Feeling overwhelmed

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as90

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I'm managing to make it through intern year but I'm feeling absolutely miserable. My body feels like it's falling apart and I just can't imagine even thinking about 2nd year at this stage. I feel so incredibly sleep deprived and so out of touch with my family back home.

I feel like I needed a break between med school and residency. I just feel like at this stage I need to take a year off between intern year and 2nd year just to give me the opportunity to visit home, take care of myself, etc. I was wondering if anyone has ever successfully taken a year off in residency? I'm in a 4 year Neuro program.
 
as90 said:
I'm managing to make it through intern year but I'm feeling absolutely miserable. My body feels like it's falling apart and I just can't imagine even thinking about 2nd year at this stage. I feel so incredibly sleep deprived and so out of touch with my family back home.

I feel like I needed a break between med school and residency. I just feel like at this stage I need to take a year off between intern year and 2nd year just to give me the opportunity to visit home, take care of myself, etc. I was wondering if anyone has ever successfully taken a year off in residency? I'm in a 4 year Neuro program.
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So a few things:

1. November-December are the absolute low point of intern year for a LOT of us. It really does get better. Come the spring, the sun is shining and you end up realizing just how much you've learned thus far during the year and how much more efficient you've become.

2. Taking a year off would be a poor choice at best. That said, it does sound like you need some time off. Have you had a vacation yet this year? Like an actual 1-2 week vacation? If not, when is your next one?
 
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The old timers will be super PO'd that I'm going to tell you to check out my post history

Check out posts re: termination, dismissal, resignation, etc

Because point is this:

You make ANY noise to your PD that you are even having involuntary dreams about a scenario in which they may be a resident down in the schedule and they may make those dreams come true... meaning they pre-emptively hire someone else to take your spot before you have a chance to surprise them

I tell you to read those posts because I want you to understand how, not completing your intern year, hell, even completing it, how giving up a residency spot.... can lead to these "help my clinical career is over and now I am financially ruined and considering suicide" threads

You need to hold to a residency spot as though everything you have ever worked for in your adult life and the rest of your financial future depends on it... because it does.

I feel for you that this sucks, and if you post back or PM me I can direct you to the following advice which is floating around in my history:
how to make time to obtain healthcare during residency
how to obtain psychiatric care during residency without tanking your whole career
how to have medical issues/disabilities accommodated
ideas to save time and get more food in
sleep hygeine
non-pharm ideas for depression
if you have EPIC some template efficiency ideas
if you are not doing well at your program what legal things to think about doing to protect yourself

TLDR
don't consider time off unless you or patients are in danger if you continue working
don't give up your spot just to have some time off
don't make such noises to your PD yet without reading about what can go wrong
hold to a residency spot like Rose did the raft in Titanic
more advice should you ask have I, young Jedi
 
I did take 2 weeks off already. I feel like I can hardly move some days without taking a bunch of advil. medical school never felt so physically tiring. I feel like I've fractured my bones when I come home from work everyday.
 
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as90 said:
I did take 2 weeks off already. I feel like I can hardly move some days without taking a bunch of advil. medical school never felt so physically tiring. I feel like I've fractured my bones when I come home from work everyday.
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Nobody said it wouldn't be tiring and hard. Most people find the resolve to push through. I would lay off the Advil though.

Taking a year off at this juncture is not without career implications. You probably should make an appointment with a healthcare professional on your stress issues before contemplating something so drastic.
 
The problem with taking a year off is that your neuro program will not likely "hold your spot" for you. They will hire another PGY-2 into your spot, and then the next year when you're ready to return you'll be hunting for new open spots -- which may be far and few between. Plus, programs will see your history of "I worked hard for one year and then needed to take a year off" and worry that the same thing will happen to you after a year of neuro.

So, the advice in this thread is good. You sound ill. Get evaluated. See if this is something fixable. Perhaps consider a short LOA during this year -- if you have an elective, you could take an unpaid LOA instead. You will need to make up that month in the future, but if it helps you recharge that's good. If the LOA is declared as a medical LOA, then it may be paid also via your disability policy.
 
Hang in there man

Ive said this many times in different forums but residency sucks. All of them. Having to work all day and then study all night, having to give up almost everything you enjoy in life, having to constantly be abused by nurses, patients, and even your faculty---that my friend, is residency in a nut shell. It can make anyone suicidal and depressed.

But hang in there; remember why youre doing this in the first place. Remember that there is no pleasure in life, only a relief of pain. Remember that in order to be on top, you have to suffer. Remember all of the things you did to get to this point. You'll survive.
 
as90 said:
I did take 2 weeks off already. I feel like I can hardly move some days without taking a bunch of advil. medical school never felt so physically tiring. I feel like I've fractured my bones when I come home from work everyday.
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Do not underestimate the physical feeling of pain that can come with depression and similar issues. Does your program have a counseling program you can use??
 
22031 Alum said:
Do not underestimate the physical feeling of pain that can come with depression and similar issues. Does your program have a counseling program you can use??
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This was something that came to mind to me as well.

Are you depressed?

Could you have developed some sort of autoimmune condition (namely RA or some other inflammatory arthritis, especially since ibuprofen is helping)? Some of these conditions can lead to substantial fatigue over and above what you experience from being an intern.

Fibromyalgia?

Hypothyroidism?

When was the last time you saw a doctor?

If you're leery of prescription antidepressants, exercise and now light therapy (which was previously used only for SAD) have evidence supporting efficacy for MDD. Talk therapy always helps too.
 
Medical issues are poorly managed on anonymous message boards, seek out medical help STAT!


as90 said:
I'm managing to make it through intern year but I'm feeling absolutely miserable. My body feels like it's falling apart and I just can't imagine even thinking about 2nd year at this stage. I feel so incredibly sleep deprived and so out of touch with my family back home.

I feel like I needed a break between med school and residency. I just feel like at this stage I need to take a year off between intern year and 2nd year just to give me the opportunity to visit home, take care of myself, etc. I was wondering if anyone has ever successfully taken a year off in residency? I'm in a 4 year Neuro program.
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Intern year is a major suckfest -- watch your interactions with your PD and other residents -- I don't care if they smile in your face while patting your arm and making sympathetic clucking sounds -- if it benefits them, they will screw you.

Recognize this -- PDs have the ultimate, unchecked power -- if it's you individually vs the PD, you are done. Only if the entire class gets together and files with the state board vs the PD will anything be done. Do NOT screw with or try to play headgames with the PD -- they can make your residency and post residency life very difficult -- don't ask me how I know --

Also, do NOT think of quitting residency or intimating that you may want to leave to ANYONE -- once that rumor starts, you are in el deepo kimchio ---

for now, just suck it up and make it through, learn what you can and recognize it'll be over soon
 
Intern year sounds miserable. As a first year medical student who transferred from a cutthroat industry (money driven) people in the medical field are brutal to each other. I was surprised.
 
Tacit_iconoclast said:
That is pretty cold. I left a lucrative job because I think the human body is fascinating and I genuinely want to learn so I can serve others. This "get out if you can't cut it" attitude is pretty useless. It's not like we are fighting Al Qaeda. So much unnnecessary meanness...no wonder patients say we don't care!
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I don't think she was saying "get out if you can't cut it". Rather, simply, "you ain't seen nothin' yet". So if you're horrified by what you've heard about on SDN so far, this may not be the industry you were looking for.
 
dozitgetchahi said:
Fibromyalgia?
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unc02i.jpg
 
gutonc said:
I don't think she was saying "get out if you can't cut it". Rather, simply, "you ain't seen nothin' yet". So if you're horrified by what you've heard about on SDN so far, this may not be the industry you were looking for.
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Aaah noted. I heard the horror stories and I am a tough cookie who loves medicine so far so I'm in it for the long haul. Just reiterating that we as a profession seem to make things unnecessarily miserable.
 
Tacit_iconoclast said:
Aaah noted. I heard the horror stories and I am a tough cookie who loves medicine so far so I'm in it for the long haul. Just reiterating that we as a profession seem to make things unnecessarily miserable.
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With the exception of my surgery rotation as an M3, I have not found any part of my education, training or practice to be "unnecessarily miserable", nor have I ever felt targeted by anybody.

Just like finance (or fast food for that matter) there are a**holes in medicine and there are whiners in medicine. Put them together and you get the vast majority of the posts on SDN.
 
JustPlainBill said:
Intern year is a major suckfest -- watch your interactions with your PD and other residents -- I don't care if they smile in your face while patting your arm and making sympathetic clucking sounds -- if it benefits them, they will screw you.
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Not a whiner. Case in point.
 
Tacit_iconoclast said:
Intern year sounds miserable. As a first year medical student who transferred from a cutthroat industry (money driven) people in the medical field are brutal to each other. I was surprised.
Click to expand...

Not all residencies are like this, last thing you should do is take things on SDN at face value
 
Tacit_iconoclast said:
That is pretty cold. I left a lucrative job because I think the human body is fascinating and I genuinely want to learn so I can serve others. This "get out if you can't cut it" attitude is pretty useless. It's not like we are fighting Al Qaeda. So much unnnecessary meanness...no wonder patients say we don't care!
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Ahem -- without sounding like an a**hole being mean unnecessarily but as someone who had the same attitude you did when entering the field after a career in another venue --- most people don't want your help -- they want what they want/need to get down the road in their current lifestyle -- they don't want/need help controlling their chronic diseases, just keep them going so they can party/live through the next major calendar milestone -- in my 3 years at Parkland, I can count on the fingers of one hand the number of people who actually listened, sought my advice/help when I was their physician during a physician/patient encounter or who actually made lasting (albeit sometimes small) changes that positively impacted their lives or thanked me for my help -- I am not kidding -- if you're going into this for some idealistic idea that you're going to serve people and when they recognize your innate human goodness to them and mankind that rainbows, unicorns and Dora the Explorer (with/without Diego) will magically appear to escort you over the bridge to self fulfillment, you are in for a rude awakening --

yes, some of my medical colleagues were mean because they were in positions of unchecked power -- as Santyana said,'Absolute power corrupts absolutely' -- some were just so overburdened that they had a low tolerance for stupidity and BS and never forget, just because you're good at something doesn't mean you can teach or have the personality to teach ---

So, step back, get a function check on reality, go work at a homeless shelter "serving people" for about 6 months, day in and day out and see if you still have the desire to "serve others" ---

I have a Don Quioxte complex to a certain extent and keep plugging away but as others on these forums will tell you, there's usually a major gripefest Qweekly to blow off steam ---
 
JustPlainBill said:
Ahem -- without sounding like an a**hole being mean unnecessarily but as someone who had the same attitude you did when entering the field after a career in another venue --- most people don't want your help -- they want what they want/need to get down the road in their current lifestyle -- they don't want/need help controlling their chronic diseases, just keep them going so they can party/live through the next major calendar milestone -- in my 3 years at Parkland, I can count on the fingers of one hand the number of people who actually listened, sought my advice/help when I was their physician during a physician/patient encounter or who actually made lasting (albeit sometimes small) changes that positively impacted their lives or thanked me for my help -- I am not kidding -- if you're going into this for some idealistic idea that you're going to serve people and when they recognize your innate human goodness to them and mankind that rainbows, unicorns and Dora the Explorer (with/without Diego) will magically appear to escort you over the bridge to self fulfillment, you are in for a rude awakening --

yes, some of my medical colleagues were mean because they were in positions of unchecked power -- as Santyana said,'Absolute power corrupts absolutely' -- some were just so overburdened that they had a low tolerance for stupidity and BS and never forget, just because you're good at something doesn't mean you can teach or have the personality to teach ---

So, step back, get a function check on reality, go work at a homeless shelter "serving people" for about 6 months, day in and day out and see if you still have the desire to "serve others" ---

I have a Don Quioxte complex to a certain extent and keep plugging away but as others on these forums will tell you, there's usually a major gripefest Qweekly to blow off steam ---
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I'm not so sheltered either and having worked with underserved youth in a mentoring capacity definitely dont have the idea ppl are looking to be "saved". But I still hope to be a positive factor in changing people's lives - even if it isnt something they want immediately. Lifestyle changes are hard but I feel part of being a good physician is coaching and being familiar with constant disappointment / disillusionment.

(Actually a first generation college graduate and grew up low income.)

In retrospect your post was warranted because most medical students are idealistic 20 somethings who want to save the world. As an older, well-traveled person I am not one of them.

Edit: sorry for derailing this post OP. Hang in there and I hope you can find help in a safe environment. A malicious workplace is poisonous and not productive.
 
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Tacit_iconoclast said:
I'm not so sheltered either and having worked with underserved youth in a mentoring capacity definitely dont have the idea ppl are looking to be "saved". But I still hope to be a positive factor in changing people's lives - even if it isnt something they want immediately. Lifestyle changes are hard but I feel part of being a good physician is coaching and being familiar with constant disappointment / disillusionment.

(Actually a first generation college graduate and grew up low income.)

In retrospect your post was warranted because most medical students are idealistic 20 somethings who want to save the world. As an older, well-traveled person I am not one of them.

Edit: sorry for derailing this post OP. Hang in there and I hope you can find help in a safe environment. A malicious workplace is poisonous and not productive.
Click to expand...

Similar situation/mindset -- just remember to embrace the suck -- it's easier that way ---
 
JustPlainBill said:
Ahem -- without sounding like an a**hole being mean unnecessarily but as someone who had the same attitude you did when entering the field after a career in another venue --- most people don't want your help -- they want what they want/need to get down the road in their current lifestyle -- they don't want/need help controlling their chronic diseases, just keep them going so they can party/live through the next major calendar milestone -- in my 3 years at Parkland, I can count on the fingers of one hand the number of people who actually listened, sought my advice/help when I was their physician during a physician/patient encounter or who actually made lasting (albeit sometimes small) changes that positively impacted their lives or thanked me for my help -- I am not kidding -- if you're going into this for some idealistic idea that you're going to serve people and when they recognize your innate human goodness to them and mankind that rainbows, unicorns and Dora the Explorer (with/without Diego) will magically appear to escort you over the bridge to self fulfillment, you are in for a rude awakening ---
Click to expand...

Maybe you're just in the wrong field. I have people thanking me on a near daily basis for what I do. And most of the time I feel like I didn't actually do anything.

Yes, I have patients and families exactly as you describe, but I also have multiple families who come to me after seeing those who take care of adults, and feel that I really listened and did what was best for their child. And sometimes, I take an uncontrolled problem and all of a sudden make it controlled, just by switching up some meds or setting them up with therapy.
 
Hang in there. It gets better when the daylight comes back in March/April. Talk to friends about your stress, its a good way to vent. I agree however not to tell others if you are thinking of quitting.
 
mppcc said:
Hang in there. It gets better when the daylight comes back in March/April. Talk to friends about your stress, its a good way to vent. I agree however not to tell others if you are thinking of quitting.
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And by talk to friends, that does NOT include anyone at work. I don't care HOW close you are to your co-intern/s.
 
Crayola227 said:
And by talk to friends, that does NOT include anyone at work. I don't care HOW close you are to your co-intern/s.
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I disagree. I found that my co-interns were the best ones to vent to about how stressful intern year was. No one else really understood. Just don't tell them you are thinking of quitting.
 
mvenus929 said:
Maybe you're just in the wrong field. I have people thanking me on a near daily basis for what I do. And most of the time I feel like I didn't actually do anything.

Yes, I have patients and families exactly as you describe, but I also have multiple families who come to me after seeing those who take care of adults, and feel that I really listened and did what was best for their child. And sometimes, I take an uncontrolled problem and all of a sudden make it controlled, just by switching up some meds or setting them up with therapy.
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And that's the thing -- the op is a neurology resident which means he/she is doing an internal medicine year and will start neurology next year. Based on that, I'd hate to see him/her make permanent decisions right before essentially starting a new job anyway. The neurology residents I worked with weren't too happy during their internship, but I think the general consensus was that things got better afterwards.
 
Raryn said:
I disagree. I found that my co-interns were the best ones to vent to about how stressful intern year was. No one else really understood. Just don't tell them you are thinking of quitting.
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I would be very careful what sort of stress you share.

I could make a whole list of topics I think are wisely kept to yourself. Sure, I've violated my own list, with mixed results.
Personal life drama --> especially significant other
Financial woes
VERY careful in complaints about anyone at work, from the janitor to the SW to the PD, attendings, fellow residents
Mental health
Physical health problems
Substance use (mentions of hangovers, or even "I got crunk this last golden weekend")
At least use this list to very carefully consider what you reveal at work

Ultimately no one cares about your problems at work, they want you to be someone who takes away problems not adds to them. Everyone feel like crap and I would suggest that you commiserate but not initiate such discussions of feeling like crap.

I don't think the phrase "I feel overwhelmed" or anything that sounds like doubt in your ability to be promoted to next year should ever leave your lips. As an attorney once said anyone can be made to be a witness in a court of law. You would be shocked the things that make it back to the Chief or PD BTW and can be made to haunt you. "I'm sure the rest of you feel like this too, but I feel tired and need a cookie. Then I'll be OK." Follow up anything that happens to sound like a question to your ability to handle things with something asserting your ability to handle it at the end.

TLDR
be very careful what you share
 
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Crayola227 said:
Personal life drama --> especially significant other
Financial woes
VERY careful in complaints about anyone at work, from the janitor to the SW to the PD, attendings, fellow residents
Substance use (mentions of hangovers, or even "I got crunk this last golden weekend")
Click to expand...

Well ****, just taking these few off alone, 100% of our residents violate this pretty much every time you get more than two of us together. Talking about relationships, bitching about how we're broke, how dumb/silly/frustrating consultants/sw/attendings are, and how we're planning on relaxing with a decent drink are all standard topics of conversation... But maybe we're not all as paranoid as you.
 
Raryn said:
Well ****, just taking these few off alone, 100% of our residents violate this pretty much every time you get more than two of us together. Talking about relationships, bitching about how we're broke, how dumb/silly/frustrating consultants/sw/attendings are, and how we're planning on relaxing with a decent drink are all standard topics of conversation... But maybe we're not all as paranoid as you.
Click to expand...

I think it depends on how close of a group y'all are and how much you trust them as a result.
 
Raryn said:
Well ****, just taking these few off alone, 100% of our residents violate this pretty much every time you get more than two of us together. Talking about relationships, bitching about how we're broke, how dumb/silly/frustrating consultants/sw/attendings are, and how we're planning on relaxing with a decent drink are all standard topics of conversation... But maybe we're not all as paranoid as you.
Click to expand...

This is how it is at our residency program.
 
Not sure this helps, but at the same time, I know how you feel. Our PGY-1 is fairly brutal when I compare to my peers at other institutions. (Although tamer than some other programs). HOWEVER, I'm just going to put my head down and go. You need to do the same.

I feel it's a lot like a long distance run. If you've ever done one. I mean, there's a point when you're exhausted. However, you still have some baseline amount of energy to push through and keep going. And when you are really exhausted, you realize you are on auto-pilot. Just putting one foot in front of the other cuz you are used to it.

That said, I've done so much gen med (hell) floors at this point, I'm just putting one foot in front of the other. W/ a tough attending. Who sets her expectation that I already be transitioning to a resident. She explains that I'm not a medical student anymore. I shouldn't even be an intern anymore. She wants me to be a doctor! She wants to see a thought process. Critical thinking. She does NOT care if I know how to treat pancreatitis. She sez any medical student w/ access to Uptodate can do that. Instead she wants to know what I'm doing to figure out why? What is my plan of care? What is my metric for disposition? "Secretarial" work is over. I can't just "copy/paste" my daily notes.

And so it escalated w/ my new attending. But I'm used to the "secretarial" work already. The one foot in front of the other repetition. Time to run, uphill, in the rain, with a 40 lb backpack, barefoot.

I use copious amounts of caffeine to stay alert. I use melatonin to be able to fall asleep. For the few hours I get. I've lost 10 lbs. Cuz eating is a luxury. My eczema is raging. I don't date. I drink in my free time. And my survey of my fellow PGY-1's makes that par for the course.

Fight through it. You got this!
 
Spoken like a true manic! Above poster has the right idea though... Keep your head down and run.
 
But wait! There's more!

Actually, I have found that embracing the suck is what gets you through it, at the end. Finding enjoyment in the frustration and fatigue, finding excitement through the fear and nausea that comes from being strung out and exhausted, and getting yet another page. That and physical exercise. Run up the stairs when you can, even if you don't have any reason to (best done on nights, so people don't think you are a mentally unstable freak) so you can get your heart rate up. Focuses your mind. Helps you enjoy what you are doing. Do push ups in the call room. Find a way to work in some simple exercise into your day.

Try not to make the same mistake more than once. Be nice to other residents, especially when they are getting their butt kicked. Try to teach a medical student something. Make a point of doing something better, faster, more pretty than you did the last time. If you can trick yourself into enjoying what you do, you'll do it better. When you do it better, you'll enjoy it more.
 
Law2Doc said:
While you are likely correct, I would wager nobody has ever done a study on this. 🙂
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Even if they did, it doesn't matter unless it's a double blind RCT. All other studies are useless (and long live the P value).
 
Gfliptastic said:
... Who sets her expectation that I already be transitioning to a resident. She explains that I'm not a medical student anymore. I shouldn't even be an intern anymore. She wants me to be a doctor! She wants to see a thought process. Critical thinking. She does NOT care if I know how to treat pancreatitis. She sez any medical student w/ access to Uptodate can do that. Instead she wants to know what I'm doing to figure out why? What is my plan of care? What is my metric for disposition? "Secretarial" work is over. I can't just "copy/paste" my daily notes.
Click to expand...

do you think that this is an unreasonable expectation for a mid year intern?
 
As I sit here as a Pgy 1 psych resident reading this thread, I think House of God may be truer to life than I originally gave it credit for.
 
rokshana said:
do you think that this is an unreasonable expectation for a mid year intern?
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Not really at all. Her reputation precedes her. But what used to be aces for my last attending is borderline unacceptable for. I've been adapting. I'm not backing down. I mean, it's expected. As we "embrace the suck" (as someone else mentioned) the fact is...interview season is coming to an end. The interns are coming.

It is a gyp, cuz there are "lax" attendings still letting "secretarial work" slide. The point I was alluding to is that, just when you are "comfortable", the game changes.

(We got our census down to 6 w/ multiple d/c's...I'm home after only 10 hrs of work. Booyah! lol)
 
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