In 2014, I started recording simple teaching videos for medical students. Built a website to stream the content, put it behind a paywall, and slowly grew the library over years. By 2022, it was generating millions in revenue and I sold the company to McGraw Hill where it’s now publicly traded on the NYSE. Reposting this podcast where we discuss this wild journey. If you’re an entrepreneur in medicine, dream big. youtu.be/4yYIvL-f87M?is=D7kI…

Jehovah’s Witnesses can now receive blood transfusions. USMLE question writers in full scale panic. abc.net.au/news/2026-09-24/j…

Good piece by Rachel Bedard @RBMD1982 on how AI may affect medical students and residents. Complaints like "the younger generation isn't learning medicine like I did" have been around forever, but with AI it feels like something is different this time. nytimes.com/2026/09/25/opini…

USMLE Tip: Asthma classically begins in childhood. New-onset disease in adulthood in board questions should make you consider these diagnoses: Environmental or occupational exposure Aspirin-exacerbated respiratory disease Eosinophilic granulomatosis with polyangiitis (EGPA) Allergic Bronchopulmonary Aspergillosis (APBA) Clues in the stem will usually tell you which one it is.

Fantastic article.

Medical History Lesson: For surrgery before 1846, patients got alcohol or opium but were basically awake and could thrash around and scream. In 1846 at Mass General Hospital, surgeons operated on a man who had a tumor in his neck. Just before the operation, a dentist (William Morton) arrived with a glass container of ether. The patient inhaled the ether and went unconscious. Tumor was removed while the patient lay quietly. October 16, 1846 became “Ether Day” and the operating theater became the “Ether Dome.” {It’s still there} One of my favorite medical history stories, but don’t tell your surgery and anesthesia attendings they owe their modern practice to dentists.

USMLE History Lesson: Nobody uses digoxin much these days, but in the late 1700s it was like magic. William Withering ground up foxglove plants and gave it to patients with "dropsy" which was basically leg swelling and dyspnea that we now call heart failure. The plant had compounds similar to digoxin. Within a few days, patients started peeing, their edema went away, and their breathing improved. Seemed like pure wizardry back in the day. Old school medicine must have been cool. Just imagine your deadly condition cured by a guy who gave you a potion from some random plant.

A Wild Medical History Lesson: Use of forceps to deliver babies was pioneered by the Chamberlen family of physicians in England in the early 1600s. They used the tool to guide the baby out of the birth canal in difficult deliveries, thereby preventing fetal or maternal injury and death. You might think they'd let other people know about this, but the family kept the invention secret for almost a hundred years. They snuck the forceps in and out of deliveries and sent people out of the room when they used them. This allowed the Chamberlens to achieve amazing outcomes in difficult deliveries compared with other physicians. The family passed the technique on for generations until it became more widely known and used by other obstetricians. Anyone who says doctors aren't good at competing in business needs to meet the Chamberlen family! Additional trivia: In 1813, someone renovating the original Chamberlan house found old forceps from the 1600s hidden beneath the floor of the attic. How'd you like to stumble on that inside your new house!

USMLE History Lesson: If you saw a patient with COPD in 1965 you would very likely prescribe theophylline and isoproterenol, two drugs hardly ever used today. Lots of smokers back then (think: Don Draper on Mad Men), and none of the modern COPD therapies were available. Theophylline was oral with a narrow therapeutic index and high risk of toxicity (tremor, restlessness, tachycardia). Isoproterenol was an inhaled non-selective β1/β2 agonist. It activated β1 receptors in the heart causing palpitations, tachycardia and arrhythmias. These drugs were widely used until the 1980s. They are rarely ever prescribed now because of newer beta 2 agonists (albuterol/salmeterol) and anticholinergics (ipratropium/tiotropium). But don't worry: They live on in glory on USMLE exams!

Had a great time today speaking with medical students at UNIBE in Santo Domingo about preparing for the USMLE Step exams. Really enjoyed meeting so many students and answering their questions afterward. Thanks to everyone at UNIBE for the warm welcome and for inviting me to be part of the event!

ChatGPT’s sad attempt at the Gettysburg Address: Two hundred and fifty years ago, Americans brought forth on this continent a republic founded upon a proposition: that no person stands above the law, that legitimate government rests upon the consent of the governed, and that citizens who profoundly disagree may nevertheless govern themselves together. We are again testing that proposition. We have not gathered upon a battlefield. Yet we inherit a nation shaped by those who fought, argued, sacrificed, compromised, built, protested, served, and sometimes died to bring its conduct closer to its promises. They did not leave us a finished country. They left us an unfinished experiment. Our task is not to prove that our side was right and theirs was wrong. It is to determine whether a free people can still discover when they themselves are wrong. For no republic can long endure if its citizens demand accountability only from their opponents; if political victory becomes more important than constitutional restraint; if disagreement becomes disloyalty; if facts become possessions of factions; or if we profess principles that we abandon whenever those principles become inconvenient. The measure of our devotion to democracy is not how firmly we hold power, but how we behave when power is uncertain, divided, or lost. It is therefore for us, the living, to take up the unfinished work: to restore the habits upon which self-government depends—to listen without surrendering judgment, to disagree without making enemies, to test our beliefs against evidence, to expose our own contradictions as readily as those of others, and to leave institutions stronger than we found them. We will not agree on all that America should become. We need not. But we must remain dedicated to the proposition that our common republic is greater than any party, president, faction, ideology, or generation; that power must remain accountable to law; that citizenship carries obligations as well as rights; and that each generation holds this experiment temporarily in trust for the next. The question before us is therefore much the same as it was at Gettysburg: Whether a nation so conceived, so divided, and yet still capable of learning, can long endure. That answer will not be given by what we say we believe. It will be given by what we do.

Medical History for USMLE: In the 1960s, researchers developed methods to determine HLA types meaning the genetic variants that encode MHC proteins in humans. They began comparing HLA types in patients with disease to healthy controls. This was largely a fishing expedition: nobody knew what they would find. One of the earliest discoveries came in 1973 with HLA-B27 and ankylosing spondylitis. B27 was present in about 5–8% of the general population, but over 90% of patients with AS. To this day, it remains one of the strongest and most famous associations between an HLA allele and human disease. Other HLA types are associated with RA, celiac disease, and type 1 DM, but B27 and AS is the absolute classic. It's ridiculous that med students have to memorize these associations, but historically they were early evidence that the genes controlling our immune system influence our risk of autoimmune disease. A huge discovery at the time.

USMLE TIP: As you learn about disease states, take note of things that increase or decrease. These are the basis for LOTS of USMLE questions. Don't just memorize. Understand! Heart Failure (left sided): Cardiac output: ↓ Left atrial pressure: ↑ SVR: ↑ Acute kidney injury (prerenal): GFR: ↓ Filtration fraction: ↑ Urine sodium: ↓ Emphysema Residual volume: ↑ Total lung capacity: ↑ Functional Residual Capacity: ↑ Tidal volume: No change (tricky one!!)

Still time to sign up for our free webinar tonight at 7PM ET. My goal is to share all I've learned over the years about how students stay positive, avoid burnout, and succeed in medical school. Details below...

USMLE History Lesson: You won't see many patients taking phenytoin (Dilantin) these days, but it will come up on Step exams. The reason why is HISTORY. In the early 1900s, the major seizure treatments were bromides and phenobarbital, both of which caused profound sedation. In 1938, phenytoin was discovered to have antiseizure effects without causing nearly as much sedation—a huge breakthrough. It became the mainstay of treatment for seizure disorders until the 1990s. But it had a terrible side effect profile: CYP450 induction, gingival hyperplasia, hirsutism, cerebellar ataxia, peripheral neuropathy, osteopenia, megaloblastic anemia, rash/SJS, and teratogenicity. Doctors back in the day had to know all of these and could very likely see them clinically. Phenytoin has now been largely replaced by newer drugs like Levetiracetam (Keppra) which are safer. But it lives on in glory on USMLE exams!

Took my mom out for her 83rd birthday tonight. A lot us don’t get so many years on the planet. Count your blesssings and celebrate when you can!

There is a USMLE free 120 question of a 5 year old kid who is just constipated (answer to question is constipation). The wrong answer choices are Hirschsprung's, intussusception, hookworm infection and cystic fibrosis. As a student I would have definitely gotten this wrong. I would never have thought a kid in a board question was just plain old backed up.

Free Webinar — Still Time to Sign Up! Join me Wednesday, Sept. 16 at 7pm EDT for a free webinar on Surviving Medical School, together with ophthalmology resident Dr. Alex Suh. We’ll talk about staying focused without burning out, succeeding on clinical rotations, and what it really takes to match into a competitive residency. We’ll also leave plenty of time for an open Q&A—bring your questions! Sign-up link below. Hope to see you there! learn.mheducation.com/FABB_I…