Psychiatry intern on medicine...please help?

[HemeOncHopeful19]

Where I trained the off-service Psych interns just did one month of medicine! WTF!?

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[nebuchadnezzarII]

Where I trained the off-service Psych interns just did one month of medicine! WTF!?

That’s more than enough lol.

 

[nebuchadnezzarII]

2.5 more weeks to go...at my breaking point now lol. Anyone feel like the hospitals have been especially busy recently?

 

[Chads2]

OP,

First of all, I wish I had gotten to this thread sooner. I’m an IM teaching attending and at this point in my career, I’ve had many, many off-service interns. Yes, I believe it’s inhumane for you to be on wards for so long. You must be in a program where the residents are not plentiful in number and psych residents are expected to be all-purpose interns.

As an attending, my expectation is always that the off-service intern knows quite a bit less medicine and I am training them to keep patients alive this year and then in the upcoming years to recognize when you need an internist’s help. (“That’s not dementia, that’s crypto meningoencephalitis!”)

I almost never expect an intern to know everything...at least the first time around. If on day one, I ask you “what’s the INR today?” I don’t expect you to have it stored in your head. I expect you to look it up and give me the answer faster than I can click on it myself. But I also expect you to have that number ready on day 2 and every subsequent day be cause I asked for it.

like I said, I wish I’d been on this thread sooner but you’re almost done. Just keep swimming.

 

[nebuchadnezzarII]

OP,

First of all, I wish I had gotten to this thread sooner. I’m an IM teaching attending and at this point in my career, I’ve had many, many off-service interns. Yes, I believe it’s inhumane for you to be on wards for so long. You must be in a program where the residents are not plentiful in number and psych residents are expected to be all-purpose interns.

As an attending, my expectation is always that the off-service intern knows quite a bit less medicine and I am training them to keep patients alive this year and then in the upcoming years to recognize when you need an internist’s help. (“That’s not dementia, that’s crypto meningoencephalitis!”)

I almost never expect an intern to know everything...at least the first time around. If on day one, I ask you “what’s the INR today?” I don’t expect you to have it stored in your head. I expect you to look it up and give me the answer faster than I can click on it myself. But I also expect you to have that number ready on day 2 and every subsequent day be cause I asked for it.

like I said, I wish I’d been on this thread sooner but you’re almost done. Just keep swimming.

Wish more attendings were like you. Thanks for the insight. Less than a week left now. Feel numb everywhere mentally and physically lol. Gained a bunch of weight and developed bad habits over the past several months. I dunno how you IM people do it without breaking. Though, I will say, not even the IM interns do floors consecutively for this many months.

 

[robellis]

Wish more attendings were like you. Thanks for the insight. Less than a week left now. Feel numb everywhere mentally and physically lol. Gained a bunch of weight and developed bad habits over the past several months. I dunno how you IM people do it without breaking. Though, I will say, not even the IM interns do floors consecutively for this many months.

Surgery is a lot lot worse than IM months and they do it for years, you will get through it and it’ll toughen you up a bit

 

[Mad Jack]

Lol let’s not take it that far..you’re practicing medicine you’re not a slave in the fields..not that big of a deal man just keep going you’re almost done

Cognitive demands can be much more distressing than mindless physical ones. There's also a big difference between doing something for 80 hours a week for several months that you want to do for the rest of your life and something you're forced to do that you'd rather not be doing. Drafted soldiers and conscripts tend to not fare as well as volunteers, and so it goes for medicine.

If you tried to force most non-physicians to do medicine (medical school, wards, any of it), they would become depressed, guaranteed. It's a challenging lifestyle and most would be content to do almost anything else.

 

[robellis]

Cognitive demands can be much more distressing than mindless physical ones. There's also a big difference between doing something for 80 hours a week for several months that you want to do for the rest of your life and something you're forced to do that you'd rather not be doing. Drafted soldiers and conscripts tend to not fare as well as volunteers, and so it goes for medicine.

If you tried to force most non-physicians to do medicine (medical school, wards, any of it), they would become depressed, guaranteed. It's a challenging lifestyle and most would be content to do almost anything else.

Well agree to disagree, IM is the core of all medicine, it’s the quintessential “doctor” if you can’t manage a few months of it during residency maybe being a doctor isn’t for everyone. Surgery is a different beast and certainly not everyone should be forced to do months of that

 

[Chads2]

I dunno how you IM people do it without breaking.

Because we love it. You put me on psych for a few months and I would be just as broken down as you.

Polish off your DSM-V. It’s waiting for you.

 

[Mad Jack]

Well agree to disagree, IM is the core of all medicine, it’s the quintessential “doctor” if you can’t manage a few months of it during residency maybe being a doctor isn’t for everyone. Surgery is a different beast and certainly not everyone should be forced to do months of that

I mean surviving it is one thing, but I wouldn't expect someone that isn't going into IM or an IM subspecialty to not be mildly to moderately depressed on the inpatient service. I thought it was fine, but I can definitely see it making some people miserable

 

[mvenus929]

Well agree to disagree, IM is the core of all medicine, it’s the quintessential “doctor” if you can’t manage a few months of it during residency maybe being a doctor isn’t for everyone. Surgery is a different beast and certainly not everyone should be forced to do months of that

I mean, I'm pretty sure attending IM docs aren't doing 60-80 hours of wards per week, every week, for months on end... And those in IM programs may have a couple months in a row that they do that, but it's sprinkled with outpatient or other lighter rotations where you can reclaim some of your sanity.

At least, that's how it is in peds. Maybe IM people are just bred differently.

 

[nebuchadnezzarII]

I mean, I'm pretty sure attending IM docs aren't doing 60-80 hours of wards per week, every week, for months on end... And those in IM programs may have a couple months in a row that they do that, but it's sprinkled with outpatient or other lighter rotations where you can reclaim some of your sanity.

At least, that's how it is in peds. Maybe IM people are just bred differently.

Yeah all the main IM people or pre lims have at most 4 weeks in a row on floors. Otherwise it’s usually 3 weeks floors 1 week outpatient or 2 weeks floors 2 weeks elective.

 

[Chads2]

Congratulations on surviving!

 

[deleted1022040]

Yeah all the main IM people or pre lims have at most 4 weeks in a row on floors. Otherwise it’s usually 3 weeks floors 1 week outpatient or 2 weeks floors 2 weeks elective.

How are things since you survived IM?

By the way, damn proud of you not only for opening up about what you were feeling/experiencing but for pushing through.