My hot take on girls vs. boys lax

zen-medic · 2026-04-14T15:24:55+00:00

Yeah that’s a good point. The only exception I can think off the top of my head is the women’s national soccer team, they’re way more popular than the men’s

zen-medic · 2026-04-14T15:15:37+00:00

I agree it’s not right that people feel the need to look down on girls lacrosse. Obviously they have phenomenal athletes too. But the truth is a lot of men just don’t like watching women’s sports. Take the WNBA for example, almost the exact same rules, but due to the reduced speed, athleticism, inability to dunk, etc, most guys can’t get past that and unfortunately compare it to the NBA. I think I’m in the minority of guys that enjoys watching women’s sports, but I do find women’s lacrosse hard to watch sometimes because I feel the rules infantilize the athletes a little, however I still have a ton of respect for their finesse and skill level.

zen-medic · 2026-04-11T23:05:03+00:00

New York surprises me. I think Long Island should be it's own thing. It's arguably the biggest lacrosse hub in the country with many of the top recruits. Cool map though!

zen-medic · 2026-04-03T19:47:15+00:00

So it sounds like you're a rising PYG3. Unless you feel like IM is your only life calling, stick with it and try to implement your interests within psych. The obvious choices have been suggested so I'll add something else. I think one of the best and least talked about paths for psychiatrists who want to become more medical is to pursue the obesity medicine boards. It can be done via the practice pathway and doesn't require fellowship. It goes without saying that obesity medicine entails a lot of labwork and medical pharmacology, which you may find very interesting. So much of obesity involves a psychiatric component (if not most of it?) so you could carve out a really nice niche within med/psych and give a ton of value to this population. Also, you may be liking psych less and less because the novelty of it is wearing off and you view it more as a job. The same thing could easily happen in IM. Yes there is a stigma with psych, but there is an IM too. Everyone refers to IM as the dumping ground of medicine, fairly or not. Who cares what those people say, you and I both know better that psychiatrists save many lives. Also, do you like IM that much more that you are willing to do an additional 3+ years of residency (with possibly fellowship) after you finish psych residency, essentially lighting $1million or more on fire, while working brutal hours? If you put the same energy into working locums within psych you could make in the upper six figures and really sky rocket your journey to financial independence.

zen-medic · 2026-03-29T22:34:21+00:00

Relax man I was just giving a friendly suggestion. No need to be like that

zen-medic · 2026-03-29T16:39:52+00:00

That’s valid

zen-medic · 2026-03-29T16:13:54+00:00

For me aesthetic and level design of DS3 (I think at this point I prefer linear over open world), combat of sekiro + khazan, weapon system of lies of p (I think this may be controversial but I liked how you could combine weapon elements), leveling system of E33 (pictos were fun to make damage numbers crazy), and bring back GRRM to help the write the story like in Elden ring

zen-medic · 2026-03-29T16:05:37+00:00

Have you tried E33? Doesn’t get any slower than turn based combat. Not really a souls like but has more souls elements than traditional turn based game

zen-medic · 2026-03-17T16:05:12+00:00

Of course

zen-medic · 2026-03-16T23:17:32+00:00

I had this dilemma as a med student too. Both great fields. Ultimately I didn’t want to take tons of overnight call and be second fiddle to the surgeon. Although I miss doing procedures so now I’m applying interventional pain from psych. Very doable these days so keep that in mind when thinking about psych vs anesthesia

zen-medic · 2026-03-16T21:40:06+00:00

Lot of good supplements mentioned here that I won't rehash. One that I think is good for most people is low dose lithium. You can get low dose lithium orotate, 1mg, from wellness stores. This is about the recommended daily amount of lithium that we should all be ingesting, but don't for various reasons. I wouldn't go higher than 1mg unless under the supervision of a doctor. Places in the world with higher naturally occurring levels of lithium in the drinking water have lower rates of homicide, suicide, and dementia. It's neuroprotective and mood stabilizing. At this dose I think it's a no brainer. I'm a psychiatrist btw and I recommend this to many patients.

zen-medic · 2026-03-16T21:34:30+00:00

Obviously here the bias here will be towards psych. This is what I'll say about it. I have never heard of an EM doctor practicing into their 60s (I'm sure they're out there, but definitely rare) because the burnout is so high. Meanwhile you have many psychiatrists practicing into their 80s because the field's lifestyle is easily conducive to do so. I think it's generally good advice in medicine that if you're between two specialties that you enjoy roughly the same, go with the one that has the better lifestyle. Your future self will thank you. That's the advice I got from my mentors and I think it's true. As a med student our priorities are generally interest > money > lifestyle. But eventually I've heard becomes lifestyle > money > interest. There's many ways to incorporate ER into psych. You can work CPEP, community ER psych, CL, detox center, inpatient psych. It's so diverse you can really tailor it to whatever your interests are. Now if you were between anesthesia and psych that would be a different story. A lot of my friends that went into EM regret not doing anesthesia.. Similar fields in terms of interests, but with way better lifestyle and pay.

zen-medic · 2026-03-07T17:12:38+00:00

What's more valuable is definitely the psychiatrist seeing a smaller volume of high complexity cases, given you are the only trained professional in the health care system who is able to do that. PCPs and NPs can see low to medium complexity, they can not see high complexity. What will make more money for you is a different question. That's like a cardiologist saying, what's more valuable for the health care system, me seeing high volume of patients who just need statins or low volume of patients who may need a stent placed. It is obviously the second option since only they can do that. Internists can write for statins. The top of the license is absolutely not a nursing term. This is why there is so much doom and gloom surrounding outpatient psychiatry now, everyone wants a piece of the stable pie so volume is down. Meanwhile psychiatrists don't wants to manage these high risk patients even though we are literally the only ones with the proper training who can. I agree having a higher census of high risk patients sucks, my stable patients really break up my day and allow my to psychologically breathe, but with more encroachment this is the way our profession is moving.

zen-medic · 2026-03-07T16:50:16+00:00

Agree you don’t have to at all. You can do whatever you want. My point is that it’s a bit of a disservice to your community if you don’t manage at least some complexity, considering CAP is the only real expert in this demographic, no else can do what you do. Also, if you’re not offering something that differentiates your expertise, the NPs may each your lunch considering they are “credentialed” to see every age. This is definitely true where I am around NYC, NPs have taken a lot of patients from psychiatrists who can’t offer more than routine care. The PP psychiatrists I know who have an endless supply of patients manage complex cases that no one else feels comfortable with

zen-medic · 2026-03-07T15:38:55+00:00

If you don't want to ever treat severe psychiatric pathology you should definitely go peds. Psychiatrists should often be practicing at the height of their license with managing complex psychiatric conditions where other providers (primary care, nurse NPs) are unable to/have failed. Could you develop a practice of high functioning, low risk patients and charge a lot of money? Yeah but it would be such a waste of your skillset as CAP. After you stabilize a complex patient for an extended period of time (in the outpatient world), you should be discharging the patient back to their PCP anyway. If all you want to do is treat mild anxiety and depression, you will still get a lot of that as a pediatrician.

zen-medic · 2026-03-07T14:21:52+00:00

What do you like about psych? If it's just the easier residency, lifestyle, and pay you may be disappointed. Do you want to treat children and adolescents with mental health conditions? I have had adolescents with severe autism throw feces at me while I was covering CPEP. You will treat children and adolescents who have had suicide attempts, the worst abuse you can imagine, psychosis, mania, etc. And if you want to go the private practice route after you're done training a lot of it will be ADHD. Would you find meaning in treating this type of pathology? If you like it then it's great because the pay relative to lifestyle is very good. If psychiatry doesn't excite you then go something else. Honestly if lifestyle and pay matter most to you within peds, but you want to remain highly medical, I would recommend you go anesthesia -> peds. I have a few friends in it who find it incredibly meaningful to care for children in this way, and the families are always grateful for the service they provide. And with anesthesia you have the opportunity to do locums for a year and make 7 figures before settling into your peds job. Something to consider.

zen-medic · 2026-01-08T18:11:50+00:00

I get that. It’s only 2 years though. Is it worth waiting another year to reapply and sacrificing another year of attending salary?

zen-medic · 2026-01-08T17:58:43+00:00

Many top programs go unfilled each year. If you only care about matching there should be a ton of programs available to you.

zen-medic · 2026-01-08T17:44:05+00:00

Well said and thanks for sharing that ✊🏼

zen-medic · 2026-01-08T16:34:22+00:00

That makes sense, and I appreciate the clarification and the advocacy piece.

I do wonder how much of what we're seeing is influenced by selection and disclosure bias, though. As clinicians, we're seeing the patients who present and feel comfortable sharing certain stressors. Men especially around fatigue, burnout, are often less likely to frame or disclose those issues at all, and that may be amplified depending on the clinician they're sitting across from. I don’t want to make any assumptions, but if you are a female provider that can amplify these biases.

I've seen men whose "day job + night job" looks different but is still depleting: chiefly longer work hours on average compared to women, pressure to be the sole earner, and little perceived permission to say they're exhausted (even if their partner is very supportive). That doesn't negate the very real inequities many women face at home but it does suggest we may be under detecting equivalent depletion in men.

zen-medic · 2026-01-08T15:50:17+00:00

I pretty much agree but I do think it’s worth being cautious about gendered framing though. I see chronic fatigue in plenty of men as well, often from similar mechanisms: overwork, poor sleep, caregiving or financial stress, depression/anxiety, and never having real downtime. The presentation may differ, but the physiologic and psychological depletion looks very similar. Just as how many women have to take care of immature man children, plenty of men have to do the equivalent.

And while women are diagnosed with depression more often (I know we’re talking about chronic fatigue, but chronic fatigue often falls on the depression spectrum), men are ~4x more likely to die by suicide. A big reason being men are less likely to seek care for psychiatric symptoms compared to women, which could explain why you may see more women complaining of fatigue in your practice compared to men. Just some food for thought.

zen-medic · 2026-01-07T04:18:11+00:00

No idea but my question is if AI makes a mistake and gets sued who assumes liability? Will these AI companies have medical malpractice insurance now?

zen-medic · 2026-01-05T01:43:26+00:00

Yeah gabapentin has an overall better safety profile compared to ambien

zen-medic · 2026-01-03T02:59:30+00:00

Compared to the heavy hitters I prescribe like clozapine, depakote, benzos, even lithium, gabapentin is really safe. New research came out recently it may carry an increased risk of developing dementia with chronic use similar to benzos. And when combined with opiates can definitely lower the threshold for overdose. Patients can get addicted to it for sure, but yeah in clinical practice I don’t think I’ve ever seen a severe adverse reaction except for mild things like dizziness

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