u/Odd-Boysenberry5316

See title. Rising M4, honestly thought I was chilling after getting mid 270s on step2 and all honors third year. Unfortunately my preclinical performance was total dog shit and I am guaranteed to be bottom quartile, possibly even bottom 10%. I didn’t fail anything but I passed every block by literally 1-2 points and usually failed multiple quizzes but didn’t have to remediate because I’d do well enough on the final to get me over the edge. I genuinely thought none of this mattered because we are a Pass Fail school for preclinicals but now my dean is saying all this will get reflected on my MSPE and I will likely end up with the worst possible overall adjective. How fucked am I lol? My school advisor says I need to have a back up plan for anesthesia because my peformance is reflective of someone who is “sloppy, all over the place, and possibly not ready for the demands of residency” (basically her exact words). I am so fucking done with med school holy shit they bait you with “pass fail” then stab you in the back at the last moment for no reason. What am I supposed to do

“You guys have heard enough about surgery, let’s talk about leadership“ “I could bore you a bunch of papers but let’s instead talk about crafting an academic career”. Why does every invited Grand Rounds speaker do this now. literally the last 3 invited speakers were some big name bozos flown in from half way across the country who decided to just blab about their CV for an hour instead of saying anything useful. You would think the chairs of major academic surgical departments might have some thoughts about surgery, but no, they would prefer to talk about “developing your values as a leader”. Literally what is the point of this. The whole thing is just one endless academic circle jerk. The only people who benefit are the speakers who are paid to hang out with their buddies for a day and get a free dinner IMO.

I genuinely believe that a large number of faildaughter (or son) cases we see here could have been prevented if PMC parents didn’t turn their noses up at the nursing career path. My public HS was a weird district that combined a bunch of working class neighborhoods with a very wealthy (by midwestern standards lol) neighborhood filled with doctors, attorneys, business owners etc. Girls in the former camp knew they had to start earning ASAP so you didn’t want to work a complete garbage job right out of HS the main choices were nursing or another healthcare type field or the military. Meanwhile girls in the latter camp had big aspirations and wanted to study English lit at an Ivy before heading to med school.

I’m 28 now and the chicks (plus a few guys) who became nurses are honestly killing it, closing on homes, having their 2nd kid, and making over 100k a year. Meanwhile the PMC daughters are either floundering, whining on twitter that nobody takes their public health degree seriously (which they got after flunking med school admissions), or barely surviving the “stress” of their no-work email jobs on a mix of SSRIs and stimulants. I think a lot of the children-of-PMC malaise comes from the fact that they were told growing up to become “professionals” at all costs, they shot too high, and now they are wallowing in a misery entirely of their own creation.

Getting addicted to nicotine has truly gotta be one of my biggest regrets in life. Picked up a juul habit freshman year of college and probably tried and failed to kick the habit about a dozen times since then. It's honestly so embarrassing to be dealing with this as someone who's gonna be a doctor a year from now. I ended up switching to Zyns during M1 and told myself I'd finally be done with this crap by the time I got to clinicals. Then during clinicals I figured I'd finally quit after Step 2. Now step 2 is done and I legit can't make it past 2 days without buckling and going back to the zyns or using a vape. I used to tell myself that it was helping me focus and I needed it for my anxiety but the reality is that I'm just piss poor at dealing with the constant headaches/brain fog/irritability that comes with the withdrawals.

Anyone else been in this spot? What worked for you guys? I do NOT want to carry this shit with me into residency but considering I can barely handle the stress of Sub-Is and ERAS and whatnot I don't have a whole lot of confidence in myself for the future...

M1 year I was told that all that matters for residency is your clerkship grades, Step 2 score, and research... and I took that advice wayyyy too literally. Now I am looking at my "leadership activities" and "noteworthy personal characteristics" for the MSPE and just straight up drawing a blank. Don't get me wrong I did some minor stuff here and there like volunteering for the admissions committee and one-off mentorship things but I legit have zero "major" ECs. Meanwhile half my class is like yeah I started an entire global health program in Ghana from scratch or served as the president of a public health program serving 5,000 local residents or led a research team that resulted in three first-author Nature pubs. I'm so effed and it's 100% my fault. Any advice on how to spin this big pile of nothing into something half decent lmao? Also my MSPE has a straight up demonic comment from an OBGYN preceptor who says I am incapable of taking a basic H&P so that might just torpedo my app right there... (no the school can't scrub it out smh). See y'all in the SOAP folks

Rads residents, would you recommend that PGY1s and PGY2s stick with their current career choice or is now the time to bail before AI takes over? Real question, not a troll. I am having serious worries about how long this will last. The so called hot job market could evaporate in a second after one paper in JAMA demonstrates that AI reports are noninferior to human generated reports. I am having daily anxiety attacks thinking about this. If you had the opportunity to switch out and take a categorical internal medicine spot instead of continuing onto radiology as planned, would you recommend that instead? GI and cardiology are obviously not going anywhere. Meanwhile radiologists may face mass unemployment within the next five years. Why are you guys sticking with it - why does anybody have any hope for this dying profession? Personally I think all the attendings I talked to in med school had their heads in the sand. They reassured me that AI was never going to take over. Well one simple google search about foundation AI models and you will see that the threat is much much scarier than anybody wants to admit. Legitimately crashing out over this. I'm not sure how much more uncertainty I can take :/

This is the one field that I just truly don't understand. I get the people who want a chill lifestyle and good work hours and are going into psych or PMR. I get the people who want to operate on the spine and make $2 million a year. I even get the people who love shift work and hate the pager and are going into EM. But what I don't understand is general surgery. It seems to have the most downsides of any specialty in medicine and yet there is a huge gung-ho gen surg crowd at my school that is completely sold on the profession.

This seems crazy to me given that gen surg:

• Works more hours during residency than any other specialty except NSGY
• Requires 5-7 years of training minimum (most prestigious academic programs now require or "strongly encourage" TWO years of academic development time)
• Then on top of that most people are spending 1-3 more brutal years in fellowship
• The pay is pretty meh for the work hours
  • As far as I can tell most gen surg attending jobs are like 450k range -> you can make more than this in gas or rads with way less stress and way more vacation
  • PCPs who have way more chill jobs make less than this... but not that much less. Many are making low 300s.
• The boards are brutal and cover an impossible range of content
• Subspecialty surgeons hear "gen surg" and clock you as a person who didn't have what it takes to match ENT/urology/ortho. Even the general public is like oh... just a "general" surgeon
• Has some of the most burned out unhappy people in the entire hospital

What am I missing? Why does this specialty continue to draw interest from top tier US MD candidates? Why hasn't it completely bottomed out and filled with 50% international grads and SOAPers? Real questions not a troll lmao

M4 hopefully headed into DR... the discussion around radiology always seems to include some mention of "insane increases in volumes" "massive overutilization of imaging" etc whenever med students express interest in the field. While obviously this might be something to consider for a misinformed student who thinks that rads = showing up at 9 am and just chilling in your chair sipping coffee all day, I don't understand why it's considered a BAD thing that there is massive demand for your services? As far as I can tell the significant increases in volume in excess of the increase in new graduates is basically the only thing keeping wages high as hospitals need to pay radiologists in excess of their professional fee billings to ensure reliable radiology coverage. Can any residents/attendings weigh in on this? What am I missing?