Is residency really better than M3/4?

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genessis42

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Just want an honest opinion since im finishing at a US school and starting in July.

I remember when I was an M3, we would often get pushed around by nasty residents/attendings and it would be difficult to stand up for myself as a student since we are evaluated. Is the experience better during PGY1-end?

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As always… depends

There are toxic programs and friendly ones.
As a student you may have a toxic HemOnc doc but only have to deal with them for a month, but in Residency they OWN you for 3-5 years.

If you know someone who is in a program then can use them as a gauge as to the level of toxicity on said program…. And some places have well know reputations for it so can stay away from those
 
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Depends on the rotation and your definition of "better", but generally speaking at every step of training, you should be focusing more on material that interests you and having an increased level of autonomy. If you consider that better, then yeah. Being an attending is better than fellowship which was better than being a senior resident which was better than being an intern which was better than being a subi which was better than being an m3. But that level of autonomy/responsibility often does correspond to more work or longer hours, at least temporarily, which obviously many people don't like.
 
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Yes and no. Theoretically you're in a specialty you chose to do at this point, so that should be a plus. You're also more knowledgeable than you were as an M3/4, which is also a plus. But now you have some actual responsibility for your patients, even though the buck doesn't stop with you yet. That new responsibility can be quite stressful. Hours also can be brutal depending on your specialty and your specific program. So it really depends on what specialty you're in, what program you're in, and your personality.
 
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Just want an honest opinion since im finishing at a US school and starting in July.

I remember when I was an M3, we would often get pushed around by nasty residents/attendings and it would be difficult to stand up for myself as a student since we are evaluated. Is the experience better during PGY1-end?
It all depends on you and why you don’t like MS3/4 year. I would say yes but mostly because even though you’re working harder and more hours it is less BS and people aren’t wasting your time just because their life sucks. Or it could also be because I met my spouse in M4 year, who knows.

There’s plenty of BS and stress in residency but nothing compares to waking up at 430am to drive in and write down the vitals/bowel habits of a bunch of post-op patients or holding some crap in the OR while getting pimped and actually paying tuition for the privilege.
 
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Just want an honest opinion since im finishing at a US school and starting in July.

I remember when I was an M3, we would often get pushed around by nasty residents/attendings and it would be difficult to stand up for myself as a student since we are evaluated. Is the experience better during PGY1-end?
There's a whole thread about this somewhere in this forum but if you were to ask me to rank the years from M3 through to attendinghood in terms of how much they suck.

M3 - sucks the most. You don't know what you're doing. Nobody respects you. You can't "do" anything. You have to do "everything".

Intern year - Hooray! You're doing something you want to do and you have some ability to "do stuff". Boo - You still don't know what you're doing, nobody respects you here either, the hours suck and now you have some responsibility for what happens to the patients, usually the bad stuff (your attending will take credit for the good stuff).

First year of fellowship - All the suck of being an intern, with the added bonus that everyone (including your attendings) expects you to be an expert on the subject, despite the fact that 24h prior you were a medicine R3 on your endo outpatient rotation, but now you're on the interventional cards service.

First year of attending - Sure, you're making mad cash now, but it's all on you. You're probably in a new system you don't know. Nobody knows you around there and the level of trust on both sides is probably low. About 2 months in, the imposter syndrome hits hard and you wonder why anyone hired you and how soon you're going to get fired.

All the subsequent years of training - This will obviously depend on your specialty, but nothing sucks worse than being an intern or first year fellow.

M4 - Aside from your subI and the anxiety surrounding the Match, this is the best year you're going to have for at least 4, if not 10 more years. Enjoy it.

Attendinghood beyond the 2nd or 3rd year - You've hit your groove. You know your specialty and your practice. Most importantly, you know your limits. This is when everything clicks and you're off to the races.
 
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Attending is great. You are making a lot of money. You can finally stay in 5 stars hotel when you go on vacation. I got adjusted quickly as an attending since I am hospitalist. That was pretty much all I did as an IM resident. Different institutions but same crap

4th year was a quasi vacation except I was broke

3rd year was ok since MS3 at my school was Mon--Fri. I rarely stayed past 5pm in any of my rotations except for my IM. Are there many US schools that are mon-fri for MS3? I only know one other school (Jefferson) besides mine.

My worst year was PGY1. I was working ~80 hrs/wk my first few months (I even worked 90-100 hrs a few weeks)
 
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Come join PM&R!

Ranked based on difficulty (hardest to easiest):
PGY-1
MS-3
MS-1
MS-2
Undergrad
MS-4
High School
PGY-2
Middle school
PGY-3
Elementary school
PGY-4
 
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In a word, yes it is. You have a seat at the table and you finally have some autonomy and direct influence over what happens in patient care. I was generally treated better as a resident than as a med student. On the flip side, there absolutely are problems out there that treat residents like garbage too.
 
First year of fellowship - All the suck of being an intern, with the added bonus that everyone (including your attendings) expects you to be an expert on the subject, despite the fact that 24h prior you were a medicine R3 on your endo outpatient rotation, but now you're on the interventional cards service.
This. Sooooo much this. First month on pulm "Hey, I got a consult for a pt with new peripherally sparing scattered ground glass opacities".

*internal dialogue - why the f*** are they calling me? They should call pulm. Wait. Oh no. I'm pulm. Ohhhh this is bad* Imposter syndrome hits HARD
 
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This. Sooooo much this. First month on pulm "Hey, I got a consult for a pt with new peripherally sparing scattered ground glass opacities".

*internal dialogue - why the f*** are they calling me? They should call pulm. Wait. Oh no. I'm pulm. Ohhhh this is bad* Imposter syndrome hits HARD
I’ve told this story before but one of my favorite early consults in fellowship went something like

Them: “Hey man we have this patient… blah blah I know you haven’t seen him yet but just wondering in your experience how you guys usually approach this?”

Me: “Uh well sir I have about 5 days worth of experience.”

Them: “Ahhh fair enough, well let us know whenever then!”
 
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Half of medicine is faking it until you make it.
 
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For me junior faculty was the most difficult part of my life after undergrad, followed by MS3.

PGY1+ I feel like there's a sense of it's hard to get fired, so you just push through. I actually enjoyed my internship and residency for the most part, not that there weren't challenges. If that doesn't apply to you either because you're at a malignant program or it turns out that you hate your specialty, medicine in general, or other factors, then it can be really rough.
 
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Half of medicine is faking it until you make it.
One attending in residency used to say “9/10ths of medicine is showing up and paying attention to everything you do”. It sounded absurd at the time, but the longer I’m in medicine the more I actually think it’s true. Most of what I do most days is not exotic or unusual, it’s listening to patients and their issues and consistently applying basic medical reasoning, guidelines etc to figure it out and get it done.
 
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Just want an honest opinion since im finishing at a US school and starting in July.

I remember when I was an M3, we would often get pushed around by nasty residents/attendings and it would be difficult to stand up for myself as a student since we are evaluated. Is the experience better during PGY1-end?
Unfortunately residency can be a high stress environment where those in supervisory roles have may not have adequate training nor desire to do a good management job. You'll have to navigate those hurdles and be inspired to do a better job for those you eventually supervise. I wish it weren't a common scenario, but it probably still is.

When others go to a lower level, you rise to a higher level of professionalism. It will be recognized.
 
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Residency is great because it is a job that pays you. It has its "suck" just like any job, but overall it is way better than the medical student rat race.

In med school, even if you do a great job, you worry "do they think I did a good job?"

In residency, you do a good job, and you get the satisfaction of seeing that play out. Plus you get a paycheck. The evaluations don't matter as long as you aren't terrible.
 
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Residency is great because it is a job that pays you. It has its "suck" just like any job, but overall it is way better than the medical student rat race.

In med school, even if you do a great job, you worry "do they think I did a good job?"

In residency, you do a good job, and you get the satisfaction of seeing that play out. Plus you get a paycheck. The evaluations don't matter as long as you aren't terrible.
The rat race doesn't necessarily end in residency. There's always something for which others are gunning (e.g. fellowship). If you stick around in academia, it continues on after that.

The biggest difference is that there are more offramps from the rat race (that are still great options). Once you hit residency, the knowledge that as long as you show up and put in moderate effort you can have a career which has job security and pays the bills is a stress reliever.

Finishing residency and becoming a general surgeon in a community/"private" practice setting wasn't my goal. But I wasn't (and still wouldn't be) upset if that's the way things ended up. So with that being the "worst case" scenario, it made residency a bit more tolerable.
 
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