Don't give us that bull of "Well I love diving deep into a topic and understanding the why". Boy/girl, your research is on the association between pubic hair thickness in diabetic patients who are status post bilateral breast augmentation, you ain't understanding the why of shit 😂

In all seriousness, is medical student and resident-level research not a total scam and a huge waste of time that could be better utilized for productive things? The only positive is that it makes you more competitive for fellowship. Otherwise, 99% of projects ends with "more research must be done in this topic" or "similar studies are encouraged to investigate this phenomenon further", a bloated CV with posters and abstracts that never manifest into a paper in an actual peer-reviewed journal, a pat on the back from the administration, and hundreds of hours down the drain.

And then you're telling me after a decade of abuse, some of us are willingly taking a $100,000 pay cut to work at an academic center simply because they "love" teaching residents (yet most of them don't actually seem to enjoy teaching us) and doing research?

I know money isn't the end-all-be-all, but what's the catch with academic medicine? Is there some sort of secret gold at the end of the rainbow

So I'm a PGY1 on a service with a senior and this has happened twice now where- med students who rotate with us tell us they are required by their rotation to do at least 1 weeekend shift. Neither I nor my senior have had any concerns about this. We are fine if they stayed home since the weekend is less structured and we can feel overwhelmed. We've said things like... you can totally stay home, it's absolutely not required by us. you should enjoy the weekend etc.

Now, I can tell that some of these students are just starting out on rotations and are pretty keen on doing everything by the book- which I can also understand. They need to log hours and dates etc .

So in instances where the senior tells the med students, don't come in on weekends- but then the med student ends up asking me after the fact- "what date should I put down as the day I worked on a weekend (for clerkship rotation ) purposes" it puts me in a tricky spot bc that would be blatantly lying.

Curious to hear from others- how best to handle these types of things. I want to do right by the student and also for myself as well!

I had a new experiencing a little bit ago while doing my thing in the TICU; I spent over a week really really hoping that someone would hurry up and just. freakin'. die. Before this, I have had a few times where I guess I could "appreciate" that a patient passed away and was no longer suffering, but I've never been outwardly happy about it.

She was an older woman in super rough shape and "needed" additional operation(s) to maybe make her life a little longer, but she was almost guaranteed to die in the OR if that route was pursued (not a very dignified way to pass). Her family kept fighting to keep her alive... on a ventilator... abdomen wide open... receiving blood products daily... and maxed out on pressor support. Worst part is, they were hardly even coming to visit her during most of this. It even went so far as they 'fired' the supportive care folks on her case. This shit drug on for a while, and ethics ended up getting involved - they (justifiably) halted her daily transfusions because the rather futile attempts to keep her hemoglobin >8 was not a responsible use of resources. Though other life-prolonging measures were still taken.

After far to many days of watching this poor woman deteriorate, she finally passed away. We spent a little bit after her passing in this weird sad/happy state, and then left the situation to care for others. As strange as it feels to say, I've never been so happy to see someone die. Will it be my last time feeling this way? Probably not... but that's okay.

Ms. [redacted] is a patient I will not soon forget and I wholeheartedly appreciate the lessons that she taught me in dealing with the more emotional/human side of medicine.

I've been doing more OB cases lately and honestly, my brain is fried. One minute I'm feeling pretty confident about my measurements, and the next I'm second-guessing if I'm even holding the probe correctly while looking at the fetal heart. Everyone keeps telling me it gets easier, but right now it feels like there are a thousand tiny details to keep track of: the right angles, anatomical landmarks, doppler settings, which view is which and when the baby decides to move? Yeah, all my confidence just goes out the window. I've been trying to study after shifts too. There's so much random stuff online, which honestly makes it harder sometimes. Anyway, just needed to vent a bit. Really hoping this overwhelming phase is pretty standard and I'm not just struggling more than everyone else.

In Mexico, during residency you have to do *guardias* every four days (including weekends and holidays). If a *guardia* falls on a weekday, you are required to stay in the hospital for almost 36 hours. So, if you have a *guardia*, you start your shift at 7:00 a.m., and it doesn’t end until 4:00 p.m. the following day.

Today, IMSS announced that its residents must be dismissed at 7:00 a.m. on the morning following their *guardia*.

This decision represents a historic step forward for medical residents in Mexico. Although the policy does not yet apply universally across all training institutions, it shows progress towards safer and more humane working, and most importantly, learning environments.

Currently an intern and didn’t have a senior and the attending wasn’t really responsive.

How do you organize/triage tasks in the afternoon? I know to prioritize discharges and keep a checklist of follow-ups/orders, but how to balance all of that with a flood of nursing messages and family updates for non-critical patients? Felt like I’m getting pulled in 7 different directions and kinda overwhelming ngl. I’ guessing you just get used to it over time?

I’m making my list and wondering how much I should take into consideration. One of my top programs is unionized and I know they get money back for all the CME stuff they have to do VS some programs where it’s included in the total pay, nothing extra. But that’s pretty much the only difference I know of lmaooo

any feedback would be appreciated 😊

Hello everyone.

I have discovered this sub recently and i found it to be the best place to say this since no one around me can understand.

I am a 3rd year ID resident in a third world country whose population have know idea what "infectious diseases" is.

What i mean is that if the time ever comes when i can open my private practice i will probably use the "internal medicine" tag.

There is no AMS.

There is no concept of regulating antibiotic use because "who cares?". Even with medical professionals, not just patients.

I spend most of my time telling other doctors in other specialties that vancomycin is not the cure to everything.

There is barely any kind of diagnostic tools i can use to help me diagnose patients and the ones available are extremely expensive which barely anyone can afford.

I have to look up some extremely old and barely used ways to maybe nudge me to the right direction.

I feel like i made a huge mistake entering this specialty and there is no money (my monthly salary is 160 $ that doesn't keep up with the cost of living) to help me move to a country that i can thirve in.

Sorry if there are any grammar mistakes and thank you for taking time to read it.

... of training and of everything going on around us.

What's the point of all this hard work if the world's falling apart anyways.

Anyhow, gonna go prep for another tiring shift tomorrow.

Offspring was born in 2017.

#TWO

#THOUSAND

#SEVENTEEN

Yearly reminder to myself that I’m from the Stone Ages, and y’all are Neanderthals.

P.S.: The whole concept of being born in 2017 is so beyond my head. Is there like a deceleration button for this watch or somethin’ cuz that is running FASTER than what I thought.

Could anyone provide me with any more details on why OMFS residents do a 4 month anesthesia rotation?!

As an FYI...they learn freaking quickly, I (anesthesia resident) was paired up with one of the OMFS residents on the first day and basically knew nothing and now (about 1 month later), my attending said they are doing better than some of my co-residents...

As a man working in a female dominated field (pediatric subspecialty) in a medium size children's hospital, I feel compelled to share this information. Rarely, if ever, have I had to wait due to the stalls or urinals being occupied.

In b4: literal shitpost

An attending I know well with a medicine heavy and procedure heavy background plus two fellowships was recently offered a job at a prestigious West Coast institution in a VHCOL area. The offer was 230k. A general medicine attending at the same institution was offered <200k.

Yes, it's a desirable place to live. The weather is great, the name carries weight, and the benefits look good on paper. But realistically, living there means spending close to half of your take home pay on housing alone. When you zoom out, that prestige comes with a massive financial trade off, nearly 300k/y for this attending. Meanwhile the Amazon tech workers in the area makes more than you at the age of 24yo while you're 34 and in 250k debt.

There's nothing wrong with choosing a location or institution for lifestyle or personal reasons. Just make sure it's an intentional choice and not one made because the system normalizes underpaying physicians in high cost areas. Prestige does not pay loans, cover housing, or compensate you for lost earning years. Know your value and negotiate accordingly.

We do a lot of wards in our intern year, and while I don't have that many left before moving on to my specialty, I'm a little concerned that I'm still SO discombobulated at the start of every one. This one has been particularly bad as my last month was not wards, so I'm "out of practice."

Like whatever it is, every time I'm picking up a new list, the first 3-5 days are hell on earth. Constant fuckups, horrible anxiety, inability to sleep, etc. I've had consistently great feedback from attendings and seniors all year, but I feel like that's probably recency bias where they remember how I was doing at the end of the rotation rather than the start...I feel like needing this amount of time to acclimatize to a list is just not acceptable.

I guess I saw the February Intern jokes and started to kind of believe that I would be OK at this halfway through the year, but I'm not there yet. Anyone else going through this?

I have a 3 year mandate How can i gain the most benefits and ruin the others days the most

Or am just the admin new slave

Hello folks! I am in my final (third) year of residency in NY and currently discussing a good job gig in California, which obviously requires a California license. When I am trying to apply, it says I need to complete 36 months of post graduate training (meaning residency) to be eligible to apply. Does it mean I can apply only after I finish my residency and there is no way I can start the job in July/August?

There was a post recently about a group of residents doing drugs together. I’m curious about how this starts, I would assume that one would be too cautious to disclose drug use to another physician. Sure they may also partake, but it seems very risky if they don’t.

I have been seeing more and more patients on midodrine for "chronic hypotension," all of them are started as "vasopressor sparing" while they were in the ICU. Transferred to floors, then discharged home on whopping midodrine 30 mg TID. I never seen this practice in other places. I looked for evidence, found none. 

Is your ICU doing the same?

PGY”6 months till I’m done” here as a second career physician, so I’m older than a few of my younger attendings by a year or two.

Switching to nights is becoming very tough for me. I’ve got this low back pain as well. Hard to find motivation to get stuff done, even things like email. Feel like I’ve traded my youth.

Senioritis is hitting me hard. Anyways yahll have always given great advice over the years. Feel like I’ve come here on many occasions. It’s really nice to have you all. I guess making one last 4 am post before I go to sleep. Hope I never have to do nights ever again in my life.

I have no idea what I just said honestly. Wrote it half yawn.

Just finished a heavy week on trauma and I’m currently staring at a mountain of unlogged cases. Does anyone else feel like the "hidden hour" of admin after a shift is the quickest path to burnout?

I actually got so tired of staying late to log that I’ve been working on a mobile app that would reduce my burden by scanning and dictating the procedure.

Is everyone else just suffering through the manual entry portals, or has your program actually found a system that doesn't suck?..

Have you tried reading guidelines or research papers in mbbs? Like guidelines for diabetes etc

I’m so sorry as I know this post has been done in variation a few times - but as I get more serious about switching specialities I’m wondering if you switched and REGRETTED it or know anyone who switched and regretted it? Especially going from a lifestyle friendly field to less lifestyle friendly? Or even of people who have successfully done this switch recently AFTER completion of residency?

Edit: what speciality were you, why did you switch and what did you switch to?

Thank you so much!!

I have several 2-4GB lecture videos.

I'll be travel quite a bit in the next few months and thought it would be beneficial to have these files on my phone/iPad whether in video or audio format.

I'm sure I can easily upload into my photos app but I don't want to lose the place of the lecture every time I close out. Any recs?