This.
Depends on where you do your fellowship, I do not think programs like stanford, Yale , Harvard, Johns Hopkins would let anyone in without any research exposure.
You think wrong. I know residents and fellows at 3 of the above without research or anything particularly unique or outstanding.
There’s your answer.
Dude no worries this is like every intern in every specialty ever.
Most fellowships programs do not emphasize research. Most fellowship programs focus on clinical competence, although some require QI projects. Not sure what you are talking about when saying "ones I know", though. You mean the fellows you know? Or people you know who have done research?
I would argue there is a large seperation between negligent and competent that is often labeled "incompetent". Negligence is more of an active avoidance of obvious clinical duties. Most people in general are not negligent, nor anywhere near negligent at their jobs, and physicians are no different. I think scaring interns into thinking that being less than competent constitutes as "negligence" will just lead to them feeling hesistant to acknowledge gaps in knowledge in fear of being labeled as "negligent".
There’s quite a bit of overlap between negligence and incompetence.
I have already done an intern year in my home country and worked as a doctor prior to coming to the USA. I have also worked in non-medicine fields. I can count very few people who have been negligent. Of course, I assume I am still younger than you, and I might have been lucky to be exposed to different quality of physicians and workers than you have, leading to different view-points.
I’ll give you that much. An “all negligent interns are incompetent, but not all incompetent interns are negligent” sort of thing.
I’m sorry you had to see those experiences. I agree that not reporting important information to attendings and not doing a proper follow-up when paged about a patient is negligent. I guess I was lucky that I have been exposed to trainees who haven’t done that or been in places where attendings or more experienced residents were more easily available.
I don’t think the examples you presented refer to someone being anywhere near “just competent”. I guess my final word on the matter is that I believe most medical professionals (trainee or otherwise), don’t make grossly uninformed medical decisions nor refuse to inform other physicians of important and vital information.
For sure! I work with a county population ... and psychiatry can often be one of the few medical professionals patients see. Keeping tabs on routine chronic medical conditions can be lifesaving for patients. Our inpatient unit is also separate from our main hospital system and knowing some general things from medicine wards has been helpful in managing medical conditions while people are inpatient (with internal medicine help, of course). Routine things like diabetes management, patients with new hypothyroidism, syphilis treatment, etc. etc.
I think a big area where it has been helpful is in consult work. One CL service we have is at a quaternary hospital so people are typically highly medically complex... meaning, if you need to use psychiatric interventions, you have to consider more than just if their kidney or liver function is normal. Knowing the language, being able to sift through the information, and keep on top of all of the medical management that is ongoing with your patients - all of this was more helpful having gone through medicine wards.
Nothing earth shattering and if it comes down to having to manage a medical condition, you're likely to get internal/family medicine involved anyway. But there's an extra level of absorbing knowledge/practice quirks that comes with being an intern vs. medical student on wards that I didn't really appreciate. Going through the slog that is the off-service months is tough but given that you're the main one ordering things, coming up with plans with the senior, implementing them, etc. - there's a higher level of retention there. And it's satisfying when you're on CL the next year and you realize you can focus more on the psych aspect of things and not be bogged down by trying to learn what's happening medically (or neurologically).
Hang in there! It will be tiring and you won't have time for much else. Learn what you can and you may find it coming up again in the not too distant future.
And on CL, we provide recommendations only for psychiatric management. But I found the best learning cases were those that were medically complex. So your awareness and knowledge of what was going on with them medically (including why the primary team was choosing the management they were choosing) was highly relevant to our work for the psychiatric issues. 
