Really miserable and need advice

[mojojojo]

Hey all. So, I'm a little over a month into my program (mine started early in June for some reason) and, as my title said, I'm absolutely miserable.

I went into ob/gyn and ignored a lot of warnings, figuring I just wanted to practice gyn after residency anyway. I figured residency would be "tough", but I didn't anticipate feeling the way I do. I got my number one choice in the field I thought I wanted to go into, but now I just feel like I made such a huge mistake.

When I interviewed they said the call was q5-6, but they tend to give you a week of no calls and then pile on a bunch of q2s for no reason. Last week I worked 120 hours. The calls give you NO sleep, and you never stop moving. This exhaustion is a feeling I can't describe. The program isn't what I would call deeply malignant, i.e. no one screams at you, but there is absolutely no sense of camraderie; even the second years treat the first years like dirt. I've heard "because you're an intern" about a million times. I can't believe I'm at a program where they treat people like this. But I feel like maybe it's just my field in general -- when people have to work this much, it becomes an every man for himself kind of atmosphere.

I just have this realization that I can't do this for four years. I cry all the time, and typically consider myself a very happy person, but I'm just depressed. I guess what I'm hoping for from this forum is some advice, ie, does it get better? Should I hang with it? Or is it my field? I was thinking I could switch to family practice, since really at the end of the day I would like to just treat patients, and come home to my husband. The ob/gyn attendings I work with complain bitterly about their lives.

I think I just overall feel stupid-- I thought I knew what I want, but like I said, I can't believe I made such a big mistake. I'm miserable and terrified to be feeling like this, since I was, one month ago, so sure about the plans for my life. Any advice at all would be appreciated.

Thanks.

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[RussianJoo]

I think you're just over worked... It should get better and every week the work should seem easier and easier...either you'll learn to be more efficiant and gain the knowledge so things will be second nature or you'll just get used to working hard and it won't seem like hard work anymore. Internship is nothing like med school... if you enjoy the field and the didactics then you picked the right field for you and try to ignore all the negative stuff. It should and will get easier. And you're in Manhattan the greatest city in the world... so if you get a weekend or a day off go enjoy the city. go on a date or something. And try not to let the whole "because you're an intern" BS get to you... before you know it you'll be saying the same thing to an intern that you're in charge of.

and if positive thinking doesn't work you can always get drunk.

good luck
RJ

 

[jiy76]

Hey all. So, I'm a little over a month into my program (mine started early in June for some reason) and, as my title said, I'm absolutely miserable.

I went into ob/gyn and ignored a lot of warnings, figuring I just wanted to practice gyn after residency anyway. I figured residency would be "tough", but I didn't anticipate feeling the way I do. I got my number one choice in the field I thought I wanted to go into, but now I just feel like I made such a huge mistake.

When I interviewed they said the call was q5-6, but they tend to give you a week of no calls and then pile on a bunch of q2s for no reason. Last week I worked 120 hours. The calls give you NO sleep, and you never stop moving. This exhaustion is a feeling I can't describe. The program isn't what I would call deeply malignant, i.e. no one screams at you, but there is absolutely no sense of camraderie; even the second years treat the first years like dirt. I've heard "because you're an intern" about a million times. I can't believe I'm at a program where they treat people like this. But I feel like maybe it's just my field in general -- when people have to work this much, it becomes an every man for himself kind of atmosphere.

I just have this realization that I can't do this for four years. I cry all the time, and typically consider myself a very happy person, but I'm just depressed. I guess what I'm hoping for from this forum is some advice, ie, does it get better? Should I hang with it? Or is it my field? I was thinking I could switch to family practice, since really at the end of the day I would like to just treat patients, and come home to my husband. The ob/gyn attendings I work with complain bitterly about their lives.

I think I just overall feel stupid-- I thought I knew what I want, but like I said, I can't believe I made such a big mistake. I'm miserable and terrified to be feeling like this, since I was, one month ago, so sure about the plans for my life. Any advice at all would be appreciated.

Thanks.

Think from the end mojojojo. Look how far u came. U got into your number 1 program and in the field u desire.This is the life on an intern at many places. There are a lot of people suffering. Can u at least share the misery with the other interns in the program? I am sure they are just as miserable. Find an outlet whether it be family or friends or just some alone time.You are going through the worst part of your training and its common for people to doubt the reasons they went into this whole deal to begin with.Just remember that it does get better. Good luck mojo and hang in there.

 

[paiute]

I'm over 50; been practicing for 24 years. I work in prison healthcare. Two years ago I took educational leave to do a FP residency. I worked hard for 6 months, then, on the eve of starting OBGYN, I quit. I had heard such horrible stories about it. I saw a young coworker completely change her personality after her OBGYN rotation. I heard several residents describe it as "hell." If I didn't already have a career, I probably would have continued.
Please stick with and don't quit like I did. Finish your internship and transfer to FP or IM.

 

[niuyiar]

Hang on!! I know the what you describe completely as I am in the same spot as you, I am over worked, beat around like a dirt bag, co-interns of mine cry every other day, The "because you are an intern" phrase its part of my life now, but I know that this will someday turn around for the good but you just have to develop a hard skin and do your best always, never do a mediocre job because if you do you are giving them what they need to continue bashing you. I don't know why I am even writing here but got to wait for some results and did my notes etc. so my efficiency is starting to pay off.

Tough it out, if others did it you can. Be efficient!!!! learn it from your pgy-2's the way they managed their patients. I am out got at least 5 more hours on the floors then 2 of sleep and a new day comes!!!!lol.

GL.

 

[InvitroDerm]

Perhaps you should report your program for hour violations? And, since OB/GYN's are always on those lists for having least satisfaction, perhaps you should get out now. I'm just a premed, what do I know.

 

[peppy]

Have you tried talking to the other interns about the call schedule and perhaps approaching the chief resident or program director as a group about changing call distribution to be more balanced? If the other interns are as unhappy as you are about it, that might be more effective than if you approached anyone on your own.

I do sympathize with you. I don't think anyone would be having a good time on q2 call. I guess only you can judge if you would enjoy family medicine more than ob/gyn as an attending. Would it still be worth it to you to switch to FM in the long run if it meant you wound up in an FM program that was just as bad or worse than this one? That might be something to think about since it might be hard to interview for many FM spots if your program is as inflexible about scheduling as they sound.

 

[Law2Doc]

Perhaps you should report your program for hour violations? And, since OB/GYN's are always on those lists for having least satisfaction, perhaps you should get out now. I'm just a premed, what do I know.

I don't know that OP has described an hour violation. The 80 hour week is an average, not a per week thing. At any rate, putting your program into probation probably won't make things better. If you don't enjoy what you are doing, 80 hours of it is still a lot.

 

[Winged Scapula]

Perhaps you should report your program for hour violations? And, since OB/GYN's are always on those lists for having least satisfaction, perhaps you should get out now. I'm just a premed, what do I know.

Besides the fact that L2D points out that the program may not be actually violating work hours, you have neglected the major problem with reporting such:

retribution.

Residents have no power. Reports to ACGME and RRC are not confidential; programs always find out who has reported them. Resident's lives can be made mserable by reporting.

And even if they weren't and the program ended up getting closed, the program has no requirement to find the resident another job. So residents don't say anything and shut up - sometimes a miserable existence as a physician is better than being without a job.

 

[Top Gun]

Hey all. So, I'm a little over a month into my program (mine started early in June for some reason) and, as my title said, I'm absolutely miserable.

I went into ob/gyn and ignored a lot of warnings, figuring I just wanted to practice gyn after residency anyway. I figured residency would be "tough", but I didn't anticipate feeling the way I do. I got my number one choice in the field I thought I wanted to go into, but now I just feel like I made such a huge mistake.

When I interviewed they said the call was q5-6, but they tend to give you a week of no calls and then pile on a bunch of q2s for no reason. Last week I worked 120 hours. The calls give you NO sleep, and you never stop moving. This exhaustion is a feeling I can't describe. The program isn't what I would call deeply malignant, i.e. no one screams at you, but there is absolutely no sense of camraderie; even the second years treat the first years like dirt. I've heard "because you're an intern" about a million times. I can't believe I'm at a program where they treat people like this. But I feel like maybe it's just my field in general -- when people have to work this much, it becomes an every man for himself kind of atmosphere.

I just have this realization that I can't do this for four years. I cry all the time, and typically consider myself a very happy person, but I'm just depressed. I guess what I'm hoping for from this forum is some advice, ie, does it get better? Should I hang with it? Or is it my field? I was thinking I could switch to family practice, since really at the end of the day I would like to just treat patients, and come home to my husband. The ob/gyn attendings I work with complain bitterly about their lives.

I think I just overall feel stupid-- I thought I knew what I want, but like I said, I can't believe I made such a big mistake. I'm miserable and terrified to be feeling like this, since I was, one month ago, so sure about the plans for my life. Any advice at all would be appreciated.

Thanks.

Hang in there. Its not just ob/gyn. I had to put up with all kinds of bs throughout my intern year, and I 'm doing internal medicine. I like the field well enough that I sucked it up. Things did become much easier by the end of the year.

On another note, I don't necessarily think its the field that's making you miserable. Maybe its just your program. If you are really unhappy with the program, and I mean beyond the normal intern woes, then you might consider switching to another program in the same field.

 

[peerie]

Well, I can agree that it is nice to consider a field where you can work hard during the day but then come home to your husband at the end of it and have a sort of normal life. But then I did choose family medicine.

Honestly, ob is the pitts. When I did my ob rotation everyone screamed at me or ignored me. Ok, they didn't really 'scream' at me but they snapped or growled at me. Mostly, they did that to everyone so it wasn't personal. The only people I saw who seemed pretty normal were the FM docs delivering their patients' babies. Hmmm, I thought. They seem pretty friendly and normal. They had normal conversations with me and staff, they talked to their kids on the phone. They had familes and their patients were relaxed and comfortable when they delivered. No one was ever freaking out.

That said, internship everywhere is a horrific experience in many ways; you think - am I another universe, far, far away? Where is normalcy and why am I always about to burst into tears? I have to pinch myself at mrning rounds when I am exhausted and about to present my fifth admission of the night and the attedning keeps asking: did you do/ask/see/say such and such? and I have to admit no. Personally, I am just grateful I was able to get through the night and basically get the main stuff done, and no one coded, so if I didn't look up something vaguely related to patient care, then ok so be it. I am learning to be quiet, smile alot, and say thank you very much I appreciate that feedback.

Anyway, there was an ob resident who thoughtfully worked out why s/he wanted to switch to fm and s/he did. "Caliob," maybe. If you want to enjoy your patients, enjoy talking to them and would like to also keep that darn cute little baby in your patient pool, then come over to the FM side. We would welcome you.

 

[punjabiMD]

The facts, from what I can tell:

1. It appears that there ACGME violations at your program
2. As a result, you are suffering burnout in an early stage
3. Unless things change (which they could as you get more efficient, wiser, more senior), this burnout will affect your health and well-being adversely.

Possible solutions (again, these may be useless in your situation as I don't really know what your program is like):
1. reach out to your senior housestaff
2. reach out to your PD or APDs, if they are people that you can trust
3. many institutions have housestaff councils that you can reach out to (made up of housestaff and faculty from other programs at your institution). They may have a setup available for you to get some confidential counseling (but would you even have the time?). Also, some housestaff in NYC are unionized (e.g. Bellevue housestaff are part of the CIR-SEIU which has abundant resources for them)
4. grin and bear it and hope that things get better, but if they don't realize that you will likely turn into a miserable shell of a human being during residency (sorry, had to say it)
5. report violations to the ACGME/RRC. This will put pressure on the program to change.
6. Look into transferring to a program outside of NYC (see below)

I just completed my residency in NYC, and the hospitals in NYC (even the big-name ones) are in their own world when it comes to how they are run. Nursing shortages abound, ancillary staffing is poor, the hospitals are poorly organized, and as a result housestaff in general are overworked and have to bear the brunt of the problem.

 

[burgsyloo]

Hey hang in there! It is just your first year. It is not just you, all residents feel like that in their first year. At least you are not being yelled at. Some get what you are getting and on top of it, they are yelled at and even threatened from the onset that they wouldnt finish residency. My residency was terrible and it is only recently as an attending that i got a letter of apology and a withdrawal letter to my boards withdrawing all allegations against me. Dont count the days. Just read and get comfortable with the job. When it becomes routine and you know what you are doing, the job will seem much much better. There will be easier rotations and dreadful ones up front. Yes it is true first years are treated like slaves but dont put yourself in the spotlight by complaining. Avoid altercations and be respectful. Say it wont happen again instead of giving genuine excuses. It is sad but that is the nature of residency. More than 50% of doctors are sad and have no life. Dont let these bunch be your role model. Create time for yourself and go to bed early so that you have energy during the day. Be on top of everything and be always prepared. Read the right books to get you on the way and get a 2nd year friend to put your through stuff asap. Dont change to family practice, you will make a good obgyn! Just be patient

 

[Gastrapathy]

What warning signs did you ignore?

 

[Coastie]

Besides the fact that L2D points out that the program may not be actually violating work hours, you have neglected the major problem with reporting such:

retribution.

Residents have no power. Reports to ACGME and RRC are not confidential; programs always find out who has reported them. Resident's lives can be made mserable by reporting.

And even if they weren't and the program ended up getting closed, the program has no requirement to find the resident another job. So residents don't say anything and shut up - sometimes a miserable existence as a physician is better than being without a job.

The ACGME cannot investigate anonymous reports, nor can they give out names of the residents who write comments unless they imply direct harm to the PD, faculty, or staff of a program.

The PD receives an aggregate list of the survey responses without names attached.

The ACGME does have a clause which states that a complaint submitted which is "significant" requires the complainant to be made public.

They have yet to define the above clause.

Otherwise, what are you talking about?

Let's get aprogdirector in on this discussion.

 

[NotAProgDirector]

The ACGME has a poor history of keeping whistleblower's identities secret.

In addition, programs can usually figure out whom blew the whistle.

There are plenty of good programs out there with caring PD's. There is no need for whsitleblowers there, as you can simply speak your mind.

 

[Coastie]

The ACGME has a poor history of keeping whistleblower's identities secret.

In addition, programs can usually figure out whom blew the whistle.

There are plenty of good programs out there with caring PD's. There is no need for whsitleblowers there, as you can simply speak your mind.

Whistleblower or filling out anon surveys?

The ACGME seems to differentiate between the two.

 

[Winged Scapula]

Do you really think "anonymous" surveys are really so secret?

Does the ACGME tell PDs, "psst...I know its supposed to be anonymous, but Coastie says you suck"? Of course not. But they provide these surveys to PDs and it doesn't take a lot to discover who's unhappy in a program.

Perhaps if you have 100 residents it might take a little more work, but in smaller programs unhappy residents who would complain on an anonymous survey are woefully apparent.

Thus, I am "talking about" the fact that if ACGME investigates a complaint, ie, something that they consider significant, you will be identified. They admit that your name is made public. In addition, these surveys are not truly anonymous as in most cases, a PD can find out who made complaints simply by being observant, listening and doing a little detective work.

As aPD notes the ACGME has a horrible history of keeping identities of whistleblowers confidential. It happened in my program (we were put on probation and the whistleblower identified...fortunately, she was 3 months from graduating, so finished and left) and it can happen in yours.

 

[mercaptovizadeh]

Do you really think "anonymous" surveys are really so secret?

Does the ACGME tell PDs, "psst...I know its supposed to be anonymous, but Coastie says you suck"? Of course not. But they provide these surveys to PDs and it doesn't take a lot to discover who's unhappy in a program.

Perhaps if you have 100 residents it might take a little more work, but in smaller programs unhappy residents who would complain on an anonymous survey are woefully apparent.

Thus, I am "talking about" the fact that if ACGME investigates a complaint, ie, something that they consider significant, you will be identified. They admit that your name is made public. In addition, these surveys are not truly anonymous as in most cases, a PD can find out who made complaints simply by being observant, listening and doing a little detective work.

As aPD notes the ACGME has a horrible history of keeping identities of whistleblowers confidential. It happened in my program (we were put on probation and the whistleblower identified...fortunately, she was 3 months from graduating, so finished and left) and it can happen in yours.

I'm all for someone making allegations to stand by their words, but if the issue is something objective (i.e. work hours are not being regulated properly), it's just outrageous that people are being exposed. I find it very disturbing how skewed the balance of power is against residents.

 

[maceo]

i say get the f out now take the rest of the year off.. just chill and match in a fp residency program. the reason i say this is ..... because it aint gonna get better.. you know that. everyone knows that.. the liability in your specialty is through the roof.. frivlous lawsuits are very common. the light at the end of the tunnel aint there baby.

the problem with a career in medicine is... no matter how much you love it.. no matter how much time you put into it.. it is not gonna love you back.. I realize it relatively early.. (attending for 5 years now) but some people dont realize it until they are near retirement, and they have many regrets. SO, if you wanna leave.. leave.. there is no shame in that... you only get to live your life once. IF you wanna stick it out.. thats fine as well but accept your plight. Either way you have options.

 

[Llenroc]

LOLZ. OB-Gyn is for suckers. Even I could have told you that.

 

[Dejavu]

Get Out.

Think about changing to an Anesthesia residency, you will be much happier right away. We have many people who have jumped ship and gone into anesthesia.

Life is too short to be feeling like you feel.

 

[CambieMD]

Get Out.

Think about changing to an Anesthesia residency, you will be much happier right away. We have many people who have jumped ship and gone into anesthesia.

Life is too short to be feeling like you feel.

I disagree with Dejavu. If you are interested in gyn stay the course. L&D is tough even for those who enjoy it.

Anesthesia has its' own special issues, just take a look at the anesthesia forum.

Your misery will be short lived.

Cambie

 

[cali-ob]

Anyway, there was an ob resident who thoughtfully worked out why s/he wanted to switch to fm and s/he did. "Caliob," maybe. If you want to enjoy your patients, enjoy talking to them and would like to also keep that darn cute little baby in your patient pool, then come over to the FM side. We would welcome you.

Yes, that was me. I am so sorry you are going through this, and I unfortunately know exactly how you feel. I have to be completely honest with you, if your program is an "every man for themselves" type of place, it will NOT get better. It will get worse. Second year is harder than first year in Ob at most places. If you are unhappy, and the working environment is bad, it will get worse. The program I left is still a horrible place. I still keep in touch with my class mates who are day by day fighting tooth and nail for an inch of respect. One is in therapy, one is in anger management. They did not used to be those people! They want to leave, but feel trapped.
I am so much happier now. I really loved OB, and still plan to practice OB as an FP, but now I feel free to love it again.
I know that for me and my family and the type of life I want to live, FP is a better fit. I can still do what I love, without it taking over my life. And intern year, didn't suck AT ALL compared to what I was going through in my Ob residency (I worked for 3-4 weeks straight before having a day off every month). I definitely think it was largely the place of my residency, so if you think you have really want to do Ob/Gyn, try to switch locations. Spots open up all the time. If you think you just can't take Ob/Gyn, switch to FP. It's soooooo much less stress (for me anyway). I'm happy. It took me a while to let go of the image of myself as an OB/Gyn because like you, that was all I ever wanted, but I can honestly say it was a huge learning experience for me, and I am really happy with who I am and what I do.
I would recommend your hospitals EAP if they have one, and if not, head over to the psych dept for some counseling. But do not just put your head down and bear it. This is not "intern blues" and it's not something everyone goes through. You need someone to talk to. Feel free to PM with any questions.
COB

 

[mojojojo]

Hi everyone, and thanks so much for all of the thoughtful responses.

Just to respond to an earlier question, I don't think that my program is considered to be in ACGME violation, because I tend to alternate between a 60 hour work week and a 120-130 hour work week, so I guess it passes by the law of averages. I discussed with my senior resident trying to have a more balanced schedule, and she told me to "get used to it". So, that's that, I guess.

Also, an update... I stated last week that there's no screaming at my program, but lately, the screaming has begun. Actually, funnily enough, a senior resident told me the other day that I needed to "start yelling" when a lab tech wasn't giving me lab results quickly enough. When I responded that yelling is unprofessional and I wouldn't yell at someone, he got upset with me. Sigh.

I definitely have heard opposing views on here, I guess some of you are of the "stick it out" mindset, and others with the "move on" mindset. But to be honest, I am in agreement with the last poster, I don't think it's just "intern blues". I have a lot of friends in family practice and in peds, who are of course busy and tired, but definitely aren't experiencing the things that I am, nor are they having the doubts that I have.

So, full disclosure... I registered with ERAS today. Making that decision alone felt like a huge weight off of my shoulders. I'll be registering all of my materials, but I figure I will give myself until September 1st to make my final decision as to whether or not to hit "submit". All of your opinions have been so appreciated, so please keep them coming.

Thanks again.

 

[Grace34]

I definitely think you should move on. I'm in an FP residency and, while we work hard and get tired, we residents have always been treated with respect. The support staff, nurses, attendings, and administration all treat us like valued workers and human beings. The residents work together - I've stayed late to help with admits, or traded a call night with someone who needed the night off, etc., and most of my collegues have too. Sure, you have the occasional person who's not quite the team player as everyone else, but it's the exception & not the rule. Life is good in family medicine.
Also, it's possible to find programs that are very heavy on OB. If you PM me, I might have some specifics you would be interested in.

 

[punjabiMD]

congrats on making a step towards finding a solution to your problem. I'm glad that you're already starting to feel better!

Hi everyone, and thanks so much for all of the thoughtful responses.

Just to respond to an earlier question, I don't think that my program is considered to be in ACGME violation, because I tend to alternate between a 60 hour work week and a 120-130 hour work week, so I guess it passes by the law of averages. I discussed with my senior resident trying to have a more balanced schedule, and she told me to "get used to it". So, that's that, I guess.

Also, an update... I stated last week that there's no screaming at my program, but lately, the screaming has begun. Actually, funnily enough, a senior resident told me the other day that I needed to "start yelling" when a lab tech wasn't giving me lab results quickly enough. When I responded that yelling is unprofessional and I wouldn't yell at someone, he got upset with me. Sigh.

I definitely have heard opposing views on here, I guess some of you are of the "stick it out" mindset, and others with the "move on" mindset. But to be honest, I am in agreement with the last poster, I don't think it's just "intern blues". I have a lot of friends in family practice and in peds, who are of course busy and tired, but definitely aren't experiencing the things that I am, nor are they having the doubts that I have.

So, full disclosure... I registered with ERAS today. Making that decision alone felt like a huge weight off of my shoulders. I'll be registering all of my materials, but I figure I will give myself until September 1st to make my final decision as to whether or not to hit "submit". All of your opinions have been so appreciated, so please keep them coming.

Thanks again.

 

[mercaptovizadeh]

So out of curiosity I was just browsing through the residency forums and since you've got me curious now....

what are you applying for i.e. what field? FP or something slightly more competitive like EM?

I know there are some who would say FP is hell too because FP doesn't pay enough and some programs are not that great. at the least I'd do IM so if you want to subspecialize you could do that as well. I know that Pandabear MD who used to post on here had the same misery in his FP internship before he rematched to what he had really wanted to do which was EM. But then again no hell compares to OB/Gyn or Surgery from what every single med student I've ever talked to has told me. By the end of their med school days those fantasies about becoming a surgeon or OB/gyn go thrown out the window for IM to subspecialize later on, EM, rads for the ones with competitive scores, etc.

It sounds like the OP has a passion for Ob, which FP will still allow her to do, but IM won't.

I wonder why Ob/Gyn has to be so malignant. Sure, the hours are uncontrollable, but it sounds like the personalities are malignant. It's a question whether the profession generally attracts these kinds of people or they just become that way after years of abuse.

 

[Mistress S]

Hey mojojojo,
It sounds like you made the right choice, and I hope it works out for you in the match this time around. I just started my intern year in peds, and while there are times when I'm definitely exhausted and emotional, I can't say I've been treated poorly by anyone. Quite the opposite- my seniors help us out and treat us with respect, and even cover the floor on call nights after 3 am so we can get some sleep. I feel comfortable asking them and the attendings questions and have not been belittled or yelled at by anyone. Sure, there are times I feel stupid for forgetting or not knowing things, but nobody has made me feel that way besides myself. Some of the attendings and senior residents are friendlier than others, to be sure, but none are abusive. And nobody has ever said "because you're an intern" to me yet. It also seems like our PD listens to us and many changes have been made in the program based on resident input.

I just want you to know that what you're going through isn't universal, that there are good programs out there that treat even interns with respect. Intern year is emotionally and physically exhausting anywhere, and I have certainly had my second thoughts (why didn't I just become an NP?), but overall these have more to do with being tired than being mistreated by my program. Honestly, reading about your experience made me appreciate where I'm at a lot more- hopefully you will look back on this next year and feel the same way. Good luck!

 

[mtDNA]

It sounds like the OP has a passion for Ob, which FP will still allow her to do, but IM won't.

I wonder why Ob/Gyn has to be so malignant. Sure, the hours are uncontrollable, but it sounds like the personalities are malignant. It's a question whether the profession generally attracts these kinds of people or they just become that way after years of abuse.

I don't think that very many people start out as being so miserable/angry all the time, I think it comes from a combination of way too long and miserable of hours, abuse from everybody, and a mindset that these elements are all part of a culture that is reasonable/desirable.

I am an M4, my Ob/gyn rotation was by far the worst part of med school. It was BY FAR worse than surgery! and not because the hours were worse, they were the same, but the people in OB/GYN were just awful, whereas there were actually a lot of nice people in surgery who were happy with what they were doing.

I also remember hearing the residents on OB/GYN ask the attendings if it gets better after residency, the answer was always no....incredible.

OP, run away!

 

[radslooking]

Besides the fact that L2D points out that the program may not be actually violating work hours, you have neglected the major problem with reporting such:

retribution.

Residents have no power. Reports to ACGME and RRC are not confidential; programs always find out who has reported them. Resident's lives can be made mserable by reporting.

And even if they weren't and the program ended up getting closed, the program has no requirement to find the resident another job. So residents don't say anything and shut up - sometimes a miserable existence as a physician is better than being without a job.

this is part of the reason many people get frustrated in residency. You have very little power to change your situation. Yes, you can complain or ask for a more manageable load, or say you're being overworked. But that only works to a point, and otherwise you look like you're a complainer. Most of the time you just have to grunt it out. Or leave. But leaving isn't easy.

 

[Old_Mil]

...say while you love OB, you miss the rest of medicine more than you thought you would and switch into Family Medicine?

 

[nightowl]

Good for you for registering and taking actual steps toward figuring this out. I am sure that there are MANY residents who feel exactly the same way you do, especially in ob/gyn, who are afraid to make that step. I know it takes courage to switch paths.

I'm a fourth year med student trying to decide on a specialty, and although I enjoyed the work on ob/gyn and women's health, I'm "heeding the warnings" and choosing to do another specialty. I ultimately know that I am choosing personal and emotional fulfillment over the glamor of surgery and delivering babies. I'm horrified of "turning into another person" which I've been warned about a lot. Like you, I'm a happy person who can be fulfilled doing lots of things, as long as I'm helping people. Good luck with your decision.

 

[Winged Scapula]

Sooooooooo true. I remember about 5 years ago I was well involved with AMSA as a premed student but had national membership til I realized it was too liberal for my taste. Anyhow, the poster boy for one of the amsa articles was a guy who was an EM resident at Hopkins that blew the whistle on work hour regulations at Hopkins EM residency program. The guy got found out and fired. Nearly ended up in a bad situation til Ohio State took him on.

True story...except it was an EM intern who was rotating off service on the Hopkins IM service. He was a contributor to SDN and there are many threads here about him, what happened to him and Hopkins.

 

[Impromptu]

For general advice, if one wants to be around people who treat you kindly, one would:
1. choose a different field than OB/GYN
2. move to the midwest, where smiling at a stranger doesn't automatically label you as mentally defective.

I am currently at a very non-malignant anesthesiology program (aren't they all?), and love it. But, during some long, hard hours, I can't help but fantasizing about year-long sabbaticals and early retirement. Those fantasies become less frequent when I'm not nearly as stressed out.

Recognize that it is the workload that is making you miserable, which recognition may help in buffering the sharing of misery with your loved ones and friends and save relationships. I don't know if that is your case, but it is good advice in general.

 

[mercaptovizadeh]

True story...except it was an EM intern who was rotating off service on the Hopkins IM service. He was a contributor to SDN and there are many threads here about him, what happened to him and Hopkins.

Wait - his complaints about the IM program led to his being booted out of an EM residency?

I am definitely NOT applying to Hopkins IM - heard ultramalignant things about their IM and ortho residencies and I bet the rest are just as bad.

I wonder what's the basis of firing? Complaining about work hour violations? Or is it a case of them opening up a file where they record every mistake you ever make and portray you as incompetent and boot you at the end of the year?

 

[radslooking]

Wait - his complaints about the IM program led to his being booted out of an EM residency?

I am definitely NOT applying to Hopkins IM - heard ultramalignant things about their IM and ortho residencies and I bet the rest are just as bad.

I wonder what's the basis of firing? Complaining about work hour violations? Or is it a case of them opening up a file where they record every mistake you ever make and portray you as incompetent and boot you at the end of the year?

I took one look at the Hopkins IM program and ran the other way. It did not look fun. The resident who presented on interview day gave the entire presentation rote. Like down to where the patient lived and his food preferences, etc. Any poor bastard who is doing that, either to impress others, or as peer pressure, is something I want no part of.

 

[Winged Scapula]

Wait - his complaints about the IM program led to his being booted out of an EM residency?

I am definitely NOT applying to Hopkins IM - heard ultramalignant things about their IM and ortho residencies and I bet the rest are just as bad.

I wonder what's the basis of firing? Complaining about work hour violations? Or is it a case of them opening up a file where they record every mistake you ever make and portray you as incompetent and boot you at the end of the year?

No, no, no.

Troy Madsen was NOT fired. After all the publicity, the environment at JHU wasn't very pleasant for him. He left on his own accord.

Here's a story he wrote recently for The New Physician which tells the story in a nutshell. You can Google him for more details: http://www.amsa.org/tnp/articles/article.cfx?id=493

 

[mwest]

Hey all. So, I'm a little over a month into my program (mine started early in June for some reason) and, as my title said, I'm absolutely miserable.

I went into ob/gyn and ignored a lot of warnings, figuring I just wanted to practice gyn after residency anyway. I figured residency would be "tough", but I didn't anticipate feeling the way I do. I got my number one choice in the field I thought I wanted to go into, but now I just feel like I made such a huge mistake.

When I interviewed they said the call was q5-6, but they tend to give you a week of no calls and then pile on a bunch of q2s for no reason. Last week I worked 120 hours. The calls give you NO sleep, and you never stop moving. This exhaustion is a feeling I can't describe. The program isn't what I would call deeply malignant, i.e. no one screams at you, but there is absolutely no sense of camraderie; even the second years treat the first years like dirt. I've heard "because you're an intern" about a million times. I can't believe I'm at a program where they treat people like this. But I feel like maybe it's just my field in general -- when people have to work this much, it becomes an every man for himself kind of atmosphere.

I just have this realization that I can't do this for four years. I cry all the time, and typically consider myself a very happy person, but I'm just depressed. I guess what I'm hoping for from this forum is some advice, ie, does it get better? Should I hang with it? Or is it my field? I was thinking I could switch to family practice, since really at the end of the day I would like to just treat patients, and come home to my husband. The ob/gyn attendings I work with complain bitterly about their lives.

I think I just overall feel stupid-- I thought I knew what I want, but like I said, I can't believe I made such a big mistake. I'm miserable and terrified to be feeling like this, since I was, one month ago, so sure about the plans for my life. Any advice at all would be appreciated.

Thanks.

This is definitely not how a 'normal' program should be. I can't say I am super thrilled about any residency program (as long as overnight calls are there) but my FM program is pretty cool and supportive. I have to say our hours are also much better, even at the ICU. I had a few rotations with IM ( and will have with OBGYN too) and their culture seems a little more malignant to me. The IM residents were super intimidated of their 'intimidating' attendings, something you'll never find with our FM attendings. I don't know if its just my program or the whole FM culture but the personalities are starkingly different. It's just a different world out there in the same university/hospital. This will be one of medicine's great mysteries
Between conformity and peer pressure, I think med students/doctors really lose track of what they really want to do and what they can really handle. Sometimes it's as simple as choosing a specialty that supports the kind of lifestyle you want to lead-sometimes its $ and sometimes it's time, or sometimes both. I am happy that with FM I get enough time to stay happy, even during pgy-1.

 

[DrJosephKim]

I've met many people who've been in your situation. I encourage you to speak with your program director and to consider exploring other options (including non-clinical options).

 

[San_Juan_Sun]

I wouldn't tell anyone at your program how unhappy you are. Don't go to your PD. Don't go to your chief. Don't talk about it with other residents. Don't complain about anything. Make them think you're solid like a rock, a model intern. And then bolt after year 1.

You never want to be perceived as the "weak" intern. Be strong, and put all your frustration into plotting your escape. Good luck.

 

[QofQuimica]

I wonder why Ob/Gyn has to be so malignant. Sure, the hours are uncontrollable, but it sounds like the personalities are malignant. It's a question whether the profession generally attracts these kinds of people or they just become that way after years of abuse.

It may be a bit of both. But regardless, if you come into an OB/gyn residency like a normal human being, it may well cure you of that. And if you come in already having a tendency toward truculency, an OB/gyn residency ain't gonna turn you into a saint.

I am an M4, my Ob/gyn rotation was by far the worst part of med school. It was BY FAR worse than surgery! and not because the hours were worse, they were the same, but the people in OB/GYN were just awful, whereas there were actually a lot of nice people in surgery who were happy with what they were doing.

Likewise. I had a good time on surgery, which was much better than I expected. In contrast, if all of medical school were like OB/gyn, I'd probably have dropped out within the first month of my first year.

I wouldn't tell anyone at your program how unhappy you are. Don't go to your PD. Don't go to your chief. Don't talk about it with other residents. Don't complain about anything. Make them think you're solid like a rock, a model intern. And then bolt after year 1.

You never want to be perceived as the "weak" intern. Be strong, and put all your frustration into plotting your escape. Good luck.

I agree.

OP, you're in a position of weakness as an intern, and being openly defiant is only going to antagonize people who have the power to make your life even more painful. But no worries, your chance to laugh will come on the day they ask you to sign your contract for next year. Best of luck with your apps.

 

[Winged Scapula]

I agree on staying mum.

Its too early, with lots of the year left, to be complaining, even legitimately.

At some point the PD will have to be involved in terms of scheduling interviews or even getting an LOR/statement of good standing.

But I would put it off as long as possible. Such a program usually reflects its leader and the rest of the year could become even more miserable.

 

[nancysinatra]

I'm an intern in psych and very happy. Of course our hours are not as grueling as Ob/Gyn, but we do 30 hour calls and work late plenty often. I don't feel any wish to complain about anything major right now. They way you're describing it sounds beyond normal unhappiness. I hope you figure things out for next year so you're more happy!

I am actually very curious about this Ob/Gyn personality thing. Those 6 weeks of third year were the most unpleasant weeks of my life, and I worked in some evil corporate jobs before med school. I'd hear residents denigrating their patients within earshot of the patients. Attendings would blabber about their weddings ad nauseum at 6am rounds. They'd talk to some members of the team but not others, like a middle school clique. I didn't see one drop of compassion from anyone above intern level. That's not even mentioning the screaming and sarcasm... These are not normal people and why some of them go into medicine at all is beyond me.

 

[mojojojo]

I spoke with an adviser from my medical school who stated the best time to tell my program I am leaving would be before I start interviews, i.e. November-ish. Obviously, as I will be taking time off from work to go to my interviews they would need to know why, and additionally, I was told that I would need to be in good standing from my program, and program directors at the FP programs would want to speak to my PD to make sure that's the case. Good reason to bite my tongue when people are awful, but it also helps me to stay sane to think, "Oh, you just wait until after I match!!"

My adviser also pointed out that once they know I'm reapplying to expect that I will be hated and they'll be making my life miserable. So, yikes. To add to it, we have three interns per year and another intern is also leaving, she's starting her application now too. Should make for an interesting work environment.

I have a good friend who matched in FP locally and she said there is a girl in her program who transferred in mid-year, and that she'd keep her ears open for any openings. I won't get my hopes up or anything, but sigh... to dream.

 

[sqtab]

move to the midwest, where smiling at a stranger doesn't automatically label you as mentally defective.

You mean it's worse in other parts of the country? Yikes!

I actually got tired of smiling at people in the midwest because no one smiled back! If anything, all I got was this quizzical look like, "Why the ---- are you smiling?".