Intern mom, problems with program , help and advice needed!!

[Innocent resident]

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Hi all,
I have a 10 month old baby, I m intern and not doing great so far in my internship.
Overall I was not able to fulfill the expectations of my pd.
My graduation and promotion to second year is already delayed for 3 months owing to not performing well on floors and poor ITE score.
Overall is very hard for me to manage work baby and hospital.i have no relatives in USA.i hired a nanny but that didn't work either, had to fire her..day cares are not reliable in my locality..had to send baby back home .
Now I have to focus and improve my chances for second year promotion..
Any advice to improve my self appreciated..
FYI I m a hard worker but don't know what happen now, things are not going in right direction

 

[IM2GI]

Tough situation. Do you have a spouse?

You need to realize that your career is in jeopardy and you need a reliable child care situation. Does your institution have in house daycare?

 

[northernpsy]

Sorry to hear you are having a tough time. I am a mom too so I know how easy it is for childcare problems to interfere with work. It sounds like making sure you have reliable childcare set up so you can focus on work is the top priority here.

If you have a spouse, it might be time to consider if the spouse can go to part time or take a leave of absence to focus on caring for the child while you focus on getting your career back on track.
If you're doing this all by yourself, perhaps you can get the child into a daycare, but also try to find someone on care.com or some other service who you can arrange will pick up the child and watch him/her for a few hours if daycare sends the baby home early or you have to work late?
If you can't find anyone decent on Care.com then what about asking your fellow residents if they might have a spouse or friend who would like to earn some extra money babysitting? If not, is there a college in the area where you might find students looking for babysitter jobs?

 

[Innocent resident]

Me and my spouse both are resident.
We don't have in-house day care at hospital.
Already send baby back home.baby thoughts killing me every moment.
Pd is very hard and he already put me in 3 months probation and delay for graduation.

 

[northernpsy]

It might help to remind yourself that what's best for your baby in the long run is for you to finish your residency and be able to have a good job to support your kids, so do what you have to do to focus on your residency for now.

 

[IM2GI]

Me and my spouse both are resident.
We don't have in-house day care at hospital.
Already send baby back home.baby thoughts killing me every moment.
Pd is very hard and he already put me in 3 months probation and delay for graduation.

Is this you too?

https://forums.studentdoctor.net/threads/program-not-happy-from-me.1245228/

Look the bottom line is you need full time child care. Yes it is sad and depressing and difficult.

You should go on care.com and hire someone full time. You might spend your entire paycheck to do so, but that's life. You can live off your spouse's income for a few years.

If you cannot stand to be away from your child at all, perhaps you should just resign and stay at home.

 

[Crayola227]

Is this you too?

https://forums.studentdoctor.net/threads/program-not-happy-from-me.1245228/

Look the bottom line is you need full time child care. Yes it is sad and depressing and difficult.

You should go on care.com and hire someone full time. You might spend your entire paycheck to do so, but that's life. You can live off your spouse's income for a few years.

If you cannot stand to be away from your child at all, perhaps you should just resign and stay at home.

One, they already said they have full-time child care, that's not exactly the dilemma. Two, I'm pretty sure they're aware of the solution of resigning. Three, that's likely not a good financial choice both short-term and longterm.

Likely what they need is advice on how to get out of hot water with the PD and cope emotionally with being away from the baby. Sounds like the baby had to go far.

You not only didn't provide any useful advice, you just took this as an opportunity to trivialize this person's problems and feelings. From a professional standpoint, you basically said "suck it up and **** off."

Housefire.

 

[IM2GI]

One, they already said they have full-time child care, that's not exactly the dilemma. Two, I'm pretty sure they're aware of the solution of resigning. Three, that's likely not a good financial choice both short-term and longterm.

Likely what they need is advice on how to get out of hot water with the PD and cope emotionally with being away from the baby. Sounds like the baby had to go far.

You not only didn't provide any useful advice, you just took this as an opportunity to trivialize this person's problems and feelings. From a professional standpoint, you basically said "suck it up and **** off."

Housefire.

Completely untrue. This person has gotten lots of sympathy and good advice in their other thread, including from myself.

I guess I interpreted "daycare not reliable, had to send baby back home" as the child was getting sick often and daycare was sending them home, not that the person sent their child back to their home country. Especially since the title of the thread was "intern mom" I assumed that childcare was the central issue. She also mentioned difficulty balancing work/baby.

Otherwise, within this thread, no real issue was clearly identified that they need specific help with. Please see the other thread for prior discussion.

 

[Dog_luver]

Completely untrue. This person has gotten lots of sympathy and good advice in their other thread, including from myself.

I guess I interpreted "daycare not reliable, had to send baby back home" as the child was getting sick often and daycare was sending them home, not that the person sent their child back to their home country. Especially since the title of the thread was "intern mom" I assumed that childcare was the central issue. She also mentioned difficulty balancing work/baby.

Otherwise, within this thread, no real issue was clearly identified that they need specific help with. Please see the other thread for prior discussion.

While I think there is a different issue at play here besides the baby issue, I think that male residents/fellows, etc frequently do not realize how tough it is for female residents at times to deal with everything that comes with taking care of a family, household, etc in addition to training and being a doctor. I think that's why your response comes off as insensitive. Sure lots of female residents are able to balance home life, doctor stuff, and other stuff wonderfully, but not everyone is. The vast majority of male residents, in my experience at least, typically only have to worry about "doctor" stuff either because they have an at home wife who takes care of baby stuff/home/meals, etc with the understanding that "we'll suffer for a few years and then male resident will do well financially, " or they have a working spouse who brings in some income and also takes care of other stuff also while they concentrate on "doctor stuff." Female residents with children, etc. have a whole other world of responsibility that they have to take care of in addition to "doctor stuff" even if they have supportive partners. Even if baby is technically in a good environment "back home" - which given the verbiage and the "back home" comment I'm assuming the OP is an IMG, being a new mom with a new baby and being away from baby is tough and I'm sure it's difficult to deal with.

With that said, unfortunately there is limited support and needed sacrifices that need to be made in order to make it through residency training. I think the options ultimately are to continue, work your butt off (to the OP), and persevere, maybe get some counseling to deal with the emotional issues that come with being away from the baby, or otherwise decide that if that's not feasible, perhaps staying home with the child while the spouse finishes residency is another option. Or ultimately trying to switch to a less demanding specialty, although that might be as difficult if not more given IMG status, difficulty of switching, and unfortunate probationary status.

 

[Perrotfish]

Hi all,
I have a 10 month old baby, I m intern and not doing great so far in my internship.
Overall I was not able to fulfill the expectations of my pd.
My graduation and promotion to second year is already delayed for 3 months owing to not performing well on floors and poor ITE score.
Overall is very hard for me to manage work baby and hospital.i have no relatives in USA.i hired a nanny but that didn't work either, had to fire her..day cares are not reliable in my locality..had to send baby back home .
Now I have to focus and improve my chances for second year promotion..
Any advice to improve my self appreciated..
FYI I m a hard worker but don't know what happen now, things are not going in right direction

1) What specialty?

2) How far below the average was your ITE score?

3) What specific issues were raised about your performance on the floors?

It sounds like you have the baby thing under control (If we are correct that grandma/grandpa are taking care of your child now), though I know it sucks. To move forward, right now, it sounds like you really have three questions you need to answer:

1) How do you improve your performance on wards

2) How do you improve your ITE

and most importantly

3) How do you prove to your PD, objectively, that both of those things are improving.

The PD is supposed to help you with that, but if he's not doing that then its your job to come up with an objective plan of remediation that you can give to him to show you are meeting milestones. If you want help with that we'll need to know which ITE you're taking, and also what was going wrong on wards other than issues with baby.

 

[Innocent resident]

Thank you all for the kind words / advice.
I m an IMG int - med intern..
I actually am a good /efficient resident in terms of floor responsibility..the only problem I have is really Bad ITE score..in addition to that one of my senior who was actually in probation and was in alot of trouble during her first year complained to my PD.which actually add flame to my issues..
This lady was actually not happy from me when during round I add answering questions of the attending and getting good words from them..
But since I m intern I don't have any say and having bad ITE score put me at worst situation...
I m now working really hard, already send baby back home
I appreciate if you guys suggest what should I do now to get good score in ITE..
I admit I m not a genius or position holder during my med school but I never failed and always above average.

Thank you all for your time

 

[rokshana]

Thank you all for the kind words / advice.
I m an IMG int - med intern..
I actually am a good /efficient resident in terms of floor responsibility..the only problem I have is really Bad ITE score..in addition to that one of my senior who was actually in probation and was in alot of trouble during her first year complained to my PD.which actually add flame to my issues..
This lady was actually not happy from me when during round I add answering questions of the attending and getting good words from them..
But since I m intern I don't have any say and having bad ITE score put me at worst situation...
I m now working really hard, already send baby back home
I appreciate if you guys suggest what should I do now to get good score in ITE..
I admit I m not a genius or position holder during my med school but I never failed and always above average.

Thank you all for your time

your inservice is not meant to be used for promotion or to put you on probation...if your scores are really low (<20%tile), then its a indicator that you need help, but usually intern year score are not really considered....so you weren't put on a 3 month delay only due to ITE scores...at least not I'm IM.

sounds like you need to sit down with one of your chiefs or an attending you trust and talk to them about where you stand and what you need to do make sure that you are able to stay in the program even if it means finishing off cycle.

and frankly, what the hell is your spouse doing in regards to taking care of your baby? Does he think his residency is more important than yours?

and can whoever is taking care of your child be able to come for extended visits with your baby? Can they come stay with you?

 

[Perrotfish]

Thank you all for the kind words / advice.
I m an IMG int - med intern..
I actually am a good /efficient resident in terms of floor responsibility..the only problem I have is really Bad ITE score..in addition to that one of my senior who was actually in probation and was in alot of trouble during her first year complained to my PD.which actually add flame to my issues..
This lady was actually not happy from me when during round I add answering questions of the attending and getting good words from them..
But since I m intern I don't have any say and having bad ITE score put me at worst situation...
I m now working really hard, already send baby back home
I appreciate if you guys suggest what should I do now to get good score in ITE..
I admit I m not a genius or position holder during my med school but I never failed and always above average.

Thank you all for your time

Inservice:
Well, the good thing about medicine is that, out of all the specialties, you guys have the most material to study, and therefore the easiest time setting up a plan of remediation for knowledge base issues. If you don't have an official plan to remediate your ITE, I would set a meeting with your PD to start one. I'm in Pediatrics, but my understanding is with IM you have three main resources: Medstudy, the MKSAP, and Harrisons. I think of the books Harrisons is probably best, and from what I have heard the questions are about equal but Medstudy and MKSAP are both online and therefore better than Harrisons because you can show your PD you are doing them. Again, though, its probably best to ask an actual internal medicine person about this. I think your best bet might be to make a plan to read through Harrisons, and do the associated Medstudy vs. MKSAP questions for each chapter that you read, in some reasonable length of time (1 year? 1 chapter per non vacation weekend?). Then follow up with either your PD or your advisor and ask them if they approve of your plan, as a way of letting them know you have a plan.

Wards:
You sound like you lack insight into what they think is wrong with you. I don't know what they think is wrong with you, and I don't know to what extent their concerns are true, but I am 100% sure your PD didn't put you on remediation for the sole reason that a second year problem resident called you names. If you walked away from your first interview not even knowing what the problem is then you need to go to your PD or advisor again and figure it out.

Problems on wards tend to fall into 5 categories: stupid, rude, slow, unreliable, and dishonest. Stupid means you see the data and either make the wrong diagnosis or give the wrong treatment: that requires a study plan. Rude means you don't get along with either seniors, nurses, or patients: that requires a self abasing attitude change. Slow means you're not getting the work done one time: that means getting there earlier until you speed up, and lying about work hours so that your early arrivals don't become a problem. Unreliable means you're not finishing tasks, not following up on patients , or you're absent: that requires you to, um, stop doing that. Finally dishonest, meaning you're accused of lying about what you did or didn't do, requires a subsequently spotless record and prayer, since not a lot of residents come back from that.

Do you have any idea what you're accused of?

 

[Gastrapathy]

There's also the language component. I knew you had 2 threads going because of the consistent written English errors. Your speech may be hurting their perception of your ability.

Is your husband in the same program or same hospital? What does he think is happening?

 

[Keona]

Another consideration is that with all that has been going on in your life, and in the first year postpartum that you may be having some depression as well, you are going through so many life stressors at the moment. I highly recommend going to a doctor yourself and seeing if they have any additional advice. I get to the hospital before other people b/c I am slower, I stay later in clinic b/c I have kids and I will not get work finished at home once I get there. Find out where your problem areas are and talk with an upper level and see if they can give you some advice. Losing a resident in a year is very difficult on the program and the residents and not something that your coresidents want b/c it gives them more responsibilities.

An ITE exam is usually not going to cause graduation to be delayed in my specialty, but they do want to make sure when you graduate that you're going to pass your board exams. I have a hard time following some of your writing, the only way to improve on that is to continue to practice and read as much as you can, not necessarily medical books, but just english books which might help some with helping others to interpret what you are saying. I have a younger sibling who does not speak English as his first language and this helped immensely in terms of his writing, he still leaves out words at times that I need to hear to understand what he means.

I improved my intraining exam score significantly from doing lots and lots of practice questions, it taught me what they were focusing on, along with listening to some audio lectures in the car. (I listen to audiobooks as well to give me a break from medicine when I'm not studying for an exam. We also have modules we have to complete to take boards and I worked on those in the month leading up to the ITE in the areas that I had the lowest scores from the previous year.

 

[Innocent resident]

Thank you all for your advices..
My English is surely not great but understandable and I belive that I can capable to communicate well..
I am working hard on my issues.
I would rather suggest some of you guys please of you don't have some good words to put forward don't put harsh words as well..
For example I read in some of the above post about my poor English, plz plz that's not just an issue..

 

[icd22]

As an MS4, I don't have any real advice. I just wanted to say that my grandparents raised me until I was 6. I would only see my parents 1-2x/year. Despite that, I'm now really close to my parents. They did their best and long term it was definitely better for me that they finished college. I can't even imagine how hard it's to have your child away. Best of luck.

 

[rokshana]

Thank you all for your advices..
My English is surely not great but understandable and I belive that I can capable to communicate well..
I am working hard on my issues.
I would rather suggest some of you guys please of you don't have some good words to put forward don't put harsh words as well..
For example I read in some of the above post about my poor English, plz plz that's not just an issue..

sorry, but you can't just listen to all the things that make you feel better...realize that you need to see what you are doing wrong to be able to fix it...and if your PD has delayed your graduation by 3 months, there are major things wrong and burying your head in the sand is not going to help.

And, unless you are satirizing the poor English comments with your above post, you have written communication issues that need work.

have you made an appointment to talk to someone to get an assessment of your deficiencies? a chief or an attending or one of the associate PDs?

 

[Gastrapathy]

Thank you all for your advices..
My English is surely not great but understandable and I belive that I can capable to communicate well..
I am working hard on my issues.
I would rather suggest some of you guys please of you don't have some good words to put forward don't put harsh words as well..
For example I read in some of the above post about my poor English, plz plz that's not just an issue..

The title of your thread was "help and advice needed." I tried to be gentle. I've been separated from my kids due to military service and its rough. But, here we are in another thread where OP asks for advice and then discards that advice and attacks the messenger.

Oh well. Good luck OP. The reality is that its a long way back from here.

 

[Innocent resident]

I m sorry for my attitude
I did speak to my PD and he wants me to write 10 cases , hand written..
I know you all guys are very experienced..
And trying to help me..
I just have a rough time these days..
Working on mksap mcqs
Is there any other mcqs which I should do to improve my score or just mksap?
I don't have that much time though since I m also studying Washington manual of internal medicine

 

[Spectre of Ockham]

Hi all,
I have a 10 month old baby, I m intern and not doing great so far in my internship.
Overall I was not able to fulfill the expectations of my pd.
My graduation and promotion to second year is already delayed for 3 months owing to not performing well on floors and poor ITE score.
Overall is very hard for me to manage work baby and hospital.i have no relatives in USA.i hired a nanny but that didn't work either, had to fire her..day cares are not reliable in my locality..had to send baby back home .
Now I have to focus and improve my chances for second year promotion..
Any advice to improve my self appreciated..
FYI I m a hard worker but don't know what happen now, things are not going in right direction

Make the PD an offer he can't refuse ?

 

[IM2GI]

Make the PD an offer he can't refuse ?

what does that even mean? sounds creepy

 

[Spectre of Ockham]

what does that even mean? sounds creepy

It's exactly what is sounds like , if she has been really hauling ass and the PD is a functional sadist (it happens) then working harder and pleasing the ass won't work. So plan B 😀

However if she's a slacker (also happens) then c'est la vie and à bientôt mon stethoscope.

 

[IM2GI]

I m sorry for my attitude
I did speak to my PD and he wants me to write 10 cases , hand written..
I know you all guys are very experienced..
And trying to help me..
I just have a rough time these days..
Working on mksap mcqs
Is there any other mcqs which I should do to improve my score or just mksap?
I don't have that much time though since I m also studying Washington manual of internal medicine

What does that mean? "write 10 cases, hand written." That sounds like a remedial elementry school project.

It makes me think he is worried about your communication and English skills. Given that you also performed poorly on the ITE, I think it is reasonable to bring up your broken English and possible difficulty with answering test questions.

If I had to go take my boards in a secondary language, I would get my ass kicked. It's not a judgement or criticism, it's reality.

Intern year is not the time to study to pass a test. You should be engrossing yourself with the actual practice of medicine, and reading about the diseases that your patients present with. When you have a COPD exacerbation, go read the guidelines. You can't approach it like studying for step 1. At the end of the day this is about taking care of real people.

 

[Innocent resident]

I m reading cases every day..also working on my English speaking skills..
And I will get good score in ITE..I m sure now

 

[Goro]

People come here for realistic advice, not hugs and kisses.

Thank you all for your advices..
My English is surely not great but understandable and I belive that I can capable to communicate well..
I am working hard on my issues.
I would rather suggest some of you guys please of you don't have some good words to put forward don't put harsh words as well..
For example I read in some of the above post about my poor English, plz plz that's not just an issue..

 

[Goro]

Find out what other working mom's in your hospital do.

Hi all,
I have a 10 month old baby, I m intern and not doing great so far in my internship.
Overall I was not able to fulfill the expectations of my pd.
My graduation and promotion to second year is already delayed for 3 months owing to not performing well on floors and poor ITE score.
Overall is very hard for me to manage work baby and hospital.i have no relatives in USA.i hired a nanny but that didn't work either, had to fire her..day cares are not reliable in my locality..had to send baby back home .
Now I have to focus and improve my chances for second year promotion..
Any advice to improve my self appreciated..
FYI I m a hard worker but don't know what happen now, things are not going in right direction

 

[deleted804629]

Use your spare time to tackle your weak areas.

 

[deleted480308]

1. Language skills always matter. Always. Communication is how we do our jobs and how our supervisors train/judge us

2. Do you respond to attending and senior resident critique like you have to advice here? That will sink you. Most supervisors will take some incompetence over attitude. Get used to saying "that's a fair point, I'll work on that sir/ma'am". Then get better at it and ask them in a week if they ha e observed improvement because you have been working on "x"

3. If you aren't good at 1 and 2 (and you aren't) you have to be solid on standardized assesments. I don't know hiw to study for an ITE but if I was you I would speak to your programs highest performers

I sincerely hope you can turn this around

 

[Innocent resident]

Thank you for all your help
I m working hard..
My husband is also a resident..
I hate going my apartment after work because to avoid baby thoughts
Nannys are not just expensive but they are not as trust worthy..

 

[rokshana]

Thank you for all your help
I m working hard..
My husband is also a resident..
I hate going my apartment after work because to avoid baby thoughts
Nannys are not just expensive but they are not as trust worthy..

then you haven't found the right nanny...

you can look to see if there is a college that has education majors that would like to live in or ask other residents (or attendings) if they know of a nanny or agency that they have had good experience with...or as green flowers recommended...is there a family member or someone from home that would be able to come live with you to help take care of the baby.

And i get it that your spouse is a resident as well...but presumably this is his baby as well...why is he not stepping up here?

 

[Innocent resident]

No body from my family or my husband family wants to live for long..they came for 2-4 months and left..no resident have kids in my program except one and her mother is living with her..
I think angry person is different, my husband is focusing on his residency more than me..I m very emotional and sensitive, which makes things very hard for me including my baby thoughts

 

[deleted480308]

No body from my family or my husband family wants to live for long..they came for 2-4 months and left..no resident have kids in my program except one and her mother is living with her..
I think angry person is different, my husband is focusing on his residency more than me..I m very emotional and sensitive, which makes things very hard for me including my baby thoughts

Have you sought mental health counseling?

 

[shoal007]

No body from my family or my husband family wants to live for long..they came for 2-4 months and left..no resident have kids in my program except one and her mother is living with her..
I think angry person is different, my husband is focusing on his residency more than me..I m very emotional and sensitive, which makes things very hard for me including my baby thoughts

im sorry for your difficulties and separation from your child. I think most likely your written and verbal communication is contributing to your problems. If your patient charts read anything like your conversation here... id imagine that would be a big problem. You need to talk to your PD... although taking care of a child during residency complicates matters -- there is some deficiency you are not seeing.

If you do not address it, you'll likely be terminated.

Sent from my Pixel using Tapatalk

 

[mdbarbermd]

Hi all,
I have a 10 month old baby, I m intern and not doing great so far in my internship.
Overall I was not able to fulfill the expectations of my pd.
My graduation and promotion to second year is already delayed for 3 months owing to not performing well on floors and poor ITE score.
Overall is very hard for me to manage work baby and hospital.i have no relatives in USA.i hired a nanny but that didn't work either, had to fire her..day cares are not reliable in my locality..had to send baby back home .
Now I have to focus and improve my chances for second year promotion..
Any advice to improve my self appreciated..
FYI I m a hard worker but don't know what happen now, things are not going in right direction

It's a scarifice u have to makeunfortunately

 

[Innocent resident]

Thank you all