More Knowledge than Attendings

[xmxpro]

Can anyone give some info regarding good IM Residencies? I am a PGY1, and thinking of changing due to the fact of little if any research at my program. Also, I am a FMG perm. resident who has MD, Phd.
I feel that I know more than my attending most of the time, which is good and bad. I am not saying I am a ?know it all,? although I feel I am overqualified here.

As a resident (Intern) I want to learn, and not feel as though I have to teach and guide my attending or senior residents.

Can anyone please give some guidance?

Regards,
MD

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[MustafaMond]

You remind me of some interns I know.
You may know more shallow theory, from memorizing "First Aid", and your Attd. may be slow, but No fresh intern "knows" more than someone who has had been practicing clinical medicine for years. PHD or no PHD.

You sound like you are either full of $hit, or deluded about your own skills.

If your senior resident wasn't with you, you would crap yourself...I know...I have been an intern

Its a harsh commment, but if you were such a genius, you would have done better on the USMLE, and you would be at a better program.

 

[MustafaMond]

Can anyone give input on the best states to practice medicine? I will finish my fellowship in Endocrinology.

I am a PGY1, and thinking of changing due to the fact of little if any research at my program

Damn, I wasted a lot of time with my previous post.
What a loser.

 

[xmxpro]

You remind me of some interns I know.
You may know more shallow theory, from memorizing "First Aid", and your Attd. may be slow, but No fresh intern "knows" more than someone who has had been practicing clinical medicine for years. PHD or no PHD.

You sound like you are either full of $hit, or deluded about your own skills.

If your senior resident wasn't with you, you would crap yourself...I know...I have been an intern

Its a harsh commment, but if you were such a genius, you would have done better on the USMLE, and you would be at a better program.

First off, I am at an ivy hospital in NYC, so try to narrow your search down?..
Secondly, I have practiced for sometime prior to coming to the US. So I am not a typical PGY1.
Thirdly, I scored in the top ten percentile on USMLE 1 USMLE 2 and CSA is a Pass, all in a 5 month period and pregnant.

90% of my residents are no where to be found half the time. If they are to be found, I end up correcting their mistakes. Also, they have little if any notes, so when on call I am solo.
The attending come to me the majority of the time, knowing I have more ?real: world experience than any of my resident, be it PGY1, 2, or 3.
I am not saying I know everything, if you read my prior post. I was saying that a lot of the time I know more than the attending. Most do not even know proper drug dosage, or what dosage is available.

So before you go bashing, you should get your facts straight.

I am not gloating that I am in a ivy hospital, but I am telling you that scored very well, and I AM IN A well respected hospital university setting.

You wouldn?t think maybe for a second that a PGY1 is smart; would you? It?s people like you that give medicine a bad name.

 

[Fermata]

First off, I am at an ivy hospital in NYC, so try to narrow your search down?..
Secondly, I have practiced for sometime prior to coming to the US. So I am not a typical PGY1.
Thirdly, I scored in the top ten percentile on USMLE 1 USMLE 2 and CSA is a Pass, all in a 5 month period and pregnant.

90% of my residents are no where to be found half the time. If they are to be found, I end up correcting their mistakes. Also, they have little if any notes, so when on call I am solo.
The attending come to me the majority of the time, knowing I have more ?real: world experience than any of my resident, be it PGY1, 2, or 3.
I am not saying I know everything, if you read my prior post. I was saying that a lot of the time I know more than the attending. Most do not even know proper drug dosage, or what dosage is available.

So before you go bashing, you should get your facts straight.

I am not gloating that I am in a ivy hospital, but I am telling you that scored very well, and I AM IN A well respected hospital university setting.

You wouldn?t think maybe for a second that a PGY1 is smart; would you? It?s people like you that give medicine a bad name.

 

[xmxpro]

LOL, this MustafaMond dude is a tool box.. You would think he can think outside of the box.

 

[GeneGoddess]

I had the honor to once work with the best trained group of residents EVER. The intern was a neurosurgeon who had decided to go into straight neurology instead. Even though he'd done a full surgery residency and two neuro-related fellowships, he was required to do a "medicine" internship. He was the itern. The resident was a FMG (like you) who was also an MD/PhD and had been on faculty at a prestigeous medical school in eastern Europe. Their combined training period (post medical school) was something like 30+ YEARS. The two of them knew EVERYTHING. The attending that month was VERY old school (he was about 90) and was very adamant that we always ask about the patient's shoes (foot health is important) and only have IV's if absolutely necessary. It was quite education to watch these three people work together. But they each had strengths and weaknesses. If you dislike the program because you feel that you aren't learning and growing, you might want to consider transfering. But even a lowly med student can teach a lordly attending some things.

 

[bustbones26]

xmxpro, what is your complaint??? From what I can gather, you say that you have practiced medicine before coming to the U.S., it sounds like now you're just trying to do a U.S. residency and get licensed in the U.S. That is all good and well but given your situation, where are you going to go where you WILL NOT be as smart as the attendings? Also, if you're at an ivy hospital in NYC, then why complain? Why switch?

 

[xmxpro]

I had the honor to once work with the best trained group of residents EVER. The intern was a neurosurgeon who had decided to go into straight neurology instead. Even though he'd done a full surgery residency and two neuro-related fellowships, he was required to do a "medicine" internship. He was the itern. The resident was a FMG (like you) who was also an MD/PhD and had been on faculty at a prestigeous medical school in eastern Europe. Their combined training period (post medical school) was something like 30+ YEARS. The two of them knew EVERYTHING. The attending that month was VERY old school (he was about 90) and was very adamant that we always ask about the patient's shoes (foot health is important) and only have IV's if absolutely necessary. It was quite education to watch these three people work together. But they each had strengths and weaknesses. If you dislike the program because you feel that you aren't learning and growing, you might want to consider transfering. But even a lowly med student can teach a lordly attending some things.

You nailed it.. Thanks for the post, at least you can understand my point of view.

 

[xmxpro]

xmxpro, what is your complaint??? From what I can gather, you say that you have practiced medicine before coming to the U.S., it sounds like now you're just trying to do a U.S. residency and get licensed in the U.S. That is all good and well but given your situation, where are you going to go where you WILL NOT be as smart as the attendings? Also, if you're at an ivy hospital in NYC, then why complain? Why switch?

I want to switch for the reason I stated. There is a lot more to the situation than I have time to get into. The hospital has pulled a lot of stuff this year, without telling any residents. For one, getting rid of the program Dir and the asst. prog. dir, and not telling anyone and has yet to find the two new ones.
Also, taken away electives from 6 to 2, and no longer allowing moonlight..
That is just off the top of my head, there is more..

Regards,
MD

 

[Old MD]

If you were already fellowship trained before you even came to the US, obviously you could feel that there is not much you would learn, especially if the attendings you are talking about are sub-sub specialists of the sort you often find at ivy league institutions - they will know a huge amount about their niche, but very little outside it.

However if that is your situation you shouldnt be much concerned you are not learning less because your teachers are lousy, you are learning less because you already know a lot of medicine. That's gonna be the case wherever you train. So why change?

If you are at a NY ivy league that must mean either Columbia or Cornell. Both excellent institutions. I would not leave unless there are other factors that make it difficult to be there.

 

[Old MD]

I had the honor to once work with the best trained group of residents EVER. The intern was a neurosurgeon who had decided to go into straight neurology instead. Even though he'd done a full surgery residency and two neuro-related fellowships, he was required to do a "medicine" internship. He was the itern. The resident was a FMG (like you) who was also an MD/PhD and had been on faculty at a prestigeous medical school in eastern Europe. Their combined training period (post medical school) was something like 30+ YEARS. The two of them knew EVERYTHING.

Inter or intra professional xenophobia is most acute in medical students and residents. As docs get more established in their practice, they gain better perspective on such things. The whole "surgeons are a bunch of technicians, internists are the true intellectuals" is one example. A lot of residents and med students will hold quite strongly to such stereotypes. After a time in practice, this is greatly lessened - everyone appreciates where the other is coming from, and what they can or cannot do. Besides, the mutual respect is borne not only out of greater understanding, but also the practical realization that everyone needs each other for referrals, Lol!

Same with the "Specialist vs Generalists/PCPs", or the "radiologists vs. clinicians", the "USG vs IMG", etc.

I went to a fairly 'elite' residency, and remember how we used to be quite disdainful of IMGs when we started out. We never had any IMG residents, but we did have some teachers! The smugness gradually disappeared. Some of the most memorable clinicans I have known were those old-school British profs, Edinburgh trained FRCP types, who had come over in the 60s and 70s. Some Indians too. Many settled in the North East. Very sharp. So I can see what you're saying. Even today, a lot of innovation happens in Europe. A lot of the latest general surgical innovation is French. But I think we still lead the world in basic science!

 

[MustafaMond]

Thirdly, I scored in the top ten percentile on USMLE 1 USMLE 2 and CSA is a Pass, all in a 5 month period and pregnant.

So before you go bashing, you should get your facts straight.

Sorry. I didn't know you were pregnant.

You've been an intern for what, 3 weeks? and you think you know more than these "Ivy League" attendings.
You think you are pretty smart...
But it sounds like post-partum psychosis, if you ask me.

 

[xmxpro]

Sorry. I didn't know you were pregnant.

You've been an intern for what, 3 weeks? and you think you know more than these "Ivy League" attendings.
You think you are pretty smart...
But it sounds like post-partum psychosis, if you ask me.

WOW,
Didn't know your a OBGYN. I had my baby in Dec, so I would say I am in the clear as far as post partum issues. Also, once again I never said i know more than all attendings. I was just trying to state that these attendings do not know as much as I would of thought. If you read some other posts, you will see that there are people who know how I feel.

So lets try to be buddies, and I have enough stress at work. I come here to unwind.

Regards,
MD

 

[cbc]

If you were so smart and knowledgeable, why are you here asking us questions? If you are well beyond the level of an attending, I doubt you'd find any more accurate advice here. You must be a great test taker but not very smart otherwise.

Can anyone give some info regarding good IM Residencies? I am a PGY1, and thinking of changing due to the fact of little if any research at my program. Also, I am a FMG perm. resident who has MD, Phd.
I feel that I know more than my attending most of the time, which is good and bad. I am not saying I am a ?know it all,? although I feel I am overqualified here.

As a resident (Intern) I want to learn, and not feel as though I have to teach and guide my attending or senior residents.

Can anyone please give some guidance?

Regards,
MD

 

[xmxpro]

If you were so smart and knowledgeable, why are you here asking us questions? If you are well beyond the level of an attending, I doubt you'd find any more accurate advice here. You must be a great test taker but not very smart otherwise.

Wow, good point... Does it take a M.D. to think like you?

 

[flighterdoc]

First off, I am at an ivy hospital in NYC, so try to narrow your search down?..
Secondly, I have practiced for sometime prior to coming to the US. So I am not a typical PGY1.
Thirdly, I scored in the top ten percentile on USMLE 1 USMLE 2 and CSA is a Pass, all in a 5 month period and pregnant.

90% of my residents are no where to be found half the time. If they are to be found, I end up correcting their mistakes. Also, they have little if any notes, so when on call I am solo.
The attending come to me the majority of the time, knowing I have more ?real: world experience than any of my resident, be it PGY1, 2, or 3.
I am not saying I know everything, if you read my prior post. I was saying that a lot of the time I know more than the attending. Most do not even know proper drug dosage, or what dosage is available.

So before you go bashing, you should get your facts straight.

I am not gloating that I am in a ivy hospital, but I am telling you that scored very well, and I AM IN A well respected hospital university setting.

You wouldn?t think maybe for a second that a PGY1 is smart; would you? It?s people like you that give medicine a bad name.

How about having a chat with the residents or PD, and discuss your situation with them? If they recognize that your skills and knowledge are much greater than a typical PGY1 they should recognize that. If they don't recognize your skills, perhaps there's a problem there that you need to address.

Switching programs isn't a good solution to your perceived problem. Anywhere you go will most likely be similar.

 

[Endocrine2be]

 

[Annette]

XMXPRO, take another look at your post. It seems quite arrogant, and that is why you are getting the responses you are.

Ultimately, learning is YOUR responsibility, not your teachers. If you feel they can't challenge you, find something in your program that will.

Can anyone give some info regarding good IM Residencies? I am a PGY1, and thinking of changing due to the fact of little if any research at my program. Also, I am a FMG perm. resident who has MD, Phd.
I feel that I know more than my attending most of the time, which is good and bad. I am not saying I am a ?know it all,? although I feel I am overqualified here.

As a resident (Intern) I want to learn, and not feel as though I have to teach and guide my attending or senior residents.

Can anyone please give some guidance?

Regards,
MD

 

[xmxpro]

XMXPRO, take another look at your post. It seems quite arrogant, and that is why you are getting the responses you are.

Ultimately, learning is YOUR responsibility, not your teachers. If you feel they can't challenge you, find something in your program that will.

I guess you cannot handle the truth. Truth hurts....

 

[Vision]

Just a few questions for the original poster...

1. IVY caliber hospital in NYC without ANY RESEARCH??? or "smart" attendings???? I found that hard to believe. I hope we are not talking about some little community hospital that has some loose association with Ivy league school....

2. Score in top ten percentile on USMLE 1 or 2 or CSA or any test that medical society can throw at you means you know how to study. Anybody who spend 3-4 months purely studying for these exam should do well. Matter in fact, I have not known any FMG who didn't do well on their USMLEs

3. "Correcting other residents mistakes..." Why do you think these are call training hospitals? Unfortunately most of us residents don't have the benefit of practicing medicine at a foreign country. Now if that is gonna be a problem... well you will have a tough time finishing residency anywhere in this country.

4. If you think you are not being challenged enough, apply for transfer. There is ALWAYS a spot somewhere that accept transfers. Now the question is can you get in? I am sure a person with your experience and background would have little or no trouble of getting in MGH.

 

[xmxpro]

Just a few questions for the original poster...

1. IVY caliber hospital in NYC without ANY RESEARCH??? or "smart" attendings???? I found that hard to believe. I hope we are not talking about some little community hospital that has some loose association with Ivy league school....

2. Score in top ten percentile on USMLE 1 or 2 or CSA or any test that medical society can throw at you means you know how to study. Anybody who spend 3-4 months purely studying for these exam should do well. Matter in fact, I have not known any FMG who didn't do well on their USMLEs

3. "Correcting other residents mistakes..." Why do you think these are call training hospitals? Unfortunately most of us residents don't have the benefit of practicing medicine at a foreign country. Now if that is gonna be a problem... well you will have a tough time finishing residency anywhere in this country.

4. If you think you are not being challenged enough, apply for transfer. There is ALWAYS a spot somewhere that accept transfers. Now the question is can you get in? I am sure a person with your experience and background would have little or no trouble of getting in MGH.

Thanks for the info. I am trying to make the best out of what is going on within my hospital now. We are going though some major changes and it is effecting all of us.
As far as research, they have reduced the amount of research we are allowed to do this year. I have a fair amount of prior research done in europe, altough I would like to continue to with my research here in the US.
Also, I realize that we are all learning everyday, but I would think that the knowledge the attending have at my hospital would be larger.

As far as transfer, from what I hear it is not good to transfer. Can you shed any light on this for me?

Regards,
MD

 

[pepsitwist]

I normally am pretty silent in these types of posts, but I had to say something in this case.
xmxpro what is your problem?
You claim you have more knowlege then your attendings, but it is clear that you are far behind when in comes to maturity. From your conduct in this forum, I think it is obvious that you have some growing up to do- if your patient interactions are anything like your interactions your peers that you have demonstrated here, maybe its best that you have a few more years of training. You should feel lucky that you are in a good program where this will be possible.

 

[Annette]

I guess you cannot handle the truth. Truth hurts....

Now, I'm convinced you are a troll. I thought I'd give you the benefit of doubt in that maybe your English skills didn't allow you to appreciate the arrogance in your post, and truely were at some loss as to what to do. Foolish, foolish me. Go play with yourself.