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# Ben White

Medicine & Miscellany

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## Posts

- [Archives](https://www.benwhite.com/archives/)
- [Recommended Reading for First-year Radiology Residents](https://www.benwhite.com/medicine/book-recommendations-for-first-year-radiology-residents/) - [This updated/revised article was originally published way back on December 12, 2013] Expectations for first radiology residents include a whole lot of reading. Tons and tons of reading. The follow-through on that expectation may be somewhat less impressive, but you'll still do your best to pretend. Given the dizzying array of options, a curated list
- [RadPartners' Partners are not Partners](https://www.benwhite.com/radiology/radpartners-partners-are-not-partners/) - I posted two tweets the other day that deserve some further discussion: https://twitter.com/benwhitemd/status/1662119859763781634?s=20 I've since by told by another source at RP that this is actually the third quarter in a row that profit-sharing has been delayed. These "unique" payments are the ubiquitous practice of a group putting money in your 401k. "Profit sharing" is
- [The Medical Student Research Arms Race](https://www.benwhite.com/medicine/the-medical-student-research-arms-race/) - From "Research Fever—An Ever More Prominent Trend in the Residency Match": Insanity. I have zero doubt that this incredible trend reflects a whole bunch of meaningless CV-fluffing that only further detracts from the mission of graduating good doctors. I also wonder how much the bigger numbers in ERAS even impact individual success. Yes, studies have
- [Indisputable Authorship Order](https://www.benwhite.com/misc/indisputable-authorship-order/) - Indisputable authorship ordering method: Reviewer 2 should have blocked this for not specifying the version used (N64? Melee? Brawl? This is science!).
- [Doctors: "The Instruments of Betrayal"](https://www.benwhite.com/medicine/doctors-the-instruments-of-betrayal/) - The pull of these forces left many doctors anguished and distraught, caught between the Hippocratic oath and “the realities of making a profit from people at their sickest and most vulnerable.” Not only are clinicians feeling betrayed by their leadership,” she says, “but when they allow these barriers to get in the way, they are
- [When USMLEWorld spying on you is the harbinger of our future despair](https://www.benwhite.com/medicine/when-usmleworld-spying-on-you-is-the-harbinger-of-our-future-despair/) - From Cory Doctorow's How Laws Restricting Tech Actually Expose Us to Greater Harm: Because while we've spent the past 70 years perfecting the art of building computers that can run every single program, we have no idea how to build a computer that can run every program except the one that infringes copyright or prints
- [RadPartners' Debtholders Are Lawyering Up](https://www.benwhite.com/radiology/radpartners-debtholders-are-lawyering-up/) - In Bloomberg Law, "Radiology Partners’s Lenders Seek Counsel as Debt Wall Looms": Some lenders to Radiology Partners are consulting with lawyers at Gibson Dunn & Crutcher to explore its options ahead of looming debt maturities, according to people with knowledge of the situation. The ad hoc group holds more than 50% of Radiology’s term loan,
- [June is also Student Loan Consolidation Month](https://www.benwhite.com/finance/june-is-also-student-loan-consolidation-month/) - Graduating medical students: if you haven't already begun, it's around time to consolidate your federal student loans. The benefits are discussed in this chapter from my (free) book. While you're at it, you should also probably read the whole thing.
- [NYU and the slow coming wave of “free” school](https://www.benwhite.com/medicine/nyu-and-the-slow-coming-wave-of-free-school/) - A couple of weeks ago, NYU announced that they were making medical school tuition free for every student. Dean Robert Grossman stated, "This decision recognizes a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians.” My first thought on this news was, Man, Harvard
- [A Partial Win for Non-501(c)(3) Nonprofits & PSLF](https://www.benwhite.com/finance/a-partial-win-for-non-501c3-nonprofits-and-pslf/) - When the Department of Education started reversing FedLoan's employment certification form (ECF) decisions about qualifying employment, people were rightfully troubled. The American Bar Association (and four individuals) sued. The case is over, and three out of the four won. That's nice, but the fourth would have made all the difference. The memorandum opinion from Justice Timothy
- [News: Babies Can't Read](https://www.benwhite.com/medicine/news-babies-cant-read/) - From Elisabeth Rosenthal's (author of An American Sickness) "Denials of health-insurance claims are rising — and getting weirder": An insurer’s letter was sent directly to a newborn child denying coverage for his 4th day in a neonatal intensive-care unit. “You are drinking from a bottle,” the denial notification said, and “you are breathing on your
- [Samples on Hand](https://www.benwhite.com/misc/samples-on-hand/) - From "Physicians Get Addicted Too," an Atlantic story about opiates and addiction in West Virginia: “I made pizza deliveries where I used to make house calls,” Ortenzio said. “I delivered pizzas to people who were former patients. They felt very uncomfortable, felt sorry for me.” But, he said, “it didn’t bother me. I was in
- [Radiology Call Tips](https://www.benwhite.com/radiology/radiology-call-tips/) - It's July, and that means a new generation starting radiology call. I'm not sure I've ever done a listicle or top ten, so here are fifteen. The Images Look at the priors. For CTs of the spine, that may be CTs of the chest/abdomen/pelvis, PET scans, or *gasp* even radiographs. Look at all reformats available
- [Radiology Jobs](https://www.benwhite.com/radiology/jobs/) - I believe in the importance of thriving independent private practices for the field of radiology. True private practice—where doctors control the organization, are responsible to their peers and patients, and earn the full fruits of their labor—is the benchmark that sets the market and provides the anchor against exploitation from unscrupulous employers. My group, like
- [The Girl and the Unicorn](https://www.benwhite.com/writing/the-girl-and-the-unicorn/) - This is a story written and illustrated by my six-year-old daughter, who wanted me to share it here for anyone to read. You can read more about the process of making this book here, and you can purchase paperback (or ebook) copies of the book here to support her writing. If you have any kind
- [My Daughter Wrote a Story](https://www.benwhite.com/writing/my-daughter-wrote-a-story/) - Shortly after my daughter turned six, we decided to work on a chapter book together. It's called The Girl and the Unicorn. When I was a young child living in New York, we used to visit my grandparents in Forest Hills almost every weekend. My grandmother, before she had been a mother, had been a
- [Getting Started in Radiology](https://www.benwhite.com/radiology/getting-started-in-radiology/) - Here's a little compilation of posts from the last few years about getting started as a new radiology resident. Transitioning Scan by Scan is an essay about starting in radiology. Doing Approaching the Radiology R1 Year and its short companion post: How to be a First-Year Radiology Resident. Want something a little more controversial? You
- [Being Good Feels Good](https://www.benwhite.com/misc/being-good-feels-good/) - Isaac Asimov (from a 1988 interview), providing a different perspective on trust, incentives, and guardrails: It’s insulting to imply that only a system of rewards and punishments can keep you a decent human being. Isn’t it conceivable a person wants to be a decent human being because that way he feels better?
- [Optimizing the Diagnostic Radiology Interface as a Resident](https://www.benwhite.com/radiology/optimizing-the-diagnostic-radiology-interface-as-a-resident/) - Should new residents worry about workflow efficiency and ergonomics? Yes. I don't think it's ever too early to start thinking deliberately about what makes you better and more efficient in your job or able to act more sustainably. If anything, spending more time on workflow and ergonomics early on in your career is an investment
- [AI-wRVU](https://www.benwhite.com/radiology/ai-wrvu/) - Speaking of work units, Dr. Avery J. Knapp Jr. dreams of a different multi-parametric AI work unit for radiology, arguing that wRVUs (and even time-based units) just don't cut it: There are at least 30 factors that affect how hard a study is to read. wRVU captures approximately one of them, poorly. The RUC won't
- [Spend the Afternoon](https://www.benwhite.com/reading/spend-the-afternoon/) - From Pilgrim at Tinker Creek, by Annie Dillard: Thomas Merton wrote, "There is always a temptation to diddle around in the contemplative life, making itsy-bitsy statues." There is always an enormous temptation in all of life to diddle around making itsy-bitsy friends and meals and journeys for itsy-bitsy years on end. It is so self-conscious,
- [RP & the Art of Sharing Efficiency Gains](https://www.benwhite.com/radiology/rp-sharing-efficiency-gains/) - As a follow-up to the two posts about Radiology Partners' new time-based work units, the first quarterly TBWU adjustment is taking place quickly: July 1. This will incorporate changes related to any efficiency gains for groups on the Mosaic platform. From the May 15 FAQ: Based on the TBWU guiding principles, our objective is to
- [Errors About Errors](https://www.benwhite.com/medicine/errors-about-errors/) - Medical errors are both very real and also misunderstood by the public and mismanaged by our system. From Doctors Are Not Crashing Jumbo Jets: But a bad outcome...is not automatically evidence of an error. The public is uncomfortable with this because the public wants medicine to be deterministic. They want to prevent the next error
- [Pinnochio's World](https://www.benwhite.com/misc/pinnochios-world/) - From Om Malik’s "We Are Living in Pinocchio’s World," an essay about "our zeitgeist of half-truths": Most people remember Pinocchio as a story about lying. The nose grows. You get caught. Lesson learned. But that reading misses almost everything Collodi was actually doing. The book is a close study of a society where deception has
- [Extraordinarily Open](https://www.benwhite.com/misc/extraordinarily-open/) - From the ending of Leonard Mlodinow's Subliminal: How Your Unconscious Mind Rules Your Behavior: We choose the facts that we want to believe. We also choose our friends, lovers, and spouses not just because of the way we perceive them but because of the way they perceive us. Unlike phenomena in physics, in life, events
- [From the Inside Out](https://www.benwhite.com/radiology/from-the-inside-out/) - The late radiologist Harry Z. Mellins, M.D (1921-2009), arguing that radiologists are clinicians: The radiologist is a clinician who has sacrificed one of the greatest glories of the practice of medicine, and its greatest responsibility---the daily contact with the ill and with their families---in order to concentrate the more on the other essence of our
- [People Across the Table](https://www.benwhite.com/misc/people-across-the-table/) - Dr. Cort Wernz, writing about a private equity buyout "Negotiating Blind" in his Substack, The Impression: The upfront payout the Las Vegas radiologist described wasn’t arbitrary generosity. It wasn’t a bonus. It was his own future income, pulled forward, discounted and paid to him upfront in exchange for accepting less later. [...] The radiologist in
- [Cheap Knowledge](https://www.benwhite.com/misc/cheap-knowledge/) - Rabbi Zohar Atkins' published an essay recently, "When Knowledge Is Cheap, Insight Is Everything: Jevons Paradox applied to Torah Learning." Articles referencing Jevons are everywhere these days. I myself wrote "Radiology Isn’t an Example of Jevons Paradox" last December. Atkins' essay is a change of pace: It is worth pausing here to note that the
- [Physician Survey Signup Bonuses](https://www.benwhite.com/medicine/physician-survey-signup-bonuses/) - The current welcome bonus landscape: ENOS is a new healthcare panel offering instant payments, (including $5 when screened out) and a $25 sign-up bonus. M3 has three panels---M3 Global Research, M-Panels, and All Global Circle---and you can earn $25 for joining one panel, $40 for two, and $60 for joining all three (for the following specialties: Hematology-Oncology,
- [RLI for Residents](https://www.benwhite.com/radiology/rli-for-residents/) - The ACR's RLI Leadership Essentials 201: Preparing for Practice is "a virtual, 4-month [Sept. 1–Dec. 31, 2026] professional development program designed to help residents and fellows build leadership and professional skills often not covered in traditional radiology training but highly valued in practice." Totally free for ACR members (which is free for trainees).
- [Insurers Are Subverting the No Surprises Act](https://www.benwhite.com/radiology/insurers-are-subverting-the-no-surprises-act/) - From an article about RANT's fight with BCBS in Radiology Business: Under the No Surprises Act, enacted by Congress in 2020, physicians and payers can settle disputes over out-of-network healthcare services. This is meant to protect patients from unexpected bills, which proponents say the NSA is achieving. Radiologists and other docs are reportedly winning in
- ["Why Is It So Hard to Be Ordinary?"](https://www.benwhite.com/misc/why-is-it-so-hard-to-be-ordinary/) - In "Why Is It So Hard to Be Ordinary?" Joshua Rothman cuts deeply for The New Yorker: What’s true for Little League holds for the rest of life. In some contexts, at some times, we strive for excellence, pushing ourselves. Elsewhere, we shrug, accepting our own ordinariness or mediocrity. The excellent and the ordinary coexist,
- [Transformative Bubbles](https://www.benwhite.com/misc/transformative-bubbles/) - From Verdad’s "Priced for Perfection": The future is too uncertain and unpredictable to make high-certainty bets. Yet today’s market—and today’s largest tech companies—are taking one of the largest bets in the history of economics on the future of a new technology. One does not need to be a bear on the technology itself—we are power
- [Feynman's Rainbow](https://www.benwhite.com/misc/feynmans-rainbow/) - From Leonard Mlodinow's Feynman's Rainbow: A Search for Beauty in Physics and in Life, a memoir about his early career as a physicist and working in the same department as titans Richard Feynman and Murray Gell-Mann: People sometimes scoffed at academia because of the relatively low pay. But I had seen too many "adults" work
- [Model Capability Initiative](https://www.benwhite.com/misc/model-capability-initiative/) - Fun times at Meta, including jobs cuts and mandatory spyware to help train your replacement: ...the company introduced mandatory software onto corporate laptops that tracks what US employees are typing and clicking to gather data to train AI models that execute tasks such as web browsing or organizing folders on a computer as a human
- [Value & Competition](https://www.benwhite.com/medicine/value-competition/) - From Michael Porter's Redefining Health Care: Creating Value-based Competition on Results, published twenty years ago in 2006: Competition in the current system is too local, because it is centered on relatively small, self-contained local institutions catering to local needs. Services are both delivered locally and managed locally. The local bias in health care is a
- [The Meaning of Your Work Life](https://www.benwhite.com/misc/the-meaning-of-your-work-life/) - From Arthur C. Brooks' The Meaning of Your Life: My psychologist friend said something else that proved revolutionary for my thinking—and, in fact, my whole life: to give a great deal to one person is even more empowering than to give a little to a lot of people. In other words, making a big, tangible
- [Learning Radiology for Medical Students & Non-radiologists](https://www.benwhite.com/medicine/learning-radiology-for-non-radiologists/) - Most radiology books make for a terrible and overwhelming introduction to radiology for medical students or non-radiologists. The physics. The detail. The long lists of differentials and rare conditions. A clinician with limited time is best served with having a grasp of the different radiologic modalities, their limitations, and the proper exams to order to
- [Review: CaseStacks Radiology Call Prep](https://www.benwhite.com/reviews/casestacks-radiology-call-prep/) - Before we get to it, the usual disclosure: this is not a paid review, but it is the usual kind where I get to offer a reader discount combined with an affiliate link, a win-win that makes it worth my time to write these reviews for products that I believe in. Coupon code benwhite gets
- [Recommended Books for Radiology Residents](https://www.benwhite.com/medicine/recommended-books-for-radiology-residents/) - [This updated/revised article was originally published way back on December 21, 2013] There are lots and lots of radiology books out there. Rather than list oodles of options, I've made a short editorial selection for each section. There are obviously many good books, but your book fund is probably not infinite and you need to
- [Approaching the Radiology R1 Year](https://www.benwhite.com/radiology/approaching-the-radiology-r1-year/) - There’s always a tension between giving specific advice (that doesn’t generalize well across different programs) and broad advice (that can sometimes be almost meaningless), but with that caveat, here are some thoughts about starting radiology training: What to Learn Anatomy When starting out, it’s helpful to split your pursuit of knowledge into two big categories: anatomy
- [RP's Time-based Work Units](https://www.benwhite.com/radiology/rad-partners-time-based-work-units/) - For discussion in the broader radiology community, I'd like to share Radiology Partners' March 9th announcement email regarding their new time-based work unit system. I was really hoping to get more specific examples of this system after the April 1 go-live, but from what I've gathered, the transparency on the system is generally low, and
- [Magical Efficiency Thinking](https://www.benwhite.com/medicine/magical-efficiency-thinking/) - From "Changes in Nonprofit Hospitals’ Finances, Operations, and Quality of Care After Using Management Consultants," published in JAMA: Nonprofit hospitals in the US (n = 2343) collectively spent more than $7.8 billion on management consulting services from 2009 to 2023. A stacked difference-in-differences design comparing 306 US nonprofit hospitals that used a management consulting firm for the
- [Accommodating Skill Development](https://www.benwhite.com/misc/accommodating-skill-development/) - From the conclusion of Anthropic's article summarizing their own research into AI-assistance and skill formation: Our results suggest that incorporating AI aggressively into the workplace, particularly with respect to software engineering, comes with trade-offs. The findings highlight that not all AI-reliance is the same: the way we interact with AI while trying to be efficient
- [Somewhere to Go](https://www.benwhite.com/writing/somewhere-to-go/) - Author Zadie Smith, writing about writing: “My god, I was a different person!”—yes, all writers think this, from book to book. I know that this new novel, that I’ve hardly begun, will be shameful and strange to me soon enough. After each book is done, I look forward to hating it (and I never have
- [How to Start a Psychiatry Private Practice](https://www.benwhite.com/medicine/how-to-start-a-psychiatry-private-practice/) - Last year my wife left her employed academic position and started a cash/direct pay solo psychiatry private practice. Despite how crazy 2020 has been, it's been a great experience and we have no regrets. If anything, the flexibility of one self-employed parent was instrumental to our sanity as parents when all childcare options imploded in
- [Breaking Down the RP TBWU Schema](https://www.benwhite.com/radiology/rp-tbwu-schema-analysis/) - After last week's post about Radiology Partners' new time-based work units, a reader helpfully shared a spreadsheet with the whole schema: the codes of millions of exams across the portfolio used in its calculation, their RVUs, their TBWUs, and the percentage adjustment for emergency, inpatient, and outpatient contexts. The spreadsheet has 4362 data rows, but
- [Paying Surveys for Doctors](https://www.benwhite.com/medicine/paying-surveys-for-doctors/) - Medical surveys are an easy way to make a few bucks at a good hourly rate (well, maybe at least for a resident), and there are multiple sites offering surveys to physicians. The caveat is that, of course, most survey sponsors are typically looking for board-certified physicians with multiple years of experience, particularly in sub-specialties.
- [Medical school loans during residency: IBR/PAYE or forbearance?](https://www.benwhite.com/medicine/medical-school-loans-during-residency-ibr-or-forbearance/) - There were several things about dealing with an unhealthy amount of student-loan debt during residency that I never learned in medical school. In fact, I’d venture that the vast majority of medical students have very little idea how to approach their loans. After all, it’s not on the boards (updated November 2016). While this post
- [Refinancing Your Student Loans as a Resident](https://www.benwhite.com/medicine/you-can-now-refinance-your-student-loans-during-residency/) - Last updated July 2020 If you're a resident with a big load of student loans from the feds at a 6.8% interest rate (or worse), your choice has generally been IBR or forbearance. The mountain of debt compared with your relatively paltry resident salary has put conventional student loan refinancing—which requires a reasonable debt/income
- [Options for Medical School Student Loan Refinancing](https://www.benwhite.com/medicine/options-for-medical-school-student-loan-refinancing/) - Last updated April 2020. Medical school is expensive and getting more so every year. Meanwhile, federal student loans are still at above market rates (and many private ones are predatory). Combine the two and a new doctor will borrow more and then pay more for the privilege than at any other time in history. Over the
- [The Pros and Cons of REPAYE (and what residents should do)](https://www.benwhite.com/finance/the-pros-and-cons-of-repaye/) - This post is pretty long, but this is an important development on the federal student loan front that's worth the lengthy discussion. The bottom line is that the new REPAYE program has a lot to offer people currently not just in IBR but also PAYE. I highly recommend putting some numbers into this calculator to see
- [Useless Modules](https://www.benwhite.com/medicine/useless-modules/) - From Dr. Michael Gottlieb's "Mandatory Training Modules in Health Care—Time to Reassess" in JAMA: The annual ritual of clicking through slides, answering perfunctory quiz questions, and electronically attesting to completion sends a subtle message that documentation is valued more than thoughtful learning. He argues that 4 million physician hours are spent wasted every year.
- [Phronesis](https://www.benwhite.com/medicine/phronesis/) - One can argue that the art of medicine lies in phronesis. Aristotle differentiated this practical wisdom from episteme (scientific knowledge) or techne (technical skill). Phronesis is not just things to know or things to do, but the combination of perception, judgment, and application: the salience to grok a situation and its pertinent features and then
- [ESOP](https://www.benwhite.com/medicine/esop/) - One alternative to selling to private equity or the hospital? An employee stock ownership plan (ESOP), a type of tax-favored internal buyout where practice equity is sold to an employee trust and ownership is transferred over time as stock is allocated to employees.
- [Phantom Obligations](https://www.benwhite.com/misc/phantom-obligations/) - Terry Godier, writing about the little red unread icons that are part of every app/service in the world: PHANTOM OBLIGATION (noun): The guilt you feel for something no one asked you to do. Great term that captures the cognitive and emotional weight of all of the little red dots clamoring for your attention like emergencies.
- [A RadNet AI takedown](https://www.benwhite.com/radiology/a-radnet-ai-takedown/) - I come at these sorts of analyses totally primed for confirmation bias, but I really enjoyed this critical view of "Radnet: The AI Story That Doesn't Add Up," published by Hunterbrook. The authors argue that: RadNet’s much-hyped AI business is a sideshow The success of RadNet’s roll up business is also misunderstood The truth is
- [Choosing the Meaning of Disease](https://www.benwhite.com/misc/choosing-the-meaning-of-disease/) - From the excellent and illuminating Everything is Tuberculosis, written by YA author (e.g. The Fault in Our Stars) John Green: I want to pause here to note a defining feature of humans, which is that we like to know why things happen, especially when really bad things happen. And if a reason is not immediately
- [The Best Radiology Setup/Workstation Equipment](https://www.benwhite.com/radiology/the-best-radiology-setup-workstation-equipment/) - Here is the updated first entry in a series of posts about radiology tools, ergonomics, and efficiency. This includes the go-to stuff I use every day to practice diagnostic radiology, (briefly) how I use them, and a few alternatives. This series is the result of a lot of research, trial and error, and input from
- [An Imaging "Slowdown"](https://www.benwhite.com/radiology/an-imaging-slowdown/) - A Harvard professor argues there has been an "imaging slowdown" in a brand new paper, mostly referring to data prior to 2020 and even referencing the "Choosing Wisely" campaign as a possible reason for how "the reduction in imaging use has helped to minimize a potential [sic] shortage of radiologists." (Note: there is a shortage
- [Might as Well Pretend](https://www.benwhite.com/misc/might-as-well-pretend/) - Isaac Asimov, from his memoir, It's Been a Good Life: To me it seems to be important to believe people to be good even if they tend to be bad, because your own joy and happiness in life is increased that way, and the pleasures of the belief outweigh the occasional disappointments. To be a
- [Maximum Capacity](https://www.benwhite.com/radiology/maximum-capacity/) - I wrote "The Radiologist Shortage is Here" in 2023. A new paper in JACR showed that imaging turnaround times more than doubled between 2013-2024, mostly occurring and steeply rising in 2022 and 2023. The author's conclusion? "These sudden increases suggest that the radiology workforce has reached maximum capacity."
- [Collecting a Visual Tour of Radiology](https://www.benwhite.com/radiology/collecting-a-visual-tour-of-radiology/) - I would like to make a little collection. I would love it if you sent me pictures of radiology workplaces over the years, especially but not limited to folks who have been in practice for a while: workrooms, offices, hospitals, scanners and imaging units, computers and computer systems, light boxes, dictaphones, and screenshots or images
- [Housel's Spending Mistakes](https://www.benwhite.com/misc/housels-spending-mistakes/) - The summary list of mistakes from Morgan Housel's excellent sequel to the Psychology of Money, The Art of Spending Money: Direct your gaze at the socioeconomic group just above you, assuming that within it you will find a level of durable happiness. Pursue status at the expense of independence. Let money—the making of it, the
- [The American Board of Radiology: An Updated Unofficial Financial Analysis](https://www.benwhite.com/radiology/the-american-board-of-radiology-an-updated-unofficial-financial-analysis/) - Back in 2019, I wrote A Deep Dive into the Tax Returns of the American Board of Radiology. It's now 2026, and a lot has happened in the world, so I thought it was past time to look at the ABR again and also provide some (but not exhaustive) additional context as to how the
- [The Brand Age](https://www.benwhite.com/misc/the-brand-age/) - From Paul Graham's "The Brand Age": The way to find golden ages is not to go looking for them. The way to find them—the way almost all their participants have found them historically—is by following interesting problems. If you're smart and ambitious and honest with yourself, there's no better guide than your taste in problems.
- [Walden](https://www.benwhite.com/misc/walden/) - I read (okay, intermittently skimmed) Walden. The style hasn't aged all that well, and Thoreau is very preachy...but, this is a good line: Simplicity, simplicity, simplicity! I say, let your affairs be as two or three, and not a hundred or a thousand; instead of a million, count half a dozen, and keep your accounts
- [Democracy is Not Transmitted Biologically](https://www.benwhite.com/misc/democracy-is-not-transmitted-biologically/) - One of my old college professors, Ruth Wisse, just gave the Jefferson Lecture (the highest honor given by the National Endowment for the Humanities) at the tender age of 89. One brief quotation, about addressing the cultural drift to grievance over gratitude during Harvard faculty meetings: The best I ever did, more than once, was
- [The ABR Finesses its Bylaws](https://www.benwhite.com/radiology/the-abr-finesses-its-bylaws/) - A few years ago I published my deep dive into the bylaws of the American Board of Radiology. Bylaws are boring, dry documents that most people don't care about and even fewer read. But they do shed light on the culture of an organization and its priorities. The ABR's were comically nefarious. For example, their
- [Staffing for Average](https://www.benwhite.com/radiology/staffing-for-average/) - In radiology, staffing for average volumes is the easiest way to staff, because most times things work out—in the same way that just-in-time manufacturing is the most efficient way to make products when everything is going well. Unfortunately, all systems designed for a typical day or ideal circumstances fall apart when confronted with the reality
- [The Intern Pivot](https://www.benwhite.com/medicine/the-intern-pivot/) - A reader asked me last year whether they should pursue applying to radiology as an intern because they felt like, in the end, clinical medicine wasn't for them. I have no idea. Maybe? But also: Internships are hard, and grass is green. Everything has good and bad parts. It's easier to blame the current context
- [TBWU](https://www.benwhite.com/radiology/tbwu/) - Does anyone have official verbiage from RadPartners about the roll-out of the TBWU (their customized time-based work units)? Can anyone share a full chart of common exams and their new values? I've heard they have different weightings for ER/IP/OP exam settings, and that would also make sense, but the only partial example I've seen circulating
- [Wireless Lapel Mics are Now Great for Radiology](https://www.benwhite.com/radiology/wireless-lapel-mics-are-now-great-for-radiology/) - Take-home point: I think wireless lapel/lavalier mics are an outstanding solution for radiology. Context Longtime readers—or those who have perused my previous posts on radiology equipment—may recall that my solution for hands-free dictation over the past several years was a shotgun microphone at home (like this or this mounted to my monitor and pointed at
- [From Effort to Intuition](https://www.benwhite.com/misc/from-effort-to-intuition/) - True education isn't just transmitting information. It's the information filtered through experience that makes it real. Experience matters because it allows us to convert all that expensive type-two thinking into long-term memory. It can, in a sense, help convert type-two into type-one thinking—or at least less expensive thinking—by taking a complicated world full of many
- [Information vs Education](https://www.benwhite.com/medicine/information-vs-education/) - Preparing for standardized tests by yourself using high-quality resources is both effective and a little bit soulless. There’s a reason why much of medical education could be streamlined in both time and cost to what amounts to an old-time correspondence course—that’s because it's long been sold as an information problem, and the core question for
- [Staying Small](https://www.benwhite.com/medicine/staying-small/) - I would posit that good healthcare is more analogous to a restaurant than most large corporations. From Michael E. Porter's Competitive Strategy: Techniques for Analyzing Industries and Competitors: If close local control and supervision of operations is essential to success the small firm may have an edge. In some industries, particularly services like nightclubs and
- [Dario Dreams of Electric Radiology](https://www.benwhite.com/radiology/dario-dreams-of-electric-radiology/) - CEO of Anthropic, Dario Amodei, fighting hard on a podcast (clip here) to set a new record on how quickly you can be wrong about how radiology works and how it's been affected by AI so far: There’s this story of, like—I think it was Geoff Hinton—predicting that AI will replace radiologists. And indeed, AI
- [The Other Place](https://www.benwhite.com/reading/the-other-place/) - About the experience of grief and the inevitability of death, from Liturgies of the Wild: Myths That Make Us by Martin Shaw: Be extravagant and protracted and real in your grief. Don’t worry about doing it wrong. Labor over the preparation, exhaust yourself, show up. Make something by hand. Read stories to the beloved, allow
- [Compromise and Discomfort](https://www.benwhite.com/misc/compromise-and-discomfort/) - Optimizing is challenging (Herbert Simon argued it was impossible). Some people, in some situations, can optimize for their interests and find their magical right path (their "calling"). I never had a calling; or if I did, I missed it. I think perhaps the equally important—if less interesting—advice is to satisfy yourself across the spectrum of
- [Job Satisficing](https://www.benwhite.com/misc/job-satisficing/) - From Herbert Simon's Models of My Life: The real economic actor is, in fact, a satisficer, a person who accepts 'good enough' alternatives, not because less is preferred to more but because there is no choice. Since my world picture approximates reality only crudely, I cannot aspire to optimize anything; at most, I can aim
- [Radiology Isn't an Example of Jevons Paradox](https://www.benwhite.com/radiology/radiology-isnt-an-example-of-jevons-paradox-yet/) - A few further thoughts about NVIDIA CEO Jensen Huang's farcical description of the impact AI has "already" had in completely revamping the field of radiology. Huang presents radiology as the "evidence" of what the near-future impact of AI on the workforce will be. I'll include the quote again in this post for completeness: One thing
- [Hallucinating about AI](https://www.benwhite.com/radiology/hallucinating-about-ai/) - This week, Elon Musk and Nvidia's Jensen Huang discussed AI and the future of technology at the U.S.-Saudi Investment Forum. Here is Jensen Huang discussing radiology: One thing that I will say, give you some evidence, is that, and I was just telling Elon about this earlier, radiology, for example, has largely been converted to
- [Saving Mitigates Uncertainty](https://www.benwhite.com/finance/saving-is-uncertainty-mitigation/) - Morgan Housel's The Art of Spending Money offers an excellent reframing of saving: think of it not as delayed gratification, but as the purchase of future independence and resilience against uncertainty. Because those things have value even before the money is eventually spent later. Knowing you have that armor is protective against the generalized uncertainty of
- [Microphone Styles for Radiology Dictation](https://www.benwhite.com/radiology/microphone-styles-for-radiology-dictation/) - Lav vs. Headset vs. Handheld vs. Fixed Microphones (Updated 3/4/2026) There are three main form factors for microphones in the context of a radiology setup. You can hold a dictaphone, as radiologists have done since time immemorial. You can wear a microphone like a headset. Or you can have a microphone that is not in
- [Boring Converts](https://www.benwhite.com/misc/boring-converts/) - From Developmental Editing by Scott Norton: Authors who resort to derivative thinking usually don’t realize they’re doing so. They tend to fall into one of two categories: converts and preachers. The convert is one for whom an existing framework is a recently discovered window into reality. Being a boring convert seems like an easy trap,
- [Losing Himself](https://www.benwhite.com/misc/losing-himself/) - From a short essay written by programmer Greg Knauss: People will argue that speaking English to LLMs is just another level of abstraction away from the physics of how the machine actually works. And while that’s technically true — the worst kind of true — it also misses the point. Industrialization fundamentally changes things, by quantum degrees.
- [Solving the Functional Imperative is Not Enough](https://www.benwhite.com/misc/solving-the-functional-imperative-is-not-enough/) - Jony Ive, in a 2025 fireside chat at Stripe: I think the spiritual thing is that I believe that when somebody unwrapped that box, and took out that cable and they thought somebody gave a shit about me. I think that's a spiritual thing. What used to depress me was this sense that solving a
- [Becoming Kinder](https://www.benwhite.com/misc/kindness/) - Following up from our brief discussion of yoyu, an excerpt from George Saunders' 2013 convocation speech at Syracuse, presented without unnecessary commentary: When young, we’re anxious — understandably — to find out if we’ve got what it takes. Can we succeed? Can we build a viable life for ourselves? But you — in particular you,
- [Radiology Attention Residue](https://www.benwhite.com/radiology/radiology-attention-residue/) - The radiology job of “reading scans” is actually two different jobs in rapid alternation: pattern recognition (pixels, asymmetry, gestalt) and translation (turning that visual certainty—or uncertainty—into clean prose with a defensible impression). The vast majority of my work is diagnostic these days, but there have been times in my life when I wore lead, did
- [A Tough One](https://www.benwhite.com/writing/a-tough-one/) - From writer George Saunders' recent interview in the NYT Magazine: [Chekhov] says a work of art doesn’t have to solve a problem — it just has to formulate it correctly... My job, rather than answering your question, is to allow [the characters] to make the best possible case for their view...I wrote myself into a
- [Signal v Noise](https://www.benwhite.com/misc/signal-v-noise/) - From The Signal and the Noise: Why So Many Predictions Fail-but Some Don't by Nate Silver: Distinguishing the signal from the noise requires both scientific knowledge and self-knowledge: the serenity to accept the things we cannot predict, the courage to predict the things we can, and the wisdom to know the difference.” A clever formulation
- [Yoyu](https://www.benwhite.com/misc/yoyu/) - There is perhaps no career/life advice given more often in recent years than to say no to things. To be sure, the Power of No is important. We are finite creatures with limited time. We simply cannot do it all, and no one will respect our time for us. (And to be fair, people also
- [A Problem With Doctors' Software](https://www.benwhite.com/misc/a-problem-with-doctors-software/) - Daniel Cook on Mixing Games and Applications: Why do games have such a radically different learning curve than advanced applications? It turns out that games are carefully tuned machines that hack into human beings' most fundamental learning processes. Games are exercises in applied psychology at a level far more nuanced than your typical application. Implicit
- [The Refill Machine](https://www.benwhite.com/medicine/the-refill-machine/) - The announcement of ChatGPT Health and then immediately Claude for Healthcare (just for "informational purposes," of course) is big news, obviously. But the other big news from last week was Doctronic's new pilot in Utah: In a first for the U.S., Utah is letting artificial intelligence — not a doctor — renew certain medical prescriptions.
- [The Law of Inverse Prioritization](https://www.benwhite.com/misc/the-law-of-inverse-prioritization/) - Greg McKeown (most famous for Essentialism), on the Tim Ferriss podcast: What I have learned is this strange law of inverse prioritization: The most important thing in our lives at any given time is the least likely thing to get done. Because it's so important, the risk of failing at it is much higher than
- [A Time to be Human](https://www.benwhite.com/misc/a-time-to-be-human/) - Freya India, writing in After Babel: When so few seem interested in being a person, isn’t that the best time to be one? Maybe this is a moment for optimism. You just have to be human. [...] To have your own voice you need to venture out into the world. You need to take risks
- [How I Use the Contour Shuttle for Radiology](https://www.benwhite.com/radiology/how-i-use-the-contour-shuttle-for-radiology/) - This post could have been titled: Why and How to Use an Offhand Device for Radiology Or maybe even: How to Make the Most of All Those Extra Buttons on Your Gaming Mouse or Similar Device We'll be talking about using productivity devices to make diagnostic radiology more biomechanically (and functionally) efficient. I was personally
- [Trust does not appear in GDP](https://www.benwhite.com/misc/trust-does-not-appear-in-gdp/) - From Adam Butler's "The Strip-Mining of Trust": The economists call trust “social capital,” but the name obscures the crucial asymmetry. Trust is not like money. It is more like topsoil—built up over generations through countless small depositions, easily washed away in a single season of careless extraction, and once gone, recoverable only on timescales that
- [Task Spreading](https://www.benwhite.com/medicine/task-spreading/) - In many practices and especially in academia, important but burdensome tasks are either treated like hot potatoes or flow downhill to the most junior faculty. There are several strategies for distributing important but non-measurable or non-promotable tasks: random assignment rotating schedules clear benefits like compensatory time off automatic cycling/off periods (e.g., do a task for
- [Critter MRI](https://www.benwhite.com/radiology/critter-mri/) - I 3D-printed an MRI for my daughter's somewhat excessive Calico Critter collection. My wife overheard her playing with it, as one critter was telling another it was time for her scan. "It's your turn to take a nap in the MRI machine," one says. "What's an MRI machine?" asks the patient. "Oh, it's just a
- [Momento Mori](https://www.benwhite.com/radiology/momento-mori/) - Our family had some nice, quiet snow days over the weekend here in Dallas, so I finally finished this historically interesting if morbid Lego mosaic of the first CT scan from 1971 (right frontal GBM): The Stoics thought everyone should have a memento mori, but the typical skull is so staid.
- [Backseat Epic](https://www.benwhite.com/misc/backseat-epic/) - Mike Swanson's "Backseat Software" perfectly describes one of the many modern software problems that also happen to plague the Epic EHR: So the problem isn’t that software ever teaches, asks, or informs. The problem is that once a company builds the machinery to do it, that machinery becomes cheap to reuse, and the incentives gradually
- [The Mediocrity of Scale](https://www.benwhite.com/medicine/the-mediocrity-of-scale/) - Different doesn’t mean right or wrong. Best practices are sometimes best, and sometimes they’re just a mediocre consensus that a small group agrees to. Institutions are so often large and stupid because herds of humans are difficult to manage at scale, and the lessons learned by individuals often don't become institutionalized without significant baggage in
- [Good Questions](https://www.benwhite.com/misc/good-questions/) - On the importance of the right questions: The trouble with trying to solve questions posed by communities is that all the good ones are gone, especially if they can be answered. Why then do not we see the scientists around us spend their nights hunting for questions? Instead, it seems that having a clear question
- [Radiology Core Exam Question Banks Review](https://www.benwhite.com/radiology/abr-core-exam-qbanks-review/) - [Last meaningfully updated September 2022. As of Jan 2026, there is also a new qbank for NIS, RISC, and physics called RadCore (I haven't tried it, and I have no reader discount).] The following is a review and comparison of the available online question banks for the Core Exam. There are currently six contenders: RadPrimer,
- [Resources for the Radiology Core Exam](https://www.benwhite.com/radiology/resources-for-the-abr-core-exam/) - This is a brief discussion of commonly used and discussed resources for the ABR Core Exam. As I discussed in this lengthy post, there a lot of good but no perfect resources for the Core exam. As such, pick a few that feel right and never look back. You'll be fine. Textbooks Core Radiology Crack the
- [The Unhelpfulness of AI Predictions](https://www.benwhite.com/medicine/the-root-unhelpfulness-of-predictions-about-ai/) - Most Content is Boring Most current articles about AI and radiology work don't help us much with regard to the questions people are constantly asking about predicting the future. Publish or perish is fine, but I'll admit I also don't really care how many ways we can say these early tools are sorta maybe helpful
- [Regret Minimization](https://www.benwhite.com/misc/regret-minimization/) - Amazon founder Jeff Bezos on his decision to start an online bookstore in the 1990s: The framework I found which made the decision incredibly easy was what I called the regret minimization framework. I wanted to project myself forward to age 80 and look back on my life and I want to have minimized the
- [The Easy vs. Possible Problem of EHRs](https://www.benwhite.com/misc/the-easy-vs-possible-problem-of-ehrs/) - Basecamp's Jason Fried's brief discussion of product development should be required reading for anyone who designs software, including EHRs, PACS, dictation, or whatever new dumb AI implementation someone is pitching to revolutionize healthcare (but that no one talked to an actual doctor about). The critical tension is the balance between making features obvious, easy, and
- [Number Games](https://www.benwhite.com/misc/number-games/) - More from Alchemy: The Dark Art and Curious Science of Creating Magic in Brands, Business, and Life by Rory Sutherland (Part 1 is here): When every function of a business is looked at from the same narrow economic standpoint, the same game is applied endlessly. Define something narrowly, automate or streamline it – or remove
- [Radiology Trailblazers Ep. 7](https://www.benwhite.com/radiology/radiology-trailblazers-ep-7/) - I'm in the new episode 7 of AJR's Radiology Trailblazers podcast with Dr. Lindsey Negrete and Dr. Amy Maduram. Please do not think for a second that I accept my inclusion in any "trailblazing" premise(!), but we had a nice discussion about the writing process in and out of radiology. Whenever I do a podcast, I
- [Treadmill Desks Are So Worth It](https://www.benwhite.com/misc/treadmill-desks-are-so-worth-it/) - I finally got a standing desk, which means I was finally able to try a foldable treadmill under it. I love it. In early 2024, I started using an under-desk elliptical, and it worked surprisingly well. One downside is that since it is only self-paced, it's easy to stop. This fall, I got the WALKINGPAD
- [Gas Station Tours](https://www.benwhite.com/finance/gas-station-tours/) - Author Tim O'Reilly, in his 2006 commencement speech at UC Berkeley: Money is like gasoline during a road trip. You don’t want to run out of gas on your trip, but you’re not doing a tour of gas stations.
- [Fragmented Opportunities](https://www.benwhite.com/misc/fragmented-opportunities/) - From Michael E. Porter's classic Competitive Strategy: Techniques for Analyzing Industries and Competitors: Overcoming fragmentation can be a very significant strategic opportunity. The payoff to consolidating a fragmented industry can be high because the costs of entry into it are by definition low, and there tend to be small and relatively weak competitors who offer
- [Why are Body Imagers in Such High Demand?](https://www.benwhite.com/radiology/why-are-body-imagers-in-such-high-demand/) - A paraphrased reader question: I want to be a daytime tele neurorad. Why do so many of the listings seem to be for body? Are there too many neurorads? I don't think it's really that there are too many neuroradiologists per se. It’s that the true need across the widest variety of practice types is
- [New Ideas](https://www.benwhite.com/misc/new-ideas/) - From Developmental Editing by Scott Norton: Few pleasures are as great as the taste of a fresh idea. A new insight melts in the brain like chocolate on the tongue. Whether the insight is unprecedented in human history or news only to yourself doesn’t matter; the first time a thought occurs is always magic. That
- [Labor is a Cost](https://www.benwhite.com/medicine/labor-is-a-cost/) - From Michael Porter's Competitive Strategy: We usually think of suppliers as other firms, but labor must be recognized as a supplier as well, and one that exerts great power in many industries. There is substantial empirical evidence that scarce, highly skilled employees and/or tightly unionized labor can bargain away a significant fraction of potential profits
- [Just Halt When You Are HALT](https://www.benwhite.com/misc/just-halt-when-you-are-halt/) - Kevin Kelly, adding 101 new bits to his growing collection of pithy advice. A few of my favorites: Forget trying to decide what your life’s destiny is. That’s too grand. Instead, just figure out what you should do in the next 2 years. Try to define yourself by what you love and embrace, rather than
- [De-bogging](https://www.benwhite.com/misc/de-bogging/) - From a highly enjoyable "So you wanna de-bog yourself" (about getting "unstuck") by Adam Mastroianni: "Declining the dragon" - a medieval knight metaphor for getting unstuck: Sometimes I'll know exactly what I need to do in order to leave the bog, but I'm too afraid to do it. I'm afraid to tell the truth, or
- [The Iterative Loop of Radiology](https://www.benwhite.com/radiology/the-iterative-loop-of-radiology/) - The first few months of radiology residency can be pretty bewildering. It's rare in adult life to start from scratch quite as much as you do the summer you transition from internship. Even if you did some studying during internship or you were fortunate enough to have electives in radiology during your intern year, there
- [The Young Physician Trap](https://www.benwhite.com/medicine/the-young-physician-trap/) - About working as a hospital employee, from "The Young Physician Trap: Trading Autonomy for Salary" in Claim Denied: And then comes the pay cut. It’s framed as “efficiency.” Or “underperformance.” The implication is clear: you’re the problem. By now, the hospital knows they have you. You bought a home. You structured your life around the
- [This Site in 2025](https://www.benwhite.com/writing/this-site-in-2025/) - In 2025, I shared something like 90 regular posts and 30 asides (clearly, I have not fully embraced the microblog component of the site I added during the 2023 redesign). The total wordcount of all that writing is a bit over 70,000 words (closer to 55,000 excluding blockquotes). So I wrote a book this year.
- [The North Star](https://www.benwhite.com/misc/the-north-star/) - From The World I See, a memoir by the godmother of AI, Dr. Fei-Fei Li: This, collectively, is the next North Star: reimagining AI from the ground up as a human-centered practice. I don’t see it as a change in the journey’s direction so much as a broadening of its scope. AI must become as
- [We're Hiring](https://www.benwhite.com/radiology/were-hiring/) - Time for my semiannual update and bump of this post: like every other practice in the country, my group is also hiring! American Radiology Associates is a 100%-independent physician-owned radiology practice in Dallas-Forth Worth (of which I am a partner/shareholder). We're privademic: we have part of the practice that works with the Baylor Dallas radiology
- [What I Read in 2025](https://www.benwhite.com/reading/what-i-read-in-2025/) - The annual book list has become a fun tradition for me over the past twelve years as a way to track what I'm reading and my impressions. I am prone to book chugging, so the pausing and recording is a practice I find valuable. Over the past few years, I've also shared some of my
- [Searching for Swing](https://www.benwhite.com/radiology/searching-for-swing/) - A paraphrased reader question: I am still in the middle of residency but entertaining the idea of doing 100% remote work fresh out of training. I want to live in a rural area out west, so I am thinking of swing shift jobs in CST/EST. Do you have any advice for what to look for
- [Indy at 150](https://www.benwhite.com/radiology/indy-at-150/) - Medicine's narrowest job board, Independent Radiology---the home of radiology private practice---is sitting pretty again at 150 groups. A few groups sadly closed for good, and some---fantastically---are fully hired up, but it looks like we'll close the year back at that nice round number. If you're looking for an opportunity, perusing the listings is good holiday
- [Modern Illustration](https://www.benwhite.com/misc/modern-illustration/) - Modern Illustration is a delightful online archive of vintage (c.1950-1975) illustration curated by Zara Picken.
- [Should You Care About the ACR's DXIT Exam?](https://www.benwhite.com/radiology/should-you-care-about-the-acrs-dxit-exam/) - Who & What The Diagnostic Radiology In-Training (DXIT) is radiology's in-service/in-training exam and it's typically taken by R1, R2, and R3 residents midway through the year. Every(?) specialty has one. It's important to note that the ACR (the American College of Radiology) offers the DXIT exam, whereas the ABR (the American Board of Radiology) controls
- [The Sofas of Life](https://www.benwhite.com/misc/the-sofas-of-life/) - On living in a tumultuous, uncertain world, from the Free Press' Abigail Shrier: Overinvest, never underinvest, in people around you and in those you love. Particularly in a world with poor visibility, they are the closest thing any of us has to security. Give the community you inhabit a real shot and make a go
- [Choosing Status Games](https://www.benwhite.com/misc/choosing-status-games/) - Via The Wealth Ladder by Nick Maggiulli: As Robert Sapolsky wrote in Why Zebras Don’t Get Ulcers: When we sit around and worry about stressful things, we turn on the same physiological responses—but they are potentially a disaster when provoked chronically. A large body of evidence suggests that stress-related disease emerges, predominantly, out of the
- [The Argument for Letting AI Burn It All Down](https://www.benwhite.com/misc/the-argument-for-letting-ai-burn-it-all-down/) - Paul Ford, writing in Wired about post-bubble normalized (i.e. boring) AI: People often wonder how to get back to the vibes of the early, heady days of the internet. It’s easy: Crash the global economy and leave lots of young people with keyboards and spare time. Make it boring. That’s what’s interesting.
- [The Never-Full Eye](https://www.benwhite.com/reading/the-never-full-eye/) - A parable about greed, as relayed by a 17th-century Jewish widow Gluckel to her children: As it is told of Alexander the Macedon who, as everyone knows, travelled and conquered the whole wide world: Whereat he thought to himself, «I am such a mighty man and I have travelled so far, I must be near to
- [Moving up the Oral Boards](https://www.benwhite.com/radiology/moving-up-the-oral-boards/) - This week, the ABR quietly dropped a big change in their long-term plans for the new oral board version of the Certifying Exam. After the very first administration in early 2028 during fellowship for the class of 2027, subsequent administrations will occur at the end of residency: That's the email I got as a program
- [The Democratization of Purposelessness](https://www.benwhite.com/misc/the-democratization-of-purposelessness/) - America after World War II entered an era of economic growth and intermittent societal cohesion. It also created the American consumer, an economic system based in large part on earning money to buy things, at first to change your life (a washing machine!) and then to signal to others (another new car?). That simple instinct—to
- [Coffee at Work](https://www.benwhite.com/misc/subsidize-my-coffee/) - [This post was originally written in September 2022. But, update: Yum. I've been ordering boxes regularly since then.] The coffee at work has been—for most locations of my training and attending career—terrible. From the burnt “Parks and Coffee” drip sitting for hours on the hot plate during residency to the cheapest K-cups at the imaging
- [Coffee Me, Please](https://www.benwhite.com/misc/coffee-me-please/) - I'm running low on my stash of Cometeer coffee. If you're interested, you can get $20 off your first order + free shipping and help subsidize my terrible caffeine addiction. (Full review here. Not an ad, but I've been ordering for the past three years and I really do like cheaper coffee.)
- [Freedom from Passivity](https://www.benwhite.com/misc/freedom-from-passivity/) - David Foster Wallace, talking about TV and the dawn of the internet during his 1996(!) book tour for Infinite Jest: At a certain point we’re gonna have to build up some machinery, inside our guts, to help us deal with this. Because the technology is just gonna get better and better and better and better. And
- [Orwell on Writing](https://www.benwhite.com/writing/orwell-why-write/) - George Orwell (1984, Animal Farm), from his essay "Why I Write": I give all this background information because I do not think one can assess a writer’s motives without knowing something of his early development. His subject-matter will be determined by the age he lives in ­– at least this is true in tumultuous, revolutionary
- [Writing Makes It "True"](https://www.benwhite.com/misc/writing-makes-it-true/) - From "How to Leverage Language to Cultivate Your Creative Process" by Nicole He in Killscreen. I had a concept in my mind—maybe I felt it emotionally, I had a feeling about what this thing is supposed to represent. Now what I’m saying makes it real. After that, I started responding to journalists the next morning.
- [The Wealth Ladder](https://www.benwhite.com/reading/the-wealth-ladder/) - A framework on how to think about financial wealth, from The Wealth Ladder by Nick Maggiulli: Some people have warped perceptions of wealth and what it means to do well financially. If we map the different economic classes in the U.S. onto the Wealth Ladder, we can see this more clearly: Level 1. Lower class
- [Goodharting Medical School Admissions](https://www.benwhite.com/medicine/goodharting-medical-school-admissions/) - Adam Cifu, writing in Sensible Medicine: We profess to value diversity among our students, yet our admission requirements enforce homogeneity. If everyone must excel academically, publish articles, and complete service activities, how much diversity is left? Does the art history major, who aced his required science courses and then spent two years on a scaffolding
- [The Laws of Medicine](https://www.benwhite.com/medicine/the-laws-of-medicine/) - From The Laws of Medicine, a short book by Siddhartha Mukherjee: My medical education had taught me plenty of facts, but little about the spaces that live between facts. I could write a thesis on the physiology of vision. But I had no way to look through the fabric of confabulation spun by a man
- [Autonomous Driving](https://www.benwhite.com/misc/autonomous-driving/) - I recently experienced a trial of Tesla's full self-driving capability for the first time. It was a decent, if bewildering and somewhat spooky experience. It’s unusual to see a computer do a task in the real world that you have been doing—and had to do yourself—for decades. For some reason, feeling a computer manifesting its
- [Learning to Make Mistakes](https://www.benwhite.com/medicine/learning-to-make-mistakes/) - Some career advice from the archives of an otherwise defunct blog from venture capital billaionaire Marc Andresseen: In my opinion, it’s now critically important to get into the real world and really challenge yourself—expose yourself to risk—put yourself in situations where you will succeed or fail by your own decisions and actions, and where that
- [The Thin World](https://www.benwhite.com/misc/the-thin-world/) - Karl Ove Knausgaard, writing in Harper's earlier this year: It feels as if the whole world has been transformed into images of the world and has thus been drawn into the human realm, which now encompasses everything. There is no place, no thing, no person or phenomenon that I cannot obtain as image or information.
- [Automate or Collaborate](https://www.benwhite.com/misc/automate-or-collaborate/) - Popular essays about AI published in our current media like to cycle between utopianism to massive dystopian automation/disruption to the "plea for collaboration." The latter, from "A Better Way to Think About AI" by David Autor and James Manyika in The Atlantic: In any given application, AI is going to automate or it’s going to
- [Structured Procrastination](https://www.benwhite.com/misc/structured-procrastination/) - From "Structured Procrastination" by John Perry, philosopher and author of The Art of Procrastination (delightfully subtitled: A Guide to Effective Dawdling, Lollygagging and Postponing): The key idea is that procrastinating does not mean doing absolutely nothing. Procrastinators seldom do absolutely nothing; they do marginally useful things, like gardening or sharpening pencils or making a diagram
- [The Hard Work Muscle](https://www.benwhite.com/reading/the-hard-work-muscle/) - From Don't Believe Everything You Think by Joseph Nguyen: While a job may be demanding, does that mean it must lead to suffering? Or put another way: Is it absolutely true that every person who has the same intense job feels the exact same way about that job? The ability to work hard is trainable
- [Small World Networks, Game Theory, and Keyboard Warriors](https://www.benwhite.com/misc/keyboard-warriors-small-world-networks-and-game-theory/) - In real life, you can---to an exent---choose your community and who you hang out with. Online with social media, that's much, much harder. This is a good video ("Something Strange Happens When You Trace How Connected We Are") from Veritasium, and if you’re busy, that link takes you to the section on how the classic
- [30-year Timelines](https://www.benwhite.com/medicine/30-year-timelines/) - The average radiology trainee will finish residency in their early 30s and hopefully enjoy a 30-plus year career if they like it (and otherwise make enough money fast enough to retire early if desired). 30 years is a long time Do we really think that we have any idea what the world will look like
- [Fall](https://www.benwhite.com/reading/fall/) - Blammo, it's decorative gourd season again.
- [The Old Good Old Days](https://www.benwhite.com/reading/the-old-good-old-days/) - From her remarkable memoirs, the German-Jewish Gluckel of Hameln, writing about her childhood village of Altona sometime in the 17th century: But great love and a close community spirit reigned among them, and in general they all enjoyed a better life than the richest man today. If a man were worth only 500 Reichsthalers, he
- [Draft No. 4](https://www.benwhite.com/writing/draft-no-4/) - Four of my favorite passages from Draft No. 4: On the Writing Process by John McPhee: The approach to structure in factual writing is like returning from a grocery store with materials you intend to cook for dinner. You set them out on the kitchen counter, and what’s there is what you deal with, and
- [Medical Selection](https://www.benwhite.com/medicine/medical-selection/) - As is the case with so many things in medicine, our selection process—for medical school, residency, and nearly every stage until a person has the requisite skills to practice—is riddled with suboptimal, if not entirely meaningless or counterproductive, proxy measures. When we select college students for medical school, or medical students for certain residencies, the
- [Things Become Other Things](https://www.benwhite.com/reading/things-become-other-things/) - From the titular passage of Craig Mod's Things Become Other Things, a memoir partially about walking through the ancient pilgrimage trails of Japan's depopulating Kii peninsula: As the husband drives me down off the mountain, back to the Ise-ji path, he breaks our silence by saying, She aint... our daughter. I am entranced by something
- [What Makes a Radiologist Feel Special?](https://www.benwhite.com/radiology/what-makes-a-radiologist-feel-special/) - Not all radiology jobs are created equal in part because not all radiologists with the same job are treated equally. In a field divided between democratic groups, corporate employers, and academic institutions, the meaning of fairness and the value of “specialness” vary wildly. Compensation, autonomy, and respect are all on the table. For different kinds
- [The Residency Selection Research Arms Race](https://www.benwhite.com/medicine/the-residency-selection-research-arms-race/) - Laws of unintended consequences combined with a crappy system, this can't be the right way for people to spend their time collecting brownie points: When I see the graphs showing the medical student research arms race, it seems to me that the numbers between unmatched and matched students are pretty similar in most fields. Is
- [The Failed Experiment of Low Expectations](https://www.benwhite.com/misc/the-failed-experiment-of-low-expectations/) - From "The Perverse Consequences of the Easy A," published last month in The Atlantic: When everyone gets an A, an A starts to mean very little. The kind of student that gets admitted to Harvard (or any elite college) wants to compete. They’ve spent their lives clawing upward. Khurana, the former dean, observed that Harvard
- [Nanoism graduate](https://www.benwhite.com/reading/nanoism-graduate/) - I opened the email from Amazon this month about its Kindle First Reads and immediately recognized the author of this new book: A House Between Sea and Sky. And that's because I published its author, Beth Cato, way back in 2009 in Nanoism, the absurd little internet publication for Twitter fiction I edited for 14 years.
- [Unskilling](https://www.benwhite.com/medicine/unskilling/) - Deskilling and automation bias will be big problems with useful AI, but what do you call it when someone never has to develop skills in the first place? Unskilling? (Apparently, a at least one new paper describes it as "never-skilling") Residency faculty, do you have an AI usage policy for your trainees? Why or why
- [Transformative Experience](https://www.benwhite.com/misc/transformative-experience/) - “For many big life choices, we only learn what we need to know after we’ve done it, and we change ourselves in the process of doing it." - LA Paul
- [Smooth Pass-throughs](https://www.benwhite.com/radiology/smooth-pass-throughs/) - Another lawsuit against Radiology Partners due to its billing practices, this time from UnitedHealthcare (again) in Arizona. Like the Aetna lawsuit in Florida, this one focuses on abuse of the No Surprises Act's Independent Dispute Resolution process by routing in-network claims through an out-of-network subsidiary in order to make more money. Perhaps it shouldn't be
- [Associate vs Partner Pay](https://www.benwhite.com/radiology/associate-vs-partner-pay/) - A previous reader question: What do you think is a fair compensation ratio for pre-partner to partner pay? It seems like a lot of jobs offer a 50 to 100 percent pay bump. Is there a threshold that should be a red flag? I don't think there is a red flag number. These numbers mostly
- [First Job Support](https://www.benwhite.com/radiology/first-job-support/) - A reader question: A lot of my attendings recommend my first job should be somewhere like academics or a hospital system where I have support if there's a complicated case or someone to help me. Do you feel like you have that in private practice? So I personally had/have that. Does everybody? No, it depends
- [The Generalist vs Subspecialist Continuum](https://www.benwhite.com/radiology/the-generalist-vs-subspecialist-continuum/) - When I was in training in the 2010s, there was a big push for sub-specialization. It was felt to be the future of radiology (and of course, everyone absolutely needed to do a fellowship). Observers opined that the days of the general radiologist were numbered because people needed fancier skills to deal with the increasingly
- [Wild Problems](https://www.benwhite.com/reading/wild-problems/) - From Wild Problems: A Guide to the Decisions That Define Us by Russ Roberts: Instead of spending more time trying to make the right decision, I show you that often there is no right decision in the way we usually think of the term. Sometimes there are no right or wrong choices, just choices. And,
- [Baumol’s Cost Disease and the Undercutting of Physician Pay](https://www.benwhite.com/medicine/baumols-cost-disease-and-the-undercutting-of-physician-pay/) - In the 1960s, economist William Baumol attempted to explain why services like healthcare and education keep getting more expensive: they’re labor-intensive, and there’s a ceiling on how much productivity can improve without sacrificing quality. This idea—known as Baumol’s cost disease—goes like this: In sectors like manufacturing or tech, productivity is routinely increasing. You can automate,
- [The Lucrative Business of Narrative Fallacy Trafficking](https://www.benwhite.com/reading/the-lucrative-business-of-narrative-fallacy-trafficking/) - From How Not to Invest by Barry Ritholtz: There is a forecasting-industrial complex, and it is a blight on all that is good and true. The symbiotic relationship between the media and Wall Street drives a relentless parade of money-losing tomfoolery: Television and radio have 24 hours a day they must fill, and they do
- [Justified Leisure](https://www.benwhite.com/reading/justified-leisure/) - On the spurious need to justify leisure for leisure's sake, via Four Thousand Weeks: John Maynard Keynes saw the truth at the bottom of all this, which is that our fixation on what he called “purposiveness”—on using time well for future purposes, or on “personal productivity,” he might have said, had he been writing today—is
- [Radiology Subspecialty Demand Updates](https://www.benwhite.com/radiology/radiology-subspecialty-demand-updates/) - Since we are in a new academic year at the height of job time, I thought I'd post an update on the "demand for radiology subspecialties" from Independent Radiology, which currently features 152 private practices (an interesting nationwide slice of the radiology job market). Here is the breakdown of subspecialty openings today: Body: 76% (115),
- [Optimizing for $/RVU](https://www.benwhite.com/radiology/dollar-per-rvu/) - How radiologists generate revenue is straightforward (you read cases), but how they are compensated varies based on the employment model, practice structure, payor contracts, stipends, etc etc etc. Comparing opportunities is challenging. One way to attempt an apples-to-apples comparison is by summarizing a position into a single figure: $/RVU. You take your total compensation, divide
- [Radiology Ergonomics and Productivity](https://www.benwhite.com/radiology/ergonomics-and-productivity/) - Here is the updated collection of my posts on radiology setups/hardware, ergonomics, and productivity: § 1. The Best Radiology Setup/Workstation Equipment Here’s what I have idiosyncratically landed on as a stable happy set-up that balances efficiency and comfort (and an editorial selection of those favored by others). Life is too short to use what comes
- [Reading Comprehension](https://www.benwhite.com/radiology/reading-comprehension/) - After my rant last week that radiology software companies need to spend the resources to actually involve radiologists in product creation, I got a great email from a large company who loved the article, asking if I could review their roadmap because they would "appreciate" my "perspective and feedback on where we are heading." They
- [Gell-Mann Amnesia](https://www.benwhite.com/reading/gell-mann-amnesia/) - Michael Crichton (famous novelist and never-practicing MD), describing the cognitive bias of “Gell-Mann Amnesia” in a 2002 speech (as included in How Not to Invest by Barry Ritholtz): You open the newspaper to an article on some subject you know well. You read the article and see the journalist has absolutely no understanding of either
- [Automatic Template Loading with Easy Delete](https://www.benwhite.com/radiology/automatic-template-loading-with-easy-delete/) - This isn't earth-shattering stuff, but I do think it's a tidy illustration of how a small, easy-to-make change with a relatively minimal amount of hassle can nonetheless reap a small but measurable benefit—and in the long term, meaningful time and energy savings. I appreciate/hope that this will all be irrelevant for radiologists very soon, but
- [Attitudes are skills](https://www.benwhite.com/misc/attitudes-are-skills/) - "Shame is a dream killer" and 64 other helpful short notes from Seth Godin.
- [The Business Half-Life](https://www.benwhite.com/misc/the-business-half-life/) - Morgan Housel, "Little Ways the World Works": Chamath Palihapitiya once noted that however fast your business grows, that’s the half-life for how quickly it can be destroyed. So many companies, flush with cheap money from previous years, are learning this right now. Every business and every industry has a natural growth rate – push beyond
- [Lumexa](https://www.benwhite.com/radiology/lumexa/) - Private equity radiology company US Radiology Specialists (USRS) is changing its name to Lumexa Imaging. Lumexa sounds like prescription eye drops or a new antidepressant. Or maybe an overseas manufacturer for flashlights on Amazon.
- [Strength to Strength](https://www.benwhite.com/reading/strength-to-strength/) - Regarding the nature of a "good job" vs/and/or a good career, the two different types of ancient Greek "happiness" as relayed by Arthur C. Brooks in From Strength to Strength: Hedonia is about feeling good; eudaimonia is about living a purpose-filled life. In truth, we need both. Hedonia without eudaimonia devolves into empty pleasure; eudaimonia
- [Revolution or Evolution](https://www.benwhite.com/radiology/revolution-or-evolution/) - A few weeks ago, I got to enjoy a pitch for another poorly conceived "revolutionary" radiology AI workflow and reporting tool. Tech people: Just bring on a radiologist CMO and a couple more to work on product. Stop cheaping out. Give them stock if you can’t pay, but these mostly suck and will continue to
- [Family Medicine Needs a Rethinking](https://www.benwhite.com/medicine/family-medicine-needs-a-rethinking/) - Another year of the NRMP match results, and Family Medicine continues to be a relentless slow-moving disaster within the house of medicine. 805 unfilled postions, only 28% filled by US MDs. Just 1,501 US MDs in the whole country matched to one of the most critical jobs in all of healthcare (1739 applied, but the
- [Should You Be Scared of the PE Sale Rug Pull?](https://www.benwhite.com/radiology/should-you-be-scared-of-the-pe-sale-rug-pull/) - It's job-hunting season, and I've received a variation of the following question several times this week alone: "How do I figure out if a practice I interview at might sell to private equity?" I appreciate the fear of joining a private practice only to have the rug pulled during the workup in a sale to
- [The Spectre of Automation Bias in Radiology](https://www.benwhite.com/radiology/the-spectre-of-automation-bias-in-radiology/) - In his 2023 book Decisions about Decisions, Harvard Law School professor Cass Sunstein offers this advice: Rather than concentrating on the probability of being right or wrong in a decision—which is often impossible to determine due to the intrinsic uncertainty and the unpredictability of the future—focus instead on comparing the cost of being wrong with
- [Why I Chose Privademics](https://www.benwhite.com/radiology/why-i-chose-privademics/) - When I was a fellow, my key metric when choosing my job was variety, not so much in terms of pathology or the pictures themselves but in the day-to-day. Variety helps me do one overarching critical thing for my professional satisfaction: optimize for enthusiasm. There are a lot of things I like about radiology and
- [Job Unpacking](https://www.benwhite.com/misc/job-unpacking/) - From Face it: you're a crazy person, about the importance of "unpacking" a job to understand your relationship to a potential career: High-status professions are the hardest ones to unpack because the upsides are obvious and appealing, while the downsides are often deliberately hidden and tolerable only to a tiny minority. [...] Making matters worse,
- [Notion for Organizing CME](https://www.benwhite.com/medicine/notion-for-organizing-cme/) - If you have ever dabbled in personal productivity or internet software, you may have heard of—or already be using—Notion. Notion is an incredibly powerful and sometimes complicated web software that allows you to create, essentially, a digital brain/personal database for just about anything. Many companies use Notion for literally everything, and there are certainly many
- [Giving and Taking in Radiology](https://www.benwhite.com/radiology/giving-and-taking-in-radiology/) - In Give and Take, Adam Grant divides people into three types: givers, takers, and matchers. Takers try to get more than they give. Matchers aim for even trades. Givers help without expectation. Grant argues that givers are both the most and the least successful (because people like givers, but they are also the easiest to
- [Dictation is a Superpower](https://www.benwhite.com/misc/dictation-is-a-superpower/) - Dictation is such a powerful skill. I strongly believe that writing is incredibly valuable, and in many ways, I feel that writing is how you really learn how you think. But speaking out loud has its own benefits—for figuring out what you want to say and practicing the skill of taking nebulous ideas and turning
- [The Fence](https://www.benwhite.com/medicine/the-fence/) - In The Thing (1929), G.K. Chesterton argued: In the matter of reforming things, as distinct from deforming them, there is one plain and simple principle; a principle which will probably be called a paradox. There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence
- [Moats against AI](https://www.benwhite.com/writing/moats-against-ai/) - Niko McCarty, writing about writing in the age of AI: “This is so boring. Why do you write like this?” The truth is that my past slew of academic and corporate jobs had neutered my ability to write evocatively and creatively. Up until that point, I had never really stood up for anything in public. Perhaps I
- [Spaceballs Returns](https://www.benwhite.com/misc/spaceballs-returns/) - After 40 years, Spaceballs is set to return. Mel Brooks, a national treasure, will, incredibly, be over 100 if it comes out in 2027 as planned. My son is overdue to see the original.
- [Oregon passes SB 951](https://www.benwhite.com/medicine/oregon-passes-sb-951/) - Oregon passed a law attempting to ban the corporate practice of medicine. It's probably not going to work? There are carveouts. It would still allow for private equity to use a puppet doctor to run the show equally poorly (already common practice). It doesn't address hospitals/health systems taking over the world, which often use the
- [Radiology Quality Police](https://www.benwhite.com/radiology/radiology-quality-police/) - What is quality care, and how do you define it? I suspect for most people that quality is like pornography in the classic Supreme Court sense—you know it when you see it. But quality is almost assuredly not viewed that way when zoomed out to look at care delivery in a broad, collective sense. Instead,
- [Mitigating Liminal Moments in Radiology](https://www.benwhite.com/radiology/mitigating-liminal-moments-in-radiology/) - It’s easy to measure radiologist productivity in terms of RVUs per hour. What’s harder to assess is how efficiently a radiologist reaches that production number—both cognitively and psychologically. I’ve written a lot about the biomechanical side of reducing friction in the radiology workflow: better input devices like programmable mice, off-hand keypads, and simple AutoHotkey scripts.
- [Obsolence rents](https://www.benwhite.com/misc/obsolence-rents/) - From Obsolescence Rents: Teamsters, Truckers, and Impending Innovations, published by the National Bureau of Economic Research: We consider large, permanent shocks to individual occupations whose arrival date is uncertain. We are motivated by the advent of self-driving trucks, which will dramatically reduce demand for truck drivers. Using a bare-bones overlapping generations model, we examine an
- [Black and White Thinking](https://www.benwhite.com/radiology/black-and-white-thinking/) - I made the mistake of procrastinating on something more meaningful by reading a variety of random commenters on issues related to radiology. One type of flawed thinking stuck out: the all-or-nothing fallacy. For example, as it pertains to artificial intelligence, the argument often goes, "AI will never replace a human in doing what I can
- [The (Internal) Effort RVU](https://www.benwhite.com/radiology/the-internal-ervu/) - Clinicians can bill, at least to an extent, to account for complexity. When a patient walks into a clinic for an annual physical, an acute upper respiratory tract infection, or an endless litany of chronic complaints including uncontrolled hypertension, diabetes, and hypercholesterolemia, and an acute complaint, their documentation and the codes they use can differ
- [June is DI Month](https://www.benwhite.com/finance/june-is-di-month/) - Trainees: It's never too early, but if you haven't looked into getting disability insurance yet, you should especially get some quotes in June before leaving your institution after finishing residency/fellowship. If you know where you'll be next month, a good agent will be able to compare your available institutional discounts from each location and make
- [Recent Radiology Market FAQs](https://www.benwhite.com/radiology/recent-radiology-market-faqs/) - I've been fielding job questions via email over the past months and after my talks at RSNA, ACR, and ASNR, so it seemed like the easy solution was to collect some responses here for dissemination (instead of trying to turn them into a bunch of separate posts). As always, no one has to agree with
- [Incidental Waste](https://www.benwhite.com/medicine/incidental-waste/) - From the intro article for a new series on aging, by Joe Nocera in the Free Press: Every six months for the last few years, I’ve been getting an MRI scan of my brain. There is a little dot in my left frontal lobe—"subcortical white matter," my chart says, that "may represent a chronic microhemorrhage
- [Sentiment Snapshots for Posterity](https://www.benwhite.com/radiology/sentiment-snapshots-for-posterity/) - A new small AI sentiment study, as summarized in Becker's: "Patients undergoing mammography preferred having their images interpreted by a radiologist before and after AI review." Having their imaging interpreted by AI alone was acceptable to 4.44% participants. Having their imaging interpreted by AI after radiologist interpretation was acceptable to 71% of participants. The finding
- [ASNR 2025](https://www.benwhite.com/radiology/asnr-2025/) - If you're at ASNR this year, I'm doing part of the session on Choosing & Navigating Your First Job tomorrow (Wednesday) at 1:15pm. Come say hi!
- [ABR at ACR](https://www.benwhite.com/radiology/abr-at-acr/) - I was at the ACR last weekend (giving a talk about the current radiology practice landscape) and had the chance to enjoy one of the American Board of Radiology's periodic update sessions, this time given by Executive Director Dr. Wagner (who, for the record, is a nice guy). There were several things that I would
- [Tiny signposts](https://www.benwhite.com/radiology/tiny-signposts/) - A Doximity “2024 recap” email reminded me that it was exactly one year ago today that I first wrote about job boards in radiology because of those misleading listings from RP. That’s what first got me thinking about doing something different with Independent Radiology (and the monthly jobs post). I’m glad it’s working so far
- [Scan by Scan](https://www.benwhite.com/radiology/scan-by-scan/) - I don’t think I was ever more uncertain about my chosen field than during the first couple of months of my R1 year. Coming off my intern year, I had gained in skill and responsibility, and I wouldn’t have been unhappy taking on a role as an internist during my PGY2 year. I didn’t read
- [Envision Quits Radiology, "Transitions" to RP](https://www.benwhite.com/radiology/envision-quits-radiology-transitions-to-rp/) - A struggling post-bankruptcy Envision was so desperate to get out of their radiology business---presumably due to the impossibility of recruiting/retaining, meeting clinical obligations, navigating the general tumult, etc.---that they have agreed to "transition" their remaining practices/contracts to RadPartners. Sounds like they already shed the salable groups/assets/non-competes, so this is most likely a final liability dump/hand-washing
- [Distraction and Control](https://www.benwhite.com/misc/distraction-and-control/) - We discussed "Choosing Rocks" earlier this year, and I wanted to return to Four Thousand Weeks again to discuss distraction and control. On the true nature of saying "no": Elizabeth Gilbert points out, it’s all too easy to assume that this merely entails finding the courage to decline various tedious things you never wanted to
- [Crowdsourced Advice for Being a Young Radiology Attending](https://www.benwhite.com/radiology/crowdsourced-advice-on-being-a-young-radiology-attending/) - When I was serving as chair of the Texas Radiological Society's Young Professional Section, I surveyed practicing radiologists about the transition between training and independent practice. This collection, along with other career advice, is collected on the YPS page of the TRS website. Here are some highlights from their advice: § On the Single Biggest
- [Rational Alchemy](https://www.benwhite.com/misc/rational-alchemy/) - From the excellent Alchemy: The Dark Art and Curious Science of Creating Magic in Brands, Business, and Life by Rory Sutherland: In theory, you can’t be too logical, but in practice, you can. Yet we never seem to believe that it is possible for logical solutions to fail. After all, if it makes sense, how
- [Choosing Rocks](https://www.benwhite.com/misc/choosing-rocks/) - There's a common first-things-first productivity parable of the rocks and the jar. It goes like this: Imagine you have an empty jar that represents your life, and you have different sizes of rocks that represent different priorities and commitments. The big rocks represent the most important things in life, like your family and health. Medium
- [A few docs talk about early career financial mistakes](https://www.benwhite.com/finance/a-few-docs-talk-about-early-career-financial-mistakes/) - A bunch of physician finance bloggers (and me) were asked to weigh in on early career financial mistakes for MDLinx's relatively new PhysicianSense blog. Everyone else said don't buy a house and don't try to beat the market. I largely agree with both of those sentiments. I'm not exactly a finance blogger, even though I write
- [Review: The Physician Philosopher's Guide to Personal Finance](https://www.benwhite.com/finance/review-the-physician-philosophers-guide-to-personal-finance/) - Back in May, I had the chance to sit down with The Physician Philosopher's Guide to Personal Finance: The 20% of Personal Finance Doctors Need to Know to Get 80% of the Results. The Pareto approach is a good conceit and is most of what people need. Real personal finance for most people is two
- [Effective Rates of Negatively Amortized Federal Student Loans](https://www.benwhite.com/finance/effective-rates-of-negatively-amortized-federal-student-loans/) - Excellent post from my internet friend Dr. Sotirios Keros over at Doctored Money (a great non-profit non-conflicted site on physician finance and student loans), "Your Federal Student Loan Interest Rate May Be Lower Than You Think": Federal students loans are unlike other types of debt in that the interest is not capitalized except in certain
- [See you at WCICON20](https://www.benwhite.com/finance/see-you-at-wcicon20/) - Registration for the 2020 Physician Wellness and Financial Literacy Conference (WCICON20) opened tonight. It takes place in Las Vegas from Thursday through Saturday, March 12-14th, and yours truly will be giving a talk on Friday about---you guessed it---student loans. Prepare: Mind Blown Explosion GIF from Mindblown GIFs
- [The Coming Changes to USMLE Scoring](https://www.benwhite.com/medicine/the-coming-changes-to-usmle-scoring/) - In March of this year, there was the InCUS: Invitational Conference on USMLE Scoring. The results page is here, and the summary report is here. Invitational? That means that the only people invited were stakeholders who are deeply entrenched in the status quo and/or directly profit from the USMLE system. Namely, the Association of American Medical
- [Teachers sue the Department of Education over PSLF](https://www.benwhite.com/finance/teachers-sue-the-department-of-education-over-pslf/) - Earlier this year the DOE mostly lost a lawsuit against the American Bar Association about PSLF. In that case, the government lost because it didn’t play by its own rules when it changed some complicated details about case-by-case employment approvals and then tried to inflict those changes retroactively on borrowers. It was pretty blatant and
- [FedLoans instructs borrowers to commit fraud](https://www.benwhite.com/finance/fedloans-instructs-borrowers-to-commit-fraud/) - I keep hearing of cases of FedLoan Servicing providing blatantly false and dangerously misleading advice to borrowers when it comes to submitting their annual income recertification. In fact, it’s so clearly wrong that I wondered if the people reporting it were simply mistaken or confused until I’d heard it repeated so many times. It concerns
- [The 2019 ABR Core Exam Results, the Board Prep Arms Race, and Where It All Went Wrong](https://www.benwhite.com/radiology/the-2019-abr-core-exam-results/) - On August 15, the ABR released the 2019 Core Exam results, which included the highest failure rate since the exam’s inception in 2013: 15.9%. (Side note: due to a “computer error,” the ABR decided to release the aggregate results before sharing individual results with trainees, resulting in entirely unnecessary extra anxiety. This itchy trigger finger
- [A Deep Dive into the Tax Returns of the American Board of Radiology](https://www.benwhite.com/radiology/a-deep-dive-into-the-tax-returns-of-the-american-board-of-radiology/) - With the class-action antitrust suit filed against the ABR earlier this year, a post looking deeper at the finances that make an appearance in the lawsuit is overdue. You can find the recent filings that I used for this post collected here. I promise this is a more interesting read than one might think. Background
- [Academic Medicine and the Peter Principle](https://www.benwhite.com/medicine/academic-medicine-and-the-peter-principle/) - Over four years of medical school, a one-year internship, a four-year radiology residency, a one-year neuroradiology fellowship, and now some time as an attending, one of my consistent takeaways has been how well (and thus how badly) the traditional academic hierarchy conforms to The Peter Principle. The Peter Principle, formulated by Laurence J Peter in
- [Dealing with Test Anxiety and Demoralization](https://www.benwhite.com/misc/dealing-with-test-anxiety-and-demoralization/) - For as long as I’ve been taking multiple choice question tests, I remember when I’d get a question wrong, a lot of the time I would say: Oh wait, that doesn’t count, I really knew that one. But the fact is that there’s more than one way to get a question wrong. Most people think
- [A Deep Dive into the Bylaws of the American Board of Radiology](https://www.benwhite.com/radiology/a-deep-dive-into-the-bylaws-of-the-american-board-of-radiology/) - In this post, we're diving deep into the bylaws of the American Board of Radiology and picking out some choice quotations for perusal and discussion. Consider this part two of a two-part series (with the first being this enjoyable breakdown of the ABR's tax returns). You can download a word document of the ABR's Bylaws
- [When Danger is Only Online](https://www.benwhite.com/misc/when-danger-is-only-online/) - Jonathan Haidt, author of The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure, in an interview for Next Big Ideal Club: Back in the 1990s, the Cold War was over, the fear of nuclear war was gone, the [United States] ran a surplus, the crime
- [Pass/Fail Step 1: Initial Thoughts](https://www.benwhite.com/medicine/pass-fail-step-1-initial-thoughts/) - I was going to write a lengthy post, but then my medical education spirit animal Bryan Carmody did and said most of what I have time to say at the moment better than I would have anyway. Take the time to read it: USMLE Pass/Fail: A Brave New Day. He's created an impressive collection of
- [Moral Humility & The Ethical Career](https://www.benwhite.com/misc/moral-humility-and-the-ethical-career/) - From Maryam Kouchaki and Isaac H. Smith's "Building an Ethical Career" So how can you ensure that from day to day and decade to decade you will do the right thing in your professional life? The first step requires shifting to a mindset we term moral humility—the recognition that we all have the capacity to transgress
- [Student Loans & The CARES Act](https://www.benwhite.com/finance/student-loans-the-cares-act/) - The new CARES act pauses student loans for six months without interest. A few important facts: This is a pause (administrative forbearance) until September 30, not a typical forbearance. No capitalization will occur. You don't need to do anything. It's automatic for those currently in IDR. These $0 "payments" count for PSLF and long-term IDR
- [Stockdale’s Reality Confrontation](https://www.benwhite.com/misc/the-stockdale-paradox/) - Jim Collins, quoting Admiral Jim Stockdale, who called spending seven years in a Vietnamese prison camp "the defining event of my life that would make me a stronger and better person." This is what I learned from those years in the prison camp, where all those constraints just were oppressive. You must never ever ever
- [The ABR's New "Agreements"](https://www.benwhite.com/radiology/new-abr-agreements/) - Update: Two days after this post was written, the ABR announced they were essentially following the recommendations at the bottom of this post including removing all the problematic language from the agreement and extending a new less onerous version to all diplomates, including those who had already signed the version I've outlined below. I have
- [It's Time to Disseminate the ABR Core Exam](https://www.benwhite.com/radiology/its-time-to-disseminate-the-abr-core-exam/) - The Coronavirus pandemic has forced us to confront the status quo in many walks for life, and there is no doubt that many things will no longer be the same even once it has passed, remote work among them. The topic of this post is undeniably small fries given the breadth and severity of the
- [The ABR and the Practicability of Doing Its Job](https://www.benwhite.com/radiology/the-abr-and-the-practicability-of-doing-its-job/) - Yesterday, the American Board of Radiology announced in an email blast that it was canceling the planned in-person administrations of the Core and Certifying Exams and postponing until an unspecified time in 2021. I wasn’t the only person to tell the ABR that its November in-person exam plan was---from its inception---magical thinking. So on one
- [Review: Orbit CME](https://www.benwhite.com/medicine/review-orbit-cme/) - It was always a good idea, but in this new world where conferences and live events are canceled for the foreseeable future, Orbit CME is a great idea. (I previously got temporary free access to Orbit for the purposes of writing this review over a year ago, and I’ve got the usual reader discount affiliate
- [The Trajectory of American Education](https://www.benwhite.com/misc/the-trajectory-of-american-education/) - From "Our Educational Colonialism" by Chris Arnade: Yet it is the kids sitting in middle row I have the deepest sympathy for because they are the most harmed, and the ones you hear the least about. They are mostly working class kids who don’t really fit into the back row because they are very disciplined,
- [The Cost, Price, and Debt of Medical Education](https://www.benwhite.com/medicine/the-cost-price-and-debt-of-medical-education/) - From "The Cost, Price, and Debt of Medical Education" in NEJM. In the 1960s, 4 years of U.S. medical education could be purchased for about $40,000 (in 2018 dollars). By 2018, the average price had increased by 750%, to about $300,000; approximately 75% of students took on loans, and their average debt at graduation was
- [Buying Disability Insurance As a Medical Student](https://www.benwhite.com/medicine/buying-disability-insurance-as-a-medical-student/) - Let's start by saying that I'm certainly not the only person on the internet that thinks it's critical for all doctors to buy true own-occupation disability insurance that protects you in the event that you become disabled and can't earn your full income. Your earning potential is too high and school is too expensive to
- [A brief interview (about my Free 120 explanations)](https://www.benwhite.com/misc/a-brief-interview-about-my-free-120-explanations/) - I did a brief interview with the folks at Elite Medical Prep about my Free 120 explanations ages ago that went live today. I can't believe I've been writing up explanations for the NBME practice materials for so long, but, well, I guess I have.
- [Lessons from the American Board of Surgery's Virtual Board Exam Debacle](https://www.benwhite.com/medicine/lessons-from-the-american-board-of-surgerys-virtual-board-exam-debacle/) - Lesson 1: Beware Third Party Services During the slow drama that has been the delivery of high-stakes during the pandemic, some organizations like the American Board of Radiology resisted agreeing to a virtual exam for so long precisely because they couldn't control the environment, delivery, and security. Unfortunately, we have some great evidence that offloading
- [Recalls and Exam Security](https://www.benwhite.com/medicine/recalls-and-exam-security/) - Out of all the reasons organizations like (but not limited to) the ABR have used as an excuse to shy away from remote content or historically relied on commercial testing centers, I strongly suspect exam security is the only one that actually matters. While an individual not cheating on the exam is important for exam
- [The Power of Pausing](https://www.benwhite.com/misc/vivek-murthy-and-the-power-of-pausing/) - Solitude on its own won’t give us knowledge and compassion—it depends how we use that time with ourselves. But it gives us the opportunity to listen to ourselves, to hear the ideas, inspiration, feelings, and reactions that arise, and hopefully to approach what arises with kindness and compassion even when the thoughts that come up
- [Frozen Meat: A New Standard for COVID-19 Research](https://www.benwhite.com/misc/frozen-meat-a-new-standard-for-covid-19-research/) - As a physician, I mostly read medical journals. I also occasionally read economics and psychology literature, usually because they are frequently cited in popular books for laypersons. But I don't normally read business or communications literature. That is until I saw this paper about frozen meat company Steak-umm's surprisingly awesome Twitter account: https://twitter.com/benwhitemd/status/1307012316442120196?s=20 The title
- [Anger and Outrage: Features, Not Bugs](https://www.benwhite.com/misc/anger-and-outrage-features-not-bugs/) - From Cal Newport's Digital Minimalism: Choosing a Focused Life in a Noisy World: The techno-philosopher Jaron Lanier convincingly argues that the primacy of anger and outrage online is, in some sense, an unavoidable feature of the medium: In an open marketplace for attention, darker emotions attract more eyeballs than positive and constructive thoughts. For heavy
- [When "value" became shorthand for "economic worth"](https://www.benwhite.com/reading/when-value-became-shorthand-for-economic-worth/) - From Doughnut Economics: Seven Ways to Think Like a 21st-Century Economist by Kate Raworth (emphasis mine): Despite such misgivings from the twentieth century’s two most influential economists, the dominance of the economist’s perspective on the world has only spread, even into the language of public life. In hospitals and clinics worldwide, patients and doctors have
- [Simple Sabotage](https://www.benwhite.com/misc/simple-sabotage/) - Simple Sabotage: A Modern Field Manual for Detecting and Rooting Out Everyday Behaviors That Undermine Your Workplace is a book inspired by a real World War II CIA field manual called "Simple Sabotage" that was written to help "guide ordinary citizens, who may not have agreed with their country’s wartime policies towards the US, to destabilize
- [Bigger isn't always better](https://www.benwhite.com/reading/bigger-isnt-always-better/) - From Company of One: Why Staying Small Is the Next Big Thing for Business by Paul Jarvis: I like reading things that are not about medicine and seeing what lessons cross domains and apply. The premise of Jarvis' book is that growth for growth's sake is a terrible business model for many businesses and especially the
- [How the ABR's MOC OLA scoring works](https://www.benwhite.com/radiology/how-the-abrs-moc-ola-scoring-works/) - I've been talking to the ABR for a bit recently about OLA scoring. I've made no secret about my opinions on the actual content of the ABR's 52-question-per-year MOC qbank and the likelihood of its ability to ensure anything meaningful about a radiologist's ability to practice. But I've been especially interested in how OLA is
- [Pedigree is a poor proxy for quality](https://www.benwhite.com/misc/pedigree-is-a-poor-proxy-for-quality/) - From "Graduates of Elite Universities Get Paid More. Do They Perform Better?" an article published in the Harvard Business Review about comparing the "performance" of graduates from elite and non-elite universities: All in all, our results suggest that hiring graduates from higher-ranked universities would lead to a nominal improvement in performance. However, the university rank
- [1980 or 2020?](https://www.benwhite.com/misc/1980-or-2020/) - There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that “my ignorance is just as good as your knowledge.” --Isaac Asimov, in his
- [Some Practical Thoughts on the Virtual Interview Season](https://www.benwhite.com/medicine/some-practical-thoughts-on-the-virtual-interview-season/) - I’ve done enough Zoom nonsense since March that I thought I’d put down a few thoughts on optimizing your setup during the remaining interview season. This situation is garbage, and while I’m thrilled that this year’s students won’t have to shoulder the typical fourth-year travel costs, I don’t envy anyone’s decision-making process. Programs can feel
- [The AAMC on Interview Hoarding](https://www.benwhite.com/medicine/the-aamc-on-interview-hoarding/) - The AAMC recently released an open letter sounding the alarm bells on how the residency interview season is shaping up this year: We are seeing students in the highest tier receiving a larger number of interviews per person than in past years, leaving other students – including those in the middle of the class –
- [Carving out a Creative Routine](https://www.benwhite.com/writing/carving-out-a-creative-routine/) - From Keep Going: 10 Ways to Stay Creative in Good Times and Bad by Austin Kleon: In his book Daily Rituals, Mason Currey catalogs the daily routines of 161 creative individuals: when they woke up, when they worked, what they ate, what they drank, how they procrastinated, and more. It’s a wild collage of human
- [Most States Don't Actually Require COMLEX Exams](https://www.benwhite.com/medicine/most-states-dont-actually-require-comlex-exams/) - Update 2/11/2020: The NBOME cancelled indefinitely postponed COMLEX Level 2-PE. Not sure why they needed the extra shame of waiting two weeks to cave to reality. Here's the refund waiver link for students who already paid. On the heels of this week's USMLE Step 2 CS cancellation and the immediate bold non-cancellation of the COMLEX Level
- [Choosing the Best Solo 401k](https://www.benwhite.com/finance/choosing-the-best-solo-401k/) - What’s a Solo 401k? A Solo 401k, officially known as an Individual 401k, is a 401k retirement account available to businesses with no employees (other than the owner or the owner's spouse). It is the most common retirement used by the self-employed. Of note for someone like me, who runs a very small writing and
- [The ABR's virtual Core Exam worked](https://www.benwhite.com/radiology/the-abrs-virtual-core-exam-worked/) - Last year as the pandemic spiraled out of control, the ABR resisted---as they have for years---calls for disseminated exams away from their centers in Chicago and Tuscon. The lack of a foreseeable endpoint and pressure from advocates was finally enough for the ABR to make the switch. And to their credit, when the ABR came
- [Explanations for the 2020 Official Step 3 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2020-official-step-3-practice-questions/) - Here are my explanations for the November 2020 update of the official practice materials. My explanations for the 2018/2019 set are here. The one before that, which I explained here, was revised in November 2017. The asterisks (*) signify one of the 71 new questions. You can find my thoughts on preparing for Step 3
- [Physics is now just another Core Exam section](https://www.benwhite.com/radiology/physics-is-now-just-another-core-exam-section/) - Probably the biggest news in radiology over the past year (at least for residents) was the announcement that the upcoming and all future ABR examinations were moving to an online remote/virtual format. That's worked out pretty well so far. One bit of nice unexpected news that was announced very quietly this week was that the
- [A Chance for Meaningful Parental Leave During Residency](https://www.benwhite.com/medicine/a-chance-for-meaningful-parental-leave-during-residency/) - Last year, the ABMS---the umbrella consortium of medical specialties---waded into the established toxic mess of medical training schedules with a new mandate to provide trainees with a nonpunitive way to be parents, caretakers, or just sick: Starting in July 2021, all ABMS Member Boards with training programs of two or more years duration will allow for a
- [Organization Habit Loops](https://www.benwhite.com/reading/organization-habit-loops/) - From Charles Duhigg's The Power of Habit: Why We Do What We Do in Life and Business: That’s when [Alcoa CEO Paul] O’Neill’s education in organizational habits really started. One of his first assignments was to create an analytical framework for studying how the government was spending money on health care. He quickly figured out
- [Attending](https://www.benwhite.com/medicine/attending/) - A few separate passages I've combined from Dr. Ronald Epstein's Attending: Medicine, Mindfulness, and Humanity: Altogether, I saw too much harshness, mindlessness, and inhumanity. Medical school was dominated by facts, pathways, and mechanisms; residency was about learning to diagnose, treat, and do procedures, framed by a pit-of-the-stomach dread that you might kill someone by missing
- [Scheduling Slack](https://www.benwhite.com/medicine/scheduling-slack/) - From Alan's Weiss' classic Getting Started in Consulting: Medical consultants advise doctors never to schedule wall-to-wall appointments during the day, because inevitably there are emergencies, late patients, complications on routine exams, and so forth. These create a domino effect by day’s end, and some very unhappy scheduled patients. Instead, they advise some built-in slack time
- [Underwriting is Noisy](https://www.benwhite.com/misc/underwriting-is-noisy/) - An example a brief essay "Bias Is a Big Problem. But So Is ‘Noise." about noise and decision-making in the NYT by Daniel Kahneman and his co-authors in support of their new book Noise: A Flaw in Human Judgement: Consider another noisy system, this time in the private sector. In 2015, we conducted a study
- [Price Transparency and the True Cost of Quality Healthcare](https://www.benwhite.com/medicine/price-transparency-and-the-true-cost-of-quality-healthcare/) - When you read healthcare reviews online, so many of the 1-star reviews relate to prices: patients frustrated by high costs or surprised by high bills. It's easy to think that price transparency rules will help. One key problem is that healthcare consumers are intermittently if not completely insulated from the true costs of their care
- [Being "Backable" for Residency Interviews](https://www.benwhite.com/medicine/being-backable-for-residency-interviews/) - After reading stories of match success and failure on social media this spring, I'm already thinking about another set of virtual interviews this fall and contemplating how applicants can shine. Here are some takeaways from Backable: The Surprising Truth Behind What Makes People Take a Chance on You. While this book and its many examples
- [Equity, Organized Medicine, and the Radiology Value Chain](https://www.benwhite.com/medicine/equity-organized-medicine-and-the-radiology-value-chain/) - It’s often said that large organizations are difficult to steer and slow to change course, but that’s only part of why they sometimes act in seemingly inexplicable ways. There’s another more insidious reason, and that is conflicts of interest, not just within leadership but also in the changing demographics of the membership. A passage from
- [The Stress Heuristic](https://www.benwhite.com/misc/the-stress-heuristic/) - Cal Newport, author of the beloved Deep Work (among others), writing in The New Yorker. ...most workers who are fortunate enough to exert some control over their efforts—such as knowledge workers and small-business entrepreneurs—tend to avoid working way too much, but also tend to avoid working a reasonable amount. They instead exist in a liminal
- [Driving at Stable](https://www.benwhite.com/misc/driving-at-stable/) - A classic Jeff Bezos quotation: I very frequently get the question: “What’s going to change in the next 10 years?” That’s a very interesting question. I almost never get the question: “What’s not going to change in the next 10 years?” And I submit to you that that second question is actually the more important
- [The ABR is Sorta Changing Its Fees](https://www.benwhite.com/radiology/the-abr-is-kinda-sorta-changing-its-fees/) - In recent years, the American Board of Radiology (ABR) has utilized a membership fee model, where---for example---those working towards an initial certification in diagnostic radiology would pay a $640 annual fee until passing the Certifying Exam. Since one takes the Certifying Exam 15 months after finishing residency, that has meant recent diplomates have paid a
- [A Glimpse at the Coming Metaverse](https://www.benwhite.com/misc/a-glimpse-at-the-coming-metaverse/) - Ben Thompson of Stratechery talking about why he's becoming more bullish on virtual reality than augmented reality during an interview with Mark Zuckerberg about the Metaverse: I do have to say, the last couple of years, particularly the COVID era, has changed my perspective a little bit as there does seem to be more and
- [Review: Sulcus Neuroradiology CAQ Prep](https://www.benwhite.com/reviews/sulcus-neuroradiology-caq-prep/) - The neuroradiology subspecialty exam (aka the CAQ or certificate of added qualification) is a tedious, basically redundant, and expensive waste of time taken by a relatively small number of people every year. As a result, there are very few dedicated recourses. In fact, there is only one, and it's Sulcus. Based on an informal survey
- [The ABR Online Testing Experience](https://www.benwhite.com/radiology/the-abr-online-testing-experience/) - When I finally got around to taking the Neuroradiology CAQ Exam this fall, I finally had the pleasure of partaking in the ABR's remote testing platform. I put a lot of work into my posts about the Core and Certifying Exams back in the day, but they do hail from the pre-pandemic era. Here are
- [All About the Neuroradiology CAQ](https://www.benwhite.com/radiology/neuroradiology-caq-exam/) - The CAQ exams are likely the least discussed and widely known facet of radiology certification. Until now. Background The CAQ---or, Certificate of Added Qualification---is something most radiology residents and other doctors don't even know about. It's an extra subspecialty certification you get by giving the American Board of Radiology (ABR) a bunch of money and
- [What I Read in 2021](https://www.benwhite.com/reading/what-i-read-in-2021/) - It turns out that this was the eighth year that I've kept track of at least the book-reading fraction of my entertainment consumption. It's a practice I encourage, especially if you can jot down a few notes to yourself about your thoughts afterward (I read most of my nonfiction on my Kindle because of the
- [Atomic Habits](https://www.benwhite.com/reading/atomic-habits/) - Atomic Habits was apparently the very best-selling book of 2021. I don't re-read books often, but James Clear's entry is short and tactical, and it makes for a nice "get your head in the game" reset prior to a new effort (such as new year's resolutions if that's something you typically enjoy planning and then
- [The Private Equity Model in Medicine is Flawed](https://www.benwhite.com/medicine/the-private-equity-model-in-medicine-is-flawed/) - It can be hard for trainees in the job market to make sense of the current state of affairs. Everyone knows private equity companies have been gobbling up practices around the country in an ever-consolidating market, but the implications of this trend are another matter entirely. Most people willing to talk openly about private equity
- [The ABR Lawsuit Continues](https://www.benwhite.com/radiology/the-abr-lawsuit-continues/) - I thought after the last dismissal that the class-action lawsuit against the American Board of Radiology had died, but it continues. Last week on February 16th, the "Court Of Appeals 7th Circuit" on YouTube (1.1k subscribers, in case you're curious) streamed a brief 20-minute back-and-forth between the lawyers and the appeals court judges. You can
- [The COVID-related PSLF boon continues](https://www.benwhite.com/medicine/the-covid-related-pslf-boon-continues/) - You probably know by now that the pandemic student loan payment pause was officially extended through Aug 31, 2022. Given midterm elections in November, I suspect there will be one more round of good news announced this summer and payments won't actually start until---for example---January 1. So that 0% rate continues to save people lots
- [The Truth about Private Equity and Radiology with Dr. Kurt Schoppe](https://www.benwhite.com/medicine/the-truth-about-private-equity-and-radiology-with-dr-kurt-schoppe/) - Have you ever talked to someone above you on the food chain—usually with the word manager, director, or Vice President somewhere in their job title—and after they depart, you just stared blankly into the distance while slowly shaking your head thinking, Wow, they really don’t get it. What a useless bag of skin? Well, that’s
- [You Should Be Correlating Clinically](https://www.benwhite.com/radiology/you-should-be-correlating-clinically/) - While I generally like to stay away from absolutely prescriptive advice, I think most radiologists would agree that the specific phrase "correlate clinically" is basically a microaggression against clinicians. It’s a triggering common joke that automatically lowers your work in the eyes of the reader. If somebody must correlate, then they should be told what
- [It's Always Your Fault](https://www.benwhite.com/misc/its-always-your-fault/) - I came across this brief article ("It's Always Your Fault") from 2016 by DHH, who---among other things---was the creator of the web application framework Ruby on Rails and co-founder of Basecamp/37Signals: There’s a system in place that caused this to happen, and you’re part of that system. Shit never happens in a vacuum. The vast
- [Joining and Leaving Private Equity: A Radiologist's Story](https://www.benwhite.com/radiology/joining-and-leaving-private-equity-a-radiologists-story/) - Previously in the PE series, we spoke with someone who joined a practice that had previously been purchased (before eventually leaving). In this entry, we're hearing from someone who joined an independent practice and was an associate in the work-up when the group sold. Just like last time, I’ve sanitized names and some details. This case
- [Perceptions of Radiology MOC](https://www.benwhite.com/radiology/perceptions-of-radiology-moc/) - In August, the results of a large ACR survey about radiologists' opinions concerning MOC were released. The summary: Similar proportions judged the existing program as excellent or very good (36%), or fair or poor (35%), with 27% neutral. MOC–CC was perceived more often as excellent or very good by those who were grandfathered yet still
- [Explanations for the 2022 Official Step 3 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2022-official-step-3-practice-questions/) - Here are my explanations for the August 2022 update of the official practice materials. (As of 2024, the PDF of these questions is no longer available, but the 2020 set is still archived and nearly identical to the 2022 PDF.) The asterisks (*) signify one of the only two new questions compared with the prior
- [Improving my Figs](https://www.benwhite.com/medicine/improving-my-figs/) - I finally broke down and bought a pair of Figs so I could try to fit in with the young folk. But I had to do a little surgery with my seam ripper: Just because I want to pretend I can pull off squeezing into some joggers doesn’t mean I want four(!) separate branding labels
- [Hindsight in the Valley of the Normal](https://www.benwhite.com/misc/hindsight-in-the-valley-of-the-normal/) - From Nobel-laureate Daniel Kahneman's Noise: A Flaw in Human Judgement: More broadly, our sense of understanding the world depends on our extraordinary ability to construct narratives that explain the events we observe. The search for causes is almost always successful because causes can be drawn from an unlimited reservoir of facts and beliefs about the world.
- [Writing "Content"](https://www.benwhite.com/writing/writing-content/) - I've been writing online ("blogging", cringe) for over 14 years now, and there can be a sometimes strange (and strained) relationship between writing-as-service and writing-as-expression. I've mostly written whatever I want, or at least whatever I thought had two or three of this magic combination: interesting to me would be helpful to other people either
- [Noise in Medicine](https://www.benwhite.com/medicine/noise-in-medicine/) - Some medical takeaways from Nobel-laureate Daniel Kahneman’s Noise: A Flaw in Human Judgement: The large role of noise in error contradicts a commonly held belief that random errors do not matter, because they “cancel out.” This belief is wrong. If multiple shots are scattered around the target, it is unhelpful to say that, on average, they
- [Approaching the Private Equity Job Offer](https://www.benwhite.com/medicine/approaching-the-private-equity-job-offer/) - Here are some thoughts from a seasoned radiologist who was there for the sale and just bailed from an unhealthy private equity-owned radiology practice. They’ve seen many trainees filter through the recruitment process recently as the group aggressively recruits to combat attrition, and they reached out with some brief advice on how to approach the
- [The Negativity Tendency](https://www.benwhite.com/medicine/the-negativity-tendency/) - The late Hans Rosling gave an amazingly popular TED talk back in 2006 (and many other popular talks since). You may have seen it. It’s the one showing recent human progress by following counties over time as a series of bubbles. It’s not all rosy, but it shows us how counterintuitive reality can be compared
- [CFE 2023](https://www.benwhite.com/medicine/cfe-2023/) - The online course version of WCICON23, "Continuing Financial Education 2023: The Latest in Physician Wellness and Financial Literacy" is now available. It includes 55 hours of content and qualifies for 22 hours of CME. It also includes a talk from yours truly on the surprisingly interesting topic of thinking about thinking. Enrollment is $100 off
- [The Sin of Monotony](https://www.benwhite.com/misc/the-sin-of-monotony/) - Delightful: Monotony, the cardinal and most common sin of the public speaker, is not a transgression—it is rather a sin of omission, for it consists in living up to the confession of the Prayer Book: "We have left undone those things we ought to have done." Emerson says, "The virtue of art lies in detachment,
- [United against Radiology Partners](https://www.benwhite.com/radiology/united-against-radiology-partners/) - Update 10/24/2023: The case went to arbitration this fall, and the panel has initially ruled in favor of RP. United is going to fight this, and there are still outstanding counterclaims from United against RP. From the Radiology Business article: “We do not agree that Singleton will recover an award from UnitedHealthcare,” the Minnetonka, Minnesota,
- [Backwards to the Future: The Return of the Radiology Oral Boards](https://www.benwhite.com/radiology/backwards-to-the-future-the-return-of-the-radiology-oral-boards/) - Earlier this year at the Texas Radiological Society annual meeting, I attended an ABR update given by current ABR president, Bob Barr, where he announced the rapid progress of the ABR’s plan to revitalize the Certifying Exam to address widespread discontent. I wrote about it here. The plan was to announce the change no later
- [The Radiologist Shortage is Here](https://www.benwhite.com/radiology/the-coming-radiologist-shortage-is-here/) - It should go without saying, but I’ll say it anyway: these are my opinions, formed from the combination of my biases, my experience as a radiologist since beginning residency 10 years ago, and my many conversations with radiologists across the country. You don't have to agree with me. Not Enough and No Help Coming For
- [Unofficially Official ABR Core Exam Practice Questions](https://www.benwhite.com/radiology/unofficially-official-abr-core-exam-practice-questions/) - Years ago, when I was a resident and the ABR Core Exam was still novel, the ABR offered a lengthy "ABR CORE Examination Study Guide" PDF, which---in addition to over a hundred pages of endless bullet points listing every conceivable topic in radiology---included 57 official practice questions at the end (with an answer key). They
- [Prompting Equity](https://www.benwhite.com/misc/prompting-equity/) - People have really enjoyed asking the current generation of large language models (LLMs) like ChatGPT about AI: a sort of overly on-the-nose meta-discussion. Reid Hoffman, co-founder of LinkedIn and techno-optimist/evangelist, co-wrote a free book about AI with GPT-4 called Impromptu: Amplifying our Humanity Through AI. In a late chapter, Hoffman makes an argument that modern
- [Envision: A Very, Very Big Private Equity Bankruptcy](https://www.benwhite.com/medicine/envision-a-very-very-big-private-equity-bankruptcy/) - It took a few years before it finally got there, but massive private equity-owned physician staffing company Envision finally filed for Chapter 11 bankruptcy this week. The harbinger of the coming wave of PE defaults, bankruptcies, distressed exchanges, and other failures has fully arrived. Make no mistake, this is just the beginning. There are people
- [Ultralearning Radiology](https://www.benwhite.com/radiology/ultralearning-radiology/) - The science of learning has become a lot more popular over the past few years than when I was a student. Contemporary medical students utilize spaced repetition algorithms for their Anki flashcard decks, enjoy high-quality question banks, watch videos at 2x speed, and drill with picture-based mnemonic tools like Sketchy Medical. These techniques have minimal
- [Flipped Classrooms Shouldn't Save Medical School](https://www.benwhite.com/medicine/flipped-classrooms-shouldnt-save-medical-school/) - Here's a passage from another op-ed about the reality that conventional preclinical medical education isn't really working, titled: "Medical students aren't showing up to class. What does that mean for future docs?" We believe the immediate next step for preclerkship medical science medical education is clear. A flipped classroom, and thus an increased role for
- [SAVE is the New REPAYE](https://www.benwhite.com/finance/save-is-the-new-repaye/) - The Biden student loan forgiveness plan was blocked by the Supreme Court, but the new repayment changes are currently (and will likely stay) alive and well. The "New REPAYE" plan has been rebranded: SAVE ("Saving on a Valuable Education," in case you were wondering). Here are the take-home points, mostly courtesy of this brand new
- [Do I Need to Do a Radiology Fellowship?](https://www.benwhite.com/radiology/do-i-need-to-do-a-radiology-fellowship/) - A few years ago, nearly every radiologist completed a fellowship. It wasn't so long ago that the job market was so tight there was a real concern that doing two back-to-back fellowships was going to become the norm. Oh, how times have changed. Recently I've been asked by several readers if I thought that fellowships
- [Is Radiology Still a Viable Career?](https://www.benwhite.com/radiology/is-radiology-still-a-viable-career/) - Radiology is as popular as ever with medical students and enjoyed a very competitive and completely-filled match last year. But I also know that students and residents---because they keep asking---are wondering: Given ChatGPT and other recent seemingly rapid advances in AI, is radiology still a viable career choice? Yes, I think it is still viable.
- [AutoHotkey for Radiology](https://www.benwhite.com/radiology/autohotkey-for-radiology/) - AutoHotkey is powerful free software you can use to control your computer and generate simple (or complex) macros to automate tedious or repetitive tasks. For radiology, I consider the most important ability AHK enables is true hands-free dictation. Ultimately, you can go crazy with this power, and it only takes a few minutes to learn
- [The Feigned Complexity of Simple Things](https://www.benwhite.com/medicine/the-feigned-complexity-of-simple-things/) - From Humankind: A Hopeful History by Rutger Bregman: That’s right, Buurtzorg [a nurse-led home healthcare organization] is better for patients, nicer for employees and cheaper for taxpayers. A win-win-win situation. Meanwhile, the organisation continues to grow. Every month, dozens of nurses leave other jobs to sign on with Buurtzorg. And no wonder: it gives them
- [Radiology Partners Enters the Lending Business](https://www.benwhite.com/radiology/radiology-partners-enters-the-lending-business/) - Update 1/11/2024: The specific practice loan that I referenced as giving rise to this post began earlier in 2023, and this post was months in finalizing. I'd originally intended to publish it in the summer. Since publishing, I've since learned that RP's extra support has briefly paused. That's right, at least for a month or
- [The Little White Lies of Radiology Partners](https://www.benwhite.com/radiology/the-little-white-lies-of-radiology-partners/) - The American College of Radiology runs a large and presumably quite profitable job forum. (I believe they outsource its management to a third-party company, but it's on their website, and their branding is all over it.) And I'm sure the ACR doesn't want to police the content of that job forum, if nothing else because
- [Using the Zelotes C18 for Radiology](https://www.benwhite.com/radiology/using-the-zelotes-c18-for-radiology/) - The Zelotes C18 (aka TRELC Gaming Mouse with 5D Rocker aka ZLOT Vertical Mouse) is a solid very inexpensive productivity and ergonomics upgrade. If you've never used a mouse other than whatever's plugged into the computer already, this currently sells for just $29. It's probably the best way to trial a vertical mouse for radiology
- [Prenuvo: The Turtle Catcher](https://www.benwhite.com/medicine/prenuvo-the-turtle-catcher/) - Excellent piece on Prenuvo's whole body scans by Dr. Dhruv Khullar in The New Yorker: Doctors sometimes use a barnyard analogy to talk about the vast differences between cancers. A tumor can be a turtle, a bird, or a rabbit, depending on its speed and ability to escape; the goal of screening and treatment is
- [United is Still Fighting Radiology Partners](https://www.benwhite.com/radiology/united-is-still-fighting-radiology-partners/) - As you might recall, UnitedHealthcare sued Radiology Partners in April 2023 for an alleged pass-through billing scheme during an ongoing arbitration process about underpayment initiated by RP's subsidiary group Singleton Associates in April 2022. RP called shenanigans. The judge made them fold that complaint into the ongoing arbitration process, in which there are currently three
- [Radiology Partners and a "Comprehensive Set of Financing Transactions"](https://www.benwhite.com/radiology/radiology-partners-and-a-comprehensive-set-of-financing-transactions/) - Last week, Radiology Partners released an announcement that it was "commencing a comprehensive set of financing transactions to strengthen its financial position." Setting the Stage Going into 2024, RP was already cashflow negative (i.e. losing money) to say nothing of the massive debt payments due this year and next. For a reminder of what was
- [Productivity is a Trap](https://www.benwhite.com/reading/productivity-is-a-trap/) - A little over a year ago, I found Oliver Burkeman's Four Thousand Weeks: Time Management for Mortals to be one of the most excerpt-able books I'd read in a while. In it, Burkeman describes cosmic insignificance theory, the perhaps counterintuitive argument that I would summarize as, "You really don't matter very much in the grand
- ["A fearless adventure in knowing what to do when no one’s there telling you what to do"](https://www.benwhite.com/misc/a-fearless-adventure-in-knowing-what-to-do/) - The gaming company Valve started in 1996, became initially successful with the award-winning game Half-Life, even more famous for the early multiplayer mods/games Team Fortress and Counter-Strike, expanded to change videogame distribution with the Steam store/platform, made the innovative/beloved genre-bending puzzle shooter Portal, and even recently released the powerful handheld gaming device, the Steam Deck.
- [Luminello Sold to SimplePractice and Now Everything Sucks](https://www.benwhite.com/medicine/luminello-sold-to-simplepractice-and-now-everything-sucks/) - Private Equity came for my wife's psychiatric private practice EHR, Luminello. Luminello sold to SimplePractice, which is owned by EngageSmart, which is owned by Vista Equity Partners Management. From the press release: “Both SimplePractice and Luminello were founded by clinicians looking to simplify the business of running an independent solo or small group mental health
- [Growing as a New Radiology Attending](https://www.benwhite.com/radiology/growing-as-a-new-attending/) - When you first get into practice and really want to make a good early impression, you’re going to make some mistakes, and some of them are going to be pretty boneheaded. Everyone has holes in their knowledge, and there are almost certainly things that you should know that you somehow don’t. Depending on your practice---and
- [The Government Wants Your Input on Consolidation in Healthcare](https://www.benwhite.com/medicine/the-government-wants-your-input-on-consolidation-in-healthcare/) - The US government---specifically the Department of Justice, Department of Health and Human Services, and the Federal Trade Commission---is asking for public input about consolidation in healthcare. A summary quote from FTC Chair Lina Khan from an article in the WSJ: FTC Chair Lina Khan said that while some private-equity investment could be beneficial, too many buyout
- [Post-match Life Research](https://www.benwhite.com/medicine/post-match-life-research/) - Post-match fourth year is a great usually "less-stressful" time to get your required education in personal finance. My free book is a nice, readable, and to-the-point primer on the essentials of personal finance including student loans. Read (or download it) here. Note that the new SAVE plan has simplified the student loan part for the
- [Dealing with a USMLE Failure](https://www.benwhite.com/medicine/dealing-with-a-usmle-failure/) - This post is for anyone who is lost and dejected after failing one of the Step exams. § First, I’m sorry that you’re going through this. The path to becoming a doctor is long and hard, but there’s something unique about high-stakes testing that adds stress and uncertainty. I know this may sound a little
- [FTC Attempts to Ban Noncompetes](https://www.benwhite.com/misc/ftc-attempts-to-ban-noncompetes/) - Yesterday, the FTC passed its proposed ban on noncompetes along party lines. This is not a done deal. The US Chamber of Commerce (which is a large lobbying organization, not a part of the government) intends to sue immediately, and they won't be alone. Among other complaints, the Republican members of the committee who voted
- [Needless Customer Antipathy](https://www.benwhite.com/medicine/simple-practice-is-mean/) - Luminello, my wife's (now former) small practice EHR, just shut down, so I thought we'd end our sold-to-private-equity-just-to-be-shuttered-with-gusto story with a final litany of needless suffering and smarm. Timing To pressure people to switch to SimplePractice, busy psychiatrists running small private practices were given just two months before their current EHR shut down to research,
- [The Daylight Computer](https://www.benwhite.com/misc/the-daylight-computer/) - It may just be the marketing, but the newly announced DC-1 tablet from Daylight seems poised to scratch an itch of our times. As summarized by Om Malik: What the company has created is a beautiful tablet— about the size of a normal iPad Air. It is just a “little less than white,” white, with
- [A Primer on Disability Insurance for Doctors](https://www.benwhite.com/medicine/disability-insurance-for-doctors/) - Introduction Disability Insurance is a boring and expensive but critical component of a physician's financial plan. While life insurance pays your beneficiaries when you die, disability insurance pays you when you can't work due to a medical condition. It insures your most valuable asset: your future earnings potential in a profession after you spent years
- [Psychiatry EHR Comparison](https://www.benwhite.com/medicine/psychiatry-ehr-comparison/) - 5 years into running a small one-physician psychiatry private practice, my wife's EMR/EHR, Luminello, sold to private equity and was shut down to force its users to transfer to its new owner, SimplePractice. The whole experience was so shady that she was forced to survey the market and pick a new EHR. So she did. (This
- [Independent Radiology](https://www.benwhite.com/radiology/independent-radiology/) - Something happened to the field of Radiology. Actually, a lot of things have happened and are happening to Radiology all the time, but one of those things has been that the proliferation of corporate and private equity-backed radiology practices over the past decade has been followed by a historic radiologist shortage, a subsequent piping-hot radiology
- [Counting Chickens: RP loses its windfall award from United](https://www.benwhite.com/radiology/counting-chickens-rp-loses-its-windfall-award-from-united/) - The battle between Radiology Partners and UnitedHealthcare has ended with United as the victor. The summary: RP claimed United owed them lots of money for underpayment because United was using a 2020 contract to determine some of its payments instead of a more lucrative 1998 contract originally held by one of its purchased groups, Singleton.
- [Screening Narratives](https://www.benwhite.com/medicine/screening-narratives/) - From Nassim Nicholas Taleb's famous The Black Swan: A life saved is a statistic; a person hurt is an anecdote. Statistics are invisible; anecdotes are salient. A notable inversion: medical screening, such as the whole body MRI hyped by Prenuvo (previously discussed here) and Ezra as well as cancer blood tests like GRAIL. The anecdotal
- [It's Hard to Remember Subtraction](https://www.benwhite.com/misc/its-hard-to-remember-subtraction/) - From "People systematically overlook subtractive changes," published in Nature back in 2021: Participants were less likely to identify advantageous subtractive changes when the task did not (versus did) cue them to consider subtraction, when they had only one opportunity (versus several) to recognize the shortcomings of an additive search strategy or when they were under
- [What I Read in 2024](https://www.benwhite.com/reading/what-i-read-in-2024/) - This past year was the fifteenth of this site and this is my eleventh reading list. This year, among other things, I also took over as the neuroradiology division chief for our large private practice (in addition to serving as associate program director for our radiology residency) and then started a new hand-crafted high-touch job
- [Aetna v. Radiology Partners](https://www.benwhite.com/radiology/aetna-v-radiology-partners/) - The first pile-on lawsuit against Radiology Partners has arrived: UnitedHealth's original 2023 lawsuit against RP for an alleged "pass-through billing scheme" wrapped up this fall, and Aetna just filed their own Christmas present on December 23. For those curious about how that United lawsuit played out, here are my three posts covering that story: United
- [Writing in 2025](https://www.benwhite.com/writing/writing-in-2025/) - 2024 was a busy year for me (as all years feel busy, just as I suspect they do for literally everyone). Here on the site I did more quote-and-commentary posts and short asides, which I find enjoyable to write and share but also help me cover emotionally for fewer longer or more involved postings amidst
- [Some Advice on Learning Radiology](https://www.benwhite.com/radiology/some-advice-on-learning-radiology/) - Here are several things to consider about learning radiology in addition to my articles on Approaching the R1 Year, How to be a First Year Radiology Resident, and Radiology Call Tips. Develop Robust Search Patterns Real search patterns are not just the order in which you analyze a fresh scan, they are a series of
- [Self-Worth as an Early Radiology Trainee](https://www.benwhite.com/radiology/self-worth-as-an-early-radiology-trainee/) - Your value as a person is never just your job performance, but even your value as a resident isn't just what you bring to your early efforts: after years of steady skill and knowledge acquisition during school and internship, the R1 step backward into novicehood can be emotionally challenging. For better or worse, it's in
- [Quality, speed, and "productivity"](https://www.benwhite.com/radiology/quality-speed-and-productivity/) - The Tension There is an inherent tension in radiology between quality and speed. Obviously, there are faster radiologists and slower radiologists. And there are better radiologists and worse radiologists. It is not even that you are either fast or slow in all contexts. It is also not a false dichotomy in that you are either
- [The Necessity of Internal Moonlighting](https://www.benwhite.com/radiology/the-necessity-of-internal-moonlighting/) - I've been advising a radiology app startup called LnQ. I think of it like Qgenda for radiology moonlighting. It can link up with your practice schedule and HL7 feed and helps groups/hospitals/etc leverage the excess capacity in their own workforce: a practice can activate LnQ when there is extra work to do and automate telling
- [Feedback as a Radiology Resident](https://www.benwhite.com/radiology/feedback-during-residency/) - The Good Jobber and the Critical Curmudgeon Most radiology resident evaluations are a one-way trip on the “keep reading” express. Maybe, in harsher climates, “read more,” which is just a coded way of saying I wish you were better and more knowledgeable with the word "reading" used as a stand-in for "learn more useful stuff
- [Application Selection using WinActivate + Regular Expressions for AutoHotkey](https://www.benwhite.com/misc/application-selection-using-winactivate-regular-expressions-for-autohotkey/) - This is a brief adjunct to my post on using Autohotkey in Radiology (which basically every radiologist should be doing, by the way). I include it here not because I expect many people to run into the same problem I did but rather because it's a good example of the not-so-challenging troubleshooting that we shouldn't
- [Fasttracking Radiology Fellowships](https://www.benwhite.com/radiology/fasttracking-radiology-fellowships/) - This month, at the request of the Society of Pediatric Radiology, the ABR announced the addition of pediatric radiology to the "do a fellowship during residency" pathway first pioneered by nuclear medicine several years ago. One surmises this new pathway is not being offered because pediatric radiology is easier or requires less training and expertise
- [Autoscrolling with AutoHotkey](https://www.benwhite.com/radiology/autoscrolling-with-autohotkey/) - If you read my article on using Autohotkey for radiology, I describe that I use a click-lock script to simulate holding down the left mouse button. This allows me to power-scroll by using a single keystroke (in my case, backslash) to toggle scrolling on/off instead of needing to hold the mouse in a death grip
- [Will Automation Bias be Tractable?](https://www.benwhite.com/radiology/will-automation-bias-be-tractable/) - In this previous post about breast imaging, we briefly touched on the soon-to-be-growing-and-maybe-even-critical problem of automation bias in radiology caused by the growing use of AI. This study evaluating AI-assisted detection of cerebral aneurysms had similar findings: Results False-positive AI results led to significantly higher suspicion of aneurysm findings (p = 0.01). Inexperienced readers further recommended significantly
- [Radiology Staffing Shortages and Group Culture](https://www.benwhite.com/radiology/staffing-shortages-and-group-culture/) - One thing our recent discussions of the nationwide shortage of radiologists didn't include (in addition to a solution) is how the shortage has impacted the culture of radiology: Pulse and a License One of the concerning features of the current staffing shortage is the desperation with which many universities/hospitals/groups are recruiting new talent. When the
- [Dealing with an ABR Core Exam Failure](https://www.benwhite.com/radiology/dealing-with-an-abr-core-exam-failure/) - Firstly, it should almost go without saying, but: you can do this. I'd also like to acknowledge that nothing below is particularly noteworthy or novel advice. The Core Exam is like the other high-stakes multiple choice exams you’ve taken except for the fact that it has more pictures. And, of course, the question of how
- [Who or What is the O-Ring? And Who or What Will It Become Over The Coming Years?](https://www.benwhite.com/misc/who-or-what-will-be-the-o-ring-over-the-coming-years/) - From Stripe's 2024 Annual Letter: Much as SaaS started horizontal and then went vertical (first Salesforce and then Toast), we're seeing a similar dynamic playing out in Al: we started with ChatGPT, but are now seeing a proliferation of industry-specific tools. Some people have called these startups "LLM wrappers"; those people are missing the point.
- [Arguing with Toddlers](https://www.benwhite.com/misc/arguing-with-toddlers/) - The toddler puts on a show of having an argument, but they are holding a tantrum in reverse. If they ‘win’ the argument, no tantrum is needed. If they lose, they can tell themselves that they tried but the other person deserved the tantrum because they didn’t listen. - Seth Godin, "How to win an
- [On Building](https://www.benwhite.com/medicine/on-building/) - Highlights from Build: An Unorthodox Guide to Making Things Worth Making by Tony Fadell (who led the teams for the iPod, iPhone, and Nest Learning Thermostat): On the need to divide decisions into two main camps, data-driven or opinion-driven: Data-driven: You can acquire, study, and debate facts and numbers that will allow you to be
- [Radiology Surge Pricing](https://www.benwhite.com/radiology/radiology-surge-pricing/) - As we discussed in The Necessity of Internal Moonlighting, you can regularly need some extra manpower to maintain turnaround times or mitigate misery without the need for a full additional FTE shift on the schedule (or, alternatively, where you do need some real shiftwork but don't want to press people into service without additional reward).
- [Sales Advice](https://www.benwhite.com/misc/sales-advice/) - Giving advice and selling can't be the same thing. Nassim Taleb, pithily summarizing a lot of problems. For example, the core problem of much of the financial planning industry.
- [Top 40 Radiology Resources](https://www.benwhite.com/radiology/top-40-radiology-resources/) - Some really good follows on the Imaging Wire's 2025 list of Top 40 Radiology Resources. I'll happily accept the description of "excellent insights into the vagaries of being a working radiologist."
- [Back on Backtable](https://www.benwhite.com/radiology/back-on-backtable/) - My first Backtable episode about the rad shortage, the job market, and PE in radiology was back in 2023. I'm back on Backtable this week with a wide-ranging conversation about the job market, teleradiology, updates in the world of radiology private equity, etc etc. Always fun to chat with Ally and Mike, they're awesome. Though,
- [Current Demands for Radiology Subspecialties](https://www.benwhite.com/radiology/current-demands-for-radiology-subspecialties/) - As of this week, Independent Radiology features 125 private practices, which gives us an interesting look at a slice of the radiology job market. Here is the breakdown of subspecialty openings today: Mammo: 79% (99) Body: 78% (98) General: 71% (89) Neuro: 66% (83) MSK: 54% (67) VIR: 43% (54) Chest/Cardiovascular: 37% (46) NM/PET: 34%
- [Open Loop Errors](https://www.benwhite.com/medicine/open-loop-errors/) - From "The how we need now: A capacity agenda for 2025 and beyond," published by the Niskanen Center think tank: We need a new operating model for government if we are to restore our capacity to achieve our policy goals. This model must close the open loop we described in Part 3: a one-way system
- [Why a netbook?](https://www.benwhite.com/misc/why-a-netbook/) - As I type this on my msi wind "netbook," it occurs to me that some otherwise very smart people are getting a very odd message from the explosion in this new computer category's popularity. Farhad Manjoo, Slate's tech guy and author of a book that has received very respectable reviews on Amazon, wrote last week
- [Finally, an interesting phone on Sprint](https://www.benwhite.com/misc/finally-an-interesting-phone-on-sprint/) - For the first time, there is a phone on my carrier that genuinely interests me: The Palm Pre, a brand new smartphone that has, at least at first glance, a winning combination of features. It's a touchscreen phone, and it offers all the fun gesture support of the iPhone. While some press members noted that
- [The ABR's New EULA](https://www.benwhite.com/radiology/the-abrs-new-eula/) - Back in 2020, the American Board of Radiology released new agreements in order to participate in maintenance of certification "continuing" certification, the thing you have to do in order to be board-certified and practice radiology no matter how meaningless the process is (thankfully, the ABR's OLA process is relatively painless). Back then, there was a
- [The Fool's Errand of 30-year Radiology Predictions](https://www.benwhite.com/radiology/the-fools-errand-of-30-year-radiology-predictions/) - From a Radiology Business summary of two new JACR papers predicting the future radiology market: In the next 30 years, the supply of radiologists is expected to grow by nearly 26%, assuming no increases in the number of radiology residents. Meanwhile, imaging utilization will climb between 17-27% during the same time, depending on modality, experts
- [The Procedure Fetish / Bureaucratic Anxiety Cycle](https://www.benwhite.com/misc/the-procedure-fetish-bureaucratic-anxiety-cycle/) - From "The how we need now: A capacity agenda for 2025 and beyond," published by the Niskanen Center think tank. What are the forces making the government so slow? The first of those dysfunctions is what Nicholas Bagley of the University of Michigan calls the “procedure fetish,” and we dub the bureaucratic anxiety cycle. Anxiety
- ["Only the paranoid survive"](https://www.benwhite.com/misc/only-the-paranoid-survive/) - Old advice from Andy Grove, former CEO of Intel (back when Intel was killing it), from a 2007 Esquire interview: Not all problems have a technological answer, but when they do, that is the more lasting solution. The problem, as anyone who has used an EHR or any other enterprise software, is that the problem
- [If private practice is so great...](https://www.benwhite.com/radiology/if-private-practice-is-so-great/) - Since I started writing about private equity in radiology back in 2022 and more recently since featuring private practice jobs on the site followed by launching Independent Radiology, I often get questions that read something like this: If private practice is so great, why are so many groups struggling? Because it's hard. I believe that
- [New Social Feeds](https://www.benwhite.com/misc/new-social-feeds/) - I signed up for my Threads and my Bluesky accounts in addition to OG Twitter/X or even LinkedIn a while back but never started really using them (@benwhitemd across the board, links above--give me a follow?). I've now set those up so that I can more easily share tweets of new blog posts across all
- [Ashes to a New Radiology Practice](https://www.benwhite.com/radiology/ashes-to-a-new-radiology-practice/) - People often ask me what I think will/does happen when private equity groups fail. The answer I've always said is it probably depends. The work needs to get done, so there are three big options: Direct hospital/system employment probably with locums in the short term New private practice Outsourced to teleradiology firm (potentially with IR/DR
- [Falling for Profit](https://www.benwhite.com/medicine/falling-for-profit/) - From "Serious Medical Errors Rose After Private Equity Firms Bought Hospitals," reported by the NYT: The study, published in JAMA on Tuesday, found that, in the three years after a private equity fund bought a hospital, adverse events including surgical infections and bed sores rose by 25 percent among Medicare patients when compared with similar hospitals
- [The Radiology Report Podcast](https://www.benwhite.com/radiology/the-radiology-report-podcast/) - For those with an extra ~50 minutes in their lives, Daniel Arnold and I had a wide-ranging conversation on the newest episode of the Radiology Report podcast.
- [Radiology Practice Consolidation By the Numbers](https://www.benwhite.com/radiology/radiology-practice-consolidation-by-the-numbers/) - From "The U.S. Radiologist Workforce: AJR Expert Panel Narrative Review," just published in AJR: Between 2014 and 2023, the number of radiology practices decreased by over 17%, while the number of practices with 25-49, 50-99, and 100 or more radiologists grew by 33%, 126%, and 349%, respectively. Consolidation in action. An arduous regulatory climate, challenging
- [The Short Long Term](https://www.benwhite.com/radiology/the-short-long-term/) - Imaging provider Akumin's new post-bankruptcy CEO, in an interview with Radiology Business, describes their new owner, Stonepeak, which took control of the company after swapping ~$470 million in debt for equity and dropping an extra $130 million as part of a Chapter 11 bankruptcy: Stonepeak has a longer-term investment horizon compared to traditional private equity,
- [The Gilded Age of Medicine](https://www.benwhite.com/medicine/the-gilded-age-of-medicine/) - It is because doctors are understood to place patients’ interests above commercial ones that they have long enjoyed professional autonomy and public trust. The history of medicine is too littered with incompetence and immorality to believe that doctors have always been worthy of this status. Still, something profound is lost when we submit to the
- [Write-nots and Think-nots](https://www.benwhite.com/writing/write-nots-and-think-nots/) - Regarding the future of writing (and thinking) in an AI-enabled world, from "Writes and Write-Nots" by Paul Graham: The result will be a world divided into writes and write-nots. There will still be some people who can write. Some of us like it. But the middle ground between those who are good at writing and
- [A Job Board Milestone](https://www.benwhite.com/radiology/a-job-board-milestone/) - I started Independent Radiology--a job board exclusively dedicated to featuring physician-owned private practices--on August 14. This past weekend we hit a major milestone I wouldn't have predicted: 100 groups advertising their openings. The level of group and user engagement has been great to see.
- [RSNA 2024](https://www.benwhite.com/radiology/rsna-2024/) - If you’re a trainee going to RSNA this year, I’ll be giving a talk about careers in radiology during Session M3-RCP20: Navigating the Job Market at 9:30am on Monday. Come say hi!
- [Review: Proscan’s MRI Online](https://www.benwhite.com/reviews/proscan-mri-online/) - MRI Online (now Medality) is an advanced (MRI-focused) online radiology video platform offered by Dr. Stephen J Pomeranz, who is primarily a musculoskeletal radiologist. Just one dude. This in contrast to most online offerings in radiology, which are typically recorded board reviews or CME lectures from the big popular courses at places like Stanford, Hopkins,
- [The Academic Radiology Salary Gap](https://www.benwhite.com/radiology/the-academic-radiology-salary-gap/) - They used to say academics was less production/pay and private practice was high stress/high comp. The gap has narrowed because the academy is demanding much more, lots of rads are just nonacademic employees of the university behemoth working a generic job, and the labor shortage means hospitals/universities need to pay more to compete in the
- [IndyRad Newsletter](https://www.benwhite.com/radiology/indyrad-newsletter/) - Add this to the list of things that I should have had ready for launch day back in August: the Independent Radiology Newsletter. Sign up now to receive monthly job updates from the world of private practice radiology.
- [Recreate Constructively & Invent Life's Meaning](https://www.benwhite.com/misc/recreate-constructively-invent-lifes-meaning/) - Bill Watterson, who created the best comic strip of all time (Calvin and Hobbes), gave the commencement address at Kenyon College back in 1990, which he titled, "Some Thoughts on the Real Word by One Who Glimpsed It and Fled": It's surprising how hard we'll work when the work is done just for ourselves. And
- [A Man for All Markets](https://www.benwhite.com/reading/a-man-for-all-markets/) - A Man for All Markets by Edward O. Thorpe is a fascinating memoir from the mathematician/gambler/investor who solved card counting and essentially invented modern quantitative investing strategies. While reading, I was struck by two things: One, unsurprisingly, Thorpe is/was curious, industrious, and clearly a genius. Two, that his life as a latchkey kid in the
- [A Bias for Unfiltered Input](https://www.benwhite.com/medicine/a-bias-for-unfiltered-input/) - Henrik Karlsson, from "Scraping training data for your mind," on the need for the right kind of information to learn new skills: [You] want the input you observe to be as closely connected to a practice as possible. You want to see the process, not just the results. The results are often misleading. If you
- [The Effectance Motive](https://www.benwhite.com/misc/the-effectance-motive/) - Some passages on what makes a job "good" from The Happiness Hypothesis by Jonathan Haidt: Psychologists have referred to this basic need as a need for competence, industry, or mastery. [Psychologist Robert] White called it the “effectance motive,” which he defined as the need or drive to develop competence through interacting with and controlling one’s
- [Existential Humility](https://www.benwhite.com/misc/looking-for-exoplanets/) - It’s an incredible privilege to work at a place and live in a country that is willing to set aside money to answer these existential questions. I heard a phrase the other week, existential humility, and I really liked that. We’re this complex life form that has evolved over billions of years to the point where
- [The Irreplaceable Radiologist](https://www.benwhite.com/radiology/the-irreplaceable-radiologist/) - The radiologist shortage is definitely here. There are different ways to approach the market, but balancing short-term vs long-term plays is nontrivial. Leverage is great, but using too much can amplify negative downstream second-order consequences too. What's happening now varies and what will happen is anyone's guess, but this anonymous op-ed "Radiologists need to be
- ["Chatting by Chance"](https://www.benwhite.com/misc/chatting-by-chance/) - If you haven't yet read an explainer on "AI", I consider Jeremiah Lowin's "An Intuitive Guide to How LLMs Work" to be a good one.
- [The Low (Possibly No) Tax for Pre-Tax Argument](https://www.benwhite.com/finance/the-possibly-no-tax-on-pre-tax-argument/) - An important pre-tax vs Roth argument that is often missed, from "Why Pre-Tax Retirement Contributions Are Better Than Roth In Peak Earning Years (Even If Tax Rates Increase)": The most powerful argument for a pre-tax account as a retirement savings vehicle is that it comes with the option to convert the pre-tax dollars in the
- [Thoughts on Joseph Young's <em>Easter Rabbit</em>](https://www.benwhite.com/reading/easter-rabbit/) - Edward Mullany over at matchbook wrote an excellent review that I largely agree with. John Madera of Big Other wrote a review on NewPages that I largely disagree with. Between the two you'd get the idea. Easter Rabbit is a collection of microfictions, each under 200 words and many hovering around 50. The stories themselves
- [Radiology Reporting Preferences: What Do Referring Clinicians Want?](https://www.benwhite.com/radiology/radiology-reporting-preferences-what-do-referring-clinicians-want/) - Another paper suggesting that clinicians prefer some structure (but not too much structure) in radiology reports. There are always edge cases where structured reporting becomes cumbersome--and overly parsed reports are also inefficient/unreadable--but there's no denying it's so much easier for me to scan a prior report when it's not narrative free text.
- [New Radiology Practices](https://www.benwhite.com/radiology/new-radiology-practices/) - A reader asked if anyone had successfully started a new radiology private practice recently, particularly one that involved financing, opening up new imaging centers, and fresh payor contracts. There is a vacuum in some areas, especially with the PE-exacerbated instability, and therefore a clear opportunity to those who can muster the manpower (no easy feat).
- [Coherent Professions](https://www.benwhite.com/misc/coherent-professions/) - In The Happiness Hypothesis, Jonathan Haidt describes work by William Damon at Stanford that sought "to see why some professions seemed healthy while others were growing sick": Picking the fields of genetics and journalism as case studies, they conducted dozens of interviews with people in each field. Their conclusion is as profound as it is
- [How to start a website](https://www.benwhite.com/misc/starting-a-website/) - Despite the widely publicized demise of the blog, personal websites continue to exist, and writers like myself continue to publish them. I’ve also received a steady stream of requests for background information and approaches to maintaining a "successful" long-running website over the past decade, so here are my thoughts. What follows is most definitely my
- [Making an Opinionated Project](https://www.benwhite.com/misc/making-an-opinionated-site/) - Or, "Why Independent Radiology is different from most job boards (but also still boring)" So recently I created a simple, small website called Independent Radiology. It’s a boring job board, but it’s also different from most job boards. Jason Fried from 37signals (makers of Basecamp, HEY, and other stuff) argued years ago that software should
- [Making the Most of PowerScribe](https://www.benwhite.com/radiology/making-the-most-of-powerscribe/) - With the recent advances in LLMs, I suspect dictation improvements are one of the things that will be increasingly available in the very very near term future (though how cost-effective those plugins or replacements will be remains to be seen). In the meantime, PowerScribe is ubiquitous in radiology practices across the country, and it's the
- [August](https://www.benwhite.com/writing/august/) - The month of August has been almost exclusively related to the usual activities of daily living and the new/growing job board I've started dedicated to true independent physician-owned radiology private practices, which now has 45 groups. I know a service like Independent Radiology probably has more impact than my usual sporadic writing, but I'm personally
- [The SAVE In-School Loophole](https://www.benwhite.com/finance/the-save-in-school-loophole/) - I wrote about this last September, but it's important enough that I'll repeat myself with more bullet points and shorter sentences. The Summary The new SAVE student loan plan has a generous unpaid interest subsidy: every dollar of accrued interest that isn't covered by your monthly payment is waived. SAVE also has a feature ("loophole")
- [Inescapable Finitude](https://www.benwhite.com/misc/inescapable-finitude/) - More fun from Oliver Burkeman's Four Thousand Weeks: Time Management for Mortals. In case you missed it, we started with happy nihilism through cosmic insignificance theory and acknowledging the trap of productivity. More on that inescapable finitude: And it means standing firm in the face of FOMO, the “fear of missing out,” because you come
- [The Right Kind of Expert](https://www.benwhite.com/misc/the-right-kind-of-expert/) - From Paul Graham's "The Right Kind of Stubborn:" The persistent are attached to the goal. The obstinate are attached to their ideas about how to reach it. Worse still, that means they'll tend to be attached to their first ideas about how to solve a problem, even though these are the least informed by the
- [Situational Awareness](https://www.benwhite.com/misc/situational-awareness/) - An interesting essay by Leopold Aschenbrenner discussing the recent history of as well predictions for the next 10 years of AI: "From GPT-4 to AGI" A long but good read, which itself is part of an even longer series.
- [Magical Nanobots](https://www.benwhite.com/misc/magical-nanobots/) - Forget about AI taking your job, maybe we'll all just live forever.
- [Writer Math](https://www.benwhite.com/writing/writer-math/) - From "Writer Math" by Elissa Bassist in McSweeney's: If you think a piece is 100 percent done, it’s actually 45 percent done. To get it to 100 percent done, you can’t.
- [Need-Fulfilling Strategies & Future Self-Continuity](https://www.benwhite.com/finance/need-fulfilling-strategies-future-self-continuity/) - Via Loaded by Sara Newbomb: "Specifically, when the future self shares similarities with the present self, when it is viewed in vivid and realistic terms, and when it is seen in a positive light, people are more willing to make choices today that may benefit them at some point in the years to come." —Hal
- [Rad Job Board Update](https://www.benwhite.com/radiology/rad-job-board-update/) - Yes, I've started the process of creating a small dedicated job board just for independent radiologist-owned private practices. With all the corporate noise out there, I'm hoping we can connect radiologists looking for the real deal with those groups who are doing it. Still a ways to go, but feel free to reach out to
- [Just For Us](https://www.benwhite.com/misc/just-for-us/) - If you have HBO Max, standup comic Alex Edelman's one-man show was excellent. The official description of its main narrative thread: "In the wake of a string of anti-Semitic threats pointed in his direction online, standup comic Alex Edelman decides to go straight to the source; specifically, Queens, where he covertly attends a meeting of White Nationalists."
- [Deny deny deny](https://www.benwhite.com/medicine/deny-deny-deny/) - The tale of case review at Cigna in ProPublica: “Deny, deny, deny. That’s how you hit your numbers,” said Day, who worked for Cigna until the late spring of 2022. “If you take a breath or think about any of these cases, you’re going to fall behind.” [...] The early 2022 dashboards listed a handle
- [Noncompetes on the Cusp](https://www.benwhite.com/misc/noncompetes-on-the-cusp/) - On April 23 at 2 pm ET, the FTC is holding a special open meeting with a live webcast to discuss the proposed final rule banning most noncompete clauses. At the end of the meeting, "the Commission will vote on whether to issue the final rule." Potentially huge news (that will then immediately be challenged
- [Radiology Micro Job Board](https://www.benwhite.com/radiology/radiology-micro-job-board/) - It’s recruitment season, the radiology job market is hot, and there’s a lot of corporate noise. I’m thinking of maybe starting the world’s smallest radiology job board right here, open exclusively to a limited handful of 100% independent private practices. If your group is interested in advertising on this site (and also therefore supporting my
- [SAVE Can Save Lots of Interest, Even When in Graduate School](https://www.benwhite.com/finance/save-can-save-interest-even-when-in-graduate-school/) - Every new student loan plan has created some presumably unintended management strategies (i.e. "loopholes"). Over the years, some features have been removed from newer plans, like the "payment cap" from IBR & PAYE that previously capped your payments at the 10-year standard amount no matter how much money you earned. Others have been codified, like
- [The Best Book for the Texas JP Exam](https://www.benwhite.com/medicine/the-best-book-for-the-texas-jp-exam/) - Update 2024: Yes, it's still up-to-date, and yes, it remains the go-to resource for the JP Exam. Update 9/1/2019: The Exam is now online. It's 50 questions taken over 60 minutes and costs only $34. You can take it from the comfort of your own home, and my book remains the go-to resource for thousands
- [Studying for the Texas Jurisprudence Exam](https://www.benwhite.com/medicine/studying-for-the-texas-jurisprudence-exam/) - Update April 2024: My book is up-to-date and has remained the go-to resource for taking the physician JP exam since its release. Update September 2019: As of 9/1/2019, the TMB has moved the test to be self-administered online, which is great. The price has also decreased to $34 per attempt with unlimited attempts, which is
- [Relying on "A Guy"](https://www.benwhite.com/misc/relying-on-a-guy/) - Incredible story briefly detailed in NYT's "Did One Guy Just Stop a Huge Cyberattack?" by Kevin Roose: In the cybersecurity world, a database engineer inadvertently finding a backdoor in a core Linux feature is a little like a bakery worker who smells a freshly baked loaf of bread, senses something is off and correctly deduces
- [Show Your Work](https://www.benwhite.com/writing/show-your-work/) - In Show Your Work, Austin Kleon argues "the best way to get started on the path to sharing your work is to think about what you want to learn, and make a commitment to learning it in front of others." That's what I've been doing since 2009. One downside of Showing Your Work is when
- [Radiology Toys (TL;DR)](https://www.benwhite.com/radiology/radiology-toys-tldr/) - I wrote a long post with lots of options for the best personal radiology equipment (and additional posts about using a left-hand device or implementing the magic of AutoHotkey for achieving hands-free dictation and efficiency). But gosh, all those words! For the use-with-your-hands part, here are some quick contexts and a single choice for each
- [Inconvenient Data, Untellable Stories](https://www.benwhite.com/misc/inconvenient-data-untellable-stories/) - From last year's "Nutrition Science's Most Preposterous Result" by David Merritt Johns in The Atlantic ("Studies show a mysterious health benefit to ice cream. Scientists don’t want to talk about it."): In 2004, the English epidemiologist Michael Marmot wrote, “Scientific findings do not fall on blank minds that get made up as a result. Science
- [PAYE vs REPAYE: interest capitalization cap better than interest subsidy?](https://www.benwhite.com/finance/paye-vs-repaye-interest-capitalization-cap-better-than-interest-subsidy/) - The PAYE interest cap is essentially never better than the REPAYE interest subsidy. There are reasons PAYE can be a better choice for many borrowers, but the interest capitalization cap isn't really one of them. But let's take a step back: If you're reading this post, you may already know the relevant facets of income-driven
- [Talking Student Loans with SLP](https://www.benwhite.com/finance/talking-student-loans-with-slp/) - I was on the Student Loan Planner podcast with Travis Hornsby this week dispelling myths and getting into the weeds on student loan loopholes. Good times, and we discuss some really good tips. Check it out. In related news, I made my usual periodic updates to my definitive, comprehensive, and completely free student loan books
- [Underdesk Ellipticals](https://www.benwhite.com/misc/underdesk-ellipticals/) - I got an underdesk elliptical a couple of weeks ago...I think maybe it's awesome and wish I had gotten one a long time ago. I'm honestly a little surprised I can pedal while thinking. I tried a few, and this is the one I landed on: very stable, pretty cheap, reasonably quiet.
- [Post-Match Personal Finance Checklist](https://www.benwhite.com/finance/post-match-personal-finance-checklist/) - Post-Match Fourth Year is a time of impending change, and there is no better time for a soon-to-be physician to learn the basics of personal finance and get their financial house in order before residency. There are a lot of things you can do, but here are my top 5: 1. Learn the basics of
- [Post-bailout Troll-break](https://www.benwhite.com/radiology/post-bailout-troll-break/) - In which we have the nonphysician CEO of the largest radiology company/practice in the country—one that employs 10% of the workforce, just received $720 million in rescue funding, and is valued at several billion dollars—taking the time to troll an individual radiologist on X (née Twitter): Clearly, a man delighting in his bailout.
- [RP Delays Finance Drama for Another 4 Years](https://www.benwhite.com/radiology/rp-delays-finance-drama-for-another-4-years/) - Update 2/27/2024: S&P broke down the uses of that $720MM investment: $380MM to pay off the revolving credit line. $168MM for the company’s term loan. $68MM will cover its secured notes. $100MM to transactional costs and people's pockets. So that $500MM in "cash and liquidity" RP reported isn't much cash. It's mostly liquidity in that
- [Clinically Correlate](https://www.benwhite.com/radiology/clinically-correlate/) - Another wide-ranging radiology conversation, this time for an episode with the resident-run radiology podcast, Clinically Correlate.
- [Copious Coffee Breaks and Neuroradiology Errors](https://www.benwhite.com/radiology/copious-coffee-breaks-and-neuroradiology-errors/) - Fresh off the press in AJNR: Lower [neuroradiology] shift volumes yielded significantly lower error rates. The lowest error rates were observed with shift volumes that were limited to 19–26 [CT/MRI] studies. Error rates at shift volumes between 67–90 studies were 226% higher, compared with the error rate at shift volumes of ≤ 19 studies. I
- [RP vs USRS](https://www.benwhite.com/radiology/rp-vs-usrs/) - Radiology Partners is in the news more (especially now), but here's an interesting compare/contrast from S&P back in March 2023 looking at RP vs US Radiology (free account required). From that, an interesting chart for a bird's eye view: Note: this chart is almost a year old and predates a lot of recent developments including
- [Peer Learning](https://www.benwhite.com/misc/peer-learning/) - C.S. Lewis (of Narnia fame) on peer learning: It often happens that two schoolboys can solve difficulties in their work for one another better than the master can. The fellow-pupil can help more than the master because he knows less. The difficulty we want him to explain is one he has recently met. The expert
- [For the Patients](https://www.benwhite.com/medicine/for-the-patients/) - There's a Derek Sivers quote about business in Anything You Want that I think applies well to healthcare. I've replaced "customer" with patient": Never forget that absolutely everything you do is for your patients. Make every decision — even decisions about whether to expand the business, raise money, or promote someone — according to what’s
- [Management by Values](https://www.benwhite.com/misc/management-by-values/) - Steve Jobs, as collected in Make Something Great: There’s a lot of management techniques. I’m sure you study a lot of management techniques. When I was younger, it was management by objective. It’s all a crock. They’re all after-the-fact management techniques: “You’ve failed, and I know that because we are going out of business tomorrow.”
- [2023 Word of the Year](https://www.benwhite.com/misc/2023-word-of-the-year/) - The American Dialect Society chose their 2023 word of the year: enshittification. From its coiner, Cory Doctorow: Here is how platforms die: first, they are good to their users; then they abuse their users to make things better for their business customers; finally, they abuse those business customers to claw back all the value for
- [Paying Attention to Attention](https://www.benwhite.com/misc/paying-attention-to-attention/) - From "Burned Out on Burn Out" by Sanj Katyal MD: As we get older, time seems to fly faster and faster. And it's not just a hackneyed expression (it's that too, of course), but studies really show that we experience time differently as we age. One argument is that we feel time as a fraction
- [From Haldol to Now](https://www.benwhite.com/misc/from-haldol-to-now/) - Long but good read: “The pharma industry from Paul Janssen to today: why drugs got harder to develop and what we can do about it” by Alex Telford.
- [The Zelda Puzzle of Schoolwork](https://www.benwhite.com/misc/the-zelda-puzzle-of-schoolwork/) - From "How to Do Great Work" by Paul Graham: Schools also give you a misleading impression of what work is like. In school they tell you what the problems are, and they're almost always soluble using no more than you've been taught so far. In real life you have to figure out what the problems
- [The Bitter Lesson](https://www.benwhite.com/misc/the-bitter-lesson/) - From "The Bitter Lesson" by Rich Sutton: In speech recognition, there was an early competition, sponsored by DARPA, in the 1970s. Entrants included a host of special methods that took advantage of human knowledge---knowledge of words, of phonemes, of the human vocal tract, etc. On the other side were newer methods that were more statistical
- [Happy Birthday to Whatever This Is](https://www.benwhite.com/writing/happy-birthday-to-whatever-this-is/) - In addition to being New Year's, this site turned 15 years old (!) today. It contains hundreds of posts, over a half million words, and oodles of my time. Thanks for reading!
- [What I Read in 2023](https://www.benwhite.com/reading/what-i-read-in-2023/) - 2023 is the tenth year of sharing my reading list. (The blog is also turning 15(!). I am...aging. Here are the prior years: 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, and 2014. The Subtle Art of Not Giving a F-ck by Mark Manson (I read Will last year, which Manson co-wrote and which was interesting if a bit ego-driven ((and
- [RP and the Loan](https://www.benwhite.com/radiology/rp-and-the-loan/) - My crystal ball is as cloudy as ever. Earlier this month I wrote about Radiology Partners loaning a group money to help shore up radiologist compensation. That happened, but I was also wrong in my estimation of the likelihood of repayment: it turns out RP may be getting some of that money back after all.
- [The World of World of Warcraft](https://www.benwhite.com/misc/the-world-of-world-of-warcraft/) - It's a joke, but a fantastic one: the Onion's "World of World of Warcraft," a veritable nerdgasm of meta gaming. Amusingly, I imagine this game would actually be more fun than Second Life.
- [A new year's resolution](https://www.benwhite.com/misc/a-new-years-resolution/) - It's always a strange thing to start a site, especially the first post. It's a bit of a quandary, how to strike a balance of tone and content, not to wax too self-important or with an excessive amount of false-modesty (because the truly, truly modest probably wouldn't be publishing anything in the first place, really).
- [Poor Charlie's Almanack](https://www.benwhite.com/reading/poor-charlies-almanack/) - In honor of the late great Charlie Munger, Stripe Press has his popular book (mental models, decision-making, stuff like this) available for free online in both a well-formatted browser-based ebook and audiobook formats: Poor Charlie's Almanack: The Essential Wit and Wisdom of Charles T. Munger
- [Anesthesia War Games](https://www.benwhite.com/medicine/anesthesia-war-games/) - People like to operate under the belief that services like anesthesia, radiology, and pathology are totally interchangeable commodities. We do the work but don't generate it, and patients generally don't get to pick. But in the real world, labor isn't as cog-like as you might think, and culture matters (yes, even in our dysfunctional healthcare
- [The Emergency Mind](https://www.benwhite.com/medicine/the-emergency-mind/) - A passage about the fear of consequences from The Emergency Mind: Wiring Your Brain for Performance Under Pressure by Dan Dworkis MD PhD: In or out of the emergency department, all emergencies share three common structural characteristics: • Emergencies involve uncertainty. • Emergencies have high-impact outcomes. • Emergencies occur under significant pressure. Whatever the potential
- [Private Equity & Piracy Metaphors](https://www.benwhite.com/misc/private-equity-piracy-metaphors/) - Time horizons, incentives, and moral hazard: a very enjoyable easy-listening zoomed-out discussion of the Private Equity industry on the Freakonomics podcast. If you find the discussion of healthcare and PE on this site and others to be too tedious and haven't learned more about this very large and very important industry, this is a great
- [Neuroradiology Threads](https://www.benwhite.com/radiology/neuroradiology-threads/) - Making a compilation list of links to Dr. Lea Alhilali's excellent neuroradiology "tweetorials" was literally on my to-do list, but now her threads are all collected on Radiopeadia (so I don't have to).
- [RP Wins Round 1](https://www.benwhite.com/radiology/rp-wins-round-1/) - The UnitedHealthcare vs Radiology Partners lawsuit went to arbitration instead of a jury trial last month. Last week, the arbitration panel ruled in favor of RP and its practice Singleton Associates, awarding them $153.5 million. United, for its part, says it's not done, and that there are still unaddressed counterclaims. From that Radiology Business article:
- [Recent Radcasts](https://www.benwhite.com/radiology/recent-radcasts/) - Two great quick radiology podcasts, well worth your time for a better understanding of radiology in 2023: First, the state of the radiology residency match and how things look for medical students as well as the radiology workforce, courtesy of Dr. Francis Deng (@francisdeng). I agree with everything he said, and he said it better
- [The Availability Heuristic in Practice](https://www.benwhite.com/medicine/the-availability-heuristic-in-practice/) - We all use mental models (heuristics, rules of thumb) across a host of simple and complex problems. They often work; they sometimes don't. You shouldn't (and can't) avoid having and using them, but you should be aware of them (and their limitations). "The Influence of the Availability Heuristic on Physicians in the Emergency Department" is
- [Preliminary Medicine vs Transitional Year Internships](https://www.benwhite.com/medicine/preliminary-medicine-vs-transitional-year-internships/) - I've noticed a trend when I talk to applicants on the trail: a significant number of faculty advisors are giving some questionable advice, such as recommending that their students applying to advanced specialties (e.g. derm, ophtho, rads) only apply to preliminary medicine programs because transitional year (TY) programs are too competitive. That, combined with a lot of
- [Distant grass will always have a greener hue](https://www.benwhite.com/misc/distant-grass-will-always-have-a-greener-hue/) - From "COMMON PROVERBS AS VIDEO GAME TUTORIALS" in McSweeney's: Notice how after you consumed the Cake, the Cake is no longer in your inventory.
- [This is Going to Hurt](https://www.benwhite.com/medicine/this-is-going-to-hurt/) - From the original UK version of Adam Kay's This is Going to Hurt: Secret Diaries of a Medical Resident: Asked to review a patient in labour ward triage and repeat a PV as the midwife is uncertain of her findings. Her findings were of cephalic presentation with cervix 1 cm dilated. My findings are of
- [Excellent Advice for Living](https://www.benwhite.com/reading/excellent-advice-for-living/) - 2. Being enthusiastic is worth 25 IQ points. 12. Pros are just amateurs who know how to gracefully recover from their mistakes. These gems from the original 68 bits of unsolicited advice have joined more of Kevin Kelly's wisdom in a new book containing 450.
- [Energy Makes Time](https://www.benwhite.com/misc/energy-makes-time/) - From the short essay, "Energy Makes Time," by Mandy Brown: But there’s something else I want to suggest here, and it’s to stop thinking about time entirely. Or, at least, to stop thinking about time as something consistent. We all know that time can be stretchy or compressed—we’ve experienced hours that plodded along interminably and those that
- [How to Study for the ABPN Psychiatry Boards](https://www.benwhite.com/medicine/how-to-study-for-the-abpn-psychiatry-boards/) - About the Exam The ABPN psychiatry exam is a marathon day-long computerized multiple-choice exam offered once a year with two dates in September. You can apply as early as November but the deadline is February (current dates here) through the "folio" website. You won't schedule the actual exam until scheduling is opened, usually around 2
- [Best books for psychiatry residents](https://www.benwhite.com/medicine/best-books-for-psychiatry-residents/) - Below are my categorized and annotated book recommendations for psychiatry residents, including book recommendations for the psychiatry boards. General Texts The DSM-V is a no-brainer to occupy your future office bookshelf (if someone else is paying), although if you're choosing, the desk reference is less meaty and easier to carry around. The big boy is
- [The Nudge Manifesto](https://www.benwhite.com/reading/the-nudge-manifesto/) - From the free ebook A Manifesto for Applying Behavioral Science from the UK's Behavioural Insights Team: The other concern is that [behavorial science] theories can make specific predictions, but they are disconnected from each other - and from a deeper, general framework that can provide broader explanations (like evolutionary theory, for example). The main way
- [Backtable](https://www.benwhite.com/radiology/backtable/) - For those who want to listen for almost an hour about PE in radiology, the current radiologist shortage, and navigating the job market, I was on the BackTable VIR podcast.
- [#IMatchedwithCOMLEX](https://www.benwhite.com/medicine/imatchedwithcomlex/) - There's something very sad about the NBOME (the NBME's osteopathic counterpart) marketing their COMLEX licensing examination with such cringeworthy desperation: https://twitter.com/NBOME/status/1634302379783798787?s=20 Look everyone, some people can match without taking the USMLE too! In other news, no one is going to use that hashtag. The COMLEX is an expensive, duplicative exam that has almost no purpose
- [Don't Mind the Dust](https://www.benwhite.com/misc/dont-mind-the-dust/) - Hi! I’ve been wanting to revamp my site for years, but some mandatory security updates have forced my hand, so now we’re in the middle of frantic unplanned unavoidable total website redesign (oops)! Please excuse any quirks as I work on this in my copious free time.
- [Yo-Yo Master](https://www.benwhite.com/misc/yo-yo-master/) - Humans--with some incredible diligence and lots of practice--can do such fascinating things. https://youtu.be/BwsKpXwVMTM Pretty unreal.
- [Pirate Practice](https://www.benwhite.com/radiology/pirate-practice/) - In a similar vein to our recent discussion of radiology practice and game theory, this is from Andrew K. Moriarity's new article in JACR, "Pirate Practice": Employed sailors could count on the guarantee of agreed-upon pay in return for work performed. However, each pirate must be primarily motivated to ensure group success by their own
- [Writing Begets Writing](https://www.benwhite.com/writing/writing-begets-writing/) - Hold in the back of your mind the notion that someday you’re gonna write a book. You don’t have to write it this year. Meanwhile, writing begets writing. Just get into some kind of situation where you are writing, and if it’s some various thing you’re publishing online, it’s still grist to the mill. Legendary
- [Where Have All the Great Works Gone?](https://www.benwhite.com/reading/where-have-all-the-great-works-gone/) - From Tanner Greer's The Scholar's Stage: The professionalization of intellectual pursuit is another problem. Melville would never have written Moby Dick if he had spent years enrolled in an MFA program instead of spending years at sea. Men and women who in past ages would have observed humanity up close (or at least who would
- [Amazon Associates](https://www.benwhite.com/misc/amazon-associates/) - This site participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. If you click on our Amazon.com links and buy something, I earn a (very) small commission, yet you don’t pay any extra.
- [Evidence is Ubiquitous](https://www.benwhite.com/misc/evidence-is-ubiquitous/) - When you look for the answers needed to confirm your beliefs, you can almost always find evidence. That doesn't mean you're right. It means confirmation bias is a real cognitive trap. Radiologists (or clinicians of any stripe) need to constantly regulate and bring to consciousness balanced decision-making between observation and synthesis (putting together multiple findings
- [So now I’m using Bear](https://www.benwhite.com/writing/so-now-im-using-bear/) - Update: I went back to just using Workflowy for all drafting. It's just so easy and awesome. There were two developments that led to me implementing new workflows to get my writing done. I've been interested in different writing environments and different tools for longer than I've actually done any significant writing but always fell
- [How I wrote my second book](https://www.benwhite.com/writing/how-i-wrote-my-second-book/) - I published my second book a little over a month ago. It took about 11 months from conception to release, clocks in at around 45,000 words, and the bulk of the first draft was written (actually dictated) on my iPhone using Siri and an app called WorkFlowy. A significant fraction of that was "penned" walking
- [Workflowy redesign](https://www.benwhite.com/misc/workflowy-redesign/) - This is some niche dorky stuff for a Saturday night, but I'm excited: My digital brain, Workflowy, just got a modern redesign. For those who don't know, Workflowy is a totally free (with very optional paid options) outliner/todolist/organizer that allows you to have infinitely nested arbitrarily large outlines/lists. If that doesn't make sense, just try it. It's
- [Paying to Get Paid](https://www.benwhite.com/medicine/paying-to-get-paid/) - Great reporting by Cezary Podkul in ProPublica (and amazing perseverance by Dr. Shteynshlyuger): A powerful lobbyist convinced a federal agency that doctors can be forced to pay fees on money that health insurers owe them. Big companies rake in profits while doctors are saddled with yet another cost in a burdensome health care system.
- [Radiology, Private Equity, and the Prisoner's Dilemma](https://www.benwhite.com/radiology/radiology-private-equity-and-the-prisoners-dilemma/) - Last week, Dr. Ashutosh Rao from Quantum Radiology wrote an email with an interesting take on the corporate ownership of radiology practices as seen through the lens of Game Theory. He was gracious enough to allow me to share a version of it here for your enjoyment. § For decades, the unwritten covenant between private
- [These Are the Plunderers](https://www.benwhite.com/finance/these-are-the-plunderers/) - "Our Economy Is Being Plundered By Wall Street Elites" is fantastic discussion of private equity in America on the Wealthion Podcast. It's an interview with Gretchen Morgenson, Pulitzer-prize winning author of the new bestselling These Are the Plunderers: How Private Equity Runs―and Wrecks―America. If you've been wanting to learn more about the industry but haven't
- [FSU/Tallahasse](https://www.benwhite.com/medicine/tallahasse/) - I'll be giving the keynote at the FSU College of Medicine's Business & Medicine Symposium in Tallahassee this Saturday. If you're a student there, make sure to come say hi during the morning coffee or lunch after!
- [ESR eBook for Undergraduate Education in Radiology](https://www.benwhite.com/radiology/esr-ebook-for-undergraduate-education-in-radiology/) - On my brief perusal, the eBook for Undergraduate Education in Radiology (developed by the European Society of Radiology) seems like a great and entirely free first radiology book for medical students and first-year residents. In particular, the sections I looked at included a great first pass of high-yield anatomy. Strongly recommended.
- [#telemedicinegoals](https://www.benwhite.com/misc/telemedicinegoals/) - How amazing does this new retro NES-themed mechanical keyboard look? And an included separate pad with two huge programmable buttons? That's a great way to toggle dictation or almost have fun navigating Epic.
- [The IDR Waiver is Working](https://www.benwhite.com/finance/the-idr-waiver-is-working/) - $39 billion of student loans were forgiven tax-free this month. If you have any FFEL, Perkins, or Health Education Assistance Loan (HEAL) Program loans, please check out the IDR Waiver FAQ. You have until the end of 2023 to do a Direct Consolidation to make those loans eligible for loan forgiveness programs and count previous
- [Cheaper E-Ink Please](https://www.benwhite.com/misc/cheaper-e-ink-please/) - Filed under things I really want but for way, way cheaper: Project E Ink's "$2500 e ink art piece that displays daily newspapers on your wall."
- [Monetizing Medicine](https://www.benwhite.com/medicine/monetizing-medicine/) - From MONETIZING MEDICINE: PRIVATE EQUITY AND COMPETITION IN PHYSICIAN PRACTICE MARKETS, a report by the American Antitrust Institute: Price increases associated with PE acquisitions are exceptionally high where a PE firm controls a competitively significant share of the local market. When we focus our analysis on markets where a single PE firm controls more than
- [Radiologists Think Radiology is Mentally Demanding (and Other News)](https://www.benwhite.com/medicine/radiologists-think-radiology-is-mentally-demanding-and-other-news/) - This chart comes from a Joint Commission paper on Physician Task Load and the Risk of Burnout: It reads like a meaningful comparison, but the data is actually just self-reported from a survey of different specialties. It is a (nonetheless flawed) reflection of how these groups of doctors viewed themselves, their work, and its challenges.
- [Explanations for the 2020-2022 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2020-2021-official-step-2-ck-practice-questions/) - Update: The March 2021 pdf is identical outside of some minor formatting changes. Update: The April 2022 pdf also seems to be unchanged. The NBME released a completely new set of questions in March 2020, which was the first major update since basically 2015. The 2019 set, which is completely different, is available and explained
- [Private Equity Inflects](https://www.benwhite.com/medicine/private-equity-inflects/) - Jeff Goldsmith in "What Can We Learn from the Envision Bankruptcy?": Strategically, the Envision bankruptcy raises anew the question of whether there are economies of scale, and investment returns to scaling, in healthcare. Certainly the conventional wisdom argued that large firms like Envision had the ability to recruit and retain clinicians across vast geographies, and
- [Honing Stupidity](https://www.benwhite.com/misc/honing-stupidity/) - CEO’s Skill Set Transferable To Any Job That Requires Dumbass To Receive Big Salary: “I have the incompetence necessary to effortlessly transition into a role at any company that yields a seven-figure income.”
- [Want to Invest in RadPartners?](https://www.benwhite.com/radiology/want-to-invest-in-radpartners/) - RadPartners is desperately trying to raise capital to pay off its debts via another round of equity funding (i.e. creating and selling new shares of preferred stock). If successful, this would dilute the value of shares held by current shareholders (historically, ~40% of the company was owned by current or former RP radiologists). In reality,
- [Yachts, a red flag?](https://www.benwhite.com/medicine/yachts-a-red-flag/) - The Department of Justice said the defendants allegedly defrauded programs used to take care of elderly and disabled people, and in some cases used the ill-gotten money to buy exotic cars, jewelry and yachts. DOJ busts $2.5 billion healthcare fraud scheme.
- [The Mean World](https://www.benwhite.com/misc/the-mean-world/) - From Humankind: A Hopeful History by Rutger Bregman: “Imagine for a moment that a new drug comes on the market. It’s super-addictive, and in no time everyone’s hooked. Scientists investigate and soon conclude that the drug causes, I quote, ‘a misperception of risk, anxiety, lower mood levels, learned helplessness, contempt and hostility towards others, and
- [Stop Free-Dictating](https://www.benwhite.com/radiology/stop-free-dictating/) - There are many institutions/practices with well-defined “normal” templates for all types studies, which help provide a reasonable approximation of a house style. A clinician (or the next radiologist) has a reasonable chance of knowing where to find the information in the report. The reader can see something in the impression and quickly find the longer
- [Scarcity is a superpower](https://www.benwhite.com/misc/scarcity-is-a-superpower/) - Morgan Housel, author of the excellent The Psychology of Money, writing "a few rules": Being good at something doesn’t promise rewards. It doesn’t even promise a compliment. What’s rewarded in the world is scarcity, so what matters is what you can do that other people are bad at. A corollary: Being good at doing (or even
- [Fudging with "Adjustments"](https://www.benwhite.com/finance/fudging-with-adjustments/) - From Verdad's "Private Equity Fundamentals" (a good albeit somewhat technical read): The sample of companies we looked at is nearly unprofitable on an EBITDA basis, mostly cash flow negative, and extraordinarily leveraged (mostly with floating-rate debt that is now costing nearly 12%). These companies trade at a dramatic premium to public markets on a GAAP
- [Confidence in RadPartners Continues to Fall](https://www.benwhite.com/radiology/confidence-in-radpartners-continues-to-fall/) - As reported by Radiology Business, S&P has downgraded Rad Partners’ credit rating from B- to CCC+ (from vulnerable to speculative/junk) The full descriptions of those ratings are here: An obligation rated 'B' is more vulnerable to nonpayment than obligations rated 'BB', but the obligor currently has the capacity to meet its financial commitment on the obligation.
- [COI at the ACR](https://www.benwhite.com/radiology/coi-at-the-acr/) - I appreciate that not everyone is on Twitter—and frankly that’s probably for the best since it’s largely a toxic dumpster fire—but I did want to share this tweet/thread about a real situation unfolding at the American College of Radiology, the largest and most important radiology organization in the US. Among other things, the ACR sets
- [ChatGPT Passes a Written Radiology Exam](https://www.benwhite.com/radiology/chatgpt-passes-a-written-radiology-exam/) - ChatGPT's newest version, GPT4, was able to pass a no-image multiple-choice radiology exam. GPT4 is neat, but this says a whole lot more about how useless and off-base a radiology exam without pictures is than about how ready for prime time the current AI tools are. But they're coming, and I for one am interested
- [A neurosurgeon's final message](https://www.benwhite.com/misc/a-neurosurgeons-final-message/) - Paul Kalinithi, writing to his infant daughter in his last op-ed before succumbing to lung cancer: That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do
- [Meet Patrick](https://www.benwhite.com/medicine/meet-patrick/) - The future of prostate exam training is here, and his name is "Patrick." Half sensor-embued tush-model and half computer-simulated cartoon-man, Patrick promises to grade medical students on their technique while also "present[ing] a realistic patient encounter” including "software that enables him to interact emotionally with the student." (Before the exam begins, he tells you how scared he is.)
- [Smuggling a beer](https://www.benwhite.com/medicine/smuggling-a-beer/) - Dr. Daniela K Lamas, writing in the NYTimes: My patient gave me a thumbs-up. I wished that I had known him better. “Cheers,” he said.
- [Gravitational waves explained](https://www.benwhite.com/misc/gravitational-waves-explained/) - This awesome comic explains gravitational waves and the amazing experiment that detected/detects them. Einstein was right again!
- [Origins of the heart symbol](https://www.benwhite.com/misc/origins-of-the-heart-symbol/) - Just in time for Valentine's day, Priceonomics discusses the history of the highly anatomically incorrect heart symbol.
- [The Scope](https://www.benwhite.com/medicine/the-scope/) - The Scope is a new free weekly medicine newsletter that distills down some highlights from the major journals (NEJM, JAMA, etc) in plain English with a dose of context and light analysis. I've added it to my newsletter subscriptions, which also includes The New Yorker Minute (which reads the New Yorker so you don't have to,
- [A new study shows...](https://www.benwhite.com/misc/a-new-study-shows/) - John Oliver turns his incisive gaze on scientific studies: https://www.youtube.com/watch?v=0Rnq1NpHdmw&feature=youtu.be Fantastic as always, with some great "TODD" talks too.
- [General Tso's isn't what you think](https://www.benwhite.com/misc/general-tsos-isnt-what-you-think/) - General Tso was a real general His chicken was a dish actually created by a Taiwanese chef and isn't a bastardized American creation. Chef Peng Chang-kuei, the inventor of General Tso's chicken, just passed away at the age of 98.
- [Stealth/Health Battles](https://www.benwhite.com/medicine/indecipherable-medical-bills/) - The stealth battle between hospitals and insurers over bills for each hospitalization, office visit, test, piece of equipment and procedure is costly for us all. Twenty-five percent of United States hospital spending — the single most expensive sector in our health care system — is related to administrative costs, “including salaries for staff who handle
- [Self Deception: a tool that works](https://www.benwhite.com/misc/self-deception-a-tool-that-works/) - Von Hippel offers two pieces of wisdom regarding self-deception: “My Machiavellian advice is this is a tool that works,” he says. “If you need to convince somebody of something, if your career or social success depends on persuasion, then the first person who needs to be [convinced] is yourself.” On the defensive side, he says,
- [When people are angry](https://www.benwhite.com/misc/when-people-are-angry/) - When people criticize or respond negatively to me, usually they’re responding to this character that they’re seeing on TV called Barack Obama, or the office of the presidency, or the White House and what that represents. So, you don’t take it personally. You understand that if people are angry that somehow the government is failing,
- [Why would the brain be spared?](https://www.benwhite.com/misc/why-would-the-brain-be-spared/) - It's surprising to me that people would question that obesity would have a negative effect on the brain, because it has a negative effect on so many other bodily systems," he says, adding, "why would the brain be spared?" - Terry Davidson, director of the Center for Behavioral Neuroscience at American University in Washington, D.C,
- [Standard Ebooks](https://www.benwhite.com/reading/standard-ebooks/) - Standard Ebooks is an awesome long overdue idea: Standard Ebooks is a volunteer driven, not-for-profit project that produces lovingly formatted, open source, and free public domain ebooks. Ebook projects like Project Gutenberg transcribe ebooks and make them available for the widest number of reading devices. Standard Ebooks takes ebooks from sources like Project Gutenberg, formats
- [Nonidentical identical twins](https://www.benwhite.com/misc/nonidentical-identical-twins/) - Genetics, the environment, adversity, and perseverance—all in this short documentary from The Atlantic: https://youtu.be/V0Hp3HnS8M4
- [If things seem a little quiet around here...](https://www.benwhite.com/misc/if-things-seem-a-little-quiet-around-here/) - ...it's because we have two adorable kids now. (Photo by @whatlbsees)
- [America's Advisor](https://www.benwhite.com/misc/american-psycho/) - From David Roth's The New Republic piece, "American Psycho," an absolutely scathing brief profile of Jared Kushner's role in unquestionable pandemic mismanagement: So here we have Kushner, a powerful special adviser with no meaningful expertise in public health or epidemiology, using a breathtakingly specious chart produced by an economist who’d flubbed the biggest prediction he’d ever
- [The Path Forward](https://www.benwhite.com/misc/the-path-forward/) - “The world needs you at the party starting real conversations, saying, ‘I don’t know,’ and being kind.” —Charlie Kaufman
- [Feynman's Wish](https://www.benwhite.com/reading/feynmans-wish/) - As we near the end of the residency interview season, a choice quotation from "Surely You're Joking, Mr. Feynman!": Adventures of a Curious Character: So I have just one wish for you—the good luck to be somewhere where you are free to maintain the kind of integrity I have described, and where you do not
- [Eating the Red Pill](https://www.benwhite.com/misc/eating-the-red-pill/) - There is something to be said about a truly disastrous meal, a meal forever indelible in your memory because it’s so uniquely bad, it can only be deemed an achievement. The sort of meal where everyone involved was definitely trying to do something; it’s just not entirely clear what. I’m not talking about a meal
- [Always Something to Learn](https://www.benwhite.com/misc/always-something-to-learn/) - From the very pleasant small corner (seriously, just check out the comments!) of the internet that is author George Saunders' substack, Story Club, answering a question about finding a mentor: One of the things I’ve come to love about this Story Club community is its generosity. From where I sit, it feels like people show
- [Asking AI about AI in Medicine](https://www.benwhite.com/medicine/asking-ai-about-ai-in-medicine/) - I had a brief chat with OpenAI's ChatGPT about noise, radiology, and AI in medicine: Human: Summarize the book Noise by Daniel Kahneman AI: Noise by Daniel Kahneman is a book that examines how our minds work in a noisy, uncertain world. It dives into the cognitive biases and heuristics we use to make decisions
- [The Devil's Tic Tac](https://www.benwhite.com/medicine/the-devils-tic-tac/) - From "Nobody Has My Condition But Me" by Beverly Gage in The New Yorker: Plus, the longer you stay on it the harder it becomes to stop. Prednisone is sometimes referred to as “the Devil’s Tic Tac”: cheap and available and effective, but at potentially scorching long-term costs. Great term. I always find it interesting
- [Pushes the Right Buttons](https://www.benwhite.com/misc/pushes-the-right-buttons/) - The final trailer for the Super Mario Bros. movie dropped, and it looks like it might be the rare (only?) (did you like the Sonic movie?) video game movie that hits the important game notes for enjoyable fan service while also looking like a decent movie. https://youtu.be/RjNcTBXTk4I Our family is genuinely looking forward to seeing
- [Teleradiology as a First Job](https://www.benwhite.com/radiology/teleradiology-as-a-first-job/) - From an opinion piece in AJR recently titled "The Case for Presence as a Source of Professional, Educational, and Social Fulfillment": Although the long-term impact on social wellbeing of working virtually compared to working in-person is not yet fully understood, physical presence is likely to be conducive to establishing connectedness. This is a valid knock
- [The ABR Discusses the New Oral Boards](https://www.benwhite.com/radiology/the-abr-discusses-the-new-oral-boards/) - Here is the video for the American Board of Radiology's town hall discussion about the new oral boards, which are coming to a computer near you in 2028: https://youtu.be/oEvr4JfcwaY Some highlights: The ABR would like you to know that discussions about revamping the Certifying Exam started internally and "did not arise from an assumption that
- [Sidestepping the Match](https://www.benwhite.com/medicine/sidestepping-the-match/) - Speaking of physician shortages, Tennessee just became the first state to pass legislation allowing international medical graduates to obtain licensure and practice independently without completing a U.S. residency program. Bryan Carmody breaks it down.
- [The Consequences of Poorly Conceived Admission Requirements](https://www.benwhite.com/medicine/the-consequences-of-poorly-conceived-admission-requirements/) - From "The relationship between required physician letters of recommendation and decreasing diversity in osteopathic medical school admissions": Osteopathic and allopathic physicians, DOs and MDs, are already essentially the same and have been increasingly so over recent years. But one admissions practice is very common for osteopathic schools and exceedingly rare for allopathic schools: requiring a
- [About those Letters of Recommendation](https://www.benwhite.com/medicine/about-those-letters-of-recommendation/) - This study was from 2014 and titled, "What Aspects of Letters of Recommendation Predict Performance in Medical School? Findings From One Institution." Do you have a guess? Being rated as “the best” among peers and having an employer or supervisor as the LOR author were associated with induction into AOA, whereas having nonpositive comments was
- [The Looming Spectre of Automation Bias](https://www.benwhite.com/radiology/the-looming-spectre-of-automation-bias/) - From "Automation Bias in Mammography: The Impact of Artificial Intelligence BI-RADS Suggestions on Reader Performance": Inexperienced radiologists were significantly more likely to follow the suggestions of the purported AI when it incorrectly suggested a higher BI-RADS category than the actual ground truth compared with both moderately (mean degree of bias, 4.0 ± 1.8 vs 2.4
- [Goodbye, Nanoism](https://www.benwhite.com/writing/goodbye-nanoism/) - When I started the current iteration of this site in January 2009, I was also writing short fiction. In fact, one of my self-imposed creative writing projects was an exercise in the form of a daily tweet-sized story. Very strange, it's true, but 2009 was a long time ago in internet years, and it seemed
- [Explanations for the 2020 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2020-official-step-1-practice-questions/) - Another year, another set of explanations. As always, the order here reflects that of the new PDF released in February 2020. The official practice material page subsequently reverted back to the 2019 version, but as you can see the 2020 link remains live. (If you're taking this in 2021, then see those explanations for updated
- [Explanations for the 2019 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2019-official-step-1-practice-questions/) - The 2019 set was recently updated in February. Of the 117 questions in the PDF, only two have been changed, which I've answered below. The order and content otherwise appear unchanged, including the three multimedia questions at the end of the online version. Please see last year's 2018 explanations for the remainder. The many comments
- [Journey to the ABR Certifying Exam](https://www.benwhite.com/radiology/the-abr-certifying-exam/) - If there is little information online about the ABR Core Exam, there is essentially none about the Certifying Exam. After several years, the only nuggets on the grapevine were that it was easy, nobody has ever failed, and you might as well do all your selected modules in the field of your fellowship. All of
- [The good-reason-to-be-a-doctor police](https://www.benwhite.com/medicine/the-good-reason-to-be-a-doctor-police/) - From Insider's Pre-Med Guidebook: Advice from admissions faculty at America's top medical schools: Every year, hundreds of thousands of students pursue premedical studies at four-year universities across the United States and the world, and they, too, want to become physicians for a myriad of reasons. Many will find their reasons to be mature and well-reasoned.
- [The Distressed Debt of Healthcare Private Equity](https://www.benwhite.com/medicine/the-distressed-debt-of-healthcare-private-equity/) - I'm guessing it doesn't feel great for Radiology Partners to once again be one of a handful of named companies in another “distressed debt” article. From last month's "Health-Care Debt Gets Harder Look as Distress Builds" in Bloomberg: The companies face legal and regulatory pressures too. The No Surprises Act, which makes it harder for
- [Free USMLE Step 1 Questions](https://www.benwhite.com/medicine/free-usmle-step-1-questions/) - No matter how much money you spend on books, every medical student needs to do a ton of practice questions for the USMLE Step 1. Questions are an excellent way to learn the useful tip-offs and keywords, and—depending on the source—get a better feel for the board format. They're also a form of active learning,
- [Mild to Moderately Severe](https://www.benwhite.com/radiology/mild-to-moderately-severe/) - https://twitter.com/benwhitemd/status/1632062980916662272?s=20 First, undoubtedly, we need to flesh out the bottom of the scale to include nominal < trace < minimal. Then if we give partial gradations like my old attending (not just moderate, moderate to severe, and severe but further subdividing fractions of each!), then we can truly attain radiology nirvana.
- [The ABR Core Exam Experience](https://www.benwhite.com/radiology/the-abr-core-exam-experience/) - The ABR has requested that I not use their logo or any images anywhere in this post lest there be any confusion about our non-relationship and non-endorsement. I have of course complied. Let me take this chance to also remind readers that the writing on this site (benwhite.com) reflects the wholly personal views of Ben
- [The ABR Certifying Exam will change (in 5 years?)](https://www.benwhite.com/radiology/the-abr-certifying-exam-will-change-in-5-years/) - The American Board of Radiology came to the Texas Radiological Society annual meeting this past weekend and presented an update. Some things have changed recently. For example, the ABR is now handling all remote-proctoring in-house instead of using Procturio. Something things haven't really changed: You still have to do your MOC OLA in small batches
- [Rules to Live By](https://www.benwhite.com/reading/rules-to-live-by/) - Summarized from the epilogue of Humankind: A Hopeful History by Rutger Bregman, itself a pretty compelling read that summarizes the real world flaws and scholarship foibles of most negative philosophical and psychological research about man's beastly nature (e.g. Machiavelli, Lord of the Flies, the Stanford Prison Experiment, etc) and instead argues that we are, on
- [The missing piece: "deliberate rest"](https://www.benwhite.com/misc/deliberate-rest/) - The forgotten half of the 10,000 hours to mastery popularized by Malcolm Gladwell, as argued by Alex Soojung-Kim Pang in Rest (emphasis mine): “Deliberate practice,” they observed, “is an effortful activity that can be sustained only for a limited time each day.” Practice too little and you never become world-class. Practice too much, though, and you
- [CTAs for Vertigo, A Sonnet](https://www.benwhite.com/medicine/ctas-for-vertigo-a-sonnet/) - I asked Poe, a new AI chatbot, to write me a sonnet about a negative CTA for vertigo: A CT scan of the head and neck was done, To search for the cause of vertigo's plight. But alas, the results came back as none, No evidence of any wrong or right. The images showed the
- [Explanations for the 2017 Official Step 3 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2017-official-step-3-practice-questions/) - Here are my explanations for the 2017 version of the official USMLE Step 3 free question pdf. This is a constant reader request, so enjoy my take on these 137 questions. You can find my thoughts on preparing for Step 3 here. In short, I think the free materials and UWorld should be enough for
- [Incidental Pain and Suffering](https://www.benwhite.com/medicine/incidental-pain-and-suffering/) - From Matthew Davenport's upcoming article in AJR, "Incidental Findings and Low-Value Care": It is increasingly recognized that incidental findings are incompletely understood, expensive, and surprisingly harmful. Rather than a benefit of imaging, they are usually a harm. They are not sought, the odds of them being important is low, and they create tremendous uncertainty and
- [Munger on Incorrect Approaches to Medicine](https://www.benwhite.com/medicine/munger-on-incorrect-approaches-to-medicine/) - In 2003, Charlie Munger gave a lecture titled ‘Academic Economics: Strengths and Weaknesses, after Considering Interdisciplinary Needs,’ at the University of California at Santa Barbara. It's a pretty good read. He mostly discusses problems with economics as a soft science that desperately wants to be a hard science. Medicine is also surprisingly soft. I've replaced
- [Death of the Noncompete?](https://www.benwhite.com/medicine/death-of-the-noncompete/) - Last week the FTC announced a proposed rule banning non-compete agreements. You can read the announcement here and the actual rule here. The rule would, if enacted, not just ban all non-competes going forward but nullify previous agreements as well. Non-competes are ubiquitous in medicine and a big factor locking doctors into their jobs, typically
- [FTC Chair Lina Khan on non-competes](https://www.benwhite.com/misc/ftc-chair-lina-khan-on-non-competes/) - Lina Khan, in an op-ed for The New York Times: Noncompete clauses systemically drive down wages, even for workers who aren’t bound by one. Every worker stuck in a job represents a position that isn’t opening up for someone else. And if employers know their workers can’t leave, they have less incentive to offer competitive
- [WCICON23](https://www.benwhite.com/medicine/wcicon23/) - Registering through the link here is also one of those effortless ways you can support this site while doing what you were going to do anyway. I'm very much looking forward to speaking again this coming year at the Physician Wellness & Financial Literacy Conference (aka WCICON23), which will take place March 1-4 at the
- [What I Read in 2022](https://www.benwhite.com/reading/what-i-read-in-2022/) - 2022 was the ninth(!) year that I’ve kept track of my book consumption. I'm still trying to get better at capturing even just some brief thoughts/impressions about what I read (especially the fiction, which sometimes fades from memory almost as fast as I can read it). I still read most of my nonfiction on my
- [ABR soliciting nominations for its Board of Governors](https://www.benwhite.com/radiology/abr-soliciting-nominations-for-its-board-of-governors/) - The bylaws of the American Board of Radiology are interesting. I've written about them here, and you should read that post. Go ahead, I'll wait. Relevent to an email blast the ABR sent out this week is section 4.3: Section 4.3. Election of Governors. Nominees shall be solicited from the Board of Trustees and Board of Governors,
- [How to Study for the USMLE Step 3](https://www.benwhite.com/medicine/how-to-study-for-the-usmle-step-3/) - The old adage has been two months for Step 1, two weeks for Step 2, #2 pencil for Step 3. In reality, it's probably more like two months for Step 1, 1 month for Step 2, and two weeks for Step 3. But if you are worried about getting that competitive cardiology fellowship, it's hard
- [Thoughts on studying in medical school](https://www.benwhite.com/medicine/how-to-study-in-medical-school/) - Let's start with this premise: In the 21st century, the medical school basic science curriculum is probably best learned through guided self-study and likely not whatever your school is trying to teach you (especially if that involves the blind leading the blind via TBL). How much you can fulfill this ideal will unfortunately depend on how
- [Explanations for the 2018/2019 Official Step 3 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2018-official-step-3-practice-questions/) - Update: The November 2019 update didn't make any changes. There was a practice material update for the official free Step 3 materials back in November 2018. The previous set, which I explained here, was revised in November 2017. Most of the questions are the same with the same order, but there were a few changes,
- [Forgiveness App is Live](https://www.benwhite.com/finance/forgiveness-app-is-live/) - The official application for the Biden student loan forgiveness is now live. Impossible to say if any legal action will block it in the end, but for now the safest thing to do if you qualify is to apply as soon as possible. It'll take about 2 minutes. Apply here.
- [Unisex Disability Insurance Rates Are Basically Gone at the End of 2020](https://www.benwhite.com/finance/unisex-disability-insurance-rates-are-basically-gone-at-the-end-of-2020/) - I've been meaning to write about this for a while, but just wanted to put out quick post for those of you who should have already purchased disability insurance but haven't gotten a policy yet. Women pay more than men for disability insurance across the board (while men pay more for life insurance). One of
- [Envision: The PE Healthcare Harbinger](https://www.benwhite.com/finance/envision-the-pe-healthcare-harbinger/) - From Bloomberg, some crazy machinations involving the restructuring of Envision, the massive medical staffing company, in order to pay off debts. This is because Envision had $7 billion debt from its 2018 leveraged buyout by KKR, and KKR needed to find ways to exploit the paper details in order to restructure the company without getting taken
- [The Reward of Writing](https://www.benwhite.com/writing/the-reward-of-writing/) - Anne Lamott from her lovely book on writing, Bird by Bird: Writing has so much to give, so much to teach, so many surprises. That thing you had to force yourself to do—the actual act of writing—turns out to be the best part. It’s like discovering that while you thought you needed the tea ceremony
- [Losing the Track is Part of Tracking](https://www.benwhite.com/reading/losing-the-track-is-part-of-tracking/) - From The Lion Tracker's Guide To Life by Boyd Varty: You must train yourself to see what you are looking for. Perhaps the most concise description of radiology training. “I don’t know where we are going but I know exactly how to get there,” he says. Process > outcome. I think of all the people
- [A Curated Collection of Interview Questions](https://www.benwhite.com/medicine/a-curated-collection-of-interview-questions/) - During my fourth year I asked my peers to submit questions they received on the interview trail. Some (most) were banal. Some were bizarre. Doing my best to keep the list short and readable, here are some results. Overall, the take home message is this: if you have a bad experience on interview day—when both
- [Biden and Student Loans: Cancellation and The Final Payment Extension(?)](https://www.benwhite.com/finance/biden-and-student-loans-cancellation-and-the-final-payment-extension/) - Big long-hinted-at news in the world of student loans this week. Please peruse the Biden Student Loan Fact Sheet. The Official FAQ is short and very readable. Here are some highlights: Student Loan Pause Payment pause extended "one final time" through Dec 31, 2022. This is again a massive benefit to current borrowers and especially
- [On the long list for second place](https://www.benwhite.com/radiology/on-the-long-list-for-second-place/) - It was a nice surprise to see over my busy call long weekend that I was nominated as a semifinalist for Aunt Minnie's "most effective radiology educator" this year. Or something like that: https://twitter.com/PrometheusLion/status/1565118659240001539?s=20&t=PUxRKJnzqPV3qiuqppaTuw As always, thanks for reading.
- [Data-driven Personal Finance Takeaways](https://www.benwhite.com/reading/data-driven-personal-finance-takeaways/) - Some interesting passages and food for thought from Just Keep Buying: Proven Ways to Save Money and Build Your Wealth by Nick Maggiulli (a personal finance book with much more data behind its analysis than average for the genre). On saving: And one of the most common financial stressors is whether someone is saving enough.
- [Earning the Bare Minimum](https://www.benwhite.com/medicine/earning-the-bare-minimum/) - From the (the free or inexpensive) The Almanack of Naval Ravikant: A Guide to Wealth and Happiness: If you look at even doctors who get rich (like really rich), it’s because they open a business. They open a private practice. The private practice builds a brand, and the brand attracts people. Or they build some kind
- [Review: ExamGuru Shelf Exam Question Bank](https://www.benwhite.com/medicine/review-examguru-shelf-exam-question-bank/) - Updated 5/16/2016 to reflect new prices, new discount code, and some additional changes. Updated since then to reflect new discount codes. ExamGuru is the brand new and currently only question bank geared specifically for the third year NBME shelf exams. While the product itself is new, the company is not: it's a new brand of the COMQUEST family,
- [Working for Private Equity: A Radiologist's Experience](https://www.benwhite.com/radiology/working-for-private-equity-an-interview-with-a-radiologist/) - This is part three in a series of posts about private equity in radiology. The first was this essay. The second was an interview with former PE analyst and current independent radiologist Dr. Kurt Schoppe. This third entry is a Q&A with a radiologist who recently left a PE-owned practice and their experience as someone
- [Sigh-RADS](https://www.benwhite.com/radiology/sigh-rads/) - This is a work in progress, but I humbly submit a draft proposal for a new multimodality standardized radiology grading schema: Sigh-RADS. Sigh-RADS 1: Unwarranted & unremarkable Sigh-RADS 2: Irrelevant incidental finding to be buried deep in the body of the report Sigh-RADS 3: Incidental finding requiring nonemergent outpatient follow-up (e.g. pancreatic cystic lesion) Sigh-RADS 4:
- [A lopsided fig](https://www.benwhite.com/misc/a-lopsided-fig/) - Jason Kottke, a true OG blogger, on taking a sabbatical: Does what I do here make a difference in other people’s lives? In my life? Is this still scratching the creative itch that it used to? And if not, what needs to change? Where does kottke.org end and Jason begin? Who am I without my
- [Studying for Third Year NBME Shelf Exams](https://www.benwhite.com/medicine/studying-for-third-year-nbme-shelf-exams/) - [The original version of this newly updated/revised post was first published way back on August 19, 2012.] Chances are, your third-year clerkship grades will hinge more on your NBME Shelf exam scores than on your clinical evaluations. The strategy I advocate is to come off of Step 1 strong by immediately shelling out for the
- [External Medicine](https://www.benwhite.com/medicine/external-medicine/) - I was on the External Medicine podcast for a wide-ranging conversation about medical education, training, blogging, and even nanofiction. It's a really well-edited show run by two brothers (who also happen to be starting radiology residency in a few months). Check it out here or on your favorite podcast app.
- [A slow end to a long hobby](https://www.benwhite.com/writing/a-slow-end-to-a-long-hobby/) - The more intrepid readers of this site may know that one of my more unusual hobbies for the past 13 years has been running an indie lit mag called Nanoism. Back when it launched in March 2009, you see, I was doing more short fiction writing than blogging or other writing (oh how times change).
- [Best Books for Medical School](https://www.benwhite.com/medicine/best-books-for-medical-school/) - This is technically a list of my book recommendations for the basic sciences, classically the MS1/MS2 years (my books recommendations for the clinical clerkships are here). In practice, there are no true "best" books, but there often multiple good ones. I've made an editorial selection here to provide a few good and reasonable options depending on
- [Wanting Less](https://www.benwhite.com/misc/wanting-less/) - Some highlights from the essay "How to Want Less" by Arthur C. Brooks in The Atlantic. Homeostasis keeps us alive and healthy. But it also explains why drugs and alcohol work as they do, as opposed to how we wish they would...It’s why, when you achieve conventional, acquisitive success, you can never get enough. If
- [The Cost of PCP Burnout](https://www.benwhite.com/medicine/the-cost-of-pcp-burnout/) - Continuity of care is valuable. While the paper's methodology requires some significant guesswork, "Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis" by Sinsky et al attempts to estimate the cost of primary care physician (PCP) turnover. They combined several data sources to estimate excess expenditures and then used
- [Measuring the Attending Job](https://www.benwhite.com/medicine/measuring-the-attending-job/) - This lesson comes from Clayton Christensen’s How Will You Measure Your Life. Christensen references Frederick Herzberg's "motivation-hygiene theory" of satisfaction. The argument is that there are two different types of job factors: hygiene and motivation. Motivation factors stem from the intrinsic character of the work itself: challenge, recognition, personal responsibility, meaningful impact, involvement in decision-making,
- [How to approach NBME/USMLE questions](https://www.benwhite.com/medicine/how-to-approach-nbme-usmle-questions/) - There is more to the USMLE than the requisite volume of knowledge, and you can take the test efficiently by acknowledging outright the things your subconscious probably already knows. This is a somewhat randomly chosen question from the official 2013 USMLE Step 1 information booklet: A previously healthy 48-year-old man comes to the physician because of
- [Resident Retirement Contributions and PSLF: Pretax or Roth?](https://www.benwhite.com/finance/resident-retirement-contributions-and-pslf-pretax-or-roth/) - Saving for retirement, even as a resident, is a good thing. The absolute amount of money you can likely contribute is relatively small, but it does add up and over time it will compound to a larger amount. However, the most important reason to do so as soon as possible is to start the saving
- [Qbanks & USMLE success: optimism, excitement, and joy](https://www.benwhite.com/medicine/qbanks-usmle-success-optimism-excitement-and-joy/) - This post is adapted from a response to a reader email. There's a special kind of question I get a lot of every spring. The format is always the same: there is an unmet goal or stagnated improvement on a qbank during dedicated board review with a subsequent ton of anxiety about succeeding on the test. This is
- [The Resident to Midlevel Ratio](https://www.benwhite.com/medicine/the-resident-to-midlevel-ratio/) - As a great bookend to my recent brief article about resident pay, here’s an interesting little data point from this article about the shutdown of UNM’s neurosurgery residency for ACGME violations: In the immediate future, UNM plans to double the number of neurosurgeons on staff by March. They have also hired 23 advanced practice providers
- [Considerations for Your First Job in Radiology](https://www.benwhite.com/radiology/considerations-for-your-first-attending-job-in-radiology/) - The majority of radiology trainees will take jobs in private practice, but whether academics or PP, there are still a lot of details that will significantly change what your job is actually like and what you should consider in choosing. This post is very long (~3600 words), but I don't feel like trying to publish
- [The ABR and Platinum Transparency](https://www.benwhite.com/radiology/the-abr-and-platinum-transparency/) - It's the time of year for breaking New Year's resolutions and paying annual fees to the ABR. In honor of the season, from the American Board of Radiology's blog: "In October, we posted on our website the most recent financial statements for the ABR and the ABR Foundation. Postings include the 2020 990 forms and
- [The public would prefer you to not be tired](https://www.benwhite.com/medicine/the-public-would-prefer-you-to-not-be-tired/) - The public apparently likes the 16-hour shift cap: After people hear arguments both in favor and against eliminating the 16-hour shift limit, voters' opposition holds firm at 86%, 79% strongly opposed," she said. "Eight in 10 would support decreasing the shift limits for second-year residents from 28 hours to 16 hours as well. These are
- [Discussing Med Ed on the Medical Mnemonist](https://www.benwhite.com/medicine/discussing-med-ed-on-the-medical-mnemonist/) - I did an interview with Chase DiMarco on the Medical Mnemonist that just dropped over the holiday. You can check it on the Prospective Doctor site linked above or wherever you usually enjoy fine podcasts. It's sorta crazy to think about how much things have both changed and stayed the same in medical education since
- [Revenge Bedtime Procrastination](https://www.benwhite.com/misc/revenge-bedtime-procrastination/) - "Revenge bedtime procrastination describes the decision to sacrifice sleep for leisure time that is driven by a daily schedule lacking in free time." Or, as described by Anne Helen Petersen: You stay up binging a mediocre show. You can’t stop scrolling Instagram or Twitter or a dating app. You’re reading some overly-detailed breakdown of a sporting
- [Functional Embezzlement](https://www.benwhite.com/finance/functional-embezzlement/) - From Charlie Munger’s Herb Kay Memorial Lecture, "Academic Economics: Strengths and Weaknesses, after Considering Interdisciplinary Needs" (University of California at Santa Barbara, 2003): ...I asked the question “Is there a functional equivalent of embezzlement?” I came up with a lot of wonderful affirmative answers. Some were in investment management. After all, I’m near investment management.
- [The Big (Temporary) PSLF Expansion](https://www.benwhite.com/finance/the-big-temporary-pslf-expansion/) - You may have heard the news by now: PSLF has been (temporarily) expanded (again). Back in 2018, TEPSLF created a new pot of money to help borrowers who had used the wrong payment plans in the past. Now, in a final heave of their national emergency powers, the government will finally fulfill the spirit of
- [Your ERAS application photo](https://www.benwhite.com/medicine/your-eras-application-photo/) - You may not have thought about it, but a lot of people are going to be looking at your glamour shot. The program director and any application reader will see it before you're chosen for an interview. Your interviewers will see it. It'll probably make it into a big interview day composite along everyone else
- [What to look for in a radiology residency program (independent call)](https://www.benwhite.com/medicine/what-to-look-for-in-a-radiology-residency-program-independent-call/) - Let's start with all the things that you should look for in a radiology program except the one that I've alluded to in the title. Many of these features are broadly generalizable and largely not unique to Radiology, and no one needs to tell you that they're important. The Usual Stuff We don't need to spend
- [Bedside Business (Podcast)](https://www.benwhite.com/medicine/bedside-business-podcast/) - I did a Q&A about student loans and the transition to residency (as well as a dash of passion is overrated and medical education is toxic) with the fine students across the DFW Metroplex at TCOM this spring, and it's now available as an episode of the Bedside Business Podcast (Apple | Spotify | Google | Stitcher). The Zoom recording audio
- [The Jargon of the Business Dark Arts](https://www.benwhite.com/medicine/the-jargon-of-the-business-dark-arts/) - From Brian Alexander's The Hospital: Life, Death, and Dollars in a Small American Town: (Phil Ennen, one of the main characters, is the CEO of a struggling small-town community hospital in Bryan, Ohio.) That was the world where Ennen and the vice presidents now found themselves as they listened to consultants they were auditioning to help
- [Applying to Radiology](https://www.benwhite.com/medicine/applying-to-radiology/) - Applying for residency is anxiogenic. That's true for essentially anyone and everyone but perhaps even more so when applying to competitive fields, advanced specialties requiring a preliminary year, or field/location combinations you are not necessarily competitive for. The bright side is that it's a temporary problem, and in a few extra months you'll probably have
- [Semiannual Social Media is Terrible PSA](https://www.benwhite.com/misc/semiannual-social-media-is-terrible-psa/) - Here's a little exercise adapted from "You Really Need to Quit Twitter" in The Atlantic: Step 1: Take the Simone Weil essay “On the Abolition of All Political Parties” and replace the word "parties" with something that maybe shouldn't exist, like social media: The mere fact that social media exists today is not in itself
- [A Few Lessons from Becoming a Mom in Residency](https://www.benwhite.com/parenthood/a-few-lessons-from-becoming-a-mom-in-residency/) - This is the very first guest post ever on this site, and it comes from none other than my awesome wife. Thanks for sharing your experiences and insight! I'm the type of girl who likes to be prepared. Give me a test and I will highlight, notate, and study my anxieties away. Years of pre-med,
- [How to be a First Year Radiology Resident](https://www.benwhite.com/radiology/how-to-be-a-first-year-radiology-resident/) - This is a brief companion post to my original post on approaching the radiology R1 year. This is what you need to do to succeed in radiology and life: Be a decent human being and use common sense. If that's not enough to go on, here's a longer list: Be on time Be excited Be
- [Explanations for the 2021 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2021-official-step-1-practice-questions/) - This year's set was updated in February 2021 (PDF here). The asterisks (*) signify a new question, of which there are only 2 (#24 and 53). The 2020 set explanations and pdf are available here; the comments on that post may be helpful if you have questions. The less similar 2019 set is still available
- [To STAT or not to STAT](https://www.benwhite.com/medicine/the-power-of-stat/) - A passage about limited resources and optimizing imaging from The Emergency Mind: Wiring Your Brain for Performance Under Pressure by Dan Dworkis MD PhD: Within the broader context of your responsibility however, there frequently will be significant variability in the relative urgencies of individuals being imaged. Some patients—like a person seemingly experiencing an acute stroke—do
- [How to Study for the USMLE Step 1](https://www.benwhite.com/medicine/how-to-approach-the-usmle-step-1/) - I've spent the majority of my "adult" life as a standardized test taker. As a resident physician, my skills are still developing. But as a student, as an aficionado of the multiple choice question, I've already reached (and probably lost) my peak abilities. I am asked frequently about my thoughts on the Step exams, especially the USMLE Step
- [The Lesser "Personal" Side of Medicine](https://www.benwhite.com/medicine/the-lesser-personal-side-of-medicine/) - A century-old tidbit of wisdom from the Book on the Physician Himself by DW Cathell MD (published way back in 1902, so ignore the pronouns): EVERY Medical Man discovers sooner or later that The Practice of Medicine has two sides: A Greater Scientific Side, and a Lesser, but important, Personal Side, and that to fight
- [The Limitations of Copy and Paste](https://www.benwhite.com/misc/the-limitations-of-copy-and-paste/) - From "To Kickstart a New Behavior, Copy and Paste" by Kathy Milkman, author of the new book, How to Change, which suggests the best way to master a new skill is to emulate the methods of someone successful. Happily, it’s easy to turn yourself into a deliberate copy-and-paster. The next time you’re falling short of
- [Shallow versus Deep. Prolific versus Profound.](https://www.benwhite.com/medicine/shallow-versus-deep-prolific-versus-profound/) - From Rest: Why You Get More Done When You Work Less: We see work and rest as binaries. Even more problematic, we think of rest as simply the absence of work, not as something that stands on its own or has its own qualities. Rest is merely a negative space in a life defined by
- [How to Schedule Residency Interviews](https://www.benwhite.com/medicine/how-to-schedule-residency-interviews/) - You've sent in your application. Your anxiety increases. You begin to compulsively check your email account. Your heart skips a beat when you have a new message. Welcome to interview season. Getting the interview You will be contacted via email (very rarely by snail mail) if a program wishes to interview you. They will generally
- [Focus on the drive, not the distraction](https://www.benwhite.com/reading/focus-on-the-drive-not-the-distraction/) - NYT Columnist David Brooks writing about "The Art of Focus" back in 2014: If you want to win the war for attention, don’t try to say ‘no’ to the trivial distractions you find on the information smorgasbord; try to say ‘yes’ to the subject that arouses a terrifying longing, and let the terrifying longing crowd
- [Translating the ABR's Response to Exam Postponement Discontent](https://www.benwhite.com/radiology/translating-the-abrs-response-to-exam-postponement-discontent/) - Two days after they announced the second cancellation of scheduled exams this year, the ABR felt compelled to rapidly address the massive discontent in the radiology committee. Perhaps hearing that a joint letter from every trainee and many rad organizations was in the pipeline gave them the extra incentive to try and preempt (unsuccessfully, see
- [Diganostic FOMO](https://www.benwhite.com/medicine/diganostic-fomo/) - From Suneel (brother of Sanjay) Gupta's Backable: The Surprising Truth Behind What Makes People Take a Chance on You: Apply the following quotation to why doctors don't want to make the call: If the fear of betting on the wrong idea is twice as powerful as the pleasure of betting on the right idea, then
- [Don't forbear your loans during residency (if you can help it)](https://www.benwhite.com/finance/dont-forbear-your-loans-during-residency-if-you-can-help-it/) - The most fiscally responsible thing you can do as a resident with student loans is either enter an income-driven repayment (IDR) program like REPAYE, PAYE, or IBR or (rarely) refinance privately. Please see basically any chapter of the book. Everyone is currently enjoying a 0% federal interest rate, but that's set to expire this fall.
- [Student loan debt predicts burnout](https://www.benwhite.com/misc/student-loan-debt-predicts-burnout/) - From "Predictors Between the Subcomponents of Burnout Among Radiology Trainees" by Le et al. in JACR. In summary: Debt level < $200,000 was associated with lower [emotional exhaustion] scores among upper-level trainees and was the only predictor of burnout that significantly affected multiple years of training. I suspect there is a dose-response above
- [Residency and the Craftsman Mentality](https://www.benwhite.com/medicine/residency-and-the-craftsman-mentality/) - From Cal Newport's excellent Deep Work: Rules for Focused Success in a Distracted World: Whether you’re a writer, marketer, consultant, or lawyer: Your work is craft, and if you hone your ability and apply it with respect and care, then like the skilled wheelwright you can generate meaning in the daily efforts of your professional
- [The One Thing](https://www.benwhite.com/reading/the-one-thing/) - From The ONE Thing: The Surprisingly Simple Truth Behind Extraordinary Results: When everything feels urgent and important, everything seems equal. We become active and busy, but this doesn’t actually move us any closer to success. Activity is often unrelated to productivity, and busyness rarely takes care of business. You can become successful with less discipline
- [Regulatory controls and not-so-free markets](https://www.benwhite.com/misc/regulatory-controls-and-not-so-free-markets/) - Not just doctors but all sorts of students and professionals scrambled to figure out how to deal with their high-stakes exam during the pandemic. Lawyers were no exception. Some states had new lawyers take the bar remotely. But a few states just got rid of it altogether and allowed diplomas from accredited schools to stand
- [Program directors and the pass/fail USMLE](https://www.benwhite.com/medicine/program-directors-and-the-pass-fail-usmle/) - Just over a year ago, the NBME announced that Step 1 would soon become pass/fail in 2022. A lot of program directors complained, saying the changes would make it harder to compare applicants. In this study of radiology PDs, most weren't fans of the news: A majority of PDs (69.6%) disagreed that the change is
- [Private Equity & the Comeback of the For-Profit Medical School](https://www.benwhite.com/medicine/private-equity-the-comeback-of-the-for-profit-medical-school/) - You may be used to hearing about private equity takeovers of medical practices, but you may be less familiar with the recent growth of for-profit (primarily osteopathic) medical schools, two of which are owned by Medforth Global Healthcare Education. Medforth, as you might have guessed, is a private equity firm based in New York, NY.
- [Old Guard Medical Wisdom? Rest](https://www.benwhite.com/medicine/old-guard-medical-wisdom-rest/) - From Rest: Why You Get More Done When You Work Less: Neurosurgeon Wilder Penfield, for example, warned medical students that unless they cultivated other interests, “your specializing will expose you to an insidious disease that can shut you away from all but your occupational associates” and “imprison you in lonely solitude.” Penfield’s mentor, William Osler,
- [Patient Satisfaction: A Danger to be Avoided](https://www.benwhite.com/medicine/patient-satisfaction-a-danger-to-be-avoided/) - Doctors intuitively know that the Yelpification of medicine is bad. But it’s not just toxic to the physician-patient relationship and bad for burnout, it’s actually dangerous. The outsized and misplaced importance of patient satisfaction scores is a perfect embodiment of Goodhart’s law, well-paraphrased as “when a measure becomes a target, it ceases to be a good
- [A $310,284.24 PSLF Success Story](https://www.benwhite.com/finance/a-three-hundred-thousand-pslf-success-story/) - People often ask me if I know anybody who has successfully received public service loan forgiveness (PSLF). For the past couple of years, my answer has been that I've seen multiple verified examples of PSLF but didn't know anyone personally (in real life). That's mostly because I graduated in 2012, so my former classmates are
- [Approaching the Radiology Core Exam](https://www.benwhite.com/radiology/approaching-the-abr-core-exam/) - We'll start with some general thoughts on the exam and preparation, delve into the image-rich, physics, and non-interpretative skills. We'll conclude with my personal approach (which you probably shouldn't do), and some thoughts on adapting that to a reasonable regimen that should serve many people well. This post, like all of my Core Exam posts,
- [Leadership and Resident Satisfaction](https://www.benwhite.com/radiology/leadership-and-resident-satisfaction/) - It's residency Rank Order List season, and I thought I'd share a paper published in AJR from 2016 titled, "Radiology Resident' Satisfaction With Their Training and Education in the United States: Effect of Program Directors, Teaching Faculty, and Other Factors on Program Success." It was a small study where the authors surveyed 217 radiology residents.
- [The ABR dreams of a low-cost world](https://www.benwhite.com/radiology/the-abr-dreams-of-a-low-cost-world/) - The February 2021 issue of the BEAM features a short article with the title, "Board, Staff Working Together to Control Expenses." As the Board of Governors discussed these new [remote] exam tools, one of the perceived potential benefits was the intuitive opportunity to decrease costs and, by extension, reduce fees. However, there are persistent barriers
- [How I read NBME/USMLE questions](https://www.benwhite.com/medicine/how-i-read-nbme-usmle-questions/) - From a reader: What's your step by step process when answering questions on the NBME shelf exams? I have been reading the question first while highlighting the key words and then reading the answer choices (often glancing back at the words I highlighted to confirm that the answer choice I chose is correct.) With this method,
- [Review: WCI's "Fire Your Financial Advisor" Online Course](https://www.benwhite.com/finance/review-fire-your-financial-advisor/) - I’ve been reading Jim Dahle’s White Coat Investor blog for years. And by "blog" I mean watching the WCI empire grow from blog to book to advertising magnate to website network to now e-course. The newest WCI endeavor is a video course on the Teachable platform called “Fire Your Financial Advisor.” Because of the site
- [Consolidate Your Student Loans after Graduation and Automatically Max Out the Student Loan Interest Deduction](https://www.benwhite.com/finance/consolidate-student-loans-after-graduation-and-automatically-max-out-the-student-loan-interest-deduction/) - I've previously discussed in the detail the benefits and importance of consolidating federal student loans into a Direct consolidation loan as soon as possible after graduating. One side perk of doing so is that most people will also max out their student loan interest deduction for that tax year regardless of whatever actual monthly payments
- [Medical Curriculum Development is an Oxymoron](https://www.benwhite.com/medicine/medical-curriculum-development-is-an-oxymoron/) - A few separate paragraphs I've tied together from Curriculum Development for Medical Education: The difference between the ideal approach and the current approach represents a general needs assessment. [A] curriculum can be written, starting with broad or general goals and then moving to specific, measurable objectives. Objectives may include cognitive (knowledge), affective (attitudinal), or psychomotor
- [Step 2 CS Canceled Forever (Hopefully)](https://www.benwhite.com/medicine/step-2-cs-canceled-forever-hopefully/) - The NBME announced yesterday that they're scrapping plans to relaunch the USMLE Step 2 CS as a virtual telehealth evaluation that pretends to assess clinical skills: Following the May 2020 suspension of Step 2 CS due to the COVID-19 pandemic, we announced our intention to take 12-18 months to bring back a modified Step 2
- [Slim pickings high up on the ladder](https://www.benwhite.com/reading/slim-pickings-high-up-on-the-ladder/) - From Nobel laureate economist Richard Thaler's Misbehaving: The Making of Behavioral Economics: A competitive labor market does do a pretty good job of channeling people into jobs that suit them. But ironically, this logic may become less compelling as we move up the managerial ladder. All economists are at least pretty good at economics, but
- [The Support Page](https://www.benwhite.com/misc/the-support-page/) - It's one of those things I probably should have done around a decade ago, but last week I put up a "support" page. As I don't run any ads and the vast majority of my writing is unmonetized, this site is largely a labor of love (and I'm happy with that). But... I also talk
- [Biden Continues the Pandemic Student Loan Pause](https://www.benwhite.com/finance/biden-continues-the-pandemic-student-loan-pause/) - Good news for student loan borrowers, President Biden has extended the pandemic pause on federal student loan interest and payments for borrowers until September 30, 2021. You might remember this first started with the CARES Act last, which I discussed here. No reason to make this complicated: $0 Payments 0% Interest These months continue to
- [ABR Wins Round 2 in its Antitrust Lawsuit](https://www.benwhite.com/radiology/abr-wins-round-2-in-its-antitrust-lawsuit/) - Judge Alonso dismissed the amended class-action lawsuit against the ABR on January 8, continuing the trend of denying a duel by trial in the ongoing saga of various doctors against the ABMS hegemony. You can read his opinion (~15 pages) here (and my most recent prior lawsuit-related post is here). I can't speak for its
- [Productive Procrastination](https://www.benwhite.com/misc/productive-procrastination/) - From Indistractable: How to Control Your Attention and Choose Your Life: I discovered that living the life we want requires not only doing the right things; it also requires we stop doing the wrong things that take us off track. If distraction costs us time, then time management is pain management. That's a catchy line.
- [What I Read in 2020](https://www.benwhite.com/reading/what-i-read-in-2020/) - I said at the end of my 2019 reading list that I thought 2020 was "going to be a good year." Well. I did, however, manage to read some books. I also said last year that I'd discovered an absurdly dorky subgenre called LitRPG (basically fantasy novels crossed with role-playing games) and that I probably
- [Blaming the Algorithm](https://www.benwhite.com/medicine/blaming-the-algorithm/) - From a WaPo article discussing protests at Stanford about a vaccine distribution plan that favored remote-working employees over trainees: The “residents” — medical school graduates who staff the hospital for several years as they learn specialties such as emergency medicine, internal medicine and family medicine — were furious when it became clear that just seven
- [The Basis for No](https://www.benwhite.com/misc/the-basis-for-no/) - In Essentialism, Greg McKeown writes: Many capable people are kept from getting to the next level of contribution because they can’t let go of the belief that everything is important. We're in the middle of residency interview season, but for many students, the CV-padding season started in high school and never ended. We have a
- [Charity Tax Deductions and the CARES Act](https://www.benwhite.com/finance/charity-tax-deductions-and-the-cares-act/) - Another quick PSA: The Trump tax cuts raised the standard deduction, which has meant that a lot fewer people are itemizing deductions. For example, the kind of house a resident can afford is the kind of house that doesn't generate enough of a deduction to make itemizing worth it these days. And if you don't
- [Radiology and the Private Equity Bait and Switch](https://www.benwhite.com/radiology/radiology-and-the-private-equity-bait-and-switch/) - With permission, I'm reposting a (very lightly edited) anonymous social media post from a young radiologist who joined a private practice that had recently been purchased by private equity: I think I committed a huge mistake in signing up for a job with a large private practice group that was bought by a big private
- [WCICON 2021](https://www.benwhite.com/medicine/wcicon-2021/) - The next Physician Wellness and Financial Literacy Conference (WCICON21) will be online from March 4-6, 2021. I'll be there virtually to answer questions and give two talks, one about writing (worth CME) and one about student loans. It's a great opportunity to use those CME funds that are feeling neglected during the pandemic. Registration is
- [Virtual Exams and Security Theatre](https://www.benwhite.com/medicine/virtual-exams-and-security-theatre/) - Many months into the pandemic, and we’re all acquainted with the difference between a true public health measure and security theatre. Being outdoors instead of crowding inside? Meaningful intervention. Daily temperature screens? Theatre. We know that most people with the virus who are putting themselves around other humans will not be actively febrile but are
- [Learning & The Transfer Problem](https://www.benwhite.com/medicine/learning-and-the-transfer-problem/) - There's a classic quote that gets attributed to a whole bunch of people, and it goes like this: “In theory, there is no difference between theory and practice. But in practice, there is.” This is the transfer problem, and it's a real thorn for how we learn (and especially how we learn to perform in
- [The Report of the ACR Task Force on Certification in Radiology](https://www.benwhite.com/radiology/the-report-of-the-acr-task-force-on-certification-in-radiology/) - The report from the ACR Task Force on Certification in Radiology is out. This is the American College of Radiology's formal take on how the American Board of Radiology is doing exercising its monopoly on radiology certification. It's clear, concise, well-researched, and contains wonderfully diplomatic language. I admire the restraint (emphasis mine): Fees have remained
- [Imaging is the great equalizer](https://www.benwhite.com/reading/imaging-is-the-great-equalizer/) - Imaging is the great equalizer. When we look deep into ourselves from the vantage of this fundamental level, with exterior barriers and labels removed, we just might just see ourselves, other people, and our lives in a whole new light. From Dr. Cullen Ruff's Looking Within: Understanding Ourselves through Human Imaging, currently an Amazon Black
- [A Virtual Step 2 CS: More convenient, equally if not more useless](https://www.benwhite.com/medicine/a-virtual-step-2-cs-more-convenient-equally-if-not-more-useless/) - The NBME announced a new virtual USMLE Step CS would replace the pre-pandemic in-person exam that's topped the list of medical student headaches for recent generations. While light on details, it sounds like it's going to be a bunch of telehealth visits that will do away with the pretense that the exam evaluates students' ability
- [Time to ditch the ERAS application photo](https://www.benwhite.com/medicine/time-to-ditch-the-eras-application-photo/) - Pretty damning results about the impact of perceived attractiveness on residency application success. Suffice to say, what came up didn't exactly make it into the NRMP Program Director's Survey. There's a new paper in Academic Medicine titled "Bias in Radiology Resident Selection: Do We Discriminate Against the Obese and Unattractive?" coming out of Duke. Hint:
- [Residency Consultants](https://www.benwhite.com/medicine/residency-consultants/) - I get emails all the time asking for residency application advice. A lot of these come from IMGs, which isn't surprising: applying to residency in the US from the outside is stiffly competitive, and the support/advice from home isn't always sufficient. Others are those with competitive dreams or particular needs for residency that make fourth
- [Tomorrow is a new day](https://www.benwhite.com/reading/tomorrow-is-a-new-day/) - Finish every day and be done with it. You have done what you could; some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day; you shall begin it well and serenely, and with too high a spirit to be cumbered with your old nonsense. —Ralph
- [To be home is to be known](https://www.benwhite.com/reading/to-be-home-is-to-be-known/) - If anyone was looking for a summary of a core problem in American society, from former Surgeon General Dr. Vivek H. Murthy’s lovely book, Together: The Healing Power of Human Connection in a Sometimes Lonely World: While loneliness engenders despair and ever more isolation, togetherness raises optimism and creativity. When people feel they belong to
- ["It would be nice to have more, but I’ll manage."](https://www.benwhite.com/reading/it-would-be-nice-to-have-more-but-ill-manage/) - That’s a quote from Josh Kaufman's How to Fight a Hydra. Here’s another: Fear of the unknown will always be with you, no matter what you do. That’s comforting in a way: if there’s nothing you can do to change it, there’s no reason to let it stop you.
- [What Money Buys](https://www.benwhite.com/reading/what-money-buys/) - From How to Think About Money by Jonathan Clements: First and foremost, money buys time and autonomy. Secondarily, it buys experiences. Last, and least, it buys stuff, and more often than not, the stuff we buy makes us miserable. Most people live their lives with these in the opposite order, but Clements is absolutely right.
- [The ABR Comes Around](https://www.benwhite.com/radiology/the-abr-comes-around/) - The American Board of Radiology announced earlier this week that they would indeed be joining the civilized medical world and moving to a virtual exam solution for all future exams and maintaining the current proposed February and June dates for next year’s administrations: We appreciate the constructive feedback regarding our 2020 exam schedule and recognize the significant
- [Studying during residency](https://www.benwhite.com/medicine/studying-during-residency/) - Here are some questions I received a long time ago about studying during residency: Do you have any thoughts on studying to become a better doctor? What and how do you study when not preparing for some fun standardized test? The easy answer for the latter is that in our modern system of medical education
- [ABR & Guessing the Cost of a Lawsuit](https://www.benwhite.com/radiology/abr-guessing-the-cost-of-a-lawsuit/) - All non-profits have to file a Form 990 with the IRS detailing their finances. The ABR's 990 says "THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST." I've already read and discussed the bylaws, but I thought I'd ask for the financial statements. Two emails went unanswered, but after I asked
- [Status Quo Bias](https://www.benwhite.com/misc/status-quo-bias/) - From Machine, Platform, Crowd: Harnessing Our Digital Future by Andrew McAfee and Erik Brynjolfsson: Research in many different fields points to the same conclusion: it’s exactly because incumbents are so proficient, knowledgeable, and caught up in the status quo that they are unable to see what’s coming, and the unrealized potential and likely evolution of
- [Good ideas need to outlive the old guard](https://www.benwhite.com/misc/good-ideas-need-to-outlive-the-old-guard/) - Nobel-prize winning physicist Max Planck argued in his autobiography that change takes time because good ideas need enough staying power to outlive their detractors: A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that
- [RBG on Writing](https://www.benwhite.com/writing/rbg-on-writing/) - Former two-time law clerk for Ruth Bader Ginsburg, David Post: Most of what I know about writing I learned from her. The rules are actually pretty simple: Every word matters. Don't make the simple complicated, make the complicated as simple as it can be (but not simpler!). You're not finished when you can't think of anything more to
- [Attention is a Gift](https://www.benwhite.com/reading/attention-is-a-gift/) - From the highly readable Nobody Wants to Read Your Sh*t by Steven Pressfield: You begin to understand that writing/reading is, above all, a transaction. The reader donates his time and attention, which are supremely valuable commodities. In return, you the writer must give him something worthy of his gift to you. When you understand that
- [Private Practice vs. Academic Radiology](https://www.benwhite.com/medicine/private-practice-vs-academic-radiology/) - Disclaimer: I was a resident who had neither started nor completed the process of getting a job when I wrote this. I was however asked to weigh in on pursuing a radiology job in academics vs. private practice, particularly with regards to how one's future desires might shape an applicant's choice of residency program. Overall,
- [What's healthcare's sideways threat?](https://www.benwhite.com/medicine/whats-healthcares-sideways-threat/) - It’s the “sideways threats” that bite companies, he said. “If you think of Kodak and Fuji, competing in film for 100 years, but then ultimately it turns out to be Instagram.” - Reed Hastings, CEO of Netflix, interviewed in the NYT. If medicine is anticipating disruption from AI, everyone is wary of private equity and
- [Sociopaths need data too](https://www.benwhite.com/misc/sociopaths-need-data-too/) - I just finished John Carreyrou's Bad Blood: Secrets and Lies in a Silicon Valley Startup, about the fall of Elizabeth Holmes and Theranos, the Silicon Valley Unicorn that pretended to be a pioneer in laboratory testing but was really just a purveyor of bloated promises and outright lies. A sociopath is often described as someone
- [Focused Nonchalance](https://www.benwhite.com/misc/focused-nonchalance/) - Focused nonchalance is, I believe, the ideal attitude to cultivate when preparing for and taking a high-stakes exam. While much much easier said than done, the goal of attitudinal preparation is to strive for a state of flow when answering multiple-choice questions: focused and potentially even joyful as you take an exam, marshaling all of
- [Updates in the ABR Lawsuit](https://www.benwhite.com/radiology/updates-in-the-abr-lawsuit/) - The back and forth continues. You can see the duel laid out on the lawsuit's website, but they're now up to 9 filings, most recently on August 12, when the plaintiff added their "Sur-Reply in Opposition to Motion to Dismiss" (which is an additional response to specific arguments made by the American Board of Radiology
- [Review: Doctor's Orders (Hierarchies in Medicine)](https://www.benwhite.com/medicine/doctors-orders-hierarchies-in-medicine/) - Sociologist Tania M. Jenkins compares and contrasts two geographically similar academic and community internal medicine residencies in her book, Doctor's Orders, which discusses hierarchy in medicine. Her overall thrust: Amidst a widespread and pervasive emphasis on individual merit in medicine, I found that largely structural advantages and disadvantages, often dating back to childhood differences in
- [Less Certainty, More Inquiry](https://www.benwhite.com/misc/less-certainty-more-inquiry/) - Maria Konnikova, psychologist and rapid-onset Poker champion, relaying a story from her mentor and seasoned Poker champion, Erik Seidel: Seidel doesn’t give me much in the way of concrete advice, and our conversations remain more theoretical than I would prefer. He focuses more on process than prescription. When I complain that it would be helpful
- [Student Loans Virtual Noon Conference](https://www.benwhite.com/medicine/student-loans-virtual-noon-conference/) - I gave a virtual noon conference today for MRI Online. It requires a free registration, but it's one of a collection of great radiology lectures available for free. This is week 19 of the series. My talk is permalinked here. It starts with discussing a brief history of student loans in the US as well
- [Panglossian Medical Fallacies](https://www.benwhite.com/medicine/panglossian-medical-fallacies/) - From Dr. Benjamin Mazer's "Medicine’s dangerous optimism – Lessons from Dr. Pangloss," published in The Journal of the Royal Society of Medicine. Consider the story of Dr. Pangloss, the fictional “professor of metaphysico-theologico-cosmolo-nigology” in Voltaire’s satirical eighteenth-century novel Candide. Dr. Pangloss is remembered for declaring that we live in the “best of all possible worlds.”
- [Explanations for the 2018-2019 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2018-2019-official-step-2-ck-practice-questions/) - The NBME recently released an "updated May 2018" official "USMLE Step 2 CK Sample Test Questions," but these are actually completely unchanged over the past two years since the June 2016 update, which was itself almost unchanged from the 2015 set. Since it's been a couple years, I've included the explanations below (which are, again, unchanged).
- [Guesting on Doctor Money Matters](https://www.benwhite.com/misc/guesting-on-doctor-money-matters/) - Another pre-pandemic podcast recording is out this week, this one discussing student loans (and some other stuff) on the excellent Doctor Money Matters. Check it out on your favorite podcast app and give Dr. Patel a nice review. We covered some good stuff! Now that I keep mentioning my next book in progress on all
- [Talking about Life, Finance, and Student Loans](https://www.benwhite.com/misc/talking-about-life-finance-and-student-loans/) - I recorded an episode of Dave Denniston's Freedom Formula for Physicians Podcast earlier this year and it's up this week. I had fun, and we actually covered a lot more personal stuff compared to my usual writing. You can listen here (or on your favorite podcast app—I recommend Overcast).
- [The disappearing USMLE 2020 practice questions](https://www.benwhite.com/medicine/the-disappearing-usmle-2020-practice-questions/) - Update: my explanations for these sets are now available: Step 1 and Step 2 CK. Earlier this year the NBME released updated 2020 practice materials for both Step 1 and Step 2 CK. There are a bunch of new Step 1 questions and the Step 2 set is entirely brand new (the first meaningful change
- [The Machinery of Skepticism](https://www.benwhite.com/misc/the-machinery-of-skepticism/) - Carl Sagan, famous astronomer and author of Contact and Cosmos (among others), writing about "The Burden of Skepticism" way back in 1987: It seems to me what is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same
- [Flywheels and Doom Loops](https://www.benwhite.com/misc/flywheels-and-doom-loops/) - Jim Collins, author of Built to Last and Good to Great, talking on The Knowledge Project: What we found is that the most durable results happen as a series of good decisions that accumulate one upon another over a very long period of time, that create a massive compounding effect. And just like investing, where
- [Private Equity and Healthcare, a Marriage in Crisis](https://www.benwhite.com/misc/private-equity-and-healthcare-a-marriage-in-crisis/) - "Is Private Equity Having Its Minsky Moment?" is another excellent article from Matt Stoller's BIG newsletter, something that anyone who is interested in PE and corporate finance should be reading (I referenced a couple of his newsletters previously). You’ve probably been hearing about salary cuts, furloughed employees, and big losses in health systems around the
- [The ABR and the Pinnacle of Flexibility](https://www.benwhite.com/radiology/the-abr-and-the-pinnacle-of-flexibility/) - From ABR President Brent Wagner's article, "ABR, Stakeholders Remaining Flexible During Uncertain Times," in the May issue of the BEAM: For the ABR, as it became clear that standard exam development activities would not be effective in the short term, staff and volunteer content experts quickly made adjustments: test assembly activities for upcoming exams were
- [Symbolic Measures and the Silence of the ABR](https://www.benwhite.com/radiology/symbolic-measures-and-the-silence-of-the-abr/) - Earlier today the ACR passed resolution 50 without dissent, a gesture made in response to the recent (and ongoing?) MOC agreement debacle. The thrust of the resolution is that the American Board of Radiology should strive to "minimize power imbalance in decision-making between those professionals and the certifying body by committing to representative, inclusive, and
- [ABR MOC and the Art of the Apology](https://www.benwhite.com/radiology/abr-moc-and-the-art-of-the-apology/) - This week the American Board of Radiology emailed its diplomates in response to the continued concern that its initial fix to the over the top legalese in its agreements was buried so deep that no one could see it as well as the frustration that people who caved early didn't have a chance to sign
- [Free Radiology Resources from the ACR RFS](https://www.benwhite.com/radiology/free-radiology-resources-from-the-acr-rfs/) - Residents from across the country in the ACR Resident and Fellow Section came together and assembled a nice collection of free radiology learning resources from across the interwebs including lots of videos. You can help to add more. It's a Google doc. Check it out.
- [Timeless Advice: The Golden Rule will never fail you](https://www.benwhite.com/misc/timeless-advice-the-golden-rule-will-never-fail-you/) - Kevin Kelly, former editor of Wired and the writer who popularized the 1000 true fans idea, decided to give 68 bits of unsolicited advice on his sixty-eighth birthday. It's an excellent quick collection, but here are a few great ones that apply especially well to medical training: Being enthusiastic is worth 25 IQ points. Promptness is
- [The ABR's Thoughts on Doing the Right Thing](https://www.benwhite.com/radiology/the-abr-rejects-doing-the-right-thing/) - In response to concerns about exam administration, the American Board of Radiology has now released a "Statement on Delivering Remote Exams" to their Coronavirus updates page: In response to queries, delivering our exams remotely is problematic. We have investigated many options, but the inability to adequately control image quality, the testing environment, and security would
- [Living Happily in a World You Don't Understand](https://www.benwhite.com/misc/living-happily-in-a-world-you-dont-understand/) - Morgan Housel, discussing the problematic narrowness and personal bias of most people's mental models: I don’t know what I don’t know. No one does. But we can’t walk around confused all day. Nassim Taleb says “I want to live happily in a world I don’t understand.” Which is exactly what we do. We take the
- [The Overtautness of American Healthcare](https://www.benwhite.com/misc/the-overtautness-of-american-healthcare/) - Siddhartha Mukherjee, author of the excellent Pulitzer Prize-winning The Emperor of All Maladies, writing for The New Yorker (emphasis mine): To what extent did the market-driven, efficiency-obsessed culture of hospital administration contribute to the crisis? Questions about “best practices” in management have become questions about best practices in public health. The numbers in the bean
- [The ABR's Revised New MOC Agreement](https://www.benwhite.com/radiology/abr-revised-moc-agreement/) - Last week, people were upset about the heavy-handy liberty-destroying verbiage of the ABR's new MOC agreement. Some people complained. At least one cranky fellow wrote a blog post about it, and then two days later the ABR backtracked and promised to remove the language about waiving various rights. They did, in fact, do that. But,
- [Awkward ABR Propaganda](https://www.benwhite.com/radiology/awkward-abr-propaganda/) - Little known fact, but the ABR recently added a public member to the Board of Governors. She recently wrote a hello article for The BEAM. How boards like the ABR certify that their members have the requisite skills and knowledge to benefit patients is not well understood by the public, nor by many people in
- [Thinking Alone](https://www.benwhite.com/misc/thinking-alone/) - William Deresiewicz, author of Excellent Sheep: The Miseducation of the American Elite and the Way to a Meaningful Life, in a lecture on Solitude and Leadership at West Point in 2009: That’s really the great mystery about bureaucracies. Why is it so often that the best people are stuck in the middle and the people
- [Paying for COVID-19](https://www.benwhite.com/misc/paying-for-covid-19/) - Morgan Housel, describing how we'll hopefully "pay" for the truly massive bailouts we'll need to get through the Covid-19 pandemic: I’ve heard many people ask recently, “How are we going to pay for that?” With debt, of course. Enormous, hard-to-fathom, piles of debt. But the question is really asking, “How will we get out from
- [The ABR Defines the Intent of the Core Exam](https://www.benwhite.com/radiology/the-abr-defines-the-intent-of-the-core-exam/) - Radiographics hosted a Twitter chat this week to discuss a recent op-ed, "Have We Done Radiology Trainees a Disservice by Eliminating the Oral Board Examination." I was asked to participate. ABR President and soon to be highly-compensated Executive Director Brent Wagner was also set to throw down and managed to fire off a couple of
- [Anticipatory Grief, Anxiety, and—of course—COVID-19](https://www.benwhite.com/misc/anticipatory-grief-anxiety-and-of-course-covid-19/) - David Kessler, co-author of one of the classic books with Kübler-Ross detailing the 5 stages of grief, interviewed in the Harvard Business Review: Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in
- [WCI's Continuing Financial Education 2020](https://www.benwhite.com/finance/wcis-continuing-financial-education-2020/) - I was very much looking forward to traveling to Las Vegas to speak at WCICON20 earlier this month but ended up unable to because of the whole devastating pandemic thing, but Jim and crew have released the conference e-course today. I and several other folks who couldn't make it in person recorded our talks for
- [Coronavirus: The Hammer and the Dance](https://www.benwhite.com/medicine/coronavirus-the-hammer-and-the-dance/) - Another excellent follow-up from Tomas Pueyo about the need to stop doing half-assed mitigation measures. On one side, countries can go the mitigation route: create a massive epidemic, overwhelm the healthcare system, drive the death of millions of people, and release new mutations of this virus in the wild. On the other, countries can fight.
- [Maxims for Academic Medicine](https://www.benwhite.com/medicine/maxims-for-academic-medicine/) - Highlights from Joseph V. Simone's "Understanding Academic Medical Centers," published way back in 1999 (hat tip @RichDuszak): Institutions Don’t Love You Back. A wise colleague once told me that job security was the ability to move to another job (because of professional independence). Institutions Have Infinite Time Horizons to Attain Goals, But an Individual Has
- [Coronavirus & Distance](https://www.benwhite.com/medicine/coronavirus-distance/) - There have been lots of good articles about the novel Coronavirus and the embarrassing state of America's public health response. This one from Vox has some excellent charts. This one on Medium breaks down some of the underlying relationship mechanics of social distancing measures and spread as well as how one estimates the number of
- [Explanations for the 2018 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2018-official-step-1-practice-questions/) - Here are my explanations for the new NBME 2018 USMLE Step 1 Sample Test Questions. This year there are 51 new ones (marked with asterisks). Like in years past, the question order here is for the PDF version (not the FRED-simulated browser version). This facilitates using these explanations in future years when they change the available question
- [OLA Makes Sure Radiologists Have Evolved](https://www.benwhite.com/radiology/ola-makes-sure-radiologists-have-evolved/) - From "Focus on DR," which appeared in the most recent January 2020 edition of the ABR's newsletter, The BEAM: Over time, diagnostic radiology has evolved, and imaging techniques and exams have changed. Computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound improved and replaced many traditional exams. The practice of many diagnostic radiologists now consists
- [Will I qualify for PSLF?](https://www.benwhite.com/finance/will-i-qualify-for-pslf/) - After some high profile new stories about the initial 99% rejection rate for PSLF application, I wrote back in 2018 about how using that number as a means of summarizing the PSLF program was essentially clickbait. I still see the 99% figure used all the time by ill-informed people in arguments about how everyone should
- [Fragmentation and the Family](https://www.benwhite.com/medicine/fragmentation-and-the-family/) - Affluent conservatives often pat themselves on the back for having stable nuclear families. They preach that everybody else should build stable families too. But then they ignore one of the main reasons their own families are stable: They can afford to purchase the support that extended family used to provide—and that the people they preach
- [ABR Lawsuit: The Amended Complaint](https://www.benwhite.com/radiology/abr-lawsuit-the-amended-complaint/) - If you've been keeping up, the original motion to dismiss filed by the ABR was granted by the court, basically parroting the similar intially dismissed case filed against the ABIM. So an amended complaint was filed on January 24, 2020. (Also, a reminder: I'm still not a lawyer.) The Honorable Jorge Alonso's opinion was basically:
- [The Slow Death of Contrast-Induced Nephropathy](https://www.benwhite.com/radiology/the-slow-death-of-contrast-induced-nephropathy/) - There are few things less evidence-based since medical antiquity than contrast-fear and contrast-management. We are slowly, slowly, as a field trying to correct long-held mistakes based on bad correlative science. Intravenous iodinated contrast media are commonly used with CT to evaluate disease and to determine treatment response. The risk of acute kidney injury (AKI) developing
- [The ABR’s new Online Longitudinal Assessment (OLA)](https://www.benwhite.com/radiology/abr-new-online-longitudinal-assessment-ola/) - It was super duper gratifying to receive my first OLA email from the ABR this past month. OLA (Online Longitudinal Assessment) is the ABR’s new longitudinal MOC (Maintenance of Certification) process, where diplomates take 52 questions every year instead of a big test every decade. I took the Certifying Exam in October and received my
- [Believing Anything and Nothing](https://www.benwhite.com/misc/believing-anything-and-nothing/) - The political theorist Hannah Arendt once wrote that the most successful totalitarian leaders of the 20th century instilled in their followers “a mixture of gullibility and cynicism.” When they were lied to, they chose to believe it. When a lie was debunked, they claimed they’d known all along—and would then “admire the leaders for their
- [The Rise of the Consultancy](https://www.benwhite.com/misc/the-rise-of-the-consultancy/) - Management consultants insist that meritocracy required the restructuring that they encouraged—that, as Kiechel put it dryly, “we are not all in this together; some pigs are smarter than other pigs and deserve more money.” Consultants seek, in this way, to legitimate both the job cuts and the explosion of elite pay. Properly understood, the corporate reorganizations were, then,
- [On the WCI Podcast](https://www.benwhite.com/misc/on-the-wci-podcast/) - I had a lot of fun talking to Dr. Jim Dahle on this week's episode of the White Coat Investor Podcast about student loans: I honestly think we may have talked more about my journey on this episode than I have with my actual writing on this site for the past eleven years,
- [Student Loans: In Print and Online](https://www.benwhite.com/writing/student-loans-in-print-and-online/) - I published the first edition of Medical Student Loans: A Comprehensive Guide in 2017. Waiting almost three years to put out a print version is what happens in the perfect storm of total DIY, extreme retentiveness, and being a generally lazy procrastinator. Oops! But I'm happy to say I finally put the finishing touches on the
- [If You Have a REPAYE Subsidy: Maximize It, Don’t Pay Extra](https://www.benwhite.com/finance/if-you-have-a-repaye-subsidy-maximize-it-dont-pay-extra/) - A general rule of debt repayment is that it’s never a bad idea to put extra money towards paying down your debt faster. More money means getting out of debt faster and less money spent on interest. This is true for credit cards, most student loans, car loans, etc. However, this is actually not necessarily
- [Match Fever, AAMC Apply Smart, and Oodles of Bias](https://www.benwhite.com/medicine/match-fever-aamc-apply-smart-and-oodles-of-bias/) - Brian Carmody is a pediatric nephrologist, associate program director, and man after my heart. He's been publishing an impressive series of excellent, well-researched, and well-argued articles about basically everything wrong with the current medical school-industrial complex and the biases of its major players that have resulted in the general crapifying of medical education. And here
- [What I Read in 2019](https://www.benwhite.com/reading/what-i-read-in-2019/) - Continuing my tradition of posting my annual book diet, this year wasn't nearly as good of a reading year as 2018. 2019 was (extremely?) busy with the birth of our baby daughter, the continued raising of our four-year-old son, my wife starting a solo private practice (that's another post), and my first full year as
- [Gratified](https://www.benwhite.com/radiology/gratified/) - I don't normally talk much about the places I work or the institutions I've been affiliated with on the site. After all, these views are my own. But I'm just going to drop this here briefly because I'll freely admit that I was honored and gratified to win Teacher of the Year my first full
- [Student Loans Books: Free Forever](https://www.benwhite.com/writing/student-loans-books-free-forever/) - When I began the project that eventually resulted in my two books on student loans, my long-term plan was to sell them temporarily, recoup some of the incredible time (and opportunity cost) burden of putting them together, and then eventually release them for free. I’m happy to say that day is finally here. From now
- [Thought Experiment: Borrow a Direct Loan as soon as possible in order to secure the possibility of PSLF](https://www.benwhite.com/finance/thought-experiment-borrow-a-direct-loan-as-soon-as-possible-in-order-to-secure-the-possibility-of-pslf/) - Back when the Republicans held the Presidency, Senate, and the House, there was constant bellyaching about when the government would shutter the PSLF program. As we've discussed previously, despite various proposals, any practical discussion that suggested an imminent demise was either unfounded, misguided, and/or primarily promoted by news organizations who need advertising eyeballs or by
- [Residents Are Underpaid, But You Knew That](https://www.benwhite.com/medicine/residents-are-underpaid-but-you-knew-that/) - A handful of notable free tuition experiments aside, the combination of rising medical school costs, vocational pressures, life-quality issues, and reimbursement battles has clearly had a chilling effect on many lower-paying specialties and continues to funnel medical students into procedural fields and surgical subspecialties. An individual student’s personal calculus aside, the broader question is still
- [ABR wins lawsuit first round](https://www.benwhite.com/radiology/abr-wins-lawsuit-first-round/) - On November 18, a federal judge has granted the ABR's motion to dismiss for the lawsuit filed this February. Judge Jorge Alonso was unconvinced by the argument that the ABR has illegally tied its MOC product to its initial certification product, agreeing with the ABR that the two things are really two parts of the
- [How/Why to Consolidate Federal Student Loans When You Graduate Medical School](https://www.benwhite.com/finance/how-why-to-consolidate-federal-student-loans-when-you-graduate-medical-school/) - When you get federal student loans from the government for medical school, you don't just get one loan: you get at least one per year. Back in the day when graduate students still received subsidized loans, many borrowers would receive three: one subsidized, one unsubsidized, and often a small "low-interest" (5%) Perkins loan. Now, in
- [Guesting about PSLF on the Financial Residency Podcast](https://www.benwhite.com/medicine/guesting-about-pslf-on-the-financial-residency-podcast/) - Listen to me and Ryan Inman of the excellent Financial Residency podcast nerd out about PSLF and why you should 1) be diligent and 2) ignore the clickbait/majority of what you read online. Check it out. I would normally give the disclaimer that I had a cold, but I have a four-year-old and now an
- [Budget and law proposals don’t matter: PSLF will work for people who already have loans](https://www.benwhite.com/finance/budget-and-law-proposals-dont-matter-pslf-will-work-for-people-who-already-have-loans/) - If you took out federal student loans after 2007, the master promissory note—the legal contract between you and the US government—had this buried in it: A Public Service Loan Forgiveness (PSLF) program is also available. Under this program, we will forgive the remaining balance due on your eligible Direct Loan Program loans after you have
- [Graduated and Extended Payment Plans now count toward PSLF (temporarily)](https://www.benwhite.com/finance/graduated-and-extended-payment-plans-temporarily-count-toward-pslf/) - The new budget just passed ponied up an extra $350 million to help those ineligible for PSLF due to repayment plan technicalities. Here is the language, followed by the translation. From the recently passed budget (aka Consolidated Appropriations Act, 2018), SEC. 315 (pages 1008-1010): For an additional amount for ‘‘Department of Education—Federal Direct Student Loan Program Account’’,
- [Goals and Consequences of Private Equity](https://www.benwhite.com/misc/goals-and-consequences-of-private-equity/) - A couple of interesting reads from Matt Stoller's BIG newsletter about private equity. Given the current flood of PE group buyouts and market consolidation in healthcare, it's not hard to draw parallels between radiology practices ten years from now and what happened to Toys R Us in 2018 or to identify the obvious issues that
- [ABR OLA MOC: The First-Year Experience](https://www.benwhite.com/radiology/abr-ola-moc-the-first-year-experience/) - 2019 was the initial offering of ABR's MOC of the future: Online Longitudinal Assessment (OLA). I wrote about it earlier this year, but to recap: All Diagnostic Radiology ABR diplomates including those fresh off their Certifying Exam victory lap were immediately thrust into the new paradigm. This amounts to answering a whopping 52 multiple choice
- [PSLF is also a partial federal match for pretax retirement contributions](https://www.benwhite.com/finance/pslf-is-also-a-partial-federal-match-for-pretax-retirement-contributions/) - For those who qualify, PSLF can make an incredible difference in your long-term financial health by wiping away your student loans well before and for less money then you may be able to accomplish for yourself. Due to the way income-driven repayment plan monthly payments are calculated, PSLF also acts as a government subsidy on
- [Free USMLE Step 2 Questions / How to Study for the USMLE Step 2 CK](https://www.benwhite.com/medicine/free-usmle-step-2-questions/) - After taking Step 1, I imagine most students realize how overextended they became trying to get through multiple books during Step studying. In the end, it was the questions that mattered. It's always the questions. So, here's my list of free Step 2 CK questions (updated June 2019): The NBME has its free Step 2
- [Talking to Strangers & Professional Identity](https://www.benwhite.com/misc/talking-to-strangers-professional-identity/) - From this NYTimes' interview with Malcolm Gladwell about his new book, Talking to Strangers: “That happens in these divided times — your professional identity becomes your identity,” Mr. Gladwell said. “On every level,” he added, “I feel like there is this weird disconnect between the way the world is presented to us in the media
- [Mammogeddon: Yes, the conclusion](https://www.benwhite.com/radiology/mammogeddon-yes-the-conclusion/) - This is my fourth (and final) post about the little snafu surrounding the mammography portion of the ABR Core Exam last summer. I wrote about what happened here. I wrote about what the response was here. I wrote about the proposed solution here. Now, we’ll finish with how that do-it-yourself online module went. Logistically, it
- [ABR totally botches 2017 Core Exam](https://www.benwhite.com/radiology/abr-totally-botches-2017-core-exam/) - This email belies how royally the ABR botched the 2017 Core Exam. What the ABR should have done is what any accountable organization should do when they mess up. Express regret and acknowledge responsibility Be transparent and describe the mistake Give an action plan and steps to correct the problem Ask for forgiveness Instead, examinees received the
- [Once in IDR/IBR/PAYE/REPAYE, Always in IDR/IBR/PAYE/REPAYE](https://www.benwhite.com/finance/once-in-idr-ibr-paye-repaye-always-in-idr-ibr-paye-repaye/) - “I got married” or “My income went up” and “they MADE me change repayment plan because I didn’t qualify anymore.” No no no. They cannot make you do this. You are never forced to leave a federal repayment plan once you have been accepted for it, ever (unless you are not making your payments or
- [Don't Break the Chain, or, the first motivational system I've ever used](https://www.benwhite.com/misc/dont-break-the-chain/) - Researching ways to get things done (or keep New Year's resolutions) is like scouring the web for distraction-free writing apps when you're supposed to be writing. Just because its a related task doesn't make it anything other than procrastination and self-sabotage. I've tried Evernote and Day One and Wunderlist and it seems like every other
- [Utopia for Realists](https://www.benwhite.com/misc/utopia-for-realists/) - Rutger Bregman, author of Utopia for Realists and the Dutch historian from the viral video calling out billionaires at Davos ("taxes taxes taxes, all the rest is bullshit in my opinion"), talking to Ezra Klein in Vox: We should never underestimate capitalism’s extraordinary ability to come up with new bullshit jobs. ... We could theoretically live in some
- [Measles is the original measles vaccine](https://www.benwhite.com/medicine/measles-is-the-original-measles-vaccine/) - Measles is the original measles vaccine. It’s a natural method that’s been around for centuries. It was good enough for my mother and my mother’s mother and her mother before her. Unlike synthetic vaccines, which are modified by scientists in underground labs to reduce their potency, measles is completely organic. From "I'm vaccinating my child
- [You don’t need to submit a PSLF ECF when you first start a new job](https://www.benwhite.com/finance/you-dont-need-to-submit-a-pslf-ecf-when-you-first-start-a-new-job/) - You need at least one Employment Certification Form per employer for PSLF. A good rule of thumb is to submit annually to help make sure that FedLoan is counting your eligible payments correctly, and it's a perfectly good idea to submit your first ECF a few months into a new job. But, as you
- [DeVos Doubles Down: One Servicer to Rule Them All](https://www.benwhite.com/finance/devos-doubles-down-one-servicer-to-rule-them-all/) - After rolling back modest consumer protections last month, Education Secretary Betsy Devos' tenure has released its biggest change yet. In an example of doublespeak that would make Orwell proud, DeVos said this in the announcement: From day one, my priority as Secretary of Education has been to put students' needs first. This amended solicitation does just that.
- [Tuition Dollars at Work](https://www.benwhite.com/medicine/tuition-dollars-at-work/) - From Dr. Daniel Barron's "Why Doctors Are Drowning in Medical School Debt" in Scientific American's Observations blog. Each year, only 41 percent of applicants are accepted into medical school. Because demand outstrips supply, medical schools have the economic upper hand and, because lenders invariably approve loans to cover tuition, schools can effectively set the price
- [Switching from REPAYE to PAYE after residency](https://www.benwhite.com/finance/switching-from-repaye-to-paye-after-residency/) - From a reader: Incoming PGY1. Your posts are tremendously helpful! My question is, why aren’t all residents (or at least the majority) doing REPAYE and then switching to PAYE at the end of their training? I feel like I am missing a key pitfall or something. Is it a pain in the ass to switch?
- [Help with Residency Relocation Costs](https://www.benwhite.com/medicine/help-with-residency-relocation-costs/) - For those moving for residency, there's a new free service from a couple of fellow docs called Backlode. The idea is based on the fact that moving companies can often be persuaded to give a discount for the return leg after a long-distance move (because they need to drive back to their home base anyway,
- [Buying a house during residency](https://www.benwhite.com/finance/buying-a-house-during-residency/) - Should I buy a house as a resident? Probably not. The American tendency to prioritize owning your house or car can be a bit misguided. When you buy a house with a mortgage, the title may be in your name, but it's really the bank that owns it. You're slowly buying it from the bank,
- [Updated Student Loan books](https://www.benwhite.com/writing/updated-student-loan-books/) - Nice, productive holiday weekend. I also got around to making some minor revisions and 2019 updates to Medical Student Loans and Dealing with Student Loans, both of which you can always download for free right here. Yes, these beloved best-in-class books are completely free, because student loan debt is crippling generations of Americans, and that outweighs
- [Updated Guide to Fourth Year](https://www.benwhite.com/writing/updated-guide-to-fourth-year/) - I've just updated my guide to being a senior medical student, Fourth Year & The Match. It remains awesome and free as well as being up-to-date for 2019-2020. Even if you've downloaded the old version, you can still receive the new one by dropping your email address here. I have yet to actually
- [Fourth Year & The Match](https://www.benwhite.com/medicine/fourth-year-the-match/) - May 2019 update: This super helpful book was revised for 2019-2020, is still totally free, and even has a new cover. Get it in your inbox by signing up below. Here’s a new book. It’s called Fourth Year & The Match, and you can get your copy by using this form to (at least
- [Neverending oil and water optics of corporate for-profits and healthcare](https://www.benwhite.com/medicine/neverending-oil-and-water-optics-of-corporate-for-profits-and-healthcare/) - Mednax, Inc.'s CEO Roger Medel on their Q1 2019 Earnings Call: Looking across our service lines. Volumes increased modestly in most of our women and children specialties. In neonatology, the underlying trend of births at the hospitals where we provide services remained negative, but our volumes increased based on rate of admission into the neonatal
- [Doctor jobs at “nonprofit” 501(c)(3) hospitals don’t all qualify for PSLF](https://www.benwhite.com/medicine/doctor-jobs-at-nonprofit-501c3-hospitals-dont-all-qualify-for-pslf/) - Depending on where your searches take you or which books and articles you read, you may come across some questionable insight when it comes to PSLF eligibility for doctors. In short, people often argue that because approximately 70% of all hospitals in the United States are nonprofit hospitals, that a similar fraction of jobs at
- [Core Exam Predictors](https://www.benwhite.com/radiology/core-exam-predictors/) - For those radiology residents agonizing over the coming Core Exam in June, there is a new article in JACR that discusses Core Exam predictors for success. One takeaway? It doesn't matter what you use to study.
- [Image-guided Epidural Blood Patches](https://www.benwhite.com/radiology/epidural-blood-patches/) - If you've ever wanted to learn more about fluoroscopic-guided epidural blood patches, someone just had an article about that published in Applied Radiology.
- [Book Review: Medical School 2.0](https://www.benwhite.com/medicine/book-review-medical-school-2-0/) - Despite the rave reviews from family, friends, and readers on Amazon, I thought David Larson's Medical School 2.0: An Unconventional Guide to Learn Faster, Ace the USMLE, and Get into Your Top Choice Residency overall falls prey to the common trap of the self-help genre: overpromise and underdeliver. It's unapologetically the approach to medical school as
- [Class Action Lawsuit against the ABMS](https://www.benwhite.com/medicine/class-action-lawsuit-against-the-abms/) - There are separate class action antitrust lawsuits against the ABIM, ABR, and ABPN. But there's also a class action lawsuit against the umbrella organization, the American Board of Medical Specialities (ABMS), which names all of the member boards as "co-conspirators." The premise is the same in all of the suits: the ABMS and its member
- [Explanations for the 2019-2020 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2019-2020-official-step-2-ck-practice-questions/) - The USMLE has "updated" the free 120 Step 2 CK questions. By updated, I mean the webpage says "updated March 2019" and the "Content Description and General Information Booklet" was revised in some way. However, the practice materials PDF and the questions themselves are completely unchanged. You can read my explanations for the full set from
- [Explanations for the 2016-2017 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2016-2017-official-step-2-ck-practice-questions/) - Here are the explanations for the updated 2016-17 official "USMLE Step 2 CK Sample Test Questions" PDF, which can be found here. Overall, the June 2016 update removes 21 questions as a result of the decrease in block size taking effect this year. There are exactly two new questions in this year's set (#19 and #117), but the question
- [Best Books for Elective Rotations and Sub-internships](https://www.benwhite.com/medicine/best-books-for-elective-rotations-and-sub-internships/) - First, my book recommendations for the core third-year clerkships can be found here. What follows are "best" book recommendations geared for MS3/MS4 elective rotations and sub-internships ("sub-i's"), including most of the surgical and medical subspecialties. Some of these books are geared for medical students; others more for residents. I've done my best to include both when appropriate,
- [What to do with your old employer-sponsored retirement accounts](https://www.benwhite.com/finance/what-to-do-with-your-old-employer-sponsored-retirement-accounts/) - After you've switched employers, it's time to think about what to do with the old retirement account(s) (401k/403b/457) you previously contributed to. But before you do anything, make sure any company match dollars you've earned have vested appropriately. Vesting schedules (i.e. when the money is yours free and clear) vary, and vesting may occur immediately,
- [Should I start saving for retirement during residency?](https://www.benwhite.com/finance/saving-for-retirement-during-residency/) - If your employer offers matching contributions to a tax-advantaged retirement account, then yes. You should be contributing to the match limit. That's free money. Obviously, if you're training in a high cost of living area and surviving on ramen you steal from a roommate you found on Craigslist, then nevermind. From there, if you have more
- [Considerations for the Couples Match](https://www.benwhite.com/medicine/considerations-for-the-couples-match/) - Why would I/we enter the couples match? Generally, because you are married or close enough. Any two people can enter the NRMP match as a couple, which will tie your residencies together by whatever rubric you choose. This is usually done in order to end up in the same geographic location, which can be defined
- [Patriot Act inadvertently demonstrates the needless complexity of student loans](https://www.benwhite.com/finance/patriot-act-inadvertently-demonstrates-the-needless-complexity-of-student-loans/) - Hasan Minhaj, discussing student loans on his Netflix show Patriot Act. You can't call loan servicers financial terrorists. Terrorists take responsibility for their actions. Full clip: https://www.youtube.com/watch?v=t0CyBv18A5k Minhaj spends a lot of time slamming Navient, which makes sense because Navient is terrible. It’s a solid episode that also spends a nice amount of time lambasting
- [Class Action Lawsuit Against the ABR](https://www.benwhite.com/radiology/class-action-lawsuit-against-the-abr/) - Radiology joined the ranks of physician-led class action lawsuits against the ABMS member boards last week when interventional radiologist Sadhish K. Siva filed a complaint on behalf of radiologists against the ABR for (and I’m paraphrasing) running an illegal anticompetitive monopoly and generally being terrible. You can read the full 30-page suit if you're interested. Legal
- [ABPN? Also sued.](https://www.benwhite.com/medicine/abpn-also-sued/) - Hot on the heels of last week's anti-ABR lawsuit (which itself followed the ABIM lawsuit), two psychiatrists have submitted a very similar class action suit against the American Board of Psychiatry and Neurology (hat tip Dr. Wes). And by "very similar" I mean it's mostly the same lawyers, it's filed in the same Northern District
- [Goldman Sachs and the Optics of Drug Discovery](https://www.benwhite.com/medicine/goldman-sachs-and-the-optics-of-drug-discovery/) - Goldman Sachs analyst Salveen Richter, channeling the obvious in a note to clients (excerpted by CNBC): The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies.
- [John Oliver explains investment fees](https://www.benwhite.com/finance/john-oliver-explains-investment-fees/) - I somehow missed this back in 2016, but it's still an excellent discussion of financial advisors and management fees: https://www.youtube.com/watch?v=gvZSpET11ZY So good!
- [Yes, you can switch back from REPAYE to IBR or PAYE](https://www.benwhite.com/finance/yes-you-can-switch-back-from-repaye-to-ibr-or-paye/) - There has been a lot of confusion from borrowers whether or not REPAYE, with its partial interest subsidy, is a good choice for people with high future income (e.g. residents). The main concern is what happens after training when salaries increase and the possibility of breaking past the monthly payment cap, which could make you lose money
- [Pitfalls of Private Equity Takeovers](https://www.benwhite.com/medicine/pitfalls-of-private-equity-takeovers/) - You may have heard about this absurd story in the NYTimes a few months ago: An academic journal pulled a legitimate article comparing practice characteristics of groups that take on private-equity funding and those that do not. Why? Because a PE firm put the squeeze on their editor, that's why: In an interview, Dr. Hruza [the incoming president
- [NRMP Says: Rank Them How You Want Them](https://www.benwhite.com/medicine/nrmp-president-says-rank-them-how-you-want-them/) - President and CEO of the NRMP, Mona M. Signer, talking with Medscape: I certainly understand why applicants and programs engage in post-interview communication, but applicants and program directors shouldn't create their rank-order list on the basis of post-interview communication from the other party. They ought to create their rank-order list based on their true preferences.
- [Step 1 keeps you safe from the dangers of fun](https://www.benwhite.com/medicine/step-1-keeps-you-safe-from-the-dangers-of-fun/) - If students were to devote more time to activities that make them less prepared to provide quality care, such as binge-watching the most recent Netflix series or compulsively updating their Instagram account, this could negatively impact residency performance and ultimately patient safety. That's Peter Katsufrakis, MD, MBA, president and CEO of the National Board of
- [What I read in 2018](https://www.benwhite.com/reading/what-i-read-in-2018/) - This is the fifth time I've published my book diet for the year (though admittedly a few days late). It's a pretty eclectic mix this year, and I'm happy to report I did manage to squeeze in a few classics amidst my steady diet of not-so-classics. Not gonna lie, Gilgamesh (humankind's earliest surviving written story) is kinda
- [What I read in 2017](https://www.benwhite.com/reading/what-i-read-in-2017/) - Putting out my fourth annual reading list means that it's officially a site tradition. That same year I also started really using Audible, which has been life-changing (no exaggeration) for the commute and chores like laundry. Their current signup promotion is two free audiobooks, which is awesome. No Country for Old Men by Cormac McCarthy
- [Kosher(ish)](https://www.benwhite.com/misc/kosherish/) - Some of you may have noticed that things have been a little bit quieter than usual around here. While I'm still writing (and have plenty more in store), my attention was divided recently on a new passion project my wife and I just launched. It's called Kosher(ish), and it's basically the first part of a
- [Retort of the week](https://www.benwhite.com/medicine/retort-of-the-week/) - Do you have any idea how many bullets I pull out of corpses weekly? This isn’t just my lane, it’s my [expletive] highway. Pathologist Dr. Judy Melinek, responding on Twitter to an NRA tweet admonishing doctors to “stay in their lane” and stop discussing gun control.
- [Review: The Unremarkable reMarkable](https://www.benwhite.com/reviews/the-unremarkable-remarkable/) - Man, I really really wanted to like the reMarkable ($100 off with that link). The reMarkable, if you haven’t heard of it yet is a large format e-ink device the bills itself as a Paper replacement. It's billed as a large touchscreen enabled Kindle with a fast refresh rate and a bundled non-battery-powered stylus that supposedly
- [Q&A: Pros/Cons of Choosing Radiology](https://www.benwhite.com/radiology/qa-pros-cons-of-choosing-radiology/) - Answers to some frequently asked questions about being a radiologist: How bad is the grind? Depends. Is there a race to the bottom? Yes. Do procedures add or detract from the grind? Depends. Do you begin to feel comfortable with radiology material during residency? Yes. How much studying do you need to do? Does
- [IMGs and the Match: What are my chances?](https://www.benwhite.com/medicine/imgs-and-the-match-what-are-my-chances/) - Much more than US students, IMGs have a much harder to time figuring out a satisfying answer to the "what are my chances?" game. If you haven't already read it, I'd strongly recommend reading the “Charting Outcomes in the Match for International Medical Graduates” available at http://www.nrmp.org/match-data/main-residency-match-data/. For an example of IMG board score considerations:
- [PSLF & Double Part-Time Employment](https://www.benwhite.com/finance/pslf-double-employment/) - Qualifying employment is a critical component to the PSLF formula: Eligible Loans + Qualifying Payments + Qualifying Work x 120 months (10 years) = Public Service Loan Forgiveness But most folks haven’t considered a nuance in the PSLF law that currently applies to very few people but could easily apply to more. Part-time work counts,
- [When antibiotics equals ratings](https://www.benwhite.com/medicine/when-antibiotics-equals-ratings/) - A new study published in JAMA last week (summarized by NPR) is another great example of the obvious negative externalities of prioritizing patient satisfaction scores (i.e. the Yelpification of medicine). It analyzed a large number of telemedicine visits for URI: Seventy-two percent of patients gave 5-star ratings after visits with no resulting prescriptions, 86 percent
- [Servicers other than FedLoan don't handle PSLF](https://www.benwhite.com/finance/servicers-other-than-fedloan-dont-handle-pslf/) - I've heard a few stories of attendings calling their servicers after making years and years of payments to get started filing for PSLF and being laughed off the phone because of their high salaries. To be clear, PSLF has no maximum salary. The master promissory note you signed says this: A Public Service Loan Forgiveness
- [Yes, PSLF is really happening](https://www.benwhite.com/finance/yes-pslf-is-really-happening/) - People often ask if I personally know anyone who has gotten their loans forgiven via PSLF since the first crop of folks became eligible in October 2017. It's a reasonable question, but it's also the wrong one. Because, despite the legitimacy of the PSLF program, there are very few people who could have actually benefitted
- [Free Online Medical School Learning Resources](https://www.benwhite.com/medicine/free-online-medical-school-learning-resources/) - If I could go back to the first two years of medical school, I would buy USMLE World and make it an integral part of my longitudinal studying. The more I look back, the more I believe that doing questions as a primary learning activity formed the basis of the vast majority of my medical
- [How to Succeed in Your Clinical Clerkships](https://www.benwhite.com/medicine/third-year-basics/) - How do you succeed during your third year of medical school? How do you do well in your clinical clerkships? How do you "honor" a rotation (and since when is honor a reverse transitive verb)? Now, there are entire books dedicated to clerkship success: pages and pages of "pearls," entire tomes dedicated to helping you
- [Student loan books now on iBooks](https://www.benwhite.com/writing/student-loan-books-now-on-ibooks/) - I've been a bit slow on expanding the availability of my two books on student loans, but as of today, Medical Student Loans and Dealing with Student Loans are now available on Apple iTunes/iBooks as well as from Amazon. Get them here: Medical Student Loans (iBooks, Amazon) Dealing with Student Loans (iBooks, Amazon)
- [The Med Ed Trifecta](https://www.benwhite.com/medicine/the-med-ed-trifecta/) - Akhilesh Pathipati, writing "Our doctors are too educated" in the Washington Post (emphasis mine): U.S. physicians average 14 years of higher education (four years of college, four years of medical school and three to eight years to specialize in a residency or fellowship). That’s much longer than in other developed countries, where students typically study for 10 years.
- [The Hit Points](https://www.benwhite.com/misc/the-hit-points/) - Starting in 2003, my secret work/study music has mostly been comprised of hundreds of wonderfully creative arrangements of video game music, largely thanks to a website called OverClocked Remix, which has been steadily curating a massive collection of high-quality pieces for almost 20 years. Which brings me to this stellar bluegrass rendition of a theme
- [My books about Student Loans are free through the end of July](https://www.benwhite.com/writing/student-loans-books-free-through-the-end-of-july/) - Last year I published a book about managing student loans for medical students and doctors. Earlier this year I extensively revised that into a new book for a general audience. This week, I updated both books. And now, I'm giving them away for free (at least until the end of July 2018). Student loans are now
- [Burnout may be a misnomer](https://www.benwhite.com/medicine/burnout-may-be-a-misnomer/) - Simon G. Talbot and Wendy Dean, arguing in STAT that burnout is actually a misdiagnosed consequence of unchecked moral injury: We believe that burnout is itself a symptom of something larger: our broken health care system. The increasingly complex web of providers’ highly conflicted allegiances — to patients, to self, and to employers — and
- [Explanations for the 2017-2018 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2017-2018-official-step-2-ck-practice-questions/) - The updated 2017-18 official “USMLE Step 2 CK Sample Test Questions” PDF, released in May and available archived here. The PDF set is completely unchanged from last year. You can read the complete explanations for last year’s set here. A helpful reader Jarrett Lever made a PDF to online version conversion list. As for the updated multimedia
- [Financial Planning for your Fourth Year](https://www.benwhite.com/medicine/financial-planning-for-your-fourth-year/) - If you are footing the bill for medical school (and by you, I mean the US government), you'll like receive slightly more financial aid during fourth year to cover the increased costs. However, depending on your field of interest (and the number of programs you need to apply to and interview at), it's extremely easy
- [The ABR supports nursing mothers](https://www.benwhite.com/radiology/the-abr-supports-nursing-mothers/) - I’ve given the ABR a lot of flak over the past few years at pretty much every opportunity, from their expensive, non-portable, and occasionally questionably-written examination to their fumbling of a technical mishap during last year‘s June examination in Chicago. Today, I wanted to highlight something I think the ABR does well, which is something
- [Guide to Fourth Year & the Match](https://www.benwhite.com/medicine/guide-to-fourth-year-and-the-match/) - You should read my new free book on this subject. Below are links to the original posts that make up my series on fourth year and the match: Quick And Dirty Suggestions for the Match The data you should analyze before choosing your specialty Do I need to do an away rotation? Obtaining Letters of
- [Step 1 Score Correlations](https://www.benwhite.com/medicine/step-1-correlations/) - People often ask me about Step 1 corrections, particularly with regards to the Free 150 120 (for which I've posted explanations for several years). The data I'd come across over the years was super old. Last month, Reddit user Waygzh posted the results of a 208 person survey (with an above average mean score of 245), which
- [Explanations for the 2016 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2016-official-step-1-practice-questions/) - The NBME has released the new 2016 "USMLE Step 1 Sample Test Questions," which reflect a sizable decrease in the number of questions from 308 down to 280 and now 40 questions per block after May 9th, 2016. Exam duration is unchanged, so this should help those who have difficulty with time management/finishing sections on time. Additionally,
- [Explanations for the 2017 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2017-official-step-1-practice-questions/) - The NBME has released the new 2017 USMLE "Step 1 Sample Items" set last month, which is identical to the one released in 2016. Last year they finally updated the software version to be browser-based instead of the old downloadable Windows application, so now you can do the interactive version like the real deal regardless of your computing preferences. It
- [Know Your Field](https://www.benwhite.com/medicine/know-your-field/) - In answering some recent reader emails and doing some mock interviews with fourth-year medical students, I've noticed an interview deficiency that's worth correcting. Residency interviews are generally benign, but you still want to be able to talk cogently about why you've chosen the field you have as well about the field itself. You can start
- [ABR simplifies Core Exam scoring](https://www.benwhite.com/radiology/abr-simplifies-core-exam-scoring/) - After years of pretending that people could actually fail (“condition”) individual exam sections other than physics in its convoluted two-stage exam scoring process, the ABR has decided to simplify things going starting this year in 2018. From now on, there are three scoring outcomes: PASS if you get a score of 350 or higher when averaging
- [Explanations for the 2015-2016 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2015-2016-official-step-2-ck-practice-questions/) - Here are the explanations for the updated 2015 (effectively 2015-16) official "USMLE Step 2 CK Sample Test Questions," which can be found here. Overall, there are a solid 41 new questions when compared with last year's set, which I've marked with asterisks below. For those who have done last year's set, a list of the new question numbers is in this footnote.
- [More Perks of Flexible Duty Hours](https://www.benwhite.com/medicine/6447/) - You may recall the ACGME recently nixed its 2011 rule that mandated a 16-hour shift maximum for interns after "minimal" differences were noted in a study of surgical residents. I discussed those results here and the ACGME change here. Even in that study, the surgery trainees were basically less happy. So, the ACGME didn't wait for
- [ABR manages expectations for the 2018 Core Exam](https://www.benwhite.com/radiology/abr-manages-expectations-for-the-2018-core-exam/) - In the wake of last year's impressive technical failure during the Core exam, the ABR has decided to try something new. On Monday, when registration opened for the 2018 Core Exam, the ABR decided to not send all candidates the email at the same time. Instead, swathes of people had their invites delayed by several
- [Running from Depression](https://www.benwhite.com/medicine/running-from-depression/) - Scott Douglas, writing in Slate, on why doctors don't prescribe the very effective treatment of moving for depression: Why is the United States such an outlier? Structural barriers may be to blame. The U.S. health care system famously incentivizes procedures and pills over a holistic approach. That might be especially true with antidepressants, which the
- [Explanations for the 2015-2016 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2015-2016-official-step-1-practice-questions/) - The NBME just released the updated 2015 sample questions this past month, and there are no new questions in this iteration (at least in the downloadable pdf version). In fact, six questions have been removed (two from each section), which was done to reflect the decrease in total Step 1 test items starting May 11
- [Doctors, Revolt!](https://www.benwhite.com/medicine/doctors-revolt/) - I had known Dr. Lown as a doctor and a patient; now I got to know him as an activist. We agreed that the health care system needed to change. To do that, Dr. Lown said, “doctors of conscience” have to “resist the industrialization of their profession.” Rich Joseph, writing about his relationship taking care
- [Big Update to Medical Student Loans](https://www.benwhite.com/writing/big-update-to-medical-student-loans/) - In addition to publishing my "general audience" student loans book last week, I also pushed a pretty sizable update to the original doctor’s version last week. Medical Student Loans has been revised for 2018 with a slew of small updates and a few new features, including expanded sections on the “married filing separately” loophole and
- [My newest book is Student Loans: A Comprehensive Guide](https://www.benwhite.com/reading/my-newest-book-is-student-loans-a-comprehensive-guide/) - I just released my third book. OK, it's really more like my 2.5th book, because Student Loans: A Comprehensive Guide is a line-by-line reworking and expansion of my second book, Medical Student Loans: A Comprehensive Guide. As with all of my longer projects, I drastically underestimated the amount of effort and time it would take
- [Alto’s Odyssey](https://www.benwhite.com/misc/altos-odyssey/) - The sequel to my favorite iOS game came out last week. Alto's Adventure, which came out in 2015, was a snow-boarding-themed endless runner that has remained the iPhone’s best meditation app for several years. I’ve been playing the new sequel Alto’s Odyssey since it came out last week, and it builds on the original to deliver an
- [The Radical Idea to Forgive all Student Loans](https://www.benwhite.com/finance/the-radical-idea-to-forgive-all-student-loans/) - This interesting article in New York Magazine about the proposed economic benefits of forgiving all of the outstanding $1.4 trillion in student loans has been making the rounds recently: According to the Levy Institute paper, authored by economists Scott Fullwiler, Stephanie Kelton, Catherine Ruetschlin, and Marshall Steinbaum, canceling all student debt would increase GDP by
- [Trump hasn't killed PSLF yet](https://www.benwhite.com/finance/trump-hasnt-killed-pslf-yet/) - There are a lot of headlines talking about what Trump is doing to PSLF. But, to be clear, Trump isn't doing anything to PSLF. What Trump has done is release a budget proposal, as the sitting president does every year. This proposal is meant to signal policy goals for the administration, but nothing in it
- [Brevity: A Flash Fiction Handbook](https://www.benwhite.com/reading/brevity-a-flash-fiction-handbook/) - I finally had a chance to sit down and enjoy Brevity: A Flashfiction Handbook by David Galef. This was particularly fun because: I’ve published six stories by Mr. Galef in Nanoism, my unusual journal that exclusively features Twitter fiction, the longest running of its kind. Keeping it in the family, I’ve actually published even more (10!)
- [Concussion Protocol](https://www.benwhite.com/misc/concussion-protocol/) - https://youtu.be/r51aLlwS7w4 Shaun King reacting to Josh Begley's short reverse-highlight reel “Concussion Protocol” in The Intercept: It’s not a headache. It’s not “getting your bell rung.” You don’t have a bell. It’s a traumatic brain injury.
- [Amazon Enters](https://www.benwhite.com/medicine/amazon-enters/) - Amazon is now so dominant as a corporate force that even the announcement of a plan to someday enter a new industry is enough to crush stocks. This happened to Blue Apron last summer after Amazon bought Whole Foods and filed a trademark for a possible meal-kit service a week after Blue Apron's IPO, whose new
- [Book Review: Crack the Core, Radiologic Physics War Machine, CTC Case Companion](https://www.benwhite.com/radiology/book-review-crack-the-core/) - Here we review Prometheus Lionhart's multipart book series for the Core Exam. If you're interested in someone's thoughts on the Titan Radiology video series, you'll have to look elsewhere. TL;DR: Every book in the Crack the Core series is generally humorous, relatively engaging, high yield, and conversational—as well as full of typos and (mostly minor) errors.
- [The Texas JP Exam guide, now in print](https://www.benwhite.com/writing/the-texas-jp-exam-guide-now-in-print/) - [Update: Sorry, I'm no longer offering the print edition] I finished polishing the print version of my review book for the Texas Medical Jurisprudence Exam and made it available on Amazon last month. It started outselling the Kindle version after a few weeks, which goes to show that—assuming relative costs are reasonable—a lot people still
- [Ursula K. Le Guin](https://www.benwhite.com/reading/ursula-k-le-guin/) - Ursula K. Le Guin, one of my very favorite writers, passed away this week at the age of 88. Le Guin was sometimes referred to as a really good speculative fiction author—which is wrong. She was a fantastic writer who happened to mostly write genre fiction. Her meticulously crafted imaginative work set the stage for
- [The big industry of big pharma ads](https://www.benwhite.com/medicine/the-big-industry-of-big-pharma-ads/) - From Harper's January 2018 index: Amount the US pharmaceutical industry spent in 2016 on ads for prescription drugs: $6,400,000,000 Number of countries in which direct-to-consumer pharmaceutical ads are legal: 2 $6.4 billion? Holy moly, what a depressing figure. Think about how much healthcare that would buy. In case you're curious, our partner in crime is
- [Obtaining Letters of Recommendation for Residency](https://www.benwhite.com/medicine/obtaining-letters-of-recommendation-for-residency/) - Residency programs generally require three letters of recommendation (LOR) in addition to your Dean’s Letter (MSPE). Some programs/fields will request four, and some programs will have stipulations concerning their make-up: one may need to be a so-called "chairman’s letter" or come from an outside institution or research mentor. Obtaining a LOR: The most important thing in
- [Do I Need to Do an Away Rotation?](https://www.benwhite.com/medicine/do-i-need-to-do-an-away-rotation/) - Maybe. Away rotations are generally done for three purposes: For fields that require or generally prefer Letters of Recommendation from institutions outside of your home school: Emergency Medicine, some surgical sub-specialties (e.g. neurosurgery) Audition rotations (especially helpful for marginal candidates trying to “come off the page” or when trying to break into a specific out-of-your-region
- [SmashUSMLE](https://www.benwhite.com/medicine/smashusmle/) - Longtime readers know that I don't do ads, guest posts, or push products. I do however share a coupon or referral code or two for something people might actually want if it results in someone saving money (and not just me making a few bucks). Which brings us to SmashUSMLE. The bottom line is that
- [iPhone X: First Impressions](https://www.benwhite.com/misc/iphone-x-first-impressions/) - Background: I generally try to spend money deliberately, particularly when it comes to what might be considered "nonessential" purposes. This year that included the iPhone X. Our son is two and a half, so the main reason I've been upgrading my phone annually the past few years is to have the very best smartphone camera
- [My book on med school student loans is free through Friday](https://www.benwhite.com/writing/my-book-on-med-school-student-loans-is-free-through-friday/) - Amazon is running a promotion on my book Medical Student Loans: A Comprehensive Guide so that it's free on Kindle through the end of Friday. If you haven't already, now would be a great time to check it out and get your finances in order.
- [A 280-character Twitter is stupid](https://www.benwhite.com/writing/a-280-character-twitter-is-stupid/) - A lot of people place their hopes on tech companies to save the planet and make literally everything better. At least the tech companies like to pretend they will. And then you realize how silly so much of it is and how poorly run many of these companies truly are, with so many of them desperately
- [Department of Education decides that loan holders aren't really consumers and that students don't need protection](https://www.benwhite.com/finance/department-of-education-decides-students-arent-consumers/) - Last month Betsy DeVos' (Trump's) Department of Education ended their cooperation with the Consumer Finance Protection Bureau, because, you know, the CFPB was "overreaching" in trying to actually protect student loan borrowers. Shocking that the same DOE that wanted to consolidate the entire servicing industrial complex into one giant government contract with a shortlist that
- [Explanations for the 2013-2014 Official USMLE Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-official-usmle-step-1-practice-questions/) - From the official 2013-14 “Step 1 Content Description and General Information” booklet (archived here), I’ve listed the correct answer for each question with a brief explanation ± take home points. I can't reproduce the questions themselves of course as they're copyrighted. The newest set of official questions (2014-2015) has been released. My explanations can be found here.
- [Best Small Fictions 2017](https://www.benwhite.com/reading/best-small-fictions-2017/) - Got my contributing editor's copy of The Best Small Fictions 2017 in the mail the other day. Nanoism had another finalist this year, to accompany our finalists and winners from 2015 and 2016. Great little collection of very short stories.
- [Surprises All Around](https://www.benwhite.com/radiology/surprises-all-around/) - A VA branch is under investigation for poor quality radiology care (and for firing the whistleblower in retaliation): As many as four to five times a day, Leskosky said, he found serious errors in prior readings, despite just four other radiologists being on staff. In one particularly egregious case, a radiologist missed a 17-centimeter tumor
- [The "1-minute" workout: not quite](https://www.benwhite.com/misc/the-1-minute-workout-not-quite/) - The popular press has been all over a new study out of McMaster University in PLOS One that demonstrated that 1 minute of intense exercise in the midst of 10 minutes of lesser activity had similar cardiovascular benefits to 45 minutes of moderate exercise (in otherwise sedentary men). The major novel finding from the present study was
- [Medscape resident survey, embarrassingly interpreted, again](https://www.benwhite.com/medicine/medscape-resident-survey-embarrassingly-interpreted-again/) - Medscape's newest resident compensations survey is out and discussed in "Most Residents Say They Deserve Big Raise, Survey Shows." The main thrust is fine, discussing that today's residents feel more underpaid than generations past, which is no surprise given the proliferation of mid-levels who work alongside them making considerably more (and likely combined with the
- [The Single Student Loan Servicer That Wasn't](https://www.benwhite.com/finance/the-single-servicer-that-wasnt/) - InsideHigherEd on the rapidly abandoned plan to consolidate all student loan servicing into a single monolithic "too-big-too-fail" mega contract: DeVos has taken heat since May from members of Congress and representatives from the loan-servicing sector over the plan to pick a single servicer that would hire subcontractors to collect loan payments. Department officials at the time
- [Mammogeddon 2017: The Conclusion?](https://www.benwhite.com/radiology/mammogeddon-2017-the-conclusion/) - From the ABR's July 19 email: Some of you are wondering why it has taken so long for the ABR to provide a solution. We apologize for the delay as we know this has been stressful for you. More than 450 candidates were affected by this situation. The cause of the problem was not initially
- [The ABR Mammography Saga Continues](https://www.benwhite.com/radiology/the-abr-mammography-saga-continues/) - This week's ABR Core exam snafu update: Dear ABR Candidate, The ABR board members and staff sincerely apologize for the problems with the diagnostic radiology Core Exam on Thursday, June 8, 2017 at our Chicago Exam Center. We did not start the exam on time, had intermittent interruptions, and we failed to deliver the breast
- [Review: Refinancing with Credible for Doctors](https://www.benwhite.com/finance/review-credible-for-doctors/) - Like the ACA healthcare marketplace or Kayak, Credible isn't actually lender itself. It's a student loan marketplace of (currently) 9 vendors that allows you to apply to multiple companies simultaneously and compare rates (and terms, monthly payments, total payoffs, etc). Pros: Polished interface Easy initial application process Ability to compare rates from multiple lenders simultaneously Saves
- [My new book: Medical Student Loans](https://www.benwhite.com/writing/my-new-book-medical-student-loans/) - My second book, Medical Student Loans: A Comprehensive Guide, is now out. It's a novella-length treatment of student loans specifically for physicians and written to cover the topic for all levels: premeds, medical students, residents, and attendings. It's especially helpful for graduating MS4s and by its nature also covers important basic financial literacy in a hopefully
- [How do you fail the USMLE Step 2 CS?](https://www.benwhite.com/medicine/how-do-you-fail-the-usmle-step-2-cs/) - If you're a North American allopathic medical student, with difficulty. And yet several hundred students fail their first attempt at this "English" test every year. SDN and the like are full of stories about students with massive Step 1 scores who fail Step 2 CS, which makes anyone reading think that no one is safe
- [Navient is still lying to borrowers despite lawsuit](https://www.benwhite.com/finance/navient-is-still-lying-to-borrowers-despite-lawsuit/) - Unsurprisingly, Navient is still lying to borrowers despite the ongoing lawsuit (for misleading borrowers) from the Consumer Finance Protection Bureau. I was talking to a fellow resident last week. She has almost a half million dollars in student loans from medical school and has been repaying in IBR. She recently got married, and her husband,
- [More Open Access Journal Shaming](https://www.benwhite.com/misc/more-open-access-journal-shaming/) - There seems to be a never-ending shaming parade of "peer reviewed" open access journals that exist to extract one-time lump sum payments from desperate authors in exchange for a publishing credit and poorly formatted PDF. "The conceptual penis as a social construct" in Skeptic Magazine takes it the next level, by also lampooning an entire
- [CFPB sues Navient (even the feds aren't happy with their own student loan servicers)](https://www.benwhite.com/finance/cfpb-sues-navient/) - The Consumer Finance Protection Bureau is a nonpartisan government agency that was created after the 2008 financial crisis to help protect us from evil banks, credit card companies, predatory lending practices, etc. They announced this week that they're suing Navient, the biggest federal (and private) student loan servicer for defrauding borrowers and being generally terrible.
- [Betsy DeVos: It's okay for servicers to mislead borrowers](https://www.benwhite.com/finance/betsy-devos-its-okay-for-servicers-to-mislead-borrowers/) - What a mess. Education Secretary Betsy DeVos has decided to roll back two Obama-era memos that were intended to guide servicers in their customer service efforts with borrowers. I discussed one the other week. Now that second shoe has dropped, peeling away the reasonable-sounding requests that basically servicers should be held accountable if "the company had misled
- [Monuments and Symbols](https://www.benwhite.com/misc/monuments-and-symbols/) - New Orleans Mayor Mitch Landrieu on the removal of four historic statues commemorating the confederacy: These statues are not just stone and metal. They are not just innocent remembrances of a benign history. These monuments purposefully celebrate a fictional, sanitized Confederacy; ignoring the death, ignoring the enslavement, and the terror that it actually stood for.
- [MEDSKL](https://www.benwhite.com/medicine/medskl/) - MEDSKL is a new free medical education site with a much greater than average pedigree. It's a group of 180+ physicians/professors/faculty from medical schools in the US and Canada who are promoting FOAMed (free and open access education) for medical students. Its clinical (not basic science) focus is well-suited to third and fourth (and industrious second)-year
- [Explanations for the 2014-2015 Official Step 1 Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2014-2015-official-step-1-practice-questions/) - Using the official 2014-15 "USMLE Step 1 Sample Test Questions," (cached version here) I’ve written explanations and take home points for each of the 138 questions (the "Free 150"). The 2015-16 set has no new questions (a few have actually been removed), so this is still current. I can't reproduce the questions themselves of course as they're uber-copyrighted.
- [Visions, people, and milestones](https://www.benwhite.com/misc/visions-people-and-milestones/) - Alan Kay on Xerox's culture back when it was killing it: A few principles: 1. Visions not goals 2. Fund people not projects — the scientists find the problems not the funders. So, for many reasons, you have to have the best researchers. 3. Problem Finding — not just Problem Solving 4. Milestones not deadlines
- [Apparently you can't trust FedLoan](https://www.benwhite.com/finance/apparently-you-cant-trust-fedloan/) - The wrinkles continue on the story that first appeared last December about folks being denied PSLF-eligibility for jobs they'd previously gotten approval for. From the NYT (emphasis mine): Last week, the [Education] department filed a reply that said that FedLoan’s responses to borrowers’ certification forms cannot be trusted. A FedLoan approval letter “does not reflect a
- [How to Write (and maybe understand) a USMLE-style Question](https://www.benwhite.com/medicine/how-to-write-and-maybe-understand-a-usmle-style-question/) - Whether to help yourself or your classmates practice, produce learning materials for your students, make money, or perhaps to create a large free question bank the likes of which have never been seen, knowing how to write a USMLE-style board may be a skill you're interested in cultivating. In fact, even for students who only
- [Charlie Munger understands the unintended consequences of screening](https://www.benwhite.com/misc/charlie-munger-understands-the-unintended-consequences-of-screening/) - Charlie Munger about self-improvement and solving problems: Well the big ideas, I think you should be intelligent in improving yourself. You’re way better to take on a really big important idea that comes up all the time than some little tiny idea that you might not face. I always tried to grab the really big
- [TMJP Exam Milestone](https://www.benwhite.com/writing/tmjp-exam-milestone/) - Hit 100 reviews on Amazon this week. 4.9-star average rating. Tickled and gratified.
- [Trump's first student loan action](https://www.benwhite.com/finance/trumps-first-student-loan-action/) - In this "Dear Colleague" letter, Trump's administration takes its first action on student loan policy. Unsurprisingly, it was to rollback an Obama administration Dear Colleague Letter that prevented some collection agencies from charging extremely high fees when collecting on old defaulted FFELP loans if the borrower tried to respond quickly and enter into a loan
- [ACGME pays increased lip service to physician wellness](https://www.benwhite.com/medicine/acgme-pays-increased-lip-service-to-physician-wellness/) - Because actually changing how young doctors are trained or medicine is practiced is a big hairy potentially expensive and undoubtedly difficult problem, the ACGME has opted to abandon doubling down on actual rules governing work hours and instead focused on broad and largely unenforceable mandates on "wellness." You can read the track changes version of
- [16 hours is a nice start to the shift](https://www.benwhite.com/medicine/16-hours-is-a-nice-start-to-the-shift/) - Changes to the 2017 ACGME program requirements: Maximum Duty Clinical Work and Education Period Length Duty periods of PGY-1 residents must not exceed 16 hours in duration. Duty periods of PGY-2 residents and above may be 547 scheduled to a maximum of 24 hours of continuous duty in the hospital. Clinical and educational work periods
- [ACGME reaffirms independent call for radiology is okay](https://www.benwhite.com/radiology/acgme-reaffirms-independent-call-for-radiology-is-okay/) - They didn't actually do that. That is my subjective interpretation as a random person of the language of the current ACGME Common Program Requirements (emphasis mine): For many aspects of patient care, the supervising physician may be a more advanced resident or fellow. Other portions of care provided by the resident can be adequately supervised by the
- [The danger (?) of intravenous contrast media](https://www.benwhite.com/medicine/the-danger-of-intravenous-contrast-media/) - Another study piling on the mounting evidence that at least modern contrast agents put into people's veins (and not arteries) for CT scans might not be bad for your kidneys after all. The biggest single center study of EM patients was just published in The Annals of Emergency Medicine, which studied 17,934 patient encounters and
- [Articles before Acronyms](https://www.benwhite.com/misc/articles-before-acronyms/) - Recent pet peeve, of which many healthcare writers and physicians are guilty: using the incorrect article before an acronym. Everyone knows that you use "a" before a consonant and "an" before a vowel. What people may not realize is that it's not the spelling that matters of the following word but its pronunciation. The actual
- [Residents & The Match: Overworked, Underpaid](https://www.benwhite.com/medicine/residents-and-the-match-overworked-underpaid/) - The Atlantic has a nice brief history of the NRMP Match and an argument for it as a causal factor as to why being a resident is generally terrible. And, in case you didn't know, the public also wishes you weren't working so hard: Medicine enjoys the status of being the most prestigious profession in
- [Board Review: The Gunner "Methods to Success" Fallacy](https://www.benwhite.com/medicine/board-review-the-gunner-methods-to-success-fallacy/) - Much of the entire self-help book market is predicated on the idea that copying the habits of successful people will make you successful. This is untrue. This isn't to say that no one benefits from shared wisdom, but while someone else's methods may work for you, the most important thing to know about other peoples' success
- [Medical training return on investment](https://www.benwhite.com/medicine/medical-training-return-on-investment/) - Some fun (but not new) light reading for those debating whether pursuing medicine was a mistake: UC Berkeley's Nicholas Roth's The Costs and Returns to Medical Education. Overall, of the specialties included, rad onc and radiology topped the scale and endocrinologists bottomed it. The data is from 2009, so some of the assumptions are out of date (as
- [Incrementalism](https://www.benwhite.com/medicine/incrementalism/) - Atul Gawande with another fun New Yorker feature on The Heroism of Incremental Care: Rescue work delivers much more certainty. There is a beginning and an end to the effort. And you know what all the money and effort is (and is not) accomplishing. We don’t like to address problems until they are well upon us and
- [How to submit PSLF employment verification](https://www.benwhite.com/finance/how-to-submit-pslf-employment-verification/) - The general approach for PSLF is succinctly summarized here. In order to qualify, you'll need to prove you were gainfully employed at a qualifying institution for 120 payments. That means you'll need to account for 10 years of working life. The Feds recommend you certify your employment every year, which sounds like a pretty good idea
- [The Calm Company](https://www.benwhite.com/misc/the-calm-company/) - Amidst desires for simultaneous growth, quality, profit, and patient satisfaction, the delivery of healthcare has gotten more...complicated. But the disconnect between the powers that be and the providers who actually work on the ground has turned work for big hospitals and institutions into something increasingly more like working for a big widget factory. Spurred by rising costs,
- [Employer verification: the lynchpin of PSLF](https://www.benwhite.com/finance/employer-verification-the-lynchpin-of-pslf/) - The week of Christmas, the NYTimes published a story about people who anticipated their loans being forgiven this year with PSLF and are now in the midst of a legal battle instead. The suit, filed in United States District Court for the District of Columbia, says some borrowers received approval on their certification forms, then,
- [What I read in 2016](https://www.benwhite.com/reading/what-i-read-in-2016/) - The little one is a bit older and I had marginally less call this year, but I also had to take the boards in June, so reading time definitely benefitted from the flexibility of ebooks on the phone and the magical powers of Audible. Overall, it was a better reading year than 2015. The Etymologicon
- [When breath becomes air](https://www.benwhite.com/misc/when-breath-becomes-air/) - I actually posted this excerpt once before, but I just finished Paul Kalanithi's When Breath Becomes Air and was moved anew by his missive to his infant daughter: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and
- [Study shows women are still better at everything](https://www.benwhite.com/medicine/study-shows-women-are-still-better-at-everything/) - Yesterday in JAMA: We found that elderly patients receiving inpatient care from female internists had 30-day lower mortality and readmission rates compared with patients cared for by male internists. This association was consistent across a variety of conditions and across patients’ severity of illness. Taken together with previous evidence suggesting that male and female physicians
- [It was the best of exams. It was the worst of exams.](https://www.benwhite.com/radiology/it-was-the-best-of-exams-it-was-the-worst-of-exams/) - From the awesome and scathing "What Went Wrong With the ABR Examinations?" in JACR: The new examination format also does a poor job of emulating how radiology needs to be practiced. Each candidate is alone in a cubicle, interacting strictly with a computer. There is no one to talk to and no opportunity to formulate
- [What I read in 2015](https://www.benwhite.com/reading/what-i-read-in-2015/) - Between the birth of our first child in April and by far my busiest call year of residency, 2015 was shaping up to be an abysmal year for pleasure reading. Ultimately, the saving grace was the combination of my much-lengthened daycare-related commute with Audible (the free 30 day trial/two free audiobooks via that link got me completely hooked).
- [How/where to learn to read EKGs](https://www.benwhite.com/medicine/how-to-learn-to-read-ekgs/) - EKG/ECG instruction is a mixed-bag nationwide. Every physician is supposed to know how to read an EKG, though for many students, EKG interpretation is a skill one is supposed to somehow pick up naturally (magically) on the wards. No one seems as confident in their abilities as they'd like. And while EKG machines themselves can
- [Obama thinks about the future](https://www.benwhite.com/misc/obama-gets-it/) - The New Yorker has a fascinating article about Obama dealing with the fact that Trump won. It's eminently quotable, but I particularly liked his brief discussion on the futility of trying to "bring back" lost industry through protectionism: The prescription that some offer, which is stop trade, reduce global integration, I don’t think is going to
- [Questions to ask yourself (and others) about residency programs](https://www.benwhite.com/medicine/questions-to-ask-yourself-and-others-about-residency-programs/) - The first question for many students to ask (themselves) is where? Because the majority of physicians practice in the same location they trained, some would argue that residency is about Location, Location, Location. Using FRIEDA, you can search all accredited programs by field and location to help you find potential residencies. Are you considering enough
- [Rules for making your Rank Order List (ROL)](https://www.benwhite.com/medicine/rules-for-making-your-rank-order-list/) - Rules for the Rank Order List (ROL) Put them in the order you actually want them. There is no reason to change how you will rank programs based on post-interview communications or voodoo. Your number one should be your dream program. You must "certify" your ROL when you first make it and whenever you make
- [Radiology's continuing PR problem](https://www.benwhite.com/medicine/radiologys-continuing-pr-problem/) - A couple of months back, JACR published an article with the self-evident conclusion that patients would prefer to hear the results of their radiology studies from their doctor (the ordering provider) instead of a radiologist. Duh! Who wants to hear they have cancer from a stranger who they may never see you again nor have
- [Best Books Methodology](https://www.benwhite.com/misc/best-books-methodology/) - I sporadically post "best books" recommendations for medical topics, which if you're reading this you've likely also noticed sometimes cover topics that I'm not in expert in and discuss books I haven't actually read. This is my general methodology, for those curious: For specialties and niches, I typically get a first-round of book recommendations from people
- [The slow growing tide against PSLF](https://www.benwhite.com/finance/the-slow-growing-tide-against-pslf/) - Jason Delisle does a nice job describing the majority of the arguments used to suggest that PSLF should be severely curtailed or destroyed in "The coming Public Service Loan Forgiveness Bonanza" for the Brookings Institution. PSLF will be revised at some point if no other reason than this: In 2014, the CBO estimated that the
- [Additional thoughts on residency interviews](https://www.benwhite.com/medicine/additional-thoughts-on-residency-interviews/) - After a few years of seeing medical students on their interviews from the other side, here are a few of my favorite new considerations for dos/don'ts during your interviews (note, many of these also apply to your personal statement): Don't: Say negative things about other fields. The fact that you think other fields suck is
- [How to Succeed in Your Residency Interviews](https://www.benwhite.com/medicine/how-to-succeed-in-your-residency-interviews/) - Interviews for residency are generally unlike those you are familiar with. They tend to be more conversational and are at least as much a marketing session for the residency programs as they are an evaluation of you (the applicant). The most common question you will receive on the interview trail is "do you have any
- [Applying for a Medical License in Texas](https://www.benwhite.com/medicine/applying-for-a-medical-license-in-texas/) - Update 11/2015: Essentially, things have gotten cheaper (crazy!). New costs reflected below. Update 1/2016: I wrote a JP exam review book (more info here), which you could buy. Update 9/2016: DPS numbers are no longer a thing, because Texas finally realized it was stupid to essentially duplicate the DEA number everyone needs to have anyway.
- [The Mini Step 1](https://www.benwhite.com/medicine/the-mini-step-1/) - For around $35 a pop, your medical school can pay the NBME to let you and your classmates take the Mini Step 1 ("Comprehensive Basic Science Examination"), a 200 question multi-subject basic science test. The grading and its relationship to Step 1, according to the NBME: The subject examination score is [was originally] scaled to
- [Guide to The Core Exam](https://www.benwhite.com/radiology/guide-to-the-core-exam/) - Below are the current entries in the ABR Core Exam Series: The Core Exam Experience Detailed post describing the process of registering for the exam, selecting testing location and lodging, the actual test day experience, and the exam itself including the exam breakdown, scoring, and results Approaching the Core Exam Detailed post discussing approaching the
- [Organizational stupidity](https://www.benwhite.com/misc/organizational-stupidity/) - Please read and cherish this incredibly cynical essay in Aeon, "Stupefied: How organisations enshrine collective stupidity and employees are rewarded for checking their brains at the office door." I'm going to superblockquote a chain of some of my favorite parts. Please tell me this doesn't describe every hospital you've ever worked in: No matter how hard
- [Nothing > Fitbit](https://www.benwhite.com/medicine/nothing-fitbit/) - Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches. That's the conclusion
- [[Education Needs] Denied](https://www.benwhite.com/misc/education-needs-denied/) - Sad, no good, very bad, depressing reality reported by the Houston Chronicle: Over a decade ago, the officials arbitrarily decided what percentage of students should get special education services — 8.5 percent — and since then they have forced school districts to comply by strictly auditing those serving too many kids. Their efforts, which started
- [Prisons and Profit](https://www.benwhite.com/misc/prisons-and-profit/) - Very long but excellent journalism in Mother Jones from Shane Bauer, who spent 4 months working undercover in a Louisiana private prison. Hint: it's terrible. Here's one terrible facet from an almost endless number of ways in which this system is failing: If [an inmate] were sent to the hospital, CCA would be contractually obligated to pay
- [2:1](https://www.benwhite.com/medicine/21/) - For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work. That is the conclusion of a paper
- [My absolute favorite penlight](https://www.benwhite.com/medicine/my-absolute-favorite-penlight/) - Okay, so penlights (pen lights?) are not the sexiest topic within medicine. However, I struggled with them a lot as a medical student. As in, I never seemed to have one when I needed one. And, when I did have one, more than once it had died when I finally tried to save the day
- [The Equipment You Need (or Don’t) for Medical School](https://www.benwhite.com/medicine/equipment-for-medical-school/) - "What equipment do I need for medical school?" was a question I had as a nascent first year. At the time, I just listened to whatever my school demanded and bought most my stuff from the bookstore. Bad idea on both counts. I've written about some of my favorite purchases and some of the less
- [Planning for PSLF](https://www.benwhite.com/medicine/planning-for-pslf/) - I've discussed (in great and somewhat confounding detail) income-based repayment (IBR), public service loan forgiveness (PSLF), and forbearance previously. (Read it if you haven't already. Go ahead, I'll wait). To sum up: the best and most straightforward reason to plan to apply for PSLF is if you want to both train and practice at a
- [The movement to end Step 2 CS](https://www.benwhite.com/medicine/the-movement-to-end-step-2-cs/) - If you hadn't heard, there is growing movement to end Step 2 CS (because it's a stupid, expensive, and ultimately ineffective test). You can read about the background and sign the petition here. There's also a fun additional JAMA editorial. 20,190 MD (ignoring DOs who mostly don't take it and IMGs, for whom the test was
- [Book Review: Core Radiology](https://www.benwhite.com/reviews/core-radiology/) - Jacob Mandell's Core Radiology is the book that first year residents should be reading to get a foothold in radiology. The classic Brant & Helms is too unwieldy, too long for a first shot, and a mishmash of styles with lots of words, comparatively few pictures, and a relative dearth of diagrams and other helpful practical
- [Post-interview Correspondence Do's and Don'ts](https://www.benwhite.com/medicine/post-interview-correspondence-dos-and-donts/) - NRMP Rules concerning correspondence (that are sadly and awkwardly broken all the time): A program may not ask you how you will rank them You may not ask a program how you will be ranked It is perfectly okay and common to tell a program how you feel, and some programs may send you love
- [Survivorship Bias & Other Problems With Science](https://www.benwhite.com/misc/survivorship-bias-other-problems-with-science/) - Two great longish weekend reads: Vox's The 7 biggest problems facing science, according to 270 scientists: Scientists need more carrots to entice them to pursue replication in the first place. As it stands, researchers are encouraged to publish new and positive results and to allow negative results to linger in their laptops or file drawers.
- [Should your radiologist tell you the results of your scan?](https://www.benwhite.com/medicine/should-your-radiologist-tell-you-the-results-of-your-scan/) - Probably not. But some interesting lines from Gina Kolata's article in the NYTimes: Dr. Christopher Beaulieu, chief of musculoskeletal imaging at Stanford: At that point the radiologist may be capable of transmitting the information but the obvious next question for the patient is, ‘What do I do now?’ which, as nontreating physicians, radiologists are not trained to
- [Letter to a Third Year](https://www.benwhite.com/medicine/letter-to-a-third-year/) - I stumbled across this in my Google Docs. My school used to put together a book of letters every year from third years at the end of their year to give to students about to start clinical clerkships. This was written in 2011 (I still largely agree with myself). Long before the end of third year, people
- [Explanations for the 2013-2014 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-official-step-2-ck-practice-questions/) - The NBME graciously provides brief practice materials for its USMLE tests, including pdf and software versions. While answers are included, there haven't been explanations available online (until now). If you haven't taken a moment recently to think about how you approach Step-style questions, I might refer you to my discussion of that particular topic, particularly the
- [Explanations for the 2014-2015 Official Step 2 CK Practice Questions](https://www.benwhite.com/medicine/explanations-for-the-2014-2015-official-step-2-ck-practice-questions/) - Update 8/5/2015: They’ve now updated to the new 2015-16 question set and removed the old links (they've previously kept the old ones working for several years). You can still access cached versions of 2014-15 and 2013-14 for now (cachedview.com is helpful in cases like these). My explanations for the new set are available here. Here are the explanations
- [The Call for Technological Humility](https://www.benwhite.com/misc/the-call-for-technological-humility/) - Maciej Cegłowski runs pinboard, a fantastic and fantastically simple bookmarking site (it's what I use to power the interesting links sidebar section of this site). He's also a level-headed, funny, and cogent writer on software and technology. From the transcript of his recent talk on the moral economy of tech: But as anyone who's worked with
- [Pepsi learns that nothing is quite like the bittersweet tang of aspartame](https://www.benwhite.com/misc/pepsi-learns-that-nothing-is-quite-like-the-bittersweet-tang-of-aspartame/) - Less than a year after ruining the flavor of diet Pepsi by switching from aspartame to sucralose due to "customer demand," Pepsi plans to bring back the original formulation. When PepsiCo removed aspartame from Diet Pepsi in August, it said the change was the No. 1 request by customers. Industry executives have blamed the declining
- [Undoing the Undue Burden](https://www.benwhite.com/medicine/undoing-the-undue-burden/) - When a State severely limits access to safe and legal procedures, women in desperate circumstances may resort to unlicensed rogue practitioners, faute de mieux, at great risk to their health and safety,” she concluded. “So long as this Court adheres to Roe v. Wade and [Casey], Targeted Regulation of Abortion Providers laws like H.B. 2
- [Studying for the NBME Pathology Shelf](https://www.benwhite.com/medicine/studying-for-the-nbme-pathology-shelf/) - Because Pathology is a cumulative all-encompassing subject, it makes sense that preparing for the Step 1—reading the First Aid—would be good preparation for Pathology Shelf. And while that would work, I don't think that's the best use of your time if you only have a few days to try to cram it all in. Pathology
- [Helping surgeons stop lying on their duty hours](https://www.benwhite.com/medicine/helping-surgeons-stop-lying-on-their-duty-hours/) - Not ready yet to extend the rule loosening, the ACGME is expanding and extending its study of the effects of longer shifts for surgeons. The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) has unsurprisingly shown that occasionally longer shifts and a less stringent rest period did not affect the rate of "surgical fatalities or serious complications."
- [The looming GME funding crisis](https://www.benwhite.com/medicine/the-looming-gme-funding-crisis/) - David Silberswieg, Professor of psychiatry and Academic Dean at Harvard Medical School, writing in the Washington Post about the increasingly underfunded mission of academic medicine: But while there is a need for oversight, in some political and journalistic quarters there are exaggerated senses of mistrust, attack, mixed messages (if not hypocrisy), and mis-aligned incentives...Ever-increasing regulation brings
- [Me & Nanoism on NPR](https://www.benwhite.com/writing/me-and-nanoism-on-npr/) - Got to put on my writer/editor hat and be a guest on WNPR's Colin McEnroe Show to talk about Twitter Fiction, Nanoism, and read a few tweet-sized tales. This was my very first radio interview (and live is tough, oof!). My part is toward the beginning, with Colin introducing me around the 6:45 mark. But you should at least listen
- [Book Review: The Hidden Curriculum & The Doctor's Basic Business Handbook](https://www.benwhite.com/medicine/book-review-the-hidden-curriculum-the-doctors-basic-business-handbook/) - David Kashmer's The Hidden Curriculum: What They Don't Teach You At Medical School is up next on the Kindle Unlimited tour of physician books. I really feel like the title should read "in Medical School." Kashmer's hardest sells in the book are on how valuable he thinks his MBA training was and how great locum
- [Approaching the radiologist](https://www.benwhite.com/medicine/approaching-the-radiologist/) - Rewind. Time for the Jedi Mind Trick. I held the films out. “This patient isn’t an operative candidate. I don’t know if you could even biopsy this mass. It’s really in there.” I prayed his ego would take the bait. The radiologist turned and snatched the films from me then threw them up on the
- [The second skin is coming](https://www.benwhite.com/medicine/the-second-skin-is-coming/) - From the NYTimes piece about a new synthetic polymer that could be used medically to keep topical medications on the skin, maintain moisture in conditions like eczema, and—of course—to temporarily reduce wrinkles: A Harvard colleague, Dr. Mathew Avram, who was not associated with the company or its product, said he had tried second skin, putting
- [MINCOME](https://www.benwhite.com/misc/mincome/) - From FiveThirtyEight's article, What Would Happen If We Just Gave People Money?, discussing the results of the MINCOME experiment in Canada in the 1970s where families received a basic income, no strings attached: Families receiving MINCOME had fewer hospitalizations, accidents and injuries, Forget found. Mental health hospitalizations fell dramatically. And the high school completion rate ticked up
- [The new third leading cause of death](https://www.benwhite.com/medicine/the-new-third-leading-cause-of-death/) - If you've seen the headlines, then you know that this open letter to the CDC from three medical students and Martin Makary at Johns Hopkins has gained a lot of media attention. In it, they argue that the CDC should allow doctors to list medical error as a cause of death. So far so good. Then
- [1 in 3 antibiotic prescriptions are unnecessary](https://www.benwhite.com/medicine/1-in-3-antibiotic-prescriptions-are-unnecessary/) - Fresh from JAMA: In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship. If 1 in 3 seems low to you (and it certainly does
- [Book Review: So You Got Into Medical School....Now What?](https://www.benwhite.com/medicine/book-review-so-you-got-into-medical-school-now-what/) - Newly minted orthopod Daniel Paull MD's So You Got Into Medical School....Now What? came out last year. The book attempts to be a one-stop shop of medical school advice with a big focus on how to study. I bet the idea of a detailed how-to guide for medical school seems compelling to a lot of
- [The Texas JP Exam Book available on iTunes and Kobo](https://www.benwhite.com/writing/the-texas-jp-exam-book-available-on-itunes/) - My very short and very well received book (26 all 5-star reviews and counting, hooray!), The Texas Medical Jurisprudence Exam: A Concise Review, is now available on iTunes/iBooks and Kobo in addition to Amazon. Additional ebook formats and the print version are forthcoming. While I personally use Amazon for just about everything, I know some people prefer
- [Game Theory for Parents](https://www.benwhite.com/parenthood/game-theory-for-parents/) - From Scientific American, paraphrasing The Game Theorist’s Guide to Parenting: So which of your kids will lay down arms first? You can try to initiate cooperation by taking turns with one child until a recalcitrant sibling jumps in. Or you might try the opposite strategy: You become the person who refuses to cooperate. It works
- [Book Review: Physician Finance](https://www.benwhite.com/finance/book-review-physician-finance/) - Next up through the Kindle Unlimited tour of "free" books written for physicians is Physician Finance: A Personal Finance Guide for Doctors by KM Awad. This book's style is very casual. Normally that's fine, but I wonder if perhaps among the jokes and looseness if the message is maybe diluted (some may appreciate it more than me;
- [How NBME Shelf Scores Work](https://www.benwhite.com/medicine/how-nbme-shelf-scores-work/) - How do you interpret a shelf exam score? The NBME shelf exams were originally scaled to a mean of 70 and a standard deviation of 8. Keep in mind, this is not recalculated every year. The actual average in a given year has tended to creep up and is usually somewhere in the low-to-mid 70s.
- [Megaviruses](https://www.benwhite.com/misc/megaviruses/) - The "Shrink" episode of Radiolab was fascinating: we thought viruses were all small, but that was a consequence of the method we used to first discover them. But now we know better, and there are some giant viruses out there, some even bigger than bacteria and large enough to get their own viruses.
- [Switching from IBR to PAYE](https://www.benwhite.com/finance/switching-from-ibr-to-paye/) - Update 2/2016: The DOE newest repayment plan, REPAYE is now available. For many if not most residents, REPAYE is probably a better choice than PAYE. I wrote about the pros and cons of REPAYE at length in this post. While the benefits and numbers are a bit different, the process of changing plans is the
- [Book Review: Pay Yourself First & Changing Outcomes](https://www.benwhite.com/finance/book-review-pay-yourself-first-changing-outcomes/) - I recently started a 30-day Kindle Unlimited free trial, which gave me a chance to pick up a bunch of Kindle titles (to read on my phone). I used the opportunity to take a look at a large fraction of the (mostly self-published) books on medical school advice and physician finance. My first review is
- [Amazon Bestseller? No big deal](https://www.benwhite.com/writing/amazon-bestseller-no-big-deal/) - I'm going to leave this right here: Goes to show that you too can have a bestseller on Amazon if you publish in a low-volume niche category (and check routinely, because rankings are based on very short term sales trends). Still, kinda fun.
- [Who do doctors marry?](https://www.benwhite.com/misc/who-do-doctors-marry/) - From Bloomberg, an interactive infographic that looks at interprofessional marriage from the 2014 US Census. Female doctors, whether gay or straight, tend to marry other doctors. Straight male doctors also marry doctors, but they're almost as likely to marry nurses or schoolteachers. According to the census data, gay male doctors most commonly marry nurses.
- [Amazon prepares for the zombie apocalypse](https://www.benwhite.com/misc/amazon-prepares-for-the-zombie-apocalypse/) - From section 57.10 of the updated service terms for Amazon's popular AWS service (emphasis mine): Acceptable Use; Safety-Critical Systems. Your use of the Lumberyard Materials must comply with the AWS Acceptable Use Policy. The Lumberyard Materials are not intended for use with life-critical or safety-critical systems, such as use in operation of medical equipment, automated
- [Backing off for creativity](https://www.benwhite.com/parenthood/backing-off-for-creativity/) - Adam Grant, writing in the NTTimes Sunday Review: So what does it take to raise a creative child? One study compared the families of children who were rated among the most creative 5 percent in their school system with those who were not unusually creative. The parents of ordinary children had an average of six
- [Nanoism in the Washington Post](https://www.benwhite.com/writing/nanoism-in-the-washington-post/) - Very fun: Nanoism, a few tiny stories, and I made an appearance in the Washington Post yesterday in an article about Twitter's planned/rumored character-limit change. For what it's worth, while the type of fiction I've purveyed is only fun within a predominantly constrained system, for people who write Twitter fiction differently, the ability to say more probably wouldn't be much of
- [Life Lessons from P. T. Barnum](https://www.benwhite.com/misc/life-lessons-from-p-t-barnum/) - You may not be familiar with P. T. Barnum, but you'd probably recognize the 19th century showman's longstanding legacy: the Barnum & Bailey circus. In 1880, he also published the self-help/personal finance book, The Art of Money Getting; Or, Golden Rules for Making Money, which contains essentially everything you've ever read in a blog or book about
- [Nanoism in Verizon Wireless](https://www.benwhite.com/misc/nanoism-in-verizon-wireless/) - Yours truly is quoted a couple of times about Twitter Fiction in Verizon Wireless Mobile Living. See "Telling a story, 140 characters at a time," where a classic Nanoism story from 2013 also makes an appearance (#537).
- [The Great Filter of Artificial Intelligence](https://www.benwhite.com/misc/the-great-filter-of-artificial-intelligence/) - From Raffi Khatchadourian's "The Doomsday Invention" in The New Yorker, a profile of philosopher of Nick Bostrom and discussion of the (highly dangerous) future of artificial intelligence: He stopped and looked ahead. “What I want to avoid is to think from our parochial 2015 view—from my own limited life experience, my own limited brain—and super-confidentially
- [Folding Clothing: The Life-Changing Magic of Tidying Up](https://www.benwhite.com/misc/folding-clothing-the-life-changing-magic-of-tidying-up/) - Marie Kondo's The Life Changing Magic of Tidying Up was arguably the biggest 'self-help' book of the year (i.e. NYTimes #1 bestseller). The book's central premise is something that I think everyone deep down knows and that that my wife and I rediscovered for ourselves while preparing for the birth of our first child. Organizational
- [Turkey on Wheat is back](https://www.benwhite.com/writing/turkey-on-wheat-is-back/) - My very short story "Turkey on Wheat" is back online, republished in The Story Shack with accompanying art by Hong Rui Choo.
- [Studying for the Basic Sciences and (preclinical) NBME Shelf Exams](https://www.benwhite.com/medicine/tips-on-nbme-shelf-exams/) - Some thoughts for intrepid and probably antsy first-years as they stumble upon this page on their search for the truth. Here are some tidbits about the Anatomy, Physiology, Biochemistry, and Microbiology shelves. Anatomy: Anatomy, if learned well over the year, is doable. It is crammable if (and only if) you've actually paid attention and learned
- [Modern Romance](https://www.benwhite.com/reading/modern-romance/) - I recently finished "reading" the audiobook of Aziz Ansari's Modern Love (coincidentally narrated by Aziz Ansari), which is essentially an amusing presentation of real sociological research focused on how dating has changed in the internet era. Made for a good listen in the car on the way to daycare, which has become my primary reading time of
- [ACP begs clinicians to stop ordering so many CTs for PEs](https://www.benwhite.com/medicine/acp-begs-clinicians-to-stop-ordering-so-many-cts-for-pes/) - In their newest best practice guidelines in the Annals of Internal Medicine, the American College of Physicians practically begs clinicians to stop chasing phantom pulmonary emboli. Nothing super new here, but they do explicitly call out the big offenders: Best Practice Advice 1: Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in
- [Book Review: Medical School and the Residency Match](https://www.benwhite.com/medicine/book-review-medical-school-and-the-residency-match/) - There's a new residency guidebook on the scene, Medical School and the Residency Match, and the reviews on Amazon are great. So I'm reviewing it. This time, instead of being written by a residency consultant (like this or this), the book is written by a group of post-match medical students. As such, it's a refreshingly honest
- [Submit your ERAS!](https://www.benwhite.com/medicine/submit-your-eras/) - If you're an MS4, submit your ERAS today. Be the early bird. And, when you're done with that, you might prepare for the rest of the season with the Guide to Fourth Year.
- [Book Review: The White Coat Investor](https://www.benwhite.com/finance/book-review-the-white-coat-investor/) - I just finished reading James Dahle's The White Coat Investor: A Doctor's Guide To Personal Finance And Investing for the second time. I recommend it as a great first finance book for medical students, residents, and even attendings. Physicians are notoriously terrible at personal finance, and as a profession we are routinely preyed on by those in
- [Oliver Sacks' last essays](https://www.benwhite.com/misc/oliver-sacks-last-essays/) - Oliver Sacks, writer of "neurological novels" and one of my favorite authors, died on August 30 from metastatic ocular melanoma. His last three essays are now available, "Sabbath" in the New York Times, "Urge" in the New York Review of Books, and "Filter Fish" in the New Yorker. Longform has links to 11 of his best essays,
- [Oh, the late night snacking is why we're fat](https://www.benwhite.com/misc/oh-the-late-night-snacking-is-why-were-fat/) - The Washington Post recently ran "Why eating late at night may be particularly bad for you and your diet," which discusses emerging research that after dinner snacking is bad for you. The thrust of the article is that calories consumed at night result in more weight gain than the same number of calories consumed earlier in
- [Veterans decide CT lung cancer screening will help them continue to smoke](https://www.benwhite.com/medicine/veterans-decide-ct-lung-cancer-screening-will-help-them-continue-to-smoke/) - Linkbait-y title aside, JAMA Internal Medicine has an interesting new too-small too-ungeneralizable study of 35 veterans across multiple VAs. In it, 49% (i.e. 17 patients) admitted that the availability of CT lung cancer screening reduced their motivation to quit. Reportedly, quitting is hard and CT scans are easy. Of course, hunting for and even
- [App Review: Quest](https://www.benwhite.com/reviews/quest/) - I am one of those supremely unproductive people who frequently spends hours researching distraction free writing programs and other workflow micromanagement with zero sense of irony. Nothing helps. Anyway. One app I do use extensively is the Apple's default Reminders app, which I've long used as both an actual todo list as well as a
- [Making MS3 Clerkship Study Schedules](https://www.benwhite.com/medicine/making-ms3-clerkship-study-schedules/) - This is another reader request and companion post to Studying for Third Year NBME Shelf Exams. Let me start by saying that I've never personally utilized a detailed schedule as a binding contract. My ability to master my personal will with regularity is limited, and the day-to-day variability of a clinical workload makes strict planning difficult.
- [Prime Day is here](https://www.benwhite.com/misc/prime-day-is-here/) - Prime Day is here, and while Wal-Mart is copying the idea, I think only Amazon can make a national news story by unilaterally promoting a sale. And while good discounts on some Kindles, other miscellany, and fabled "lightning" deals every 10 minutes may generate some revenue, I have no doubt that the main thrust of the
- [The satisfied patient is the one we're killing](https://www.benwhite.com/medicine/the-satisfied-patient-is-the-one-were-killing/) - From a UC Davis study that analyzed a >50,000 person national Medical Expenditure Panel Survey: The study found that patients who were most satisfied had greater chances of being admitted to the hospital and had about 9 percent higher total health-care costs as well as 9 percent higher prescription drug expenditures. Most strikingly, death rates also
- [QuantiaMD, now paying for new members](https://www.benwhite.com/medicine/quantiamd-now-paying-for-new-members/) - QuantiaMD, the "social learning and collaboration platform that helps physicians," is now temporarily paying people $10 to sign up. I assume with the rapid growth of Sermo (which has been paying doctors to join for a while now), they're getting a bit more desperate to compete. Click the link, confirm your "clinician status," and you earn
- [Overkill](https://www.benwhite.com/medicine/overkill/) - Atul Gawande, writing about useless medical care for the New Yorker: One major problem is what economists call information asymmetry. In 1963, Kenneth Arrow, who went on to win the Nobel Prize in Economics, demonstrated the severe disadvantages that buyers have when they know less about a good than the seller does. His prime example was health
- [America's Doctor](https://www.benwhite.com/medicine/americas-doctor/) - From Julia Belluz's portrait of Dr. Oz in Vox, now apparently America's most famous and most trusted physician: This setback didn't slow down Oz in his study of alternative medicine — or his embrace of fame. In the early 2000s, he worked with a reiki healer named Raven Keyes. She told me recently, "My reiki
- [Alto's Adventure](https://www.benwhite.com/misc/altos-adventure/) - This past week, as Dallas was intermittently "covered" in ice and snow, the hospital was intermittently quiet enough to download and play Alto's Adventure a bit a lot on my iPhone, a new snowboarding-theme one-touch endless runner with a beautiful, relaxing visual and musical design. Come for the backflips and wingsuit, stay for watching the sunrise over
- [Well this changes everything](https://www.benwhite.com/misc/well-this-changes-everything/) - 7 pounds 8 ounces of pure awesome.
- [The Radical Humaneness of Norway’s Halden Prison](https://www.benwhite.com/misc/the-radical-humaneness-of-norways-halden-prison/) - Ragnar Kristoffersen, an anthropologist who trains Norway's correctional officers, quoted in a fascinating NYTimes piece about a different kind of maximum security prison: He leaned back in his chair and went on. “We like to think that treating inmates nicely, humanely, is good for the rehabilitation. And I’m not arguing against it. I’m saying two
- [Oliver Sacks learns he has terminal cancer](https://www.benwhite.com/misc/oliver-sacks-learns-he-has-terminal-cancer/) - Oliver Sacks, in his moving NYTimes op-ed about learning that his ocular melanoma has metastasized to his liver: I have to live in the richest, deepest, most productive way I can. This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some
- [Scientific Blindspots](https://www.benwhite.com/misc/scientific-blindspots/) - One of the internet's double edged swords: a lot of information is good, but the consequent ton of poorly researched and incorrect information is bad. Even lay people who want to be up-to-date on science must swim through the well-intentioned mistakes of their sources. Take, for example, this article: "Blindspot shows brain rewiring in an
- [What I read in 2014](https://www.benwhite.com/reading/what-i-read-in-2014/) - 2014 wasn't a particularly big year for my library, but it is the first year I kept track of all of the books I read for pleasure, reproduced here in the order I consumed them: Steelheart by Brandon Sanderson (Reckoners #1) Divergent by Veronica Roth (Divergent #1) The Calling by Robert Swartwood Insurgent by Veronica Roth (Divergent #2)
- [In which Amazon realizes that I'm not a student anymore](https://www.benwhite.com/misc/darn-not-a-student-anymore/) - It couldn't last forever, and so today is the end of a personal era: Amazon figured out that I'm not a student anymore. Which is too bad, because now I'll have to pay full price for Amazon Prime. I spent the last year of medical school (and two bonus years to hit three of the maximum total
- [Ebola Reading](https://www.benwhite.com/reading/ebola-reading/) - The current Ebola scare and the growing story of its mismanagement made me remember two excellent books: The Hot Zone, the nonfiction thriller about Ebola that I found highly disturbing in middle school. For an even scarier read, try its spiritual sequel, The Demon in the Freezer (in which Preston details how much bioweapons grade Smallpox the
- [The resident gender pay gap?](https://www.benwhite.com/medicine/the-resident-gender-pay-gap/) - When people talk about the very real gender pay gap, they're talking about women and men being paid different amounts for doing the same work. There is a pay gap in medicine, and that's a problem. What's so odd then is this discussion of the gender pay gap in the most recent Medscape Resident Salary
- [What stethoscope should I buy?](https://www.benwhite.com/medicine/what-stethoscope-should-i-buy/) - The Littmann Cardiology III. Oh, you actually want to read a treatise on stethoscopes? Well then don't let me stop you! A reasonably good stethoscope is the one (and I mean one) and only piece of medical equipment that every medical student should purchase. You will use it during the preclinical years for training and
- [A new (!) (very very short) story in Microliterature](https://www.benwhite.com/writing/a-new-very-very-short-story-in-microliterature/) - Microliterature ("the most popular publication for acclaimed works between 1-1000 words") has published another entry in my extremely slowly growing collection of Craigslist fiction: "1938 'Yosemite Landscape' Oil Painting," up on the front page for the next week and at the link above indefinitely. Microliterature has been around for just over four years, and while
- [Bed Bath and Beyond Silly](https://www.benwhite.com/misc/bed-bath-and-beyond-silly/) - A bizarre conundrum: If you make a return to Bed Bath & Beyond with a gift receipt, you get a gift card for store credit. If you make the same return without a receipt, you get a store credit receipt: a regular-looking paper receipt with some old-fashioned highlighting and a signature or two or three.
- [Steps](https://www.benwhite.com/reading/steps/) - Yesterday I read and finished the short novel Steps, which had been recommended to me specifically because it is composed entirely of short vignettes. What I didn't know at the time was that Steps, which was published in 1968, won the National Book Award for Fiction, and that its author, Jerzy Kosinski, was a Polish Jew whose family
- [Do I need to buy an otoscope/ophthalmoscope?](https://www.benwhite.com/medicine/do-i-need-to-buy-an-otoscopeophthalmoscope/) - Do I need to buy an otoscope/ophthalmoscope? And if I do, which one should I get? These are two of the first questions I used to hear from every MS0/MS1 during welcome weekend, white coat ceremony, or orientation. Medically, the answer for most students is "no." Most hospitals and clinics have Welch Allyn diagnostic sets
- [Craigslist fiction lives again](https://www.benwhite.com/writing/craigslist-fiction-lives-again/) - The Story Shack has republished my story "You read about local politics and hate the sox" with an accompanying illustration by artist Mike Young. I love this site, and I consistently love seeing what the artists do with their assigned stories. It's such fresh, inspiring stuff.
- [Florence](https://www.benwhite.com/writing/florence/) - I don't write as much these days as I'd like. And until I began writing some non-fiction pieces about my experiences in medicine last year, I probably hadn't written a personal narrative in over three years. The process is somewhat disquieting. Accuracy and authenticity and honesty and feeling can be shifting features on a zero-sum
- [NBME Shelf Exam scores, with a grain of salt](https://www.benwhite.com/medicine/nbme-shelf-exam-scores-with-a-grain-of-salt/) - The NBME Shelf exams are enjoyable standardized tests that every first year looks forward to with almost unbearable glee. Each tests a single subject ("Anatomy") and is (for the preclinical years) made up from the old or junior varsity questions from the USMLE Step 1, a test that makes the MCAT look like the GRE
- [Quick And Dirty Suggestions for the Match](https://www.benwhite.com/medicine/quick-and-dirty-suggestions-for-the-match/) - 1. Establish a relationship with the program director at your institution (and additional mentors, when possible) for the specialty of your choosing to help you develop your plan for fourth year. He or she will help you determine: Your competitiveness for the field How many programs (and of what type) to apply to based on
- [Easter Rabbit, Microfiction, Contests, Comics, and Free Stuff](https://www.benwhite.com/misc/easter-rabbit-microfiction/) - I've been winning some free stuff recently, and I've come to the conclusion that I really really like it. I just won a copy of Joseph Young's Easter Rabbit from Publishing Genius. Young has made a name for himself as the microfiction guy. His approach is similar to some of the writing I've done for
- [On a Narrow Windowsill](https://www.benwhite.com/misc/on-a-narrow-windowsill/) - As time marches on, the number of Twitter-based books continues to increase. There's the crowd-sourced book of clever tweets in Twitter Wit: Brilliance in 140 Characters or Less; there are the celebrity cash-in's, like Dennis Leary's new twitter-feed on paper, Suck On This Year: LYFAO @ 140 Characters or Less; not to mention the countless
- [Updates in the world of itty-bitty stories](https://www.benwhite.com/writing/updates-in-the-world-of-itty-bitty-stories/) - Last month Michael Rudin (author of nano #147) published his piece "From Hemingway to Twitterature: The Short and Shorter of It" in the Journal of Electronic Publishing. It's a thoughtful academic look at the different ways we're writing (short and cheap) in the digital age that also includes a couple selections from the Nanoism archives
- [How to write your personal statement for ERAS/residency applications](https://www.benwhite.com/medicine/how-to-write-your-personal-statement-for-eras/) - The personal statement is occasionally a chance to “make” your application, but it's always a risk to “break” it. Keep in mind: it’s only 1 page (literally—it should fit on no more than one page when printed from the ERAS application, which is somewhere around 750-800 words on the longer end; 600-650 is a better
- [Lip service surveys](https://www.benwhite.com/misc/lip-service-surveys/) - The world is full of surveys: surveys for free meals at TGI Friday's, surveys for news polls, and at school, surveys for curricular reform: "In order to improve this course for next year, we would appreciate it very much if you would take a few minutes and fill out this evaluation form." And the idea
- [Nanoism cameo in <em>The Writer</em> magazine](https://www.benwhite.com/reading/nanoism-cameo-in-the-writer-magazine/) - Nanoism makes a brief cameo in the March 2013 issue of The Writer magazine as part of an article "Hey, shortie!" by Karen M. Rider about flash fiction. In this appearance, I am—as always—attempting to argue that the joys of tiny tales do not come at the expense or eschewment of longer pieces but are
- [The data you should analyze before choosing your specialty](https://www.benwhite.com/medicine/the-data-you-should-analyze-before-choosing-your-specialty/) - The NMRP puts out the results of the match every year, allowing you to see what programs fill their spots, average step scores for different fields, numbers of programs ranked per candidate, etc. The numbers can be overwhelming, but it’s a good way to get a realistic picture of what your dream looks like on
- [Your CV for ERAS and residency](https://www.benwhite.com/medicine/your-cv-for-eras-and-residency/) - The CV (curriculum vitae) is an essential professional summary of your qualities as a candidate for residency, and there is no better time to start on it than as soon as possible. Not only do you need it for ERAS itself, but you'll also need it for away rotation applications and for the faculty writing
- [Six Questions for Nanoism](https://www.benwhite.com/writing/six-questions-for-nanoism/) - Six Questions For... is an interesting site: an ever-growing compilation of interviews with editors of flash fiction publications. Each interview is composed of exactly—wait for it—six questions. Today's six questions are with me. About Nanoism. You can read them here.
- [Memories of Life: re-published and available online](https://www.benwhite.com/writing/memories-of-life-re-published-and-available-online/) - My flash piece "Memories of Life" was originally published in the now defunct BURST magazine back in 2009. Such is the circle of internet literary magazine life. Not only has it been republished, courtesy of The Story Shack, but it's been upgraded with a piece of artwork by Hong Rui Choo that was inspired by
- [Memories of Life](https://www.benwhite.com/writing/memories-of-life/) - "Memories of Life" appears in the Summer 2009 issue of Burst Magazine, a publication specifically designed for mobile phones (and including only pieces of 700 words or fewer). Even though iPhones and the like can handle normal web pages, there is something to be said for a magazine that knows what it does and who
- [Yes, medical school could definitely be shorter](https://www.benwhite.com/medicine/yes-medical-school-could-definitely-be-shorter/) - Two articles this week—one from the Atlantic and the other from the NYT—deal with a couple of rare modern pilot programs to condense medical school into three instead of four years for a small number of students. The Atlantic article in particular is pretty bad and clearly written by someone who has no meaningful familiarity
- [The #Twitterfiction Festival](https://www.benwhite.com/writing/the-twitterfiction-festival/) - Last month, Twitter—one of the patron saints of creativity—held its first ever Twitter Fiction Festival (#twitterfiction, naturally). Perhaps because Nanoism is straight-up stories and not some sort of collaborative tweetganza, my little longest-running twitter fiction magazine of all time wasn't made an official selection. Didn't stop me from doing a little daily themed contest in
- [In which Robert Swartwood and I discuss tiny tales](https://www.benwhite.com/writing/in-which-robert-swartwood-and-i-discuss-tiny-tales/) - Robert Swartwood, creator of Hint Fiction and man after my own heart, and I discuss twitter-fiction on his podcast. Good times are had by all. Those with an interest in very very very short stories will enjoy some interesting pearls and insights into the form. And other stuff.
- [I Can See](https://www.benwhite.com/writing/i-can-see/) - Writer's Bloc (Rutgers) is a rare site that has a new design--a good design--with every issue. I have piece in the new issue 7. Check out the splash page to see the issue's underwater theme in action, as well as the writing of Jimmy Chen (owner of the best personal url meme of all time)
- [Turkey on Wheat](https://www.benwhite.com/writing/turkey-on-wheat/) - I have a new (actually old) story up in the very new site thickjam (specializing in the shorts that are "substantial, sticky and hard to rub off"). It's called Turkey on Wheat. Yes, it's a play on Bukowski's Ham on Rye. I like a good Jewish rye, but I don't eat ham.
- [Did you hear about Lauren?](https://www.benwhite.com/writing/did-you-hear-about-lauren/) - Amidst graduation and moving across the state, I let the publication of my very short story "Did You Hear About Lauren?" in Microliterature pass me by. But it's out, and I still like it, and you should go read it now.
- [Microchondria](https://www.benwhite.com/writing/microchondria/) - I received my contributor's copy of Harvard Book Store's Microchondria yesterday in the mail. It's that great pocket size and a pretty neat project. And since I was fortunate enough to earn two out of the forty-two spots, my stories also make up 1/21 of the final product (one, "Consumer Reports," is a traditional short
- [Cobblestones](https://www.benwhite.com/writing/cobblestones/) - I have another very short story in thickjam. It's called The Cobblestones Will See Me Grow.
- [The Nano Title](https://www.benwhite.com/writing/the-nano-title/) - Robert Swartwood is hosting a big contest to celebrate Hint Fiction's birthday and keep us excited for Hint Fiction: An Anthology of Stories in 25 Words or Fewer, which comes out in November from Norton. Incidentally, Amazon has a good price right now for preorder, so you might want to jump in on that deal.
- [First Footing](https://www.benwhite.com/writing/first-footing/) - Necessary Fiction has a neat premise for their rotating monthly Writer-in-Residence series. For January, it's been "First Footing," where each story begins with the last sentence of another story by another author. For example, Marcelle Heath (who incidentally wrote several of my favorite pieces in Nanoism) used nano #249 by Martha Williams as the basis
- [Interviews and Songs](https://www.benwhite.com/writing/interviews-and-songs/) - First, Zine-Scene (a blog, lit-mag, lit-mag highlighter, etc) features a profile of Nanoism and interview with me. The overview is here, with links to both. Good times were had by all. Second, you may remember my very short story "When We Are Old" from its publication in Dogzplot. You then might remember it as a
- [<em>Hint Fiction</em>: An Anthology of Stories Including One of Mine](https://www.benwhite.com/writing/hint-fiction-an-anthology-of-stories-including-one-of-mine/) - With November comes the release of your #1 bestselling anthology on Amazon: Norton's Hint Fiction: An Anthology of Stories in 25 Words or Fewer, edited by Robert Swartwood. It contains a blurb from Jodi Picoult and stories from me ("Before Perseus"), Joyce Carol Oates, and James Frey (among many others), so go read it. Everyone
- [Heron 3](https://www.benwhite.com/writing/heron-3/) - I'm super pleased to say that my story "Cryo" is Folded Word's third issue of Heron, a minimag that you can read, listen to, download, or print out and fold your own. What an honor! Go read it!
- [You Read About Local Politics and Hate the Sox](https://www.benwhite.com/writing/you-read-about-local-politics-and-hate-the-sox/) - I have a new piece of Craigslist Fiction up today at Staccato Fiction. It's nice and short and you can read it here. You could, with a few bucks to spare, also buy the first issue of Thirty First Bird Review and read my story "The Presentation of the Virgin."
- [A collaboration, a reprint, and a unicorn](https://www.benwhite.com/writing/a-collaboration-a-reprint-and-a-unicorn/) - 1. David Backer (from FictionDaily) and I have a new fiction collaboration. It's called whtsgngon. It's very short fiction based on/reflecting current news stories, and words throughout link to interesting resources and articles from around the web. It's a quick read, but the links also provide a chance for some interesting directed reading. 2. Roxane
- [Experiments in Literary Charity](https://www.benwhite.com/misc/experiments-in-literary-charity/) - During the month of April, I used Nanoism to run a little experiment in subsidized charity, the 2010 Nanofiction Contest (For Haiti). Perhaps "subsidized" isn't quite correct—as not all donors received compensation—but I think it sounds better than raffle-backed charity or contest charity. Oh, how about incentivized. Yes, perfect. Either way, writing contests, as a
- [Unhappy Relationships and Death](https://www.benwhite.com/writing/unhappy-relationships-and-death/) - Here is my thesis: Death is an event, not a story. Here is my second thesis: A description of one or more (unhappy) people is a character sketch, not a story. A story implies motion. It's not just description. Something needs to change. With regards to the twitter-sized fiction that I read on a daily
- [A Hint Fiction Anthology](https://www.benwhite.com/misc/a-hint-fiction-anthology/) - Robert Swartwood is a man after my own heart: a lover of the incredibly short-form. Earlier this year he coined the term "Hint Fiction" to mean "a story of 25 words or less that suggests a larger, more complex story." Then he got a book deal from W.W. Norton to edit an anthology. Boom, like
- [FictionDaily](https://www.benwhite.com/reading/fictiondaily/) - I read an article the other day stating that MFA programs are on pace to churn out sixty thousand new writers every ten years. Between that and sheer volume of information available and accessible online, the next battle for grassroots entertainment is not production but curation and aggregation: there is too much to read even
- [Milestones](https://www.benwhite.com/writing/milestones/) - I have a new story up at Everyday Genius, called "Milestones." Thanks go to March editor Laura Ellen Scott, now slated to be the fiction editor for Prick of the Spindle, which should be good things for LES and good things for POTS, so cheers all around. I like acronyms. This story is actually based
- [Litwit Love](https://www.benwhite.com/writing/litwit-love/) - David Backer of FictionDaily has a guest post over at The Millions, Long Live Fiction: A Guide to Fiction Online. It's a great, positive look of a newcomer to the world of fiction publishing online. A year ago I also literally had no idea these sites or the writers that populate them even existed. When
- [Harriet](https://www.benwhite.com/writing/harriet/) - I have a letter (yes, an actual letter) published in this issue of The Dirty Napkin, which is an awesome publication with intimidating contributor bios. The wonderful editors have also decided to make my audio reading one of the handful available to non-subscribers—so anyone can listen to me read it (beware). The epistle is an
- [Outshine](https://www.benwhite.com/writing/outshine/) - Outshine is a science-fiction "twitterzine" (there, I said it) notable for its focus on near-future optimistic SF prose poems or "flash-forwards" of 140 characters or less, this being Twitter after all. No nuclear apocalypses appear in Outshine's twice-weekly pieces. Outshine is awesome for many reasons (including paying $5 per poem, which is about a quarter
- [The Role of Ritual in Medical Training](https://www.benwhite.com/medicine/the-role-of-ritual-in-medical-training/) - While Final Exam, a memoir by transplant surgeon Dr. Pauline Chen, deals primarily with doctors' troubled relationship with death and dying, I was struck most by an essay that deals directly with medical training's preoccupation with protocol, algorithm, routine, and ritual. For Chen, rituals during her medical training were the foundation on which she built
- [Read PANK, this month and every month](https://www.benwhite.com/writing/read-pank-this-month-and-every-month/) - I say this now in part because I have three short (nontraditional-ish) pieces in the December issue: two Craigslist stories and one 21st-century epistle (aka email). I originally thought these would appear in the January issue, so it's a final 2009 surprise. There is something I really like about these forms, but I have a
- [Will Babysit for Little $$$](https://www.benwhite.com/writing/will-babysit-for-little/) - I have a very short piece with a critical thought up on the front-page of Matchbook for the next two weeks. It's the last piece I have out for a while, but I've been looking forward to it since October. It's more Craigslist fiction; read it here. Matchbook is unique in two great ways. They
- [I need a friend](https://www.benwhite.com/writing/i-need-a-friend/) - "I need a friend" is another piece of Craigslist Fiction, now up in issue 30 of Right Hand Pointing, alongside fine folks like Nanoism contributor, K.M.A. Sullivan. The series continues...on January 18th. And how about that near comeback for the Longhorns during the BCS Championship?
- [Wack Bible Stories](https://www.benwhite.com/misc/wack-bible-stories/) - At the request of Publishing Genius' Adam Robinson, I wrote a guest post at HTMLGIANT about the fascinating story of Onan: And Onan knew that the seed would not be his; and it came to pass when he went in unto his brother’s wife, that he spilled it on the ground, lest he should give
- [Free Story Idea](https://www.benwhite.com/misc/free-story-ideas/) - This is golden, I just don't have time to write it: Victorian-age retelling of Homer's Odyssey using a cat as the protagonist, who is accidentally left to make the long journey home alone after falling out of his spinster's carriage. Magical cat powers and epic animal battles optional (but encouraged). You're welcome.
- [19 years young and other tidbits](https://www.benwhite.com/writing/19-years-young-and-other-tidbits/) - This month's edition of Monkeybicycle's "One Sentence Stories" is up and includes quick fiction from yours truly + Nanoism contributors Ethel Rohan and Brendan O'Brien, among others. Also, some bonus Thaumatrope bits from November: Veteran's Day, Thanksgiving, and (oh, I don't know, let's call it) 2012. So Electric Literature just serialized a Rick Moody story
- [Midnight...Poetry?](https://www.benwhite.com/writing/midnight-poetry/) - November is a good time to share some itty-bitty poems that have been popping up here and there. I had a 'stone' in A Handful of Stones, a wonderful little site that asks us to "pay pay proper attention to one thing every day." My fourth prose poem ("She Wakes...") in Outshine (read the first
- [Craigslist Fiction and Iranian Food](https://www.benwhite.com/writing/craigslist-fiction-and-iranian-food/) - I've been fascinated recently by what I think of as authentic stories: writing that—while fictional—uses everyday forms to tell realistic, might-as-well-be-true stories. Now, there's nothing wrong with the traditional narrative. It's familiar and effective. But still, there are true stories everywhere, hidden within the innocuous interactions of the 21st century for anyone who cares to
- [Some things will appear](https://www.benwhite.com/writing/some-things-will-appear/) - I've written some new things. A subset of these will appear in Matchbook, PANK, Writers' Bloc, Four and Twenty, A Handful of Stones, Outshine, and elimae. I now have a bunch of half-started things that I would like to finish but probably won't. I have however ruled out urology and nephrology as future specialties. Matchbook,
- [The Presentation of the Virgin](https://www.benwhite.com/writing/the-presentation-of-the-virgin/) - My short piece "The Presentation of the Virgin" is now up at Thirty First Bird Review (scroll down a bit), a site with a focus on cultural/religious interplay. It's an old piece, and I've always had a bit of a soft spot for it—it's based off this wonderful painting by the fifteenth-century Italian artist/monk/engineer Fra
- [Twitter Wit: A Review](https://www.benwhite.com/reading/twitter-wit-a-review/) - Twitter Wit is not the first book of little things; it is another crowd-sourced cousin to the likes of The Truth About Chuck Norris and the Six-Word Memoirs series. There must be an almost irresistible urge to collect a bunch of small things and make a big thing, like stacking the sugar packets at the
- [Google Apps DIY Submission System](https://www.benwhite.com/misc/google-apps-diy-submission-system/) - When it comes to getting information from people, we use email. If you need to organize a lot of it (as if, say, you ran a lit mag) and you have money or the right friends, you might get your hands on a submission system to compile and organize all that good information. Or you
- [This week in tiny fiction](https://www.benwhite.com/writing/this-week-in-tiny-fiction/) - Last week I was fortunate enough to be featured in PicFic; this week I find myself with five stories in Seven by Twenty, another twitter-based 'zine for stories and poems and brief awesomeness. This five-part set includes a healthy mix of older Midnight Stories and some fresh material: On a breezy summer day... Once the
- [PicFic](https://www.benwhite.com/writing/picfic/) - Folded Word is a wonderful group of people unafraid to embrace any means necessary to get literature to the masses: we're talking a youtube-based lit mag (one of a kind, I believe) AND promoting DIY guerrilla-style flash fiction dissemination. Audio, video, online, print. Every angle covered. So it was no surprise that March saw them
- [Procrastination](https://www.benwhite.com/misc/procrastination/) - First the dogs ate our work, but I did not speak up because I did not have a dog. Then floppy disk failures ate our work, but I did not speak up because I kept a spare. Then social networks ate our work, and I knew we were in serious trouble.
- [Characters](https://www.benwhite.com/writing/characters/) - My nonfiction piece "Characters" appears in the Summer 2009 issue of Flashquake, a really great site with flash (less than 1000 words) fiction and nonfiction pieces coupled with cute banner graphics and an interesting stipend system (with pay based on the editors' collective enthusiasm for the piece). After taking a creative nonfiction class during my
- [Twitter Wit](https://www.benwhite.com/writing/twitter-wit/) - Perhaps I shouldn't be surprised that my very first words published in print are in the form of a "tweet" I posted on Twitter on April Fool's Day this year. This particular savory morsel of bite-sized brilliance is in Twitter Wit: Brilliance in 140 Characters or Less, a brand new book from HarperCollins filled with
- [In-ear, shmin-ear](https://www.benwhite.com/medicine/in-ear-shmin-ear/) - Every few months, I see some news report on the revelation that listening to loud music can cause hearing loss. Yesterday, Time online posted "iPod Safety: Preventing Hearing Loss in Teens," the latest in this series of mediocre ear-science. I'll admit that in this case the facts are accurate, it reminds me of a lot
- [Thaumatrope, twitterpunk—literature for procrastinating during your procrastination](https://www.benwhite.com/writing/thaumapunk/) - Thaumatrope: the first (and first paying) twitterzine (@thaumatrope), a twitter-based publication for microfiction. It is an idea that may almost seem frivolous to the uninitiated—stories in 140 characters? Why bother? What can you really say in around 20 words? Literary merits aside—with Twitter as a backdrop, would anyone argue that an intriguing or witty tweet-story
- [The Woman on the Sidewalk](https://www.benwhite.com/writing/the-woman-on-the-sidewalk/) - I have an edgy, mildly graphic piece in the new issue of SUB-LIT ("publishing the best in literary dissidence"), a site that specializes in awesome pieces that should (and do) have the tagline, Sex, Literature, and Rock & Roll. I actually wrote "The Woman on the Sidewalk" over two years ago only to let it
- [Anatomy of an NBME Shelf Exam](https://www.benwhite.com/medicine/anatomy-of-a-nbme-shelf-exam/) - The NBME offers comprehensive subject exams, ostensibly to torture students and devour whatever scraps of self-worth they have left. The typical question format: A X-year-old [type of person] reports to the doctor/ER with a X-hour/day/week/month/year history of not-feeling-so-hot. Upon examination, distracting details. Irrelevant information. Single key relationship. More words to make the test take longer.
- [The Gates of Leaven](https://www.benwhite.com/writing/the-gates-of-leaven/) - Novels take time to write. What better way to catalog the essence of a story than by writing only the first and the last sentence? First and Last Sentence Magazine publishes just that: novels that don't really exist by fictional authors offering up stories like mystery-meat sandwiches. Interesting premise. My offering, "The Gates of Leaven,"
- [A Harvard Workshop](https://www.benwhite.com/writing/a-harvard-workshop/) - An old-school New Yorker-esque self-consciously-super-pretentious non-fiction profile piece was published a few days ago in issue six of The Legendary. On a related note, I actually thoroughly enjoyed that class. Granted, during senior spring, even reading a male classmate try to channel Jane Austen every week is better than biochemistry.
- [Too Quiet on the Carpet](https://www.benwhite.com/writing/too-quiet-on-the-carpet/) - I'm really excited to see "Too Quiet on the Carpet" published as this week's story at Brain Harvest: An Almanac of Bad Ass Speculative Fiction. Brain Harvest has been publishing one 750-word or shorter story each week since March, and each has been—in my reading—fully deserving of its "bad ass" designation. As for my little
- [What do you think of when you think of me?](https://www.benwhite.com/writing/what-do-you-think-of-when-you-think-of-me/) - I have a piece in issue #15 of Six Little Things, themed "Captain McHurkeydurkey's Utterly Masturbatory Prose Parade"—which is in fact the very best theme for any issue of any magazine, ever. When I saw it, I knew I had to submit (and that surely I had something really self-consciously masturbatory from my college writing
- [Twiction](https://www.benwhite.com/writing/twiction/) - Is it the fate of the internet to endlessly combine two words to make memes? Will these neologisms always make normal, everyday people throw up in their mouths, just a little? I recently discovered twiction, a combination of "twitter" (for the microblogging service) and "fiction" (as in fiction). Twiction, AKA twitter-fiction or (even worse) tweetfic,
- [Harvardian Advice](https://www.benwhite.com/writing/harvardian-advice/) - "Harvardian Advice" is my tongue-through-cheek advice for how to get into Harvard, playing off the stereotypes that are—in general—completely untrue. It's a feature in this month's first issue of the The Cynic Online Magazine.
- [When We Are Old](https://www.benwhite.com/writing/when-we-are-old/) - My flash "When We Are Old" went up in Dogzplot (which is always solid) yesterday. Go ahead and give it a read; it's only 158 words.
- [Small Gestures](https://www.benwhite.com/writing/small-gestures/) - My very short story "Small Gestures" appeared in Six Sentences today, a really interesting online publication that only publishes stories of exactly six sentences. 6S is full of really great quick reads—and it's only because of wonderful sites publishing flash fiction like this that I'm reading any stories at all these days. So, thanks.
- [She is my sponge](https://www.benwhite.com/writing/she-is-my-sponge/) - Monkeybicycle has published my whole-heartedly non-autobiographical untitled story ("She is my sponge") for this month's "one sentence stories," a great helping of 7 microfiction stories.
- [Sympathy-inspiring?](https://www.benwhite.com/misc/sympathy-inspiring/) - This is not: "You Try to Live on 500k in This Town," a NY Times article that explains why Obama's proposal will make life unlivable for the executives whose daily life is inexorably tied to wasteful extravagance. When you don't follow your own advice and save some of your 1+ million dollar salary, it's harder
- [Taking Games Seriously](https://www.benwhite.com/misc/taking-games-seriously/) - If I were still in college, and if I spent my time in college with a schedule that allowed for such awesome frivolity, then I would want to take a class that did in-depth (with some calculus!) analysis of StarCraft. Homework would never be so fun again...
- [The source of my source of knowledge](https://www.benwhite.com/misc/the-source-of-my-source-of-knowledge/) - I came across an interesting article by Henry Blodget, who attempts to reaffirm the original idea that Wikipedia is indeed a product of crowdsourcing, as opposed to obsessive work of a few hundred (or few thousand, it turns out) or so "fanatics, " as Wikipedia creator Jimmy Wales has previously said. The gist is that
- [Doctorate Factory](https://www.benwhite.com/misc/doctorate-factory/) - There's no surprise people are realizing and writing about the low-value of advanced degrees. Schools have used grad students as educational fodder, producing far more than the demand for academics can keep up with. People hoping for their PhD to be something beyond their pursuit of an intellectual interest unfortunately will continue to be disappointed

## Pages

- [Home](https://www.benwhite.com/)
- [Student Loan Refinancing](https://www.benwhite.com/refinancing/) - The market for private student loan refinancing continues to grow with multiple options piling up over time. As a group, these companies are far more similar than they are different, and the main differentiating factor in most cases will be the rate each gives you on a given day. Applications are short and surprisingly painless,
- [Federal "Direct" Consolidation](https://www.benwhite.com/studentloans/federal-direct-consolidation/) - When you get federal student loans from the government for medical school, you don’t just get one loan: you get at least one per year. Back in the day when graduate students still received subsidized loans, many borrowers would receive three: one subsidized, one unsubsidized, and often a small subsidized "low-interest" (5%) Perkins loan. Now,
- [Supporting My Work](https://www.benwhite.com/support/) - Thank you for reading. Spending a little bit of your valuable attention here means a lot to me. This is the internet and I have a fragile ego, so the easiest way you can support this site is by heaping praise on me and sharing my writing with your friends. But. You can also support
- [Fourth Year & The Match](https://www.benwhite.com/fourth-year/) - In 2018, I released Fourth Year & The Match, a 22,000-word free ebook that breaks down--spoiler alert--the final year of medical school and the residency interview/match process. It remains a standalone component of a larger book project that I will never finish. I updated it in May 2019 for 2019-2020, and it's still free (for now).
- [About](https://www.benwhite.com/about/) - Hi, I'm Ben. These days that entails being a father, husband, neuroradiologist, writer, and perpetually short on time. I was born and partially raised in New York, spent my more formative years in Dallas, went to Harvard for college, and then returned to Texas for medical school, residency, fellowship, and attendinghood. My debt-to-income ratio is
- [Resources and Advice for Medical School, Residency, & Beyond](https://www.benwhite.com/medical-school-advice/) - I've been writing online here for over a decade. While none of the following should be construed as actual "medical advice," this is a selection of some of the highest-yield posts about approaching medical school, the boards, residency, and young physician finance. The Basic Sciences Best Books for the Basic Sciences Thoughts on Studying in
- [Newsletter](https://www.benwhite.com/newsletter/) - I don't really have one, but I might one day! You can sign up for that here: If you're interested in receiving private practice radiology job updates, you can sign up for that newsletter here.
- [The Workflow](https://www.benwhite.com/studentloans/the-workflow/) - A lot of this book has been detailed background coupled with an in-depth discussion of your options and considerations for evaluating student loan debt and picking a repayment strategy. Admittedly, some of the details and scenarios we’ve discussed do not pertain to many borrowers, but the goal here isn’t to tell you what to do
- [The Texas Medical Jurisprudence Exam: A Concise Review](https://www.benwhite.com/jp/) - The Texas Medical Jurisprudence Exam: A Concise Review is the most efficient, readable, and reasonable option to prepare for the Texas Medical Jurisprudence Examination, a required test for physician licensure in Texas. This is all you need. This up-to-date guide hits the sweet spot between concise and terse, between reasonably inclusive and needlessly thorough. You can
- [REPAYE](https://www.benwhite.com/studentloans/repaye/) - REPAYE (Revised Pay as You Earn) became the newest federal student loan repayment option at the end of 2015. Because of how REPAYE handles unpaid interest (negative amortization), it’s the ideal plan for many (but not all) residents, even those who would otherwise qualify for PAYE. Let’s review: what is REPAYE? REPAYE was created
- [Blog](https://www.benwhite.com/blog/)
- [Asides](https://www.benwhite.com/asides/)
- [Writing](https://www.benwhite.com/writing/) - My three books: Dealing with Student Loans (2018) Medical Student Loans: A Comprehensive Guide (2017) The Texas Medical Jurisprudence Exam: A Concise Review (2016) Anthologized: "Before Perseus," Hint Fiction: An Anthology of Stories in 25 Words or Fewer (W.W. Norton) 140 And Counting (Upper Rubber Boot Books) On a Narrow Windowsill: Fiction and Poetry Folded
- [Student Loans](https://www.benwhite.com/studentloans/) - Student loans are now depressingly the largest category of consumer debt outside of mortgages. In 2017, I published a book about managing student loans for medical students and doctors. In early 2018, I extensively revised that into a new book for a general audience. And they’ve been revised continually since then, most recently in November 2019.
- [Other Forgiveness & Loan Repayment Programs](https://www.benwhite.com/studentloans/other-forgiveness-and-loan-repayment-programs/) - Note that many organizations that offer repayment assistance are also government or non-profit work and thus also qualify for PSLF. Job-related repayment/stipends Some employers offer student loan repayment as a bonus package for new employees. In many cases, these payments are made directly to the servicer on your behalf and are considered a taxable
- [Medical Student Loans: A Comprehensive Guide](https://www.benwhite.com/msl/) - Medical Student Loans: A Comprehensive Guide is exactly what it sounds like, and I wrote it from the ground up specifically to help doctors: to concisely cover a complex topic and give you (the premed, medical student, resident, or attending physician) the tools and background you need to handle the big investment you've made in
- [Public Service Loan Forgiveness](https://www.benwhite.com/studentloans/public-service-loan-forgiveness/) - PSLF is the holy grail of federal loan forgiveness. The master promissory note you signed when you took out your loans had this paragraph toward the end: A Public Service Loan Forgiveness (PSLF) program is also available. Under this program, we will forgive the remaining balance due on your eligible Direct Loan Program loans after
- [Private Refinancing](https://www.benwhite.com/studentloans/private-refinancing/) - While medical school is expensive and getting more so every year, federal student loans are still earning the government a tidy sum (at least those actually being repaid). Combine the two and a new doctor will borrow more and then pay more for the privilege than at any other time in history. Over the past
- [Long-term Loan Forgiveness](https://www.benwhite.com/studentloans/long-term-loan-forgiveness/) - If you’ve heard about getting your loans discharged after 20 years (PAYE) or 25 years (REPAYE/IBR), you should probably forget about it. Unless you quit medicine and never make a decent attending salary, all but those with the most egregious student loan amounts won’t get their loans forgiven this way. Even if you did, you wouldn’t save much
- [Paying Down Faster](https://www.benwhite.com/studentloans/paying-down-faster/) - Let’s say you’re one of the 60% of docs who plan to actually pay off your loans yourself. There are no "5 crazy tricks to blasting your student loans," but there are a few considerations to speed things up. Pay more Just pay more per month. It’s that simple. Earmark more of your income
- [Taxes](https://www.benwhite.com/studentloans/taxes/) - Basic Tax Aside You don’t pay your marginal tax rate on all of your income. You fill the brackets sequentially with rising income. When people get angry that some small amount of money "pushed them into a higher bracket," they are demonstrating a fundamental misunderstanding of the US tax code. Being in a higher bracket
- [Contributing toward Retirement](https://www.benwhite.com/studentloans/contributing-toward-retirement/) - About Retirement Accounts: Note that when you place money into a pre-tax retirement account, you receive a tax deferral and not a true deduction or credit. You're deducting it from this year's taxes, but you're going to pay money on the distribution (when you take the money out) instead of the contribution (or in a
- [The Future](https://www.benwhite.com/studentloans/the-future/) - Prognostication is a uniquely human trait that, at least when it comes to matters of money, we fail at as a species. You can’t time the market, professional investors can’t beat the index over the long term, and no one can predict interest rate changes. The same could easily be said for forecasting changes to
- [Good Luck](https://www.benwhite.com/studentloans/good-luck/) - After a few hours of counting cents and trying to make sense of your options, it’s worth noting that real life can easily get in the way of almost every repayment strategy. You could get married and your spouse could have a ton of student loans, making REPAYE or even federal forgiveness programs make sense
- [Maximizing PSLF](https://www.benwhite.com/studentloans/maximizing-pslf/) - If after the last chapter you're not interested in attempting to dedicate your limited financial energies to a program that may or may not exist forever, ignore this chapter. This is all about minimizing your payments made during the 120 months required to achieve loan forgiveness. When it comes to PSLF, I advocate a trust-but-verify
- [Further Facets of Income-Driven Repayment](https://www.benwhite.com/studentloans/further-facets-of-income-driven-repayment/) - Undergraduate or old grad school loans during medical school While you can’t enter repayment for the loans you’ve borrowed for your current schooling due to their "in-school" status, you can decline the normal in-school deferment on your old loans. You can even do a federal consolidation early so you can pick your servicer (especially helpful
- [Borrow Less and Save More](https://www.benwhite.com/studentloans/borrow-less-and-save-more/) - This chapter is geared toward current and prospective students, but there’s still something in here for everyone. Borrow less to owe less This is not really the kind of personal finance book where we spend a lot of time talking about spending less and saving more (though of course, you should). We're also not
- [Introduction](https://www.benwhite.com/studentloans/introduction/) - In 2017, Americans owed $1.4 trillion in student loan debt with the average college graduate owing nearly $40,000. 70% of college students will use loans to fund their education and over 10% will eventually default on those payments. Students who go on to get advanced degrees like law and medicine are in substantially worse shape:
- [The Pain of Forbearance](https://www.benwhite.com/studentloans/the-pain-of-forbearance/) - Penny wise, pound foolish. People often chase sales and discounts on basically piddling amounts of money while letting their loans fester at high rates for inappropriate lengths of time. It's silly to clip coupons and then ignore your loans. While your life circumstances may ultimately force your hand, forbearance is probably the worst financial decision
- [Income-Driven Repayment](https://www.benwhite.com/studentloans/income-driven-repayment/) - As we’ve discussed, there are multiple loan repayment programs available, but the vast majority of borrowers are eligible for and will choose an IDR plan during residency. Those with lower loan amounts and no partial financial hardship should instead go with the standard plan, which will spread out your complete repayment over 10 years, or
- [Federal Repayment Options](https://www.benwhite.com/studentloans/federal-repayment-options/) - There are several repayment options available for federal student loans: traditional plans (standard, graduated, extended) and income-driven plans (income-based repayment (IBR), income-contingent repayment (ICR), pay as you earn (PAYE), and revised pay as you earn (REPAYE)). The plans are not one-time binding decisions, and you can switch plans if your needs or wants change as
- [How Much Do You Owe (and to Whom)?](https://www.benwhite.com/studentloans/how-much-do-you-owe-and-to-whom/) - Most people have exclusively federal loans. Immediate Aside: If you do have any private loans, they are ineligible for the magical IDR repayment plans and other possible forgiveness mumbo-jumbo that make up a big portion of this book. The best thing you can do with private loans is to make sure you have the lowest
- [Context](https://www.benwhite.com/studentloans/context/) - Not too long ago, my wife and I were medical students living off our student loans. Now, we're doctors with a toddler and even bigger loans (thanks, negative amortization). This book, which grew out of over eight years of writing about student loans online, exists because the Internet is full of tripe when it comes
- [How Federal Loans Work](https://www.benwhite.com/studentloans/how-federal-loans-work/) - Direct & Unsubsidized Nowadays, all federal student loans are lent directly by the federal government itself (so-called "Direct" loans). Prior to the financial crisis in 2008, loans were predominately given by private lenders/banks but "guaranteed" by the government under the now-defunct Federal Family Education Loan (FFEL) program. Direct loans are given out to undergraduate and
- [The Power of Interest](https://www.benwhite.com/studentloans/the-power-of-interest/) - What is interest? Interest is your source of pain as a debt holder and the purpose of investing. As a borrower, interest reflects your charge from lenders in order to use their money. It’s also the source of their profits. When you take out a loan, the balance is called the principal. When you borrow
- [The Purpose of Money](https://www.benwhite.com/studentloans/the-purpose-of-money/) - Consider for yourself the true purpose of money: to allow you to live and to support your happiness. The "correct" financial decision from the "having more money is always better" perspective is always to pick that which costs the least amount of money or saves you the most. But most people don't live and can't
- [Glossary](https://www.benwhite.com/studentloans/glossary/) - Before we dive too deep, first let’s define some terms. We're doing it at the beginning, just to make sure everyone is on the same page. Loan - A sum of money you borrow from somebody, typically the federal government or a bank for the majority of student loans. Interest rate - The rate at
- [Professional Advice](https://www.benwhite.com/studentloans/professional-advice/) - After you read that little story, you may be wondering with whom you should talk about your loans. You may have friends from high school or college who are financial advisors who would love to lend you a hand. But even most well-meaning financial folks are not fully versed in the nuances of student loans,
- [A Student Loan Story](https://www.benwhite.com/studentloans/a-student-loan-story/) - Let’s begin with the story of Ben (any resemblance to any person either living or dead is purely coincidental), a pretty "average" doctor. Between scholarships and parental help, he finished his undergraduate studies debt-free. He then borrowed around $40,000 a year at 6.8% to pay for tuition and living expenses for medical school. Because those
- [Other Forgiveness & Loan-Repayment Programs](https://www.benwhite.com/other-forgiveness-and-loan-repayment-programs/) - Note that many programs offering repayment assistance (like the VA) are also government work and thus qualify for PSLF. This list is inevitably not exhaustive, so don't forget to Google. Job-related repayment/stipends Some employers offer student loan repayment as a bonus package for new employees. In many cases, these payments are made directly to
- [Payment Failed](https://www.benwhite.com/payment-failed/) - [simpay_error show_to="admin"] We're sorry, but your transaction failed to process. Please try again or contact site support.
- [Payment Confirmation](https://www.benwhite.com/payment-confirmation/) - [simpay_payment_receipt]
- [Privacy Policy](https://www.benwhite.com/privacy/) - Your privacy is extremely important to me just as it is to you. As this is the Internet and I am a simple human being and not an evil corporate entity, you can feel free to use a made up, fake, or pseudonymous name and enter a completely fake email address when commenting if that

## Categories

- [Miscellany](https://www.benwhite.com/topic/misc/)
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