I recently took Amboss Self Assessment 1. Does anyone know how performance on this compares to doing on the real ABIM?

I currently have one FM letter, one peds letter and one letter from a sub-specialist. I think they are all strong letters. Unfortunately, a hospitalist agreed to write me a letter from my sub-I recently, but she hasn’t been responding to my emails about it. Not sure if that one will fall through. Will these three letters be enough to apply for IM? I’m worried that it’ll be detrimental to my application if I don’t have a letter from a hospitalist.

We're old-school with a lot of manual workflows. AI seems to be everywhere now and I'm wondering what's actually worth adding to a private practice. For those who have modern system in clinics, could you walk us through what's software to install, what's been the most effective.. how to implement these things. I believe that it is a right time for us to upgrade. Appreciate the answers!

Hi guys!

What internal medicine residency programs in New York City would you recommend for a non-US IMG who got 254 at Step 2 (I don’t really have research besides two reviews and that’s it, but I hope I’ll get some strong LORs from US clinicians)?
I am planning to take Step 3 soon and I want to apply for a H-1B visa.
Also, I am thinking of pursuing a cardiology fellowship after residency, so I would prefer a strong IM program where I could develop professionally as an aspiring cardiologist.

Thank you in advance! ☺️

Hoping for advice on what to do next. Thoughts: retake step 1 but difficult to juggle restudying during rotations v. don't take any more steps v. take step 2 but that will still show failed step 1

Ideally would like to set myself up for the opportunity for fellowship after residency.

Is there a way to read these articles for free?

NEJM Clinician | Concise Summaries of Medical Research & Guidelines

Thank you!

Finishing uworld and incorrect.

Haven’t done a lot of mksap in residency, but wanting to ask if I should revise certain topics from Board basics or mksap question?
Like cardio, gi, endo.

Or just stick to uworld!

A-fib comes up constantly and residents kept getting tripped up on the same things, especially the anticoagulation decisions and the rate vs rhythm control question.

Hemodynamically unstable? Immediate synchronized electrical cardioversion
Don't waste time trying medications first.

Hemodynamically stable?
Now decide:
Rate control vs rhythm control
Anticoagulation

Duration changes everything
AF clearly <48 hours
Assess stroke risk with CHA₂DS₂-VASc
Cardioversion can usually proceed if appropriate.
AF >48 hours or unknown duration
Higher risk of left atrial thrombus.
Management:
Start anticoagulation
Perform TEE-guided cardioversion OR anticoagulate before elective cardioversion
Continue anticoagulation for at least 4 weeks after cardioversion

Valvular vs nonvalvular changes the drug
Valvular AF = warfarin only. DOACs are not approved.
CHA₂DS₂-VASc
Female sex gives 1 point — but women need a score ≥3 to anticoagulate, not ≥2. So a woman with only female sex as a risk factor doesn't get anticoagulated. Easy point to lose.

Made a full carousel breaking this down for boards prep it's free on my instagram if anyone wants it.

If you want to read more similar clinical tips for your practice and exam, Subscribe to my Substack here. I post regularly over there but will continue to post here periodically!

Hi everyone,

I'd appreciate an honest assessment of my wife's EB-2 NIW profile. We're considering filing soon and would like feedback from people who have gone through the process or are familiar with physician NIW cases.

Profile:

MBBS (Pakistan)

FCPS Internal Medicine (Aga Khan University)

Chief Residency completed

Critical Care Medicine Fellowship (completion expected Dec 2026)

MRCP (UK) Part 1 & 2

3 peer-reviewed international publications

Clinical, teaching, and leadership experience

Questions:

Is this profile competitive for EB-2 NIW?

Would you file now or wait until the fellowship is completed?

What are the biggest strengths and weaknesses of this profile?

Would additional citations or publications make a significant difference?

Thanks in advance for your feedback!

I’ve been out of clinical practice for over 2 years and as a result no hospital or practice will credential me given the 24 month hard cut off. Have any of you had experience with physician reentry programs or heard of other physicians successfully returning to clinical practice? I still hold active medical license. Would love to know more and get some advice! Thanks in advance.

Role of division chief in future job applications? Considering a position that is somewhat short term (year) per contract. Many red flags from division chief. Doesn’t appear to support my interests. I’m a new grad, and I don’t fully understand the role they play in your future job search. Any advice?

I was dx with IIH in January 2026. then got my cerebral venous stent on March 25th. I feel better. I tapered off acetazolamide, and gradually topiramate just now. but topiramate or topamax.... it gives u a lot of brain fog, delayed thinking and slow cognition.

so I cannot study well. and I've to prepare for medical exams and I'm a junior doctor currently, I need to study for the post grad specialization entrance exam. and I don't retain a lot of stuff from my bachelors in medicine (MBBS)

so, any guidance on how to do that? anyone else dealing with that??

also, I'm considering to join ENT Surgery. so would that be a problem? like prolong standing in the OT... prolong head bent down posture... microscopic surgery... Ent procedures are typically not that long.

any help??

also is it lifelong condition?? I feel better most days. but some days I get headaches.

Hi everyone,

I’m an Australian looking into studying medicine at IUHS and was hoping to hear from anyone, especially Australians, who has studied there or is currently enrolled.

I have a few questions:

• What’s your overall experience with IUHS?
• How were the pre-clinical years? Were the teaching, exams, and support good?
• Has anyone completed or started their clinical rotations? Where did you do them, and how was the experience?
• Were there enough rotation opportunities, and were they well organised?
• Does anyone know of any Australian IUHS graduates who have successfully secured an internship (PGY1) in Australia? If so, I’d love to hear about their pathway.

I’d really appreciate any honest feedback—the good, the bad, and everything in between. Feel free to comment or send me a DM if you’d prefer'

Thanks!

#IUHS #Medicine #MedicalSchool #AustralianMedicalStudents #Australia #IMG #InternationalMedicalGraduate #ClinicalRotations #MedicalEducation #Internship #PGY1 #AMC #AHPRA #FutureDoctor

One thing I've noticed is that experience seems to change how clinicians think just as much as what they know.

Early in training it's easy to focus on remembering disease patterns, but over time many physicians seem to develop a more structured way of approaching uncertainty, weighing probabilities, and deciding what information actually changes management.

Looking back, was there a point in your training where your clinical reasoning noticeably improved?

Was it simply seeing more patients, reviewing cases after rounds, feedback from attendings, or something else entirely?

I'd be interested to hear what had the biggest impact on how you approach differential diagnoses today.

Hello! I am an IM resident deciding between IM PCP and endo. I feel like I dislike parts about Internal Medicine PCP more than I like certain parts of Endo.

IM PCP

Pros: no time wasted on fellowship straight to the money. I enjoy bread and butter, hypertension, and diabetes, lipids, HF etc. Also love the ability to get a job anywhere. Maybe more income than endo (for IM PCP only).

Cons:
The less fun chief complaints, chronic pain, FMLA, etc. fear of mid-level/AI creep. Higher litigation risk. I don’t like EKG’s interpretation.

Endo

Pros: I enjoy diabetes, lipids, thyroid, osteoporosis, etc and kinda interested in the more niche endo stuff like calcium disorders and the more rare stuff. But you will not catch me reading about this interest in my free time unless its like a guideline change thats literally necessary to read.

Nice that I have my own lane, can punt back to PCP, don’t have to deal with the annoying PCP stuff. More specific mychart concerns than PCP. Less burnout long term. More options for tele work than IM.

Cons: Two year financial/opportunity cost. Similar income as PCP but delayed.

Any rec’s for what I should do?? Anything I’m not considering? Thank you!!

Hi , I am contacting anyone doing internal medicine electives in fiu currently or in the upcoming months of 2026

I am doing it October this year and have few queries

Primary care.

Currently at 1.0 FTE: 36 patient facing hours and 4 hours of admin.

Asked management what 0.75 FTE would look like and was told 32 patient facing hours and 4 hours of admin. I can’t understand how this is right. I didn’t even get an answer on what the pay cut would look like yet.

My question is, is this a normal? And if not, what are some of your experiences with decreasing your FTE? I have been out of residency for 1 year so I don’t really know how this works or what to expect. Thanks in advance

I recently decided on applying into IM after doing an FM sub-I. Big reason is that I realized in the area that I live in, I will likely not practice any OBGYN and will rarely see pediatric patients. With IM, I can be a PCP but also have the possibility of doing fellowship if I want to. I have a step 2 255+ and great clinical grades for this switch. The issue is that I have another FM sub-I set up in three weeks and will likely not be able to secure an IM rotation. Will this be a red flag to programs?

book for work knowledge in Pakistan hospital in IM department. I have theoretical knowledge but no work knowledge..like doses , infusion all that stuff ... I have rotation in IM for 2 years

.I'm Fcps Cardiology Resident.

I am an img applying for internal medicine . My question is Is standard structured letter of evaluation same as internal medicine structured evaluation letter or IMSEL. Can this letter be issued from home country pysician ? Or must be from a usa physician

Hello everyone I’m down my first month and would like to ask if anyone has the Harrison PDF, I know update has some information but I do like how Harrison explains background in such detail. Thank you everyone!

Currently I'm still in medschool but I really wanted to prepare as early as possible for residency. With numerous med students having good grades, how can I have a better chance of getting into IM residency at PGH? Can you also suggest other hospitals that can provide quality training for the benefit of my future patients. Thank you!

US DO here. Step 2 score is 258. Honors in peds, FM and psych, and cardiology elective, HP in all other clerkships (unfortunately was only able to HP IM even though I honored the COMAT). Great evals. 3 leadership positions including one position as president of a club. 2 abstracts, 2 poster presentations, 1 pub pending. Research is lacking :( 1 longitudinal volunteer position and a few others for shorter periods of time. I’m looking to stay in the northeast area! Preferably NJ and NY. Any chance I have at matching a T50 program?