Intern Year - What you're in for

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songl4a said:
My guess is it must be a top school, where everyone gets good spots, otherwise yes, it could be bittersweet or embarrassing.
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I've heard of it being done at schools that aren't considered top tier as well. Never really understood it. I get the celebratory nature of the occasion, but it seems like the opening of the envelope should be a semi-private moment. Just asked in case there was some aspect of it I wasn't getting. Anywho, apologies for derailing.
 
rilte4 said:
Why are there schools that make students open their envelopes and announce their match results at the podium in front of everyone? That sounds horrifying.
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"Good evening. Many of you may know me as Prospectivekidd. Some of you know me as the man who saved the lives of two patients during medical school when I plugged the left ventricle within the heart of newborn siamese twins with my pinky. I am happy to be with you to reveal my residency program to you all tonight. Without further adieu, please hand me the envelope. Yes, and I am pleased to announce I have ..... wait a minute......oh my god......landed.......... in .......family medicine!?!?!??!, North Dakota Community Hospital!!!!!!??????"
A4wy_f-maxage-0.gif

Taker4.gif


:laugh::laugh::laugh:
 
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rilte4 said:
Why are there schools that make students open their envelopes and announce their match results at the podium in front of everyone? That sounds horrifying.
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It's very common among medical schools.

At my school we also had to submit a song to be played overhead and a picture slideshow to be played on the big screen behind the stage.
 
rilte4 said:
Why are there schools that make students open their envelopes and announce their match results at the podium in front of everyone? That sounds horrifying.
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no one is forcing you to go up on that stage. many students rightfully elect to read their results in private
 
It's kind of like the NFL draft. It's really cool -- a once in a lifetime experience -- to be pleasantly surprised in front of friends and family. You won't get that elation elsewhere, it's a big deal for some. And the schools also want to instill the notion that everyone is in this together, it's not meant to be mean. And it's a particularly useful opportunity to find out where everyone else is going and congratulate and cheer them because everyone tends to disappear after the match. And sometimes you appreciate your match more when you hear others cheer your luck, even if it wasn't your first choice. But every now and then there's someone who free falls like those poor SOBs in the NFL green room. So yeah you can be the next Geno Smith/Myles Jack, so there is a downside. I think it's a net positive for most, which is why places continue the tradition.
 
Maybe I'm just naive, but an average 11 hour day doesn't sound THAT bad. I mean I guess it's a rough 11 hours, but 11 hours seems pretty doable. You can still get a reasonable nights sleep, cook dinner, etc on that then table.

Famous last words I bet...
 
alpinism said:
It's very common among medical schools.

At my school we also had to submit a song to be played overhead and a picture slideshow to be played on the big screen behind the stage.
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Wtf.

I'd submit Let The Bodies Hit the Floor with a slideshow of nothing but cats in protest.
 
The Knife & Gun Club said:
Maybe I'm just naive, but an average 11 hour day doesn't sound THAT bad. I mean I guess it's a rough 11 hours, but 11 hours seems pretty doable. You can still get a reasonable nights sleep, cook dinner, etc on that then table.

Famous last words I bet...
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When I was on contract back in the day I'd do 4 12s and a 16 a week every week, bookended by an hour drive on either end- it's exhausting but doable. Though I'm going to be older in residency, so maybe I'll feel differently.
 
The Knife & Gun Club said:
Maybe I'm just naive, but an average 11 hour day doesn't sound THAT bad. I mean I guess it's a rough 11 hours, but 11 hours seems pretty doable. You can still get a reasonable nights sleep, cook dinner, etc on that then table.

Famous last words I bet...
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It isn't..I found this article to actually be pretty encouraging because it's no where near as bad as I thought things would be. I've worked at least 3200 hrs/yr for the past 2 yrs. It's definitely miserable for the first 2 months and then you adjust. The only thing is that medicine is more physical than my current work and doesn't have as regular a schedule, but that's just another thing you can adjust to. But 18hrs days will probably be challenging

'“A typical day” in the life of an Internal Medicine intern consists of rising as early as5AM"
--> Does this mean waking up at 5am or getting in by 5am? Because I would also say a huge part of the working world gets up around then.
 
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Probably waking up at 5. The max number of patients for an IM intern on a normal team with 1 upper level and two interns is 10, I think. Most places have night float/ call check out at like 7:30 followed by conference for an hour and rounds starting around 9ish. So you have to see 10 patients before 7:30. That doesn't take 2.5 hours, especially when most of the patients you will know.
 
kavorca said:
Probably waking up at 5. The max number of patients for an IM intern on a normal team with 1 upper level and two interns is 10, I think. Most places have night float/ call check out at like 7:30 followed by conference for an hour and rounds starting around 9ish. So you have to see 10 patients before 7:30. That doesn't take 2.5 hours, especially when most of the patients you will know.
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Is that a rule? How is this guy saying he has up to 100 patients it's sound like complete and total bull
 
I think that's the rule for IM. Surgical services can carry many more.
 
ProspectiveKidd said:
Is that a rule? How is this guy saying he has up to 100 patients it's sound like complete and total bull
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He was talking about aggregate # of patients over the whole year, not how many patients he was taking care of at once. Like he said 147 patients in 18 clinic days--> average of 8.2 per day.

Looking at the article again, this guy has also been to more cities and more countries in one year that I have in 24 yrs, so there must be a good amount of time available to travel
 
Mansamusa said:
He was talking about aggregate # of patients over the whole year, not how many patients he was taking care of at once. Like he said 147 patients in 18 clinic days--> average of 8.2 per day.

Looking at the article again, this guy has also been to more cities and more countries in one year that I have in 24 yrs, so there must be a good amount of time available to travel
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I worked the most night shifts at the County: 4 weeks covering the entire hospital’s Medicine or ICU census from 8pm – 7:30am, during which I was the only MD available for a few dozen patients

Yet this was cake compared to the week I spent covering 60-100ICU and Ward patients overnight at the academic hospital. Many people do not know that nighttime is the hardest time to get 1 on 1 attention from a doctor. When I say “1”, I mean the ratio of doctors to patients is 1 of me to 60-100 patients whose care I am responsible for during the night.

To be fair I guess these were isolated or rare occurrences but it just seems like it would never happen due to the hospital not wanting to get their asses sued when something goes wrong because someone who was a medical student 6 months ago is not responsible for all those patients.
 
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ProspectiveKidd said:
I worked the most night shifts at the County: 4 weeks covering the entire hospital’s Medicine or ICU census from 8pm – 7:30am, during which I was the only MD available for a few dozen patients to upwards of 70 or 80 (average 60s).

Yet this was cake compared to the week I spent covering 60-100ICU and Ward patients overnight at the academic hospital. Many people do not know that nighttime is the hardest time to get 1 on 1 attention from a doctor. When I say “1”, I mean the ratio of doctors to patients is 1 of me to 60-100 patients whose care I am responsible for during the night.
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Oh, maybe overnights work differently or he was doing telemedicine monitoring or he is exaggerating. I don't know enough to know if that's normal. (Probably something to do with how it's cheaper to pay nurses and NPs overnight than physicians)
 
ProspectiveKidd said:
"


I worked the most night shifts at the County: 4 weeks covering the entire hospital’s Medicine or ICU census from 8pm – 7:30am, during which I was the only MD available for a few dozen patients to upwards of 70 or 80 (average 60s).

Yet this was cake compared to the week I spent covering 60-100ICU and Ward patients overnight at the academic hospital. Many people do not know that nighttime is the hardest time to get 1 on 1 attention from a doctor. When I say “1”, I mean the ratio of doctors to patients is 1 of me to 60-100 patients whose care I am responsible for during the night.
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Patients you are covering aren't technically "your" patients. You're basically just keeping things running overnight so that actual work can get done on day shift. His aggregate patient numbers were likely the patients he cared for in a real capacity, many of whom overlap from day-to-day (you'll have 14 patients some days, but a lot of them are the same patients you've had for the past three days or w/e, so you'll have 14 patients for 5 days straight but only have cared for 24 different people over those days).
 
The Knife & Gun Club said:
Maybe I'm just naive, but an average 11 hour day doesn't sound THAT bad. I mean I guess it's a rough 11 hours, but 11 hours seems pretty doable. You can still get a reasonable nights sleep, cook dinner, etc on that then table.

Famous last words I bet...
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And yet like every other bright-eyed and bushy-tailed medical student, you won't know just how much it sucks until you get there. There are only two good things about intern year, 1) you finally learn what it is to be a doctor, and 2) it ends on June 30 when a new batch of suckers come in to take over your horrible job.
 
Mansamusa said:
It isn't..I found this article to actually be pretty encouraging because it's no where near as bad as I thought things would be. I've worked at least 3200 hrs/yr for the past 2 yrs. It's definitely miserable for the first 2 months and then you adjust. The only thing is that medicine is more physical than my current work and doesn't have as regular a schedule, but that's just another thing you can adjust to. But 18hrs days will probably be challenging

'“A typical day” in the life of an Internal Medicine intern consists of rising as early as5AM"
--> Does this mean waking up at 5am or getting in by 5am? Because I would also say a huge part of the working world gets up around then.
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Depends on the service. Surgeons may actually start rounds at 5-530. Other fields need to pre round before 7-730. The first scene of the Greys Anatomy pilot shows Merediths alarm clock going off at 4am, and was pretty accurate.
 
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The Knife & Gun Club said:
Maybe I'm just naive, but an average 11 hour day doesn't sound THAT bad. I mean I guess it's a rough 11 hours, but 11 hours seems pretty doable. You can still get a reasonable nights sleep, cook dinner, etc on that then table.

Famous last words I bet...
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11 hour days are fine but bear in mind that it won't necessarily be 11. As senior residents you can be in the hospital 24 hours in a row. And the 80 hour work week is an average -- meaning you are allowed to have weeks above that. And not every program sticks to hours and some residents fudge and work "off the clock". And of course there's commutes etc. it's definitely doable but it's more of a grind than you think.
 
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Law2Doc said:
As senior residents you can be in the hospital 24 hours in a row.
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Ah, that's what I was thinking residency was like, which is why I was surprised by the 11hrs. So the long shifts come when you are more useful and better know what you are doing?
 
Ah that's true, I guess 11 hour average doesn't mean 11/day necessarily...you can be there 24 on/24 off for the same total hours/day.

Plus does being on call count into that total?
 
Mansamusa said:
Ah, that's what I was thinking residency was like, which is why I was surprised by the 11hrs. So the long shifts come when you are more useful and better know what you are doing?
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Interns usually are used in 11-14 hour stints. They do weeks of night float (eg 6 days in a row of 6pm to 7am) instead of 24 h call.

Yes being on call counts toward your duty hour limits -- you will be physically in the hospital, not doing call from home as an intern at most places. (If that's what you were suggesting).
 
songl4a said:
How about moonlighting during residency, is that very common?
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Strongly depends on the program and specialty. You can't go above 80 hours with your moonlighting included, so if you're at a place or in a specialty that pushes your hours to their limits, you aren't moonlighting even if it's allowed. Many programs also don't allow moonlighting at all, so those make it a no go regardless of hours worked.
 
The hours vary immensely. I'm in peds (2nd year now), and I will have some months where I'm working 8-5 (clinic months), and other months where I'm working 16 hours most days. We typically average one day off a week (you might work 14 on before a day off though as long as it averages out). How exhausting it is depends on what you're doing. ER shifts mean you're on your feet the entire day and dealing with lots of stressful situations (from codes to difficult and angry patients), and even after a 12 hour shift, it's not uncommon to have 3 hours of notes to do. The hardest part is switching your schedule back and forth. I'll commonly have a week of days, a week of evenings, and a week of night, and it's hard on your body to keep changing your eating and sleeping schedule. Some services, I'll cover 8-15 patients a day, but on nights, I usually cross covered around 60 patients per night (some nights are relatively quiet and routine calls for Tylenol and Desitin while other nights are a whole lot of kids crashing and being sent to the ICU). We have a night team for primarily cross cover and a team for primarily admit at my program; so, on admit nights, I'd routinely admit 15-20 kids over the course of 12 hours and would frequently stay long after finishing H&Ps.
 
Mad Jack said:
I've never heard of a place that allows it- moonlighting generally requires a medical license, which requires one year of GME, amirite?
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Not quite rite. Depends what you are doing and where you are doing it. There are a variety of internal in-house moonlighting jobs you could still do under your training license. And people in second residencies for whatever reason might already have a license.
 
Law2Doc said:
Not quite rite. Depends what you are doing and where you are doing it. There are a variety of internal in-house moonlighting jobs you could still do under your training license. And people in second residencies for whatever reason might already have a license.
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Makes sense.
Lost in Translation said:
You liar. Hare Hare Yukai and record that **** or else I'm not going to be your kouhai anymore.
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:laugh: That might get my degree rescinded
 
rilte4 said:
Why are there schools that make students open their envelopes and announce their match results at the podium in front of everyone? That sounds horrifying.
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take note
because medical culture loves humiliation, stiff-upper-lipp-ed-ness, and likes to watch you try to choke back tears
really
 
Crayola227 said:
take note
because medical culture loves humiliation, stiff-upper-lipp-ed-ness, and likes to watch you try to choke back tears
really
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Nah, they want you to be thick skinned and roll with the punches. Because this won't be the only kick to the gut you'll have along this path, and it might not be the hardest.
Something like 80% of people get one of their top three places, some percentage will be happy with any of their ranked programs, and anyone who soaped already knows their match by match day, so it's really a very small minority who truly will get unpleasantly surprised. Odds are it won't be you.
 
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