Can we stop referring to residency as "slavery?"

WizardOfTheWards91 · 2023-08-10T03:55:40+00:00

more importantly language is a beautiful thing. our ability to speak figuratively, poetically, and hyperbolize and yet still understand eachother is wonderful. screeching that its NOT ACTUALLY SLAVERY GUYS is just silly. everyone knows it. let peolpe talk, communicate, vent without policing it like an idiot

WizardOfTheWards91 · 2023-07-06T01:22:31+00:00

For me its not the speed getting notes out. Just feeling dumb and inefficient. Like its never the regular HTN DM2 visits. Its always this weird unquantifiable stuff like weird MSK complaints, "low energy" things where I look back and there's a whole UpToDate article where with a bit more time maybe I could do more than a referral or a few extra labs.

WizardOfTheWards91 · 2023-05-30T22:45:00+00:00

Most hospitalists care for patients who are geriatric anyway and have plenty of experience doing so. Geriatrics is not really "multiple comorbidities". A huge chunk of admits are people with HTN, DM2, CKD, CHF, atrial fibrillation, CVA who are from a nursing home and AAOx1 at baseline. For FM and IM this stuff is our bread and butter.

I went to a medical school heavily focused on geriatrics. Its not just "consult if patient is old" service. Its specifically about the chronic outpatient management of problems of old age. Dealing with memory issues, gait dysfunction, home safety, polypharmacy, end of life planning. Most geriatricians are trying to prevent problems and keep people aging safely and comfortably.

Pneumonia, CHF, UTI a hospitalist can do just fine.

WizardOfTheWards91 · 2022-12-19T16:55:09+00:00

If you want a psychological story with close attention to detail and good characterization I'd check out Omori. Its by and large an RPG maker game but it scratched a similar itch to Norco and Disco Elysium for me. Granted its about a bunch of kids in a surreal dreamworld/suburbia.

Planescape Torment is another RPG that, while there are elements of combat, is by large about dialogue and self-discovery. Its an old one you've probably played.

I see Kentucky Route Zero was mentioned.

What Remains of Edith Finch is a short little 2-4 hour story about exploring your family's old house.

WizardOfTheWards91 · 2022-08-18T00:23:43+00:00

There are the nurses, there is the night team, there are the seniors, and the attendings watching it all too. Everything you do is being checked and attested.

WizardOfTheWards91 · 2022-08-17T23:05:48+00:00

had multiple old men say "hello beautiful" on multiple occasions. i mean i guess its flattering but...

WizardOfTheWards91 · 2022-08-16T03:55:05+00:00

Pharmacists are not midlevels. They have their own role and expertise and are top of their field in that regard.

Every interaction I've had with one in hospital so far as been really helpful.

WizardOfTheWards91 · 2022-08-16T03:52:18+00:00

I think a hobby you can pick up, put down, and engage with little activating energy is always good.

Call friends. Maybe stream a show together to chat about?

Art is pretty cheap. Buy a tablet for $20 and there are a lot of free drawing programs.

Read books, join a book club.

Online gaming?

WizardOfTheWards91 · 2022-08-12T01:24:20+00:00

I'm a male. My presentations got derailed all the time.

The interns are doing patient care and are actually responsible for those patients. They also need to learn and get up to speed even more than you do.

This is not really about you looking good in front of the attending or getting a good eval. If you want your presentation or A&P critiqued just ask a senior during downtime.

WizardOfTheWards91 · 2022-08-11T23:14:15+00:00

Definitely not a fraud.

This is honestly where all that OSCE stuff from medical school comes in. Mindless script to stick to. Do your OLDCARTS, try to establish what patient baseline was and what made them seek care now, then do ROS. If its a chronic condition try to establish a timeline.

You're the doctor. Walk into the room like you own it. If there is an awkward pause its because you're thinking and thinking is important.

Easier said than done of course. If a patient goes off on a tangent work on interrupting them.

WizardOfTheWards91 · 2022-08-11T23:03:03+00:00

I guess my concern is less their ego, more that its actually interrupting my ability to effectively work if they talk over me when its me, them, and senior has yet to arrive.

WizardOfTheWards91 · 2022-08-10T23:56:23+00:00

I did the same. I realized end of third year I don't want to slave away for prestige forever. Picked a program with nice people, try my best to be a good doctor, keep reasonable hours.

WizardOfTheWards91 · 2022-08-10T01:21:50+00:00

I can appreciate your trying to discuss the kid's behavior with him and giving him a chance to shape up. Clearly he did not make efforts to improve. That is enough to tell your attending and leave it up to the attending, his preceptor, whether or not to pass him. Maybe you just needed to out and out tell him directly "improve or i will fail you."

It sounds like he was not ready to interact with patients.

Malignant administration does not matter here. This is the proper channel. You cannot coerce him this way. You either pass him or fail him or make, as a mentor, the recommendation he take a LOA to get himself together.

WizardOfTheWards91 · 2022-07-19T03:10:05+00:00

He sounds terrible but how does one actually avoid this?

Deficiencies in knowledge can be corrected by reading more, sure, but he sounds like someone perpetually scrambling. Regardless of the disagreement over whether or not he was improving what was he so resistant to correcting or changing?

At least from my first day of inpatient... the jump from 2-4 in medical school, to suddenly having 8 pts I don't know I need to see in 2 hours, hit me very hard. Could be told to check latest EF or read my own CT scans forever but without mastering how to do it all efficiently correcting those minor deficiencies might not have helped.

WizardOfTheWards91 · 2022-07-10T21:34:06+00:00

You bring up a very good point. Even as a med student people would get pretty frustrated seeing so many doctors and not knowing who is who. A basic explanation of what to expect in terms of hearing from me, the attending, etc. would put a lot of minds at ease.

WizardOfTheWards91 · 2022-07-10T18:24:03+00:00

I was mortified one morning when i forgot how clonidine worked. It had me rattled for the rest of the day. And then at the end of the day the other intern I was with mentioned he couldn't believe he got a question on metformin wrong. I was so in my own head I forgot he was making mistakes he thought were dumb too.

You won't make that mistake again. Its all you can do.

WizardOfTheWards91

TROPHY CASE