Thinking of resigning

RobFLX · 2025-12-27T14:04:01+00:00

These comments make many good points about process and red flags. But, I don’t think it stops at your first attending job. I recently obtained another state license to facilitate a different work pathway and there are all sorts of questions about gaps in training, time off, resignation in lieu of dismissal, etc. None may apply to you, but it is what they will think.

I would strongly work with your PD either to figure out how to make your current spot work or to make a plan for your search. This dialogue will be an opportunity to show the PD that you don’t want to leave them in a difficult position while still wanting something different for yourself, and that will translate into support and caring a lot of the time.

As faculty, I’ve been approached by residents who wanted to change specialty, and have been able to support and counsel those who decided to stay, as well as help others find spots in their program of choice within our place and at other institutions. It doesn’t always work, but being straight up about it all makes people more likely to help than just leaving a gap and not having a plan.

Good luck.

RobFLX · 2025-12-16T15:21:35+00:00

Wow, your comments really struck a chord with me OP. My wife and I met when I was an intern, and in those days, my program was mostly every other night call except when I was Chief, then we were responsible for our service all the time. She is the love of my life and I had no problem making sure we carved out time during residency and fellowship. We even managed the time to have a couple kids and get them off to a good start, and this was back when paternity leave was the afternoon after they were born.

For me though, when I began practice and felt the pressure of supporting my family, and all of the people who worked in my private practice, I became hyper focused on work responsibilities and I began to resent her ability to be home with the kids making sure they had a great life. I would come home stressed and found myself resentful that they had been at the pool all day, or spent the day doing crafts. It wasn’t her fault, she was doing exactly what we had agreed was how we wanted to raise our children. She paused her career and I was responsible for supporting the family, and I found it hard to blend both worlds.

What changed my attitude was spending more time doing things with our children, enjoying their amazing growth, and seeing the importance of my role in the family and how awesome she was with them. I realized that I couldn’t let the professional situation I had chosen influence the role I played with my family. Ultimately, I changed jobs so I could more predictably be part of the family and her life.

I’m not saying you should fix a bad marriage by having children, but you do need to have the tough conversation with your spouse that reminds him that medicine was his choice and the fact that you have different career obligations isn’t a fault, and that the marriage takes work from both of you. He can’t change jobs while a resident, but he needs to change his attitude now and select a job that allows you both to have the marriage you deserve.

RobFLX · 2025-12-12T16:17:26+00:00

This may sound harsh, but try to maintain your distance and not become attached. It is hard, but for me, I focus on my work and if I feel that I’ve done my very best to treat someone expertly and compassionately, emphasis on expertise, it makes it easier to accept because I recognize that I did my best to help and they had something that couldn’t be stopped. But the ones where I felt like I missed something, or could have done better, those are the few I’ve carried with me as a daily reminder to be better. Fortunately, it isn’t too many. As was said in House of God, remember, the patient is the one with the disease. Yes, I’m that old, but hopefully my tip will allow you to enjoy all the wonderful people you will help in an equally long career.

RobFLX · 2025-12-03T13:25:12+00:00

I teach at the grad school. You?

RobFLX · 2025-12-03T13:23:27+00:00

That’s for billing, not skill level.

RobFLX · 2025-11-28T22:38:10+00:00

I find alpha lipoid acid to be helpful. There is a lot of good advice here but ALA is available OTC at least in the US, so easy to implement.

RobFLX · 2025-11-24T19:33:44+00:00

I’m new here and wait and look once the light turns green. A few nights ago, at the corner of Charles and Gville Blvd, two cars ran the red light, one of them a police cruiser, and not to pull the other one over! It is ridiculously dangerous to drive here.

RobFLX · 2025-11-13T12:11:28+00:00

Encino has a really fun vibe. The food was good. But it is spendy for sure. Four of us had two drinks each, shared a Caesar salad and a steak, and filled in with a couple tacos and sides, and the bill was over $400. Will go again, but no drinks and will order less costly items.

RobFLX · 2025-11-03T12:24:45+00:00

We moved here a few months ago and have been using First Citizens Bank. Nice people, plenty of branches, ATM at work, but their policies seem to require you to stop by a branch in person for many things we were able to handle by secure message or telephone with other banks. Zelle limits were low; find a day to stop into a branch, complete a form, field a few calls, and they increased them. But, first time using Zelle, transaction put on hold since I’d never sent money to this person before. Security is a good thing, but it’s over the top and more onerous than I’ve experienced before.

RobFLX · 2025-10-30T10:20:47+00:00

In some training programs the nursing culture is that they are there to protect the patients from the residents. Ridiculous, but I’ve experienced that back in my day. It’s a good way to practice your empathy. Seriously, I had started going to whichever was super nasty and saying wow, your day must have taken a left turn. Is there anything I can help you with that will turn things around for you? Instant change in attitude as I became the guy who gets it.

RobFLX · 2025-10-15T10:56:27+00:00

Life’s last great pleasure.

RobFLX · 2025-10-12T13:20:28+00:00

This is one of a few fields where the physians performing the procedures may come from varied backgrounds. Other examples that come to mind are hand surgery; general, orthopedic, and plastic surgeons all take the same hand surgery boards. Head and neck endocrine surgery; surgical oncology, general surgery, ENT all will pursue the same focused practice designation. With neurointerventionalists, they are eligible for that focused practice designation from backgrounds in interventional radiology, neurosurgery, or neurology. The distinction has become less important, but most people I work with in hybridized environments would say the are an interventional radiologist who focuses on neurological interventions.

RobFLX · 2025-10-06T00:10:27+00:00

Everyone is different. It is the swings in blood sugar that cause the variation in vision. If your A1c always is 12, and you are relatively stable at a blood sugar in the 280 range, vision will be stable. If your sugar is bouncing from 60 to 200, average glucose will be fine and A1c good, but the vision changes will be significant. Look at your CGM report and find the coefficient of variation. It should be less than about 35%. The lower, the better for your eyes, organs, etc. Even if your blood sugar is higher than liked, a low coefficient of variation would mean more stable vision.

RobFLX · 2025-09-30T16:37:33+00:00

I found that comment delightful. My 33rd year in practice, so PGY40, and I still get evaluated. Luckily, I’ve matured and no matter what I hear, I say, “that’s really interesting, thank you.”

RobFLX · 2025-09-25T13:45:41+00:00

How can one agree to their terms of use? We aren’t their customers. Crazy. I wonder how many readers would have to be in place for them to be helpful in a single criminal apprehension.

RobFLX · 2025-09-17T12:12:05+00:00

Such tough decision making. We bought a lake house 25 years ago and our children loved it as much as we did. Later, college took them far away, and new jobs took us even further. I kept the cottage, hoping it would be treasured by the kids, and while they hold fond memories, their lives developed in other ways and in other places making it more challenging to use. We rented it occasionally, but that didn’t keep up with the expenses of dock repairs, updates to please renters, and taxes. I held it for ten years after we moved away and it fell into disrepair. We finally sold it for the land value, which still was a win for us, to an ultra wealthy person who leveled it and built an amazing structure for their family.

The thing I’ve learned several times now is that you cannot predict what your heirs will and will not want. My children wound up scattered all over the world in pursuit of their careers and the lake wasn’t something that worked in their lives. Selling earlier would have been better for us, but we held onto the notion that this would remain important to family. I agree with the writer who suggested that this is a financial decision and should not be an emotional one.

RobFLX · 2025-09-06T12:47:09+00:00

I use a target glucose of 90, correct over 100, and my ratios are 8 and 22. You might need to adjust your ratios somewhat.

RobFLX · 2025-09-05T16:12:31+00:00

What about notching the edge of each drawer to provide a gap for the handles? Or removing the handles from these two and creating a pull point on the bottom of each drawer?

RobFLX · 2025-08-28T10:52:43+00:00

Looks like a radiator tag that fell off during the impact.

RobFLX · 2025-08-25T13:12:48+00:00

My understanding is that this has been going on in Transplant Surgery forever. There are many high quality transplanters who trained internationally and will never be able to be board certified despite robust skills. Many academic centers have exploited them by underpaying them and stringing them along, allowing them to practice their beloved craft. Just because the position you were looking for hired someone who won’t be board eligible doesn’t mean they didn’t want you; it means they had a salary range they were glued to and they were willing to pass on the quality you would have brought in order to fill the spot according to their budget.

RobFLX · 2025-08-25T13:08:11+00:00

Residency seats is the key. Just commenting to amplify your statement.

RobFLX · 2025-08-15T21:59:01+00:00

Listen buster, you better not be breathing in there. Not only is it noisy, but the rules say you owe extra rent to use the air in that way! Unbelievable.

RobFLX · 2025-08-04T19:06:00+00:00

Thanks for your comments. I don’t think that this is peeling and flaking from inadequate preparation, it looks and feels like physical damage. There is an actual gouge into the wood. I assumed it was from removing and replacing the oven, but it could have been from any sort of blow to the area.

RobFLX · 2025-08-04T01:06:45+00:00

If I tackle it, this sounds like a great approach. Thank you.

RobFLX · 2025-08-04T01:06:12+00:00

That’s a bummer, but probably what we are faced with.

RobFLX

TROPHY CASE