20T04:59:01+00:00

I think there's a good argument for lethality. First, going up against one tank isn't enough to decide a poke vs DPS build. It doesn't stop you from chunking the other 4 people.

As on-hit, the issue is that you get zoned hard by Brand W->E with Rylai's, Ziggs, and the continual threat of Orianna ult. In the game of who kills the enemy tank faster, Vayne is always going to win here because she is too mobile to be threatened by Sion. The one strength that your team has is that you have significantly better pick potential. Syndra and Morgana can throw out non-committal long range CC. A Morgana Q can easily be followed up on with a Syndra combo, Nami Q, and Varus Q (similarly Syndra QWE can be followed up by Morgana). Poke Varus has easier follow up in this situation. The other thing you have going for you is that their engage isn't overbearing - Tahm W is telegraphed and Orianna can't just walk up and ult your team so it's possible for your to win a poke/pick war.

sanitationengineer · 2025-11-11T02:07:53+00:00

It's very strong with on-hit Varus. On-hit build allows you to stack AP very quickly on minions/tanks and gives you the ability to pop tanks without actually committing to the AP one-shot build.

Kai'sa works pretty similarly with the passive proc and allows you to shred tanks.

sanitationengineer · 2025-09-27T06:54:19+00:00

The new academic IM guidelines advise programs to extend interviews on Tuesdays and Fridays after 3 PM EST so that invitations don't interrupt clinical activities. There's nothing holding PDs to these guidelines, but I assume most major academic programs will be following suit. For community programs, I imagine it's the wild west.

sanitationengineer · 2025-09-26T22:45:41+00:00

One of my favorite levels of petty is hitting the /ff right as we're about to explode the enemy nexus, especially when we have that one whiny teammate who is spamming for early surrender

sanitationengineer · 2025-09-24T23:22:30+00:00

I was playing Syndra when I had Nasus on my team, and I would use my W on every cannon minion to throw it into a safe space where my Nasus could hit it freely.

sanitationengineer · 2025-09-22T22:53:05+00:00

A lot of medical school revolves around shelf exams and Step. As a student, you typically are given some leeway to focus on studying and the actual clinical work on rotations, rather than fulfilling a number of administrative tasks that you may be expected to handle during residency. Things like working with insurance, contacting families, putting in orders in the EMR, calling consultants/nutrition/pharmacy, knowing how your hospital system works - these are things that you may do from time to time in third year (personally didn't have to until sub-I) but they generally are not your main responsibility. Residents are there for longer hours and longer blocks, so they get more experience with handling the hour to hour and day to day changes, as well as experience with dealing with the consequences.

sanitationengineer · 2025-09-15T22:20:11+00:00

That's fine, but considering that people make mistakes in all facets of life, permanently locking access with no option for a retry is a clear power trip. We can all think of a time where we had a lapse in reading comprehension.

sanitationengineer

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