Your first day of residency

[Obedeli]

Mine sucked. I worked 45 hours in the first 3 days. It wasn't due to the program, it was because I was new to the facility and my first day was a long call. I had to get used to admissions, dictating, and looking up old records. I really truly thought I would never leave. In those first three days I noticed my co-interns were all thinking the same thing... "did I make a mistake by going into medicine?" I thought I would not be able to take it if the rest of the year turned out like the first three days.
It didn't.
The rest of year has had its highs and lows but overall it has been manageable. I am just sharing this with all of you new to-be-interns. Don't get demotivated by the first couple of days, it does get better unless you are in surgery
j/k *


*disclaimer: I am not in surgery

---

Members don't see this ad.

 

[penguins]

Mine sucked. I worked 45 hours in the first 3 days. It wasn't due to the program, it was because I was new to the facility and my first day was a long call. I had to get used to admissions, dictating, and looking up old records. I really truly thought I would never leave. In those first three days I noticed my co-interns were all thinking the same thing... "did I make a mistake by going into medicine?" I thought I would not be able to take it if the rest of the year turned out like the first three days.
It didn't.
The rest of year has had its highs and lows but overall it has been manageable. I am just sharing this with all of you new to-be-interns. Don't get demotivated by the first couple of days, it does get better unless you are in surgery
j/k *


*disclaimer: I am not in surgery

I just hope I don't kill anyone the first day!
Thanks for the encouragement - I need it!

 

[APACHE3]

That was nice post..by the way, which button turns on the dictation machine?

 

[Obedeli]

That was nice post..by the way, which button turns on the dictation machine?

What really blows is when you go to hit the pause number on a dictation and you accidently it "complete."
ARGGGGGGGGGGGGGGGGGGGGGGGGGGGG

 

[Blade28]

My first week was rough - around 115 hours, I think. But I was lucky to have a very supportive team during that month (surg onc) to help me with the floor. I also got in my first case, a wire loc breast excisional biopsy!

 

[ears]

My first day of internship I was on-call in the MICU. I got one lady in the morning, who had been resuscitated after a cardiac arrest. Her family agreed to withdraw care, and she died in the late afternoon. I had another lady who was resuscitated after an arrest; it seems like she had some kind of vascular catastrophe somewhere, and she died in the early evening. It turns out there's a lot of paperwork for people who die on you like that, especially when they haven't been in the hospital for 24 hours.

Then in the evening, I got a bolus of three patients: one lady with hyponatremia (110), which turned out to be psychogenic. I did the world's worst H&P on her, and basically ignored her. I got a shambles from a rehab: chronically trached, chronically infected, chronically almost no mental status. Just sorting through all of his issues and entering his orders took forever.

And I got one post-op urology patient (who due to a vagary of the system, is cared for overnight by the MICU team, which is to say, me). She turned out to be really, really sick. The blood samples we got kept coming back hemolyzed, and it took a long time to figure out that it was because she was hemolyzing intravascularly. She went into hyperkalemic arrest at 4am or so, and died after a forty-five minute code. That was a whole bunch of paperwork, too.

I was still working on the sequelae of all of that when the team showed up to round at 7am. I left at around 10am after rounds to go home, and I wanted to quit medicine; I thought I just wouldn't be able to do it. I went home and slept and felt somewhat better. I came in the day after that, and talked to my residents and the ICU attending, and was encouraged by them. That helped a lot, too.

The shambles guy died in the unit a week later. The hyponatremia lady is fine, I guess; I've wondered whether I should warn her that she's the only one of my five admissions who survived the month.

I've never had another night that was anywhere near as difficult, both because that was an unusually hard night and because I'm smarter and more experienced now. I still feel bad about the hyperkalemic arrest. If I was only a couple of weeks smarter, I might have prevented her death that night. I wouldn't have made a lot of difference; her prognosis was terrible. But letting one's patient die in hyperkalemic arrest is just bad form.

I know this: I'm a better doctor for that day. (But I sure wouldn't want to go through it again. )

 

[DrRobert]

I still feel bad about the hyperkalemic arrest. If I was only a couple of weeks smarter, I might have prevented her death that night. I wouldn't have made a lot of difference; her prognosis was terrible. But letting one's patient die in hyperkalemic arrest is just bad form.

What would you have done differently? Were there peaked T waves on EKG/telemetry that you missed?

 

[glorytaker]

Holy Crap! I'm starting with ICU first. I'm going to get my butt kicked.

On another note, what did you do for the hyperkalemic code? A bunch of Insulin, Bicarb, Calcium and Kayexelate?

 

[Mumpu]

There is a lot to be said for going to residency at the same place where you did med school.

I'm sorry you had such a rough start Ears (which penguins don't really have... I don't think ). That really sucks.

Intravascular hemolysis = hyperkalemia. I wish "old school" stuff like doing your own peripheral smears was still taught -- a manual diff can take hours, especially at night. Schistocytes on a peripheral smear would give you the diagnosis in seconds. Looking at urine sediment could be very helpful as well, although a little nonspecific in this case (your ddx is myoglobin vs hemoglobin vs AIP). I once called rhabdo from urine sediment before it even made it onto our ddx.

Glory, I don't think kayexelate will help you much during a code. "Poop dammit! Poop!" Calcium, insulin, glucose, rinse, repeat. My impression is that the bicarb and beta agonist evidence is soft but I've been wrong before and over and over and over again.

 

[14022]

I still feel bad about the hyperkalemic arrest. If I was only a couple of weeks smarter, I might have prevented her death that night.

Where the heck were the upper level residents or fellows to help you out with this? There is no way you can blame yourself for this when it was your first day, even first year, of residency. It is your program's responsibility to make sure you have adequate help to make up for your lack of experience. It sounds to me like the hospital and residency program let this poor lady down.

 

[DOtobe]

What really blows is when you go to hit the pause number on a dictation and you accidently it "complete."
ARGGGGGGGGGGGGGGGGGGGGGGGGGGGG

I hate when I do this...

I was scared to death on my first day of internship, because my first rotation was surgery - and I hadn't had surgery since my MS-3 year. I was just dreading my first cross cover call from the floors. My first call from the floor was about a pt who was tachycardic, and I freaked and immediately called my chief resident, telling her, "They say he's tachycardic, what should I do?" She replied, "Um, did you go see the patient?" In my panic I hadn't thought of that.

It's amazing how steep the learning curve is in internship. I still am nervous to be a senior resident (I'm scared to run a code), but it's amazing how much more I know now compared to when I started.

 

[ears]

Thanks for thoughts of support. I don't want to get into (another) post-mortem of her case, certainly not in this forum. Scholes insightfully put his finger right on the key point: insufficient senior-level support during the crisis.

But my point in sharing the story were the lessons I learned:

• You can survive an incredible butt-kicking on call, even situations that seem overwhelming as you think about them right now;
• You need to be totally comfortable telling your seniors when you feel like things are getting hairy; and
• Everyone gets Kayexalate (ha, ha, only serious).

You can definitely get through the first day. Just keep figuring out the next thing to do, and doing it. Even if it sucks, you'll at least get a good story out of it.

 

[CANES2006]

There is a lot to be said for going to residency at the same place where you did med school.

I'm hoping to bank on this.

 

[glorytaker]

There is a lot to be said for going to residency at the same place where you did med school.

I'm sorry you had such a rough start Ears (which penguins don't really have... I don't think ). That really sucks.

Intravascular hemolysis = hyperkalemia. I wish "old school" stuff like doing your own peripheral smears was still taught -- a manual diff can take hours, especially at night. Schistocytes on a peripheral smear would give you the diagnosis in seconds. Looking at urine sediment could be very helpful as well, although a little nonspecific in this case (your ddx is myoglobin vs hemoglobin vs AIP). I once called rhabdo from urine sediment before it even made it onto our ddx.

Glory, I don't think kayexelate will help you much during a code. "Poop dammit! Poop!" Calcium, insulin, glucose, rinse, repeat. My impression is that the bicarb and beta agonist evidence is soft but I've been wrong before and over and over and over again.

Yeah, I know that pooping isn't going to help immediately but I was thinking of getting rid of it eventually, even if it's half an hour later. I mean, insulin, calcium and bicarb only covers the fire, it doesn't put it out.

Also, what's wrong with doing residency at the place you did med school? It is a bad thing? 'Cuz that's what I'm doing.

 

[toofache32]

I just hope I don't kill anyone the first day!
Thanks for the encouragement - I need it!

Killing someone the first day is definately bad. At least wait until day 4.

 

[Obedeli]

Yeah, I know that pooping isn't going to help immediately but I was thinking of getting rid of it eventually, even if it's half an hour later. I mean, insulin, calcium and bicarb only covers the fire, it doesn't put it out.

Also, what's wrong with doing residency at the place you did med school? It is a bad thing? 'Cuz that's what I'm doing.

There is nothing wrong with doing residency at your home school. As a matter of fact, it helps in that first week or so because you know how things get done (which orders require phone calls, which consults require phone calls, where do the orders go, where the heck are the MARS or vitals, what floors have good nursing, who are these nurses, where is the ER, how do you admit, where am I, who are you?)
Does this help?

 

[Skrubz]

My advice, watch the first episode of Scrubs the night before your first day and tell yourself that it can't be *that* bad. Then watch it again after you get home and laugh at the similarities.

 

[Blade28]

My advice, watch the first episode of Scrubs the night before your first day and tell yourself that it can't be *that* bad. Then watch it again after you get home and laugh at the similarities.

I couldn't sleep the night before my first day, especially since I had to present 14 patients to the chief that morning. I ended up watching that episode of Scrubs 3 times - great stuff! (I'd seen it before, obviously, so knew how great it was.)

 

[inositide]

Ear, you wrote that after speaking with the icu attending and your seniors the day after you felt better. What exactly did you say to them?

 

[CANES2006]

What exactly did you say to them?

You guys suck?

 

[Mumpu]

No, I think going to a home residency is a good thing. I'm doing it.

 

[8744]

You know what sucks? The utter contempt many attendings and upper-level residents have for my free time. Obviously many of them have no lives outside the hospital so they have no interest in using time efficiently or making timely decisions.

And call is stupid. Yeah, I know, you learn by admitting patients blah blah blah. Medicine needs to go to a shift system in residency. Losing sleep is pointless. Medicine has changed considerably from the days when residents actually resided in the hospital. Things moved slower and they got more sleep even on call.

 

[ears]

Ear, you wrote that after speaking with the icu attending and your seniors the day after you felt better. What exactly did you say to them?

I just reconstructed the the situation, and described how things had gone down. (I'd already gotten over wanting to quit.) They reassured me that the situation had been very difficult, and that my performance had been acceptable for my level (that is, 20 hours into internship). They also told me that if I feel like my senior isn't in control of the situation, I should make sure the attending gets called early. When it comes right down to it, that's the thing I absolutely should have known to do that I failed to do. I've never made that mistake again.

 

[DrNick2006]

Holy Crap! I'm starting with ICU first. I'm going to get my butt kicked.

On another note, what did you do for the hyperkalemic code? A bunch of Insulin, Bicarb, Calcium and Kayexelate?

OBviously not - the patient arrested

 

[penguins]

I couldn't sleep the night before my first day, especially since I had to present 14 patients to the chief that morning. I ended up watching that episode of Scrubs 3 times - great stuff! (I'd seen it before, obviously, so knew how great it was.)

I downloaded and watched that first episode last night. I had never seen it, it made me nauseous - while my husband was laughing I was having visions of not being able to start an IV!!!

 

[ears]

I downloaded and watched that first episode last night. I had never seen it, it made me nauseous - while my husband was laughing I was having visions of not being able to start an IV!!!

My experience---hellish though it was on that first day---has universally been that the people around me in the hospital want me to succeed. Any time I've needed help, it's been there for the asking.

You probably will be able to start that IV, but if not, someone will be there to help you.

And people don't mention this enough---being an intern is fun. (Believe me, I know all of the ways it sucks, but I stand by my statement.) You're learning so much stuff so fast, and you're able to actually do more and more things as you go along. It's a cool job.

 

[Blade28]

I still have problems starting IVs on some patients, especially the ones who are dehydrated, old, have had multiple IVs blow out in the past, and have bad diabetes/peripheral vascular disease.

 

[ericdopt]

And call is stupid. Yeah, I know, you learn by admitting patients blah blah blah. Medicine needs to go to a shift system in residency. Losing sleep is pointless. Medicine has changed considerably from the days when residents actually resided in the hospital. Things moved slower and they got more sleep even on call.

I agree that, for the most part, call is pretty stupid. Especially for those of us not going into medicine. Yes, I know how important medicine is to everything. But, I agree that being on call is pretty low yield after month 3. Little learning has been done at night by me. Most attendings either 1)don't call back or 2)ask why they hell are you bothering them! I actually had one interupt me to ask, "do you have a question". I was trying to let him know he had a patient in the hospital and what I found/did/etc. Pretty lame, I thought. I cannot think straight at 3 am, I miss easy stuff that I should know (upon review the next am.)

 

[Mumpu]

Most attendings I've worked with (except for a few old-schoolers) do respect the residents' time. Sit down rounds and breakfast post-call are always appreciated. If you can't teach on the fly while making efficient rounds, you can't teach. And shouldn't. And no, you cannot pull up another ^&%& Powerpoint on your laptop.

The county hospital in my almost-there! program uses a shift system. Funny thing is, residents who used to take call there like it. Interns who started under the shift system complain that they would've preferred the call.

I think intern year will be a lot of fun. I have no anxiety at all -- just really psyched.

 

[radonc]

I agree that, for the most part, call is pretty stupid. Especially for those of us not going into medicine. Yes, I know how important medicine is to everything. But, I agree that being on call is pretty low yield after month 3. Little learning has been done at night by me. Most attendings either 1)don't call back or 2)ask why they hell are you bothering them! I actually had one interupt me to ask, "do you have a question". I was trying to let him know he had a patient in the hospital and what I found/did/etc. Pretty lame, I thought. I cannot think straight at 3 am, I miss easy stuff that I should know (upon review the next am.)

are you serious? the best learning i ever received was taking care of a crashing patient by myself (ie analyzing data, giving orders/meds, etc) before i called anyone else. yeah, it sucks to be up at 3am, but the more patients you see/situations you are involved in, the more on-the-job training you get.

the 80 hour work week is ridiculous. whats next? 40 hour work weeks? in france, their residents are on a strict 40 hour work week. and the EU is considering making it mandatory...the US is not far behind.

talk to your attendings (old timers) about what it was like back when they trained. people now-a-days (including myself) arent nearly as well trained as docs back then...

 

[penguins]

are you serious? the best learning i ever received was taking care of a crashing patient by myself (ie analyzing data, giving orders/meds, etc) before i called anyone else. yeah, it sucks to be up at 3am, but the more patients you see/situations you are involved in, the more on-the-job training you get.

the 80 hour work week is ridiculous. whats next? 40 hour work weeks? in france, their residents are on a strict 40 hour work week. and the EU is considering making it mandatory...the US is not far behind.

talk to your attendings (old timers) about what it was like back when they trained. people now-a-days (including myself) arent nearly as well trained as docs back then...

Are you serious? France has a 40-hour work week for residents!!!??? Wowzers! They are even crazier over there than I thought. I think 120 was extreme (not for me) and 80 sounds just about right. I can't imagine 40 - I couldn't even get those hours as a chemist when I ran my own little lab area! No body works just 40 hrs anymore! Wow.

 

[SoCuteMD]

are you serious? the best learning i ever received was taking care of a crashing patient by myself (ie analyzing data, giving orders/meds, etc) before i called anyone else. yeah, it sucks to be up at 3am, but the more patients you see/situations you are involved in, the more on-the-job training you get.

the 80 hour work week is ridiculous. whats next? 40 hour work weeks? in france, their residents are on a strict 40 hour work week. and the EU is considering making it mandatory...the US is not far behind.

talk to your attendings (old timers) about what it was like back when they trained. people now-a-days (including myself) arent nearly as well trained as docs back then...

This coming from the person with the username "radonc".

 

[Mumpu]

Remember, Europeans in general make less money than equivalent Americans. On a hunch, I would guess that working considerably less probably has something to do with it.

 

[CameronFrye]

talk to your attendings (old timers) about what it was like back when they trained. people now-a-days (including myself) arent nearly as well trained as docs back then...

Yeah, talk to them. Ask them what it was like to have patients hanging around in the hospital for weeks on end with nothing really happening.

Medicine has changed over the years. In general, the patients are now sicker, there are more interventions, there are quicker turnaround times, etc. All of this leads to harder call nights.

 

[8744]

Yeah, talk to them. Ask them what it was like to have patients hanging around in the hospital for weeks on end with nothing really happening.

Medicine has changed over the years. In general, the patients are now sicker, there are more interventions, there are quicker turnaround times, etc. All of this leads to harder call nights.

Right. My current serivce with a census of about twenty turns over almost completely every three days or so. I repeat, the standard hospital stay for an MI back in the sixties was three weeks . Today, three days is considered excessive.

You cannot get "used" to going without sleep. It effects you how it effects you. I bet I have gone without sleep more than anyone on this forum by virtue of my almost eight-year service as a Marine Infantryman and I never got used to it, just learned to suck it up.

This is not the Marines. It's just a friggin' job. If they had to pay us overtime they'd be a lot more careful with our time.

 

[8744]

are you serious? the best learning i ever received was taking care of a crashing patient by myself (ie analyzing data, giving orders/meds, etc) before i called anyone else. yeah, it sucks to be up at 3am, but the more patients you see/situations you are involved in, the more on-the-job training you get.

the 80 hour work week is ridiculous. whats next? 40 hour work weeks? in france, their residents are on a strict 40 hour work week. and the EU is considering making it mandatory...the US is not far behind.

talk to your attendings (old timers) about what it was like back when they trained. people now-a-days (including myself) arent nearly as well trained as docs back then...

I've got no objection being up at 3 AM. In fact, I rather like it as the hospital is empty of the usual distractions and you get to do a lot more. I love shift work which is why I matched into EM (starting in July, thank God, although I do have to repeat intern year).

I would like to get eight hours of sleep every night. And a day off now and then without it being considered some great friggin' privalege. Not to mention that the hospital won't crumble if we pause for a decent lunch with the team.

And I'd take your argument more seriously if so much of the eighty hour week wasn't wasted on absolutely pointless paperwork.

 

[Obedeli]

Hey! Wha' happened?!??!?!

(ala Best in Show )
This became the ol' anti-80 hour vs no-80 hour?!?! This debate has no end and is easily based on one's situation at the time of resicency (i.e. generally, those with families like myself, would deteriorate if I lived at the hospital and never saw my kids). NOBODY is going to change ANYONE's mind on this. It is a waste of time and energy. It should be shelved away in the MD vs DO, outsourcing of radiology, mac vs. pc, pepsi vs coke, yada ya da ya...da.
My point of this thread was to encourage those getting ready to make that giant transition of slack 4th years to code jumping interns. It is a tough time and I thought that others could share their experience.

 

[8744]

Hey! Wha' happened?!??!?!

(ala Best in Show )
This became the ol' anti-80 hour vs no-80 hour?!?! This debate has no end and is easily based on one's situation at the time of resicency (i.e. generally, those with families like myself, would deteriorate if I lived at the hospital and never saw my kids). NOBODY is going to change ANYONE's mind on this. It is a waste of time and energy. It should be shelved away in the MD vs DO, outsourcing of radiology, mac vs. pc, pepsi vs coke, yada ya da ya...da.
My point of this thread was to encourage those getting ready to make that giant transition of slack 4th years to code jumping interns. It is a tough time and I thought that others could share their experience.

True. But I think with more non-traditional medical students matricualting and entering residency training even the 80-hour week will fall. Something similar happened in the Marines even in my brief career. As you may know, we used to spend a lot of time cleaning the barracks, doing menial work details (the equivalent of "scut") and generally living as if it was the 1940s.

I lived in a squadbay (a long, open room with bunks) for the first four years of my career and had the usual gaurd and mess duty to contend with.

As more married guys enlisted (or got married after enlisting) the tolerance for this kind of thing went way down and was reflected in retention. Nobody wanted to stay in and live like that . So the Marines built better barracks, upgraded the mess-halls, become more aware of their Marine's family obligations (I mean, as much as possible. It's still the Marines.) and tried to make things more livable, wihtout I might add taking anything away from real miltary training which has continued to improve since my discharge.

Residency is a tougher nut to crack as the people in charge are often-times terrible leaders and incredibly pig-headed. (which is not typical at all of Marine officers) Still, with the material benefits of being a doctor decreasing there may come a time when quality people will even want to go to medical school much less work the benign 80-hour week.

I have worked eighty hour weeks as a civilian but I was paid for it.

 

[mysophobe]

If you can't tolerate the 80-hour work week, go into a different profession. Try nursing.

 

[Obedeli]

True. But I think with more non-traditional medical students matricualting and entering residency training even the 80-hour week will fall. Something similar happened in the Marines even in my brief career. As you may know, we used to spend a lot of time cleaning the barracks, doing menial work details (the equivalent of "scut") and generally living as if it was the 1940s.

I lived in a squadbay (a long, open room with bunks) for the first four years of my career and had the usual gaurd and mess duty to contend with.

As more married guys enlisted (or got married after enlisting) the tolerance for this kind of thing went way down and was reflected in retention. Nobody wanted to stay in and live like that . So the Marines built better barracks, upgraded the mess-halls, become more aware of their Marine's family obligations (I mean, as much as possible. It's still the Marines.) and tried to make things more livable, wihtout I might add taking anything away from real miltary training which has continued to improve since my discharge.

Residency is a tougher nut to crack as the people in charge are often-times terrible leaders and incredibly pig-headed. (which is not typical at all of Marine officers) Still, with the material benefits of being a doctor decreasing there may come a time when quality people will even want to go to medical school much less work the benign 80-hour week.

I have worked eighty hour weeks as a civilian but I was paid for it.

I was a Marine as well. Good preperation for residency.

Stay motivated.

 

[8744]

If you can't tolerate the 80-hour work week, go into a different profession. Try nursing.

No. I'm going into EM. After I repeat my intern year (unfortunately, the price for not matching last year) I will be doing about sixty hours a week...which is OK by me.

 

[8744]

I was a Marine as well. Good preperation for residency.

Stay motivated.

I agree. And it's not a question of motivation. I am almost done with intern year and am none the worse for it. I'm just observing that a lot of what we do in medical training is both pointless as it has more to do with lawyer care than patient care and inefficient as it is based on a paradigm that vanished thirty years ago, that is, the lone Physician who made all the decisions and not a leaf turned or a sparrow fell in the hospital without his say-so.

You know. Back when nurses dressed like porn stars.

Today it's a team effort. I don't see why the shift system is not universal. I sign out my patients before I go home after call, why not sign them out after a 12 hour shift? Most of the action is at admission anyways.

I am not flaming anybody, just pointing out that "because it's always been done that way" is not neccessarily a great arguement. And I'll be done with residency long before any change could possibly take effect so it is of academic interest to me only.

Sergeant Bear, Panda USMC (former)
Kilo 3/8 1983-1991

 

[Obedeli]

If you can't tolerate the 80-hour work week, go into a different profession. Try nursing.

Nice snide remark. Try Parris Island.

 

[Obedeli]

I agree. And it's not a question of motivation. I am almost done with intern year and am none the worse for it. I'm just observing that a lot of what we do in medical training is both pointless (as it has more to do with lawyer care than patient care) and inefficient as it is based on a paradigm that vanished thirty years ago, that is, the lone Physician who made all the decisions and not a leaf turned or a sparrow fell in the hospital without his say-so.

You know. Back when nurses dressed like porn stars.

Today it's a team effort. I don't see why the shift system is not universal. I sign out my patients before I go home after call, why not sign them out after a 12 hour shift? Most of the action is at admission anyways.

I am not flaming anybody, just pointing out that "because it's always been done that way" is not neccessarily a great arguement. And I'll be done with residency long before any change could possibly take effect so it is of academic interest to me only.

Sergeant Bear, Panda USMC (former)
Kilo 3/8 1983-1991

Panda,
"Stay motivated" as in "stay motivated recruit" on the chow line at P.I.
I would not knowingly flame a fellow marine.
The post about spending the first day in the MICU from one person was something! Naturally, you mention something medical (hyperkalemia) and everyone with some medical knowledge assail the poster with questions about kayexelate, insulin, D50, etc. The poster had no intention on discussing the emergent treatment of hyperkalemia. Open up Harrison's if you really want to know or is it more like people on this message board want to show how smart they are and display their knowledge. You can practically see them in a lecture feverishly raising their hands saying "oo ooo I know teacher, I am ever so smart!" I would hope by this point that it is at least understood on how to treat hyperkalemia. The original poster was good enough to stay clear from this discussion but it droned on without his help. Now the 80 hour work week debate entered the picture.... ZZZZZZZZZzzzzzzzzzzzzzzzzzzzzzzz *snore* I am just saying the meaning of this thread was to share first day experiences of residency. How did you cope, what happened. I learned it takes me 40 minutes to dictate an H&P. I learned most importantly that it doesn't last forever (as you will feel it will).

 

[kbrown]

Does anyone have a link to where I can view the first episode of Scrubs. All the places that I have found on the net want me to pay for some one year subscription to view one flippin' episode.

suggestions?

 

[Entei]

Does anyone have a link to where I can view the first episode of Scrubs. All the places that I have found on the net want me to pay for some one year subscription to view one flippin' episode.

suggestions?

It's out on DVD. You should just rent/buy it, since downloading things from teh interweb is bad!

I mean, there are people out there who distribute entire seasons of tv shows as BitTorrents on sites like torrentspy.com, but you should never, ever, ever download something like this. Because it's illegal. Piracy is bad.

 

[Blade28]

Scrubs is a great show. I highly recommend buying at least Season 1.

 

[mysophobe]

No. I'm going into EM. After I repeat my intern year (unfortunately, the price for not matching last year) I will be doing about sixty hours a week...which is OK by me.

Nice snide remark. Try Parris Island.

I'm sorry, I forgot that jokes were not allowed on this forum.

 

[8744]

I'm sorry, I forgot that jokes were not allowed on this forum.

I took it as a joke and I am not offended in the slightest. The funny thing is that some of the nurses think that we work shifts. One of them asked me if I was working the "night shift" and she seemed sore amazed when I said our call "shifts" were thirty hours long.

 

[Waiting4Ganong]

Remember, Europeans in general make less money than equivalent Americans. On a hunch, I would guess that working considerably less probably has something to do with it.

It is true our sub-specialists in the UK, on average, make less than their peers in the US - but, our pay as residents is much better.

As an PGY1 next year I'll be working max average 56hrs/wk and earning around $55-65K/yr with free accommodation. As a PGY2 that is $70K. And so on.

We work more on the principle that it is a job (rather than "education" as residencies are defined) from day 1 and hence are compensated accordingly (with paid pension, 6wks leave etc etc). The trade-off is of course that the service component of UK training means the time to become "fully-trained" is longer. Works for some (those married, with kids, hobbies etc) but as you say is a more European rather than American ethos of work. Of course the seniors here (who as recently as 10yrs ago worked 120hrs/wk in training on a q2 call schedule) think we have drastically overshot the "happy medium".

One thing though is most doctors here spend about 10hrs week extra after their jobs studying for the series of national exams in their field (having to pass exams every few years typically). 10+56 probably isn't far off the hours worked by the average Medicine PGY3??

okay. seriously off-topic but though might be of interest how we do it over here. To bring it back on topic - I'm still dreading starting my intern year in the Summer with a 7 day week of 8pm-8am nights (56hrs is just on average, not every week...).