hmm...i'm a third year...getting home post call (4pm today...usuall 1pm though), but i see how hard the residents here work and how thin they are spread...it scares me to think of doing a medicine residency. I currently struggle with the balance of most of my life being here in the hospital, and then dividing up whatever little remaining time I have between my girlfriend, family, sleeping, cleaning, ...etc etc..you all know what i'm talking about if the responsibilities only increase, and time spent in the hospital goes up too in residency (and yes, there is that 80-hr work week...but from what i've seen...residents do not go home until the work is done...so basically attendings are just a bit louder and more adament about getting us home...but once they have left. labs/procedures etc, still have to be ordered read, Pcps have to be called, you name. it. WHEN DOES THIS GET ANY BETTER? ? ? ? I have a big interest in medicine. I love the fact that its so stimulating and intellectual. I think being able to medically manage a patient is extrememly fullfilling....BUT...at what cost. when my sleep, my hobbies, my personal family time is taken away, and i'm soo tired...i start resenting being in the hospital . all i think about is GOING HOME AND SLEEEPING> ...i always think that I don't know enough. and that knowing enough would require me to go home, just do the basic necessities like eat sleep, and read. that's it. you have to read with hospital work, but honestyl...who wants to read when they come home that late...tired, and spread so thin? again, i have to reiterate, that I really like the foundation of medicine, and what it is all about. I love those attendings who bring out the beauty of medicine in every patient interaction that i observe (and bad attendings should honestly be prosecuted b/c they are NOT helping the 'image' or lucrativeness of primary care).... does it get better? do I have to honesstly accept this lifestyle the way it is in order to be stimulated in my career, or is the only way of having a nice mentally friendly lifestyle, to pick an avenue that isn't so stimulating...?????? I don't know...please your thoughts...thanks.. oh, here is something that makes me queezy. 76year old hispanic women with a-fib and dementia (of unknown duration..we don't know her baseline) presents with rt shoulder subluxation and frontal lobe on CT (she had acute mental status changes)... we reduced her shoulder, we are observing her possible UTI....and we need her consent for an MRI with contrast and possible sedation. She is definetely NOT Alert and oriented x3. it actually varies during the day. she'll go on and on..as iff nothing is wrong with her...than she'll start talking about semi precious stones in her brain? I explained the procedure to her...and she gave me consent...then she denied it later when I needed her to resign the document (which had to be re-written)...only, to eventually give consent again.. its like every time i asked her, she didn't even remember the previous time I asked. chasing down her family/friends is futile. these studies will be helpful...if we would do anything about it (she probably has AVM). but, I have this feeling...since we were post call...and my senior and all of us were over worked...said..."you must get this done by tommorrow"..... i have this feeling that i got consent from a women who wouldn't be able to remember that gave me consent. additiaonlly, i feel like I violated something...but to be honest....NO one really cares because the work has to be done. and we are probably doing what we need to do anyways. and if we listened to her actual wishes, which change over and over again, we'd be going no where...ugh....... i feel like this is real common. i dont' know.... is there a light at the end of the tunnel that is not the high beams of an oncoming locamotive? call sucks....IDEAL scenario. medicine residency with 1call/week. and/or weekends OFF. when will these idiots in our health care system start paying/reimbursing people for THINKING! hello...what the hell. I don't understand...okay, enought bitching.
Intern year is very tough in most fields. I'm going into Psych and I am NOT looking forward to the 4-6 months of medicine we have to do (depending on the program). At least you get some autonomy, get paid, and you have more respect from staff and the other physicians (compared to when you are a MS). Those things make me feel a little better about intern year and taking calls. A program I interviewed at has 100% home call ('cept Medicine part of Psych.), and its looking better and better to me.
Why wasn't psych consulted to evaluate whether or not she has the capacity to give consent? This would be standard procedure at my hospital as a CYA.
Yes, there is light at the end of the tunnel. If I hadn't had >100K in loans already, I would have dropped out 3rd year. I was really miserable, and the culture of the inpatient medicine months made those the worst of the whole year. I was very afraid of intern year, but it is better! Regardless of the atmosphere, I am happier as an intern because I have work to do, as opposed to making myself look busy and hoping to please the right people as a 3rd year. I think that the misery level also depends greatly on the culture wherever you are; the medicine months in my intern program are tough (Q4 call, average of 1 day off/week, not necessarily weekend, not necessarily Q7) but the seniors and faculty were all helpful and supportive and even though some of the seniors ended up working really awful hours, they weren't short with us interns. It made a world of difference from my 3rd year. Keep in mind, too, that the number of inpatient and on-call months varies. Even though I am in psychiatry, supposedly an easy residency, I am on call for 11 months this year, worse than my friend in a med/peds program. Lots of inpatient medicine months cut close to the 80 hour limit, but I don't know anybody who got stuck with 11 months of inpatient medicine.
