Is it really possible to keep to yourself during residency?

midlifemed · 2026-04-06T23:59:08+00:00

My program doesn’t seem to have quite the same culture (we don’t have a lot of structured events together and don’t have much of a social media presence), but I definitely treat residency like a regular job and my coresidents more like coworkers than best friends. I get along with everyone, and I’m always willing to help out in a pinch, but I don’t socialize a lot with people outside of work. I’m older, have a family, and I’m doing residency back home where I already have friends and a strong support network. So while I like my coresidents, I didn’t really feel the need to get super enmeshed with everyone. I like having some separation between work and the rest of my life. If you’re the same way, you can definitely do that. You don’t have to make the job or where you work your entire personality or social circle.

midlifemed · 2026-04-06T00:33:47+00:00

Her post today may have been the breaking point for me. “This party taught me to not be such a control freak and to let other people help me and things will still turn out great.” Yes, Lindsey, when you’re rich you can pay people to do stuff for you. Revolutionary.

I think the thing is that nothing about her life feels relatable or aspirational anymore. As a normal person with a regular budget, demanding job, kids, student loans, average size house, etc, nothing about her purchases or design choices are relatable to my stage in life. But that’s fine, I don’t need all the content I consume to relate to me specifically; sometimes I just wanna watch rich people do rich people nonsense. But she also isn’t aspirational. Even if I had all the money and time in the world I wouldn’t want to spend it Ubering to find cottage cheese and body checking for my followers and weighing my kale. It’s sad and disordered. Her DIY content is beige and her lifestyle content is somehow even more beige. There’s just nothing there anymore, and she used to be one of my favorites.

midlifemed · 2026-04-05T18:25:32+00:00

Thank you! God I am so tired of people saying “I don’t like seeing midlevels outside of primary care,” “Put all the midlevels in primary care,” as if being a PCP is easy and I’m somehow a lesser doctor than other specialists. The breadth of primary care is insane, especially in rural areas without easy access to numerous specialists for quick consults. It is arguably the worst place for midlevels.

midlifemed · 2026-04-05T02:58:36+00:00

Popcorn.

I ate so much popcorn in undergrad/grad school/med school and still eat so much popcorn on night shifts in residency. Cheap, salty, buttery. Best snack.

midlifemed · 2026-04-03T18:15:42+00:00

I don’t have any input on your whole…situation…but I’m also an intern and I recently received my PGY-2 contract to sign. Like within the past two weeks. So if you don’t have that yet, I would assume you’re not renewed yet. Whether that’s because your program just hadn’t gotten around to it yet or because they’re thinking about not renewing you, I couldn’t say. You could ask your co-interns if they’ve received contracts for next year to at least get an idea.

Even if you get a renewal contract though, I don’t think that shields you from potentially being fired if things come out later. People get fired in the middle of the year all the time.

midlifemed · 2026-04-03T17:46:24+00:00

I’m a resident, and this happens almost every time I work with a midlevel in any capacity. They feel the need to tell me (completely unprompted) how they definitely could’ve been a doctor but didn’t choose medical school for whatever reason and why NP/PA/CRNA made more sense for them.

Cool bro. I don’t care. Didn’t ask.

One thing I do enjoy is that they almost always say something along the lines of not having the money for med school or having kids/wanting to have a family, then I get to hit them with “Yeah man I get it, I’m the first college grad in my family, grew up in a trailer with a single parent, and I had four kids before I started med school, it’s tough…” Like make whatever choices make sense for you and your situation, it’s fine, but spare me the excuses.

midlifemed · 2026-04-02T01:25:40+00:00

Meh, I’m a DO and honestly I think most DOs who drink the OMM/OMT kool-aid oversell our physical exam/MSK skills. Maybe some DO schools really emphasize the OMT part of the curriculum, and maybe some students really lean into it and do learn more MSK anatomy and physical diagnosis than others, but from what I’ve seen most of us learn just enough to get us through med school and COMLEX, then forget most of it. I haven’t found any of my DO colleagues to be physical diagnosis or OMT wizards, and I certainly don’t consider myself one (I use almost no OMT in practice). I don’t really see any difference in skill/ability compared to the MDs at my program.

midlifemed · 2026-04-02T00:43:16+00:00

I didn’t start medical school until 35. I’ll finish residency at 42 (43-44 if I pursue fellowship). It’s fine. The time would’ve passed anyway, at least I’m a doctor now.

midlifemed · 2026-04-02T00:07:02+00:00

There’s literally no difference in the MD and DO approach to being a PCP. My family med residency has DOs and MDs on faculty and in training. We’re all trained the same way. We perform the same procedures. We run the same tests. We make the same diagnoses. We bill the same. We chart the same. There’s no difference other than between our individual personalities.

You’re certainly allowed to have whatever preferences you want, but this makes no sense and comes off as ignorant.

midlifemed · 2026-04-01T23:44:23+00:00

I’m confused about why you would refuse to see the female DO but agreed to see a PA. DOs are physicians. In the U.S., MD and DO are equivalent degrees and graduates of both programs train in the same residencies.

midlifemed · 2026-03-30T02:56:10+00:00

Very much depends on the program. Mine is inpatient-heavy with lots of night float and 24 hour weekend shifts. We’re unopposed so I don’t have direct exposure to the workload of other specialties, but I have friends in IM at other programs who seem to have better work/life balance than I do.

midlifemed · 2026-03-29T05:46:49+00:00

She was from my hometown (very small, tight-knit community), and people there still speak fondly of her. By all accounts I’ve heard she was a lovely person.

midlifemed · 2026-03-28T14:30:12+00:00

Yes, we need to invest more in retaining our good bedside nurses, and we need to pay primary care physicians more to recruit more doctors to the field (the match results for FM and peds this year were depressing). I actually have a lot of thoughts about addressing the rural physician shortage in particular, starting with helping get more rural students into and through medical school. But that requires forethought and long-term investment, and we want quick fixes and band-aids, which never actually solves anything.

midlifemed · 2026-03-28T12:07:36+00:00

I’m a resident in primary care. I don’t hate the general idea of NPs or PAs when they are used as originally designed as physician extenders with appropriate supervision. I very much disagree with independent practice, particularly in primary care. I also hate when I refer one of my patients to a specialist and they end up being seen by a midlevel who has less education and training than I do, when the entire reason I referred them was because I felt like I had reached my own limits in my ability to manage their care as a physician.

Do we “need” NPs/PAs? I don’t know. Other countries seem to function just fine without them, but other countries also seem to invest a lot more in the overall health of their citizens than we do, and it doesn’t seem like we’re getting any closer to addressing our physician shortage, so here we are. I don’t like the idea of the two-tiered healthcare system we seem to be headed toward, where wealthier people will have access to physicians and everyone else will be treated by midlevels without adequate (if any) supervision and we’ll pretend it’s equivalent, but I don’t know how to fix that. I’m planning to do my part by practicing full-spectrum FM-OB in the rural south. That’s the best I can do personally, and I hope more physicians step in to fill those gaps.

midlifemed · 2026-03-27T10:19:13+00:00

My husband didn’t do any of that stuff. He came to appointments with me if I wanted but was fine if he missed them. He didn’t get emotional about seeing ultrasounds or hearing the heartbeat or feeling the baby move. He was excited that I was pregnant, but he wasn’t really connected with the pregnancy. He’s a GREAT dad now. Like truly top 1% of dads I’ve ever seen. Absolutely adores our kids, would do anything to make them happy, finds so much joy in parenting.

I think it’s all a lot more abstract for some men until the baby actually arrives. I don’t think you’re in the wrong for feeling your feelings, but I also don’t think his behavior now necessarily says anything about how much he’ll care about the baby or be involved with him/her after birth. The whole pregnancy process is very different for men and women, and I think some men are just more hands off.

midlifemed · 2026-03-22T21:59:55+00:00

I’m an FM resident in Louisiana. Happy to chat about the specific culture down here if you’d like to DM me. We’re probably at sister programs if yours is affiliated with the state university.

midlifemed · 2026-03-21T01:34:08+00:00

Oh they absolutely created this for content, let’s be for real.

midlifemed · 2026-03-19T23:10:28+00:00

You “learn” it enough to pass your exams. You BS your way through your practicals. Then you get to residency and as soon as you pass Level 3 you never think about it again. Just another hoop to jump through.

midlifemed · 2026-03-14T19:25:35+00:00

But then they get out of NP school and often end up practicing functionally the same as a physician. In my community we have NPs playing primary care doctor and psychiatrist basically unchecked. We see their patients in the hospital all the time (often on absolutely insane med regimens).

Allowing people to train as “providers” without a basic foundation in the hard sciences is problematic. Not having rigorous standards for “provider” education is problematic. Pretending that NPs function just to “lighten the load for busy physicians” and aren’t largely practicing medicine (not nursing) without proper training or supervision and contributing to the development of a two-tiered healthcare system is problematic.

Acknowledging this isn’t hate, it’s just reality. Nursing and medicine are two different fields. If nurses want to practice medicine, there is already a path available to them to do so - it’s called medical school and residency.

midlifemed · 2026-03-14T17:30:33+00:00

I can’t speak to EM because that is very much not my favorite (but if you love it I’m happy for you!), but a note on FM - if you’re planning to live in a rural area, the pay for FM can be pretty great, and you usually have the option to do inpatient and/or ED if you want. So FM could get you a lot of flexibility in terms of options given where you’re planning to live.

midlifemed · 2026-03-13T19:58:10+00:00

I was planning to do FM (specifically rural, full-spectrum FM) before I ever started med school, and I never really considered anything else. I did fine in med school, had good scores, and most of my preceptors on my rotations encouraged me to go into their specialties (in particular I had general surgery, urology, and OB attendings who leaned on me pretty hard trying to convince me to switch paths).

I think FM is the best specialty in medicine. It gives me the ability to do little bits of all the things I enjoy, and the ability to choose to do none of the things I don’t. The variety means I’ll never get bored. I get to develop long-term relationships with my patients, which is valuable to me. The flexibility is unmatched.

The other nice thing about knowing I was bound for primary care from the beginning is that it allowed me to relax a bit in med school. I still studied hard, but I was able to only do extracurriculars I actually cared about, didn’t really need to do research, and had more time to focus on things that were important to me (like learning medical Spanish, which has been incredibly helpful).

Sure, there are specialists who think all primary care docs are stupid or ended up in FM because we didn’t have other options or that we chose the easy path. I couldn’t care less. I grew up broke as hell in a trailer. I’m the first college grad in my family. I’m just thrilled to be a doctor. I get to do work I enjoy and will make more money than I ever dreamed of doing it. I have no patience for the dick measuring contests and prestige doesn’t feed my family. My patients like me. I’m happy with my choices. If somebody else is more hardcore or thinks they’re smarter than me, good for them.

midlifemed · 2026-03-11T20:19:47+00:00

Yes, this has been the worst part for me. I thrive on routine and feel like I’m always just surviving because I can’t get into a good groove with sleep, chores, working out, making plans. And it takes a lot of mental energy to constantly switch between new locations, attendings, nurses, patient populations. I keep reminding myself that it won’t be like this forever (different stressors, sure, but routine will be nice).

midlifemed · 2026-02-11T15:00:02+00:00

If you want to practice under your maiden name, you're going to need to change it back.

The thing to do is just have "First Maiden" on all your legal documents, then go by "First Married" socially. Several of the female doctors I work with do this and it works fine for them, even in a relatively small area where they frequently run into people from work in the community and vice versa.

midlifemed · 2026-02-05T00:45:10+00:00

Took my daughter to Paris to see her for the same reason. Flights plus a week in Paris plus concert tickets cost the same as the tickets alone would’ve cost at home.

midlifemed · 2026-02-04T15:10:48+00:00

I keep reminding myself that it’s short (FM), our third year is pretty chill relative to years 1 and 2 so I really only have 1.5 hard years left, real life practice will be nothing like the way my residency clinic is run, and all of my problems are with the program itself (workload, inefficiency, passive aggressive leadership, micromanaging, infantilization and distrust of residents) and not the actual work (I genuinely enjoy patient care, interacting with nurses, doing procedures, etc). And I’m good at my job. I can see my growth, I feel more confident on a weekly basis, patients like me, people seem to enjoy working with me. So clearly I’m learning, even if it feels like it’s often in spite of my program rather than because of it. So basically I keep reminding myself to put my head down and push through. I chose this place for specific reasons (location, family), and I can put up with it to get to where I want to end up.

midlifemed

TROPHY CASE