the official COMAT shelf thread

[ohmanwaddup]

two days off feels wonderful after IM. scrolling through the ERAS and Residency panic threads. It is insane to think our journey is so close to being finished and in a few short months we will be the ones stressing out in those threads.

I only have one core rotation left. It truly does feel like yesterday I was walking out of my first 3 hour biochem lecture thinking "Oh **** oh **** oh ****"

At our white coat ceremony the Dean made the comment that "the days in med school are long, but the years are short". He was absolutely right.

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[iforget2]

two days off feels wonderful after IM. scrolling through the ERAS and Residency panic threads. It is insane to think our journey is so close to being finished and in a few short months we will be the ones stressing out in those threads.

I only have one core rotation left. It truly does feel like yesterday I was walking out of my first 3 hour biochem lecture thinking "Oh **** oh **** oh ****"

At our white coat ceremony the Dean made the comment that "the days in med school are long, but the years are short". He was absolutely right.

For real can't believe we're here already. 3rd year for the most part has been so much better than pre-clinical years. I had to TA for one of the 2nd year OMM labs recently and everyone was just freaking out about boards and their exam next week. I was just waiting until 5 so I could go home and play video games the rest of the night lol.

 

[fldoctorgirl]

two days off feels wonderful after IM. scrolling through the ERAS and Residency panic threads. It is insane to think our journey is so close to being finished and in a few short months we will be the ones stressing out in those threads.

I only have one core rotation left. It truly does feel like yesterday I was walking out of my first 3 hour biochem lecture thinking "Oh **** oh **** oh ****"

At our white coat ceremony the Dean made the comment that "the days in med school are long, but the years are short". He was absolutely right.

I feel this so much. It's absolutely insane.

 

[fldoctorgirl]

When you're doing UWorld and you accidentally click on the wrong answer choice

 

[sunshinefl]

When you're doing UWorld and you accidentally click on the wrong answer choice

The worst is when I thought I chose 1 and it was correct but turned out I omitted 😞

 

[calivianya]

Started my surgery flashcards today and starting my rotation tomorrow... can’t sleep now because I’m so dang nervous about going in in the morning. I think I’m still carrying around the lingering shame from when my OB preceptor basically told me I was unprofessional and a crap doctor because I didn’t get to round and finish all the notes on all the patients before surgery (I had 7 to do). “If it was your mom, you would want the doctors in the room to be prepared.”

I’m gonna be telling that story with the same amount of salt 30 years from now. I feel it.

I also really want to not suck this rotation.

 

[Cranjis McBasketball]

Started my surgery flashcards today and starting my rotation tomorrow... can’t sleep now because I’m so dang nervous about going in in the morning. I think I’m still carrying around the lingering shame from when my OB preceptor basically told me I was unprofessional and a crap doctor because I didn’t get to round and finish all the notes on all the patients before surgery (I had 7 to do). “If it was your mom, you would want the doctors in the room to be prepared.”

I’m gonna be telling that story with the same amount of salt 30 years from now. I feel it.

I also really want to not suck this rotation.

Yeahhh thats a classic story you'll tell a 3rd or 4th year rotating with you in 20 years haha

 

[ASGD1983]

Started my surgery flashcards today and starting my rotation tomorrow... can’t sleep now because I’m so dang nervous about going in in the morning. I think I’m still carrying around the lingering shame from when my OB preceptor basically told me I was unprofessional and a crap doctor because I didn’t get to round and finish all the notes on all the patients before surgery (I had 7 to do). “If it was your mom, you would want the doctors in the room to be prepared.”

I’m gonna be telling that story with the same amount of salt 30 years from now. I feel it.

I also really want to not suck this rotation.

As a MS3 I think all we need to do is to show up, be polite and follow the flow as best as we can (which includes occasional presentation and writing notes). Getting scalded for not writing notes in time for 7 patients is ridiculous. That kind of hardship is for when we'll be at residency, not MS3. Especially considering most of our notes or presentations are just for us to learn, 99% attendings discard them anyway or don't even check them.

 

[ohmanwaddup]

Got the email my PE was canceled. Says refund should show up in 1-2 weejs

 

[ASGD1983]

Got the email my PE was canceled. Says refund should show up in 1-2 weejs

Fingers crossed PE is done and will only live forever in annals of history

 

[calivianya]

As a MS3 I think all we need to do is to show up, be polite and follow the flow as best as we can (which includes occasional presentation and writing notes). Getting scalded for not writing notes in time for 7 patients is ridiculous. That kind of hardship is for when we'll be at residency, not MS3. Especially considering most of our notes or presentations are just for us to learn, 99% attendings discard them anyway or don't even check them.

That bit about the notes couldn’t be farther from the truth at my facility. Every note I write has been signed by my attending as the note for that service for the day for every rotation I’ve been on. My attendings co-sign it and usually add “agree with medical student’s note above“ and don’t write anything else by the end of the rotation if I’m lucky. They usually have lots to add at the bottom of my notes during my first week with them.

I’ve only had one attending discard any of my notes, and it was my notes for the first day I wrote notes for him. I got better after he informed me in minute detail about everything I did wrong as far as formatting, standard things I left out, etc. went. Same attending from the above story, btw. Really glad that rotation’s over.

 

[fldoctorgirl]

That bit about the notes couldn’t be farther from the truth at my facility. Every note I write has been signed by my attending as the note for that service for the day for every rotation I’ve been on. My attendings co-sign it and usually add “agree with medical student’s no

This is how it's been for me on this IM rotation where I'm basically like an intern. I am responsible for everything for my patients: notes, reviewing tests, putting in orders. Attending either approves or denies my orders and then just co-signs my note, typically doesn't add anything. Honestly it's been a pretty great learning experience, I feel much more prepared for residency after this rotation.

 

[ohmanwaddup]

This is how it's been for me on this IM rotation where I'm basically like an intern. I am responsible for everything for my patients: notes, reviewing tests, putting in orders. Attending either approves or denies my orders and then just co-signs my note, typically doesn't add anything. Honestly it's been a pretty great learning experience, I feel much more prepared for residency after this rotation.

Jelly, I was expected to pre round and write notes on all my patients, come up with continuing assessment and plan, but The hospital doesn't let the attending use our notes (there is a big red bolded heading at the top of anything says "this is a student not for education purposes only do not use it for anything at all) and we aren't allowed to submit any order. was still a good experience I guess but felt lacking in some areas.

 

[ohmanwaddup]

Anyone else feel bad for taking time for themselves? Bout to have a 5 day weekend because my preceptor does not come in on Mondays and my school is giving us the option to take off 2 days to prep for their version of PE prep.

I've only got a 2 months left in this area and I'm really trying to hike and explore the caves around here before I leave, but I will be missing a non insignificant amount of time if I Take the 2 days off. Granted my preceptor is off those days two as well, but offered to have me go with one of her colleagues for one of the days. I'm leaning heavily towards taking the days since life is only going to get more busy and hectic as we continue this journey, but I feel like I'm being lazy and wasting rotation time.

Anyone have any thoughts?

 

[Hippocrates II]

Anyone else feel bad for taking time for themselves? Bout to have a 5 day weekend because my preceptor does not come in on Mondays and my school is giving us the option to take off 2 days to prep for their version of PE prep.

I've only got a 2 months left in this area and I'm really trying to hike and explore the caves around here before I leave, but I will be missing a non insignificant amount of time if I Take the 2 days off. Granted my preceptor is off those days two as well, but offered to have me go with one of her colleagues for one of the days. I'm leaning heavily towards taking the days since life is only going to get more busy and hectic as we continue this journey, but I feel like I'm being lazy and wasting rotation time.

Anyone have any thoughts?

Medicine is always there to take and take and take. When you have the opportunity to take a little for yourself, I think you need to jump on that. It's crazy how much time we dedicate to all of this, but then feel guilty the moment we have the rare chance to enjoy life outside of medicine for a little bit (I'm the same way).

 

[fldoctorgirl]

Anyone else feel bad for taking time for themselves? Bout to have a 5 day weekend because my preceptor does not come in on Mondays and my school is giving us the option to take off 2 days to prep for their version of PE prep.

I've only got a 2 months left in this area and I'm really trying to hike and explore the caves around here before I leave, but I will be missing a non insignificant amount of time if I Take the 2 days off. Granted my preceptor is off those days two as well, but offered to have me go with one of her colleagues for one of the days. I'm leaning heavily towards taking the days since life is only going to get more busy and hectic as we continue this journey, but I feel like I'm being lazy and wasting rotation time.

Anyone have any thoughts?

Take the days. Agree with everything said above.

 

[fldoctorgirl]

IM COMAT is this Friday. Really wanna honor this one. Any last minute tips? Cheesy Dorian IM + neuro deck done (and almost done with the entire deck since I've had all but one core rotation), all of UWorld IM questions done. Since my school only uses the shelf for honors, I need to honor this otherwise both my months of IM will just get a 'pass'.

 

[ohmanwaddup]

IM COMAT is this Friday. Really wanna honor this one. Any last minute tips? Cheesy Dorian IM + neuro deck done (and almost done with the entire deck since I've had all but one core rotation), all of UWorld IM questions done. Since my school only uses the shelf for honors, I need to honor this otherwise both my months of IM will just get a 'pass'.

I did all that, but did all of COMQUEST at the expense of 200-300 unworldly questions. nothing felt alien on it, but i Felt a little crunched for time so watch out for that. if anything Id say do incorrects on uworld.

also my condolences that you’ve had to balance this CSA nonsense and your IM comat. It was such annoying busywork

 

[fldoctorgirl]

I did all that, but did all of COMQUEST at the expense of 200-300 unworldly questions. nothing felt alien on it, but i Felt a little crunched for time so watch out for that. if anything Id say do incorrects on uworld.

also my condolences that you’ve had to balance this CSA nonsense and your IM comat. It was such annoying busywork

Yeah I joked several times that of course the school would schedule all this extra busy work during the one month I actually care about haha.

 

[iforget2]

IM COMAT is this Friday. Really wanna honor this one. Any last minute tips? Cheesy Dorian IM + neuro deck done (and almost done with the entire deck since I've had all but one core rotation), all of UWorld IM questions done. Since my school only uses the shelf for honors, I need to honor this otherwise both my months of IM will just get a 'pass'.

I don't know if this is anyone else's experience, but I found IM to be the easiest of the comats I've taken so far. If you've done Cheesy Dorian and all the UW questions you should be good. It felt the most straightfoward to me, and UW really hit all the points you needed to know for it. FM had a lot of USPSTF guidelines that weren't all on UW, some random peds/OB things that I didn't know to study for. Psych had a couple of neuro things that I should have read up on that weren't covered in UW. OMM was... well OMM lol (it sucked). I was able to get a high score without doing the neuro deck so I feel like you're well prepared.

 

[fldoctorgirl]

I don't know if this is anyone else's experience, but I found IM to be the easiest of the comats I've taken so far. If you've done Cheesy Dorian and all the UW questions you should be good. It felt the most straightfoward to me, and UW really hit all the points you needed to know for it. FM had a lot of USPSTF guidelines that weren't all on UW, some random peds/OB things that I didn't know to study for. Psych had a couple of neuro things that I should have read up on that weren't covered in UW. OMM was... well OMM lol (it sucked). I was able to get a high score without doing the neuro deck so I feel like you're well prepared.

I'm just nervous because my performance on IM blocks was below what it's been for all the other subjects. It was hardddd.

 

[EMDoc22]

I don't know if this is anyone else's experience, but I found IM to be the easiest of the comats I've taken so far. If you've done Cheesy Dorian and all the UW questions you should be good. It felt the most straightfoward to me, and UW really hit all the points you needed to know for it. FM had a lot of USPSTF guidelines that weren't all on UW, some random peds/OB things that I didn't know to study for. Psych had a couple of neuro things that I should have read up on that weren't covered in UW. OMM was... well OMM lol (it sucked). I was able to get a high score without doing the neuro deck so I feel like you're well prepared.

Agree with this. I thought IM was the most fair of all the ones I've taken so far. I thought UWorld was far harder than the actual COMAT.

 

[ASGD1983]

I felt IM had least amount of vague questions nbome likes to include in exams, so that was good. My biggest issue was timing. I’m a slow test taker and I had to guess on last 5 questions.

 

[ohmanwaddup]

Oh **** my refund showed up

 

[fldoctorgirl]

Oh **** my refund showed up

Same!! Feels good.

 

[EMDoc22]

So happy to see that show up in my bank account this morning. Screw you NBOME.

 

[ohmanwaddup]

22 hour shift on OB. Whoof

I forgot how hard it was to do a rotation where you have zero background knowledge, and it’s not like the repro meds were high yield on step 1. Going to be a busy month

 

[fldoctorgirl]

Worth watching the Emma Holiday IM review? I haven't watched her for anything this year because there's a subdeck in Cheesy Dorian for her vids. It's ~2 hours....not sure if better to do more UWorld (finished all of IM, but have been going through the ambulatory med questions).

 

[EMDoc22]

Worth watching the Emma Holiday IM review? I haven't watched her for anything this year because there's a subdeck in Cheesy Dorian for her vids. It's ~2 hours....not sure if better to do more UWorld (finished all of IM, but have been going through the ambulatory med questions).

I personally didn't since like you I did UWorld and the Cheesy Dorian deck and I was fine. I think doing more UWorld would be best since I thought their questions were harder than what's on the COMAT.

 

[ohmanwaddup]

110 on IM comat. Best so far and a great score on any comat but still not the 112 needed to honors.

This sucks lol

 

[calivianya]

22 hour shift on OB. Whoof

I forgot how hard it was to do a rotation where you have zero background knowledge, and it’s not like the repro meds were high yield on step 1. Going to be a busy month

Yo, that was how I felt my whole last month. Broke my spirit, felt like I didn’t belong here and thought about quitting daily lmfao.

I feel so much better on surgery now. I don’t know anything about the actual surgeries themselves either, but there is so much taking care of post-surgical patients involved and I know how to do that, so I feel like I finally have my mojo back. OB was rough, though. Easily the worst rotation I’ve had in both volume of unknown knowledge and how busy it was.

110 on IM comat. Best so far and a great score on any comat but still not the 112 needed to honors.

This sucks lol

All this crap is so arbitrary; 110 really is a great score.

 

[calivianya]

I'm just nervous because my performance on IM blocks was below what it's been for all the other subjects. It was hardddd.

Just wanted to wish you good luck! You’ve done way more prep than I did and I did well enough to honor, so I think you’re going to kill it!

I’m gonna echo the thing on timing, though. I have never in my life even come close to running out of time on any exam, ever, for any reason, and I had four minutes left when I finished the IM comat. It took me right at one hour to finish the psych comat so it was a real surprise to cut the IM one so close.

I never skip around on tests (have never seen the point of doing that before), but I would advise if you think a question is really going to eat your time, to flag it and move on, because there really is a risk of running out of time for this one.

 

[fldoctorgirl]

110 on IM comat. Best so far and a great score on any comat but still not the 112 needed to honors.

This sucks lol

Oof. Our school's grading system really sucksssssss. NBOME recommends 107+? Nah let's make it 112 lolz. You still crushed it.

 

[fldoctorgirl]

Just wanted to wish you good luck! You’ve done way more prep than I did and I did well enough to honor, so I think you’re going to kill it!

I’m gonna echo the thing on timing, though. I have never in my life even come close to running out of time on any exam, ever, for any reason, and I had four minutes left when I finished the IM comat. It took me right at one hour to finish the psych comat so it was a real surprise to cut the IM one so close.

I never skip around on tests (have never seen the point of doing that before), but I would advise if you think a question is really going to eat your time, to flag it and move on, because there really is a risk of running out of time for this one.

Thank you for this advice! I will keep it in mind. Can't wait to be done with this and officially pretty much check out for the rest of third year lol.

 

[EMDoc22]

Just got done with the surgery COMAT. I didn't think it was that bad and felt UWorld and Anki covered 95%+ with the random NBOME questions no one knows representing the other 5%. I only have EM and OB left to take and then I'm done with COMATs forever.

 

[ASGD1983]

Was doing some prep questions today and I'm at a loss here, can anyone help me diagnose this as it didn't came with answer:
75yo pt presents to ED via EMS with an 7 hour history of sudden movements of her left arm and leg. Her son reports she has been flailing her arms uncontrollably. Her speech stops during movements, but pt is able to speak between episodes. Pt denies any pain, except bruises on arm and leg. PMH is significant for HTN, DM2 and hypercholesterolemia. Vitals: 192/110, HR 100bpm, RR 18 per minute.
What medication is the most appropriate to suppress her movements:
Baclofen, Propranolol, Clonidine, Haloperidol, Diphenhydramine, Diazepam.

I went for Baclofen, but I'm not sure what the diagnosis is to be honest. I was thinking right hemisphere involvement since speech is involved together with left arm and leg, but I'm not sure if a stroke can cause intermittent on and off episodes? Seizures? But seizers can't just selectively affect right hemisphere can they? Hemiballismus or something? I even considered elderly abuse with her son hitting her on right side of head that possibly leads to some epidural/subdural hematoma with lucid intervals that come and go lol I know it's unrealistic. Can hypertensive crisis present that way? Some meds side effects? I couldn't figure out diagnosis in 70sec timeframe given for question, but even now I still can't really grasp what's going on exactly here. For me it seems a bit weird question, but probably I'm overlooking something simple.

 

[fldoctorgirl]

Finished IM COMAT. Agree with what you guys said, overall felt pretty fair. Still no idea how I did. I felt okay about a lot of it but some of them seemed out of left field.

 

[fldoctorgirl]

Was doing some prep questions today and I'm at a loss here, can anyone help me diagnose this as it didn't came with answer:
75yo pt presents to ED via EMS with an 7 hour history of sudden movements of her left arm and leg. Her son reports she has been flailing her arms uncontrollably. Her speech stops during movements, but pt is able to speak between episodes. Pt denies any pain, except bruises on arm and leg. PMH is significant for HTN, DM2 and hypercholesterolemia. Vitals: 192/110, HR 100bpm, RR 18 per minute.
What medication is the most appropriate to suppress her movements:
Baclofen, Propranolol, Clonidine, Haloperidol, Diphenhydramine, Diazepam.

I went for Baclofen, but I'm not sure what the diagnosis is to be honest. I was thinking right hemisphere involvement since speech is involved together with left arm and leg, but I'm not sure if a stroke can cause intermittent on and off episodes? Seizures? But seizers can't just selectively affect right hemisphere can they? Hemiballismus or something? I even considered elderly abuse with her son hitting her on right side of head that possibly leads to some epidural/subdural hematoma with lucid intervals that come and go lol I know it's unrealistic. Can hypertensive crisis present that way? Some meds side effects? I couldn't figure out diagnosis in 70sec timeframe given for question, but even now I still can't really grasp what's going on exactly here. For me it seems a bit weird question, but probably I'm overlooking something simple.

Sounds to me like hemiballismus.

 

[ASGD1983]

Sounds to me like hemiballismus.

Is speech affected in hemiballismus? In that case, do you think haloperidol is a better answer choice?

 

[fldoctorgirl]

Is speech affected in hemiballismus? In that case, do you think haloperidol is a better answer choice?

Well, hemiballismus can be caused by a stoke so that might be what they are going for? It's an interesting question for sure. Given her history (HTN, HLD) and the super high BP, maybe a lacunar stroke --> hemiballismus? This is just my opinion, I really have no idea what they're going for ha.

 

[ohmanwaddup]

Oof. Our school's grading system really sucksssssss. NBOME recommends 107+? Nah let's make it 112 lolz. You still crushed it.

There’s SGA rumors it’ll be changed, I’ll pray

 

[calivianya]

119 on the OB comat - my school never releases scores on time.

I’m starting to think that the more that I hate the rotation, the better I’m going to do.

 

[fldoctorgirl]

119 on the OB comat - my school never releases scores on time.

I’m starting to think that the more that I hate the rotation, the better I’m going to do.

I feel this lol. Surgery was my highest one.

 

[ohmanwaddup]

119 on the OB comat - my school never releases scores on time.

I’m starting to think that the more that I hate the rotation, the better I’m going to do.

I cheer and hate you all lol

Fantastic score my dude!

 

[sunshinefl]

119 on the OB comat - my school never releases scores on time.

I’m starting to think that the more that I hate the rotation, the better I’m going to do.

(My field was my lowest score 😞 ..... so maybe your trend was true for me too)

 

[fldoctorgirl]

YA GIRL HONORED INTERNAL MEDICINE. I OFFICIALLY DONT CARE ABOUT THE REST OF THIRD YEAR.

 

[ohmanwaddup]

YA GIRL HONORED INTERNAL MEDICINE. I OFFICIALLY DONT CARE ABOUT THE REST OF THIRD YEAR.

Congrats fam, super happy for you

 

[EMDoc22]

110 on the surgery COMAT which is honors at my school. Didn’t honor the eval and wasn’t expecting or trying to do so, I’m just happy to be done with that rotation. I have EM next block and that’s the one I really want to honor.

 

[Hippocrates II]

YA GIRL HONORED INTERNAL MEDICINE. I OFFICIALLY DONT CARE ABOUT THE REST OF THIRD YEAR.

There was basically zero chance you weren't going to honor that thing with the prep you did, but I'm far too superstitious to be the one to jinx you like that

 

[calivianya]

You guys, unrelated question, but since I know you all are applying to clinical rotations too...

That stupid precheck background check the HCA hospitals use? It just says employment history, period... not past few years or whatever. Are you guys seriously putting your entire employment history on there? I have jobs stretching back to 2004 and I have no idea who tf my supervisors were or anything like that. I think I only remember my supervisors for like two of my jobs and I’m really not sure on the dates of a lot of them. Yeah, I know I should have written all this stuff down somewhere, and I used to have old resumes with at least my dates on them, but I have no idea where those are. I think I deleted them.