Wayfaring MD

I am a family medicine resident who likes to highlight the hilarious in medicine as I write about patients, medical school, residency, medical missions, and whatever else strikes my fancy.

HIPAA is for reals, folks. All of my "patient stories" have been changed to protect patient privacy. I will change any or all identifiers, including age, location, race/ethnicity, sex, medical history, and quotes. Also, I am an anonymous internet person. Why should you trust an anonymous internet person to give you medical advice? Don't ask me, ask your doctor!
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Posts tagged "medical school"
Asker ramacero Asks:
In my health care ethics class I am currently taking, we are discussing medical enhancements and our book mentions the use of Adderall in medical students just to keep up. How many students would you think use Adderall in medical school, and would me not using it hurt my performance in my future career? It makes me nervous to think that I could be shoved out of competition because I refuse to use a medication for ADHD, which I don't suffer from, to make myself better in the medical school.
wayfaringmd wayfaringmd Said:

I’m not sure what percentage of people use Adderall (prescribed or not) in med school. In my class I knew of a few, but I expect the numbers have increased.

Let me rephrase your question a bit to this: will using a medication illegally or obtaining it under false pretenses for a condition I do not have possibly negatively affect my career?

The answer to that is a definite yes. I’m a big proponent for using the brains God gave you without using drugs you don’t need. Now if you truly do have ADHD, then by all means, take your medicine. But abusing a medication (and the system) is not a great way to start out a medical career. What will you do when you start residency or go out in practice and the stress and pressure increases? Keep searching for more and more substances to give you a boost? Sounds like a dangerous path to start down if you ask me.

Using meds that aren’t prescribed to you is not only dangerous to your health and illegal, it’s also cheating. And you certainly don’t want cheating on your transcript. That don’t look so pretty to residency programs. 

Thousands— millions—of doctors made it through without using stimulant meds. Heck, Cranquis made it through without caffeine, and I made it through with very little caffeine as well (and no coffee what?!). It absolutely can be done, and you don’t have to be a super genius or a 24/7 studying gunner to make it happen. 

Asker Anonymous Asks:
Will my medical school know if I have a medical marijuana card?
wayfaringmd wayfaringmd Said:

Hmm, I really don’t know. Marijuana isn’t legal in my state. But I would think that your medicine would be your business. But you need to look into your school’s and your clinical rotation site’s drug testing policies too.

Asker Anonymous Asks:
hey wayfaringmd! love your tumblr! I was wondering, how did you study for your third year of medical school on clinical rotations? Was there a syllabus that you had to follow? Are there any books you would recommend? Thanks!
wayfaringmd wayfaringmd Said:

No, we didn’t have a syllabus for our third year rotations. We usually asked 4th years which books helped them prepare the best for rotations. 

If I encountered a diagnosis or drug or treatment that I was unfamiliar with or didn’t understand, I usually looked it up on UpToDate or ePocrates. Those can be extremely helpful.  It’s a good idea to go home and read about your patients’ conditions every night in addition to your book reading to prepare for your test. That way you’re prepared for your test and your patient presentations and pimp questions and, well…life as a doctor.

I also stuck with 1 or 2 books per rotation so that I could actually get through them and absorb them. It’s been a while so I don’t remember all of them, but I remember I used Blueprints for OB/GYN, Step up to Medicine for IM, and Case Files for Surgery. I liked Case Files a lot as my back-up book for studying. And I usually had some sort of QBank that I would review during the rotation too, like MKSAP or USMLE or something like that. 

My advice to you: 

  • get a comfortable couch or desk chair. You will spend a lot of time sitting down and reading.
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  • get a copy of First Aid now and review it as you go along. 
  • come up with a standard snappy comeback for the aunts and uncles who will insist on asking you “so are you still single?” at EVERY FREAKING family gathering
  • get ALL the Goljan bootlegs (ask a second year. They’ll hook you up) 
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  • get some butcher paper and draw out the giant biochemical pathway chart with everything all interconnected. Hang it on your wall and stare at it for 15 minutes every day until you can see it behind closed eyes. 
  • dedicate a few t-shirts that you are “so over” to cadaver lab. Your good clothes will appreciate it. Goodwill scrubs are also excellent for this. 
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Asker Anonymous Asks:
Hello! I really enjoy your blog! I feel like you give a fairly accurate picture/ the truths of going through med school and being a doctor. Anyway, I was wondering what are the rotations available to you during medical school. Does it vary depending on the school? If so, could you tell me some of the basic ones that most schools would have? Thanks in advance!
wayfaringmd wayfaringmd Said:

All medical schools will offer the 3rd year required core rotations, though they may require you to travel to a different facility for some of them. These would include:

  • Family Medicine
  • Internal Medicine
  • Pediatrics
  • OB/GYN
  • General Surgery
  • Psychiatry

Some schools also require a neurology rotation during 3rd year. Mine didn’t, thank goodness. 

Electives vary widely and most people will travel for an elective or two during 4th year. Common electives would include (stars by things most schools will offer):

  • Internal Medicine sub-specialties: *Cardiology, *Nephrology, *Pulmonology/Critical Care, Endocrinology, *Infectious Disease, *Neurology, *Heme/Onc, *GI, Rheumatology, Allergy & Immunology
  • Peds subspecialties (these will likely only be at large academic centers or, of course, childrens’ hospitals): Cardiology, Behavioral Medicine, Nephrology, Endocrinology, Neurology, GI, Heme/Onc
  • Surgery Subspecialties: *Orthopedics, *ENT, Trauma, Vascular, Pediatric, Transplant
  • OB/GYN Subspecialties: Reproductive Endocrinology, *Maternal-Fetal Medicine, Urogynecology, GYN Oncology
  • Psych subspecialties: Child & Adolescent, Geri Psych, Neuropsych, Addiction Medicine
  • Dermatology
  • *Radiology
  • *Emergency Medicine
  • *Geriatrics/Hospice/Palliative Care
  • *Community Medicine/ Rural option
  • *Ethics
  • *EKGs
  • *Anesthesiology
  • *ICU/ Critical Care
  • *Pathology or forensic pathology
  • Ophthalmology
  • *Pharmacology
  • Pain Management
  • *Sports Medicine
  • Global Health
  • Physical Medicine & Rehab
  • Adolescent Medicine
  • Research

Any advice for an incoming med student? Like what was first year like & any tips/hints to help survive??  — lifeofastudentdoc

Part I: What will it be like?!

There will be lots of smart people there. Most of them will be smarter than you, or at least they’ll think they are. Being around smart people all the time will send you into a constant fluctuating state of confidence and crushing self-doubt. image

On the first day you will go home and crack open a book, read for 8 hours, and remark to yourself, “this ain’t so bad.” On the 4th day of such reading, you will start calculating how much debt you will be in if you quit on day 5. 


You will learn an entire new language made mostly of gibberish, Latin, and acronyms. Get to know your -ologies, your hypers- and hypos-, and always pronounce the word the way your professor does, even if there’s a perfectly acceptable alternative pronunciation.



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if given the chance of re-doing undergrad and grad years, would you still pursue medicine?
wayfaringmd wayfaringmd Said:

Definitely so if I started over with none of the knowledge I have now. But if I had to do it all over again but had the experience I have now, I’d have to really think about it. I love medicine, but I think there are other things I could have done and been just as happy (and relatively debt free). 

Actually, that’s something Cranquis and I had in common on our personal statements — we both basically said we could take or leave medical school, and could find other ways to follow our passions without medical school. Maybe that’s the secret to getting in ;) 

A good patient presentation should be like a woman’s skirt. Long enough to cover the good stuff, but short enough to create interest.

Highly inappropriate OB attending.

Asker vinkavinxs Asks:
Sorry if this question has been asked before, but do only the smartest people at med school get to become surgeons? Or can toy become a surgeon, should you have reasonable marks and a suitable personality? Thanks heaps!
wayfaringmd wayfaringmd Said:

General surgery is fairly competitive and requires above average test scores, but it’s not the most difficult specialty to get into by far. And of course, high scores don’t necessarily mean they’re better (or even smarter) doctors. I think the average Step 1 score for surgery is in the 230 range. 

Personality does have a lot to do with it as well. You have to be pretty tough to go into surgery and last through 5 years of torment and long hours. Plus residency programs tend to pick applicants that fit the “culture” of the program. 

Hello! c: I was wondering if you had any opinions on pursuing military medicine or military HPSP programs for medical school?
wayfaringmd wayfaringmd Said:

I don’t know tons about it other than if you’re willing to sacrifice 4 years or so to the military (and potentially go to a military residency), it’s a great way to get your loans paid off. Ask aspiringdoctors. She’s doing the military thing and can give you more info than I could.

I’ve been seeing a lot of Step-1 induced panic in my inbox and on my dash over the past few weeks.


I know some of you are super confident in your own abilities and never express the tiniest bit of doubt and are sure that you’re going to blow Step 1 out of the water. Those of you that fit that description should probably check the Step 1 discussion boards on SDN, start pimping your fellow students, and go ahead and start studying for Step 2.


The rest of you have some doubts about your abilities to make it through the last week or so of Step 1 studying. Others of you are starting your second year and panicking at the very thought of Step 1 coming soon. So here comes a little advice/encouragement/empathy from someone who’s been there just 4 short years ago (WHAT WAS IT REALLY THAT LONG AGO? HOW OLD AM I?!).

 beyondtheoath:      Mister Rogers says goodbye. x    I needed that.    4894489548964897

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How important is playing a sport in high school to get into college/med school?
wayfaringmd wayfaringmd Said:


Asker Anonymous Asks:
Hi lovely lady! Awesome blog :) I was wondering if you could explain something about step 2ck and 2cs. Which one would you have to take first? What are the best resources to study and prepare for those two tests? How soon after passing step 1 do people usually take step 2? Thank you :)
wayfaringmd wayfaringmd Said:


Cannot answer because I just haven’t even looked into it yet! I was seriously too focused on surviving step 1 to think about step 2 yet. I just haven’t figured it out yet. I will eventually but I’m really focused on the next test ahead of me right now—IM shelf exam!! 

But I’m hoping that one of the other awesome medblrs who’s already taken Step 2 can answer these questions—for this anon and for me. :) 


Step 2 is usually taken in the beginning of the 4th year of med school when you’re freshly through your core rotations and haven’t gotten senioritis yet. It doesn’t matter what order you take them. Most people use USMLE world questions to prepare for Step 2 CK (+/- DIT videos). I did 4 weeks of easy electives that were half-day things, and then used the other half of the day to do World questions. Step 2 and 3 don’t require as much studying as Step 1 does.

Step 2 CS doesn’t require much preparation if your clinical skills are halfway decent. First Aid for CS has practice cases that I went through a few days before the test. Otherwise, speak clear English, wash your hands, and drape the patient and you’ll do just fine. 

Asker Anonymous Asks:
Is running a Tumblr blog worth putting on your med school app?
wayfaringmd wayfaringmd Said:

Ooh, be careful with that. If there is even ONE post on there that may put you in a negative light to the school, it’s a bad idea. It also really depends on your subject matter. If you’re just reblogging a bunch of science posts from other people, what does that show to the application committee? But if you’re running an original content blog that is innovative or research-based, it may be appropriate. I would not put a blog like mine on an application (because I share patient stories and personal stuff), but ones that probably would look good to admissions committees are ones like thebiopsy, in-training, and thedifferentialdiagnosis. Also be careful to research the school’s social media policy before you disclose a blog to them. 

Asker Anonymous Asks:
What can I do to "make up for" a dismal passing score on Step 1? Are my residency choices severely limited now?
wayfaringmd wayfaringmd Said:

Yeah, that sucks, because you can’t retake it unless you failed. 

Well, when Step 2 rolls around, study extra hard and improve that score. I did a lot better on Step 2 than Step 1 (like 30 points better), and a few programs actually commented on it during my interviews. Improving scores will show that you are continually learning and that you’re probably better at clinical medicine stuff than basic science stuff (as most of us are). 

Even with improved scores on Step 2, yes, your residency choices will be somewhat limited. I mean, probably not going to get into a derm or ortho surgery spot with a 195. But hey, even if your score is a little below the average for the specialty you’re interested, it doesn’t mean you can’t match into it. Also remember not everyone gets the average score. Half are below the average score ;). Plus if the rest of your application is outstanding, it will help. Programs may see that you’re just not a stellar test taker.