medical school

ER docs are pretty nuts ime

Oh, also, to one of gbx's earlier points about the amount you pay for applying to extra places. This year, it broke down like this:

For $85, you could apply for anywhere from one to ten places in any given specialty. To apply to places 11 through 20, the extra cost was $8 each; for 21-30, $15 each, and for 31 and beyond, $25 each.

This worked out well for me; I applied to 47 places, all told, but 20 were in one specialty (so neuro was $165), and the prelims ended up being 25 Preliminary medicine (for $240) and 2 Transitional Years ($85). I spoke with a dude who applied to 50ish ortho programs and dropped over $1000 for the privilege. We also had to pay some extra money for our board scores to be released, and like $50 to activate something or other with the match process itself (I dunno, I don't care, I just paid when they tell me to).

Fourth year also is noteworthy for Step 2 CK ($500ish) and Step 2 CS ($1100ish), with Step 2 CS requiring travel expenses unless you happen to be in Philadelphia, Atlanta, Houston, Los Angeles, or Chicago. (I took CS on December 27th while in California for the holidays, and stayed with my parents, so I saved that, at least.) For those of us who took a national application strategy (My top 4 places are in four different time zones), plane flights and hotels and rental cars also are a serious thing. If I had been one of those people who just stayed along the eastern seaboard I would have saved myself some grief and money, but I am not East Coast people, alas. I had the good fortune of having several hotel rooms comped by the programs, at least; I balled pretty hard when it was not my own dime, and rolled the dice with Hotwire otherwise.

Basically, though, money, time, and motivation are the limiting factors in the scope of your application. People apply to 100 programs, and people do even more ridiculous interview strategies than mine, but somewhere around January we all are broke and exhausted, and you start to reassess.

Also my guess is that doing anything at Brigham and Women's (where Gawande works iirc) is probably a stressful place to do your thing because that whole MGH/B&W/BI zone is serious business.

Update! E-mail recieved about an hour ago:

Subject: Did I Match?

Congratulations! You have matched.

* Reggaeton Horn *

mazel tov!

:D

I hear North Dakota has dr. jobs

grats yo

congrats, C-L!

Interestingly North Dakota has about as many residency spots as you might guess (from last year's data, 18 Family Medicine, 4 Internal Med, 4 Psych, 3 General Surgery, 8 Transitional Years and 2 Prelim Surgery) so really I think we've found the one flaw in Todd Buchholz's theory, potentially, IF Todd Buchholz's theory has any flaws.

I guess we could advise the unmatched people that a career in fracking could be theirs.

yay C-L!

my dude

u r killin me smalls

c'mon, man! inquiring minds NEED TO KNOW

haha either way he has to be blind drunk by now, right?

haha mabes

apparently there is a mixer tonight at the TOP OF MPLS's TALLEST BUILDING

one of the more stellar/qualified bros i know got his fifth pick :-/

I am relatively sober! (For now)

I got my #1 Neurology and #3 Prelim! (UCLA and Maryland, respectively)

Several of my friends are featured in this: http://www.wjla.com/articles/2012/03/matching-day-for-medical-school-students---what-about-romance--73861.html
(But I do not think I can see me anywhere)

Partyin, partyin' yeah!

MY MAN

gettin down on fri-day

fri-day fri-day

Seven a.m. its 0445 oh god why, waking up in the morning
Gotta be fresh, gotta go downstairs
Gotta have my bowl coffee, gotta have cereal NOTHING ELSE
Seein' everything, the time is goin'
Tickin' on and on, everybody's rushin'
Gotta get down to the bus stop lol there is no bus now but w/e
Gotta catch my bus, I see my friends (My friends) schedule and realize its a call night and i forgot contact lens solution god DAMMit

yay again C-L!

niiiiice

Oh wow congrats that is so awesome!!!!!

Strong work, Dr C-L. Well deserved, I'm sure.

otm. those were some great posts. and congrats on the picks too i guess?

I started today by finding out that one of my patients died overnight. But everyone else was either stable or improving, and one lady in particular seemed about as happy as I've ever seen her. So on balance, it was a pretty good day to have my last day of clinical rotations in the hospital as a medical student.

The suddenness of the end of medical school is really quite remarkable. There were some days in there where it seemed like it was never gonna end and now it has pretty much ended. USA! USA! USA!etc

v sorry to hear about yr patient, man, i've definitely had that a few times (esp jarring is the "come back on monday, ask about X, who looked well on friday")

congrats, though! now gimme all the answers to the shelf

Any situation where patient is dry with BP like 80/40 = give IV NS before doing anything. Even if their sodium is like 120 or 150. That is my primary lesson from studying for the Medicibe shelf with USMLE World.

yeah i feel like 'push fluids' is kind of a safe go-to intervention

btw by 'shelf' i mean all the shelfs

OK so how much of this can I remember:

Medicine shelf: U-World + MKSAP + everything you did to an actual patient (seriously this is the stuff you do not have to study, you're just like "Oh of course it is to begin HAART therapy, because we had that guy who had Cryptosporidium and all we did was give him HAART and some Immodium.")

Peds shelf: Pretest

Surgery shelf: there are really only maybe 15-20 sorts of scenarios where surgery is testable (appys, cholecystitis vs cholangitis vs choledocholithiasis, perforations, etc.). It is less daunting than it appears. Also it is generally best to select the most conservative option (although watchful waiting is not always actually the most conservative therapy).

Psych shelf: I forget.

OB shelf: I felt like this one sucked because the OB you are supposed to know as a 3rd year is a relatively finite batch of common issues, and thus pretty manageably knowable (preeclampsia and gestational diabetes and chorioamnionitis and such), but the actual exam tests almost none of this in favor of the things you may see like once a year.

Step 2 CK: Take after medicine if possible. Also there is some OB and a little Peds but medicine is where the action is.
Step 2 CS: is stupid, and expensive. Do not fail it because my God it would suck to have to do it again.

Awwww yeah, it is officially official today.

ahhhh congrats!!!

Hell yeah. Congratulations.

bigtime!!!!

soooooo i think i'm going into psych

(you win, horseshoe)

tell me more in a possibly emo fashion!

feel free to use all caps!

also yay!

wow dude that's boss

the brainsick of the world thank u gbx (though I've still never seen a proper psychiatrist)

that's because psychiatrists just rx the drugs and leave the therapy to clinical psychologists, counselors, social workers, etc.

um, hi...I'm here for the gbx livejournal? :)

(xp I have drugs, got them from my PCP though)

PSYCHIATRY

CONS FIRST, ALWAYS START WITH THE CONS:
- BASICALLY YOU JUST WASTED A FEW YEARS LEARNING SHIT YOU WILL NEVER EVER DO OR NEED AGAIN, EVEN IF YOU LIKED IT, LOL TOO BAD
- CAN'T DELIVER BABIES
- USELESS ON AN AIRPLANE
- EVERYONE AND THEIR FUCKING PROBLEMS, GAWD
- LOTS OF THINKING, NOT A LOT OF DOING
- WILL ASSUME EVERYONE PUTS IN THEIR OWN AIRQUOTES WHEN YOU TELL THEM YOU'RE A PHYSICIAN
- YOU'RE JUST A DRUG-DEALER, LET'S FACE IT

XP KATE78 GETS IT
- WHILE WE'RE FACING IT: YOUR COLLEAGUES DO NOT RESPECT YOU AND YOUR FLIM-FLAMMERY
- FRIENDS RELATIVES AND PPL AT PARTIES WILL ASSUME YOU'RE EVALUATING THEIR PSYCHE ALL THE TIME, AND WILL CERTAINLY BRING IT UP IN TIMES OF CONFLICT
- YOUR KIDS ARE GOING TO BE FUCKED UP (SEE PRECEDING)

you've just described... every job

HEY MAN I'M JUST DOING WHAT THE LADY ASKED

haha my parents are doctors and have said some asshole shit about psychiatrists in their time but i would have really appreciated it if one/both of them had seen a pscyhiatrist at some point in their lives if you catch my drift.

why do you want to do it then? i read a book that convinced me drugs are bad

also thank you evan!!!

let us just be real that lots of thinking in a job sounds awesome. or is that the caricature of psychiatrists? either way, it sounds awesome.