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i hate intern year

Discussion in 'General Residency Issues' started by lmouse2488, Sep 3, 2014.

  1. lmouse2488

    7+ Year Member

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    I have felt miserable and depressed every day since I have started intern year. I feel that attendings think I am stupid and have become increasingly paranoid that I will be terminated. The only feedback I've gotten from my attending on my floor month is that I generally did a good job, but that I needed to be careful about copying and pasting my physical exam notes from the previous day progress notes (this made me feel horrible). I really really really wish I could quit but I have no idea what I would do. I would honestly work at The Gap if it meant I didn't feel this way anymore. I don't care about making a lot of money, but I feel overwhelmed with the amount of debt I have from medical school. Any thoughts/ advice appreciated. Thanks.
     
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  3. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    Did you feel the same way when you were burned out during your surgery clerkship? Did it pass back then once you got the hang of things or moved onto something you like (e.g. peds?) If so, then this is just temporary. Learn the ropes, remember what you like about the work and focus on that. You're going to get a lot of crap during residency and you're going to get yelled at for screwing up. If you weren't screwing up and needed someone to watch your back, you'd be an attending already. This is normal.

    If you have legitimate concerns about your performance beyond one comment about copying/pasting previous progress notes, ask someone about it early before it becomes a problem.
     
  4. anes

    anes ASA Member
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    Internship is challenging. Suck it up. Most people feel like you do. You will be fine.
     
  5. Law2Doc

    Law2Doc 5K+ Member
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    It's definitely a hard year. Certain mindsets and personalities make it easier, but it's basically a gauntlet you must run through. In retrospect you will find you learned a lot and are much better at making sound and snap decisions, a skill that will aid you later. Everybody has to do it to get to where they want to go. You just keep your head down and push on. I actually liked intern year, after I started figuring how things worked. It's really just a game with slightly fluid rules, but if you play it well, you get the pat on the back as the future colleague instead of the harsh words as the screw up.
     
  6. SouthernSurgeon

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    Yup.

    And someone with the mindset because an attending said casually "yo, watch out for copy and pasting your progress notes" that they are going to get fired is probably going to have a hard time.

    OP needs an attitude adjustment.
     
  7. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ
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    Have you seen how many threads on termination there are in this subforum? The paranoia is not entirely unfounded.
     
  8. SouthernSurgeon

    Physician Lifetime Donor Classifieds Approved 7+ Year Member

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    And yet the number of residents that actually get fired is exceptionally low. This forum is hardly a neutral lens into the residency world. And as has been detailed many, many, many times here - oftentimes in these "help my mean program fired me" posts there is more going on than meets the eye.
     
  9. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ
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    I am aware of that. I'm just saying that the overall gestalt on this forum, and with good reason, is that residency is a very vulnerable time. Given that, the slightest criticism or brusque behavior by seniors or attendings tends to snowball in our minds into termination at the end of the road.
     
  10. SouthernSurgeon

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    My point was that this in itself is a problem. The OP's post reads like someone with anxiety issues.

    Some people are able to handle criticism and respond positively.

    Other people let it cripple them and get overwhelmed by anxiety and paranoia.

    Guess which ones tend to do better in residency?
     
  11. lmouse2488

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    Thanks.. That is ACTUALLY a helpful post. It's nice to know that others on this forum understand.
     
  12. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
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    Everyone feels that way at least sometimes, and those who say they loved their intern year are either liars or confabulating. Fortunately, things do get better the farther along you go as you start figuring out what you're supposed to be doing. And as the others have said, in spite of how it looks on this forum, the vast majority of residents don't get terminated (and if they do, it's not for one minor little thing like copy-pasting their notes).

    I suggest you take advantage of whatever mental health services your program/hospital provides. Seriously, go vent for a full hour to someone who's paid to listen to you gripe and who you know won't blab it back to the entire hospital. If there's no such service for residents at your program, then start a diary and use it the same way. But I'd also caution you that if you find yourself truly getting overwhelmed by depression (especially if suicidal), get help sooner rather than later. Also, take care of yourself. Especially on your days off, make sure you eat, sleep, shower, and do something fun. I found it helps a lot when you have something to look forward to on your days off.
     
  13. galactus

    galactus Devourer of WORLDS
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    I actually LOVED intern year. Honestly I thought it was the easiest year of residency. My job was simple: do what your told. I was given a set # of patients to see in the wards, and i saw them.
    The transition from med student to intern I thought was a big curve, but honestly I felt like the transition from intern to 2nd year/upper level was even bigger. Work got harder, responsibilities became greater, and I was responsible for both myself and everyone below me. I made sure my interns were doing the right things so they didn't look foolish before rounds. It was exhausting. Was it better than intern year though? I still say yes because I was more comfortable with everything.
    All that being said, would I want to be an intern again? No. :whoa:
     
  14. meerkat111

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    gatactus, Then you are a good senior. Most seniors do not help the interns. I think you are a good resident and a good senior/
     
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  15. Law2Doc

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    I don't know if anyone can say "most" here since few of us have worked at more than a couple of programs. I certainly had some great seniors and chiefs that looked after the interns and ran interference with the attendings. I'm aware of a few from my med school days that maybe didn't bank the same kind of loyalty with their troops, but they were definitely the minority. If I had to put a number on it I'd guess many many more seniors are "good" than not. But you aren't going to see venting about how great someone's senior is on SDN so it probably just seems like there are a lot more jerks out there than there really are.
     
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  16. secants

    secants about:blank
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    Intern year has it's ups and downs. The only way I know people kept sane was with scattered easy elective months and clinic week. Although I honestly think have a good cohesive group of co interns is what makes or breaks your experience.
     
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  17. DermViser

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    Aw. That's really nice of you. :)
     
  18. Law2Doc

    Law2Doc 5K+ Member
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    Yep. Have a good attitude. Joke around with a good crowd. It goes by real fast. A blur, really.
     
  19. DermViser

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    I think this is more indicative of an anxiety problem. This criticism is hardly scathing to say the least, although it is hard for you to see this objectively.
     
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  20. rkaz

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    I am having a painful time in intern year as well. I am in psychiatry and love my program. But I had an off-service (non-psych) rotation last month, and one of the senior residents in that service wrote a very harsh eval for me about my lack of medical knowledge and lack of proactiveness (while another resident had great things to say about me about how detailed and thorough I am). The resident wrote the eval without telling me what to change during my time with her, as I only spent a few days with her, and if I had gotten feedback when I could still salvage the evaluation, I would have made every effort to do so. I am already doing things differently and being WAY more proactive since I got that horrible eval, and I think I am doing a much stronger job now. I'm taking a much more active role now for patient management. I think it is just a learning curve, as not that much was expected of me as a medical student. The medical students at the program where I'm now an intern have way more responsibility for patient management than I ever did as a student... so it was an issue of getting accustomed to a new role. As far as medical knowledge, I'm doing a bit of reading when I come home, but it is not as much as I'd like to do. Will work to be more efficient during the day so I can have more time to read at night.

    After reading threads on this forum about residents getting fired for medical incompetence, I am feeling utterly devastated by my harsh eval as it has been stressing me out beyond belief. No one in my program has brought it up yet, though I fear I will be terminated over another resident writing on my eval that I lack medical knowledge. This month I'm doing another off-service rotation and working over 90 hours per week. (I'm not supposed to be breaking duty hours, but I stay extra because that's how long it takes for me to get my work done and notes finished as I have ADD. I don't have to log my hours, so that's not the issue as I'm not 'officially' violating anything... but I'm afraid that other on-call teams are noticing me staying several hours after everyone else, and will think I can't get my work done in a timely fashion.) Not only is working such long hours hard enough in which I'm just trying to survive another day, but carrying around the pain and fear from last month's negative eval is just crushing my soul at this point. Getting through residency means everything to me, and I don't mind living at the hospital and having no life if I have to for this brief time. There is no time for my personal life. I am in a new city away from family and I made a few friends here... but I just don't have time right now to talk to anyone. I don't mind working hard, and I can truly say I'm working to well over 90%+ capacity and burning out.... but being criticized for not being competent enough when I'm putting all I have into what I'm doing is just too demoralizing. I'm putting myself totally into my work.... yet it is still not good enough. Getting through each day is a challenge. I'm not normally anxious like this, but right now I am very freaked out about the situation. I feel like someone will call me any day to let me know I'm out of the program. I wish interns were allowed 4-5 months before evals of competency really counted, so that we don't get penalized for the first bad one. I'm only sleeping 5-6 hours per night, and I'm just trying to hang in there without breaking down. I wouldn't wish this upon anyone.
     
    #19 rkaz, Sep 6, 2014
    Last edited: Sep 6, 2014
  21. Law2Doc

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    First, an evaluation written by a resident on another service probably won't even come back to bite you. It doesn't carry the same weight as an attending in your specialty's opinion would. I wouldn't sweat this, but I would probably think over how you might want to address it if it for some reason comes up in your semi-annual evaluation with your PD. But certainly no reason to carry around pain and fear. Worry about problems only when they actually become problems. Don't sweat the small stuff.

    Second, working harder on your subsequent off service rotation is never a bad idea. While you really ought to be able to do the job in about the same timeframe as your peers, give or take, I suspect all residents have done our share of coming in early and staying late "off the books" to look a bit more prepared. Even now I show up a half hour early for certain things I'm slower at. You do what you need to to get the job done and/or look competent.

    Third, "no time for a personal life" during the first half of intern year isn't unusual. It's a very steep learning curve for most -- it gets better.

    Fourth, sleeping 5-6 hours a night for much of intern year isn't that unusual (maybe for psych, but not for most of the rest of us who did true intern years). I was pretty ecstatic if I ever got six actually. It wasn't that long ago that interns did 30 hour calls (my intern year) and not that long before that since there was no 80 hour limit and people routinely worked over 100 hours a week. It's hard but people survived it. You will bend but not break.

    So I say relax. Take a deep breath. It's a Learning curve. It's rare to get thrown out, despite the several threads you see on SDN. and you get one or more talkings to by your PD before you even get to that stage, so I sure wouldn't sweat one weak evaluation from an off service resident.

    And to be honest, the residents rotating from other specialties often ARE bad by comparison to the categoricals in ones own field. I've worked with people rotating through during intern year and many can't hide that they are only here because they have to be. Being a good intern is 90% attitude. So they often get weaker evaluations, often deservedly, and their PDs usually ignore them and life goes on. Once in a while you see a superstar from another specialty and you try to convince him/her to switch specialties, but most of the time the people just rotating through maintain the expression of someone asked to eat a bug on Fear Factor the whole month and clearly cant wait to get back to the psych wards or wherever. So it's hard to give them a pat on the back and write "great job". If they seem into it and pull long hours, etc, then that's different. But that's not common.
     
    #20 Law2Doc, Sep 7, 2014
    Last edited: Sep 7, 2014
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  22. rkaz

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    Thanks for your post, L2D. Really... thank you. It made me feel a LOT better. Intern year is really rough, especially off-service rotations. Next year will be a lot more fun for me, as I will have almost every weekend off next year in my psychiatry training since we have a chill PGY2 year. But this year, I just have to white knuckle it. I feel like I'm in a big lake with only my open mouth above water, and trying not to drown. It's uncomfortable. I'm counting days at this point, until this off-service rotation is over (we're about 1/3 of the way through this month). I think it's going decently well this month. I'll get through my training as long as I can stay in my program. Hopefully whatever happened last month won't be an issue, as I'm making efforts to do a good job. I was recently with another intern (not in my program, but who is off-service with me) who also told me that she was feeling pretty depressed and hating intern year also... so I guess there is a lot of us in a similar place.
     
  23. johndoe44

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    I think it is hilarious how some of you guys give advice on this site; OP you do not need to just "suck it up" that's just something people say because they think they are "billy bad ass MD" but in reality people that say these things are feeble and likely have not participated in many extra curricular activities in high school other than chess club. They derive some sort of weird pleasure by thinking they are tough.................... anyway what I am trying to say is don't listen to any of this crap.

    If you feel you are actually experiencing clinical depression you should just go to your physician and speak with him about starting an antidepressant. I mean we are doctors right, we get down from time to time and while I do admit its the nature of industry it doesn't have to make you hate you job. Speak with others you can confide in like girlfriend, parents, close friends; anyone who you can trust and let me know that you just aren't feeling yourself and you just want their support. Oftentimes, that's all you need. Take time for yourself on your off days and take a jog, ride a bike through a trail or even go out barhopping with buddies and reintegrate yourself into society. You can still be a great doctor and not let it be all consuming; even during intern year.

    Of course this is what any reasonable person would say but you are now reading advice from a guy who actually was terminated but not for copying and pasting or dealing with mental illness. Nevertheless, do the best you can and try to remember there are other things in life besides living in the hospital. If you do have depression thought you really should speak with a physician and see if maybe he/she can give you something to improve your experience.
     
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  24. johndoe44

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    At least you received some sort of feedback; positive or negative.
     
  25. Doctor Bagel

    Doctor Bagel so cheap and juicy
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    What's your sense of your program directors and chiefs? If they seem approachable, maybe you could proactively talk to them about this evaluation. My program had sit down meetings with a program director 3 times a year, so they'd notice all the evaluations by then anyway. If this evaluation is out of keeping with your other evaluations, talking to them might give you some reassurance. Honestly no sane program director wants to fire residents because that's too much work/pain for them, so it would be very rare for someone who is trying to get fired over one negative evaluation (or even to get talked to about it) especially an evaluation from a resident.

    Do you have a MH provider where you are to help with the ADHD/anxiety? It might be a good idea to find one.

    Anyway, hang in there -- it will get better next year. There's also a lot of talk right now about resident firings on this forum, which can make anyone who is new to a program a little paranoid. It's hard to remember that firing residents or putting them on probation is not at a common occurrence, and it usually follows lots of other things.
     
  26. thepoopologist

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    I wouldn't lose any sleep over another residents eval. You should be able to let this stuff roll off your shoulders
     
    #25 thepoopologist, Sep 16, 2014
    Last edited: Sep 16, 2014
  27. thepoopologist

    thepoopologist Ph.D in Clinical Meconium
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    Intern year is definitely a learning curve. But don't sweat what hasn't happened
     
  28. apevo8

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    I have been feeling the same way since residency started. Constantly feeling overwhelmed and stressed out which is what is expected, I know. I have never had issues with this in the past or any other depression. I feel as if I am not cut out for this career even though I have received nothing but positive feedback from my seniors and attendings. I've already sought some guidance from one of the chiefs. Things are tolerable right now but I'm about to get into the hardest part of my schedule and the winter time which concerns me the most.
     
  29. greg1184

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    "needed to be careful about copying and pasting my physical exam notes from the previous day progress notes"

    You felt miserable about this? If that is the worst of your feedback then you are doing great. Sounds like constructive feedback to me.

    Intern year is just that.... a year. I went through it, you will go through it. There is greener grass in the field ahead of you... no matter what field you are in. Just be sure to empathize when the next July interns come.

    Try to spend time with your cointerns. They can make great emotional support. Best of luck.
     

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