Sometimes everyone’s a jerk. The hosts discuss the importance of self-evaluation in medicine, but sometimes you just gotta ask–was I a jerk? Dave Etler, MD/PhD student Miranda Schene, M4 Happy Kumar, and M2 Holly Hemann use Reddit’s ‘Am I the Asshole?’ submissions to exploring feelings of impostor syndrome, the ethics of classroom behavior, fair recognition of achievements, and cases of medical malpractice. Along the way, they provide practical advice for medical school admissions, dissect the delicate balance of maintaining professionalism in the medical field, and what to think when even mom craps on your dreams. Shut up, mom!

LIstener Neurotic Premed dropped us a message at https://theshortcoat.com/tellus to ask what medical students in long-distance relationships, both platonic and romantic, do to keep them alive and healthy. MD/PhD student Madi Wahlen, M2 Fallon Jung, M3 Jeff Goddard, an PA2 Julie Vuong have a lot of experience in that area. From long-distance parenting to making sure friends still feel connected, it takes planning and intentionality along with a slight tweak to what it means to be "together." They share how they do it successfully!

Plus, Chinese researchers appear to have cured a man of his diabetes, Ozempic is powerful enough to affect the food and beverage industry's bottom lines, and Florida allows c-sections outside of hospitals in a bid to improve access.

M1 Fallon Jung, PA1 Olivia Quinby, MD/PhD student Faith Prochaska, M2 Jeff Goddard, and special guest Dr. Peter Kaboli dive deep into the heart of rural medicine. We kick off with a candid discussion about growing up in small towns and how these experiences shape our understanding of community and healthcare. Dr. Kaboli, an expert in rural health with the Veterans' Administration, shares his insights into the nuances of rural medicine. We explore the multifaceted challenges and rewards of practicing medicine in rural settings, from the importance of forming deep connections with patients to navigating the scarcity of healthcare resources. Telemedicine, workforce issues, geographic barriers, and the digital divide are central to the art of medicine in small towns and on county roads, sometimes requiring innovative approaches to healthcare delivery.

The Sheriff of Sodium investigates the state and future of medical training. If you’ve wondered how well the system that trains future doctors works, or about what factors really determine which medical students get into the most competitive residency programs, this episode is for you. M1 Fallon Jung, M2 Jeff Goddard, and M4 AJ Chowdhury get deep into these issues with a very special guest – Dr. Brian Carmody, known on his blog and YouTube channel as “The Sheriff of Sodium.” Dr. Carmody, a pediatric nephrologist by training, closely analyzes and shares data-driven perspectives on medical education, pulling on threads to understand whether the current medical training system is truly functional, fair, and efficient, examining factors like student debt burdens, physician shortages projections, and why people cheat on licensing exams. Like any good sheriff, Dr. Carmody is skeptical, especially about ideas like future physician shortages, and how schools report residency match outcomes.

Listener Eden is looking ahead to how she'll finance medical school as someone who is in the disadvantaged category of applicants. One option she asked us to talk about is the Health Professions Scholarship Program offered by the US military, and she wanted to hear from someone who is in that program. M4 Wilson Fitzgerald gave us the details, some ideas about what it's like to be a physician in the military, the sacrifices he's decided to make to take advantage of the program, and how it's working out for him so far. PA faculty member Jeremy Nelson, M2 Fallon Jung, and M3 Happy Kumar helped discuss why it might not be a great idea to wait to start medical school so that you have time to save up tuition. And Dave pulls out a bunch of reels he's been saving in his drafts because he doesn't think they're any good. Spoiler alert: they should have stayed in his drafts--but you can see them on our Instagram anyway!

Life’s grey areas, offered up for internet discussion

From the discussion:

Project 2025 is the name of a project that hopes to serve as a blueprint for a future conservative administration that would promote natural family planning methods and reduce insurance coverage for certain contraceptives. M1s* Fallon Jung, Taryn O'Brien, and Gizzy Keeler (who are--boop boop boop!--leveling up to M2s), with help from Curriculum Manager Billie Ruden, discuss what that might mean for training MDs, where they'll be willing to go, and why it's not just OB/Gyn aspirants paying attention. Meanwhile, congress will consider a bill to make permanent several telehealth changes that were enacted to ease the healthcare crisis during the COVID crisis. KFF.org releases a helpful primer about the US healthcare system everyone should know about, and a scandal at the NIH further jeopardizes trust in science.

On this episode we welcome guest Dr. Joshua Trebach, an emergency medicine physician here at Iowa. This past spring he posted on X that medicine must "lose the mentality of thinking its okay to be miserable for years (or decades) to justify it being 'finally worth it' in the end."

We couldn't agree more--live now, not later! Which is why PA2 Julie Vuong, M2 Fallon Jung, and MD/PhD student Madi Wahlen are each finding ways to reject that mentality. Indeed, medical education is changing, perhaps slowly, to reinforce the idea that just because medicine can be a difficult life doesn't mean that you should obsessively look forward to the day it gets better. That day is a long way away, so do what you can (what you must) to be who you want to be even as you're drinking from the firehose.

Also, we answer one of listener Mohamed's questions on how he can jump right into his first year this fall with his eyes on patient advocacy.

It's easy to forget from our ivory tower that many Americans don’t get beyond high school, making it less likely their kids will. Those kids who do are at a disadvantage compared to peers with college-educated parents. First-generation medical students are even rarer and face more challenges. These students, like PA1 Julie Vuong, M1 Amanda Litka, MD/PhD student Faith Prochaska, and M1 Holly Hemann, bring valuable perspectives to medicine, understanding a wider range of patient experiences and health determinants.

This week we discuss their challenges, the impact on their future practice, and how learning medicine highlights (somewhat uncomfortably) their own families' health struggles. And while some medical schools are going tuition-free, this hasn’t increased low-income student enrollment or primary care graduates...and seems to have done some harm.

Its Our monthly roundup of news from the margins of medicine! M1s Fallon Jung and Taryn O’Brien, M2 Jeff Goddard, and MD/PhD studnet Riley Behan Bush are on hand for our monthly news roundup. Including news that presidential candidate and anti-vaxxer Robert F. Kennedy’s brain was ‘eaten’ by a worm and his love of tuna sandwiches. Virtually all healthcare providers globally suffer from a clinical psychiatric disorder. Beethoven really liked lead-sweetened wine, which is probably why he was so sick and deaf. And a Tesla Cybertruck owner smashed his own finger with his vehicle’s frunk to prove that his vehicle’s frunk couldn’t smash his own finger. And can we guess what the shitty life pro tip from Reddit is? Plus lots more observations and revelations from the margins of medicine!