throwaway20425
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- Joined
- Nov 14, 2023
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TLDR: The culture of psychiatry rotations at my school has made me scared of what psych residency might look like for an uncompetitive psych applicant who is maybe too idealistic.
Greetings all,
I’m a DO student finishing up my third year. Before med school, I had several years of experience in dual diagnosis treatment, as well as with SMI in my immediate family; I loved this work and I came to med school to become a psychiatrist. However, after completing two psych rotations, I feel disheartened and am questioning my future. I’d appreciate some perspective on whether this stems from my own naivety or if it's a result of the particular experiences I've encountered (or perhaps both), as well as what this might mean for residency ahead. I probably also need to just vent a bit.
I know psych rotations are often referred to as “psych-cation”. However, I thought I'd be able to opt in, to engage and learn more on these rotations given my excitement about this work. Instead, I've learned that, in the case of my school's rotations, there is not additional work to opt in to. Most of the psychiatry preceptors for my school work "full time" at multiple facilities, earning staggering salaries while providing what I consider to be substandard care. I'm talking about no intake evals on new inpatient SMI admits, just copying forward an H&P and calling it a day, sub-1-minute follow-ups (I truly have timed it), or just skipping follow-up entirely but writing a note anyway. I feel upset that I'm complicit in the poor care they're providing. I'm learning very little on the job. I'm not getting support or mentorship through some of the challenging experiences I've had.
Of course, I knew that there were providers like this out there, but I never expected them to be working in academic medicine or serving as preceptors. I didn’t realize how much I crave mentorship until these rotations showed me what it’s like to be without it. So now, I’m worried about experiencing something similar in residency.
Can any of y’all speak to experiencing apathy like this from attendings or other trainees in residency? Are there programs where it's normalized to practice medicine to this standard? How can I identify and avoid programs with this culture, short of participating in audition rotations? As a middle to low-stat DO applicant, I'm realistic about the sort of residency program I might end up at, and I’m apprehensive now that I’ll be relegated to a program that doesn’t align with my values.
I feel disappointed and worried. I'm not sure if I could handle the moral injury of a whole residency that is like these past two rotations.
Greetings all,
I’m a DO student finishing up my third year. Before med school, I had several years of experience in dual diagnosis treatment, as well as with SMI in my immediate family; I loved this work and I came to med school to become a psychiatrist. However, after completing two psych rotations, I feel disheartened and am questioning my future. I’d appreciate some perspective on whether this stems from my own naivety or if it's a result of the particular experiences I've encountered (or perhaps both), as well as what this might mean for residency ahead. I probably also need to just vent a bit.
I know psych rotations are often referred to as “psych-cation”. However, I thought I'd be able to opt in, to engage and learn more on these rotations given my excitement about this work. Instead, I've learned that, in the case of my school's rotations, there is not additional work to opt in to. Most of the psychiatry preceptors for my school work "full time" at multiple facilities, earning staggering salaries while providing what I consider to be substandard care. I'm talking about no intake evals on new inpatient SMI admits, just copying forward an H&P and calling it a day, sub-1-minute follow-ups (I truly have timed it), or just skipping follow-up entirely but writing a note anyway. I feel upset that I'm complicit in the poor care they're providing. I'm learning very little on the job. I'm not getting support or mentorship through some of the challenging experiences I've had.
Of course, I knew that there were providers like this out there, but I never expected them to be working in academic medicine or serving as preceptors. I didn’t realize how much I crave mentorship until these rotations showed me what it’s like to be without it. So now, I’m worried about experiencing something similar in residency.
Can any of y’all speak to experiencing apathy like this from attendings or other trainees in residency? Are there programs where it's normalized to practice medicine to this standard? How can I identify and avoid programs with this culture, short of participating in audition rotations? As a middle to low-stat DO applicant, I'm realistic about the sort of residency program I might end up at, and I’m apprehensive now that I’ll be relegated to a program that doesn’t align with my values.
I feel disappointed and worried. I'm not sure if I could handle the moral injury of a whole residency that is like these past two rotations.