If you have HBO Max, standup comic Alex Edelman’s one-man show was excellent. The official description of its main narrative thread: “In the wake of a string of anti–Semitic threats pointed in his direction online, standup comic Alex Edelman decides to go straight to the source; specifically, Queens, where he covertly attends a meeting of White Nationalists.” Here’s the trailer.
On April 23 at 2 pm ET, the FTC is holding a special open meeting with a live webcast to discuss the proposed final rule banning most noncompete clauses. At the end of the meeting, “the Commission will vote on whether to issue the final rule.”
Potentially huge news (that will then immediately be challenged legally).
This post is for anyone who is lost and dejected after failing one of the Step exams.
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First, I’m sorry that you’re going through this. The path to becoming a doctor is long and hard, but there’s something unique about high-stakes testing that adds stress and uncertainty.
I know this may sound a little odd/dramatic, but I think dealing with a big testing disappointment is ultimately the same as any other grieving process. The world today isn’t the world you wanted to live in, and it takes some time to bridge the gap between where you thought you were and where you currently are. The silver lining is that—unlike losing a loved one or a serious injury—you can still get back on the path.
At the same time, while it would be nice to get the failure notice and be able to immediately double down into an amazingly efficient targeted revision process for your next attempt, you’re also a human being. You’re a human being who deserves to grieve.
Maybe you won’t go through the classic stages of grief like denial, anger, bargaining, depression, and ultimately acceptance. But you might, and there’s nothing wrong with that. Just because there are so many worse things in the world doesn’t magically make this experience not suck. Don’t add insult to injury and beat yourself up for being acutely sad.
(On a related note, I think this would also be a good time to take a serious look at your media diet)
Once you have the timeline for your next attempt and know your school schedule, it’s time to be systematic about how to use that time effectively. That should absolutely include some time initially to reset psychologically. For a week or two, make specific time and force yourself to do some things that you enjoy and find centering. You need a less heavy heart to remember why you are on this pathway and why you’re willing to work hard to get to your destination. You can’t only punish yourself for this disappointment with things that rub salt in the wound.
Next, it’s time to analyze your current performance abilities for areas of weakness, both subject matter and testing approach (see below). It may be tempting to add a bunch of new resources or completely change how you study. In some cases that may be the right choice, particularly if you haven’t been incorporating enough questions or have never heard of spaced repetition, but for many people the answer is doubling down on a limited number of high-yield resources and not breadth. If you were close to passing, you probably don’t need to reinvent the wheel.
You do need to prioritize your mental and physical health (trite but true). Diet, exercise, and sleep are huge performance factors that you have a lot of control over.
The bottom line is that you are allowed to feel sad, and you’re allowed to mourn for the world where your pathway to becoming a doctor was smooth and straightforward and where you never need to question yourself or prepare a story for others. It’s something you can and absolutely will deal with, but there’s no reason to pretend that you don’t deserve to be bummed. That’s just toxic positivity. It does suck, and it is a bummer.
But you also need to believe that you will absolutely get past this. It’s a hurdle. And hurdles are meant to be overcome.
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For further test-taking reading:
It’s recruitment season, the radiology job market is hot, and there’s a lot of corporate noise. I’m thinking of maybe starting the world’s smallest radiology job board right here, open exclusively to a limited handful of 100% independent private practices.
If your group is interested in advertising on this site (and also therefore supporting my writing), email me at ben@benwhite.com.
Recruitment is a big challenge. While the ACR subsequently addressed the issue I wrote about here, I originally had the idea because of this.
Incredible story briefly detailed in NYT’s “Did One Guy Just Stop a Huge Cyberattack?” by Kevin Roose:
In the cybersecurity world, a database engineer inadvertently finding a backdoor in a core Linux feature is a little like a bakery worker who smells a freshly baked loaf of bread, senses something is off and correctly deduces that someone has tampered with the entire global yeast supply. It’s the kind of intuition that requires years of experience and obsessive attention to detail, plus a healthy dose of luck.
This could have been an unmitigated disaster. So much of the world’s infrastructure relies on random individuals being generally good or exceptionally thoughtful, in this case, the diligence of some dude who describes himself as a “private person who just sits in front of the computer and hacks on code.”
But, on the darker side: Given the seemingly miraculous nature of this catch, what are the odds there aren’t other backdoors already in place in our key systems?
In Show Your Work, Austin Kleon argues “the best way to get started on the path to sharing your work is to think about what you want to learn, and make a commitment to learning it in front of others.” That’s what I’ve been doing since 2009.
One downside of Showing Your Work is when the showing of the work is the only work you do. I never set out to be a blogger (cringey moniker that it is). Not that there’s anything wrong with this site (I think it’s pretty good?), but it’s undeniably the lower-hanging fruit that I’ve been doing for 15 years while mostly not writing the books and stories I originally intended to write. We could call it productive procrastination.
Now that’s not entirely fair, because it turns out that I also like whatever this is. I like writing short, I always have—I edited a nanofiction literary journal for 14 years for heaven’s sake—and I like curating, sharing, teaching people, helping others, and yes, even being a curmudgeon when the situation calls.
Kleon quotes David Foster Wallace, who said that good nonfiction was like watching “somebody reasonably bright but also reasonably average pay far closer attention and think at far more length about all sorts of different stuff than most of us have a chance to in our daily lives.” Which is I think is both generous and true.
So, I wish more people had websites, took the time to have a position or make something to share/teach, and then put it online.
For anyone considering graduating from transient social media reactions to starting a site to show their work, this gem from Clary Shirky:
The stupidest possible creative act is still a creative act. On the spectrum of creative work, the difference between the mediocre and the good is vast. Mediocrity is, however, still on the spectrum; you can move from mediocre to good in increments. The real gap is between doing nothing and doing something.
Medicine is, on the whole, underserved in the public sphere by its physicians. And the field of radiology, which has made up a significant fraction of my writing over recent years, certainly deserves more independent perspectives online than mine and a handful of others.
Don’t be scared to start small and reduce the barrier to entry for yourself. You can curate more than you generate, as old tech writer Jeff Jarvis advised: “Do what you do best and link to the rest.” (Last year I even added a smaller post-style microblog here to encourage myself to share more.)
I’ve enjoyed writing in my little corner of the internet and have no intention of stopping.
But, maybe there will be another book soon.
Post-match fourth year is a great usually “less-stressful” time to get your required education in personal finance. My free book is a nice, readable, and to-the-point primer on the essentials of personal finance including student loans. Read (or download it) here. Note that the new SAVE plan has simplified the student loan part for the majority of borrowers going forward.
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Not everyone should try to buy a house during residency. With the recent housing boom and higher interest rates, home ownership is probably out of reach for a larger proportion of residents than at any other time in recent history.
But, if you are considering trying to buy a home as a trainee, you’re likely going to need a physician mortgage. One quick way to get your feelers out to several potential companies at once is LeverageRx, a totally free handy platform that will let you rapidly comparison shop multiple physician loan lenders.
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Senior medical students are also eligible to try to lock in their eligibility for disability insurance. Disability insurance isn’t cheap—and you may not be able to afford it on your current budget—but again this is a great time to at least learn about it and price out some options and see. A small ~$2k/mo benefit medical student policy will often cost in the $40-60/mo range and will lock in future insurability. The folks at LeverageRx and Pattern both offer a great no-cost no-commitment way to see what your choices look like.
It’s always good to price out different options through different agents, and it’s possible the discounts available through your medical school affiliation are better than the ones you’ll have access to as a resident. Also, you’re unlikely to get younger and healthier. It’s worth doing some due diligence.
Life insurance, on the other hand, is straightforward: if you have a spouse or dependents that are relying on you, you need term life insurance.
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(Those are both affiliate links, which means that using them supports this site at no cost to you. My aging book is just free, no strings attached.)
From last year’s “Nutrition Science’s Most Preposterous Result” by David Merritt Johns in The Atlantic (“Studies show a mysterious health benefit to ice cream. Scientists don’t want to talk about it.”):
In 2004, the English epidemiologist Michael Marmot wrote, “Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be.” Marmot was writing about how politicians deal with scientific evidence—always concluding that the latest data supported their existing views—but he acknowledged that scientists weren’t so different.
The ice-cream saga shows how this plays out in practice. Many stories can be told about any given scientific inquiry, and choosing one is a messy, value-laden process. A scientist may worry over how their story fits with common sense, and whether they have sufficient evidence to back it up. They may also worry that it poses a threat to public health, or to their credibility. If there’s a lesson to be drawn from the parable of the diet world’s most inconvenient truth, it’s that scientific knowledge is itself a packaged good. The data, whatever they show, are just ingredients.
The data are just ingredients.
I got an underdesk elliptical a couple of weeks ago…I think maybe it’s awesome and wish I had gotten one a long time ago. I’m honestly a little surprised I can pedal while thinking.
I tried a few, and this is the one I landed on: very stable, pretty cheap, reasonably quiet.
The US government—specifically the Department of Justice, Department of Health and Human Services, and the Federal Trade Commission—is asking for public input about consolidation in healthcare.
A summary quote from FTC Chair Lina Khan from an article in the WSJ:
FTC Chair Lina Khan said that while some private-equity investment could be beneficial, too many buyout firms focus on profit to the detriment of medical care. Government regulators have heard numerous reports from doctors and other medical workers about the negative consequences of private equity-driven consolidation.
The comment period runs until May 6, 2024, and you can only submit feedback through this official docket on the Regulations.gov website.Read More →