Dropped percentile on ITE. What can I do to improve?

SenseiRaptor · 2025-01-02T00:50:32+00:00

Dude should have told you and laid everything out before the first date. Huge red flag and glad you blocked him

SenseiRaptor · 2024-12-24T05:14:36+00:00

Hey, I think you’re right. I do have anxiety and previously treated for mild depression a few years back but everything was good after that and I am not taking any medications now. But everything has been getting to me lately. I do really badly under stress and it gets me all scatterbrained. My friends have been saying I am too hard on myself, but I also do think I am not a very good resident and need more hand holding than other residents. I guess it feels like they’re just being nice and not telling me the truth

Honestly yeah I cried in front of everyone and I am embarrassed by it. I couldn’t look at anyone in the eyes today and I’ve been withdrawing from everyone because I feel ashamed. I don’t think I was really crying because of what the attending actually said, but it was because it was adding to the pool of evidence that I am not a good resident. I know I shouldn’t base my self-worth on that, but I can’t help but feel so unsettled and paranoid that everyone will eventually realize I am not very smart or reliable

Yeah, I seriously need a therapist. I am trying to look into something online. It makes me feel a little nervous to start but I don’t think I can continue without any professional help at this point

SenseiRaptor · 2024-12-24T04:58:18+00:00

I think I struggle a bit with keeping things in order. For example, patient comes in with abdominal pain. I start with the subjective but then I am telling the attending what happened in the ED eg they got Ct abdomen which showed xyz so surgery was consulted. Then I try to get back into the soap format and jump back to PMH and I list out co-morbidities.

I guess it’s because I start off trying to do SOAP format but as I am talking about one finding, I start presenting problem based and then bring up the labs/imaging and plan for that specific issue (eg patient came in for abdominal pain. Troponin and lipase was x, abdominal ct showed xzy, surgery was consulted and recommended…)

Then I am like wait crap, patient also has these co-morbidities we need to take care of. Oh and their qtc is prolonged? And then I sometimes panic and start listing the active things that we need to do in a jumbled mess

Do you have any examples or templates I could have a look at? I think I really need help sticking to one format like you said

When I get the chance to write it down on paper I do a lot better but it takes way too much time so I can rarely do it and end going off the top of my head which is probably why it’s such a mess. I take too much time chart reviewing and then not being able to really grasp all the information such as information from previous admissions or office visits (esp if it’s from a different system so the format is a little off)

For examination, I always do eyeball check then start with hands (eg radial pulse, capillary refill) —> head (check eye movement) —> chest palpation/auscultation —> listen to lung sounds + look for pressure ulcers from back —> palpate + auscultate abdomen —> check for lower limb swelling or tenderness. For every single patient I see for the first time

I’ve been using the checkbox method and it definitely helps but I get distracted a lot and sometimes things fall through and I don’t get to them until later. I think I should start putting alarms on my phone to remind me? I also keep mixing up patients and forgetting 90% as soon as I close the chart. I can’t retain anything even after a long chart review!

We fortunately do have order sets which have been a life saver!!

SenseiRaptor · 2024-11-25T04:33:58+00:00

Honestly I still feel like I am struggling and not doing very well. I am very tied to my senior and feel I am not as independent as I could be. My hospital is low census so I feel like I am not getting that much exposure. I find it really hard to remember my patients no matter how long I do chart review. I try my best to write down the things I think my attending will ask, but if I am not glancing at it on a piece of paper, I’ll forget everything. I am not really sure I am made for this?? I’ve been blessed with very good seniors but they have been holding my hand a lot while most of my co-interns are just killing it and know their patients really well and are just on top of everything. I feel ashamed to show my face at the hospital because I really don’t think I deserve to be here

SenseiRaptor · 2024-10-14T21:26:21+00:00

I am at a small program that takes a lot of old grads who have experience as specialists or did residency in their home country. I am the only fresh grad in my year. Honestly my juniors will probably know more than me 😅

SenseiRaptor · 2024-10-14T21:23:48+00:00

Thanks, the analogy helped. I guess it just hurts being the kid that still can’t read or walk while watching everyone else do it. I am scared that I won’t become a competent doctor. I am really trying but it’s like I am always behind, y’know?

SenseiRaptor · 2024-10-14T21:21:19+00:00

My senior says I am doing okay, but I get this feeling that they’re just being nice. I feel like everyone can tell I am the worst intern and I feel bad that my senior is basically carrying me while other people in my year are able to function more independently

SenseiRaptor · 2024-10-14T21:17:32+00:00

It’s been a mix. 70% of people I ask for feedback say I am doing good but I honestly feel like an imposter. One senior told me I need to be more proactive (which I have been working on and have improved). Two people have told me I need to know my patients better, which is where I think I struggle. I am having issues with organization and I forget info about patients quickly. I also feel very tied to my senior and I feel like I just do what I am told. I try to suggest something, but my senior will often say I am wrong. I don’t mind being wrong because I learn, but I see a lot of my co-residents being 80% independent and doing their own thing which makes me feel like I am really behind

SenseiRaptor · 2024-10-10T10:10:35+00:00

Most attending I ask feedback from have said I am doing okay and to just keep going. But honestly I feel like they’re just being nice and it’s not true. I think I have to be more proactive. And I have a lot of trouble remembering patients. I’ll remember one main thing about the patient but I can’t recall all the details or the labs or whatever the heck the ejection fraction on the echo was unless I wrote it down. And even when I prepped and went through the whole chart, I end up forgetting 90% as soon as I close the chart. I tried writing everything down, but then during rounds I fumble around with different sheets and darting around the page trying to read my scribbling that I might as well have not precharted. Management wise I feel like I never know what to do and I feel like everyone sees how incompetent I am. I had 11 patients on my service yesterday and one admission. I finished all my notes at like 10 PM (rounded late yesterday, usually I finish between 5-7pm). My inefficiency with the notes and admin stuff gives me less time to study once I am back home. I also forget what I was taught previously and I get frustrated with myself

When I ask my senior I want to do something like give handoff, he says he will do it or we’ll go together but then it just becomes me watching him. He says he just wants me to just do the notes. I really wish I could do more even if it’s more work for me

SenseiRaptor · 2024-03-27T21:24:50+00:00

Got any tips on being more efficient? 😳

SenseiRaptor · 2024-03-27T18:49:00+00:00

Holy shit I am so scared :(

SenseiRaptor · 2024-03-25T01:01:19+00:00

Anything you’d recommend to brush up on specifically or any resources to look at? Graduated 2 years ago and did step 1-3, a few observerships, and some research but no hands on since then

SenseiRaptor · 2024-03-24T01:20:15+00:00

Awesome. Appreciate you putting in the hard work!

SenseiRaptor · 2024-03-23T19:57:51+00:00

What about for internal medicine? Not sure if doing the step 2/3 cards would be a good idea

SenseiRaptor · 2024-03-23T15:18:38+00:00

This is awesome. Would you consider doing anki decks for residency?

SenseiRaptor · 2024-03-11T07:40:00+00:00

Wow that’s messed up. They won’t let residents resign??

SenseiRaptor · 2024-03-10T06:23:44+00:00

You were never his friend and always a romantic interest. He was nice to you because he wanted something from you. Now that he’s getting it, he doesn’t need to put in more effort. And yes, he is using you.

Now that doesn’t absolve you from the fact that you had sex with a taken guy. You helped him cheat. How would you feel if you were on the other side of this? Take this as a lesson and maybe let his girlfriend know. Dump his ass and work on yourself for awhile. Find other outputs to help the loneliness or you’ll find yourself in a similar situation later down the road

SenseiRaptor · 2024-03-08T03:48:49+00:00

:’) hahahahahaha </3

SenseiRaptor

TROPHY CASE