top IM residency prograns with easier schedules

[step2account]

Looking to find programs that have solid training (top 20?) without killing myself in the process (i.e., few/none 24 hour calls). Any suggestions would be great. Thanks!

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[Instatewaiter]

Hopkins has a pretty cush schedule

 

[IMreshopeful]

Looking to find programs that have solid training (top 20?) without killing myself in the process (i.e., few/none 24 hour calls). Any suggestions would be great. Thanks!

All good academic programs have a lot of clinical work. That being said BWH and MGH is known for being cush

 

[jdh71]

Have to admit I despise these threads.

Kids are lazy af these days.

 

[mrmatt]

As a top IM program resident I'd say that you should reconsider your priorities and specialty if you're searching for easy programs. It will never be easy. Do you have children? Do you have an S/O? Perhaps there are more specific things to look into than work hours, such as support for partners and leave of absence etc.

 

[obiwan]

Have to admit I despise these threads.

Kids are lazy af these days.

Probably only going to get worse unfortunately..... its sad when my training program which is fairly regarded as a clinically rigorous program is a shell of what it once was as it has had to ease up on the housestaff

 

[pgy0246]

Try to find a top program with primary care track or VA track. You will ended up with 4-6 months of of golden weekend.
Northwestern I heard has a pretty easy schedule.

 

[Animalcules]

few/none 24 hour calls

🤣

 

[Instatewaiter]

As a top IM program resident I'd say that you should reconsider your priorities and specialty if you're searching for easy programs. It will never be easy. Do you have children? Do you have an S/O? Perhaps there are more specific things to look into than work hours, such as support for partners and leave of absence etc.

Kidding aside, I agree that most strong residencies also come with a significant amount of clinical work. Of course there needs to be some balance but you want to be put through the ringer in residency so you will be comfortable and capable as a attending.

 

[MoLarryKerlyBLine]

Have to admit I despise these threads.

Kids are lazy af these days.

Solid contribution. Glad that the previous generation was willing to get taken advantage of with no evidence of improved patient outcomes. Work smarter, not harder is the mantra of this generation. If you don't like that, you can hold fast to your opinion as dogma and drift away into obscurity, because whether or not you agree, that IS the way of the future. It's already happening in the business world, and as per the norm, medicine is well behind the curve.

 

[jdh71]

Solid contribution. Glad that the previous generation was willing to get taken advantage of with no evidence of improved patient outcomes. Work smarter, not harder is the mantra of this generation. If you don't like that, you can hold fast to your opinion as dogma and drift away into obscurity, because whether or not you agree, that IS the way of the future. It's already happening in the business world, and as per the norm, medicine is well behind the curve.

I'd like to see many of you "work smarter" - but I'm usually not impressed by your "smarts" as in I rarely see it. I was never taken "advantage of" (I signed up for all of this) - I was learning medicine. Acute illness does't follow banker's hours and is inconvenient to nights and holidays and weekends and anniversaries and sports games. In training it is important to understand the natural course of acute illness over the course of 24 hours. This isn't "dogma". This also doesn't mean you need to live at the hospital, nor does it mean that you have to only take 24 hour call all the time, but you do need to and should take some of these types of call probably a few times per month throughout your training - the context and understanding are worth their weight in gold even if you can't see that prior to training or even during. When you are out and on your own and a sick patient winds up on your service they need YOU to make the right decisions and often relatively quickly. Your comfort level and reflexes in doing so will be directly related to what you saw and went through during your training. Some day you won't be a baby physician or student any longer but ostensibly someone who is supposed to know what to do for someone on their worst day. You owe it to your patients and yourself to work as hard as you can and learn as much as you can during training, and the best way for that to translate is from the bedside.

I did my residency and fellowship under the 80hr/week work rules, and I rarely went over it.

Medicine isn't the "business world" - our problems and work occur 24/7/365. Maybe you should find a cubicle so you can work two days per week?

 

[jdh71]

View attachment 272739

Kidding aside, I agree that most strong residencies also come with a significant amount of clinical work. Of course there needs to be some balance but you want to be put through the ringer in residency so you will be comfortable and capable as a attending.

Yeah, well, I'm pretty sure I could take you in a cage match.

But seriously, the bolded part of what I quoted, is what we are al talking about.

I can also tell which of the new hospitalists that came out of weak programs based on what they panic about when asking for an ICU transfer

 

[MoLarryKerlyBLine]

I'd like to see many of you "work smarter" - but I'm usually not impressed by your "smarts" as in I rarely see it. I was never taken "advantage of" (I signed up for all of this) - I was learning medicine. Acute illness does't follow banker's hours and is inconvenient to nights and holidays and weekends and anniversaries and sports games. In training it is important to understand the natural course of acute illness over the course of 24 hours. This isn't "dogma". This also doesn't mean you need to live at the hospital, nor does it mean that you have to only take 24 hour call all the time, but you do need to and should take some of these types of call probably a few times per month throughout your training - the context and understanding are worth their weight in gold even if you can't see that prior to training or even during. When you are out and on your own and a sick patient winds up on your service they need YOU to make the right decisions and often relatively quickly. Your comfort level and reflexes in doing so will be directly related to what you saw and went through during your training. Some day you won't be a baby physician or student any longer but ostensibly someone who is supposed to know what to do for someone on their worst day. You owe it to your patients and yourself to work as hard as you can and learn as much as you can during training, and the best way for that to translate is from the bedside.

I did my residency and fellowship under the 80hr/week work rules, and I rarely went over it.

Medicine isn't the "business world" - our problems and work occur 24/7/365. Maybe you should find a cubicle so you can work two days per week?

I won't continue since I feel we will never reach an agreement.

 

[jdh71]

I won't continue since I feel we will never reach an agreement.

It's always good to know when you are WRONG in an argument and bow out.

Good luck.

 

[MoLarryKerlyBLine]

It's always good to know when you are WRONG in an argument and bow out.

Good luck.

You really are pretty insecure. Perhaps I have better things to do than bicker with strangers on the internet. But if your ego is so delicate that you need to tell yourself that, then sure.

 

[jdh71]

You really are pretty insecure. Perhaps I have better things to do than bicker with strangers on the internet. But if your ego is so delicate that you need to tell yourself that, then sure.

Insecure about what?

Exactly how much experience do you have? How many residencies and fellowships have you been through? How years of independent practice treating acutely ill patients?

My opinion about you being incorrect isn’t me beating my chest, it’s my experience telling you that you are not correct. This has nothing to do with my ego.

If you actually have “better things to do” then maybe you shouldn’t have quoted me in the first place with language clearly looking to pick a fight and maybe you should also stop replying after you got in over your head. I think you may be confused. And I suspect it’s your delicate ego you are trying to protect here. I’ve got nothing to prove to you. All the attendings in this thread have come in and agreed. Sometimes it’s best not to open your mouth and be known a fool.

 

[seeinghowitgoes]

Looking to find programs that have solid training (top 20?) without killing myself in the process (i.e., few/none 24 hour calls). Any suggestions would be great. Thanks!

Having recently gone through the interview process, I’d say most well-regarded residencies will be close to the 80 hrs when you’re inpatient (I’m at a “cushier” top program and have worked ~75-78 hrs per week inpatient thus far).

The question then is how are those hrs distributed? For example, q4 24hrs gives you a post-call day so more hrs are squeezed into a shorter timeframe than say more of a night float system where you may have fewer days off but you work less hrs each day.

Because you’re going to work a lot of total hrs no matter what, I think you want to ask yourself is 1) how do you like your weekends, 2) how do you like your hr distributions, and 3) how do you like your outpatient? Programs will often either given you 1 golden, 2 silver, and 1 black weekend per month or 1 day off each weekend (with few golden weekends but also few black weekends). Similarly you can have 24 hr call or float systems. Finally, you can have x+y systems (predictable inpatient intervals) or systems with continuity clinics (less predictable but get a clinic half day each week or so, which you may or may not personally view as a bit of a reprieve). When interviewing, I think knowing which of those you’d prefer and prioritizing that schedule can be helpful (assuming all else is equal between programs), but also beware most residencies mix many of these different schedules depending on the service (I have some 24 hr calls and some nightfloat services in my program, for example).

There will always be some exceptions to this. Like I think Mayo was on a 4+4 system which makes them perhaps more chill (4 weeks inpatient on an admitting service, 4 more chill weeks of consults or outpatient), some program probably do just have less volume so no matter what schedule they have it’ll be more chill, and obviously there are primary care programs (often times more golden weekends but you need to enjoy outpatient care and usually have some gen med narrative to your application). But on the whole figuring out if you prefer call vs float, golden+black weekends vs many silver weekends, and if you want to prioritize an x+y schedule or not - is a great start.

This will be debated by people (and again is based on what I prioritized as far as weekends and call) but from what I recall, what immediately came to my mind as some of the more chill schedules among top program included:

Brigham
Stanford
BIDMC
Mayo

And what immediately came to my mind as some of the tougher schedules (again caveat based on my priorities) included:

Hopkins
MGH
Vandy
Uwash
UChicago

*Last but not least just want to say while I had preferences for schedules, I used them only once or twice in making my final rank list as a tiebreaker. So many more important things in my opinion - personalities, faculty you want to work with, ability to work with certain patient populations, city, etc. It ended up not affecting my list much and even in my “chill” program I feel I’m working hard. In fact, some of the most unhappy residents I’ve encountered are the ones who picked a residency program because they thought the schedule was going to be easier and are now realizing it’s all relative and they are still putting in a ton of hrs - the ones who went in with open eyes seem to cope a bit better.*

 

[MoLarryKerlyBLine]

Insecure about what?

Exactly how much experience do you have? How many residencies and fellowships have you been through? How years of independent practice treating acutely ill patients?

My opinion about you being incorrect isn’t me beating my chest, it’s my experience telling you that you are not correct. This has nothing to do with my ego.

If you actually have “better things to do” then maybe you shouldn’t have quoted me in the first place with language clearly looking to pick a fight and maybe you should also stop replying after you got in over your head. I think you may be confused. And I suspect it’s your delicate ego you are trying to protect here. I’ve got nothing to prove to you. All the attendings in this thread have come in and agreed. Sometimes it’s best not to open your mouth and be known a fool.

Ahh, the curmudgeon is dripping off this post. Like most of your post history.

 

[realrebelohio]

Current resident at UT Southwestern, we do q4 28 hr call a lot but it's fun! You'll be amazed how much more fun residency is than medical school! In medical school I dreaded rotations with long hours, but when ur actually the person doing the doctoring it's awesome! I wouldn't worry too much about it, just go to the best program you can get into.

 

[jdh71]

Ahh, the curmudgeon is dripping off this post. Like most of your post history.

Was that an argument? Lol

 

[jdh71]

If I had a dollar for everyone on this site who thought pointing out they didn’t like my style as if it was relevant I’d eat steak dinner tonight. At the nice restaurant. I’d get a cocktail. One them $15 fancy ones.

 

[Instatewaiter]

Solid contribution. Glad that the previous generation was willing to get taken advantage of with no evidence of improved patient outcomes. Work smarter, not harder is the mantra of this generation. If you don't like that, you can hold fast to your opinion as dogma and drift away into obscurity, because whether or not you agree, that IS the way of the future. It's already happening in the business world, and as per the norm, medicine is well behind the curve.

Interesting diatribe from a person who has been an intern for all of 5 minutes... You're arguing with a handful of attendings while the ink is still drying on your diploma... Interesting choice

FYI, you can't just work smarter... You must have volume and longitudinal experience which takes time and effort. Working banking hours isn't going to cut it. You can read books until you're blue in the face and it won't substitute for clinical exposure which is why a strong step score isn't a substitute for clinical experience. Every class (mine included) talked about working smarter and you know what we found? Theres only a small amount of efficiency to be taken from the system. More importantly, every extra minute you put in during residency, may be a life you save.

If you aren't working 80 hours a week 3 weeks into internship, you just aren't working hard enough. You are at your least efficient right now

 

[rokshana]

Ahh, the curmudgeon is dripping off this post. Like most of your post history.

Dude, you are not a big enough dawg to be on jdh’s porch...stop...just stop.

 

[Anicetus]

Have to admit I despise these threads.

Kids are lazy af these days.

We just see how miserable the generation above us is from working hard in “grit”. Heck, if we become socialists later what’s the point if 90% of every dollar over 250k is going to be taken away from us by good old Uncle Sam (Bernie Sanders).

In all honesty tho, overworked residents led to a generation of what we younger doctor’s view as miserable old fools. Someone needs to stand up for our own happiness, which has been shown as all county hospitals in 2019 are way less desirable than non county programs.

 

[rokshana]

We just see how miserable the generation above us is from working hard in “grit”. Heck, if we become socialists later what’s the point if 90% of every dollar over 250k is going to be taken away from us by good old Uncle Sam (Bernie Sanders).

In all honesty tho, overworked residents led to a generation of what we younger doctor’s view as miserable old fools. Someone needs to stand up for our own happiness, which has been shown as all county hospitals in 2019 are way less desirable than non county programs.

You know which doctors were probably the most satisfied with their lives? Those that trained in the 60s and the 70s...and they probably were the epitome of what a physician should be a strive to be...my dad was a surgical intern and resident in the late 60s-early 70s ( those who know, know what this means)...there is a reason training doctors were called residents and house officers...they lived in the hospital...

Frankly, if medical education keeps going the way it’s going, either residencies will have to be longer for resident to get the needed exposure to be competent in the real world or MDs and NPs really will be the same.

And realize that all the pt caps, duty hour restrictions, required naps, etc will cease to exist in the real world... better that residency be harder than attending life.

 

[jdh71]

We just see how miserable the generation above us is from working hard in “grit”. Heck, if we become socialists later what’s the point if 90% of every dollar over 250k is going to be taken away from us by good old Uncle Sam (Bernie Sanders).

In all honesty tho, overworked residents led to a generation of what we younger doctor’s view as miserable old fools. Someone needs to stand up for our own happiness, which has been shown as all county hospitals in 2019 are way less desirable than non county programs.

You think it's being "overworked" *in residency* that has lead to job dissatisfaction *following*?? Non sequitur.

Your experience with residency training and post training work is what, exactly, that you think you can make such an ridiculous statement. Or maybe you're simply ignorant.

Regardless . . . *your* happiness isn't what this job is about. Which is *not* the same as arguing you need to be miserable or even attempt to maximize your misery. In residency you are learning to be a physician - the guy (or gal [or helicopter because this is 2019 after all]) who is willing to step into the gap and help people on their worst days because we signed up to do this and we are the only folks who know how to do it. It's not something you can get much help with at the local diner or Lowe's.

 

[jdh71]

Dude, you are not a big enough dawg to be on jdh’s porch...stop...just stop.

That was a very nice thing to say about me rokshana.

 

[MoLarryKerlyBLine]

Dude, you are not a big enough dawg to be on jdh’s porch...stop...just stop.

Irrelevant, non-point.

You think it's being "overworked" *in residency* that has lead to job dissatisfaction *following*?? Non sequitur.

Your experience with residency training and post training work is what, exactly, that you think you can make such an ridiculous statement. Or maybe you're simply ignorant.

Regardless . . . *your* happiness isn't what this job is about. Which is *not* the same as arguing you need to be miserable or even attempt to maximize your misery. In residency you are learning to be a physician - the guy (or gal [or helicopter because this is 2019 after all]) who is willing to step into the gap and help people on their worst days because we signed up to do this and we are the only folks who know how to do it. It's not something you can get much help with at the local diner or Lowe's.

God complex. You can a be both well-trained and have a fulfilling life outside of medicine. I didn't choose my program based on lifestyle. Tbh, I don't give an F about lifestyle in residency because it's 3 short years. But I damn well will not be ****ting on future generations like you are. That's a fact. Times change; accept and move on.

 

[jdh71]

God complex. You can a be both well-trained and have a fulfilling life outside of medicine. I didn't choose my program based on lifestyle. Tbh, I don't give an F about lifestyle in residency because it's 3 short years. But I damn well will not be ****ting on future generations like you are. That's a fact. Times change; accept and move on.

You can be both well trained and have a fulfilling life outside of medicine. I don't think I have suggested otherwise anywhere.

I'm sorry you are mad that I find your generation lazy, but I'm not sorry I find them in general to be lazy.

I don't know how any of this makes me have a "god complex" - I don't think I'm God - you could flesh that out or just sit, again, with your weak non-argument personal attack and a rather impressive lack of self-awareness for the embarrassing real ad hominem twice in one thread. Am I supposed to gather these data points and retract I suppose my accusation of being lazy when you are too lazy to even make a decent argument?

 

[blub1212]

Speaking as someone that just graduated residency less than a month ago.

I went to medical school at a place that was "cush" for internal medicine. I specifically sought out a place that would kick my a$$. Right after arriving here, it was quickly apparent that the brand new PGY2s (just finished intern year) here were better than the finishing PGY3s at the place I went to medical school. You have 3 years in residency that will determine how good you are for the rest of your life. Either suck it up or go do something else with your life. We aren't fixing cars here, what we do matters.

If you have ever been on the other end of a transfer call from OSH, speaking to a physician who is in way over their head and doesn't have any clue what they are doing, you know what I say is true. When you finish residency, you will either be making those calls, or taking those calls. The choice is yours.

 

[Anicetus]

Speaking as someone that just graduated residency less than a month ago.

I went to medical school at a place that was "cush" for internal medicine. I specifically sought out a place that would kick my a$$. Right after arriving here, it was quickly apparent that the brand new PGY2s (just finished intern year) here were better than the finishing PGY3s at the place I went to medical school. You have 3 years in residency that will determine how good you are for the rest of your life. Either suck it up or go do something else with your life. We aren't fixing cars here, what we do matters.

If you have ever been on the other end of a transfer call from OSH, speaking to a physician who is in way over their head and doesn't have any clue what they are doing, you know what I say is true. When you finish residency, you will either be making those calls, or taking those calls. The choice is yours.

Making those calls 100%. I’m at a place where I feel bad for the attendings because I’m watching their lives outside of the hospital fall apart because “medicine is their calling” and they “owe it to their patients”. I actually envy the ones handing off the patient at the little community joints because I will be happier doing it as “just a job” and get to go home at a reasonable hour.

Medicine is a job to me and nothing more. Realized this when I was too deep down the rabbit hole (debt) and no specialties were interesting me in medical school the way I hoped for.

You can be both well trained and have a fulfilling life outside of medicine. I don't think I have suggested otherwise anywhere.

I'm sorry you are mad that I find your generation lazy, but I'm not sorry I find them in general to be lazy.

I don't know how any of this makes me have a "god complex" - I don't think I'm God - you could flesh that out or just sit, again, with your weak non-argument personal attack and a rather impressive lack of self-awareness for the embarrassing real ad hominem twice in one thread. Am I supposed to gather these data points and retract I suppose my accusation of being lazy when you are too lazy to even make a decent argument?

Lazy or not, I’m going to enjoy life outside of my hours in residency because I don’t believe life should be put on hold even in residency. Maybe a lot of us went into medicine for different reasons than most of you did in your generation. I hear from my attendings “how we had it” but also hear how it messed them up regardless of how much they “worked their a** off”.

If you want to be the one everyone comes to at any hour of the day for their healthcare, be that person. I’m just saying it’s okay for those of us who don’t feel its a “calling” to still finish their MD career without the rigor and it’s more than okay to choose a Cush residency to get to that lifestyle. Sure you will be the one transferring to a tertiary care center but some of us are okay with being that doctor who isn’t as “rigorously trained.”

 

[Lexdiamondz]

Making those calls 100%. I’m at a place where I feel bad for the attendings because I’m watching their lives outside of the hospital fall apart because “medicine is their calling” and they “owe it to their patients”. I actually envy the ones handing off the patient at the little community joints because I will be happier doing it as “just a job” and get to go home at a reasonable hour.

Medicine is a job to me and nothing more. Realized this when I was too deep down the rabbit hole (debt) and no specialties were interesting me in medical school the way I hoped for.



Lazy or not, I’m going to enjoy life outside of my hours in residency because I don’t believe life should be put on hold even in residency. Maybe a lot of us went into medicine for different reasons than most of you did in your generation. I hear from my attendings “how we had it” but also hear how it messed them up regardless of how much they “worked their a** off”.

If you want to be the one everyone comes to at any hour of the day for their healthcare, be that person. I’m just saying it’s okay for those of us who don’t feel its a “calling” to still finish their MD career without the rigor and it’s more than okay to choose a Cush residency to get to that lifestyle. Sure you will be the one transferring to a tertiary care center but some of us are okay with being that doctor who isn’t as “rigorously trained.”

I think you have it a bit backwards. In every job, regardless of what you're doing, there will be times where you have to stay late. **** happens - it's a fact of life. That being said, if you are going home at austere hours every day well past signout then it's less likely that you're overcommitted and more likely that you're underprepared for the job. Good training teaches core skills of clinical acumen combined with efficiency - skills that require volume and rigour to develop. Without those, you aren't going to be good at your job and, in turn, will be way more stressed out by day to day tasks than someone who was well trained. You work hard as a resident so that it's much easier as an attending, not the other way around.

Even if you don't want to do high acuity work like critical care, surgery, anesthesia, EM or inpatient medicine you still need these skills. If anything, being in the community outpatient you need to be more efficient in order to stay afloat. There's really no getting around it, you need to train hard.

 

[jdh71]

Making those calls 100%. I’m at a place where I feel bad for the attendings because I’m watching their lives outside of the hospital fall apart because “medicine is their calling” and they “owe it to their patients”. I actually envy the ones handing off the patient at the little community joints because I will be happier doing it as “just a job” and get to go home at a reasonable hour.

Medicine is a job to me and nothing more. Realized this when I was too deep down the rabbit hole (debt) and no specialties were interesting me in medical school the way I hoped for.



Lazy or not, I’m going to enjoy life outside of my hours in residency because I don’t believe life should be put on hold even in residency. Maybe a lot of us went into medicine for different reasons than most of you did in your generation. I hear from my attendings “how we had it” but also hear how it messed them up regardless of how much they “worked their a** off”.

If you want to be the one everyone comes to at any hour of the day for their healthcare, be that person. I’m just saying it’s okay for those of us who don’t feel its a “calling” to still finish their MD career without the rigor and it’s more than okay to choose a Cush residency to get to that lifestyle. Sure you will be the one transferring to a tertiary care center but some of us are okay with being that doctor who isn’t as “rigorously trained.”

Actually it isn’t “ok”. We aren’t selling enchiladas here.

 

[rokshana]

Making those calls 100%. I’m at a place where I feel bad for the attendings because I’m watching their lives outside of the hospital fall apart because “medicine is their calling” and they “owe it to their patients”. I actually envy the ones handing off the patient at the little community joints because I will be happier doing it as “just a job” and get to go home at a reasonable hour.

Medicine is a job to me and nothing more. Realized this when I was too deep down the rabbit hole (debt) and no specialties were interesting me in medical school the way I hoped for.



Lazy or not, I’m going to enjoy life outside of my hours in residency because I don’t believe life should be put on hold even in residency. Maybe a lot of us went into medicine for different reasons than most of you did in your generation. I hear from my attendings “how we had it” but also hear how it messed them up regardless of how much they “worked their a** off”.

If you want to be the one everyone comes to at any hour of the day for their healthcare, be that person. I’m just saying it’s okay for those of us who don’t feel its a “calling” to still finish their MD career without the rigor and it’s more than okay to choose a Cush residency to get to that lifestyle. Sure you will be the one transferring to a tertiary care center but some of us are okay with being that doctor who isn’t as “rigorously trained.”

You should get your debt paid off and then get out of medicine...hopefully before you are responsible for someone’s death.
And those people taking your calls from the OSH... have absolutely no respect for you.

 

[Anicetus]

You should get your debt paid off and then get out of medicine...hopefully before you are responsible for someone’s death.
And those people taking your calls from the OSH... have absolutely no respect for you.

Lol respect?? Lost a craving for that a long time ago. One too many homeless alcohol withdrawal admissions made me realize respect is not a driving factor in my decision making in life, especially in medicine. This career is a means to an end. Yes it’s not selling enchiladas but on the other hand we don’t have to be handcuffed to our patients and responsible for their ability to do their laundry at home without hurting themselves.

 

[jdh71]

we don’t have to be handcuffed to our patients and responsible for their ability to do their laundry at home without hurting themselves.

who said you did?

 

[Anicetus]

who said you did?

Academic attendings who make us shed blood, sweat, tears for everything in our patients lives, which contributes to the backlash of our residents about “making our career our lives”. Give me the medicine to do that’s fine. But if I’m having to stay late dealing with dispo details as far as handwalking them to a taxi ride home and calling every family member they have to update them on their home nursing, i could hardly call it “better training” which is what a lot of county-ish programs with social issues advertise.

 

[jdh71]

Academic attendings who make us shed blood, sweat, tears for everything in our patients lives, which contributes to the backlash of our residents about “making our career our lives”. Give me the medicine to do that’s fine. But if I’m having to stay late dealing with dispo details as far as handwalking them to a taxi ride home and calling every family member they have to update them on their home nursing, i could hardly call it “better training” which is what a lot of county-ish programs with social issues advertise.

When you're on you take care of people. FFS. What do you think you are responsible for exactly. Maybe you should work a different job.

 

[Lexdiamondz]

Academic attendings who make us shed blood, sweat, tears for everything in our patients lives, which contributes to the backlash of our residents about “making our career our lives”. Give me the medicine to do that’s fine. But if I’m having to stay late dealing with dispo details as far as handwalking them to a taxi ride home and calling every family member they have to update them on their home nursing, i could hardly call it “better training” which is what a lot of county-ish programs with social issues advertise.

Dude, having to walk an old lady to a taxicab and call her family is not a big deal. I'm a senior resident and I do this. It literally costs me nothing and ensures that we don't get sued for her falling and cracking her head open while on eliquis, and prevents a bounceback for unsafe discharge.

You sound like you really have difficulty seeing the big picture, and suffer from a hint of laziness. Probably shoulda did something else tbh.

 

[Mad Jack]

Solid contribution. Glad that the previous generation was willing to get taken advantage of with no evidence of improved patient outcomes. Work smarter, not harder is the mantra of this generation. If you don't like that, you can hold fast to your opinion as dogma and drift away into obscurity, because whether or not you agree, that IS the way of the future. It's already happening in the business world, and as per the norm, medicine is well behind the curve.

I will say that the "lifestyle focused" docs and residents I have worked with are often the dodgiest. This isn't a part time job that you can half ass and go home unless you want to end up as the guy who has a license to kill

 

[Anicetus]

When you're on you take care of people. FFS. What do you think you are responsible for exactly. Maybe you should work a different job.

Oh if I could I would totally change specialties or jobs altogether to avoid calling the aunt over the phone to explain why the patient needs eliquis. Unfortunately in 2019 a lot of us, myself included, go into hundreds of thousands of dollars in debt and go into a specialty based on their board scores and not what they necessarily like. The trapped financial position and score/pedigree/who you know driven world of choosing a medical specialty result in people like me who have to see this job as a means to an end because it clearly isn’t a passion and there’s no way out except to not let the job eat up our lives.

You only know what you know about the career when you apply to medical school but you can’t blame some of us in our generation for being lazy residents when they just want to replace medicine with other things in our lives for various reasons.

Dude, having to walk an old lady to a taxicab and call her family is not a big deal. I'm a senior resident and I do this. It literally costs me nothing and ensures that we don't get sued for her falling and cracking her head open while on eliquis, and prevents a bounceback for unsafe discharge.

You sound like you really have difficulty seeing the big picture, and suffer from a hint of laziness. Probably shoulda did something else tbh.

 

[jdh71]

Oh if I could I would totally change specialties or jobs altogether to avoid calling the aunt over the phone to explain why the patient needs eliquis. Unfortunately in 2019 a lot of us, myself included, go into hundreds of thousands of dollars in debt and go into a specialty based on their board scores and not what they necessarily like. The trapped financial position and score/pedigree/who you know driven world of choosing a medical specialty result in people like me who have to see this job as a means to an end because it clearly isn’t a passion and there’s no way out except to not let the job eat up our lives.

You only know what you know about the career when you apply to medical school but you can’t blame some of us in our generation for being lazy residents when they just want to replace medicine with other things in our lives for various reasons.

Wow. You sound like victim. Have you told Oprah? Maybe she’d feel sorry for you. So rough. You actually had to talk to a patients family member. Sounds like a huge violation of your personal beliefs.

Seriously. GTFO of my profession.

 

[kjamess]

I think trainees are trying to paint this dichotomy of work-life balance vs training, but they arent mutually exclusive (and in fact, the latter improves the former). Being able to efficiently and comprehensively manage multiple sick/complex patients during training is what will allow you to leave work at a reasonable time for years to come as an attending. But it takes time and effort to get to that point. When people refer to "lazy" residents or colleagues, its generally aimed at people who increase the workload for others and cant hold their own. You know, the type who gets a lateish admission/consult (especially if complex) and always tries to dump everything on their colleagues. These are the same folks who are inefficient and suck at patient care because they've spent all their residency dodging work. And as far as walking grandma to her discharge uber, senior residents should delegate.

 

[Anicetus]

Wow. You sound like victim. Have you told Oprah? Maybe she’d feel sorry for you. So rough. You actually had to talk to a patients family member. Sounds like a huge violation of your personal beliefs.

Seriously. GTFO of my profession.

Hate to say it but 40 out of the 50 in our internal medicine class survey said they wouldn’t do this again and 45 of them want it easier for their outside lives.

Get ready for them all to swarm into “your profession”.

 

[rokshana]

Hate to say it but 40 out of the 50 in our internal medicine class survey said they wouldn’t do this again and 45 of them want it easier for their outside lives.

Get ready for them all to swarm into “your profession”.

Well I suspect your IM program isn’t exactly attracting the top med students, so, there is that.

 

[Mad Jack]

Well I suspect your IM program isn’t exactly attracting the top med students, so, there is that.

Nor are the majority of IM programs

 

[jdh71]

Hate to say it but 40 out of the 50 in our internal medicine class survey said they wouldn’t do this again and 45 of them want it easier for their outside lives.

Get ready for them all to swarm into “your profession”.

I’m already dealing with a few of your kind. They don’t seem to last long where I work.

 

[Lawpy]

well this is an interesting read. although i'll say I felt more reassured reading what @jdh71 @rokshana @Instatewaiter @blub1212 and others wrote.

 

[MoLarryKerlyBLine]

You can be both well trained and have a fulfilling life outside of medicine. I don't think I have suggested otherwise anywhere.

I'm sorry you are mad that I find your generation lazy, but I'm not sorry I find them in general to be lazy.

I don't know how any of this makes me have a "god complex" - I don't think I'm God - you could flesh that out or just sit, again, with your weak non-argument personal attack and a rather impressive lack of self-awareness for the embarrassing real ad hominem twice in one thread. Am I supposed to gather these data points and retract I suppose my accusation of being lazy when you are too lazy to even make a decent argument?

Ironic considering your first post was an attack on generational work-ethic. And the subsequent ones being a continuation of personal attacks. But I digress.

Making those calls 100%. I’m at a place where I feel bad for the attendings because I’m watching their lives outside of the hospital fall apart because “medicine is their calling” and they “owe it to their patients”. I actually envy the ones handing off the patient at the little community joints because I will be happier doing it as “just a job” and get to go home at a reasonable hour.

Medicine is a job to me and nothing more. Realized this when I was too deep down the rabbit hole (debt) and no specialties were interesting me in medical school the way I hoped for.



Lazy or not, I’m going to enjoy life outside of my hours in residency because I don’t believe life should be put on hold even in residency. Maybe a lot of us went into medicine for different reasons than most of you did in your generation. I hear from my attendings “how we had it” but also hear how it messed them up regardless of how much they “worked their a** off”.

If you want to be the one everyone comes to at any hour of the day for their healthcare, be that person. I’m just saying it’s okay for those of us who don’t feel its a “calling” to still finish their MD career without the rigor and it’s more than okay to choose a Cush residency to get to that lifestyle. Sure you will be the one transferring to a tertiary care center but some of us are okay with being that doctor who isn’t as “rigorously trained.”

Woah, woah. This is pretty much what @jdh71 is talking about. This is a dangerous outlook. You will NOT always have the opportunity to transfer. Sometimes you have to work with the cards you're dealt. You at least owe it to the patient in front of you to be well-trained. A patient shouldn't be transferred for a higher level of PHYSICIAN care, transfers should be due to ancillary staff, sub-specialty support, and general equipment needs.

 

[jdh71]

Ironic considering your first post was an attack on generational work-ethic. And the subsequent ones being a continuation of personal attacks. But I digress.

You have a common misconception, a personal attack or insult is NOT an ad hominem UNLESS it *IS* the argument itself. Most insults are just that insults. My initial observation was not directed at anyone in particular and I wasn’t making an argument. I was simply letting the thread know my thoughts. If you took insult from them that’s partly on you.

Now after that I’ve made many point by point arguments about how you are incorrect and wrong. You’ve responded by simply saying I’m “grumpy” or whatever. You have still yet to mount any kind of argument against all of the attendings and residents who have also told you that you are wrong.

My suggestion is to either 1) put up or 2) shut up while slowly backing out of the thread not making any eye contact as you will continue to embarrass yourself further.

You can tap out I won’t think any more less of you than I already do.