Psych Interns speak out!

[NJWxMan]

On one of my medicine months and several categorical colleagues shared with me their schedules. One guy had NO 24 HR call, the other had one. Well, somehow I ended with many more.

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[fMRI]

On one of my medicine months and several categorical colleagues shared with me their schedules. One guy had NO 24 HR call, the other had one. Well, somehow I ended with many more.

Sorry to hear that some are unhappy with their schedules. A difference of +/- 1 call is normal, due to scheduling difficulties. Life isn't fair.

If one person has NO calls, there might be a reason you might be unaware of (and people won't necessarily tell you). The person might require a regular sleep pattern due to a medical condition (like some epileptics do).

Some places don't dish out call to interns depending on who their attending is.

If you think there is a problem, address it with your chief resident or the program director. Nothing call kill work ethics and climate like a (perceived) unfairness.

Good luck!

 

[masterofmonkeys]

I ended up with a bad draw. We only do weekend call. Friday is till 7 am after normal workday (best). Sunday you get monday off (2nd best) Saturday you go from 8am to 9 am. So you work every day. Somehow I got almost no friday call, and mostly saturday call. Total awesomeness.

 

[hippiedoc13]

I second the poster above who said it: Life isn't fair. Neither is residency.

Last year I worked every single holiday (major and minor), while others had multiple holidays off. My assigned vacations were poorly spaced, with one near the beginning of the year and one at the very very end. I was sometimes required to carry extra patients because the other resident on service was weaker and couldn't handle their full patient load. One month my co-intern on a very busy service got seriously ill 1 wk into the rotation, ended up hospitalized and on medical leave for the rest of the month, and I was left as the solo intern to cover all the pts. And on and on. Yeah, it sucked. But it sucked for a lot of people, and this is what we signed up for when we chose to do residency. Things like call schedules and patient censuses(?) and such will never be exactly equal. That's the nature of the unpredictable beast. Most of the time we just need to take a deep breath, plaster on a smile, and keep on giving it our best shot.

That being said, if there is a clear pattern of long-standing inconsistencies in call schedules (such as off-service interns always having the worst call schedules while categorical interns have minimal to no call), and if there's not a good programmatic reason for it, then it should be addressed at a program level. You may need to let your own (psych) chief resident or PD know about the situation, IF it is a clear pattern, so that they can decide if it is something that is worth discussing with the internal medicine dept, for example.

Good luck and hang in there...life definitely gets better after intern year!

 

[SpiritiualDuck]

dude, it happens.

Suspiciously, or not, all the psych interns when on neuro in my program had the last Saturday call of the month during their respective rotation. Coincidence?

 

[whopper]

My PGY-1 year, I did notice my Chief pulling in some favoritism with the call schedule. It was pretty annoying, though I kept my neck out of it--mostly because I wasn't fully aware of the situation, and I wasn't on the bad end or the good end of things. I did become very aware of it after she graduated because those she was pulling favors for admitted to me what was going on.

Idiotic if you ask me. She was giving favored & choice call dates to a specific resident because they were of the same ethncity & religious background. She also vehemently defended that other resident-who was pathetically bad, and that guy showed up late on a daily basis, sometimes for more than 1 hr. She also tried to instill in that resident to make sure that the program take in more people of that ethnic background. The chief also had a problem with people of a specific ethnicity in the program--and gave those residents the worst call nights.

Paranoia on my part? Well here's how obvious that it wasn't just a pattern. Both that resident & the former chief approached me when I was chief, admitted to what was going on, demanded that I try to get more residents into the program of their ethnicity (which I thought was real stupid of them being that I'm not of the same ethnicity and have a color blind attitude with these things). Then, they went on a tirade mentioning how much they hated the other ethnic group, and admitted to some of the below the belt things they did to "fight" them which just further infuriated me because none of the people in that other group did anything below the belt to these people.

Idiotic..all of it.

However, I can tell you that I've seen plenty of call schedules, and I've seen plenty of residents formulate a conspiracy theory based on that call schedule that was completely baloney. In my own program, and since there weren't too many residents in it, when I was chief, if people didn't like the schedule, I allowed for residents to bring up their problem with it in a group format and ask if they wanted to change schedules. Certain hell days (the days no one wanted) we tried to divy it up equally. I'd tell them why or why not I could or couldn't make a change to the schedule. Factor in that this process was a complete pain in the butt, and only possible because there weren't too may residents. If there were a lot ,doing something like that would've been impossible.

Despite that there still was always someone thinking I had something against them--so I'd pretty much tell them--ok, make a call schedule for me that keeps everyone happy. They quickly shut up when I offered it to them.

 

[psymed]

I'm doing my Medicine rotation and its awful. We are expected to admit patients from the ER from Day 1 and there is little to no supervision. My first day on the job the residents didn't even examine my patients and were sitting in the MD room checking their emails. Today I had to wait three hours to find a PGY 2 /3 just so that I could discuss this patient and get him started on some treatment.

These are the responses I got, "The chief resident is on break. Try to get one of the other residents in the ER to help."........."Just write orders for some Anti HTN. You know how to do it........"

Their only reasoning for doing any test is always........"You don't want to get in trouble." My response........."You're right! but is there any medical indication for ordering this test???" I didn't really say that but I thought it.

A couple of years ago I did a year of internship in a third world country and even there, the senior residents examined the patient and discussed the management with the intern after he / she had completed the H&P. Within a couple of weeks, the interns would be weaned off and given a little bit more independence and so forth. Here.......they just leave you out to dry.

Six more months of this crap and I'm off to Psych which is a much stronger and organized program.

 

[xthine]

I'm an IMG, on my Adult medicine ER rotation right now and I received an odd feedback from my ER attending a few weeks ago. He was asking if I had worked before starting this residency to which I replied I had not, graduated back in 2002 and decided to devote my time raising a daughter and being a single mom. Anyway, he said that he's worked with a lot of Psychiatry interns in the ER and that I was different from most of them in that I was actually interested and doing well with the medicine versus the others who were not interested in doing anything else except psych. Another attending told me something like "Are you sure you want to do Psych, you're too good of a doctor to be doing Psych." I'm sure he was partly kidding but still.. Another ER attending said he was not too fond of Psychiatrists because once they go into Psych they forget their medicine. I wonder if this is the sentiment in other programs.

My co-intern who's also doing ER feels that since we're in Psych the ER attendings do not expect much from us and that I should not try to impress the ER attendings (by what? suturing and performing I and Ds?? hello.) .. totally disagree with her, I was just doing my job afterall. I am fundamentally a general practitoner, and even though I'm a Psych intern I choose to learn and do as much medicine as I can, make the most out of my non-Psych rotations. Apologize for the rant.

Overall I'd have to say I'm happy with my rotation, the ER attendings have been very supportive and they do take the time to teach and talk about the cases that we see.

 

[whopper]

Anyway, he said that he's worked with a lot of Psychiatry interns in the ER and that I was different from most of them in that I was actually interested and doing well with the medicine versus the others who were not interested in doing anything else except psych. Another attending told me something like "Are you sure you want to do Psych, you're too good of a doctor to be doing Psych."

I got the same, in fact I was offered to switch programs. I was also told by 3 gastroenterologists that if I made the switch, they would make a personal guarantee that they would get me into a GI fellowship. I had worked with those 3 during a medschool elective, got along very well with them, and I did my residency in the same hospital those 4 worked in. We did keep a good relationship even though I stayed in psychiatry, and they offered me to be a consultant for them if I stayed in the Southern NJ area (which I did not) because they needed a psychiatrist for their patients on Pegasys. They often times told me their frustration with dealing with patients who became depressed & suicidal, and not having a psychiatrist they felt they could work with.

I think its a combination of factors. First, several who go into psychiatry, while doing medicine see it as the temporary thing they just have to survive. These same people may have gone into psychiatry specifically because they found it easier than IM. Other psychiatry residents when thrust into IM do so at the latter part of the year where they are very much behind their IM colleagues in IM knowledge. Psychiatry residents that start with IM residents usually are closer if not equal to their IM colleagues by the time they leave the rotation.

You'll have the rest of your life to do psychiatry. You only have a few months of IM, and that IM knowledge will help you out tremendously as a psychiatrist. You need to approach your IM rotation as if it is a golden oppurtunity you will never have again.

You should try to get as much out of your IM rotation as possible. It will help you to study for USMLE Step III, C&L psychiatry, and it will leave a very good impression on the hospital should you choose to stay there. Trust me, I've seen plenty of non-psychiatric doctors think their psychiatric colleagues are terrible to excellent.

If you stay in that same area, and develop your rep which seems to be off to a good start, several of your future attending colleagues will be more likely to refer to you, call you up for advice, and open several other doors for you. I had about 3 possible jobs lined up by the time I left residency in that area (which I had to turn down, and I wasn't happy about doing that-some of them would've been very lucrative, some of them would've been working with people I highly respected & got along with well), and one of my colleagues who was known to be lazy had to search far & wide to find a job. I was somewhat regretting leaving the area for fellowship, knowing that if I moved, I'd have to spend another few years redeveloping that rep.