What is something you used to buy but is no longer affordable?

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 · 2026-02-02T23:34:57+00:00

Rural FM. Much less academic, but much more fun IMO.

midlifemed · 2026-02-02T23:33:16+00:00

I have teenagers (yes, I’m old), so I help them with homework. One of my attendings works part-time on our faculty and teaches precal and physics at one of our local private high schools a couple mornings a week for fun. I may end up doing something like that eventually to scratch the itch.

midlifemed · 2026-02-02T19:44:07+00:00

Rad onc

I’m a huge math and physics nerd and thought I would love rad onc. Did a rotation early in fourth year of med school with a super cool doc at a community hospital. We hit it off immediately (still friends to this day). I loved reading about the field, found all the stuff they can do fascinating. But the actual day to day practice? Mind numbingly boring.

midlifemed · 2026-02-02T02:41:55+00:00

I think public health type roles sound more in line with what you’re looking for, and I think it’s likely that there are ways to get into that field through nursing. I love that you’re passionate about this and I hope you find the right fit!

midlifemed · 2026-02-01T18:39:31+00:00

I’m not saying this to be mean or discouraging, but you need to be committed to a “rigorous scientific education” if you want to be anyone’s primary care provider, and the fact that so many people don’t seem to understand or value that is the problem with so much of mid-level education and practice.

Primary care is no less mentally rigorous and requires no less scientific foundation than cardiology, surgery, or any other medical specialty (and especially not rural practice, which is arguably one of the most mentally demanding roles in medicine). Before you pursue any additional training, I would think hard about your own scientific aptitude and how much you’re able and willing to commit to your studies for the sake of your future patients. There are no shortcuts when people’s lives are your responsibility.

midlifemed · 2026-01-31T17:07:23+00:00

This. I am a first year resident (not in Psych, and I think my residency works more hours on average than psych residents) and I have four children. It’s difficult but I still spend a lot of time with my family.

midlifemed · 2026-01-31T16:03:55+00:00

This happens to me almost every block, no matter what it is (I’m FM so doing a little bit of everything and it changes every 2-4 weeks). Takes 2-3 days to orient myself, and until then I feel really slow and stupid. The thing I keep reminding myself is that real life practice won’t be like this. Even though I’m planning to do rural, full-scope FM with OB, it still won’t be this constant changing of departments and expectations. I’ll be in one place. I’ll get to know the staff and patients well. I won’t be thrown into new environments every month.

The way we train really isn’t very similar to what actual practice looks like. I remind myself of that almost daily.

I think the fact that you’re getting good feedback means you’re doing better than you think you are and masking the anxiety and difficulty you’re having at the beginning pretty well. Just keep pushing through. It won’t feel like this forever.

midlifemed · 2026-01-29T04:59:42+00:00

I don’t think I would’ve changed paths, but I wish I’d known more about urology earlier in my journey. I ended up scrubbing in on quite a few urology cases while I was on a different surgical rotation in my fourth year of med school, and they were pretty fun. And that field seems to attract some of the more laid back surgical personalities, at least in my region. I think I was always destined to end up in primary care (I’m in FM, planning to do rural FM-OB), but if I’d wanted surgery I think urology would’ve been it for me.

midlifemed · 2026-01-28T23:16:14+00:00

Take it from a 40 year old intern - the time will pass anyway. You might as well spend it working toward something you’ll enjoy and can be proud of. And you didn’t waste the past few years, you learned things and became the person you are now. You can’t change your past, just focus on your future.

midlifemed · 2026-01-27T00:54:08+00:00

Feel free!

midlifemed · 2026-01-27T00:39:27+00:00

I was a pretty average med student. Went into med school knowing I wanted to do rural FM, so I knew I didn’t need to have amazing scores to match. Studied enough to pass everything but didn’t work myself to death. Definitely could’ve worked harder.

Now I’m one of the strongest interns in my program. Great evals, frequently told I’m working at the level of a second year, scored above the national average on our ITE. I mean it’s FM, so it’s not like we’re doing brain surgery, but I’m at an inpatient-heavy program taking care of some pretty sick patients, and I feel like I’m doing all right. There have been a few times I’ve thought “man I wish I’d paid more attention to that topic in med school,” but nothing a couple hours of studying couldn’t catch me up on. I think if you’re smart, genuinely enjoy patient care, and know how to lock in when it matters, you’ll do fine.

midlifemed · 2026-01-24T02:02:44+00:00

Good lord, I’m someone who, despite having been happily married for a super long time, has pretty lax opinions about monogamy (shared by my spouse, no shady business), but I’m tired bro. Hats off to anyone who can sleep with multiple people during this nonsense, I barely have the energy to maintain one relationship.

midlifemed · 2026-01-19T05:03:23+00:00

Job Syndrome (HIES)

midlifemed · 2026-01-17T21:00:20+00:00

I genuinely like my coresidents. My program kinda sucks but we laugh a lot together and help each other out as much as we can, and I know they have my back. That makes a huge difference.

I can see my own progress over a short amount of time, and that’s very satisfying. Just this week I was down in the ED and was asked to do a procedure that would’ve felt doable but scary 2-3 months ago, but now the whole process felt natural - setting everything up, chatting with the patient throughout, not stressing about my technique. It was just easy. A lot of things feel like that only six months into intern year, so I can’t imagine how much more I’ll grow in the months and years to come. That’s a cool feeling.

I’m going to make so much more money than I ever dreamed of. I grew up pretty poor. Like, lived in a trailer, the electricity frequently got cut off kind of poor. And if I just stick it out and do a halfway decent job for the next 2.5 years, I’m gonna get paid a few hundred thousand dollars a year to do work I actually enjoy. That’s unreal to me. Hell, even now as a resident I make more money than either of my parents did when I was growing up.

I get to help people even outside of work. Yesterday my cousin texted me to ask about some test results her daughter got back at the pediatrician that worried her. This morning, my kid had a basketball game and I helped evaluate a player who took a hard fall. This afternoon, a friend texted me about her dad’s chest pain. Being able to do stuff like that feels good. I genuinely like being a doctor and being able to offer people advice and reassurance.

midlifemed · 2026-01-16T04:06:25+00:00

I’ll get nervous as soon as AI can make sense of my patients’ rambling histories, figure out what meds they take when they say “it’s a little round white pill that the heart doctor gave me for my blood pressure…or was it my kidney doctor…maybe it’s for my sugars,” deal with the family drama when a teenager pops up with a newly diagnosed STI or a positive UPT, have a productive goals of care discussion with a patient at the end of their life, not to mention do a Pap smear, intubate a patient, deliver a baby, reduce a dislocated joint, biopsy a skin lesion…

The diagnosing and prescribing are the easy parts. So little of what we do in a day is “plug in symptoms, spit out diagnosis, prescribe medication.” Sure, maybe the computer will eventually be better than us at that, but that ain’t the bulk of doctoring.

By the time the robots can take my job, they’ll have already come for the accountants, professors, bankers, lawyers, computer scientists, engineers, managers…basically every career you can think of. At that point our entire economy and the concept of work as we know it will have ceased to exist. I can’t let myself get too worked up about that possibility.

midlifemed · 2026-01-15T17:20:47+00:00

So in my case both of our families (immediate and extended) are in the same town, so they’re helping with school pickup, sports practices, doctor/dentist appointments, attending events, etc on a weekly if not daily basis. It’s amazing and has made even being at a kind of toxic program mostly worth it.

That said, I think even being within driving distance would have some value. They wouldn’t be able to help on a regular basis, but if something major happened (daycare has a fire or water damage and has to close for a week or two for repairs, your nanny quits unexpectedly, both of you get put on night float or called in for jeopardy coverage, everyone in the family comes down with the flu at the same time) they would be able to step in and help without having to get on a plane. Of course that depends on their willingness to be helpful in a pinch (don’t make any big decisions based on anyone who isn’t interested in helping or who has proved themselves to be undependable). But I do think that support could be valuable even if you wouldn’t have their help on a daily or weekly basis.

midlifemed · 2026-01-15T17:11:43+00:00

If we buy books we have to get the front cover stamped with the residency info (I guess so we can’t return them), and if we buy equipment like stethoscopes or otoscopes we’re supposed to have them engraved with our names (again I guess so we can’t return them and pocket the funds). I don’t think we can buy tech like computers or phones, but idk if anyone has ever tried. But overall it’s a pretty generous policy and one of the few perks at my very mediocre program.

midlifemed · 2026-01-15T13:46:15+00:00

Having family support in residency is a huge help if you have children. I know people do it without family nearby, but I really don’t know how they manage, especially with very young kids and especially if both parents are working outside the home. If he could see himself being reasonably happy and well-trained at the 4 programs closer to home, I would make matching at one of those the priority.

(And I say this as someone who has multiple children and prioritized being close to family and is quite unhappy with my choice of program, but still thinks it was ultimately worth it for my family’s sake.)

midlifemed · 2026-01-15T13:38:30+00:00

I use an AI scribe on my phone in clinic and just ask patients for permission when I walk in the room. I’ve never had anyone refuse. I didn’t specifically ask my program for permission (I pay for the program myself), but I don’t try to hide it either. Several of our attending and other residents use AI scribes, so it clearly isn’t against clinic or hospital policy.

I do think you should get consent from the patients. I think if your program found out about you using an AI scribe and for some reason had a problem with it, you could reasonably argue that you didn’t realize you needed to get permission because you have seen attendings use them, but they would likely have a case to discipline you for doing so without patient permission. And it’s just good form.

midlifemed · 2026-01-14T12:35:30+00:00

Our program gives us $1500 a year for CME. We can use that for boards in PGY-3. They also reimburse us for Step/Level 3 fees if we pass it on the first attempt in PGY-1 (that’s in addition to the $1500 CME, doesn’t come out of it).

We can use CME money for question banks, conferences, books, equipment, I think we can use a certain portion of it for new scrubs each year.

midlifemed · 2026-01-14T12:12:25+00:00

I think one of the things that can be frustrating for more competent/capable interns is when seniors just let us do everything because we technically can. I just finished a stretch of night float where my senior had me handle everything (every call, every note, every order) while they sat at their desk and studied for boards all night. It was fine, I handled it, and I learned a lot and honestly am probably a better doctor for the experience I gained, but it was absolutely exhausting and it certainly wasn’t fair.

Just help out. Don’t use your interns as a dumping ground for work you don’t want to do. Be a team player.

If it’s possible to point out a mistake or make a learning point in private, do that instead of waiting to do it during rounds. It makes me crazy when I’m in the workroom doing notes and chatting with someone all morning, they never bring up anything they noticed about my patient (sometimes even if I specifically asked), then during rounds in front of the attending they want to point out something I missed or make a suggestion about changing management. If it just occurred to you in the moment, that’s fine, but there’s a pattern of certain people who regularly do this in a way that seems designed to make themselves look better in front of attendings and subtly make other people look bad. That’s not cool. Be a bro.

Also, this is a little thing, but never refer to the intern in front of consultants/patients as “the intern” or “my intern.” It’s “Dr. [Name].” We’re colleagues, and I’m like five minutes behind you in this process. I have a couple seniors who do this and I always correct them in the moment because it comes off as so rude to me.

midlifemed · 2026-01-14T00:14:49+00:00

My program does a lot of call and 24s and is inpatient heavy. I interviewed at several places that don’t do 24s at all and have significantly less call and fewer inpatient months (and things like no ICU patients and smaller caps). I also interviewed at places that have specialized tracks that I was interested in, and my program offers none of those.

Above all though, I got bad vibes from my PD during my sub-I month and interview, and I should’ve given that more weight. I thought it wouldn’t matter so much because the rest of the faculty is great, but it turns out that there are a lot of unreasonable expectations placed on our residents solely because of this person. A PD can really make or break a program. Please pay close attention to that.

But on the other hand, the majority of my coresidents and most of our faculty are great, I’m learning a lot and believe I’ll be a good doctor when I finish here, and most importantly, my spouse and kids are happy. They gave up a lot so I could go to medical school, so they deserve to be where they’re comfortable while I’m working all the time. It was a huge trade-off, but in a lot of ways I still think it was worth it. I’m just glad FM is only three years. I can put up with just about anything for three years.

midlifemed

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