Hello. My new job requires that I pick up one night shift per month. I’ve read that people who work in permanent, long term night shifts have higher risk of having health issues (diabetes, blood pressure) anybody know how safe it is to work nights once/twice per month in the long run?

Anyone know of any other companies doing hra?

Give me your best & funniest stories, overheard situations or own experiences from the wards.

I’ll kick it off with this one: patient with new confusion had escaped to the shower room on their own, and would not stop throwing their own droppings on anyone who decided to open the door. Eventually someone went in with security, all wearing head to toe protection.

I’m sure they are good ones out there but the way they’ve been pushing chemo on a family member of mine with stage 4 colon cancer is appalling. Literally wasting away, sarcopenic, non-healing sores breaking out, and they’re discussing repeating another cycle a few months from now. Bleak

Hey all, I have been prescribed adderall for 10+ years. My program asked for a pre employment drug test which popped up for amphetamine. They sent it off to the lab and said a MRO would get in touch. I told them I am prescribed adderall and the dosage.

Here’s where I fucked up: I have step 3 soon and ran out of my adderall. The day before, I took one of my partners vyanse since I was waiting for my script to be filled. I didn’t even think of the drug test. Pretty dumb, I know.

Through googling I see that the labs have the technology to differentiate adderall vs vyvanse. What I can’t figure out is will they? Am I screwed? I don’t really know what to do honestly. Seems pretty extra for a program to go the extra step like that but I was wondering if anyone had insight on this. Thanks

I see y’all MD’s giving these things away for free.

Negotiate your languages into your contract! If you speak a preferred second language…negotiate.

More than one language? Add that into your pay.

Don’t do this for free.

Peace and love

ECU.

My program has a resident that seems to be on perpetual leave. For the past few years they will come back for 2-3 months or so, then leave, come back, then take another leave. I was wondering is there an ACGME limit to how long you can be on personal leave (even MH, medical, or family leave) before you have to leave residency/are fired?

Or is there not a rule stating residency must be done with a certain amount of continuity?

How does on call work? Do you only get called to deal with your practices patients (or any group you help cover), or do you also have to help cover hospital shifts to keep privileges there?

Like for obgyn, would you just be on call for your practices patients, or do practice practice doctors also have to cover the hospital triage and L&D patients on some nights to maintain privledges and then go work at their own practice the next day??

The hardest part about intern year for me has been finding my confidence. I often found myself falling into the background. Imposter syndrome hit HARD. I hesitated to take control of the room, luckily there was usually someone else there who would step up and I hate how much of a relief that was for me sometimes. It’s obviously easier for bullies to bully someone who doesn’t have the confidence to stand up for themselves. But I could brush the passive aggressive comments off so I didn’t care….except now I do.

I am struggling with how to earn the respect of others. I now understand why many female residents are biatches. The further I come out of my shell, the more angry it makes me when I don’t feel like I am taken seriously by my colleagues.

Yesterday was a turning point for me. The anxiety of being wrong or sounding “stupid” didn’t feel important enough anymore. Anyone have advice?

After all the school and all the training, how much do you feel like you deserve to make?

For those of you who have switched programs, or applied out to another residency how did you bring it up to your PD and what did that conversation look like? Any advice on when to bring it up after starting residency?

And if they aren’t supportive can they stop you?

At this stage cannot fathom not pursuing residency right after med school but I was wondering what else is possible with a medical degree?

I swear working with incompetent hospitalist is the worst thing ever, Most of the hospitalist make me hate medicine . ZERO medical curiosity. They care more about how the patient is getting home (inpatient vs outpatient problem) and fucking hold the AC before procedures . I have an attending that I rotate with now , if the patient farts she would consult GI. Am at a point that am about to explode . I just don't wanna lose my job but God some hospitalist when u work with u wonder if they had an art major instead of going to med school

Edit: I apologize if I hurt anyone, going into medicine I wanted to solve problems and puzzle and atm I feel like I am a glorified social worker honestly, I didn't know there is much layers and external pressure on hospitalists,that being said us residents were on the front line and we get ridiculed a lot by other services when the consults doesn't make sense, I understand not all hospitalists are the same.I guess the problem is within the system that doesn't allow us to explore what's really going on with patients but instead wants to abuse doctors to make the most profit. I don't have the solution to the problem either but I feel I am.losing my passion to medicine slowly

Are there any healthcare workers that are considered minorities that feel like they are discriminated from other minorities? For example, you ask for vacation and it’s denied but your colleague who is the same asks and it’s approved. This seems to happen often. Who knows if it’s that or something else and it can’t be proven but sometimes feels that way.

Who knows it could be due to being childless because it seems like it’s brought up and it’s understandable? Healthcare is demanding and people need time with their child and family.

Has anyone else experienced or felt this?

It's no surprise that female doctors often face sexism in the medical community. I've seen it many times as a medical student and experienced it first hand as a resident.

Most of the common ones I just shrug off "Nurse, get me a blanket!". "When is the doctor coming to see me? (After having explained to the patient their entire management plan)". Even sexually inappropriate comments like "Oh, I must be bleeding a lot today because of there's a pretty nurse (me) before me!", while creepy doesn't make my blood boil (although it does make me feel bad for the nurses who have to experience comments like these probably more often than me).

But there's been a common theme in the last year ever since I've moved to the more rural areas of elderly male patients calling me "Good girl", everytime I did something for them (e.g. give them their meds, paperwork, sutured them up etc.) and it just really rubs me the wrong way, like I'm a pet or something.

Please tell me I'm not alone. ☹

My husband and I are looking at taking fellowships in Boston, we would be moving from Europe with two small children.

How are you all affording to live in high cost of living areas? Is rent or childcare subsidised by your hospital? We expect to be taking home about 5.5k each, but looks like childcare is about 3k/child and rent another 4k leaves us very little.

Thankfully mortgage at home can be covered by renting out the house.

Do you just suck it up and live very frugally? We also have option to go to Houston but don’t think I’d enjoy the time here as I don’t tolerate heat very well and all four of us very fair skinned!

Would love to hear any advice you all have! Thanks in advance

 Coming from a Northern European perspective (I’m a Danish resident) the complaining about midlevel encroachment on this subreddit has been quite baffling to me.

In Denmark “encroachment” is generally encouraged and very much desired. Doctors no longer want to do veinous or arterial punctures, ECG’s, tracheal suctions, or manage the treatment of chronic diseases with established guidelines such as hypertension, heart failure, simple diabetes management or other stable chronic diseases. Nurses taking up these tasks frees up physicians to focus on more important tasks.

There’s already a shortage of healthcare workers, and having doctors perform tasks that mid-levels could do just leads to inefficiency and a worse performing healthcare sector.

 As I see it, the role of doctors is to navigate the difficult times when new medications are released and treatment guidelines for a new disease have yet to be established. As soon as guidelines are standardized and in place, we hand off the treatment to midlevels to go conquer the next frontier of medicine.

By now there’s ample evidence on the effectiveness of nurse-led clinics for an increasing number of disease, and if a nurse can lead a clinic as well as a physician, there’s generally no need for the physician to perform this task.  

TL;DR Having physicians perform tasks a mid-level can do is inefficient.

An anesthesia intern few months before the end of intern year. I am in a transitional year “style” of intern year, each month we go on a new service. This month is on ICU. Which I am enjoying the medicine very much, but struggling with the following…

My difficulty and biggest struggle thus far has been remembering my patients. I don’t remember much, and start mixing them when I start carrying 5 or more especially when they have similar path. When I can’t remember them well, my presentations are shit, my sign out is shit, and I constantly keep writing stuff down which slows me a lot. How can I improve? I feel I’ve been trying to improve but at this point I don’t know what else I can do. Most of the attendings are super nice and patient. But few has been putting me down cause I come off like I barely looked at the chart. When I’m in front of a computer and can review the chart while thinking things through, I can come up with solid plans, but I feel like my memory is so shit if I’m left with a paper before staffing a patient. Help!

I’d like to keep up with inflation and keep our salaries very high. How do we collectively increase our salaries?

RN here actually super stoked for July! I started in my position as a nurse the same week as the July interns last year and being able to learn from and with them has been one of my favorite parts of my position, and I'm looking forward to being able to do it all over again! Since I know there's often a lot of animosity between our positions I want to start the summer off right and get a little thank you/welcome gift to the new interns joining us. Thanks in advance for any recommendations and to all the new doctors starting this July, I'm so happy you're here.

Any AI program helps for presentations? Thanks in Advance

Aight y'all, drop links or photos of your favorite scrub cap designs in the comments. Looking to add some more style and personality to the collection

If you take away the economic barrier of Hippocratic altruism, what price tag would you put on your “craft” or “product”?

I.e. What is it worth to cut out cancer? Whats the price tag on keeping someone’s heart/lungs/kidneys optimized? What dollar amount would you pay to experience pain free and amnestic procedures/surgery?

Feel free to add your own…

• inspired by Friday night EtOH

Internal Medicine PGY-3 here. I remember starting residency and feeling like the Intern Starter Pack primarily included Figs and an Apple Watch.

In my sunset weeks of residency, I now wear scrub bottoms and an athleisure shirt (on night shift I’ll even throw in a band tee) +/- a Patagonia with my name and program on it. I have come to resent my Apple Watch for its unfettered access to my attention - have now silenced most notifications.

The above applies only to inpatient rotations; I always wear professional dress to clinic (no tie as a male). Not required, and I am definitely in the minority not wearing scrubs in clinic.

Interested to know what everyone else’s experience has been with work attire and how it did or did not change through training and even into practice.

Doesn't happen much but there are instances where the Attending/Senior wants us to contact a team "just to have them on board". What are some nice ways of doing that without making my senior look bad?

I normally create a simple question and check it with them. Like "This is what we have done and this is our plan, but the patient is (insert special circumstance) and we wanted to make sure we weren't doing anything wrong".

Works half of the time. Anyone got any other tricks?

The timing of the birth of my son came at a slightly later time than planned, so I will be just finishing up a 6-week of parental leave when starting up my PGY1 position (wife WFH).

I was wondering if anyone else could talk about their experience with something similar. I am not used to interrupted sleep and am unsure how it will affect my performance as I start out. I already informed the chief of the situation, so hopefully they will accommodate me for my first block.

Also, any recommendations on childcare? My wife (PhD student) thinks she will be fine on her own. Keeping daycare or a nanny around as an option may also work better as she works on her papers and tries to get a job. My hospital has an affiliated daycare. I mostly want to help inform my wife as necessary so she does not get overwhelmed.

Been contemplating whether I should start now or just worry about Step 3 during residency. Is 6 weeks enough to pass Step 3?

So my pediatric program is making some changes for next year the result of which is less inpatient hours for interns. This means the former team of 15 patients split between 2 interns and a PGY-2 will now sometimes be 1 intern plus a PGY-2. However, that intern (if it’s a FM intern rotating with us) will be gone two days a week leaving all 15 patients for the one senior (to pre round on, round on, write notes, discharge, place orders, etc) + any admits the team gets.

Is this unreasonable or par for the course compared to other residencies?

Edit: For context what really worries me is when this happens during bronchiolitis season. It’s not uncommon to have 2-3 kids on high flow and on “watcher status” which means they may need PICU but you’re not sure yet. You have to check up on these kiddos every 1-4 hours and drop quick update notes