Anyone else hate Inpatient IM with the force of a thousand suns?

[DJspreadsheet]

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Recently finished. Wanting to do that for a living should be a new diagnosis in DSM 6.

 

[shan564]

Yeah, if I had to do one extra day of that, I would have been back on the psych floor as a patient. It most certainly reaffirmed my decision to do psych. Luckily, my program splits up our psych/off-service rotations into 3-month blocks instead of 6-month blocks, so I got 3 months of psych to break it up.

 

[vistaril]

Recently finished. Wanting to do that for a living should be a new diagnosis in DSM 6.

I dislike the subject matter of medicine, so I didn't want to be an internist. And I wouldn't have been any good at cardiology, oncology, etc....

but for people who do like it, it's a pretty good life. The money to do high volume outpt IM with a couple midlevels in place can be insane. And a lot of hospitalist and night coverage jobs and medical officer on duty jobs(which are usually medicine types) don't have the same salary potential, but you often don't even have to be in house.

And then of course with the medicine specialties(which most American grads do), the money can get very very large. Multiple beach house large.

That said, the best thing to do as a psych intern is just trudge through your medicine months. Work hard, keep a low profile, and just make it through without any problems.

 

[DJspreadsheet]

I dislike the subject matter of medicine, so I didn't want to be an internist. And I wouldn't have been any good at cardiology, oncology, etc....

but for people who do like it, it's a pretty good life. The money to do high volume outpt IM with a couple midlevels in place can be insane. And a lot of hospitalist and night coverage jobs and medical officer on duty jobs(which are usually medicine types) don't have the same salary potential, but you often don't even have to be in house.

And then of course with the medicine specialties(which most American grads do), the money can get very very large. Multiple beach house large.

That said, the best thing to do as a psych intern is just trudge through your medicine months. Work hard, keep a low profile, and just make it through without any problems.

That's what I did. But when you get some over-zealous, high-energy attending, my God is it hell. I too despise the subject matter of medicine and I'm developing an increasingly low threshold of tolerance for being told by non-psychiatrists what's important for me to know as a psychiatrist. Some attendings get it and are cool. But the one's who act like you're a third year med student, want you to formally present your cases, and structure all interactions in the background of a constant didactic pimp-fest. Well....kill me. Some of these people can't have a simple conversation - I can't ask a simple question without everything turning into the ****ing Socratic method. BE A HUMAN BEING. I struggle so hard sometimes not to tell them flat out: I DON'T CARE.

 

[Leo Aquarius]

For anyone thinking about being a doctor, don't! Internal medicine will make your life a living hell.

I'm herein starting a boycott of medical education by encouraging all pre-meds to pursue pharmacy, dentistry, and podiatry until medical education directors improve how internal medicine is taught and conducted.

My internal medicine months in med school made me want to drop out of medicine. It's a shame because internal medicine can be such an exhilarating experience, but old-fashioned attendings can't figure out yet how to make it such. Having gone through IM in med school and residency, I've got lots of ideas how to make internal medicine a great experience for med students and residents. Why can't attendings see how????

 

[OldPsychDoc]

But how do you REALLY feel?

 

[Leo Aquarius]

(glad to be a doctor....shhhh 😏 )

 

[vistaril]

That's what I did. But when you get some over-zealous, high-energy attending, my God is it hell. I too despise the subject matter of medicine and I'm developing an increasingly low threshold of tolerance for being told by non-psychiatrists what's important for me to know as a psychiatrist. .

For anyone thinking about being a doctor, don't! Internal medicine will make your life a living hell.

I'm herein starting a boycott of medical education by encouraging all pre-meds to pursue pharmacy, dentistry, and podiatry until medical education directors improve how internal medicine is taught and conducted.

My internal medicine months in med school made me want to drop out of medicine. It's a shame because internal medicine can be such an exhilarating experience, but old-fashioned attendings can't figure out yet how to make it such. Having gone through IM in med school and residency, I've got lots of ideas how to make internal medicine a great experience for med students and residents. Why can't attendings see how???? Why do they have long sticks up their a**??

specifically what are your complaints about the way medicine rotations are done?

I actually learned a lot from some of the more pedantic assignments I was given to present related to a patient on the service. Not because I learned a lot necessarily about the specific question hand, but because I had to read and understand the basic principles and underlying foundation to really get into the meat of the specific topic.

Most of the idea in rounding,formal presenations, presenting articles isn't to teach others on the service. Nobody is listening, trust me.(although it generate an informal discussion at the end which may have some value). The idea is to get you to learn something. And it usually works. Now is it efficient? No, but at least there is some learning likely going on by the presenter

 

[michaelrack]

It wasn't that bad

 

[IamPsychiatrist]

For anyone thinking about being a doctor, don't! Internal medicine will make your life a living hell.

I'm herein starting a boycott of medical education by encouraging all pre-meds to pursue pharmacy, dentistry, and podiatry until medical education directors improve how internal medicine is taught and conducted.

My internal medicine months in med school made me want to drop out of medicine. It's a shame because internal medicine can be such an exhilarating experience, but old-fashioned attendings can't figure out yet how to make it such. Having gone through IM in med school and residency, I've got lots of ideas how to make internal medicine a great experience for med students and residents. Why can't attendings see how????

I agree.

IM was terrible at my institution. Everyone is so miserable and critical. Their patients are despised alongside their dull existence.

 

[notdeadyet]

It wasn't that bad

It's very institution-dependent. There are some terrible Medicine residencies out there.

It also depends on your bent. Folks who wanted to be doctors and discovered psychiatry in med school tended to like medicine more than folks who wanted to be psychiatrists and saw med school as a necessary evil. I was on the former end of the spectrum and enjoyed medicine.

That said, 4 days off a month sucked and I was happy to move on...

 

[whopper]

Agree with NotDeadyet. It all depends where you do it.

Where I did IM, I was doing 80 hrs a week wiht a militaristic like PD that condescended and humiliated residents and you did the tough stuff like ICU. My program was at two hospitals. In the other hospital, the IM was easy, with psychiatry residents only doing outpatient.

And those residents in the other hospital didn't know their medicine, but the ones that went through the tough one knew it.

But it wasn't about it so much being tough as it was that we were forced to truly practice IM. An IM program where I had to work hard but my PD would've been supportive wouldn't been the best of both worlds.

(I will say that the IM PD, however, was a damn good doctor. Just that he was too much of a drill sergeant. If you did good work your first year, he laid off of you later on.)

 

[peppy]

I always liked the idea of IM, but the actual rotations were a long slog. Psychosomatic Medicine is a nice middle ground: you get to see some medically interesting patients without having to admit every COPD and CHF exacerbation. 😉

 

[notdeadyet]

Psychosomatic Medicine is a nice middle ground: you get to see some medically interesting patients without having to admit every COPD and CHF exacerbation. 😉

You also don't have to TREAT said CHF or COPD....



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[DOswag]

So I'm a 4th yr med student here doing air force hpsp. I've been interested in EM as a career since I worked in an emergency department while in undergrad. I just found out last month I did not match EM in the military match(deferred transitional year), which was kinda expected given the spots-to-applicants ratio and me having no prior military experience to add points to my application. At first I was a little disappointed but recently I've been seeing this as an opportunity to explore other specialties since I was pretty dead set on EM from the beginning and didn't really consider much else except family med (pretty much because where I'm from a lot of ER docs are family med trained). I'm posting on this thread because I too absolutely loathed my IM month in 3rd year of school. I pretty much hated everything except for EM, FM, and much to my surprise Psych! I actually loved my psych rotation but didn't really consider it as an option at the time because I had not even done an EM rotation in school and was still pretty set on it due to prior experience. But now here I am wondering if I was really that happy all those months at the beginning of 4th year on away rotations, working night shifts, weekends, holidays, working up another cp,sob,ap. I found myself dying a little inside when I would look up at the board and see another patient check in, and watching the clock waiting for my shift to end so I could go home and anxiously wait to do it all again. I've heard all this time that EM is a lifestyle specialty. The shift work is great, when you're off you're off, no call, no patient follow up, work half the month yada yada yada. I bought into it and kept waiting for it to hit me that this is the life for me. Well it never did and now I'm really questioning if that is what I want to go into at all. I think this transitional year might be a blessing in disguise and possibly save me from a career of misery. Well now looking back I realize I really did enjoy my psych rotation. The hours were great, the stress level low, and I loved the amount of time I got to spend with my patients and really get to know them. Just wondering if this is senioritis/burned out med student talking, or am I really not cut out for EM, despite getting good evals and feedback from programs, and destined to go into psych. Anyone else have a similar situation, decide on psych late in their med school years, or just any advice? Thanks.

 

[vistaril]

So I'm a 4th yr med student here doing air force hpsp. I've been interested in EM as a career since I worked in an emergency department while in undergrad. I just found out last month I did not match EM in the military match(deferred transitional year), which was kinda expected given the spots-to-applicants ratio and me having no prior military experience to add points to my application. At first I was a little disappointed but recently I've been seeing this as an opportunity to explore other specialties since I was pretty dead set on EM from the beginning and didn't really consider much else except family med (pretty much because where I'm from a lot of ER docs are family med trained). I'm posting on this thread because I too absolutely loathed my IM month in 3rd year of school. I pretty much hated everything except for EM, FM, and much to my surprise Psych! I actually loved my psych rotation but didn't really consider it as an option at the time because I had not even done an EM rotation in school and was still pretty set on it due to prior experience. But now here I am wondering if I was really that happy all those months at the beginning of 4th year on away rotations, working night shifts, weekends, holidays, working up another cp,sob,ap. I found myself dying a little inside when I would look up at the board and see another patient check in, and watching the clock waiting for my shift to end so I could go home and anxiously wait to do it all again. I've heard all this time that EM is a lifestyle specialty. The shift work is great, when you're off you're off, no call, no patient follow up, work half the month yada yada yada. I bought into it and kept waiting for it to hit me that this is the life for me. Well it never did and now I'm really questioning if that is what I want to go into at all. I think this transitional year might be a blessing in disguise and possibly save me from a career of misery. Well now looking back I realize I really did enjoy my psych rotation. The hours were great, the stress level low, and I loved the amount of time I got to spend with my patients and really get to know them. Just wondering if this is senioritis/burned out med student talking, or am I really not cut out for EM, despite getting good evals and feedback from programs, and destined to go into psych. Anyone else have a similar situation, decide on psych late in their med school years, or just any advice? Thanks.

hearing your story, I can't help but think that a family medicine residency is the ideal situation for you now that you didn't match em.

 

[MacDonaldTriad]

Come on in, the water is fine. Drink the cool aid (or whatever it is kids are saying now). Psychiatry is full of converts and you have the advantage of not having to back up to go forward.
We are biased, but most everyone on this board likes what they do.

 

[DOswag]

Well I'm definitely keeping my options open at this point. Since I'm air force and got deferred for TY, i can reapply in the mil match again next year or go into flight med after next year and begin my payback. At least I have some time to decide at this point. I've met residents and attendings who were all along the spectrum from miserable to happy in EM. The consensus seems to be psych people are generally happier with their chosen profession. This is just kinda speculation at this point for me though on the few psych people i know and what I've read on here and various other similar forums.

 

[IamPsychiatrist]

So I'm a 4th yr med student here doing air force hpsp. I've been interested in EM as a career since I worked in an emergency department while in undergrad. I just found out last month I did not match EM in the military match(deferred transitional year), which was kinda expected given the spots-to-applicants ratio and me having no prior military experience to add points to my application. At first I was a little disappointed but recently I've been seeing this as an opportunity to explore other specialties since I was pretty dead set on EM from the beginning and didn't really consider much else except family med (pretty much because where I'm from a lot of ER docs are family med trained). I'm posting on this thread because I too absolutely loathed my IM month in 3rd year of school. I pretty much hated everything except for EM, FM, and much to my surprise Psych! I actually loved my psych rotation but didn't really consider it as an option at the time because I had not even done an EM rotation in school and was still pretty set on it due to prior experience. But now here I am wondering if I was really that happy all those months at the beginning of 4th year on away rotations, working night shifts, weekends, holidays, working up another cp,sob,ap. I found myself dying a little inside when I would look up at the board and see another patient check in, and watching the clock waiting for my shift to end so I could go home and anxiously wait to do it all again. I've heard all this time that EM is a lifestyle specialty. The shift work is great, when you're off you're off, no call, no patient follow up, work half the month yada yada yada. I bought into it and kept waiting for it to hit me that this is the life for me. Well it never did and now I'm really questioning if that is what I want to go into at all. I think this transitional year might be a blessing in disguise and possibly save me from a career of misery. Well now looking back I realize I really did enjoy my psych rotation. The hours were great, the stress level low, and I loved the amount of time I got to spend with my patients and really get to know them. Just wondering if this is senioritis/burned out med student talking, or am I really not cut out for EM, despite getting good evals and feedback from programs, and destined to go into psych. Anyone else have a similar situation, decide on psych late in their med school years, or just any advice? Thanks.

Well, I wouldn't do EM if I were you.

 

[hamstergang]

So I'm a 4th yr med student here doing air force hpsp. I've been interested in EM as a career since I worked in an emergency department while in undergrad. I just found out last month I did not match EM in the military match(deferred transitional year), which was kinda expected given the spots-to-applicants ratio and me having no prior military experience to add points to my application. At first I was a little disappointed but recently I've been seeing this as an opportunity to explore other specialties since I was pretty dead set on EM from the beginning and didn't really consider much else except family med (pretty much because where I'm from a lot of ER docs are family med trained). I'm posting on this thread because I too absolutely loathed my IM month in 3rd year of school. I pretty much hated everything except for EM, FM, and much to my surprise Psych! I actually loved my psych rotation but didn't really consider it as an option at the time because I had not even done an EM rotation in school and was still pretty set on it due to prior experience. But now here I am wondering if I was really that happy all those months at the beginning of 4th year on away rotations, working night shifts, weekends, holidays, working up another cp,sob,ap. I found myself dying a little inside when I would look up at the board and see another patient check in, and watching the clock waiting for my shift to end so I could go home and anxiously wait to do it all again. I've heard all this time that EM is a lifestyle specialty. The shift work is great, when you're off you're off, no call, no patient follow up, work half the month yada yada yada. I bought into it and kept waiting for it to hit me that this is the life for me. Well it never did and now I'm really questioning if that is what I want to go into at all. I think this transitional year might be a blessing in disguise and possibly save me from a career of misery. Well now looking back I realize I really did enjoy my psych rotation. The hours were great, the stress level low, and I loved the amount of time I got to spend with my patients and really get to know them. Just wondering if this is senioritis/burned out med student talking, or am I really not cut out for EM, despite getting good evals and feedback from programs, and destined to go into psych. Anyone else have a similar situation, decide on psych late in their med school years, or just any advice? Thanks.

What does this have to do with this thread? And why is it all one paragraph?

It also depends on your bent. Folks who wanted to be doctors and discovered psychiatry in med school tended to like medicine more than folks who wanted to be psychiatrists and saw med school as a necessary evil. I was on the former end of the spectrum and enjoyed medicine.

That said, 4 days off a month sucked and I was happy to move on...

Agreed. I didn't mind the work itself or the material -- I enjoy medicine. But the schedule and hours just made it a miserable experience that I'm glad had a fixed time limit.

 

[Leo Aquarius]

Well I'm definitely keeping my options open at this point. Since I'm air force and got deferred for TY, i can reapply in the mil match again next year or go into flight med after next year and begin my payback. At least I have some time to decide at this point. I've met residents and attendings who were all along the spectrum from miserable to happy in EM. The consensus seems to be psych people are generally happier with their chosen profession. This is just kinda speculation at this point for me though on the few psych people i know and what I've read on here and various other similar forums.

Hi DOswag, would you consider starting a new thread for your question? To answer it properly will require replies that will divert the original posters question of this thread. I would give you my full reply if this were its own thread. Withholding a response so as to not divert the current thread...

 

[DOswag]

Ha wow I'm sorry I did kinda hijack this thread. Sorry guys I'll repost in a new thread and edit it a little to make it more readable.