MD co ‘20 Residency Panic Thread

[Matthew9Thirtyfive]

I had a super annoying M3 the last few weeks on wards. She was constantly trying to flex her UW/Step 1 knowledge and ask excessive questions on patients she wasn't following which led to rounds being prolonged unnecessarily. And when the other M3 (who was more normal/nice) would be presenting her patients, she'd look things up and try to step in and answer if the attending asked. I'm really glad my senior let them leave early every day and they had the weekends off. The few times she carried patients with me it was irritating hearing her act as if she knew a lot more than me. Thankfully the M4 was stellar and helped out a ton.

Honestly though I don't even blame her that much. There's a lot of pressure on M3s with all the subjective evals and constantly feeling the need to impress.

That is my nightmare.

---

Members don't see this ad.

 

[bananafish94]

I had a super annoying M3 the last few weeks on wards. She was constantly trying to flex her UW/Step 1 knowledge and ask excessive questions on patients she wasn't following which led to rounds being prolonged unnecessarily. And when the other M3 (who was more normal/nice) would be presenting her patients, she'd look things up and try to step in and answer if the attending asked. I'm really glad my senior let them leave early every day and they had the weekends off. The few times she carried patients with me it was irritating hearing her act as if she knew a lot more than me. Thankfully the M4 was stellar and helped out a ton.

Honestly though I don't even blame her that much. There's a lot of pressure on M3s with all the subjective evals and constantly feeling the need to impress.

Assert your dominance by asking them to get outside medical records

 

[MLNS]

I had a super annoying M3 the last few weeks on wards. She was constantly trying to flex her UW/Step 1 knowledge and ask excessive questions on patients she wasn't following which led to rounds being prolonged unnecessarily. And when the other M3 (who was more normal/nice) would be presenting her patients, she'd look things up and try to step in and answer if the attending asked. I'm really glad my senior let them leave early every day and they had the weekends off. The few times she carried patients with me it was irritating hearing her act as if she knew a lot more than me. Thankfully the M4 was stellar and helped out a ton.

Honestly though I don't even blame her that much. There's a lot of pressure on M3s with all the subjective evals and constantly feeling the need to impress.

No you can blame her. She sounds psychotic

Assert your dominance by asking them to get outside medical records

Have them call the VA...

 

[ciestar]

No you can blame her. She sounds psychotic

Have them call the VA...

Eager is one thing, overbearing is another. That is just outright annoying. She needs to be told this before this continues on other rotations.

And yes, let her be the best darn record getter theyve ever seen

 

[MerYangBey]

I feel like that’s coming for me. My FM service block is my first medicine block of internship. So, four blocks of non-medicine before I do it. I feel like im gonna be behind, knowledge wise but especially doing admissions.

Yeah today was just miserable. Like nothing good I do is recognized at all. Only made to feel like an idiot for not knowing certain things. Idk I feel like I’m getting more of the wrath than I deserve to be honest. Like when my co interns say stupid crap I haven’t noticed the same reaction. Not sure exactly what I did to become the black sheep lol..

 

[Oedipa Maas]

Yeah today was just miserable. Like nothing good I do is recognized at all. Only made to feel like an idiot for not knowing certain things. Idk I feel like I’m getting more of the wrath than I deserve to be honest. Like when my co interns say stupid crap I haven’t noticed the same reaction. Not sure exactly what I did to become the black sheep lol..

I’ve gotten this from one attending so far, all negative feedback, no positive but noticed that he didn’t treat any of the seniors like that. I would have thought I was really far behind if it hadn’t been for the other attendings I’ve worked with. Part of me thinks that there are some old guard attendings that try to make intern year like a boot camp of sorts. It would be worth asking your fellow interns about, I thought it was just me but they noticed the same stuff directed at them. Also one made a snarky comment that helped me internally eye roll/laugh/brush it off when I worked with him, highly recommend.

 

[samac]

Yeah today was just miserable. Like nothing good I do is recognized at all. Only made to feel like an idiot for not knowing certain things. Idk I feel like I’m getting more of the wrath than I deserve to be honest. Like when my co interns say stupid crap I haven’t noticed the same reaction. Not sure exactly what I did to become the black sheep lol..

I’m sorry lovely.
It’ll all get better. Grit your teeth and bear it. I’m the dumb psych intern on medicine service right now and while I’m trying my best I’m just not up to par with the medicine intern and it shows in the attending’s annoyance with me.

 

[ciestar]

I’m sorry lovely.
It’ll all get better. Grit your teeth and bear it. I’m the dumb psych intern on medicine service right now and while I’m trying my best I’m just not up to par with the medicine intern and it shows in the attending’s annoyance with me.

Theyve been at this for months if that makes you feel better.

i have the same concern though. In December i do IM with an IM program, not FM. At least i do FM inpatient first, but i feel very lost with general medicine

 

[MerYangBey]

Theyve been at this for months if that makes you feel better.

i have the same concern though. In December i do IM with an IM program, not FM. At least i do FM inpatient first, but i feel very lost with general medicine

Lol I’m IM and feel lost with IM. (But its my first real inpatient rotation. )

 

[ciestar]

Lol I’m IM and feel lost with IM. (But its my first real inpatient rotation. )

Yeah i know im gonna be there.
Ive taken call but there was a senior there to guide me through it

 

[samac]

Well my attending was kind with me today and told me I care about patients and try hard and that’s what matters, and he sees that so I’m doing well.

Basically think it means you kinda suck but you’re putting in a good effort champ.

I’ll take it.

 

[Matthew9Thirtyfive]

Well my attending was kind with me today and told me I care about patients and try hard and that’s what matters, and he sees that so I’m doing well.

Basically think it means you kinda suck but you’re putting in a good effort champ.

I’ll take it.

 

[Giovanotto]

I’m sorry lovely.
It’ll all get better. Grit your teeth and bear it. I’m the dumb psych intern on medicine service right now and while I’m trying my best I’m just not up to par with the medicine intern and it shows in the attending’s annoyance with me.

Not medicine. Same here. Honestly I get entertained by it, there's just so much I can do at this point. I try to do what I can, and the rest I leave up to "faith in the system". And that's how I got through medical school as well. Just keep reminding yourself to trust the system.

 

[Necr0sis713]

Hey all,

I was hoping I could get some input on my current Step 2 CK scheduling plans. First, I’m a US MD student and strong step 1 (255-265) . Applying for IM.

Right now, my step 2 CK is scheduled for October 6, which means that if all goes in my favor I would maybe have the score the week of October 21st. However, I’m going to be stuck in a rotation until September 25, meaning I have to study after my shifts. It’s making me a bit uneasy because ideally I would have some dedicated time to study.

I was considering pushing it to either the following week (October 13ish) or a week after that, but that would mean my score won’t be back until after October 21.

I’m not too informed on the process how programs receive applications, but based on what I’ve read it seems that applicants who don’t have their step 2 ck scores in are marked as incomplete, meaning that they don’t even look at those applications unless they refresh their list (which they may not even do?)

I know that this cycle will be unique from the rest, but I would appreciate if anyone could give some insight into the impact a late step 2 ck score has on the eras application.

 

[Oedipa Maas]

Hey all,

I was hoping I could get some input on my current Step 2 CK scheduling plans. First, I’m a US MD student and strong step 1 (255-265) . Applying for IM.

Right now, my step 2 CK is scheduled for October 6, which means that if all goes in my favor I would maybe have the score the week of October 21st. However, I’m going to be stuck in a rotation until September 25, meaning I have to study after my shifts. It’s making me a bit uneasy because ideally I would have some dedicated time to study.

I was considering pushing it to either the following week (October 13ish) or a week after that, but that would mean my score won’t be back until after October 21.

I’m not too informed on the process how programs receive applications, but based on what I’ve read it seems that applicants who don’t have their step 2 ck scores in are marked as incomplete, meaning that they don’t even look at those applications unless they refresh their list (which they may not even do?)

I know that this cycle will be unique from the rest, but I would appreciate if anyone could give some insight into the impact a late step 2 ck score has on the eras application.

How hard did you have to work for that 250+ step score? Friends of mine who scored in that range really did not need all that much dedicated time or in some cases dedicated at all. I would advise you to take a practice test now and see where you are at. I took a practice test cold before I started studying and matched my step 1 score. Within two weeks of dedicated my score was up 30+ points. I had four weeks of dedicated total and didn’t gain all that much more in the last two weeks.

 

[Necr0sis713]

How hard did you have to work for that 250+ step score? Friends of mine who scored in that range really did not need all that much dedicated time or in some cases dedicated at all. I would advise you to take a practice test now and see where you are at. I took a practice test cold before I started studying and matched my step 1 score. Within two weeks of dedicated my score was up 30+ points. I had four weeks of dedicated total and didn’t gain all that much more in the last two weeks.

I just took my first NBME today, NBME 6. Got a 239. Not sure what to feel about it.

 

[MerYangBey]

I got Interesting feedback today saying that by answering the service pager during rounds that I was not taking ownership of the whole list... and that somehow I’m not familiar with the whole list. I’ve literally been printing an extra list just to write down notes about the patients that aren’t mine and I thought answering pages in a timely fashion while carrying the service pager was part of my job. So this guys is an example of damned if you do damned if you don’t. #intetnprops

 

[Giovanotto]

I got Interesting feedback today saying that by answering the service pager during rounds that I was not taking ownership of the whole list... and that somehow I’m not familiar with the whole list. I’ve literally been printing an extra list just to write down notes about the patients that aren’t mine and I thought answering pages in a timely fashion while carrying the service pager was part of my job. So this guys is an example of damned if you do damned if you don’t. #intetnprops

This is wrong on so many levels. Anyone who thinks interns should know the whole list is delusional. I want to see them do it. So mad reading this.

 

[MerYangBey]

Update new attending- way way better vibe.

 

[Giovanotto]

medicine wards has me rethinking every decision I've made in my life.

 

[ciestar]

medicine wards has me rethinking every decision I've made in my life.

Im on night float for my current rotation and these 13-14 hour shifts overnight are killer

 

[samac]

Im on night float for my current rotation and these 13-14 hour shifts overnight are killer

Our medicine doesn’t do a week of nightfloat, they just do 4 overnight shifts. But the kicker of it all is you come in at 7pm and you stay through rounds and work the next morning. Not a good time.

 

[Oedipa Maas]

Our medicine doesn’t do a week of nightfloat, they just do 4 overnight shifts. But the kicker of it all is you come in at 7pm and you stay through rounds and work the next morning. Not a good time.

Ok, what???? My understanding of nightfloat is that it provides overnight coverage to the hospital and it offers us a learning opportunity. It also allows for us not to do 24 hr shifts. What is the point of staying through the morning? It doesn’t seem to provide a benefit to the hospital because the day team is there and it doesn’t provide a benefit to you who needs to drive home safely. I feel like it would be even worse given that these are four isolated shifts and you don’t have time to get into the groove of being on nights.

 

[ciestar]

Our medicine doesn’t do a week of nightfloat, they just do 4 overnight shifts. But the kicker of it all is you come in at 7pm and you stay through rounds and work the next morning. Not a good time.

Thankfully i just sign out to the day team and leave, aka write notes.

My program doesn’t do night float at all.

 

[samac]

Ok, what???? My understanding of nightfloat is that it provides overnight coverage to the hospital and it offers us a learning opportunity. It also allows for us not to do 24 hr shifts. What is the point of staying through the morning? It doesn’t seem to provide a benefit to the hospital because the day team is there and it doesn’t provide a benefit to you who needs to drive home safely. I feel like it would be even worse given that these are four isolated shifts and you don’t have time to get into the groove of being on nights.

It’s the VA medicine’s policy. It’s such a drain. You get the day off before, then you go in 7pm the next day, you usually work until 1 pm. Don’t usually get to sleep and you go in the next day. So you have to decide to stay up all day or sleep when you went home

 

[Matthew9Thirtyfive]

It’s the VA medicine’s policy. It’s such a drain. You get the day off before, then you go in 7pm the next day, you usually work until 1 pm. Don’t usually get to sleep and you go in the next day. So you have to decide to stay up all day or sleep when you went home

So like you get Monday off, go in at 7pm on Tuesday, and then leave Wednesday at 1pm?

 

[ciestar]

So like you get Monday off, go in at 7pm on Tuesday, and then leave Wednesday at 1pm?

That really sucks because it’s an overnight shift. At least with my 24 hour calls i get to leave in the morning.

 

[Matthew9Thirtyfive]

That really sucks because it’s an overnight shift. At least with my 24 hour calls i get to leave in the morning.

Yeah, I'm biased cause I'm comparing it to my duty days as an enlisted sailor. Work 9 or 10 (or 11 or 12) hours Monday, go in at 0645 Tuesday and then leave at 1500 or 1600 on Wednesday, and come back in at 0645 on Thursday. Then a couple days later do it again lol.

 

[ciestar]

Yeah, I'm biased cause I'm comparing it to my duty days as an enlisted sailor. Work 9 or 10 (or 11 or 12) hours Monday, go in at 0645 Tuesday and then leave at 1500 or 1600 on Wednesday, and come back in at 0645 on Thursday. Then a couple days later do it again lol.

Yeah that sounds rough lol

But im also doing 13-14 hour days right now

 

[Matthew9Thirtyfive]

Yeah that sounds rough lol

But im also doing 13-14 hour days right now

Yeah they both have their downsides. I think I’d rather work longer hours and then get to be at home every night.

 

[samac]

So like you get Monday off, go in at 7pm on Tuesday, and then leave Wednesday at 1pm?

That is correct. It’s 4 shifts total in the month so it corresponds with our 4 days off.

 

[Matthew9Thirtyfive]

That is correct. It’s 4 shifts total in the month so it corresponds with our 4 days off.

That doesn’t sound terrible. Kind of weird though.

 

[samac]

That doesn’t sound terrible. Kind of weird though.

I just wish the days off were at least flipped. I hate rounding after a night shift enough, but the fact that if I go home and sleep I’m screwed for the next shift on Wednesday but staying up my afternoon/evening is going to be miserable.

 

[Matthew9Thirtyfive]

I just wish the days off were at least flipped. I hate rounding after a night shift enough, but the fact that if I go home and sleep I’m screwed for the next shift on Wednesday but staying up my afternoon/evening is going to be miserable.

Yeah that sucks. Basically ruins the whole day.

 

[popopopop]

Can we put formal names of places in our personal statement? Couldn't find a definitive answer to this, but probably being neurotic. I wanted to put the site where I did my IM rotations.

 

[Oedipa Maas]

Can we put formal names of places in our personal statement? Couldn't find a definitive answer to this, but probably being neurotic. I wanted to put the site where I did my IM rotations.

So I don’t know how this is for residency apps or how it is taken in general. I will say that when I was a screener for med school apps, I found it annoying when people were name dropping hospitals and places that weren’t us. It didn’t add anything and made me think that our school was their backup. If you are wanting to use a specific hospital and its ethos to show you are interested in a particular mission like academia or rural health that might be one thing. If you want to do a personalized statement for that particular hospital, do it! Otherwise I would ask yourself what it adds.

 

[Giovanotto]

I just wish the days off were at least flipped. I hate rounding after a night shift enough, but the fact that if I go home and sleep I’m screwed for the next shift on Wednesday but staying up my afternoon/evening is going to be miserable.

preach. I have the same schedule. We're expected to preround that morning, write notes, and follow up on everything. I don't think I will get everything done before 2-3pm day after going in at 8 pm.

 

[samac]

preach. I have the same schedule. We're expected to preround that morning, write notes, and follow up on everything. I don't think I will get everything done before 2-3pm day after going in at 8 pm.

Pro tip I’ve been doing all my H&Ps after midnight so a SOAP note isn’t required unless your program is evil. Throw in an interim summary with changes to the plan. Usually done by 1. The rounds are the killer part.

Fun fact now though my co intern had a covid exposure so I’m going to be without someone to split the load with for the rest of the month. I think my upper level is nice enough to not leave me drowning though.

 

[ciestar]

Pro tip I’ve been doing all my H&Ps after midnight so a SOAP note isn’t required unless your program is evil. Throw in an interim summary with changes to the plan. Usually done by 1. The rounds are the killer part.

Fun fact now though my co intern had a covid exposure so I’m going to be without someone to split the load with for the rest of the month. I think my upper level is nice enough to not leave me drowning though.

The people i rotate on IM with make their residents do this. My program doesnt.

 

[MerYangBey]

preach. I have the same schedule. We're expected to preround that morning, write notes, and follow up on everything. I don't think I will get everything done before 2-3pm day after going in at 8 pm.

Yeah we have the same set up after our night call except we start at 6.

 

[Giovanotto]

Pro tip I’ve been doing all my H&Ps after midnight so a SOAP note isn’t required unless your program is evil. Throw in an interim summary with changes to the plan. Usually done by 1. The rounds are the killer part.

Fun fact now though my co intern had a covid exposure so I’m going to be without someone to split the load with for the rest of the month. I think my upper level is nice enough to not leave me drowning though.

I'm confused. That's only for your new patients, however I'm being expected to round on my prior non-new patients, follow up on anything that needs to be done for them, and write progress notes for them that morning.

 

[ciestar]

I'm confused. That's only for your new patients, however I'm being expected to round on my prior non-new patients, follow up on anything that needs to be done for them, and write progress notes for them that morning.

I think she means write your new admissions for after midnight so you dont have to do a progress the next day.

 

[NotAProgDirector]

Pro tip I’ve been doing all my H&Ps after midnight so a SOAP note isn’t required unless your program is evil. Throw in an interim summary with changes to the plan. Usually done by 1.

If faculty are not seeing the patient prior to midnight, there is no billing need for a progress note the next day. Faculty will cosign / attest the H&P from yesterday and any update from today, and bill an admission code based upon both notes and their attestation. Programs that make you write a whole progress note post call are doing it for no purpose at all.

 

[NotAProgDirector]

It’s the VA medicine’s policy. It’s such a drain. You get the day off before, then you go in 7pm the next day, you usually work until 1 pm. Don’t usually get to sleep and you go in the next day. So you have to decide to stay up all day or sleep when you went home

Let me see if I've got this correct -- you get a cycle of: day off - come in at 7-8PM the next day (so, technically you have the daytime off also), work the night then work the next day, then start a day schedule the next day. Since this cycle happens 4x per block, you get your 4 days off -- so you work every remaining day. This covers 4 nights, presumably there are 28 nights to cover in a 4 week block so you need 7 people doing this to cover all the nights (or you have some people on non-call blocks with random coverage nights).

This sounds pretty horrible. I expect most of those days off are not on weekends, and working post night (even if you were off the previous day) is pretty horrible. Night float isn't great, but it does put all the nights in a row so you can flip your sleep schedule.

 

[ciestar]

Lol after a week of working nights.. i really prefer the occasionally night call my program has.

 

[Giovanotto]

Let me see if I've got this correct -- you get a cycle of: day off - come in at 7-8PM the next day (so, technically you have the daytime off also), work the night then work the next day, then start a day schedule the next day. Since this cycle happens 4x per block, you get your 4 days off -- so you work every remaining day. This covers 4 nights, presumably there are 28 nights to cover in a 4 week block so you need 7 people doing this to cover all the nights (or you have some people on non-call blocks with random coverage nights).

This sounds pretty horrible. I expect most of those days off are not on weekends, and working post night (even if you were off the previous day) is pretty horrible. Night float isn't great, but it does put all the nights in a row so you can flip your sleep schedule.

Correct. Thankfully most of mine are on the weekends. Apparently, residents voted to keep this system in place vs. a night float system, not sure why.

 

[ciestar]

Another reason night float is a killer:
I eat out if boredom. Im not allowed to sleep, so I eat because why not? And it’s just vending machine options at 3 am

 

[samac]

Another reason night float is a killer:
I eat out if boredom. Im not allowed to sleep, so I eat because why not? And it’s just vending machine options at 3 am

You’re not allowed to sleep?!

 

[ciestar]

You’re not allowed to sleep?!

It’s OB. Nopeeee lol

 

[MLNS]

If faculty are not seeing the patient prior to midnight, there is no billing need for a progress note the next day. Faculty will cosign / attest the H&P from yesterday and any update from today, and bill an admission code based upon both notes and their attestation. Programs that make you write a whole progress note post call are doing it for no purpose at all.

My program does. It annoys the hell out of me.