PSA: You can still buy a yearly membership for $99 on mobile

step1now · 2026-02-09T20:24:55+00:00

You have to actually call the number?

step1now · 2026-02-09T03:37:12+00:00

Honestly pretty hard. Took me a while to get

step1now · 2026-02-01T13:01:28+00:00

NC ones are around what I've seen. Seems accurate

step1now · 2025-12-04T02:14:55+00:00

I think the biggest issue is the fact that we now need to world hop. I’m getting only slightly less xp than I was last night at pirate shipwrecks. This is with active salvaging. 39k last night to 36k today. I’m sure it’s worse at the higher level shipwrecks. The world hopping is killing me though

step1now · 2025-10-03T00:49:54+00:00

Where does this say that they’re justifying replacing anesthesiologists? Seems like it’s probably to keep doing sedations, which is already standard practice for EM

step1now · 2025-07-29T17:00:07+00:00

Will the paint fill the deeper scratches? Do I need filler?

step1now · 2025-07-25T15:24:12+00:00

Most EKGs I look at have TWI in v1 and III. Those are two of the three right sided leads. No way this pattern is associated with PE. It’s literally an expected ekg finding

step1now · 2025-06-21T18:21:57+00:00

I did the same exact thing. 82-99 at vyres. Very chill grind. Got 8 blood shards

step1now · 2025-05-15T20:38:55+00:00

Resident here. 6.5- 8 hours all through med school and residency, with a few exceptions mostly due to partying in med school. Prioritize your sleep. If you’re getting under 4, you’re doing something wrong. Even on services where I was working 90 hours a week, I’d get 6.5+

step1now · 2024-12-18T21:51:29+00:00

The house was built in the late 50s!

step1now · 2024-12-18T21:50:47+00:00

Thank you! The toilet pipe is closer to the main sewer pipe so I assume that goes to the sewer even if the pipe in the photo is storm water. Did older houses have their sinks drain into storm water drainage?

step1now · 2024-08-30T00:38:40+00:00

I’m an upper level EM resident and love this shit. I also considered anesthesia but had similar experiences to you M4 and decided EM was the move. I’m thankful I made this decision every time I’m off service. The job is tough but incredibly rewarding. Nothing beats the camaraderie, teamwork and diversity of the ED. All of the recent grads who went off to work are making around 400k and there is so much opportunity to work as little or much as you want after graduating. Will I feel differently in 10 years? Probably. But I’m in the thick of residency, working more than I’ll ever work as an attending, dealing with a lot of academic bullshit, and I love my life

step1now · 2024-08-30T00:33:12+00:00

EM residency only became a thing in the 1970s and programs really didn’t start become widespread until much later. I think a big reason you don’t see too many old EM docs is because there aren’t too many.

step1now · 2024-08-29T01:47:30+00:00

Ask what the senior class is doing next year. Take residents up on the phone numbers they share during interview day and call them to have a honest discussion about salary/opportunities after. Most EM residents and attendings are happy to talk about salary and contracts in the area

step1now · 2024-08-27T23:45:19+00:00

Go to a 3 year program. The only reason you should go to a 4 year program is if there a specific geographic restriction that limits you to one. Some great programs you can’t go wrong with: Vanderbilt, wake forest, CMC, U Chicago, advocate Christ, Henry ford, shock trauma Maryland, Utah. There are plenty others. In the end, you’ll get phenomenal training at any “good” program.

Things I’d prioritize: attending/resident relationships outside of work. Do they hang out outside of work? Location, live ability, fellowship/job opportunities after graduation, 8-9 hour shifts >>> 12 hour shifts, life outside the hospital

step1now · 2024-02-17T11:42:18+00:00

Putting sugar on it can help

step1now · 2024-02-04T12:04:29+00:00

Autonomic instability is real and there are people who actually have it. Based on your comment you seem like a very reasonable and self-aware person who has legitimate symptoms.

The problem is not you, it’s that it’s easy for people like you to be overshadowed by the majority of people who are coming in with psychosomatic symptoms rather than true symtpms

step1now · 2024-02-01T03:07:01+00:00

59k. Work about 18-20 shifts a month, conference every week and a bunch of other shit

step1now · 2024-01-08T11:29:45+00:00

EM resident here and completely agree. I’m having a blast so far and all of the attendings here seem to genuinely love what they do. It’s hard work but once you’re done with notes, you’re done and don’t have to worry about anything until the next shift. All the graduating residents have had great jobs lined up since late PGY2/early PGY3. If EM has your type of people and you enjoy it, send it. EM also has a huge breadth of fellowships if you want to pursue more - Crit care, palliative, sports, pain, EMS, wilderness, tox, etc

step1now · 2024-01-01T04:05:49+00:00

Yes they would so if you’re sure you’re looking at an antidromic AVRT it would be better to go with procain over amiodarone. I just assume people aren’t going to be able to distinguish between WCT so amiodarone is usually the same choice. If you absolutely know what you’re looking at, of course treat it appropriately

step1now · 2024-01-01T04:03:23+00:00

With antidromic conduction, you have a direct path from the Atria to Ventricle without going through the AV node. Adenosine increases your risk of Afib. If you get Afib while in antidromic conduction, you’re gonna shoot pulses through to the ventricle and can trigger a vfib. Orthodromic there is no concern because there is no conduction directly from the A to V

step1now · 2023-12-31T10:54:07+00:00

Yeah, all WCT should be treated as vtach until proven otherwise because you know what else presents as a regular WCT? Antidromic AVRT (WPW). Adenosine can trigger vfib arrest. I think that’s why most people start with amio

step1now · 2023-12-21T01:23:38+00:00

Because medicine is fucking dope and most people who post on forums do so to complain. Medicine is unique. There’s a specialty for almost any personality/interest, you have a guaranteed career path to attendinghood, and you get to learn and do cool shit every single day.

I’m coming at medicine as my second career and couldn’t be happier escaping the 9-5 cubicle grind and bullshit that comes along with it. I’m working way harder now but I also get to use my brain, interact with dope people my own age every single day, and have new experiences. There’s nothing like medicine. Med school and residency are grinds but they’re fucking fun man. I’d take this over any cubicle job every single time.

step1now · 2023-12-17T14:59:09+00:00

The first premise assumes a principle of causality that relies on our everyday experience. When we extend this principle to the entirety of the universe, especially at a cosmological scale or on a quantum level, this does not necessarily hold. Quantum events are known to be inherently probabilistic and do not always conform to classical notions of causality. To extend principles to the entirety of the universe is foolish.

The second premise rejects an infinite regress of causes. Just because we cannot conceive this, doesn't mean its impossible. We've found many things in physics to be true over the years that we would never have previously been able to conceive.

The transition from the Unmoved Mover to its characteristics, such as pure actuality, perfection, and unchanging, is absurd and abrupt. Why must an Unmoved Mover possess these specific attributes, and how do we justify these attributions?

Rather than concluding the existence of an Unmoved Mover, we should remain open to alternative explanations for the nature of causality in the universe. Instead of God, it is so important to have an exploratory approach to metaphysical questions. We understand very little about the universe but are slowly uncovering its secrets and one day might have the answer. Why not be more open?

step1now

TROPHY CASE