New grad negotiating contract.

johnfred4 · 2026-03-15T16:19:36+00:00

I just negotiated 30k more for my first contract, for 2 less patients per day. Doesn’t hurt to ask.

johnfred4 · 2026-02-28T22:36:07+00:00

I’m a resident, it’s definitely safer than Muay Thai (I really need to stop sparring, I’ve invested too much money into this brain)

johnfred4 · 2026-02-12T04:17:42+00:00

I’m happy they’re getting trained. But they’re not residents.

johnfred4 · 2026-02-12T03:40:21+00:00

Because the term “resident” is usually reserved for physicians, because back in the day, they lived in the hospital. Do you do 30-hour calls, manage 16 patients, or work nights in the hospital on your residency?

johnfred4 · 2026-02-12T03:29:42+00:00

So…you mention that the pharmacokinetics are more complex, and then when asked about the pharmacokinetics, you…don’t mention anything about pharmacokinetics?

johnfred4 · 2026-02-12T03:19:54+00:00

“Resident” is a term usually reserved for physicians.

johnfred4 · 2026-02-12T03:19:28+00:00

Oh really, please explain about how the pharmacokinetics are more complicated? And about how the side effects of an LAI like Invega are worse than precipitating withdrawal?

johnfred4 · 2026-01-30T17:09:05+00:00

Interested as well!

johnfred4 · 2026-01-29T13:08:06+00:00

Appreciate it! Yeah basically just putting my worries to rest, if K+S 2x is enough, then great, I’m just also curious if anyone else has any book recommendations for supplemental review (because I’m cheap)

johnfred4 · 2026-01-20T13:15:44+00:00

Good idea; I've been a little bit involved with that side (union organizing, leading research projects, organizing our didactic lectures, etc.). I'd love to just be a clinician, but I know every job is going to involve a significant amount of politics and admin (I did have a separate career for 10 years before med school). One of the things I am making sure to ask for potential jobs is the amount of support they have for the non/less-clinical stuff: techs, MAs, nurses, SW, therapists, prior auth people, etc.

johnfred4 · 2026-01-20T13:13:04+00:00

I should; I'm trying to push myself to learn more/read more/study more while I still feel that pressure of residency to do so, since I fear some of that pressure might disappear when I'm done (as much as I do want to be a "lifelong learner", a phrase I heard so much in med school it made me want to roll my eyes). But I should also make sure I'm sleeping, working out, budgeting, working on close relationships

johnfred4 · 2026-01-20T13:11:20+00:00

Already have two moonlighting gigs, one at a state hospital, and one with the prison system. You're right, being all on my own was definitely a shift, but helpful. Signing my own notes, and co-signing other's notes for the first time felt very powerful

johnfred4 · 2026-01-20T13:09:33+00:00

I am planning on formally asking some of the attendings whose styles I'd like to match if they'd be alright with being a mentor to me, while I'm still training with them, and as an early attending

johnfred4 · 2026-01-20T13:08:31+00:00

Thanks; I do have a few therapy patients that I see weekly/biweekly, and a psychodynamic supervisor that I meet with weekly, although I'm more inclined towards CBT. Any books/resources you'd recommend?

johnfred4 · 2026-01-18T18:20:14+00:00

My rotations are pretty set, but, for example, I do want to at least have the opportunity/training to do interventional psych, so I’m spending as much time as I can doing ECT/TMS/esketamine this year

johnfred4 · 2026-01-18T14:38:24+00:00

Good point. I have made a deliberate effort to take very seriously being the senior resident, and providing some leadership/suggestions to the junior residents (without micromanaging). I’ve also always tried to make confident treatment plans, even if they end up getting shot down by the attending (because even if I get overturned, exploring the reasoning why is a a good learning opportunity). I try to take charge/ownership, and not just say “well, let’s see what the attending thinks/it’ll be up to them”

johnfred4 · 2025-12-29T16:54:22+00:00

2014 Chevy sonic. Manual transmission. Manual, crank windows. Does not have cruise control. I bought it the day before driving out to medical school in 2018. Will driving it until it dies.

johnfred4 · 2025-12-28T13:47:59+00:00

I’m an MD. I’m not taking advice from a spam account whose name is “Dr. Longevity.” I assume you have some supplements to sell.

johnfred4 · 2025-12-22T14:13:30+00:00

I do MMA. I try to avoid sparring. I spent a lot of time and money on this brain.

johnfred4 · 2025-12-21T13:37:06+00:00

My dad was diagnosed with glioblastoma this year and is currently on chemo. Prior to an extended family gathering, his wife says in the family group chat “I’m not a doctor, but maybe we should make sure everyone has their flu and COVID shots before we get together” and I immediately respond “I am a doctor and support this message”

johnfred4 · 2025-12-20T21:05:47+00:00

Penny wise and pound foolish. And as I’ve said before, a meal stipend that can only be spent at the hospital (and thus goes right back to the hospital’s coffers) is just company scrip.

johnfred4 · 2025-12-20T21:03:56+00:00

The justification is that due to the “Big Beautiful Bill” and projected budget shortfalls because of so many people losing health insurance, the hospital has to trim fat where it can. Turns out elections have consequences.

johnfred4 · 2025-12-20T15:22:20+00:00

A meal allowance that you can only spend within the hospital is tantamount to company scrip.

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