When Boards and Beyond was new and relatively unknown, someone posted online that the videos were trash. This was back when the library was small, and I was still adding to it. I was spending a lot of my own money to run the site, and I didn’t know if it would ever be profitable. After reading the post, the next morning I got up early before work and recorded a new video. Then another one on my lunch break. I think I made ten more videos in the next week. Years later, the website had hundreds of thousands of subscribers from around the world, and it was bought by McGraw Hill, a global leader in medical education. Don’t let the haters stop you. Use them as motivation to work harder.

I did not think the Knicks were this good during the regular season but they played like champions in the playoffs. Well deserved win.

Wemby looks gassed.

If you’re in medicine and you wish you had chosen a different career path go watch the movie Office Space. It won’t fix the problems at your job but it may make you feel like things could definitely be worse. I had a corporate cubicle job after college and the movie is 100% accurate. youtu.be/jsLUidiYm0w?is=Xrzn…

People that do not go to the gym for regular cardio are more likely to have severe osteoarthritis of the knees and hip. This does not mean that going to the gym would cure osteoarthritis of the knees and hips. If you understand this you won’t get fooled but erroneous claims over association versus causation.

Of all non-US IMGs who start down the path of matching into a US residency (any of the following: study for Step, take Step, apply, enter the match), what percentage ever achieve their goal?

Wrote this tweet after someone said to me, "My doctor trained at {fancy big institution} so I know he's very good."

If you like Wordle or the NYTimes Spelling Bee games try Pyramiddle. Awesome game that’s super addictive. apps.apple.com/us/app/pyrami…

Epic game. Great win for the Knicks. Brutal collapse for the Spurs. And OG Anunoby is a baller!!!

The notion that your doctor's training is an indicator of their skill is a fallacy. There is no medical school, residency or fellowship that always produces flawless doctors. Any graduate of any training program is capable of making mistakes. I've seen big saves and huge errors in doctors from Harvard. Also seen big saves and enormous errors in community docs who trained miles from Ivy league hospitals outside the US.

70 PAGES OF RUBBISH FAXED TO MY OFFICE. A doctor is referring a patient to me for HEADACHE. The EMR is 70 pages long of every frickin diagnosis the patient ever had. Every medicine, surgery, allergy etc. the patient ever had. Medicine is being buried under documentation bloat: 70-page EMRs full of autogenerated narrative, but no clear patient story, no synthesis, and no human clinical reasoning. And this is for a patient with headaches. I know this is a very real frustration for small private practice offices.

Medical school is filled with simulations of patient care: sim labs, OSCEs, case conferences. These things have a role in learning but can't compete with actual patient-care experience. The first time I ran a code, I was petrified even though I'd had dozens of simulated experiences before. The first time I saw ST elevations, I panicked even though I'd prepared for that exact situation. Even the first time I took a history, I blanked on what to ask. With AI, I suspect it will become even easier to simulate patient care. But to get good at medicine, you have to do it in real time with real patients.

These violent delights have violent ends

Wonderful piece on how to find meaning in the craziness of life… theatlantic.com/philosophy/2…

What does everyone think of the possibility (being discussed) of Step exams no longer being multiple choice but instead having a free text answer that is graded by AI?

Step exams are about 50% totally fair questions (stuff every doctor/student should know), 30% clever questions (fair but tricky), and 20% absolutely ridiculous exotic factoids. It's this 20% that drives most of the obsessive studying. You can't get those right without hours and hours of grinding and memorization. I often wonder what would happen if that 20% were removed from the exam. It would get easier and less stressful for sure.

Great article summarizing how AI is combing through patient data for billing: The medical-billing AI arms race between providers and insurance statnews.com/2026/06/03/ai-a… via @statnews