PGY2s
Started by rubensan
wow, it's been a really fun week but also really stressful!! I started on Cornea/glaucoma/pathology/low-vision/ and consult service!! I take consults from the main university hospital M-F 8-5 in addition to going to clinic. Good thing it's only 3 mos! But I'm having a lot of fun, and the clinics are going by really fast! (not like mind-numbing int medicine)
I'm surprised you started on consult service. First year residents have no idea what they're doing for the most part, so it seems like a waste of time for you to see a consult when you're just going to have someone else look too. Well, enjoy! Be sure to refuse those stupid new medicine interns' requests for "R/O diabetic retinopathy" consults. Anything that you can easily do outpatient that isn't urgent don't do.
This first week was stressful, but way better than internship. I was on call last weekend and was basically at the hospital for the better part of it. But instead of my call being a big waste of time being scutted out like it was last year, this time I actually saw some cool stuff (scleritis, acanthomeba (sp?) corneal ulcer, splinter in eye). It's great to finally be seeing things on call that I actually have to know about!
That said, I don't know how the heck I'm ever going to get through all this reading 😕
That said, I don't know how the heck I'm ever going to get through all this reading 😕
I'm a whopping 12 months ahead of you, but during your first year, knowledge is power.EYESURG said:
Read at every chance you can. The BCSC books are dense and are not easy to skim. There are other sources out there (ophthalmology review manual by chern, for example), but these should be supplements. A commonly repeated phrase in my program was to finish the series once each year. If you can do that, you'll be solid.
Having said that, I'm sure I'll bring out all the photographic memory people who say you don't have to read, but you do. Read about people you see on call. Carry your Will's with you wherever you go. Read about everything you think about and soon it will stick. You have to spin your wheels at first, but after you have put in your time, the knowledge will be there and you'll be grateful you read.
It's a steep learning curve at first, but before you know it the OKAPs are over and you'll be ready for your second year.
my two cents.
7ontheline said:
I am the lucky one at my residency to start on the consult service as well. It's a bit overwhelming at times, but that's ok. I've gotten some really bogus consults already such as "Reason for consult: Diabetes". When I called the doc to find out what they really wanted they stated that "the patient hasn't had her eyes checked in a while, and she doesn't have any visual complaints"! My program director does not allow us to refuse a consult, that's on his list of 'how to be a bad resident.' So for the bogus consults I always ask that the doc calls me to explain why he wants the consult, that way I can at least educate them on the topic and hopefully not get reconsulted for the same bogus stuff from that same doc. I'm happy to do them anyway, because after the consult you get to walk away while they are left to worry about placement issues, social services, drug/alcohol abuse, pain, bowel movements . . .
I'm sure I ordered consults as an intern that the consultant was thinking, "why the hell is this idiot getting this consultation?"
EXACTLY! i love writing:
Asssessment: 52 yo female with multiple medical problems including diabetes mellitus type 2. no e/o diabetic retinopathy or acute ophthalmic issues.
Recs: Tight glycemic control. RTC in 1 year for DFE/Diabetic check.
Will sign off (still a foreign concept to me, but one that i can get used to), please reconsult PRN. Thank-you for this interesting consult.
yeah, it can be kind of bogus, but then you talk to the poor intern who is managing all 101 medical/social/dispo problems with the patient and he is just happy that he can check off the box next to "ophtho consult" on his list.
okay...i better get reading. 😉
Asssessment: 52 yo female with multiple medical problems including diabetes mellitus type 2. no e/o diabetic retinopathy or acute ophthalmic issues.
Recs: Tight glycemic control. RTC in 1 year for DFE/Diabetic check.
Will sign off (still a foreign concept to me, but one that i can get used to), please reconsult PRN. Thank-you for this interesting consult.
yeah, it can be kind of bogus, but then you talk to the poor intern who is managing all 101 medical/social/dispo problems with the patient and he is just happy that he can check off the box next to "ophtho consult" on his list.
okay...i better get reading. 😉
SteelEyes said:
or how about those "STAT" consults from the panicked neurosurgical interns asking for visual fields 1 hour prior to the patients scheduled surgery. 
rubensan said:
Oh, the pain.
I can't believe I'm actually this much busier than I was during internship!
Just saw my first patient on call by myself last night. He was a "possible open globe/RD", I thought I handled it well, but then I went and read Wilson about managing open globes and found out I did everything wrong.
Oh well, I did call my upper level, and he called the retina attending, and they didn't tell me to do anything differently.
I sure hope it gets better. The upper levels tell me it does.
I can't believe I'm actually this much busier than I was during internship!
Just saw my first patient on call by myself last night. He was a "possible open globe/RD", I thought I handled it well, but then I went and read Wilson about managing open globes and found out I did everything wrong.
Oh well, I did call my upper level, and he called the retina attending, and they didn't tell me to do anything differently.
I sure hope it gets better. The upper levels tell me it does.
J
JR
🙂 the abuse has begun. It'll get better boys and girls!
rubensan said:
It certainly is great to be doing something that I am passionate about! On the other hand, it is so painful to realize that after many many many years of training, I still have so much to learn.
In clinic, even with a fairly light patient load (compared to the attendings who are seeing dozens of patients in a half-day), I am running over an hour behind sometimes! Even something simple, like applanating, takes me 10 times longer than everyone else. Ugh.
The other night on call, we had a patient with orbital cellulitis and abscess who was seen by a community doc, who did an I and D, realized how bad it was, and immediately Medi-vac'd her to our hospital. Lucky lady gets to fly from 5 hours away to see a 1 week-old ophthalmology hatchling. 😱 Lucky thing for good upper level residents and fellows.... 😳
