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1D7

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  1. Why would you think being nervous is a red flag...
  2. Just curious given your signature, do you think you would have been better off financially continuing on with nursing as a career instead?
  3. 1D7

    Income and Lifestyle

    Live frugally and invest well. You can buy houses in the GTA at sub-1 million dollar prices if you're willing to live in the periphery of the GTA.
  4. If you are considering it, you should plan out your complete career. Realize that medical school is 3-4 years, residency is 2-5 years, and fellowships are 1-3 years--and at each stage, you will potentially move cities. At a minimum that's a 5-6 year commitment and 2 potential moves, meaning a significant disruption to your children's/spouse's lives. That's assuming you already have everything else in place.
  5. Most of the academic ones I've worked with equal their IM colleagues in pay. The ones who aim to make bank surpass their surgical colleagues. Jobs are plentiful currently. The workload in residency is much lighter when compared to almost any other specialty. And of course, you rarely have any need to rush or hurry anywhere. As for why it has that reputation - I suspect certain subspecialties and outpatient psychiatry is compensated relatively poorly in comparison, which drags down the average. The field also attracts personalities that are less likely to grind for hours and days on end. Overall it's a fantastic career if you enjoy the nature of it and have the right personality. If compensation is your primary concern, psychiatry remains a great specialty.
  6. Best use of time is figuring out what you want to do. Try to narrow it down to 3 or fewer specialties. Then spend 1-2 weeks in each over the entire school year/summer—most schools have some sort of preclerkship elective opportunities that you can register once you've found a preceptor. Don't pigeonhole yourself before you've explored at least 2 specialties. If it's a competitive specialty like EM, deciding earlier is better. You probably want to decide by the summer of M1 so you have at least 1 year to do some focused activities in your specialty of interest (assuming you're in a 4 year school, otherwise you'll want to decide even earlier). Next best use of time is some sort of research (do something clinical since it's more likely to get published). It's a tickbox for most programs, but it's a tickbox you might as well check off to maximize your opportunities. And as #YOLO mentioned, you should try to enjoy those 2 years. It will probably be the least busy, or at least the most flexible time of your life for a long time.
  7. There are many, many poorly made lecture slides where there's either way too much detail or way too little. Unless you have the lecturer then you'll probably have trouble understanding what you actually need to know. Being able to listen to audio also enhances learning (though if the lecturer is poor or difficult to understand then you won't get that benefit). But still, you'll likely be able to pass every exam if that's your only goal.
  8. Yes many have done so. From my experience it's generally a better strategy but there are always a few who tell themselves they'll study and end up not doing anything. Those students do poorly or fail. If you believe you may be part of the latter group just go to class. Otherwise it's more efficient to listen to lectures 1.2-1.5x speed and spend the extra time saved going through written notes or other material.
  9. Forgot to change accounts?
  10. Physical exam costs only time and patient comfort. It is usually useful for guiding further investigation and in certain scenarios it can be diagnostic when combined with the history. The basics like inspection, lung auscultation, abdominal palpation, and neuro/MSK screens are extremely useful for any clinical specialty. The 'useless' exams are generally those that have such low sensitivity and specificity that clinical judgement should almost never rely on them. With regards to the JVP, I think it's near useless not because it has poor sensitivity/specificity (IIRC it actually correlates reasonably well with right atrial pressures when doing by attending IM docs), but because it's difficult to actually perform well and adds little to the overall. In clerkship you are expected to go into each rotation as if you want to go into that specialty. Thus, you must still learn and attempt it, since IM docs love it.
  11. Until you see real patients that's how it will feel like. For preclerkship OSCEs just focus on learning what's normal and getting the points so you can pass. As for the JVP, you can watch a few online videos on how to get it but to be honest I'm pretty sure most people make it up to some extent. If you don't plan on going into IM then it doesn't matter. If you plan on going into IM then you'll have plenty of time to practice. IMO it ranks around the same level as bowel sounds and diaphragmatic excursion percussion in terms of actual clinical utility.
  12. 1D7

    Clerkship resources

    CaseFiles is adequate as R says above; if you want a book that gives you lists, you can use Symptoms to Diagnosis. Supplement with OnlineMedEd lectures and you'll be good. If you want an approach to a specific symptom from start to bottom, and want to learn how to investigate and manage more like a resident, then I would actually use 'point of care' resources like DynaMed (it's a more concise version of UpToDate but contains much less information) or UpToDate. However going with the textbooks is generally more useful for clerkship (which is what I'm assuming you're studying for). Many attendings will expect you to know 'medical student level knowledge' and may not even bother to ask you any questions on investigations and management beyond the basics. There will be many who focus on pathophysiology, H&P, and diagnosis heavily, and will look for you to mention random 'key facts' or buzzwords. CaseFiles and other textbooks are more likely to highlight those random key facts to know.
  13. Friends: I was still involved with the core group of friends I had before medical school. Much less time to actually interact with any of them face-to-face. People I saw weekly before medical school, I met up with only monthly or a few times per year. Although the workload was not unreasonable in the preclinical years, the distance to home discouraged me from travelling back often (and even when I did, time had to be allocated to family/SO before friends). I imagine if I did my schooling close to friends that I'd probably see them more regularly during preclinical years. During clinical years there was no time at all for those sort of interactions. When we would meet up I generally avoided talking about medicine except when they asked about it. No reason to talk about it when it already dominated my conversations with my classmates/med school friends. SO: Medicine was a heavy burden. We both had busy and often incompatible schedules. Finding someone understanding and supportive is definitely key.
  14. If you consider Obstetrics a surgical specialty that's your best chance at doing a 5 year specialty with minimal or no additional training (i.e. 1 or 0 fellowships for reasonable work location). With regards to post-residency qualifications, it seems that one fellowship plus a Master's degree is sufficient in most surgical specialties to find a job, at least for now. Often a MSc can be completed in just 1 year. Surgery is the toughest road, but keep in mind that it is the norm for most 5 year specialties to face bad hours/call and require a fellowship to find work in a reasonable location.
  15. 1D7

    Med school If you don't like biology?

    The most relevant science field to understand in medicine is physiology. Learning about disease in your preclinical years is mostly learning about how and why normal physiology becomes deranged. Medical school is less basic science heavy but you will still learn and apply a lot of knowledge from physiology. On top of that, I will say that of my peers who had opportunities to go into good consulting, investment banking, and other high level business jobs, 100% of them have varying degrees of regret coming into medicine (they all came in desiring prestigious and well compensated specialties). I don't say that to discourage you necessarily, but understand that it's a tough road and that the long hours of a 5-8 year residency+fellowship is more wearing than almost any other career out there if your primary goals include prestige and financial achievement. With regards to the match, if you come into medical school for family medicine you will be okay. If there is any chance you want to pursue a competitive specialty, then prepare to work hard and network. Another plus of FM is that if you end up disliking medicine, you will only have to train for 2 years after graduation.
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