We have all seen the crap TV shows that show a soap opera centered around a residency, but does anyone know what its really like??
Im curious, do ALL grads have residencies in hospitals? If I want to go into family medicine, would i do a res. in a hospital or a practice?
Id like to know what the different options are.
Thanks!
Here's an example of an intern year experience (not giving out specialty or location, though many places and fields are similar). Typical weekly hours in most monthly rotations are between 75-85, with a few weeks above or below these lines, averaging out to about 80/week. Get there around 5:30 am and leave between 6-7pm each day, 6 days/week. You get 1 day off in 7 averaged monthly, as per the rules. Have overnight call 0-2 times per week (meaning you don't sleep at all those nights). Thanks to night float, call is less frequent, because each resident in this program does a one month block of nights during the year. Overnight shifts can run up to 30 hours (capped at this time by "law"). The averaged 30 hour rule and 80 hour work week are ACGME "legal" requirements, though many programs run afoul of these from time to time, and nobody who doesn't want to damage their program says anything. You get 3 1/2 weeks of vacation a year, which cannot be in a single block.
Needless to say, you are always tired, because the time you are out of the hospital is pretty minimal and you are always trying to push the envelope between trying to have a life and getting a night's sleep. Many average 5-6 hours/night on non-call nights, which is enough to keep you functional, but not enough to keep you from constantly yawning.
Pretty much all fields do most of their residency in the hospital setting, with some clinic exposure. The intensity varies, but there are very few residencies where you don't have a steep learning curve and long hours in the early years. Most of the cushier specialties still make folks do a prelim year in medicine, surgery or transitional (an assortment of fields) as the thinking is that folks need to be generalists first and then specialize. A lot of family medicine programs have their residents rotate along with surgery and ICU medicine interns at community hospitals.
While an intern, you are the low man on the totem pole and at some programs are treated as such. Thus the benign vs malignant issue looms large when selecting residencies, because you will be getting a beat down during intern year and it makes a big difference on how hard they like to beat you.
But you will learn a lot, and toward the end you will be good at a lot of things, be able to get patients swiftly off your service, paper the files appropriately, dictate like a machine, and have lots of defense mechanisms for anything thrown at you overnight regarding cross-cover patients you don't really know all that well. It's hard, and has an absurdly steep learning curve, but by the end, you will walk through the halls with the swagger of someone who actually feels like he knows what he's doing. And in June, the next set of interns starts and you get to join in the beat down.
:cry:
