Sub-I?

[bio-psy]

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Since most of us have to do a sub-I or externship 4th year and as far as I know there are no pathology sub-Is, I thought it would be interesting to see what everyone is doing for theirs. I'm doing Psychiatry.

 

[beary]

I wish I could do psych. 🙁

I am stuck on peds heme-onc. Just started today. q4 call. 😡

 

[Tappat]

You can do psychiatry? Lucky duck. I would like to (maybe) have done ob/gyn, but our choices were pretty much either surgery or medicine. So I did medicine. It was a much better experience than I would ever have imagined, because you have real (supervised, of course, but still pretty substantial) responsibility and for once you are in the loop about things. I hated that sniffing for crumbs feeling I had when trying to stay up on my patients in third year. Also, I tried to at least appear to have a good attitude in general, but my resident was quite understanding about my total lack of desire to learn how to do central lines and such things. It also helped that I knew I had a vacation block coming up right afterwards. Just electives now ... Oh, and match day.

 

[pathdoc68]

I did med, heme-onc and a surg-onc elective. All very valuable.

 

[Brian Pavlovitz]

We are required to do TWO sub-I's; one in medicine, one in peds (but at least for peds we are allowed to do a subspecialty). My last rotation will be my med sub-I. How unfortunate!

 

[drPLUM]

I have also just started a sub-I, med heme/onc. Q4 call and this cross cover is supposed to be brutal. Oh well, here goes nothing... counting down the days until path starts.

 

[Gut Shot]

I'm doing Psychiatry.

I did Psych... substance abuse at the VA! Holy cow, those were four blissful weeks of doing almost nothing.

 

[beary]

My sub-I is one of the worst things that has ever happened to me in all of med school. It is sheer misery.

 

[miko2005]

We actually have to do medicine and surgery sub-I's. I did sports medicine for my surgery sub-I and ICU at a small community hospital for my medicine sub-I. So glad both of those are over 🙂 .

 

[deschutes]

I did Psych... substance abuse at the VA! Holy cow, those were four blissful weeks of doing almost nothing.

And how many clued-in MSIVs got to do this per year?

 

[Prairie]

My sub-I is one of the worst things that has ever happened to me in all of med school. It is sheer misery.

I feel your pain. I am in the middle of my required "rural family medicine" sub-I and it might just do me in... I don't think I can take another patient with cough/congestion/etc. How do these family practice folks do it? Around 3 pm is when I can't pretend to care anymore...

 

[Aubrey]

The closest thing I had to a sub-I was 3 weeks or so on the cardiac critical care unit.. it wasn't bad work-wise, as the uber-nurses were on top of every little thing, but the rounds were somewhat stressful (cranky attendings, any lack of EKG reading skillz quickly exposed to the world). 😱 I got off very easy, all things considered...

 

[Stinger86]

I just started my IM sub-I this week. I work one-on-one with an ID doc and basically round on his 30-40 inpatients from 730am to 600pm each day. I occasionally have to informally work up consults, but I never have to formally present patients. No call, no weekends. So much for my last month of clinical medicine being the hardest. 🙂

Bring on graduation!!

 

[beary]

I am on call tonight for my miserable sub-I. If anybody would like to come kill me first that would be just fine.

 

[Gut Shot]

And how many clued-in MSIVs got to do this per year?

Just me, baby, just me. I bitch about spending 6 years on a PhD, but it taught me something very valuable: whenever possible, take the path of least resistance. It never ceases to amaze me how many people will actively make their own lives harder for absolutely no discernible payoff.

 

[deschutes]

Just me, baby, just me. I bitch about spending 6 years on a PhD, but it taught me something very valuable: whenever possible, take the path of least resistance.

Ha. The last time I looked though, you weren't CP-only!

 

[AngryTesticle]

Sub-I's suck ass. My goal was to piss off everyone I met by saying that I would never have to do this bullsh*t again since I was going into pathology. Stupid f*ckers.

 

[Gut Shot]

Ha. The last time I looked though, you weren't CP-only!

Therein lies the "whenever possible" qualifier. I would like to have more than 0.2 job offers when I'm done with this thang.

 

[bio-psy]

The resident for my sub-I remembers what it's like to be a fourth year, so I am very lucky. He said I can just come in around 7:30 and see my patients, round with the team, write progress notes, then go home around noon. No call, no weekends, and I'll be off all day for Match day and the day after (my school gives us official time off from 11:30 am Thursday to 12:00 pm Friday). Life is sweeeet!

 

[beary]

The resident for my sub-I remembers what it's like to be a fourth year, so I am very lucky. He said I can just come in around 7:30 and see my patients, round with the team, write progress notes, then go home around noon. No call, no weekends, and I'll be off all day for Match day and the day after (my school gives us official time off from 11:30 am Thursday to 12:00 pm Friday). Life is sweeeet!

I so much wish my senior was like this. We actually were classmates in med school so I cannot comprehend what her problem is. She is obsessed with me being an "intern," and "not being an M3 anymore," and "taking initiative." It totally sucks. I am taking Match Day off no matter what.

 

[AngryTesticle]

beary, are you doing your sub-I at the university hospital? the residents at the university hospitals tend to be a bit more malignant and intent on making you work your ass off...because there is just a lot of work to do. at michigan, we used to be able to do both of our sub-I months at outside community hospitals...and lemme tell ya, the life was cush as hell. I would get two days off straight if my patients were discharged on my day off. This happened 3 out of the 4 weeks I was on general medicine. unfortunately, michigan decided to be lame as hell and got rid of this sub-I loophole...apparently, everyone has to do one month at U of M hospital which sucks donkey balls.

 

[beary]

beary, are you doing your sub-I at the university hospital?

I am at the university hospital. We all have to do a sub-I at the university, so we don't have that loophole. There are times when we are really busy and I feel like I can help with the workload a bit, but there are other times we are super slow and they make me just sit there literally for hours with absolutely nothing to do. That is what I absolutely can't stand. They won't even let me go to my lab which is a five minute walk away and be accessible by pager, since this way I am "more accessible to the nurses." Of course I can't write orders without getting them cosigned anyway so I see absolutely zero purpose to this. 😡

 

[drPLUM]

Of course I can't write orders without getting them cosigned anyway so I see absolutely zero purpose to this. 😡

This is what I hate about sub-I's. If you can't put in orders, then you are nothing more than an M3. Residents that cosign for you have to be up to date on your patient anyway to cosign... so in the end you save them very little work. The whole "you're an intern now" thing is bogus unless you can put in orders independently. I finally talked my resident into giving me his computer order entry code (i.e. no more cosigning) and it has improved workflow tremendously... of course I had to earn his trust first that I am not a ***** and will not kill anybody (keeping fingers crossed that I won't).

This internal medicine... man... who does this for a living anyway? 😕

 

[beary]

I had to run around for an hour yesterday trying to find somebody who would cosign an order to have urine dipped for glucose. 😡 Talk about an order unlikely to kill somebody.

 

[Gene_]

I think doing the subI early in 4th year is a good idea. I didn't mind the BS as much. At this point I don't care about anything, except passing my electives so I can graduate. And let's face it, as long as you show up occasionally for your electives, you're gonna pass.

 

[sapience8x]

anything that has no call! at my school- neuro or psych.

 

[miko2005]

I am at the university hospital. We all have to do a sub-I at the university, so we don't have that loophole. There are times when we are really busy and I feel like I can help with the workload a bit, but there are other times we are super slow and they make me just sit there literally for hours with absolutely nothing to do. That is what I absolutely can't stand. They won't even let me go to my lab which is a five minute walk away and be accessible by pager, since this way I am "more accessible to the nurses." Of course I can't write orders without getting them cosigned anyway so I see absolutely zero purpose to this. 😡

Wow. Your sub-I sounds terrible! Even if I had done my medicine sub-I at my home-school, I think it wouldn't quite be as bad since all the residents let us go to wherever and page us as needed.

But at least you sound busy enough to keep your mind off the upcoming match? My primary care is just boring enough that I am constantly worrying about the match 😴 .

 

[beary]

Wow. Your sub-I sounds terrible!

It is. Absolutely terrible. 😡

I guess it has somewhat taken me off the match because all I care about is getting off this rotation. I am going to demand to get Thursday and Friday off next week.

 

[ChipLeader]

I am going to demand to get Thursday and Friday off next week.

Glad to hear it beary. Good for you!

 

[beary]

Does anybody else hallucinate that their pager is going off? This happens to me a lot.

 

[yaah]

Does anybody else hallucinate that their pager is going off? This happens to me a lot.

That's why I can't put my pager on vibrate mode - because I walk around with a tingling sensation on my belt line in anticipation.

 

[drPLUM]

That's why I can't put my pager on vibrate mode - because I walk around with a tingling sensation on my belt line in anticipation.

Pppppffffffffttttt!!!
This post just made me spew Coke all over the screen.
I nominate this for post of the year.

 

[Aubrey]

That's why I can't put my pager on vibrate mode - because I walk around with a tingling sensation on my belt line in anticipation.

Hmm, that's why I always keep mine on vibrate.