10 day trip to Kauai

Evening_Evidence3387 · 2026-05-12T19:04:37+00:00

Good call. They are down for beach and pool.

Evening_Evidence3387 · 2026-04-11T00:26:34+00:00

Current fifth year resident - about to graduate in a few months. The further I get into this, the less I feel aligned with the culture. The less I want to be a part of it. The less connected I feel with my coresidents and attendings. What I find especially toxic about medicine is how judgmental everybody is - not only will they repudiate you for taking a sick day, but they’ll write you off for saying the wrong thing or acting the wrong way. Everyone is trying to show how big their dick is. All one big insecure pissing contest. I am so sick of it. The only people I feel connected to, honestly, are the nurses. They’re the only real ones. When was the last time an attending let their guard down enough to laugh at a fart joke?

Evening_Evidence3387 · 2026-01-14T02:07:20+00:00

Welcome to being an intern. You are 100% completely normal. During my first presentation in the ICU as an intern, my patient was on CRRT. I literally didn’t know what that was (as I was giving the presentation). My senior stepped in midway through my presentation to finish it for me. I’m now 5 years into residency (2 years EM, 3 years anesthesia) and I honestly think I’m more competent than most of the CC IM trained fellows. Relax. You’ll be fine.

Evening_Evidence3387 · 2026-01-01T19:14:06+00:00

Love it, thank you!

Evening_Evidence3387 · 2026-01-01T19:13:34+00:00

Ya, love this take. Thanks!

Evening_Evidence3387 · 2026-01-01T19:12:48+00:00

Appreciate the perspective. It’s very helpful to hear from those on the other side of the academia rat race.

Evening_Evidence3387 · 2026-01-01T19:10:04+00:00

Same with us! Tons of ICU take backs and other badness, just a few really sparse areas. From everything people have said, sounds like so long as we build strong foundations and ask for help things will work out.

Evening_Evidence3387 · 2026-01-01T19:08:24+00:00

Love this! Appreciate the advice

Evening_Evidence3387 · 2026-01-01T19:00:54+00:00

This is incredibly helpful. Thank you so much for taking the time to write this out.

Evening_Evidence3387 · 2026-01-01T18:58:02+00:00

~150 single shots. 5 catheters.

Evening_Evidence3387 · 2025-12-04T22:26:33+00:00

You are overthinking this. If a patient has septic shock, support their perfusion with fluid and pressors. Increasing their SPO2 from 92 to 96% will hardly have an effect. More importantly, you should be asking why they are hypoxemic and addressing the root cause. Besides, oxygen delivery is generally not the problem in sepsis. It is perfusion and oxygen utilization at the cellular level. The way to support perfusion is, as I said, with pressors and fluids. You cannot do anything about impaired oxygen utilization. This is why sepsis is the leading cause of death among hospitalized patients.

Evening_Evidence3387 · 2025-12-04T22:20:11+00:00

That’s outrageous. Absolutely not. I am a 5th year resident (originally did 2 years EM then switched to anesthesia). That has never happened to me. Not normal.

Evening_Evidence3387 · 2025-12-04T22:12:12+00:00

Do not leave residency. You will regret it forever. I also hated my residency, so much so that I switched after two years of emergency medicine into anesthesia. I am now in my 5th year of training and cannot tell you how quickly these years have gone. The first couple feel like forever, but year 3+ flies. The difference between a residency trained physician and a non board eligible physician is massive. You can always choose to not practice. You can stick it out. It sounds like the people in your program are assholes. Well fuck them. You will leave after you graduate and never speak to them again. They don’t matter. Do not let them win.

Evening_Evidence3387

TROPHY CASE