#intern year

[slf-cntrl]

ONE OF THE MOST ICONIC SCENES…

there’s just too much going on lol

#i die every time i watch it #lmao #greys anatomy #meredith grey #cristina yang #greys abc #alex karev #mark sloan #izzie stevens #derek shepherd #merder #lexie grey #addison montgomery #richard webber #george o'malley #magic greys #intern year #seasons 1-3

[whitecoatblackmarket]

When another specialty’s resident or attending is rude to you and your senior resident or attending asks for you to give them the phone

Hahaha you’re in trouble now 😂😈

#medical school #residency #medstudent #medschool #medicine #medicalstudent #medical student #medical #med school #healthcare #resident doctors #resident doctor #physician #doctor #surgery #intern year

[cranquis]

Wanted to send you a message - I'm from another country, but wanted to match into the US healthcare system for the longest time for several reasons. Followed you for the wisecrack insights, stayed for the soul.

I've matched into my dream Anesthesiology PGY1 spot this year <3

Thank you for all that you do.

I am so excited for you, my friend and colleague! Congratulations!!! Now keep your chin up as PGY1 year does its best to smother your dreams with scutwork and stress and lack of sleep.... this too shall pass!!!

#cranquis mail #ya know 'dream anesthesiology' would make a great name for a your future medical group #medicine #medblr #pgy1 #residency #intern year #med school #encouragement

[a-young-doctors-journey]

The worst part about the ICU is that you get to a point where you're on a first-name basis with family.

Frederick was at bedside every day, sitting beside his wife. When he wasn't, they were on speakerphone, her work of breathing worse each day. We explained to the family that she was really really sick, and they understood that the prognosis was poor.

But when it came time to decide about intubation, they couldn't bring themselves to withdraw care... so we intubated, knowing there was no way that she would ever come off the vent.

It was after 10pm when the nurse came over to us.

"Room 7 won't make it through the night. Maybe you should call family."

My senior looked at me, and asked, "You wanna call the husband?"

"Frederick? No."

"It's important to learn how to have these conversations, you know," he said, somewhat gently.

"I know. And I have them plenty. But you asked me if I want to call him and tell him his wife is dying, and I don't. But I can, if you want me to."

He nodded and dialed the number from our 'Next of Kin' list. "Mr. Smith, I wanted to..."

Not even half an hour later, the monitor by my computer started beeping furiously. Her blood pressure, which had been dangerously low already, tanked. I ran to Room 7 as nurses from surrounding rooms crowded into the little space, code cart already in place.

She had no pulse. The ICU team really did have an intuition for this sort of thing.

We went through the motions of the code, not for a moment believing that we would get her back. But we did. A short-lived miracle... but maybe it would give Frederick just enough time to come back.

The second time her heart stopped, my senior asked me to let the family know that we had done everything we could. I stepped outside, the sounds of the active code behind me, and explained that there was nothing to be done.

"So this is it?" he asked matter-of-factly.

I nodded. "I'm very sorry, Mr. Smith." He thanked me as I walked back into the room just in time to hear the pronouncement.

"Time of death: 10:39 PM."

Gloves came off. Supplies were discarded. The code cart was wheeled unceremoniously out of the room. One of the nurses placed a fresh sheet over the patient, tucking it gently around her.

As I headed back to my workstation, a heart-wrenching sob pierced the hallway. Frederick - a stoic, quiet man who had spent countless hours with wife, ever so hopeful - was sobbing into his knuckles.

I felt the tears well into my own eyes, swallowed hard, and looked up to see the surgery resident coming towards me, no doubt seeing my watery eyes but making no comment.

"Are you taking care of...?"

And the rest of the night went on.

#medicine #residency #personal #intern year #residency chronicles #nursing #doctor #med life #med student #doctor patient stories #icu #intensive care #nurse

[iknowthisisnowhere]

you're the doctor now

The last few months have been a whirlwind: graduating from medical school, packing, leaving S, moving to V, starting residency. I don't feel like I've processed any of it.

I'm on emergency medicine right now. Intern year is no joke, and I'm suffering. My attending on my first day was frustrated by me, I think, and repeatedly told me, "You're the doctor now."

You're the doctor now.

I feel like a fraud. Even the nurses call me Dr. It's a lie. I have no idea what I'm doing. Clearly. Every day is a struggle just to show up, let alone practice medicine. At least I caught an acute L1 fx yesterday, though barely. A stroke of luck that I caught it. I almost missed it, and I hate myself for it.

You're the doctor now.

I feel sick.

#medblr #PGY1 #intern year

[intrainingdoc]

The next installation of our "Surviving IM/G" column by internal medicine resident & international medical graduate Dr. Gottlieb is now published to in-House, the online peer-reviewed publication for residents & fellows.

#medblr #med school #img #foreignmedicalgraduate #intern year #internal medicine #internationalmedicalgraduate #step1 #step2 #usmle

[ontrackmind]

I am one month into residency. Here are a few things I've learned (mostly about myself):

1) I am, indeed, a textbook person. I always thought I was an uptodate person, but it's just not always the best resource for peds. I have looked things up in Red Book, Lange Neonatology, Bright Futures, and AAP Peds in Review multiple times this month already. They just seem to work better for me when I have the time. Uptodate is my second choice for on-the-go reading (like when walking to morning conference)

2) organization is key. I'm not sure what system works best for me on rounds since the handoff sheet we get is completely different from what we used at my med school. (Same info, just formatted differently on the page). But, I have found having a succinct cover sheet with all of my patients only and their to-do items for the day to be way more efficient than flipping back and forth in a big packet. I'm still working out how to make the handoff page work best for me during rounds though. One thing is clear though, if you're not organized, something will be forgotten. For me, keeping lists and check boxes is key.

3) if I don't write it down, it doesn't exist. How do people remember *everything*?? If I don't write it down within 5 minutes of doing it/hearing about it/being told to do it, it's forgotten in the abyss.

4) good sleep hygiene is my BFF. I probably have co-residents with wacky schedules, but I like my routine and I have noticed I do better when I'm well rested. I typically get 6-8 hours, but in order to ensure that happens, I have a pretty consistent routine in the evenings after work and the mornings before work (especially since I don't have a yard and have to walk my dog both times). I also like feeling well rested in the morning. I'm in a better mood, less stressed, and make fewer mistakes. (Maybe this one matters more since I don't drink coffee or soda so I don't get an extra boost from the caffeine?? I've debated energy shots, but I get heart palpitations with anxiety and they freak me out. I can only imagine what extra caffeine would do)

5) I 100000% prefer to work as a team than work alone. My last block was very team oriented and I felt like I thrived. We were always asking each other how we could help and getting lunch or snacks for each other when we couldn't go together as a group. It was very much a "we all lift each other up" kind of environment. I hope that carries into my other blocks, too. I'm going to do my best to continue to be a team player and help everyone with their workload.

6) I still feel pretty dumb and unsure of myself, but the imposter syndrome is WAY less than before. Idk if it's the new environment or what, but I just don't feel that same fear of being too dumb and undeserving and being the weak link like I did during med school. Sure, I have a lot to learn and I do sometimes forget things or freeze up (for instance, I completely forgot what DI was today during rounds. Literally could not have even told my fellow my name if she had asked.lol) and while I fell a little embarrassed, it's not the same as it was before. Maybe I'm in a better mental place for now?

7) Im somehow less stressed. Like, I work hard at work and sometimes I get frustrated or get stuck, but it's not the same as being a student. I read articles and do practice questions at home but it's much more leisurely. Despite the long hours, I find this WAY more enjoyable than med school. I don't feel guilty for taking time off or enjoying my hobbies and I actually enjoy studying and looking up stuff about my patients. Residency is hard, but I am so much happier than I was before. I hope it stays this way.

8) my dog is still one of the absolutely best part of my day. She's happy when we get up in the morning and happy when I get home in the evening. She will forever be the bright, sunny spot in my day. Its a lot of work having a dog while living alone, but holy crap is she worth it❤

#residency #resident #doctor #md #md/mph #pgy1 #intern #internship #intern year #medical #medicine #physician #studyblr #study blog #medical blog #medblr

[belleofthehospital]

Oh man, found my way back after a few years. I’m a PGY-3!! I’ll be a chief resident in Internal Medicine next year!!! I’ll be applying to oncology fellowship next cycle. I look back at my posts from before I disappeared of tumblr and I see so much fear and burn-out and confusion. I’m now getting married in a month, I feel somewhat comfortable in my job, and I love where I’m at professionally. What a wild, terrifying, emotional journey. Working on night shifts with interns this week and will remember to be a little extra compassionate - especially to the ones who seem confident on the outside but are shaking a little inside.

#medblr #medicine #pgy3 #internal medicine #intern year #life update

[atmiger224]

Intern Year, Month 2–Friday night house coverage: (details changed to protect identity)

Im the only one on site and still working on a late admission from the day, ICU gives me push back on a patient my attending insists is not stable for the floors — AOx0, total white out of the right lung, hepatic encephalopathy, needs paracentesis but INR is 5. Call GI, they laugh at me, says to wait load up with vitamin K and monitor until the morning, no one wants to touch her. Call my senior who is going home because they have the blessing of freedom. Let them deal with this right now, I have to shift mode from floors coverage to house... because I have three calls, two for renewing meds, one for a pronouncement. While I’m with the family, barely get a “sorry for your loss” out when I get another call to renew restraints. And then another call for transfusion consent.

I take the paper consent and explain the benefits and risks of a transfusion to the 90+ yr old patient and her family when I get another call. This one is an emergency.

Im trying to announce myself in a room swarming with nurses. No one hears me until the third try. Thankfully the patient’s nurse tells me that the patient with dementia who was admitted for AMS has an even more acute AMS. Im looking at my patient, hx of stroke, lateral gaze deviation with temperature of 102. GSC 7. This aint right. I’m putting in stat orders when I get a call from my senior. “Are you ok?” I guess. I dont know. Im trying my best. I explain the situation and my though process. They suggest adding peripheral blood cultures. I call the primary who say this is his baseline. Like hell this is his baseline. I believe his nurse. Meanwhile no one has the EKG or stat CXR. No stat labs. Its nursing change of shift.

Dont know what to do, fine, lets escalate.

Call Code Stroke. Someone laughs, half of me is anxious its at me. No time for doubt cause the other half of me is focused on trying to read up on the patient’s med list as the patient is wheeled away for a CTA. Tell the off site neurologist the patient’s history and breath a sigh of slight relief cause here’s a Doctor Doctor and their team. Eventually we call the ICU down to evaluate and patient is upgraded.

My prayer for the rest of the night to be quiet answered, I can do all the melatonin refills.

I go home. The code continues to haunt me. Wake up this morning and read the ICU note— Pt is Covid positive. Septic. Fuck. Now im paranoid for a different reason 😂

#My awkward anxious self #life stuff #Medblr #residency #family medicine #atmeridiem #intern year

[loulovestowrite]

That surgeon who hardcore bullied me to tears every day when I was an intern just sent me a follow request on TikTok.

There’s a full moon tonight. That must be the explanation.

#medicine #medblr #psychiatry #surgery #intern year

[milktea-md]

told my friend who just started on service as an intern "some days may be better and some may be worse but the overall curve is up!" with a confidence i did not feel

#medblr #medical tumblr #residency #INTERN YEAR #that's a tag i guess #i feel like im spouting bs real easy because i dont start for another month

[whitecoatblackmarket]

When you overhear a patient say “Nurses are the ones who really care about patients, you barely even get to see your doctor!”

Ouch that kind of hurts 🥺 I love and appreciate our RN’s so much - they certainly are empathetic and wonderful - a vast majority of the work they do for patients is something patients can see, and is at bedside. The reality is that I cannot be at bedside for long periods of time because I have a lot of patients and I need to be seeing all of them multiple times per day, putting in orders, documenting their care plan in progress notes, and operating in the OR. I can’t even count the number of times I’ve stayed late to personally follow up on a patient’s results or stayed even later to personally talk to them as soon as we had new info, I make an effort to go above and beyond when I have chances to improve patient care and make their hospital stay less stressful. I’m constantly having conversations with my team, researching treatment recommendations and possible risks to each step, fighting with insurance companies and agonizing over patient care choices, but none of this is something my patients can see. I work really really long hours - a 5am-8 or 9pm day is not unusual, and I don’t hesitate to stay longer if I can be of more comfort to my patients. Just because we cannot be at beside does not mean we don’t care, and wow does it kind of sting when patients or even other healthcare workers allude to nurses being the only ones who truly care and advocate for their patients. We are all on the same team, and just because you don’t see all our hard work doesn’t mean it isn’t happening.

#medblr #medblog #medical #medicine #hospital #residency #medical school #medstudent #medschool #medicalstudent #medical student #med school #healthcare #physician #residents #resident doctor #resident doctors #intern year #surgery #surgeon

[houseplantonthedesk]

16 days into Medicine rotations as a junior doctor, and it's been quite an experience. I have also learned a few things like how one should be assertive and should know to speak up for themselves, also knowing when to step back and step out, and when to draw the line and call out someone in a composed firm manner is super important. Knowing not to get lost in petty things and focusing on your learning and bigger goals is important. Getting done with tasks on time and efficiently and then quietly slipping away to read a case and learn is important. Not knowing things and learning them right away by instantly looking them up online or in a book instead of giving yourself a hard time for not knowing it in the first place is very important.

Intern year/ foundation year of medicine is mostly scut work in the hospital, but you need to find your way to seep in the time to learn and make most of it along the way as you go. I am currently struggling with all of it, and am going to try to inculcate it into my life in the next fifteen days. Someone told me that you have got to gasp for time like one gasps for air to survive, in order to learn during intern year, and I am taking notes of it. Gasp for time, make most of each second, and study and grow as I go. God willing, Amen.

Have three calls in this fifteen day rota, one is on this Sunday, a post em one. Imma praying real hard for it to go easy and well. Amen.

More on intern year updates and study accountability later, fam.

What are some internship tips you'd like to pass on? Please comment and let me know.

#booklr #med studyblr #medical student #studyblr #biscotea tales #med school #hustle #medical school #medical side of tumblr #medical stories #intern year #junior doctor #honest medblr #tumblr writing workshop with betts #work in progress

[a-young-doctors-journey]

I’ve survived trauma. I spent most of intern year nervous about this awful month… but it came and went and I’m still alive!!!

#medicine #personal #residency chronicles #residency #pgy1 #intern year

[iknowthisisnowhere]

I haven't seen the sunlight in over a week. I get to the hospital when it's dark. I leave when it's dark. I'm not meant for 6a-9p.

Hospitalist medicine is hard.

There's no pulm/crit team... so a fucking psych intern (me) is taking care of ICU patients. Intubated, on pressors, about-to-die ICU patients.

At least I haven't killed anyone yet.

ACGME cap is 10 patients. I've had 10 every day, plus admits.

I shouldn't be complaining. I know interns are being forced to carry more than 10, I'm sure, and we all break the 80-hour rule. We have to.

I'm struggling.

#thoughts #medblr #intern year #PGY1

[andthebeanstalk]

Today my therapist introduced me to a concept surrounding disability that she called "hLep".

Which is when you - in this case, you are a disabled person - ask someone for help ("I can't drink almond milk so can you get me some whole milk?", or "Please call Donna and ask her to pick up the car for me."), and they say yes, and then they do something that is not what you asked for but is what they think you should have asked for ("I know you said you wanted whole, but I got you skim milk because it's better for you!", "I didn't want to ruin Donna's day by asking her that, so I spent your money on an expensive towing service!") And then if you get annoyed at them for ignoring what you actually asked for - and often it has already happened repeatedly - they get angry because they "were just helping you! You should be grateful!!"

And my therapist pointed out that this is not "help", it's "hLep".

Sure, it looks like help; it kind of sounds like help too; and if it was adjusted just a little bit, it could be help. But it's not help. It's hLep.

At its best, it is patronizing and makes a person feel unvalued and un-listened-to. Always, it reinforces the false idea that disabled people can't be trusted with our own care. And at its worst, it results in disabled people losing our freedom and control over our lives, and also being unable to actually access what we need to survive.

So please, when a disabled person asks you for help on something, don't be a hLeper, be a helper! In other words: they know better than you what they need, and the best way you can honor the trust they've put in you is to believe that!

Also, I want to be very clear that the "getting angry at a disabled person's attempts to point out harmful behavior" part of this makes the whole thing WAY worse. Like it'd be one thing if my roommate bought me some passive-aggressive skim milk, but then they heard what I had to say, and they apologized and did better in the future - our relationship could bounce back from that. But it is very much another thing to have a crying shouting match with someone who is furious at you for saying something they did was ableist. Like, Christ, Jessica, remind me to never ask for your support ever again! You make me feel like if I asked you to call 911, you'd order a pizza because you know I'll feel better once I eat something!!

Edit: crediting my therapist by name with her permission - this term was coined by Nahime Aguirre Mtanous!

Edit again: I made an optional follow-up to this post after seeing the responses. Might help somebody. CW for me frankly talking about how dangerous hLep really is.

#hlep #original #mental health #my sympathies and empathies to anyone who has to rely on this kind of hlep to get what they need. #the people in my life who most need to see this post are my family but even if they did I sincerely doubt they would internalize it #i've tried to break thru to them so many times it makes my head hurt. so i am focusing on boundaries and on finding other forms of support #and this thing i learned today helps me validate those boundaries. the example with the milk was from my therapist. #the example with the towing company was a real thing that happened with my parents a few months ago while I was age 28. 28! #a full adult age! it is so infantilizing as a disabled adult to seek assistance and support from ableist parents. #they were real mad i was mad tho. and the spoons i spent trying to explain it were only the latest in a long line of #huge family-related spoon expenditures. distance and the ability to enforce boundaries helps. haven't talked to sisters for literally the #longest period of my whole life. people really believe that if they love you and try to help you they can do no wrong. #and those people are NOT great allies to the chronically sick folks in their lives. #you can adore someone and still fuck up and hurt them so bad. will your pride refuse to accept what you've done and lash out instead? #or will you have courage and be kind? will you learn and grow? all of us have prejudices and practices we are not yet aware of. #no one is pure. but will you be kind? will you be a good friend? will you grow? i hope i grow. i hope i always make the choice to grow. #i hope with every year i age i get better and better at making people feel the opposite of how my family's ableism has made me feel #i will see them seen and hear them heard and smile at their smiles. make them feel smart and held and strong. #just like i do now but even better! i am always learning better ways to be kind so i don't see why i would stop