I feel so, who knows

[Psychobabbling]

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Did any of you have the experience in residency of just feeling like "F*** this, give me my license already."

I am so tired of residency it's not funny. I feel like I'm going crazy. I get so anxious sometimes walking on the floor of our program. Luckily I'm only there for a few hours once a week. Ever since I switched over from medicine to psych, I've had this horrible anxiety to be honest. I used to have panic attacks before going to work on the days I would end up crossing paths with the PD/Assistant PD/Program Secretary (Coordinator), that I started to have to take sick days. I take a lot of vacations on days that I'm supposed to be there (lectures or whatever) just so I don't have to feel this anxious dread about being around any of them.

I really don't feel comfortable going into specifics, of which I have many. I don't know what to do. I've been told so many times that "you don't care....you don't have empathy for your patients...you don't care about what it means to be a doctor....you're externalizing...YOU need therapy...'you better do xyz or else....see, now that's some therapy for ya.'

I've had days where I have to stay home and I'm in tears. I then think that it must be me, it must all be my fault. There are certainly things I could do better, I am far from perfect. But I get the microscope treatment. If I don't do something on time, it's me, I'm a horrible resident, I need to address abcd. If it's someone else, no worries, it's okay. I get told things like "do you enjoy being the problem child?"

I just don't get it. I really don't. I wish I could be more specific. I've started writing down each and every thing that has happened (I sat down and wrote about 5 pgs front and back in 20 minutes or so). I can't take this. It doesn't matter what I say or do (and I've tried to meet with said people) - it comes back "well, maybe if you stopped externalizing it wouldn't be a problem"

I'll give a hypothetical scenario. Imagine a colleague asked you to switch calls with them. You agree. Turns out their was a prior engagement (that both you, your colleague, and other colleagues), had. You miss said engagement. You are then told that you're behavior is unacceptable and is bordering on expulsion from the program. For what you ask? Because you missed said engagement. I see that, I'm really sorry, when I switched with my colleague, I don't think either of us took that into account. I told another colleague about my absence the day of, and they said they would relay the mistake to you, and that they would do my part. 'Not good enough, stop blaming other people.' I'm not blaming anyone, I'm just saying what happened, it was an honest oversight. I apologize. Nothing bad, no error, resulted from such. 'You are walking on thin ice, keep this up, and you're gone.'

Now, let's say the engagement was to pick up 5 pieces of trash from the ground outside. Instead, your colleagues picked up 6 pieces. Your colleagues told you "hey, no worries, that same thing happened to me, not a big deal, we got your back." However, this oversight now becomes grounds to talk about expulsion and desire to be a physician?

Even writing this, thinking about everything that's happened, I feel like I could just fall apart. I don't know.

 

[sunlioness]

There were times I tired of residency, but never to the extreme you describe. I always felt validated and supported by my faculty.

Are you the problem? I honestly don't know. But either way, therapy might not be a bad idea. Someone external to bounce things off of and help you process what legitimately might be yours vs not.

 

[heyjack70]

Read mount misery.

 

[skunky386]

Hey bud, sounds like there are two things going on...a general background of moderate depression/anxiety, and a very context-dependent high-anxiety situation with alot of animosity and avoidance surrounding the program coordinator, director, and secretary. Based on what limited information I know about you so far, if I were you I'd find a psychiatrist asap (the stakes are high here and sounds like you need to start doing something quick, so get an appointment asap...look into cash-pay providers as they tend to have more immediate availabilities and with evening appointments) and start an ssri as well as a PRN benzodiazepine for the ssri to fully kick in in several weeks, as well as for the situational component with the program administration. If you're unable to make it to a psychiatrist soon, try the following stop gap measures: buy some gaia brand kava kava from amazon and get it overnighted to you...based on anectotes 5 capsules is similar to about 0.5 of alprazolam. you'd be surprised by how similar it is reported to be to a benzodiazepine. Try some tea...celestial seasonings which is sold at most grocery stores makes a blend called "tension tamer" that may be helpful in the meantime. Also add some daily 5htp and SAMe (dosed on the upper end) which will act somewhat like an ssri until you're able to see a psychiatrist. And definitely think about getting some therapy. Residency is tough, especially with people making such unempathetic remarks, and therapy will not only help you perform at your best, but you'll be able to incorporate some of your own therapist's techniques into your everyday patient encounters.

I really hope you'll be able to get through this, getting kicked out of a program can be really though.

 

[GreenBirch]

It sounds like for one reason or another, you feel like your actions are unfairly criticized compared to those of your colleagues. I get it. I've been there before. And it sucks. And I'm sorry you are going through that in your residency program. As a medical student, I've had an attending pick on me that resulted in my resident turning her back on me, and suddenly I'm this terrible student (despite working my butt off). In a complete opposite world, I've had an attending tell me I'm the best student he's had. Am I two different people in those scenarios? No, I'm neither that horrible student nor the best student. I've realized that unfortunately, once people make up their mind about you, everything is colored in the way they treat you. When they don't like you, they dwell on the flaws and forget the good. When they like you, they focus on the positive and diminish the flaws. Fortunately for me, the negativity lasted one clerkship. In your case, you are stuck with the PD/aPD/coordinator through residency.

And ultimately, the problem is, when you don't feel supported by your program, you cannot even focus on improving yourself or take constructive feedback anymore. Do you have mentors that you can trust? Anyone you feel like you can talk to? Anyone that can help you feel validated? It may help to seek out support from attendings that you get along really well, outside the residency leadership. It would help with rebuilding your confidence and allow yourself to actually respond to constructive feedback, which in turn would help you feel even more validated when you see yourself improving. Seeing a therapist also can't hurt at this point. At the end of the day, stay true to your beliefs, stay true to your patients, and constantly re-examine yourself to see how you can be an even better physician. Knowing that you tried your best will help keep you going.

 

[hamstergang]

I used to have panic attacks before going to work on the days I would end up crossing paths with the PD/Assistant PD/Program Secretary (Coordinator), that I started to have to take sick days. I take a lot of vacations on days that I'm supposed to be there (lectures or whatever) just so I don't have to feel this anxious dread about being around any of them.

Actively avoiding work like this indicates to me that this is a serious problem. Not one that you can solve with some good words from the forum. I think you need real help, and would consider talking with your PD about this, but I doubt you'd feel comfortable talking with him/her.

 

[675015]

.

 

[splik]

i assume he meant switch over from the medicine half of the year?

 

[675015]

i assume he meant switch over from the medicine half of the year?

Yeah. Probably right. My bad. Thanks.

 

[notdeadyet]

Psychobabbling- strongly recommend getting professional help, as others are suggesting. Aside from it sounding like it would benefit you from a perspective of your health, it might also benefit you professionally. If your program seeks to dismiss you, being able to show that some of your challenges are due to your mental health might help you.

And skunky- it is against TOS to make specific treatment recommendations on SDN. It's also pretty clinical inappropriate to recommend particular medications based on a forum post.


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[F0nzie]

Your attendings and colleagues sound like a bunch of basketcases which is consistent with Rule #1: Staff is always crazier than the patient. If they won't get help then you should-- self care man.

 

[Psychobabbling]

Thanks everyone for your feedback, really. I've tried to talk to my PD (to some extent). It's like talking to a board - and I don't say that to be overly critical of them - every resident (current, graduated, etc) reference how them in this "rigged...unemotional..." Way. I have spoken to one person about this (non-resident) who told me (literally) "the PD has had it out for you from the beginning. Which, I don't know what's that about, because you're actually a really good resident."

Therapy isn't something I'm opposed to, but it gets thrown in my face. "You're unempathic, you need therapy." "You're like a problem child, you need therapy." I've spoken to a few non-residents about this. They commented on "how could that NOT affect you? How do you even get to a place where you can just relax and focus on your patients? Ha, I won't say anything if you won't, but they're crazy. And that clinic has some serious rescue fantasy issues..."

I gotta do something. I appreciate just being able to hear from you all. Thank you again

 

[F0nzie]

I had an attending who I swear had bipolar disorder and would be all manic talking a mile a minute non-stop for hours. He would obsessively spray disinfectant and wipe every surface in my office while patients were waiting to be seen. I seriously wanted to be like dude I have patients to see and you need to treat that. Be nice if mental illness was like a rash because nobody would have problems treating it.

 

[sunlioness]

Yikes. I worked for a doc right out of residency whom I swear was nuts (to use the technical term). She'd see patients in her pajamas and that was the least of her transgressions.

But yeah. I was out of training and had the freedom to leave. When you're in training and stuff like that happens, you're kinda stuck.

 

[Doctor Bagel]

Yikes. I worked for a doc right out of residency whom I swear was nuts (to use the technical term). She'd see patients in her pajamas and that was the least of her transgressions.

But yeah. I was out of training and had the freedom to leave. When you're in training and stuff like that happens, you're kinda stuck.

On that note, psychobabbling, is transfer an option? It sounds like sticking around in this program for 3 more years is going to be a hard thing. You'll need a letter from your pd, but it's possible they would also be glad to see you somewhere else. I imagine it's a tricky maneuver, though, if you're at a malignant place. Any mentors or contacts outside your program? Like maybe an attending from your medical school who you had a good relationship with? Others on the board with more political experience than me, please let me know if this is a ridiculous suggestion. People do transfer residencies all the time, though, so it could possibly be an option.