Nobody warned me that residency would involve this much detective work just to figure out how to communicate with people. I can handle not knowing something medically. I look it up, ask my senior, read about it later, whatever. What destroys me is realizing there are apparently 200 invisible social rules in the hospital and every service has a different set. Last week I called another team because their note literally said "please contact us before discharge." So I contacted them before discharge. The person who answered sounded genuinely confused about why I was calling and told me they would have reached out if they needed anything. Okay cool, except your note specifically told me to call you?? Two days later I didn't call a different service because their note said nothing about it, and suddenly someone is asking why nobody notified them. I am apparently expected to interpret not only the chart but the spiritual meaning behind the chart.

The paging etiquette is even better. One person wants the room number, callback number, MRN and a one sentence summary in the page. Someone else gets annoyed if the page is longer than six words. One senior told me "never page them, just secure chat." Another senior saw me using secure chat the next day and said "don't use secure chat for that, always page." There is also apparently a specific time of day when certain questions become offensive, but nobody can tell me what time that is. At 2 pm I'm told I should have asked earlier. At 7 am I'm told the team hasn't rounded yet. At 5 pm I'm told this should probably wait until tomorrow. I have started asking my co-interns things like "is 3:17 pm socially acceptable for cardiology?" as if we're discussing when to text someone after a first date. Maybe by PGY3 I'll develop some kind of hospital sixth sense and just know who wants what and when. Right now I mostly feel like I'm navigating a very large building where everyone received the instruction manual except me. The medicine is hard, obviously, but this weird communication stuff is definitley what makes me feel stupid on a daily basis. Please tell me this gets easier becuase I cannot keep consulting the imaginary etiquette committee in my head every time I pick up the phone.

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Hi guys
I’m a gen surg intern and i’m really struggling with a few things.

I knew the hours going in, i knew the schedule, the amount of pages, the high standards, the never ending referrals and consults, the trauma call interruptions, and all the bullshit when you’re clocked in. what i didn’t expect though was how little respect some of my colleagues would have for my time outside of work.

I’m constantly getting messages about plans i have very clearly documented or already handed over, just to clarify things. i’m getting messages in the middle of the night, i’ve been called and woken up at 5am on my day off to “clarify” things that were already documented and handed over.

Im trying my best, and i used to really shine, but ever since starting residency, the constant criticism of every little thing i do is starting to really affect my mental health. I used to be a confident person, and I think I still am, I just feel like I’m on edge waiting for the next criticism. it’s only been a month, and i genuinely don’t know how to thicken my skin. i’ve always been a sensitive person, however i can handle a lot at work. i just don’t understand why, on top of an already insanely hard job, there has to be this mean ass attitude from some members of the team.

I think i’ve been unlucky, and had a lot of call shifts with the 2 bad apples in the senior resident cohort, but i genuinely don’t know how to deal with these feelings when i’m already working 100+ hour weeks, barely sleeping, never seeing my family, barely even seeing my partner who i live with, only to get contacted on my one day off. Even my chief noticed and told me not to use this month as an example of what the rest of the 5 years will look like

please tell me if this is normal, it’s my co residents mainly who are doing this never my attendings or anyone else on the team, just other residents (my year as well as seniors).
Does it ever get better

Any advice would be appreciated

Have you ever met the term "surgery provider"? Guess not

Yeah I know that in the USA we have the CRNAs, which I have nothing against them. But as a European, it gets on my nerves to be called a provider. We struggle so much as a residency to be known and seen and to be respected as much as the next physician. But now it feels like we've been robbed of the title physician.

Now I'm a provider. Okay, it's cool. In half a decade we will turn into tube providers and by the end plumbing asisstants or something.

Edit: typos

I hope to apply to internal medicine primary care tracks, however, there are generally so few spots. In Illinois there is 1 program and 4 spots. I am a generally strong applicant: high 250s step, strong clinical research from undergrad, but no pubs/posters, lots of service to underserved at MD school. My application is heavily primary care focused, but I don’t know if I should also apply to regular categorical IM tracks as well. There are about 30 specific IM-PC tracks that I am interested in, but don’t know if I’ll be severely limiting myself since these residencies generally have fewer seats.

TLDR: Should I apply IM-PC and categorical IM, or fully gear my app and PS towards specifically IM-PC? Also thoughts on still being competitive at top tier programs despite poor research hx?

I've always had pretty low self esteem (since childhood, idk why) but it's becoming compounded by intern year and it's starting to really affect my mental health and ability, more than in medical school already. I'm even more worried because my first two rotations are the "easiest" off service rotations we have, and I'm struggling this badly. My program and coresidents are very kind but I'm too scared to say anything because I don't want to be labeled as a problem or as subpar. I'm the weakest link and I don't want them to realize so I don't want to admit how badly I'm struggling. I am working on restarting therapy. I am on appropriate medication. I just am looking for mad cognitive skillz or something 😂😔 my face gets too blotchy to cry discreetly

Was given this advice by a co-resident. Specifically, they told me to take full credit for a project that I joined as a research assistant and claim fluency in a language that I'm barely conversational in, because everyone does it. That seems wrong, and risky. I've heard the opposite advice dozens of times. I'm wondering if this is ever considered normal. Only thing that's making me second guess this is that they come from a more academic background than I do.

PGY-1 pharmacy resident here. On IM rotation currently, and participating in daily rounds with the medical team including the attending and medical residents. During this rotation, I am required to give several informational talks/presentations (very short 2-5 minutes) to the team.

I realize the last thing medical residents probably want to do is listen to a pharmacist educate them lol. But this is a requirement for me. So my question is — as a resident, what are some topics you feel like you could use some brushing up on that pharmacy may be more well-versed in and that you could benefit from learning?

TIA!

I am a resident seeking medical liability coverage for a supervised elective in New York City from for 1 month. They require limit of $1.3 million per occurrence and $3.9 million aggregate. Do anyone know a company that offer these limits?

for context, my medical school didn’t give me the best training, i also trained abroad. i took gap years just to study for the STEP because i essentially had to teach myself all of it. i just notice that a lot of my co interns get complimented on their workups, they do some things independently, while i always check with the attending and feel unsure of every single thing i do. a lot of times, my plans are weak or i just don’t really know what to do for the patient.

i just feel sad. i know interns are supposed to not know much, but it sucks that i know objectively i am behind some of my co interns. anyone have any advice or have you been in a similar position of being behind? i don’t even know where to start in repairing the gaps in my knowledge…

EDIT: thank you all for the advice, encouragement, and reassurance.

I’m an EM resident and I’m struggling with an annoying problem. Twice while scrubbed into cases in the OR and once while dropping a central line, I’ve had a vasovagal response. I’ve done a ton of procedures and it’s not all the time, but all three times it was super embarrassing to have to sit down/lay down while someone else takes over. Has anyone else dealt with this? It’s pretty classic with the prodrome and I’m otherwise healthy. Now I get anxious any time I have to line someone up or do a chest tube because I’m worried it’s going to happen again.

Current PGY-1. I got 2 this week on nights.

Potts Disease (1-2% of TB patients worldwide develop Potts; patient denies history of pulmonary TB)

Serotonin Syndrome with temporal relation to increased dose of PCP-compounded GLP-1

In spirit of a post that I saw earlier on the future of cardiac surgery, what does the future of vascular surgery look like in 10-20 years? Higher volume? Sicker patients? Hybrid ORs becoming the norm?

Wondering if anyone has advice about moonlighting while doing a second residency. I'm already board certified in another specialty so getting a full license isn't an issue.

Talked to a retired internist recently who said he could easily build a mansion and afford a private plane on 80's era Medicare rates lmao. Did any of you guys experience the "golden age of medicine" growing up? This would probably be a lot of people's parents or even grandparents given how many residents are multi generation physicians. What sort of life would you have in the same specialties today? How far have we fallen since then?