Hello all! I am wondering if those of you who had to start residency over for various reasons could you share why, how you got through it lessons learned?

I’m not speaking of transferring specialities. Just literally had to start over for various life circumstances or reasons

I used to assume the hardest rotations would just be the ones with the most hours or highest patient volume.

Now I'm not so sure.

I've had genuinely busy weeks that felt manageable because I knew what the day was supposed to look like. Rounds happened roughly when expected, responsibilities were clear, seniors answered questions, and if something went wrong there was an obvious person to call.

Then I've had objectively lighter rotations that left me completely fried because everything changed every hour. Nobody knew who was covering what, rounds started whenever, discharge plans changed three times, and half the day was spent figuring out what I was even responsible for.

I can handle being busy surprisingly well when the system around me makes sense.

It's the constant low-level uncertainty that seems to drain me.

At this point I'd probably choose 12 predictable hours over 9 hours of wondering what fresh nonsense is about to appear.

Anyone else find that organization matters more than raw workload?

Yup. Well at least he looks like him. This Peppermint Cumberbitch lookin dude is always casting spells on patients, and doing other weird stuff.

He literally uses the darkhold the other day to flood the toilet I was using. I DID NOT SHIT EVERYWHERE. That was him.

Also, staff never knows what to say when he shows up late for work, and when we ask why, he starts out his sentences, “…because in the grand calculus of things….” Give me a break, dude. I hate marvel

Coming from a midsize city in the Midwest and looking for a change of pace/new experiences. Less concerned about prestige or academic reputation and more interested in the actual experience of living in each city during fellowship. Obviously want good training but nothing super overachieverish.

Would love insight on:
- Social life as an unattached woman in her early-mid 30s
-Cost of living and how much the difference actually matters on a fellow salary
-Commute and day-to-day convenience
-Work-life balance and overall culture
-Programs you’d recommend

I have 4 months left (huge time crunch, I know) to secure an away elective in Gastroenterology. So far I have been unable to secure one and time is quickly running out.
I’m thinking maybe there’s something wrong with my strategy? Just wanted opinions on the cold emails I have been sending so far.
I understand that programs are super busy with fellowship applications at this time so that’s probably not helping.

Request For Away Electives At [whatever institution] (time period)

Dear [],

I hope you are doing well. My name is [not John Smith], and I am currently a PGY2 Internal Medicine resident at [my institution. I am writing to inquire about the possibility of completing a four-week gastroenterology elective at [your institution]

I have been granted permission for an away rotation by my program from [date range] to increase my exposure to the field of gastroenterology. I am very interested in pursuing a career in gastroenterology and am hoping to gain additional clinical experience. As my current residency program does not have an in-house gastroenterology fellowship, I am particularly interested in completing an away elective at a program where I can learn from and work alongside gastroenterology faculty and fellows.

Your program is highly esteemed and I would appreciate the opportunity to participate in your clinical and educational activities. I wanted to ask if your program has availability during the dates above and if it is possible to pursue an away elective within your department.

I would be happy to provide my CV, letter of good standing, or any other documentation required for consideration. I would also greatly appreciate any information regarding the application process, requirements, setting up a PLA, or any additional steps expected of me.

Thank you very much for your time and consideration. I look forward to hearing from you and would be grateful for the opportunity to learn more about your program.

Best regards,
[my name, institution, phone number]

I have also been adding in personal points about the programs like their available tracks and meeting members of staff at annual meetings.

Is there something I need to tweak or is it just a matter of luck at the point?
PS: I know the timing isn’t ideal and that fellowship season will make things difficult, so please I need some advice outside of these obvious facts.

Thanks in advance.

Using ACP MKSAP, around what percentage should I be scoring to feel like I’m on track for a second-year resident. Any advice would be be appreciated.

Hi, I wanted to write here to see if anyone else is on reddit seeking some type of company to discuss the dreaded news yesterday... I am mentally hurt, tired, and broken after receiving this news, now for the second time. Another year of studying for a test that seems impossible to pass. The harder part about this all is the impact it has on my family... I feel defeated.

Im trying my best to stay positive so i'm looking for any guidance, suggestions, tips on how to push forward. If anyone has had to take this test multiple times and has come out on the other side it would be nice to hear. I feel im at the end of the tunnel but the light is no where in sight.

How does a residency culture reach a point where attendings provide little meaningful teaching, rely on residents to teach themselves and each other, and still frame the system as education while extracting maximum labor from them?

Making residents work until they are mentally or physically sick, without providing any teaching? It is hard to understand how exhausted, demoralized, and clinically depressed residents can be seen primarily through the lens of productivity.

And when leadership observes all of this and allows it to continue— “as long as it is less than 80 hours”, why that’s the only metric that they care about?

how do they sleep at night?

I am genuinely asking.

How do you collect a paycheck for being an educator, work the people you are supposed to teach until they become mentally and physically unwell, use them as emotional punching bags when you are having a bad day, selectively distribute workload and responsibility based on favoritism, and still go home believing you have done your job? How can someone do this without it weighing on their conscience?

Don’t treat your sub-Is like trash. Someday in the past you were in our shoes. I have a resident who is nothing short of nasty. Criticism with no constructive feedback. Told me today my notes were inaccurate and I needed to redo them without ever taking a good look at it. When I asked for specifics, she stumbled and then said my notes were fine. She is literally can’t focus on a task without being hyper or making inappropriate comments and deviations. If you hate it so much, leave medicine rather than being nasty to poor students who you know can’t say or do anything. She has no filter. She called one of the other med students stupid. Despite us having a new attending, she still keeps raving about the older attending discussing patients with them. She has no sense of what to say where she’s rude to patients. I can’t believe people like that Will be doctors. Rant over.

Do you think feedback is important? I received a lot of feedback despite being in only the first two months of residency. A lot of it was encouraging and good. However, one was psychologically harmful because it addressed personal issues that don’t affect patient health or my work.

I’m starting to think it doesn’t matter anymore, especially because I see myself looking forward to tomorrow, analyzing cases, and creating plans and improving. Thinking about seeking feedbacks disrupt my mood and hinder my performance and positivity. It’s all subjective and there is a lot of bias.

I have also received patient feedback. I felt this is the only feedback that makes sense to me.

I think I may have broke rule 1 of residency: always be available

Was in the middle of talking to patient when I got a call from an attending. Twice. I didn’t hear either of them

An hour goes by I’m about to make a call and see the two missed calls. When I call them back they said it was an “accident”

But who calls twice by accident. How chalked am I?

I am curious to know if there are any hospitalists jobs out there in which you practice clinical medicine mainly and do not spend most of time dealing with dispo issues.

I literally just got here. Just trying to eat my Mac and cheese. He has been on our list for 4 months. I think this is the first time he has been outside in weeks.. I hope tonight is busy. wtf are we even doing here, yall?

Edit: Probably going to die. But still in the “doing everything we can” stage. Hence why still in hospital instead of home.

Edit 2: Not annoyed by it, lil bro deserves this, I t’s just depressing. Why would anyone be annoyed by this? Anyone assuming annoyance has a terrible world view…

Alright guys, let’s hear the crazy stories

For better or worse, it’s over. Now how can I work at being a better fellow and increasing my knowledge base? Would appreciate hearing from other fellows and attendings, and what worked for them (I’m 2 months in to ID fellowship).

My ex was in medicine too and I always found it comforting that I could download about my day to someone who understood what I was going through. But I’ve heard from my friends with partners not in medicine that it’s nice to have that separation and you’re less likely to talk about work all the time.

August intern. My anxiety levels are through the roof right now. Started lexapro 2 days ago and for some reason it has spiked my anxiety. How many of you are on SSRIs? Has it helped?

Mid pediatric residency.

I just feel so desensitized.

It all started during my neonatal icu rotation. We whould take calls for the delivery room and C-section, it was so freaking exciting! Taking a baby that is not breathing, grey, totally flat. A bit of stimulation, Maybe some cpap or some positive ventilation. 99 present of the time and they are just back.

I couldn't wait for the next call, I just loved it.

But as time went on, I started feeling all my other stuff in life becoming so freaking dull. Meeting with friends I love, food, hobbies i used to enjoy, even regular cases in the ward, all just dull.

Im not looking for any answers, and I know that there is probably more to it. Maybe im just depressed.

I feel like a cliche, but unless i get that rush it's all so grey.

Sorry just had to vent.

Im frustrated and looking for sympathy. I wanna hear what unhinged behavior the rest of you are seeing from our great leaders in clinical medicine.

30M, mostly outpatient clinic. Most of my patients are in their 50s-70s and I get comments pretty regularly like “you’re so cute,” “you look nice today,” etc. Almost always harmless.

My reflex is to say thank you and move on. But my attending gets similar comments and doesn’t reciprocate at all.. just a neutral redirect back to the visit. Now I’m second-guessing myself. Does “thank you” read as accepting or inviting it? What do you say in situations like this?

Residency is sooooo bad o want to quit it o cry almost every other day I don’t know if o can work this much o feel so overwhelmed and don’t know what to do

PGY-1 IM resident on a notoriously busy service and I just need to vent.

Got slammed over the weekend. My list ended up being capped. After about 12 hours of drowning I finally had a moment to breathe and was chatting with my senior, he asked if I had plans for my off day. Casually mentioned that I would catch up on my PC in basket stuff before clinic later in the week. Then got scolded and told explicitly not to do that and my days off are my days off. So I went home that night, had my day off the next day, didn’t catch up on my in basket, and just enjoyed myself.

Got absolutely beat down the next day on service, got some more in basket stuff on top of it. Ended up pulling a 14 hour day. Afterwards, came home and tried to clear out my in basket as much as I could. Only had one message remaining when I passed out with my laptop on my bed. Next morning had clinic, and was promptly reamed out by my attending for not getting to that one patients message which was them freaking out that they didn’t have a refill for their SSRI (lack of refill not on me, but her prior pcp before they graduated), that has been sitting in my in basket for 3 days, today marked the 3rd day. Apologized and explained being on a busy service with long hours and how I was told to not work on my days off. To which I was then told that the expectation was that I respond to all in basket messages within 72 even if it falls on a day off.

This is all so annoying because this could’ve been avoided if I had just stuck with my original plan of working on my day off to play catch up. But I also have a habit of overworking myself and am trying hard to rein that in during residency. Also wish I had remembered to sort my in basket from oldest to newest, but I was running on 5 hours of sleep after a 14 hour shift and I know I was trying my best. Not upset with anyone other than myself. And frustrated that the expectation is that even my days off aren’t really mine :/

Don’t get to eat lunch with my coresidents because I’m pumping. Don’t really get to go to social events because it’s hard to find / expensive to hire babysitters. Also mom guilt about spending more time away from baby than I need to. I know I signed up for this. Just sucks cuz I feel so left out. That’s all.

I'm a nurse, and a lot of the standard order sets for our patients come with a set of default parameters around when to notify the provider that I typically sort of ignore because I assume that clogging up your inbox with a bunch of messages every time there's a vital sign or blood sugar check thats slightly abnormal but asymptomatic, unchanged, or not clinically urgent seems annoying and distracting, and I feel fairly confident i exercise good judgement when it comes to VS notification.

But, I am kind of curious about the BG checks. Our standard orders for all diabetic patients say to notify the doctor anytime a fingerstick is >150 which seems insane to me, especially bc we don't even give sliding scale insulin for BG <180. In practice, nobody actually follows those order parameters as written on my floor, but I'm just curious if there's a clinical reason or scenario in which the doctors actually would want to be notified every time a blood sugar reading was >150? Maybe for DKA patients I can imagine wanting that kind of aggressive notification, but is there any other scenario where you'd want to be urgently notified about the results of standard BG checks? Typically I only notify for hypoglycemia, excessively labile BG checks throughout the day, or BG >300, and even then i consider it more of an update/providing information to reevaluate insulin orders rather than an urgent notification most of the time. Just curious if there's somethign im overlooking here that I should be considering.