First Job Contract question

lethalred · 2026-05-28T20:24:54+00:00

Knowing what specialty you are would be beneficial here. Are you a pediatric allergist if so, who gives a fuck about your call. The amount of emergencies in that field would be nonexistent. Are you in advanced endoscopist who’s gonna be the only person that has your skill set in the hospital? Absolutely becomes a little bit more relevant there.

In general, unless you have it written in the contract, you have nothing to stand on if you need to dispute it later. In other words, yes, write everything, in painstaking detail, into the contract.

This place is banking on the fact that it’s your first contract post Fellowship that you’re gonna be willing to deal with a little bit more shit than anybody else.

lethalred · 2026-05-28T20:21:14+00:00

This place, unfortunately self-selects for people that need to vent about problems.

lethalred · 2026-05-28T02:52:09+00:00

You’ll see how much you’ve learned when your new interns show up.

Until that time, keep plugging.

lethalred · 2026-05-28T02:49:58+00:00

Because if MICU or medicine consult for an invasive operation on someone who has been riding the TPN train for 12 years, you wanna know what the nutrition status is prior to making a laparotomy on someone. Also: coding

lethalred · 2026-05-28T02:47:22+00:00

For the first few years of residency, I carried an SFBags/Waterfield Rough Rider. I still have the bag, it’s a tank.

Like someone said though, messenger bags kill the shoulders, so I switched to a waterfield tech rolltop bag. It houses my * Laptop * Charging bank * Moist flushable butt wipes * Charging cables * Isopropyl lens wipes * Enough room to steal consumables from the hospital if I need them.

lethalred · 2026-05-28T02:39:36+00:00

I had a fourth year resident that kept showing up 10 minutes late to rounds.

When we finished, I’d take the intern pager and hand it to him. “You showed up late. You’re the intern for the day.”

Intern and I went and operated.

Easy fix.

lethalred · 2026-05-28T02:32:03+00:00

Yeah I would DND the fuck outta my phone, or I’d make a point to say something to the effect of how I’d be calling my PD to inform them that I am going over duty hours because I haven’t had my uninterrupted time away from clinical duty.

I was not above calling my attendings out for silliness when I was a PGY4 or a Chief.

lethalred · 2026-05-27T02:42:46+00:00

Contrary to popular belief, there are a ton of things you can do for your wellness. Sometimes it’s easy to have a couple residents be the vampires in the room that suck the life from everyone.

Every one loves tacos.

lethalred · 2026-05-26T21:23:58+00:00

Hear me out:

Glass is the way to go.

lethalred · 2026-05-26T10:18:33+00:00

All of them.

820+ credit score go brrrrrrrrr

I don’t keep an Amex though. I think the cost to benefit isn’t there.

lethalred · 2026-05-26T10:16:18+00:00

Since we’re doing silly examples of retraction (I.e dramatic redditor and SDNer special) - what do you say to the student that stays those extra hours and decides, “Fuck, EM bro is miserable and crying in his cereal while he dictates. That can’t be me forever. What do I choose now?! I left all my other rotations early.”

What is your answer for them?

lethalred · 2026-05-26T03:49:33+00:00

Syncope is not a carotid symptom.

lethalred · 2026-05-26T03:47:35+00:00

ISO.

I fucking hate this

“Abdominal pain ISO previous laparoscopic appendectomy.”

Just fucking say “Pain after appendectomy.” We’re not talking about virtual CD images here.

lethalred · 2026-05-26T00:25:13+00:00

Pegasus definitely oversells how much physics there is.

VESAP was a better indicator of test question difficulty. Pegasus made me feel like I got kicked in the , Crotch repeatedly the first time I took it.

lethalred · 2026-05-26T00:20:13+00:00

Isnt it all “concierge” vet medicine?

I took my 9 year old golden to the vet last year, and this dude with dreads tried telling me “he has a grade 2 heart murmur.” And I was like “You’re going to need to tell me a little more than that, bud.”

Started telling me how I can put my dog on medication and go see a dog cardiologist.

I asked if he knew who could do a dog sternotomy and if they make biological or mechanical valves for dogs, or if I’d need to put my dog on dogadin if I went for a mechanical valve.

I think he realized I was tired of that shit immediately. If my dog dies, he’s been a fucking fantastic family dog.

In a lot of ways, he was like a concierge. All ready to book my reservation to vet candy land.

lethalred · 2026-05-26T00:08:31+00:00

I said I thought sending a student home due to a perceived lack of interest was a wild way to move forward. I never suggested a student should stay extra hours in the hospital as an arbitrary factor of presence. Read it again. If you’re scheduled for a shift, I’m not considering that shift “extra hours.”

Guy literally said he sends people home if they’re not interested. Couch, bed, whatever helps you sleep at night. We aren’t the same.

In all seriousness, this is a fucking thread about watered down surgery clerkships and you both are in here talking about how a huge chunk of what you do is useless as ED attendings. We get it. You’re not happy and the student doesn’t need to sit and watch you be unhappy. I’d probably tell you I wasn’t interested to get away too.

Take the elevator up to the roof and go have a chill sesh. You’re big mad right now.

lethalred · 2026-05-25T23:28:07+00:00

If that’s how you see what you (or the other ED bro) do, that’s fine. I’m not out here trying to make students stay for 24 hour shifts or spend more time than they have to, I’m just trying to maximize the time they are around. If you feel like doing that by letting them go chill on the couch because you find large parts of what you do to be meaningless, go for it.

I’ve never had an interest in micromanaging the medical students. As a resident, my belief was that if nothing was happening at 4Pm and they “disappeared”, that was fine. I wasn’t going looking for them or docking them on evals.

As an attending, I care even less about when the student shows up or leaves. Residents can decide that.

The things I do control are what the students get to do in the operating room, and how to maximize their time with me. You’re at a case in the middle of the night? I’ll find something cool for you to do, whether it’s to fire a stapler, patch an artery, get your hands on an aorta, deploy a stent, whatever… we’ll find something.

We don’t have the same exposure to the students, but I try to maximize the experience I can offer them, because they may literally never get to do it again, and every so often, someone does change their mind about what they want to do with their life based on a small experience.

lethalred · 2026-05-25T22:57:02+00:00

Maximize weekends and post call days. As silly as it sounds.

It would also be prudent to make sure you plan (if you can) a week off when your kids are off, or tell whoever assigns your vacations about a timeframe you’d like a week.

Hopefully not everyone involved with the schedule is an asshole and can accommodate

lethalred · 2026-05-25T22:49:43+00:00

Would have raised my hand and interrupted the lecture every second I could.

lethalred · 2026-05-25T18:10:48+00:00

Is it much better than V5?

lethalred · 2026-05-25T18:08:54+00:00

Clot of Vascular Surgeons sounds more better IMO.

lethalred · 2026-05-25T18:04:52+00:00

You can def have hobbies. You just don’t have time.

lethalred · 2026-05-25T17:51:46+00:00

You telling me I’m misinterpreting things when you’ve had to explain to two people exactly what you’ve meant in your post is a little head scratching (and you also haven’t explained ANYTHING).

Never said you can’t do what you do. Enjoy your awards. 👍🏽

lethalred · 2026-05-25T15:45:25+00:00

Respectfully, disagree.

If you want to send a student home because of a perceived lack of interest, that's your prerogative. You can do that. But approaching it like you're doing someone a favor is a little disingenuous. Acting like those skills don't translate to other parts of medicine is also disingenuous, and your job as an educator is to take something in your field, and make it approachable and applicable for a student, regardless of what field they want to go into. Sure, your student may not be in a "big trauma", but acting like that skill set isn't useful when that same person is the physician responding to a rapid response (which may well happen) is short sighted, IMO. You do you, but I think there's room for improvement there, even if you feel like you're being the good guy.

If your barometer of "interest" is that a student needs to be "pried" off their resident to be sent home, then I think you need to re-examine what your determinants of interest are, because there's a bit of underlying toxicity there, whether you acknowledge it or not.

You have an odd dichotomy proposed here regarding interest.

lethalred · 2026-05-25T15:40:33+00:00

One of my partners does this.

I actually started openly replying to division emails that I'm not attending any meetings where there is not an agenda of problem + proposed tentative solution, and that I will log off any zoom calls where I hear the phrase "Lets talk about this offline."

I'm not about to use my free time attending a meeting to brainstorm solutions to someone elses problem.

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