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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Asker Anonymous Asks:
Hi! I'm a 30 year old freshman with kids and a husband. Over the last few years It's become clear that I can't shake my interest in medicine. I love the use of science for healing. It's absolutely beautiful. Unfortunately I feel selfish and indulgent considering pre-med with the intention of applying to med school. It's a really long road to drag my family through. In your opinion, at my age, am I fooling myself thinking that I could start a career as a doctor?
wayfaringmd wayfaringmd Said:

It’s certainly not too late to start a career in medicine. There’s a guy in my program who didn’t start college until his mid-30s and is now a 2nd year resident! From what I’ve seen, the non-traditional students tend to be the best ones because they’re the most driven and serious about their studies, plus they have some life experience under their belts. 


It’s gonna be hard though. It was super hard going through it single, so I’m sure going through it married will be tough. But you have a built-in support system, which is awesome! And people do it all the time, so don’t feel like you’re the only one. 

If going back to school makes you feel selfish, you need to have a talk with your husband and kids. More than once. Like before the beginning of each semester. They’re a part of your life, and their opinions count too. If they are fully supportive of your aspirations, then go for it! You still have several years before you have to decide about med school, so y’all have some time to see how things work with you being in school.  

Asker Anonymous Asks:
Any anecdotes/advice for going through a bad day in the medical field? Whether it be getting yelled at by an attending, a patient, feeling like you don't know anything, feeling like you're the only one who knows anything, etc?
wayfaringmd wayfaringmd Said:

Step 1: SLEEP ON IT. 


Bad days happen fairly frequently, but you can’t let them stick with you. Sometimes crappy stuff happens because other people are having a bad day and they take it out on you. Do your worrying and fretting for that day only, and then sleep on it. Choose not to obsess over it the next day. However, if you sleep on it and it still really bothers you, proceed to step 2.

Step 2: Complain to someone else about it.

Ideally, this person would be a fellow student who can commiserate, or maybe your mom. Moms are good at giving appropriate pity or telling you to suck it up and move on. Fellow med students can understand your situation better than your mom can (unless your mom went to medical school too) and support you through it. Then, if you are still bothered, move to step 3.

Step 3: Do something about it.

Was your attending just being a jerk? Let it out on your rotation evaluation. Or maybe you got yelled at for a good reason. Examine your own actions. Did you not know your patient’s labs? Work on being more organized so you can keep track of that stuff. Did you make a mistake? Read about the problem and learn from it so you don’t do it again. Ask someone who is getting things right to help you and give you direction. Let that bad day motivate you to do better next time. 

Chin up, greyface. 

Asker Anonymous Asks:
Hey! I'm in high school and have have rheumatoid arthritis. I really want to be a pediatric rheumatologist but my entire family doesn't want me to go to med school because of my health. Is medical school really as bad as they say?
wayfaringmd wayfaringmd Said:

Um, yes, it really is as bad as they say. That’s why they say it. Med school is HARD.  And that’s even if you have the grades and extras that it takes to get in. Getting through is tough

That doesn’t mean you can’t or shouldn’t go for it though. It just means you have to be really sure you want to dive in and can dive in before you actually dive in. You have to be aware that your illness is going to affect your ability to study well or manage the stress or work extremely long hours without a break. 


Realize that you will incur mountains of debt (if you are like the vast majority of med students who are not independently wealthy) and that there’s the possibility that you may not finish school if your health becomes prohibitive. 

I don’t mean this to sound harsh or pessimistic. I want you to be realistic. Your health conditions don’t have to keep you out of medical school, but you do need to realize that you can’t make it through on optimism and hope alone. There is a lot of struggle and stress that comes along with med school.

My best advice for you would be to talk to your own rheumatologist. Ask him or her how stressful med school was for them, and whether they think you can handle it. Talk to them about getting your rheumatoid under the best control possible to lighten the burden on you a bit. And ask to shadow them! See what they do on a daily basis and decide for sure if it’s really for you. 

Asker Anonymous Asks:
so how long would it take to pay off all the crippling debt on average
wayfaringmd wayfaringmd Said:

Depends on what payment plan you pick. Most of us go with the income-based plan now, which requires you to make 120 payments (yup, 10 years) and the amount is based on how much money you make. The new deal is that after those 120 payments, you’re done, even if there’s a balance left on the principal payment.

Then you’ve got the Standard plan, where your payments are based on how much money you owe. They are often structured over 10, 20, or even 30 years. But people who are really motivated or who have great jobs sometimes pay them off in as little as 5 years.

Right now I’m doing the income based plan because my debt is so high it’s the only way I can afford to pay anything. I haven’t paid anything on my principal yet. Not even covering my interest actually. It’s still compounding.

Asker breakempire Asks:
What was your fav part of the first year of medical school? (I just started!)
wayfaringmd wayfaringmd Said:

My favorite day was probably the afternoon that I found out I passed my first test—when I realized, hey, maybe I can do this. 

Overall though, my favorite things in first year were the times that I was allowed to work with real people instead of books. I loved anatomy lab and I loved my community medicine placement in a family practice office. I didn’t love the massive paper I had to write on community med, but I did appreciate the break from the books and the fact that my preceptor let me see patients on my own even as a first year. 

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.