Im not sure if this is going to be inflammatory, but i wanted to ask. Why in the world do people pretend ? I know 2 people at the same stage of training as me, working in the same position as i did constantly pretend like they knew some treasure trove of knowledge. And it wasn’t even clinical medicine. Just research stuff.

They both kept saying things to sound smart which were blatantly wrong . But no one said anything. The PI and the collaborators hearing this obviously understand it’s wrong but rarely correct them because they have better things to do. And they kept trying to impose this on me.

Thankfully i got assigned to separate projects that i managed. I handled the rest of their projects once they left and joined residency. The data collection and analysis they did was a complete cluster f**k and when brought to the PI’s attention, she asked me to do it from scratch. I didn’t mind that. We all make mistakes.

What i’d like to ask is if it’s common to come across people of this sentiment in residency. The “ I can never be wrong. I can never do anything wrong sort of mentality.” If so, how have they been as interns. How well are they at training interns when they become PGY2 ?

P.S. Please don’t eat me alive. Just a genuine question.

I’m an intern, exhausted, and it’s only October. Maybe this is all just burn out?

I find my largest time consumption to be documentation (duh!). The problem is that my documentation is significantly slower than my colleagues it seems and it’s cutting into my limited time at home with my partner and children.

Progress notes are one thing, but I find myself struggling on H&P‘s. I consistently ramble through an unorganized HPI, including way too much information in an attempt to tell a detailed story and provide a good summary for the next team.

Any generalized documentation tips (or shortcuts with epic) that you’ve learned along the way?

Edit: I’m an IM resident! 😊

Some of these senior residents and their absolutely horrid verbal abuse of the poor interns just doing their best.... taking advantage of them, and then talking badly about them behind their back to make other seniors biased against them before they even meet.

PSA, you're talking to a human, not a robot or a pet. If someone tried to talk to me like that on the street or in any other setting, those would be fighting words. But somehow its acceptable to berate interns and med students daily? This toxic culture of bullying in healthcare has got to stop. I stg.

Hi all, our program director invited us to her house for a holiday party. What should I take with me?

I’m not a Physician, but happily married to one for five years. We went back and forth from the time we met at 22 (she was starting Med School); all the way up to 32 when she finally finished Fellowship. She just couldn’t hack the combination of Residency / Fellowship demands, plus bring 100 percent committed to a relationship.

We were discussing the chaos of it this morning and it got me thinking, what were your relationships like during these years ?

I have a friend who switched residency programs between PGY1 and PGY2, but is having a baby this year and wants to take FMLA. Is she no longer eligible because she switched programs and is now technically in her first year at the new program? Or is there some kind of loophole since she is PGY2?

I swear I've seen this across multiple hospitals and levels of training. Like aren't you on 28h q3 trauma call???? Is call not busy???

I've done probably 5-8 epic training courses by now. Why can't we just opt out or have an expedited course if we've done it in the last year? Such a waste of time.

Thank you to the residents and attending’s that have been far more courteous to me than some of my nurse’s on the same unit I’ve had to shadow. Thank you for asking me questions about patient cases I have been assigned in clinical to help me think deeper about certain aspects of a case and feel more involved with the care of the patient. Thank you for making me feel comfortable enough to speak up during huddle and also asking y’all questions when my nurse is nowhere to be found. And finally, as someone that is going to be a RN in 6 months time, thank you for helping me gain confidence in my role as a nurse and as a part of the healthcare team.

Basically title. Urology resident on that glorious q2 call life, knee deep in hematuria consults.

you probably already, but bard has ceased production of the six-eye foley, the irrigation goat. jw what y’all are using out there.

We just ordered a Rusch simplistic catheter, haven’t tried it yet but it looks like a pvc pipe.

Hey everyone! Anesthesia intern who is almost about 1/2 through first-year. Started getting notifications about loan about my deferral period ending and was wondering trying to get payments set up. I have wondering what are the next steps to start paying these things back. A few questions:

1. When I began to enroll for a repayment plan, it said that some of my loans are not eligible and I would need to consolidate. Is this the appropriate next step?
2. What are the actual options available which are income-based given I did not making anything as a medical student last year?

Hello everyone. I am obgyn resident. This is question primarily for obgyns or obgyn residents but answers from all surgical specialists are welcomed. I was wondering how long into your residency were you allowed to place intracorporeal suture during laparoscopic surgery? Were you even allowed to do laparoscopy without any training in simulator ? Thank you for your answers.

Can we give ace inhibitors and ARBs to patients with diabetes to decrease the progression of diabetic nephropathy and albuminuria in the absence of hypertension?h

In my hospital system use of sliding-scale-insulin seems to be the default still somehow even though it's not good. Me soon to finish IM residency want to do it right with basal bolus.

I'm talking about: Hospitalized non-critically-ill patient with type 2 diabetes without prior insulin being hospitalized for whatever.

Let's say you get a Mr. Smith, 65yo, hospitalized for pneumonia. Known diabetes 2 on metformin and sglt2, HbA1c on admission of 8.0%. Glucose 234=13 on admission, after basal bolus remains around 162=9 during hospitalization. SGLT2 and Metformin are paused but restarted soon after.

My question: How do you handle it when approaching discharge? Do you just stop it on the day of discharge?

Because I'm picturing the following possible bad outcomes:

• Hospitalization should've been the time to start an insuline therapy anyway but the indication was missed because glucose values were good while in hospital and on insuline

• Patient should've continued insulin and returns two days later in DKA

Idk I guess it feels kinda weird to have a patient on insuline for a week and then to just stop it on discharge with no idea what happens afterwards. Feels especially weird when you add in something else that may mess with glucose (say: Start steroids on hospitalization that are continued for a couple of days after discharge)

Hey, I've been having difficulty revising from the source books, so I started putting important informations to revise them on daily basis and accumulating them over time on anki. The difficulty is having an appropriate setting, last time I used it was for USMLE and the options is just too much for daily revision.

What options have you been guys using regarding FSRS, lapses and daily limits for every day studying in residency?

New grad peds attending here. I’m taking a year off before fellowship, and decided to travel and do locums in the meantime. A clinic in my hometown desperately needed someone for a week literally a few days after my graduation and at the time they paid me $100 an hour. This was through a locum‘s company called Weatherby. They reached out again asking if I’m available during the holiday season and this time, want me to do overnight call for a week too. I feel like I was ripped off last time because I was new and it all happened so fast. What’s a fair, hourly rate for outpatient pediatrics, and how much do you guys typically charge extra for the days you are on overnight call? I’m just trying to make sure I don’t get taken advantage of because I’ve heard the locum’s companies get paid a lot more from the clinics than what they actually end up paying the physicians. Thank you!

I already have significant fatigue at baseline but I used to recuperate easily with a good long sleep, a full weekend to rest, and/or daily naps. I am in the process of getting tested for narcolepsy bc now that I’m a resident I really can’t do those things.

Having only 4 days off a month does not let me recover. I sleep 7-8 hours a night and yet I feel the sleep debt increase every day to the point where I’m constantly falling asleep at my desk. Like as soon as I finish my tasks, if I’m sitting still for a few minutes, I’m out. Every day. Yes I drink coffee but it doesn’t touch me anymore. Yes I sleep a ton on my day off.

I love being a resident and I love working, I don’t sleep if I have stuff to do, but I hate that I pass out during 5 minutes of downtime. Idk what to do to stay awake anymore, at least while I’m in the process of setting up sleep studies :/

And when do you expect to observe opportunistic infection?

Has anyone tried any of these AI medical note taking apps? I just started using Skriber and it's been a game changer for me. Just curious if anyone has tried any of these and thoughts on using them vs writing notes manually.

While awaiting source confirmation of infection and cultures are brewing… when would it be appropriate to add vanc? If fever curve is worsening despite appropriate anti pseudomonas coverage? Or only if skin or soft tissue infection is suspected or if patient is hemodynamicslly unstable?

Are there any good video lecture series for ABIM that anyone can recommend? Is Pass Machine/ MedQuest/ MedStudy good? If anyone can please share their experience with these.

in other words, what reminds you that its worth it to keep going on the hard days? :)

That patient who leaves AMA because they "feel like my normal self and you people just want my money" only to be admitted for the same exact CC a few days later. Or the one who refuses to take their insulin because they're "tired of needles and I know my diabetes is cured" and then gets rushed to the hospital with DKA. Oh, and let's not forget the ones who refuse treatment for a minor illness and their family is threatening to sue for malpractice, only for the illness to deteriorate to the point the patient and their family are begging for help.

When they wind up in the ED, I'm definitely pissed that they're taking up valuable time/resources that I could otherwise spend on other patients. And I'm sure as hell not wishing them to decompensate or, God forbid, die. But sometimes I smirk and really want to say "well, well, well, look who's here."

Yeah, I have problems and need to talk about them with my therapist, I know. But that smugness/self-satisfaction definitely gives me a little extra boost of energy at the tail end of a 24-hour shift.

Anyone feel this way? Or am I the only one who's scraping the bottom of the empathy/compassion barrel?

😏

Asking for a friend...

Title says it all. Just wanted to get it off my chest. I’ve always known I wanted to do sports medicine and adult medicine. But every rotation involving women’s health or pediatric care drives me insane. I hate it. I hate rotating through the pediatric ED. I hate well child clinic. I hate delivering and most of obstetric care. I absolutely hate newborn medicine (but I do love the cute babies, not a monster) With my fast paced, energetic personality I feel like i would have done much better in emergency medicine or even IM so I could just deal with adult patients.

Edit: appreciate all the kind words. I’m actually a PGY-3 at a great program for what it’s worth. Applying sports and confident I’ll match. Thought about switching after 1st year but it seemed like a daunting process. Also as a side note, I didn’t know I disliked OB/Peds OR that I liked EM. Went to a DO school with “makeshift” rotations; my OB was entirely outpatient with a couple old docs, my pediatrics was outpatient with a lazy doc, and we didn’t get EM until 4th year December - after apps went in.

I am for lack of a better analogy the human equivalent of an expiring dairy product. Once in my prime, delicious, and nutritious. I feel as if my usefulness as a resident is not quite sour, but definitely has some funk. I'm an R5 surgical resident with a fellowship in hand. I have taken to wearing a pair of T Swift inspired fabulous glasses in the OR and listening to music so loud that it's allegedly audible throughout most of the ORs.

I am grateful for the training I've received and I certainly have more to learn. There is however a minority but growing part of my duties that are no longer learning, or patient care, or even necessary scutt work but simply waiting. Waiting on people to do their jobs, waiting for people to come up with an indicated treatment plan, and most annoyingly waiting for some of the less natural attendings in the OR to make a surgical move while quietly retracting for them. I know I'm "just a resident". I know that when you become an attending "everything changes." But what I also know is that those attendings who say those things to me as if its some sort of validation for their trepidation have colleagues young and old that can SMOKE them. And they know that too. And they know, that I know, that they know... So it's all a facade.

I like teach assisting the interns, they're cool. I have a core of extremely talented and aggressive attendings, they're my heroes. But alas I must step away from them and allow those rising up through the ranks mere steps behind me the breathing room to be mentored by them as I have without my being in the room.

So now here I am finding myself a bit stuck, mostly by time, in rooms with those who are in fact capable and able but not quite decisive, deliberate, or definitive. As time goes on the funk grows stronger. July cannot come soon enough. I will finally be taken off the shelf, destined for someplace new and different, where I will have more to learn than I can comprehend. I miss that feeling.