- Joined
- Aug 7, 2017
- Messages
- 5
- Reaction score
- 2
I recently matched into my #1 pick for IM residency, but since starting my intern year, I am disappointed in the quality of education provided to residents and the quality of the care provided to patients at my new hospital. During interview season I loved the warmth and friendliness of the residents and faculty, commitment to an underserved and international population, and diverse pathology encountered. All those things are still true of the program and everyone has been super nice and helpful if I ask for something. Sure the work is hard and the days are long, but I do not feel too overworked or overstressed. I feel under-learned.
During the interview, I guess I failed to grasp that this program is very clinical with very minimal emphasis on academics. There are almost no didactics for interns. I've been to two lectures in two months, that were not very enlightening. There are usually no pre-rounds and we only do table rounds with the attendings unless it is a new patient. It seems that most attendings do not see the patients after that first encounter, unless you tell them you are worried or need help. There is almost no mention of evidence based medicine, guidelines, or studies. Most of the residents went to medical school here and follow the instructions of the attendings blindly and therefore, do not teach much themselves or discuss studies/guidelines. I trained and worked in another inpatient healthcare specialty before medical school, so I notice when care isn't exactly considered "best practices." For example, a co-intern giving me sign out for ICU and thinking it's ok to skip an LP for someone found down/acutely encephalopathic with fever or using cheaper antibiotics over evidence based drugs of choice, because the attending said so. When I have tried to voice my concerns, most people just say one of these responses: "That's just how this program works." "This is county hospital." "You will eventually drink the Koolaid and love it." Also, It doesn't help that for almost every patient you have to waste time and work through a quagmire of social issues, bureaucracy, and arbitrary policies via the social worker, care coordinator, utilization review personnel, and hospital administration, all with overlapping responsibility and who give you conflicting advice.
Finally, I talked with a fellow who did not complete his general residency here and they agreed that the education quality was not very good. They also commented that the resident performance was not as strong as other places they had trained and it seemed that IM residents were receiving training that would only prepare them for success at this program's hospital.
At my medical school with IM, we did walking pre-rounds with residents and walking rounds with attendings everyday. We had morning report and lunch time lecture every week day. I learned a lot everyday. Now I feel like I am working without using my brain or learning anything new. I almost never observe attendings providing care or gain insight from them. I am worried I will not be a competent physician when I complete this residency.
So I know I can't switch residencies and I know shouldn't quit. But I am just wondering if anyone else has felt this way and how (or if) they addressed this problem. The frustration is overwhelming at times and I am starting to become clinically depressed (positive SIGECAPS). Most other residents seem to be happy here, but they are mostly unfamiliar with other programs and will likely work in this hospital or system. Since I am new the area and the hospital, I still feel like an outsider and that it would be inappropriate to say anything. I am worried that if I voice my concerns to the PD, I will be viewed as a complainer or trouble maker.
During the interview, I guess I failed to grasp that this program is very clinical with very minimal emphasis on academics. There are almost no didactics for interns. I've been to two lectures in two months, that were not very enlightening. There are usually no pre-rounds and we only do table rounds with the attendings unless it is a new patient. It seems that most attendings do not see the patients after that first encounter, unless you tell them you are worried or need help. There is almost no mention of evidence based medicine, guidelines, or studies. Most of the residents went to medical school here and follow the instructions of the attendings blindly and therefore, do not teach much themselves or discuss studies/guidelines. I trained and worked in another inpatient healthcare specialty before medical school, so I notice when care isn't exactly considered "best practices." For example, a co-intern giving me sign out for ICU and thinking it's ok to skip an LP for someone found down/acutely encephalopathic with fever or using cheaper antibiotics over evidence based drugs of choice, because the attending said so. When I have tried to voice my concerns, most people just say one of these responses: "That's just how this program works." "This is county hospital." "You will eventually drink the Koolaid and love it." Also, It doesn't help that for almost every patient you have to waste time and work through a quagmire of social issues, bureaucracy, and arbitrary policies via the social worker, care coordinator, utilization review personnel, and hospital administration, all with overlapping responsibility and who give you conflicting advice.
Finally, I talked with a fellow who did not complete his general residency here and they agreed that the education quality was not very good. They also commented that the resident performance was not as strong as other places they had trained and it seemed that IM residents were receiving training that would only prepare them for success at this program's hospital.
At my medical school with IM, we did walking pre-rounds with residents and walking rounds with attendings everyday. We had morning report and lunch time lecture every week day. I learned a lot everyday. Now I feel like I am working without using my brain or learning anything new. I almost never observe attendings providing care or gain insight from them. I am worried I will not be a competent physician when I complete this residency.
So I know I can't switch residencies and I know shouldn't quit. But I am just wondering if anyone else has felt this way and how (or if) they addressed this problem. The frustration is overwhelming at times and I am starting to become clinically depressed (positive SIGECAPS). Most other residents seem to be happy here, but they are mostly unfamiliar with other programs and will likely work in this hospital or system. Since I am new the area and the hospital, I still feel like an outsider and that it would be inappropriate to say anything. I am worried that if I voice my concerns to the PD, I will be viewed as a complainer or trouble maker.
Last edited: