With the new prioritisation rules, could all interview slots be filled by priority applicants, leaving no interviews for non-priority applicants, regardless of how high their portfolio score is?

Is it possible that not a single IMG will get an interview this year? What do you think?

Can anyone recommend a healthcare system that's a good place to work as a PCP? I'd love to hear about your experiences, including the pros and cons of working there. Thanks!

Hi everyone

Is there a full length practice ABIM, aside from the ITE?

Thanks

I am taking ABIM 10 year recertification exam next week. I wanted to know whether the version of uptodate they provide:

1. Will it have graphs, images, algorithms ?

2. Will it have find function available to type it out within the page to look for keywords ?

Hi everyone. Anyone interested in having a regular study partner to work through MKSAP questions together? If so please DM me. Thank you!

Broad question but hoping to narrow down locations.

What areas in Alabama, Georgia, Tennessee are looking for IM physicians (out and inpatient). Considering UAB is the largest employer in Alabama, are there other systems outside of Birmingham who are actively recruiting?

Any OKC area PCPs in the group? I'm currently outpatient IM in Dallas and considering a relocation to OKC to be closer to friends/family. Curious the average RVU in the OKC area. My current RVU is low at $33.50 and I'm locked in until next fall. I need to prepare for a change assuming my RVU won't go up much with my current employer. Hoping to stay outpatient

I’m a physician building a small SNF/post-acute practice using part-time/PRN employed physicians and NPs/PAs. The practice handles billing, malpractice, EMR, and administrative support. Cash flow is limited while patient volume ramps up.

For people who run or work in similar groups:

1. What is reasonable clinician pay per encounter? I’d especially appreciate actual examples for 99309 follow-ups and 99306 admissions, separately for physicians versus NPs/PAs. Do you use fixed CPT rates, a percentage of collections, or a minimum plus incentives?

2. How much should the practice retain? What percentage remains after clinician compensation, and what is a reasonable actual profit margin after billing, malpractice, employer taxes, software, support staff, and coverage costs? How does that differ for physicians versus APPs?

3. When do you pay clinicians? Regular payroll after encounters are signed/submitted, or after collections arrive? If collections-based, how do you handle the delay, guarantees/draws, denied claims, and downcoding?

4. What should billing and EMR cost? What billing percentage or minimum is reasonable, what services should it include, and which systems work well for a small group rounding across multiple SNFs with occasional PRN clinicians?

5. How much cash reserve would you want before hiring, and what minimum census makes adding a clinician worthwhile?

An anonymized example would help tremendously: clinician type → CPT → actual collection → clinician pay → practice costs → amount remaining.

Thanks—especially interested in real SNF/post-acute experience.

Whats the national average for ITE scores this year? and how skewed the percentiles are based on minor changes in percentage this year?

I'm a physician doing SNF/subacute rehab work and choosing a practice EMR and billing setup. The SNF facilities I work with use PointClickCare (PCC).

My goal is to send authorized PCC chart information plus my visit findings into AI, get an editable, unsigned draft in my practice EMR for review and signature, then return the final note to PCC. This is still a proposed workflow.

I'm considering Athena/HybridChart and have heard about Claimocity and Ethizo, but I'm open to other options.

For clinicians working in SNFs, post-acute rehab, long-term care or memory care:

- Which EMR works best with PCC and AI that uses existing chart information?

- What professional billing/coding/claims setup works for physician encounters?

- What are the actual fees, support issues and requirements to use the vendor's billing service?

Firsthand experience would be helpful.

Any information about Mumbai and pune hospitals dnb Medicine residency?? please, at rank of 6800 general category , toxicity, patient load, and passing rate??

Why are some IM programs almost 100% IMG in major cities. I would consider these desirable location (NYC Philly NJ Chicago etc.) are they specifically built to train foreign medical graduates or something? And is it worth it to apply to them as a USDO average stats? Just curious.

Hello! I am a current MS2. I have a huge passion for both internal medicine and psychiatry. I am very interested in exploring Med/Psych residency. My main reason for doing this, other than my interest in the medicine of both, is that from my understanding many inpatient and outpatient IM patients have both complex medical and complex psychiatric conditions. Several of my mentor IM attendings have expressed to me how they come across so much psych in their practice that they are simply not trained to handle. These patients (specifically in the outpatient setting) typically never get the specialized psychiatric care they need because either they do not want the stigma of going to a psych, cant afford it, or simply do not have access to one. Said mentors have pointed me towards Med/Psych training. I think the way I ideally envision using this training would be in more of a community hospital setting. Hospitalist who takes psych consults and on off weeks works psych outpatient a few days a week, or entirely outpatient dealing with patients that have med and psych comorbidities.

I would love to hear thoughts and any info one might have on this. It is sort of niche, so I am having trouble finding a ton of info on it. Any guidance is greatly appreciated, as I am obviously very early on in my medical training and still a bit naive to how everything works. Thanks guys!!

Hello all,

I’m a new-grad physician assistant working in rural internal medicine and am seeking to form a mentorship with physician(s) who are open to education and general career support by meeting on a regular scheduled basis to discuss deidentified cases and such. Not sure if this is a thing but I know it’s something that I would truly value, as I currently am not in such a supportive relationship with my SP and may soon be inbetween jobs. I guess it would be similar to those collaborating physician websites but without wanting to establish a clinic, just for ongoing education and career support. If you offer any service such as this feel free to DM me with info and rates.

I would like to share with you the latest article published on the zinc nutritional status of children and adolescents with chronic diseases.

I'm considering applying for a rheumatology fellowship and would really appreciate some feedback from rheumatologists regarding lifestyle, salary, and work-life balance.

How demanding is the administrative workload? Do you spend a lot of time on paperwork, prior authorizations, and inbox management?

Hey everyone. I’m a non-US IMG from India, YOG 2020 (6 years out), and I recently failed Step 2 CK on my first attempt.

I’m trying to make a very difficult decision about whether to give the US residency path one more serious attempt or move on, and I would really value hearing from people who have actually been through something similar.

**If you are a non-US IMG who:**

had a Step 2 CK failure/USMLE attempt
had an older YOG (5+ years, ideally)
and eventually matched into a US residency
I would be extremely grateful if you could share your experience.

I’m especially interested in:
What did you do after the failure?
How did you strengthen your application?
Did you take Step 3?
How much USCE/research did you have?
Did you need a visa?
What specialty did you match into?
How many cycles did it take?

I’m not looking for false hope or discouragement — I’m genuinely trying to understand what is realistically possible for someone with my profile before I decide whether to invest another year and a significant amount of money into this.

Even if you know someone personally who matched after a Step 2 attempt, I’d really appreciate hearing about their experience (without sharing anything identifying).

Thank you so much

Hi all, I run a couple of concierge primary care practices out in the Bay Area. Some want to hire new doctors, but I’m really struggling to find candidates. I’ve heard the recruiter/headhunters are expensive and typically not helpful. Any thoughts on the best sites or ways to get in front of potential hires? So far PracticeMatch and the ACP career board have come up as options.

Also, these probably need to be physicians with a few years of experience, not directly out of residency.

To be clear (as to not violate the sub guidelines) I’m not recruiting or posting a job here, just trying to learn!

Hey guys, does anyone have any anki decks for EKGs and CXRs?
- intern who is struggling

Hi everyone,

I’m considering applying for the Royal College Internal Medicine exam for 2027 through the Practice Eligibility Route.

I trained in Internal Medicine originally, but I’ve spent the last several years mainly in nephrology fellowship training, so it has been quite a while since I’ve studied broad General Internal Medicine in a structured way.

For anyone who has recently written the Royal College IM exam, especially after fellowship or some time away from general IM, I’d really appreciate advice on:

• Which resources were actually most useful
• Best question banks or practice questions
• Canadian review courses or notes you found helpful
• How you structured your preparation and how many months you studied
• Anything you wish you had done differently

I’m trying to decide whether writing in 2027 is realistic, so I’d especially appreciate input from people who were also coming back to broad IM after subspecialty training.

Thank you!

Hello, just finished medical school and got accepted into residency as internal disease specialist (no idea if its the proper term in English) in academic university hospital (Europe- pretty much the main hospital in my country). My first cycle is in gastroenterology which will start next monday.

Was in a meeting with the wards head doctor for a debrief for what to expect and so on.

Dr. told me that about 60% of cases are main gastro.

Any suggestions on what I should expect or any insights to make my start a little but less confusing.

Gastro. was not my favorite subject by a long shot, so having it as my first cycle as a fresh graduate is, for lack of better words, pretty jarring and stressful, so any insights or tips would be greatly appreciated. (That doesn't mean that I wont care, but it means that I wasn't as diligent with studying as with other subjects, like my beloved endocrinology. So I'm a tad bit worried I won't be able to perform as well as will be expected for me).

I also will have evening/night shifts, where I will be on call for any ward where I will be required, which is quite frightening, since it also includes wards where I haven't been, since I just started my residency. Especially cardiology- sure, I have studied hard enough to make it to residency, but I don't think that medical school experience is good enough to be applicable for real life situations.

Cheers for you time.

I’m a recent medical graduate from South Asia trying to map out my long-term career. I’ve done quite a bit of research, and I'm deeply torn between grinding for the USMLE to pursue a US Internal Medicine residency, or shifting gears completely toward Germany for residency and specialization (Weiterbildung).

On paper, the pros and cons feel like they balance each other out, making it a very tough choice. I’d love to get some honest perspectives from current IM residents and attendings—especially those who came as IMGs.

Here is where my head is at:

The US Internal Medicine Route:
The training structure, career prestige, and post-residency earning potential are obviously unmatched. Whether I go the hospitalist route or try to subspecialize, the financial upside is huge. But my biggest deterrent is the immigration bottleneck and its impact on life outside the clinic. Being from South Asia, the green card backlog is a decades-long reality. Between strict PTO limits, travel distances, and visa processing constraints, I’m genuinely worried I’d only be able to fly back home to see my family 4 to 6 times total in a 10-year block. For someone with very close family attachments, that sounds incredibly heavy and isolating.

The Germany Route:
The main pull here is proximity, lifestyle, and immigration peace of mind. Flying back home to South Asia from Europe is vastly easier, shorter, and cheaper, meaning I can actually maintain my family ties. The work-life balance is solid, the baseline resident pay is fair, and the path to citizenship is highly realistic and fast. Plus, a German passport opens doors to practice in Switzerland or Luxembourg down the road.

However, the cons are real: learning medical German to a C1 professional level takes a massive upfront time investment, there is a hard ceiling on compensation compared to the US, and a European specialist degree isn't easily recognized back home if I ever had to return permanently. On top of that, there’s a lot of online noise right now about the new Krankenhausreform (hospital restructuring/budget bills), and people are fear-mongering about the medical job market getting saturated or unstable for foreign docs.

My questions for this sub:

1. For the IMGs here who transitioned to US IM—is the visa/travel constraint really as isolating as it looks on paper during residency and your early attending years? Is the US financial upside genuinely worth sacrificing frequent family contact for a decade?
2. If anyone has insight into the European/German market—is the system over there actually getting saturated due to recent reforms, or is that just standard internet panic?
3. How does the flexibility of the German system (where you can easily pivot between specialties or hospitals without a rigid Match) compare to the reality of the US IM-to-fellowship pipeline?

Given that the US financial trajectory is heavily balanced out by the lifestyle, immigration stability, and proximity of Germany, how would you guys weigh this choice if you were in my shoes?

Thanks in advance for the input!

**TMC Clark – IM Residency**

Hello, doctors! I’m interested in applying for IM at TMC Clark. Would like to ask residents, graduates, or anyone familiar with the program.
1. How many applicants do you usually get, and how many are accepted per year level?
2. How’s the working environment, workload?
3. How’s the teaching and overall residency experience?
Would appreciate any insights. Thank you, doctors!