When does it get better?

[Apply Pressure]

Seriously, when does life get better with regard to career/lifestyle? It seems like every year I have less time to have fun than the year before and less control in my life.

Unlike other threads about this topic, I really want to know if someone can give me a specific time when "things get better." Is it as a higher level resident? Is it when you're an attending? Or does it really never get better? If so, I'd like to know now so I can lower my expectations.

About me- MS III

Discussion appreciated. Thanks

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[Pinkertinkle]

When you match derm.

 

[RTrain]

Seriously, when does life get better with regard to career/lifestyle? It seems like every year I have less time to have fun than the year before and less control in my life.

Unlike other threads about this topic, I really want to know if someone can give me a specific time when "things get better." Is it as a higher level resident? Is it when you're an attending? Or does it really never get better? If so, I'd like to know now so I can lower my expectations.

About me- MS III

Discussion appreciated. Thanks

Totally not surprising that your life has seemed to get worse with each passing year, given that you're an MSIII now. Realistically:

It will get way way better temporarily next year, to the point that you'll almost feel normal. The following year will be a level of bad so far beyond anything so far that it will feel like a different dimension of the universe. For a variable number of years between internship and when you're a senior resident, it will be marginal, then when you are a senior/chief, it will be significantly better if you don't count the crushing responsibility.

I don't know beyond that, I'll have to keep you posted.

 

[gutonc]

Totally not surprising that your life has seemed to get worse with each passing year, given that you're an MSIII now. Realistically:

It will get way way better temporarily next year, to the point that you'll almost feel normal. The following year will be a level of bad so far beyond anything so far that it will feel like a different dimension of the universe. For a variable number of years between internship and when you're a senior resident, it will be marginal, then when you are a senior/chief, it will be significantly better if you don't count the crushing responsibility.

I don't know beyond that, I'll have to keep you posted.

After that, if you're a fellow (which, IIRC, you will be) it's back to square 1 or 1.5 at best. Sure, you know more than when you started as an intern or an MS3 but, not necessarily about what people are asking you about.

On June 30 this year, I admitted 2 STEMIs and a pt in profound cardiogenic shock to the CCU. On July 1, I wrote chemotherapy orders on 3 patients and administered intrathecal methotrexate to two others...plus I did a bone marrow biopsy. Nothing else changed overnight except the color of the embroidery on my white coat but all of a sudden, the responsibilities and expectations were much higher. On the upside, when you're a fellow, you finally get to do things you really care about which makes working hard much more enjoyable. Similarly, when you're a resident, you no longer have to do specialties you don't like (no more OR time and 5am rounds if you're in IM, no more interminable rounding and pontificating on hyponatremia if you're in Surgery, etc).

So the answer to the OP is that it get's a little better and a little worse at every step along the way - 3 steps forward, 2 steps back. MS3 and internship are the low points for sure but they have their upsides too.

 

[Law2Doc]

Seriously, when does life get better with regard to career/lifestyle? It seems like every year I have less time to have fun than the year before and less control in my life.

Unlike other threads about this topic, I really want to know if someone can give me a specific time when "things get better." Is it as a higher level resident? Is it when you're an attending? Or does it really never get better? If so, I'd like to know now so I can lower my expectations.

About me- MS III

Discussion appreciated. Thanks

Hate to break it to you, but asking this question on a residency board isn't going to give you an answer you like. It gets harder in much of residency. MS IIIs are somewhat coddled compared to what you will be doing during internship year. From what I've observed, a few years post residency, things get a bit better. You have more responsibility, more liability, but also more control over your life. But this is a path where you are always going to be working hard, always learning. So it never actually should get "easy". Just perhaps a bit better.

 

[roja]

"better" is a relative term. for me, I would take any day (even an insanely busy one) in the ED over the slowest day on the floor. For a surgeon, a day in the OR is better than one on the floor (in general).

The point being, better is dependent on who you are and what you are doing. if you hate all things that you do, than no point is going to get better.

In general though, things will get better in fourth year, stink in internship/early residency, get better as you approach senior level. Will get 'worse' as a fellow (if you do a fellowship) and then better again as an attending.


keep in mind that while 'balance' is a very important issue, people often misconstrue this concept to be one of 'daily' balance. You will probably NEVER have this. Balance is something that happens over the course of your career and life. You will have rough years and soft years. rough months/easy months. You have to work to keep the balance overall and keep the big picture in mind.

 

[razorback58]

We had a medical student that rotated during her 4th year of medical school at our hospital and was accepted into the program for this year. She seemed quite good at carrying only 2 to 3 patients.

Her quote during patient assignments - "I have my five patients!"

What? She carried only 2 to 3 during her medical school rotation and saw us carry somewhere between 8 and 12 patients each day as a PGY1- getting all our notes done before 8:30 a.m. and hopefully ready to present every freaking detail. By the way, this includes at least 2 to 3 unit patients.

Yes, it does get harded during PGY1 then a bit easier in PGY2 but with a lot more responsibility. Doing more in as a junior and senior medical student will prepare you for what is coming your way as a PGY1.

 

[DreamLover]

Totally not surprising that your life has seemed to get worse with each passing year, given that you're an MSIII now. Realistically:

It will get way way better temporarily next year, to the point that you'll almost feel normal. The following year will be a level of bad so far beyond anything so far that it will feel like a different dimension of the universe. For a variable number of years between internship and when you're a senior resident, it will be marginal, then when you are a senior/chief, it will be significantly better if you don't count the crushing responsibility.

I don't know beyond that, I'll have to keep you posted.

That's the quote of the week right there (made me laugh)....can I say it again...thank you God that intern year is over!

 

[RTrain]

After that, if you're a fellow (which, IIRC, you will be) it's back to square 1 or 1.5 at best. Sure, you know more than when you started as an intern or an MS3 but, not necessarily about what people are asking you about.

On June 30 this year, I admitted 2 STEMIs and a pt in profound cardiogenic shock to the CCU. On July 1, I wrote chemotherapy orders on 3 patients and administered intrathecal methotrexate to two others...plus I did a bone marrow biopsy. Nothing else changed overnight except the color of the embroidery on my white coat but all of a sudden, the responsibilities and expectations were much higher. On the upside, when you're a fellow, you finally get to do things you really care about which makes working hard much more enjoyable. Similarly, when you're a resident, you no longer have to do specialties you don't like (no more OR time and 5am rounds if you're in IM, no more interminable rounding and pontificating on hyponatremia if you're in Surgery, etc).

So the answer to the OP is that it get's a little better and a little worse at every step along the way - 3 steps forward, 2 steps back. MS3 and internship are the low points for sure but they have their upsides too.

Correct you are indeed.

I like your way of looking at those transitions - it may be challenging, but with each new level it becomes more your challenge of choice.

 

[docB]

Seriously, when does life get better with regard to career/lifestyle? It seems like every year I have less time to have fun than the year before and less control in my life.

Unlike other threads about this topic, I really want to know if someone can give me a specific time when "things get better." Is it as a higher level resident? Is it when you're an attending? Or does it really never get better? If so, I'd like to know now so I can lower my expectations.

About me- MS III

Discussion appreciated. Thanks

I'm really looking forward to retirement. Only 28 years to go. I'll let you know.

 

[DERMLOVER]

Seriously, when does life get better with regard to career/lifestyle? It seems like every year I have less time to have fun than the year before and less control in my life.

Unlike other threads about this topic, I really want to know if someone can give me a specific time when "things get better." Is it as a higher level resident? Is it when you're an attending? Or does it really never get better? If so, I'd like to know now so I can lower my expectations.

About me- MS III

Discussion appreciated. Thanks

when you become retired. after match you have step3 after that is ur board, then match for fellowship, then where you can find ur job, then where u can find a better one.......it never ends

 

[Faebinder]

It never gets better... you just reduce the stress with a lot of money as you advance. Get out if you still can... otherwise... Welcome to hell, better start learning some coping skills other than drugs and alcohol.

 

[masterofmonkeys]

personally, as an MS4 going into psychiatry, I'm already counting the days until I do my last ward month anywhere from 4-6 months into my intern year. If I go to a program that lets you do peds instead of IM, then it's graduation day.

 

[HRantz]

I am a third year Pathology resident, which is kind of the sweet spot in Pathology training. There is a steep learning curve, so the first year of Pathology residency is pretty bad. Then we take two board exams, not one (anatomic pathology and clinical pathology), so the fourth year is stressful preparing for them. Most people do a fellowship these days, so that puts you back somewhat, then I think the first year or two of being a "real pathologist" is pretty stressful because you are putting your own name on reports. But after that, I get the feeling it gets sweeter and sweeter as the years go by, such that some people never seem to retire.

 

[BobBarker]

Maybe my school is the exception, but everyone is of the consensus that each year has gotten progressively better. MS1 was horrible, MS2 was relatively laid back except for board prepping (We get to hang out with Dr. Goljan everyday, so he makes things easy for us), MS3 2/3 mos so far were awesome.

 

[IndyXRT]

There are lots of challenges along the way. Even after finishing residency, there are plenty of stressors. However, I think you get used to dealing with this over time. You also become more efficient, so there is a little more time for leisure activities.

 

[dragonfly99]

Good posts above.

I have to disagree with the ones that state intern year is worse than 3rd year. I think it depends on where you do med school and residency, what specialty you do, and what your personality is. I personally found 3rd year of med school to be akin to living in hell while paying massive amounts of money to be abused, with not much teaching. If someone offered me 100k now to redo 3rd year, with my current level of training, I would refuse. 2nd year at my school was also not well liked among the med students (massive memorization and very little time between 2nd and 3rd year to study for and take Step 2). 4th year is pretty good because you get a lot of electives, can avoid the fields you hate for the most part, and you know your way around the hospital and people tend to treat you better. Intern year can suck, but I found it less crappy than 3rd year, and the big difference is as an intern you are being PAID to get abused, and patients will respect you more because your nametag says "doctor". Other doctors will still not respect you, except for the attendings who like teaching and trainees, of which there will be some.

I think depending on what field you choose, things tend to start getting better and better after intern year. For surgeons, the 2nd year probably isn't much better than the intern year (I'm guessing). The workload doesn't necessarily get a ton better after intern year, except for the fact the call frequency tends to go down a lot (at least in internal medicine, which is what I did) and the stuff you do tends to get less inane and pointless (i.e. jumping through hoops for nurses and attendings and doing massive amounts of paperwork). Also, you get more and more respect as you move up the food chain, since medicine is highly hierarchical.

You'll feel less fatigued in general as you learn what you are doing, get more efficient, etc. If the lack of respect and everyone dumping on you is what bothers you about 3rd year, that will get better with each subsequent year of training. Try to choose the field you like best for residency, if you can get in, so that you won't be miserable while you are at work. Also, consider lifestyle factors if that is important to you. You'll work less hours in physical med and rehab, ER or pathology than you would in trauma surgery or neurosurgery, for example.

 

[medicinesux]

I have found that it has just gotten worse. The further down the path of medicine I go, the more I despise it. I feel like Little Red Riding Hood going deeper into the Black Forest and getting even more lost and overwhelmed to the point where finding my way out is approaching a near impossibility. Where I was initially just trying to do some good by delivering some food to my sick grandmother's house, I am instead leading myself to where the big bad wolf is waiting behind the front door to eat me alive.

 

[uclabruins47]

it doesn't get better.

not internship

not as residents

wherever u are, u will get dumped on by someone. as residents you take **** from fellows and attendings. as fellows you take **** from your attendings. as attendings you'll take **** from chiefs of services and all the other administrative personnels, insurance companies.

 

[buckley]

it doesn't get better.

not internship

not as residents

wherever u are, u will get dumped on by someone. as residents you take **** from fellows and attendings. as fellows you take **** from your attendings. as attendings you'll take **** from chiefs of services and all the other administrative personnels, insurance companies.

 

[dragonfly99]

no UCLA bruins
I disagree
You still take s*it as you go up the ladder, but it's a different quality of **** and it's a lower quantity of ****. The **** rolls downhill, so as you get higher there's less of it falling on you. And besides, if you don't like taking **** from department heads you just go in to private practice with partners that you can stand. Still have to take stuff from insurance companies, though, but you can hire people to do most of that.

Also, it's easier to take **** when you aren't staying up x 30 hours at a time and are getting paid double or triple what you were paid to take **** as a resident. Nurses and patients definitely treat you better as you get higher up too.

 

[Blade28]

As I like to say, as you advance every year, the amount of pain doesn't lessen - it just changes.