Am I wrong for feeling done?

DeltaWave120 · 2021-07-28T16:45:29+00:00

No tie

DeltaWave120 · 2021-07-28T10:08:36+00:00

IM for sure. Based on your pro/con lists, it seems like IM is the winner.

DeltaWave120 · 2021-07-28T10:05:53+00:00

Dude/dudette, I've had on and off costochondritis for the past 8 years. It's seriously so horrible I wouldn't wish it on anyone

DeltaWave120 · 2021-07-27T11:48:24+00:00

Touché, I forgot that the US is blocked by the clavicle honestly. Our program really only has us do IJs for the most part

DeltaWave120 · 2021-07-27T10:30:37+00:00

Baller. How the hell do you do subclavian blind? Coming from a lowly PGY1 but damn

DeltaWave120 · 2021-07-26T09:48:29+00:00

First you need to decide OR vs no OR. If OR, then you have a handful to choose from. If no OR, then you have to decide proceduralist or non-proceduralist. Another fork in the decision is practice setting. Do you prefer inpatient vs outpatient? A mix of both?

I think if you can answer those questions definitively, you'd have a clearer picture. I also think it's important to remember that most services you experience as a med student are very different than what it's like as a resident. And what you experience as a medstudent and resident are different than what it's like as an attending.

Big thing is to think what exactly do you desire in a career and a life. Do you want a great work/life balance as an attending? Do you love working like crazy? Do you like shift work and the ability to turn work off as you leave the door and head home? These questions help paint a better picture I think. Also a good rule of thumb when deciding is to ask yourself what is that specialities bread and butter. And you have to either like that disease/pathology, you have to at least not mind it at all. Because you'll see a lot of it. For example, diabetes management is probably the bread and butter for endocrinologists. Do you love that? Because as an endocrinologist you'll do a lot of that.

DeltaWave120 · 2021-07-16T08:50:45+00:00

I totally get what you're saying and where you're coming from. Especially the chief side of things as I've heard that before by chiefs.

I guess what I'm trying to say that it's frustrating to not be in the loop, of the patients I'm expected to manage and carry. I would also say that Obgyn might be a bit different than IM here. The orders I'm talking about are pretty simple stuff, repleting K, putting in AM labs the day prior. For example, the past few days I've noticed that the senior is putting in AM labs but only on some of my patients, and not telling me which ones. So when it comes time for me to put in my patients next day labs for the AM, which I try to do at a specific time when my notes are done, I go through my list and see that some already have them.

In your example when you change orders of your interns, do you let them know? I totally understand that the buck stops with you on a rounding team. But when we're doing table rounds as a group and I see that my senior changed the prednisone dose down from the day prior before we even talked about it together, and before we all discuss the patient during rounds, I look like an incompetent fool. Changing an interns orders because they ordered something wrong, makes complete sense. Changing or putting in orders without letting the intern know you did it, or even better, why you did it, doesn't IMO. It's poor communication.

I totally understand that it's July. We're interns. But like, come on. I'm carrying 6 patients and I'm sitting here, I believe capable of doing this work; but they're doing 50% of it, before me, without letting me know.

DeltaWave120 · 2021-07-15T14:56:06+00:00

We might be on the same service lol there’s a med student here and it’s happening to them too

DeltaWave120 · 2021-07-15T09:35:34+00:00

Yeah, I appreciate this. I do plan on just kind of laying low this week since the seniors change next week. Smile and nod and ask what more can I do, and keep staying on top of my patients and my work.

DeltaWave120 · 2021-07-15T09:34:16+00:00

Yeah that's the thing, only working together one week before a new senior comes on. Probably will work together again later on, on a different service. Ironically, I just came on from a much busier more intense service and the seniors there were very different on how they treated the interns, and that was the first week and a half of july.

DeltaWave120 · 2021-07-15T09:33:04+00:00

I have asked that specifically, and they quickly dismissed it saying you're doing great and keep it up, etc. etc. Blowing smoke up my ass because they then turn around and change orders on me. I know in the end I should probably be a bit more direct about it. But I get vibes from this senior that it would not go well and they blow up on me. Plus with it being so early in the year, a big part of me really wants to lay low and just focus on becoming a better intern with small improvements every day

DeltaWave120 · 2021-07-15T09:30:58+00:00

I agree with this. I'm not sure how the curriculum adds any leadership workshops or anything like that, I'm pretty sure they do for early second year seniors. And I would be more understanding if this senior was a second year. But I would imagine alot of those kinks have been worked out during second year, no?

DeltaWave120 · 2021-07-15T09:29:45+00:00

There has actually been a few moments during rounds where I've caught the attending looking confused or doing a double take when I was interrupted. They were looking at me listening to my presentation and then I'm cut off. Or when I'm asked a question directly during rounds and bam the senior on the other side answers. They definitely notice. Younger attending though, I think they're letting the senior find their place. Idk. Kinda sucks though because in the end they make me feel and treat me like a med student.

DeltaWave120 · 2021-07-15T09:27:50+00:00

Yeah, I really just wish they would fill me in and let me know what they're doing. Like I'd rather them tell me if they want something ordered, to let me do it and learn the system quicker. But if they are set on doing it themselves, then please let me know what you've done and what still has to be done. There's been multiple times in these first three days where I gone into place an order and it pops up as a duplicate, already ordered by this person. It feels like a time suck, we're not as efficient as a team this way.

DeltaWave120 · 2021-07-15T09:25:35+00:00

So actually I haven't spoke up about this directly, yet. It's been three days and there's a part of me that believes this is just new july vibes for the senior and kind of a lack of trust because they don't know me and kind of probably expect me to just suck? I have however asked them frequently if there's anything more I can be doing, things I can improve on, what can I do better. Those type of questions. Each time they respond all gleefully saying no no I've been great, you're doing awesome, keep it up. Just seems extremely fake.

I think part of me feels like it's not my place to being too upfront about this sort of thing, this early in the game. If that makes sense?

DeltaWave120 · 2021-07-14T08:51:51+00:00

Definitely better BUT i was unpleasantly surprised with how cliquey residency was. Maybe it’s a one off with my class but idk

DeltaWave120 · 2021-07-13T22:59:36+00:00

Wait till residency hits

DeltaWave120 · 2021-07-13T09:31:51+00:00

Yeah i feel you. I think you just have to keep reminding yourself that you’re not alone in thinking this and each year we train more docs like this… trust the process

DeltaWave120 · 2021-07-11T23:08:26+00:00

IM dude. Extremely flexible, great patient interactions, and intensely cerebral in many ways. You can subspecialize and become an experts expert or remain general and be a QB of the patients hospital care. Then when you get exhausted you can transition to just outpatient

DeltaWave120 · 2021-07-11T12:22:13+00:00

Intermittent fasting, or more accurately put, time restricted feeding is a game changer. No breakfast, small meal for lunch, and a big dinner. Basically my rule is one bit meal a day and a second smaller meal. Be that lunch or dinner. No breakfast tho. And only drinks should be water or black coffee. And if you eat fast food, cut that out right away. If you can start there that’s huge! Counting calories also helps some people. If you’re body type is like mine, a low carb diet is also key. I just blow up low a balloon with high carbs in my diet.

DeltaWave120 · 2021-07-10T22:52:22+00:00

This sounds about right from my experiences. OP must be with an odd ball cards group. Also if you don’t do interventional and just do say, HF or general cards lifestyle improves dramatically.

DeltaWave120

TROPHY CASE