452 reasons why residency sucks

[Doctor Bagel]

Having an officially sh*tty day as a resident and felt like starting this thread at an albeit bad time due to all that enthusiasm and excitement in the ROL world. Go applicants! Don't read this thread (or imagine that residency will be great if you get your top choice). And I really don't have 452 reasons, but hey, if you've got a reason, please share.

So here's what I've got:

1. You do all the work (or at least it feels that way). Worked on a huge team today, and guess who got to write all the notes. Awesome.

2. On the work note -- it can be punted to you, but you can't punt work to anyone.

3. Attendings -- sure, most of you are awesome, but I spend a good part of my day wondering what the heck you're doing since I feel like I'm doing all the work.

4. Med students -- most of you are also awesome, but I don't have time to thoroughly read all your work, teach you tons of stuff and provide thoughtful (albeit surely only positive) feedback

5. Administrative issues -- why do I have to submit 5 forms to get a vacation approved?!

6. My pager -- I don't need to elaborate on this one, do I?

7. I don't have an effing office for my clinic. Argh!

8. I've had entirely too many candy bars and chips on call and will likely die sooner than I should because of it.

9. Patients -- most of you are awesome, too, but one borderline who bounces back every 2 days while you're on inpatient can make life pretty darn miserable

10. Consulting teams -- I don't think I need to elaborate on this one, either?

11. The ED -- thanks for giving me signout on a patient you haven't even examined. Awesome.

12. Psych nurses --most of you are awesome, too, but can you not page me at 2 am for a laxative?!

13. Didactics -- thanks for making me feel guilty for not reading enough.

14. Direct loan people -- you guys really do suck. No trace of awesomeness there.

15. Working weekends = lame. I want my life back.

16. Duty hours reporting -- why is the hours logging system such a damn pain in the ass!

17. Evaluations for everything -- next, e-value will ask me to review my dinner.

18. Realizing that your promised fancy new call room is actually worse than your previous call room -- and that the call room switch was for the hospital to convert more prime real estate to something more lucrative and not really to help residents

OK, I'm wiped out. Any other residents got rants, or are we too happy of a crew around here?

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[Doctor Bagel]

OK, one more

19. I got home too late to buy my cat's special wet food and now she's staring at me and making occasional sad noises. It's the residency's fault, Bagel (see picture on the side -- she's pretty cute, huh). It's not that I'm a jerk. BTW, she does have food.

 

[belle54321]

I guess the excitement of ROL deadline must be tempered with the reality of residency life. This will be my second residency, (yes, I actually finished my first one) and your post definitely reminds me what being a resident was and will be like again.

One of my pet peeves is getting a "heads-up" from ER on someone they haven't worked up yet. Please, just call me when you have worked the patient up and that he/she really need to be seen.

Here's another one. There is always a co-resident who seems to just do the minimal amount of work, and gets away with it. In the meantime, you are working like a dog.

 

[F0nzie]

Nice list. Psych nurses on inpatient units that are poorly trained are very difficult to work with. Especially the ones that are transferred from medical floors looking for something "easy". Even though these patients are medically stable, they still need a lot of attention. From my experience, it doesn't seem like any amount of psychoeducation can get through to them if they lack the psychotherapeutic training and do not have any concept of psychodynamic principles. Rather than listening to patients, providing empathy, and setting boundaries with patients, instead they page us with a plethora of silly questions because they do not know how to establish a therapeutic alliance with them. It's a constant bombardment of pages with patients triangulating through the nursing staff because their needs are not being met. Most of these patients just need someone to talk to and unfortunately we are too busy putting out fires left and right and overburdened to spend any significant amount time with them after morning rounds. Often times when patients need to talk to someone, the nurses are sitting behind the fishbowl laughing their asses off, gossiping, and looking at Facebook profiles. It would be nice if our unit had more psych techs that could spend some time with the patients since most nurses seem so reluctant to participate in this type of work. I also feel nurses page us at 2am with worthless requests that can otherwise be addressed the next day because they don't have any respect for residents. My 2 cents on your rant.

 

[digitlnoize]

Nice list. Psych nurses on inpatient units that are poorly trained are very difficult to work with. Especially the ones that are transferred from medical floors looking for something "easy".

Even though these patients are medically stable, they still need a lot of attention. From my experience, it doesn't seem like any amount of psychoeducation can get through to them if they lack the psychotherapeutic training and do not have any concept of psychodynamic principles.

Rather than listening to patients, providing empathy, and setting boundaries with patients, instead they page us with a plethora of silly questions because they do not know how to establish a therapeutic alliance with them. It's a constant bombardment of pages with patients triangulating through the nursing staff because their needs are not being met.

Most of these patients just need someone to talk to and unfortunately we are too busy putting out fires left and right and overburdened to spend any significant amount time with them after morning rounds.

Often times when patients need to talk to someone, the nurses are sitting behind the fishbowl laughing their asses off, gossiping, and looking at Facebook profiles. It would be nice if our unit had more psych techs that could spend some time with the patients since most nurses seem so reluctant to participate in this type of work.

I also feel nurses page us at 2am with worthless requests that can otherwise be addressed the next day because they don't have any respect for residents. My 2 cents on your rant.

Yay. Can't wait for residency. Woo Hoo. Sigh.

I feel you on the psych nurses thing. Although, I can't imagine why ANYONE would be a psych nurse for the sake of easy work...lol.

I do think psych nurses should receive more training in therapy techniques, and have some empathy for the patients. How would they feel if they were trapped in a room, and their apparent gatekeepers were sitting behind glass talking and laughing.

It's not cool. I understand the need for some down time, and I love laughing at YouTube at work as much as the next guy...but do it where the patients can't see you, at least.

 

[TexasPhysician]

Definitely residency dependent. I'm having a pretty excellent time. WAY better than medical school!!!!!

 

[splik]

you seem to have had a fairly miserable 2 years of residency. it sounds like much of woes are part of inpatient psychiatry and unforseen problems in your program. hopefully when you get to outpatient year you will enjoy yourself more.

 

[OldPsychDoc]

...

3. Attendings -- sure, most of you are awesome, but I spend a good part of my day wondering what the heck you're doing since I feel like I'm doing all the work.
...

We're in our office taking calls from the guy you discharged on your last rotation who is going to "sue the hospital if you don't get my bill cancelled because all you did was push pills at me and didn't help me at all...", reviewing the documentation that clearly indicated that we told him his life would probably be more managable if he stopped smoking pot BID, and making multiple calls to the Patient Rep and social work to attempt to prevent him from filing a lawsuit that is going to REALLY make his life unhappy...

Point being...our name is The Name On The Chart, and we don't get to rotate to a new service next month.

I feel your pain, and hope that today is a better day for you and your kitty.

 

[heyjack70]

Well at least you're not a garbage collector. Then your job would really 'stink'. Ha!

But you'd probably get paid more and have weekends off.

 

[Doctor Bagel]

you seem to have had a fairly miserable 2 years of residency. it sounds like much of woes are part of inpatient psychiatry and unforseen problems in your program. hopefully when you get to outpatient year you will enjoy yourself more.

Misery tends to make me post more, so you see me at my most pissed off. Just had a really ugly day yesterday on a rotation that's supposed to be so great because we've got this huge team and all this reported support, when I realized the reality was that the support meant other people could tell me things but that I still had to stay late and write all the notes. Silly me for forgetting that when there's work to be done, the resident has to do it. Jeez, I guess I'm still mad.

Other reason why residency (particularly psych residency sucks) -- we rarely get to work on teams with other residents, which means you can't vent to anyone throughout the day.

 

[Doctor Bagel]

We're in our office taking calls from the guy you discharged on your last rotation who is going to "sue the hospital if you don't get my bill cancelled because all you did was push pills at me and didn't help me at all...", reviewing the documentation that clearly indicated that we told him his life would probably be more managable if he stopped smoking pot BID, and making multiple calls to the Patient Rep and social work to attempt to prevent him from filing a lawsuit that is going to REALLY make his life unhappy...

Point being...our name is The Name On The Chart, and we don't get to rotate to a new service next month.

I feel your pain, and hope that today is a better day for you and your kitty.

I'm sure you guys actually do do something. Some days it just feels like you exist to take up my time and not offer to help, though. But then I know you're stretched as well, which is probably why it feels that way.

I'm hoping for a better day, too, but I've got a feeling all the work that accumulates while I'm in clinic this morning will again get punted to me.

 

[Doctor Bagel]

Well at least you're not a garbage collector. Then your job would really 'stink'. Ha!

But you'd probably get paid more and have weekends off.

Sadness.

 

[Doctor Bagel]

I guess the excitement of ROL deadline must be tempered with the reality of residency life. This will be my second residency, (yes, I actually finished my first one) and your post definitely reminds me what being a resident was and will be like again.

One of my pet peeves is getting a "heads-up" from ER on someone they haven't worked up yet. Please, just call me when you have worked the patient up and that he/she really need to be seen.

Here's another one. There is always a co-resident who seems to just do the minimal amount of work, and gets away with it. In the meantime, you are working like a dog.

We get those heads up calls, too, and heads up consult calls as well, which are all lame.

Wow, can't believe you're going back for more. I'm thinking residency ranks pretty high on my list of miserable experiences.

 

[Doctor Bagel]

Nice list. Psych nurses on inpatient units that are poorly trained are very difficult to work with. Especially the ones that are transferred from medical floors looking for something "easy". Even though these patients are medically stable, they still need a lot of attention. From my experience, it doesn't seem like any amount of psychoeducation can get through to them if they lack the psychotherapeutic training and do not have any concept of psychodynamic principles. Rather than listening to patients, providing empathy, and setting boundaries with patients, instead they page us with a plethora of silly questions because they do not know how to establish a therapeutic alliance with them. It's a constant bombardment of pages with patients triangulating through the nursing staff because their needs are not being met. Most of these patients just need someone to talk to and unfortunately we are too busy putting out fires left and right and overburdened to spend any significant amount time with them after morning rounds. Often times when patients need to talk to someone, the nurses are sitting behind the fishbowl laughing their asses off, gossiping, and looking at Facebook profiles. It would be nice if our unit had more psych techs that could spend some time with the patients since most nurses seem so reluctant to participate in this type of work. I also feel nurses page us at 2am with worthless requests that can otherwise be addressed the next day because they don't have any respect for residents. My 2 cents on your rant.

We're lucky in that we have some really great, super experienced nurses who unfortunately are all retiring within the next few years. However, yeah, we've got some just like you describe, too. Staff splitting also seems to be an especially common issue in our part of the world, which is always fun.

 

[Doctor Bagel]

OK, to break from my habit on only posting bummer things (although my list was intended to be somewhat humorous), I actually had a good day today with a really supportive attending and all that. So maybe we can strike attendings from the list. OK, maybe not because what resident doesn't occasionally hate their attendings. Or the ED. Or medical students.

 

[Doctor Bagel]

Definitely residency dependent. I'm having a pretty excellent time. WAY better than medical school!!!!!

So do you think you have a fairly sanguine temperament, or is residency just a better experience for you? I suspect significant chunks of residency would be miserable wherever you are but maybe there are differences?

 

[beezley]

Life looks better now during a winding down 3rd year versus in the middle of 1st or 2nd. I think it depends where you are at and when/how the call is. Sorry that things are currently rough for you and the kitty. Certainly have been there.

Have to say as an intern I wondered about what my inpatient attendings were doing all day too. Now doing more outpatient they seem just as busy with their own patients as they are supervising us.

I don't really think the work ever gets easier. It seems like there is just always more to do at every level but at least the compensation gets better.

 

[sunlioness]

Point being...our name is The Name On The Chart, and we don't get to rotate to a new service next month.

I really miss that sometimes. It was nice in residency when I was having a particularly miserable time to be able to say, "Well, at least I only have X long to go before I get to do something else for a while." It was kind of disheartening, too, to become an attending and realize I had to work harder and bore final responsibility for everything. The money's way better though. And I don't miss having to spend upwards of 24 hours awake in a hospital. And I can choose my own practice setting now. If I don't like what I'm doing or where I'm doing it, I can always decide to do something else or go somewhere else. So all in all, I don't think I really want to go back to being a resident.

Hope you have a better day tomorrow, Doc Bagel.

 

[TexasPhysician]

So do you think you have a fairly sanguine temperament, or is residency just a better experience for you? I suspect significant chunks of residency would be miserable wherever you are but maybe there are differences?

I enjoy it. Excellent faculty. Time for teaching med students. Moonlighting in PGY-2. Friendly fellow residents. It's pretty cool.

 

[harmnot]

Having an officially sh*tty day as a resident and felt like starting this thread at an albeit bad time due to all that enthusiasm and excitement in the ROL world. Go applicants! Don't read this thread (or imagine that residency will be great if you get your top choice). And I really don't have 452 reasons, but hey, if you've got a reason, please share.

So here's what I've got:

1. You do all the work (or at least it feels that way). Worked on a huge team today, and guess who got to write all the notes. Awesome.

2. On the work note -- it can be punted to you, but you can't punt work to anyone.

3. Attendings -- sure, most of you are awesome, but I spend a good part of my day wondering what the heck you're doing since I feel like I'm doing all the work.

4. Med students -- most of you are also awesome, but I don't have time to thoroughly read all your work, teach you tons of stuff and provide thoughtful (albeit surely only positive) feedback

5. Administrative issues -- why do I have to submit 5 forms to get a vacation approved?!

6. My pager -- I don't need to elaborate on this one, do I?

7. I don't have an effing office for my clinic. Argh!

8. I've had entirely too many candy bars and chips on call and will likely die sooner than I should because of it.

9. Patients -- most of you are awesome, too, but one borderline who bounces back every 2 days while you're on inpatient can make life pretty darn miserable

10. Consulting teams -- I don't think I need to elaborate on this one, either?

11. The ED -- thanks for giving me signout on a patient you haven't even examined. Awesome.

12. Psych nurses --most of you are awesome, too, but can you not page me at 2 am for a laxative?!

13. Didactics -- thanks for making me feel guilty for not reading enough.

14. Direct loan people -- you guys really do suck. No trace of awesomeness there.

15. Working weekends = lame. I want my life back.

16. Duty hours reporting -- why is the hours logging system such a damn pain in the ass!

17. Evaluations for everything -- next, e-value will ask me to review my dinner.

18. Realizing that your promised fancy new call room is actually worse than your previous call room -- and that the call room switch was for the hospital to convert more prime real estate to something more lucrative and not really to help residents

OK, I'm wiped out. Any other residents got rants, or are we too happy of a crew around here?

I have been reading your threads of woes and I swear we must be in the same residency program I keep telling myself things will get bettter...at least thats what I told myself last year and guess how far that got me. I look foward to reading from your post cause its proof that this is not all in my head.

 

[masterofmonkeys]

Here's one, when you compute your hourly wage, you realize this is one of the lowest paying jobs you've ever worked. Even worse when you think about how AS AN INTERN, you've already got more training than a PA or NP pulling down more than double.

This only gets worse when you consider the amount the hospital actually bills for your work...

 

[digitlnoize]

Here's one, when you compute your hourly wage, you realize this is one of the lowest paying jobs you've ever worked. Even worse when you think about how AS AN INTERN, you've already got more training than a PA or NP pulling down more than double.

This only gets worse when you consider the amount the hospital actually bills for your work...

I did this recently, in another post, and it was between $10-16 per hour, depending on hours worked. I think the 10 was for 45k hitting the work hour limits and the 16 was for 50k doing 60h weeks.

Still, it's far from the lowest paying job I've worked. In fact, it's the HIGHEST paying job I've ever worked.

My YEARLY residency salary will be 2x my salary prior to med school. My hourly will likely be ~$4/hr higher than my highest paying full-time job ($12/hr).

I agree that it sucks that we're making less than NPs/PAs with less training, which is why the system needs to be overhauled...that just doesn't make any sense. Residents are, functionally, mid-level providers on their way to becoming top level providers, and should be treated at least as well as the other mid-levels.

I've said it before and I'll say it again. We need a complete overhaul of our education system, ESPECIALLY the medical education system. The pathway is too long, too grueling, too expensive, dangerous for the patients, and unfair to the people who make it go. We are losing very good people to other fields because of it.

I have one friend in particular who rocked her MCAT (>35), was accepted to many med schools, is a genius and would probably cure cancer or something...did not go to med school. Why? Wanted a normal life, a family, money, etc, etc. All the things I mentioned. Her loss is a serious blow to our profession, and a boon to someone else's. Now, her talent is being wasted schlepping networking products for big business, and she's making >200k/year doing it. We lose. There are thousands like her.

We can, and must fix it. We're supposed to be the most brilliant minds around. Let's prove it and fix it.

 

[Dr. Ducky]

i did this recently, in another post, and it was between $10-16 per hour, depending on hours worked. I think the 10 was for 45k hitting the work hour limits and the 16 was for 50k doing 60h weeks.

Still, it's far from the lowest paying job i've worked. In fact, it's the highest paying job i've ever worked.

My yearly residency salary will be 2x my salary prior to med school. My hourly will likely be ~$4/hr higher than my highest paying full-time job ($12/hr).

I agree that it sucks that we're making less than nps/pas with less training, which is why the system needs to be overhauled...that just doesn't make any sense. Residents are, functionally, mid-level providers on their way to becoming top level providers, and should be treated at least as well as the other mid-levels.

I've said it before and i'll say it again. We need a complete overhaul of our education system, especially the medical education system. The pathway is too long, too grueling, too expensive, dangerous for the patients, and unfair to the people who make it go. We are losing very good people to other fields because of it.

I have one friend in particular who rocked her mcat (>35), was accepted to many med schools, is a genius and would probably cure cancer or something...did not go to med school. Why? Wanted a normal life, a family, money, etc, etc. All the things i mentioned. Her loss is a serious blow to our profession, and a boon to someone else's. Now, her talent is being wasted schlepping networking products for big business, and she's making >200k/year doing it. We lose. There are thousands like her.

We can, and must fix it. We're supposed to be the most brilliant minds around. Let's prove it and fix it.

+1 (x 10)

 

[LEdaddy]

Having an officially sh*tty day as a resident and felt like starting this thread at an albeit bad time due to all that enthusiasm and excitement in the ROL world. Go applicants! Don't read this thread (or imagine that residency will be great if you get your top choice). And I really don't have 452 reasons, but hey, if you've got a reason, please share.

So here's what I've got:

1. You do all the work (or at least it feels that way). Worked on a huge team today, and guess who got to write all the notes. Awesome.

2. On the work note -- it can be punted to you, but you can't punt work to anyone.

3. Attendings -- sure, most of you are awesome, but I spend a good part of my day wondering what the heck you're doing since I feel like I'm doing all the work.

4. Med students -- most of you are also awesome, but I don't have time to thoroughly read all your work, teach you tons of stuff and provide thoughtful (albeit surely only positive) feedback

5. Administrative issues -- why do I have to submit 5 forms to get a vacation approved?!

6. My pager -- I don't need to elaborate on this one, do I?

7. I don't have an effing office for my clinic. Argh!

8. I've had entirely too many candy bars and chips on call and will likely die sooner than I should because of it.

9. Patients -- most of you are awesome, too, but one borderline who bounces back every 2 days while you're on inpatient can make life pretty darn miserable

10. Consulting teams -- I don't think I need to elaborate on this one, either?

11. The ED -- thanks for giving me signout on a patient you haven't even examined. Awesome.

12. Psych nurses --most of you are awesome, too, but can you not page me at 2 am for a laxative?!

13. Didactics -- thanks for making me feel guilty for not reading enough.

14. Direct loan people -- you guys really do suck. No trace of awesomeness there.

15. Working weekends = lame. I want my life back.

16. Duty hours reporting -- why is the hours logging system such a damn pain in the ass!

17. Evaluations for everything -- next, e-value will ask me to review my dinner.

18. Realizing that your promised fancy new call room is actually worse than your previous call room -- and that the call room switch was for the hospital to convert more prime real estate to something more lucrative and not really to help residents

OK, I'm wiped out. Any other residents got rants, or are we too happy of a crew around here?

Do your fellow residents seem as miserable about all of this as you are?

 

[Doctor Bagel]

I have been reading your threads of woes and I swear we must be in the same residency program I keep telling myself things will get bettter...at least thats what I told myself last year and guess how far that got me. I look foward to reading from your post cause its proof that this is not all in my head.

Yeah, residency! It's nice to know other people out there in the world feel the same way. Not to say my experience is at all House of God esq, but that book was written (and hugely popular) for a reason.

 

[Doctor Bagel]

Do your fellow residents seem as miserable about all of this as you are?

We do bitch a lot, which is residency. It's normal. I think those complaints I mentioned above would be shared by all my colleagues, yes.