Tag Archives: usmle

The Sheriff is Watching, Ft. Bryan Carmody, MD


The Sheriff of Sodium investigates the current 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 the utility of metrics like Step 1 and Step 2 scores.
  • Like any good sheriff, Dr. Carmody is skeptical, especially about ideas like future physician shortages, and how schools report residency match outcomes.

More about our guest:

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Step 1 is Pass/Fail. Now what???


explosion photo
Photo by ˙Cаvin 〄

Does making Step 1 pass/fail change everything?

The news that the USMLE changed the all-important Step 1 exam–which many residency programs have been using improperly to stratify applicants and which can affect one’s specialty choice–to pass/fail starting in 2022-ish caused quite a bit of shock and consternation last week.  Sure, some celebrated the change as a victory, but there’s just one liiiiiittle problem: the more competitive residency programs feel they need some standardized measure to base their choices on.

Several listeners wrote in with questions on the change, and the underlying concerns those questions addressed was the uncertainty left in the wake of this change–to wit, “what am I to aim for if there is no three-digit score I can point to as a mark of excellence?”  Though the powers-that-be are essentially responding, “we’re working on it, we’ll get back to you on that,” there are some possibilities to consider.   And we shall, with the help of M4 Matt Wilson, MD/PhD students Aline Sandouk and Hannah Van Ert, and M1 Nathen Spitz.

Special thanks to listener Terrified Chihuahua and everyone who reached out with questions on this sudden shift in the medical education landscape!

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What are your thoughts on how a pass/fail Step 1 score will change medical education and the residency application process? Did we miss anything? Call us at 347-SHORTCT anytime, or email theshortcoats@gmail.com!

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Why Come to the US for Residency When Turkey has Pet Parks?


istanbul photoTurkish listener Ali would like to come to the US for residency and to practice medicine someday, so he wrote to us to ask us what we knew about how that works.  Co-host Nadia Wahba happened to visit Turkey a while back and blew our minds by letting us in on a little secret: that in the city she visited, there are public parks full of well-cared-for pets you can visit and play with.

Also, Dave subjects the gang–which also includes MD/PhD student Miranda Schene, M2 Jenna Mullins, and M3 Brendan George–to a game of Great Minds Think Alike: Med School Edition.

Buy Our Merch and Give At The Same Time

You care about others, or you wouldn’t be into this medicine thing. Our #merchforgood program lets you to give to our charity of the semester and get something for yourself at the same time!

This Week in Medical News

A Florida resident calls the cops after they receive what the suspect is a box of Novel Coronavirus (now named Covid-19 by science) from China.  And how an AI alerted some agencies and businesses early to the pandemic, before it blew up and just a day after a now-deceased Chinese ophthalmologist tried to warn his med school classmates.

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Continue reading Why Come to the US for Residency When Turkey has Pet Parks?

‘Fake Patients’ and Students: a Meeting of the Minds


Few students like exams.  That probably wasn’t close-to-mind when, in 1999, the Liaison Committee on Medical Education, which accredits medical colleges, decreed that the Carver College of Medicine would incorporate clinical skills assessment into the curriculum.  Then, in 2004, the National Board of Medical Examiners began using the Step II Clinical Skills test as part of the United States Medical Licensing Examination.  This Step, one of the three that seeks to ensure students are becoming competent doctors, required students to demonstrate their clinical skills on live actors.  These actors played standardized roles so that the examination results would be meaningful.

So it was that the University of Iowa Carver College of Medicine, and MD programs across the country, created the Performance-Based Assessment Program.  The PBA program was charged with preparing third-year students for this new exam. They did this the exact same way the NBME did it: by hiring actors to portray patients with various complaints to test what third- and fourth-year students had learned about interviewing such patients.

Since then the program has grown tremendously.  Now they don’t just test medical students, but they teach them as well.  Things like general physical exam skills, PE skills specific to male and female patients, communication skills, and a lot more.

On this episode, students Cole Cheney, Senuri Jayatilleka, Michael Zhang, and Keenan Laraway joined simulated patients JC Luxton and Mary Nell Jackson meet for a little debate and an exchange of views on their roles as students and ‘fake patients.’ 

Listen to Episode 026 – Who Are These People, Anyway? Simulated Patients and Students.

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.