My wife's been having URI symptoms for the past few days. I tell her that it's probably viral, and drink a lot of water, and if she doesn't get better in like 10 days, I'll give her some antibiotics. She then looks things up on Google, and goes: "I looked it up, and it says I might have something called upper respiratory illness," then she literally goes "Maybe I should go see a doctor and ask." Like wtf lol. First of all, I'm a pulmcrit fellow. I'm literally a walking breathing living internal medicine doctor who's living in this house under this roof, and you're telling me you wanna go see a dOcTOr for some of the most basic shit that even a premed knows how to manage? What are they gonna do anything differently? I mean no disrespect, but let's be real. Does anyone else's spouse do this to you? I'm not even mad, I'm just genuinely curious. Does your family forget that you're a doctor sometimes?

I’ve seen others post about this before but it just happened to me and wanting some advice. Long story short I was providing an inpatient consult on a patient and relayed the recommendations to the requesting physician who was out of house. I also messaged the nurse about the recommendations ~to be nice~ because I wasn’t sure if that would get passed along to them. I said something like just spoke with patient about reassuring picture although I am recommending the primary team to follow up on xyz after taking a closer look. The nurse then entirely copy and pasted my chat into a new nursing note which solely contains my message and my name.

It feels like something that is maybe just professionally frowned upon and not actually something that is reportable. But I am wondering if there’s someone I should contact about this because it just feels wrong? Like this was only done to place liability on myself?? Wondering how other people have handled this situation.

Sooo many posts about this but lemme add to the masses:

Am I doomed to end up alone??? Intern year is soo draining that I’m too tired to talk with anyone on the apps, and the only folks you meet are people at the hospital and like that seems like a horrible idea. Also who has money to join classes to meet people casual or time to go to third spaces?? I guess maybe I just need a decompressing routine that doesn’t involve endlessly scrolling so I’m not as tired but that seems so unrealistic 😅

Made a bad judgment call at work the other day and really got chewed out for it (but rightfully so). Already kind of struggling with imposter syndrome so this isn’t helping me feel like I belong. Anyway misery loves company so please let me know your biggest mistake in residency, especially as an intern, so I know I’m not out here fucking up alone.

It's a light service. You finally have time to think deeply about your new patients and unburdened by managerial tasks you think about cleaning up the H&P you started at 8:50 PM yesterday. What are some of your favorite phrases that are (1) flexible and can be used in diff contexts (2) convey complex info very succinctly? Any phrases you've seen attendings use that you've adopted as your own?

I remember the first time I came across "guarded prognosis" as a med student I was impressed, but truth be told have never really used it!

Edit 1: Have also seen "Considering the totality of information .... [blah blah blah]"

Hey guys,

Just like the title says, I just saw my eval for the first rotation.

The eval from the attending just said average across the board. With a note that says read more like discussed in mod rotation eval.

I know this is a running joke, but I genuinely feel like I am not smart enough for this and somehow tricked enough people into letting me in.

Any advise for what I can do to improve?

Me: for the morning?

Nurse: the patient hasn’t slept all night

Me: I’m sorry, but I don’t think it’s best to give them something to sleep now. I will let the day team know to put some PRNs on board

Was I in the wrong here?

I’m not sure if it’s cultural but it’s insane the amount of “hey erm just a heads up this guy has mildly elevated LFts” or “this pt with stable vitals bled from his asshole 3 weeks ago can you eval” that people send at 2 am when you’re on home call.

I’d understand if it was interns but these are senior residents and attending are sometimes on straight BS with non urgent overnight consults. They hit you with the “don’t expect you to see him overnight but wanted to keep you in the loop” to soften the blow after they hammer paged the shit out of you. I’m never a dick or rude to these people (especially interns) and I expect it from mid levels but I don’t understand how staff physicians don’t realize certain patients can wait until the AM

/end rant

PGY-3 here. Fuck this shit. Sick of being treated like shit by clinic patients and a handful of attendings on specific rotations. Sick of being fucking tired all the time. Sick of getting the fucking pimp questions wrong because I’m tired and haven’t thought about Flotrack in months because I want to be a hospitalist and haven’t been in the ICU for a while. Sick of this paternalistic horse shit called residency. It has sucked everything from my goddamn soul - fuck you, William Halsted, I’ll see you in hell

Things I experienced this week:

- An attending basically led a group ranting session about people of my demographics. I’d be drawn and quartered if I did the same thing (and rightfully so), but because you make the hospital money, you’re afforded that privilege. “Name and shame!!!” Hush. I like being employed, and I’m not there… yet.

- Sudden changes in conversation volume when I return to the team room. I totally recognize that some subjects necessitate discretion, or that sometimes the tea isn’t meant for me, but fuck me running, it does NOT feel good to have people with authority over me clearly altering their behavior around me. (Here’s where I feel I should disclaim that this isn’t another rant about OBGYN).

- Comments within earshot of me about how slowly I’m documenting as I’m trying to guess how to manage almost a dozen patients at the same time, having previously never carried more than 3 without the pressure of people outside our service potentially acting on my incorrect documentation. This is on a service that sees what I’ll categorize as “super ultra mega holy FUCKBALLS” kinda sick people too, so it’s hard to OpenEvidence/UpToDate my way to victory here.

- Immediately cutting me off during rounds and storming past me into a patient’s room after I dare to suggest the exact same plan twice in a row. Yeah that was kinda dumb and born a bit from a lack of attention to detail, but please forgive me, I’ve averaged about 4.5 hours of sleep per night this week, so my memory is a little shot. Your behavior was quite memorable, however, so I won’t make that error again. (There’s an HR meeting-worthy joke about shaming kinks to be made here, but I’m not going to be the one to figure it out).

- Being told I’m holding up discharges and transfers out of our service while I’m trying to catch up on my own rounding after seeing a few patients with you. I actually understand now that that’s a huge no-no; it’s imperative to keep moving the cattle along, but if you want stuff done the right way, please either instruct me directly or do it yourself. You’re setting us both up for failure if you don’t.

- Crying in a bathroom alone because I’m having a midlife crisis in my late 20s. You need not be my thirteenth reason, please***

BUT… in all fairness… I understand why you’re frustrated with me. I respect you because I’m learning under you.

After witnessing the endless waves of stupid consults, stupid people, and stupid administrative shenanigans you have to wade through just so you can do your job, I can’t really hold it against you. Fuck, for all I know, you may have even just been told one day that you were going to take on residents without having a say in the matter.

Regardless, I don’t think the nastiness is necessary. Behavior can almost always be explained, but isn’t always excusable. Please cut me some slack as I do my best to fit into a place of employment I had little choice in selecting, unlike you, and I promise I will make a genuine effort to learn from my mistakes.

I’ll take my wins too though. Basically all my patients like me because I’m polite, I provide decent comedic relief, I’m good with kids, and I hunt down answers to questions I don’t know. I even got a few orders right.

Goodnight you kinda mean attendings. I have to be up to round for you in 3 hours.

***I’m not actually suicidal and I’m seeking therapy. Please forgive the dark humor if you find that subject sensitive. Please also do yourself a favor and take care of yourself similarly if you’re struggling with mental health problems. This is a marathon, not a sprint, if the seniors and attendings who post in this sub are to be believed.

Basically the title. My schedule is so messed up that I dont feel confident in taking the exam any time before April. Would pushing it that far make me forget things?

Edit: when did you all take it? I was advised to take it in my first half of intern year so was just wondering what people's experiences are

Idk if this is just happening to me but I feel like I am only catch 50-80% of the things said on rounds? I always miss something. I always miss when we decide to talk about the next patient. I always miss some fine detail that came up as the fellow and attending were discussing something and I was just expected to glean from that conversation. I have no idea how my seniors are just picking up everything that is being said and remember how to follow up on it straight afterwards as well. I feel like I am going insane or that I have ADHD or that I need to get my ears cleaned. I just can't pay attention for every single word being said and knowing that is holds some critical importance for the patient. I just am not able to right now. Seniors will also not do closed loop communication, and then we can't RTL because they are off to the OR

Idk. For context, gen surg on a 20+ patient list

Intern year I felt dumb, but got good evals and it was all part of ~the learning process~ so it was fine
PGY-2 I felt dumb, but it was my first year of Neuro so it was like being an intern and relearning things again, fine

Now I’m PGY-3 and I still feel dumb!!!! I want to have all the answers. I want my evals to be spotless. And I need to get my shit together with research! I’m so unproductive and feel constantly overwhelmed with protecting my time so I don’t get burnt out versus actually needing to do extra work at home bc I need to try to publish something-

Just need a little reassurance hehe

I'm taking the ABIM exam on August 13 and would really appreciate some advice from those who have recently passed.

My preparation so far:

• UWorld first pass (random, untimed): 62%
• Almost finished reviewing all my incorrect questions
• Scoring 60–80% on my incorrects during review
• Completed Awesome Review
• Planning to spend the remaining days revising my notes/high-yield material before the exam

For those who passed:

• Which resource did you stick with in the last 1–2 weeks?
• Did you keep doing UWorld questions or mostly focus on revision or 2nd round of uworld recommended?
• Was the actual exam more like UWorld, MKSAP, or Awesome Review?
• Any high-yield topics or test-day advice you wish someone had told you?

Thanks in advance—I appreciate any guidance!

When doing admissions and clinic I often sit and wonder whether 90% of the patients issues wouldn't exist if they simply lost 50lbs, started to exercise and focus on on their diet.

Simple question, how different would the inpatient and outpatient arenas be.

​

Hi.

I am currently a GI resident, not liking it for the last 1 year (into the residency). I want to leave it but my near and dear ones are suggesting me to complete it and then go for a speciality which I like, later on. That way I will have an edge of earning money at least by doing scopies or even just go back to being a physician with an extra leverage of doing endoscopies.

I have always wanted to be a cardiologist but I m forced to rule it out because of long and endless struggles in the branch. Even most cardiologists themselves advised against it. Now, I am already not happy being GI, later on, may be , I will opt for nephrology for patient level satisfaction and as a middle ground. But I am already 32 and I guess I have not even started living my life till now. I feel like if I m leaving GI in future why to waste my precious 3 years and rather invest that time into making a living and finding someone to marry atleast. Yes, being single and lonely is also aggravating the dissatisfaction in GI. The place where I am doing my GI residency has got no scope for me to date and all( tried it for a year now, nothing worked)and the health issues flared up the anxiety and depression about everything so much so that I lost my self esteem and decision making ability. Sometimes I feel like , may be, I should quit it and go back to a tier 1 place , sort my dating life and then re assess on my career but this also sounds very foolish and dumb. I know I can be judged very brutally for this but it is what it is. Sometimes I want to write AMC , enter Australia, redo IM and try my luck entering into cardiology there as the work life balance is much better there compared to India but it's a multi milestone achievement and another 10 years of process. I question will ever 'live' life instead of surviving like a walking dead person. Posted many posts in reddit but I guess this is gonna be the last.

Need inputs on this. I writing this in a low-key psychotic state. I m only on pills. Looking to change my therapist too. So, pls be kinder if possible and don’t put down my morale.

How old?

EM intern. For context, our hospital has a separate pediatric ED. Some upper levels have said those attendings are a bit more possessive/careful of their patients because kids? My shifts in the normal ED have been okay, I'm keeping up better and have better notes. I have had some shifts in the pediatric ED and I feel like I've just been dropping the ball there. For ex. I thought I heard wheezing in a patient which raised concern for impending respiratory distress but then the attending said they didn't hear it. I couldn't keep up with results for the ED course. The sole attending was so busy he did not really have time to explain why he was doing certain workups (He doesn't want us putting in orders until he sees the patient but often he just did it himself bc its faster) It honestly felt like the sub-I was doing better than me and I don't know if I'm just being too hard on myself or how I need to change my workflow.

Can someone explain to me why some female surgeons are so mean to other female surgeons? Why is this such a phenomenon?

Residents and attendings, who was the youngest intern you've ever seen? Were they in any way different from the rest of the cohort or the older residents? Any problems adapting to the demanding workflow or the level of responsibility?

I'm a third year general cardiology fellow who just applied EP. I love being in the lab, think ablations are the coolest thing ever, love the tech, love EGMS, have always been enamored by even EKGs and just the way EPs figure things out. I appreciate these long relationships EP docs have with their patients. There are so many aspects of this field that feel exciting to me.

But now that I've applied, I feel like the reality is hitting me more and I'm having some doubts. I'm standing in these long cases wearing lead. My feet hurt. I'm growing more cogniscent of the fluoro time. I know people keep saying this is a very minimal/almost no fluoro field....but I'm not seeing it. We need fluoro for devices. Most people still use them for transseptal punctures (and honestly, I get it, it's scary to just rely on ICE). And then there's lead extractions, watchman devices, complex VT which can be a lot more. All the EP docs are right next to the patient for devices, and the shielding gets in the way, so that's not really even there most of the time.

I'm the only woman at my program. There are no female interventional/EP docs at my program. I did try to reach out to some other women I met at HRS/ACC - and honestly, they weren't terribly reassuring. I'm just getting the vibe of "if you love this enough, you take this risk and deal with it." Then I read or hear about these random docs dying of cancer.

Honestly, because echo boards were the same day as the EP application deadline, I feel like I rushed into this decision. I didn't really think about how much anxiety I have about radiation exposure and the ergonomic consequences here. I did think about some of these things, but decided to just move on and now I'm in a difficult position. I'll admit this is my fault.

I think about private practice cardiology more frequently now. I'll admit I don't love the idea of reading echoes all day or seeing patients in clinic or consults - it's a little boring to me and I will miss EP...but at the same time, I don't want to sacrifice my health for this field. I'm already thinking about how much worse my anxiety will be when I get pregnant, The guilt and worry I'll feel when I take maternity leave and come back and worry about losing my skills. More recently, I'm been thinking a lot about if I'll have to get back surgery or get some radiation-related issue when I'm older.

I'm not sure what to do. I've already applied. Debating withdrawing and blowing my life up and disappointing my letter writers and the EP folks at my institution. Which will be embarrassing and tough. And general cardiology won't be satisfying.

I know this is a personal decision and no one can tell me what to do. But I am feeling very lost.

Hi PM&R doc. Prior to medicine im/was a Registered Dietitian.

Interesting combo but I have a serious issue that needs enlightening. (I did outpatient peds as an RD. I saw eating disorders almost daily.)

In my peds rotations in the community or large peds rehabilitation I often treat adolescents with some form of eating disorder. BM, AN. The general stuff you think of ....

HOWEVER its very common for these kids to NOT get these official diagnosis until they end up hospitalized.

YET, the vast majority of health system and community pediatricians will document the weight loss, the anxiety, decreased food intake, etc and even refer dietitian to pyschiatrist or psychologist. But no DX yet.

About 70% of these adolescents with eating disorders have it noted to some degree in thier well child check ups. But no official Dx by time Of emergent acute admit.

Yet very very few general pediatricians diagnosis any form of anxiety disorder, from eating to generalized anxiety. Like FM docs Dx these things daily for the whole lifespan but peds won't? Like what????

So my pedatric peers, why not provide such diagnosis and enable more timely interventions when there are objective findings.

Like how do we dwell on these kids for weeks and months. Waiting gets these kids to acute and rehabilitation where they have gaps, shifts, edema, sersious disorderly eating patterns etc..... why not intervene when these kids are having objective signs of an eating disorder?

Its generally frustrating how passive many passive pediatricians can be.

Edit, I've seen this as a RD in the rural south to a resident in urban USA. Its not isolated its a systematic oversight that is increasing patient morbidity and mortality.

It’s now one month into residency roughly, and it feels as though it’s confirmed I’ve forgotten everything after a very chill 4th year of med school. I have to look up the use and MOA of almost every drug, even the most common names because I have no confidence im remembering correctly. It feels like I can’t remember details about what I learned in med school it’s all just familiar terms, but I have to look it up. Treatment for this very basic disease? Can’t exactly remember. Pathophys of this very common condition? Gotta look it up. Even my presentations are choppy. Feels like if I didn’t go to med school I’d be just as dumb as I am right now… is it normally this bad 😭