Video

Is breast cancer a common thing or is it esoteric?

Is there a pattern of breast cancers ? Like location, size, type,etc?

If you can image it, you can remove it, right?

Good intent.

Your medical school and the testing Mafia care more about your pronouns than your medical knowledge. It's all teach to the test, a terribly flawed test at that. Medical students aren't allowed to think.

His most egregious crime was murdering hundreds of young children ,mostly orphans ,with experimental drugs in New Jersey. He had an open pit for years to dump their tortured bodies. Read RFK JRs Book :The Real Anthony Fauci” or you don’t have a clue

I know what I do before I pay my bills: get a ct screening for lung cancer.

The questions are pretty dumb often - pretty random. However, the worst part is in my ongoing certification exams which often ask us trivia. I think the problem is that academics are nerds and trivia is easy. Trivia separates who studied from who didnt….determines who puts in some effort. But the doctors dont get paid for making these questions so trivia is quick and easy for them. My background is lots of stats and Epi so I will always give them feedback about these questions and have offered to write questions - but I am not in academics and am nobody. But the work involved to improve all these things is too much for volunteers who are busy managing grants, teaching, clinic, papers.

Hi. I agree with you. I didn't know what can be done to change the culture, though. There is also hazing of young, eager students who are on their rotations, on the part of chief residents. This "beats" the humanity out some students. It's very sad to experience and watch.

The point of these exams is to separate the surgeons from the PCPs....or so USMLE/AMA thinks. In reality, they create a really screwed up way of comparing medical students for residency positions where those who score average or below have essentially 0% chance of matching into a lucrative specialty. In the end, its all about salary and prestige.

Transmission? If i feel better and don't stay home thanks to a booster, aren't i MORE likely to transmit?

No way up for reading a covid 19 book. I want to read a book that tells me about justice, that shows how those who did not and still do not accept responsibility for their wilfully misguided actions are now paying the price. A price that matches their wilful, arrogant actions.

Fauci never generated evidence to support his fatal and flawed 'expert' advice. Shame on him, an arrogant, ego run rampart poor excuse for a human being. Yet shame on those who allowed and still allow Fauci to flourish whilst so many suffer and die, still.

Dr Prasad, current US MD student here who also acknowledges that I’m paying loads of money to practice my pattern/buzzword recognition skills. With that said, would you be willing to write two or three questions yourself that you believe would be valuable for medical students and make a video going over them and explaining why they’re better than the ones here? Would love the opportunity to see what valuable questions from a practicing physician would look like. Thanks!

Healthy habits lead to a happy life. 🌟🌈

Many doctors: Med students should know everything our committee of five know about our specialties. Please do not consider that none of us have much idea about what the other four members consider essential.

This was interesting and entertaining!

Not at all surprising. I am a Hospitalist who works on the front line. Our currency is clinical uncertainty because the knowledge base is forever shifting. We are asked to make binary decisions when the educational basis for deriving them is an amalgam of uncertainty. Beware the confident recommendation because those situations are honestly pretty unusual.

Lockdowns were put in place to jusify mass mail in ballots. Period.

Do one with step 1 questions! That test asks about the most random factoids which we never use!

Please do more this!

I am not a doctor, i just find medical stuff very interesting and wish i had gone that career path. I am curious - if you saw that last question in a real patient, why would you not do an infectious disease workup before looking at cancer? Or infectious disease along with another cause of the weird leukocyte counts

It might not be about core knowledge but it's about molding one psychologically to memorize rote and develop the strong work ethic necessary to be a doctor. It's akin to telling a boxer that all those thousands of miles you ran over the years during training camp were pointless because it's only a 36 minute fight.

I've never felt better as a 4th year med student trying to go into ophthalmology than knowing the answer to that last question lol. Sketchy for the win!

Proof that it’s a business, not a training program. But how do you test, can you relate to patients in a way that gets them to open and say the buzzword, because Lord knows, it’s not going to be my physical exam of the spleen tip?

I don't think the problem is isolated to just med schools. Most public universities that I know of are absolute junk. So many "graduates" trying to get jobs that they're not prepared for. A college degree is pretty much worthless now.

You would be better to interview neuroscientist Dr Kevin McCairn and get a much better perspective on this dreadful debacle

My suggestion for endless criticism from Vinay. Create your own question bank and teach students relevant clinical medicine.

I entered the question about the 66 year old woman (Impaired effective antibody production) into chatGPT. This was the reply.... "This patient is experiencing recurrent respiratory infections and has osteolytic lesions in the ribs. Given her history and the clinical presentation, including anemia and a normal mean corpuscular volume (MCV), the most likely underlying condition is multiple myeloma. Multiple myeloma is a plasma cell malignancy that can lead to impaired antibody production, making patients more susceptible to infections. In multiple myeloma, the production of normal immunoglobulins is decreased due to the proliferation of malignant plasma cells, leading to hypogammaglobulinemia. This impaired effective antibody production increases the risk of recurrent bacterial infections, particularly respiratory infections. ### Key Points: - **Recurrent Infections:** The patient has a history of recurrent infections (pneumonia and sinusitis). - **Osteolytic Lesions:** These are characteristic of multiple myeloma. - **Anemia:** Common in multiple myeloma, likely due to bone marrow infiltration. - **No Lymphadenopathy or Hepatosplenomegaly:** Helps rule out other hematologic malignancies. ### Answer: The patient is at increased risk for recurrent infections due to: **E. Impaired effective antibody production.** This is consistent with multiple myeloma, which disrupts normal antibody production, predisposing patients to recurrent infections." What do you think of AI in healthcare?

Known-garbage-AI has long been used by Insurance Ghouls to fraudulently deny doctor prescribed medical treatments. We're being exterminated by corporate-captured quackery. Intelligent humans will fear and avoid the medical establishment, not trust it. Your "leaders" sold you out, too. Thanks for the sanity, Docs!

Keep in mind you have 1.5 minutes for this question and 319 more to go

We're starting interns now, the first thing I told them is that they have to ignore the BS they've just been taught and go see some real patients. A lot of them are from UCSF, they need a lot of help....

www.ncbi.nlm.nih.gov/pmc/articles/PMC8575140/

A lot of questions have ivory tower answers that don't apply to reality, either.

The ABP questions are horrible too, but we aren't allowed to even discuss or share their content, so it will never get fixed.

Please continue theisa series of board qs reviews!! We all need this.

This is uWorld which we use at my school to study for step 1 so yes the questions are more theoretical and biochem based than practical, but I am surprised to hear even with that being said that practicing doctors find these irrelevant. Wish we focused more on what you are talking about. For example, so many questions talk about palpating the spleen lol

Truth.

Vinay, when I was a practising Histopathologist I was sent an experimental test by the British College of Pathology to see what I thought of it. My answer was this. "I can answer some of these questions and not others. All these questions have one thing in common. Not a single one of them has knowledge which is of any use I can think of to a practical diagnostic histopathologsist." I, on the other hand, being such a practitioner would have no problem asking questions which would all be relevant. Conclusion. The tests should be set by those who do, not those who talk a lot.

A big reason I didn't go to med school, I wanted to become a doctor to help people not take exams, the test makers think they're very clever and I'm sure they'd only need 17 people to change a single light bulb. Research suggests it takes 17 people, in fact let's mandate it! 😉

Be careful giving out the student’s identity . Definitely must remain anonymous. Just like there is no transparency from usmle, they surely don’t want their beans spilled. Nice job

Great points. Thanks for the review. I agree.

Truth!

I can’t tell you how many med school graduates look at me like I’m an alien when I ask them to give me a definition of the word “diagnosis.” No one has asked before! And unsurprisingly, a good number don’t know what it means to arrive at a coherent diagnostic conclusion. The notes contain random clinical facts but no insight into the patient’s pathology. Presentation is all over the place. At internship. Some others are really good to be sure but there are interns who definitely should not have graduated.

Is there any effort today to improve the selection of questions for these tests in any professional licensure? As I attend medical lectures, I often say to myself, why is the lecturer spending any time on these obscure points when in real life practice this seems such a waste. I hope we can get better. How is it that ChatGPT is the best test taker?

Once in my entire life I palpated a spleen. It was 3rd year, Gen Surgery, morning rounds, attending asked me to palpate the spleen. It was ten pounds. 😂

I love how VP despises and disapproves of the vast and varied medical incompetencies. Does his health improve by degrees as he vents his exasperation? I think it does! And he helps civilization as well.

I wish my Hem-Onc had a potty mouth.

Med school taught me that Burkitt Lymphoma has a translocation of the MYC gene, but not that type 2 diabetes is caused by eating junk food.

It's because Step exams are bout STRATIFICATION, not CERTIFICATION. I'm learning that the hard way right now as a medical student lol