#pgy1

[this-is-mdness]

hi, residency is v hard. im pgy-2 ob. if u need anything lmk. it really sucks but you absolutely will get thru it and at the end of the day your prelim year is only one and then you'll actually be doing what you actually wanted to do with the rest of your life. ca years will also probably b v hard, one of my buddies from med school started ca-1 this year and she also is burned out and struggling. but she is doing it, and she is getting there, and you will too <3

OMG, I totally missed this! So sorry. I haven't been very active on Tumblr the last few months...

PGY1 is almost over. I'm starting to see the light at the end of the tunnel. I know that the CA years will still be hard--but hopefully some of the struggles will not be there or if they are, at least be more familiar.

I can do this. I will do this.

Tonight I met a MS4 who didn't match into anesthesia and SOAPed into EM. I told him: "the sun rises every day, and we make it through until things get better" and "I'm a big believer in the healing power of time, and that one day you'll look around and realize you stepped out of the darkness without having realized it.""

That's advice to me, too.

#personal #medblr #pgy1 #ask #soggy-cheeto

[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

[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

[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

[sooconfusedsomd]

One of my med school friends committed suicide today. He was one of the smartest person I knew, in a good residency program, happily married with a family. Fuuuuuuuuuuuuuck

Idk what to think or say.

#medblr #residency #pgy1 #em #idk how mang times I’ve restricted rights of a pts who had SI plans sinilar to mine #its more than i will ever admit

[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

[patriciawoolf]

2023.05

PGY1腫瘤科病人

#medical illustration

[writer-in-theory]

Not me finding out you have to go to college to be a pharmacist 👀

OH YEAH FOR SURE !! i get this a lot bc a lot of people hear pharmacist and immediately think of the techs you see at the counter. which, seriously we love techs they're the actual backbone of the pharmacy. i worked as tech for 4?? years and wow ouchie.

without getting toooo far into it, the basic setup of a pharmacy team is like this:

Pharmacy Tech: Usually don't need extra schooling qualifications unless they're Certified, which means they passed an exam and are licensed with the Board of Pharmacy. They can count prescriptions, complete prescription handovers to patients, receive prescriptions, and complete intake paperwork for vaccine and covid-test appointments. They can also give vaccines if they take the certification course. They cannot answer any medical questions, check prescriptions, or review medical information on patient records for accuracy/safety.

Pharmacy Intern: a current PharmD candidate who is licensed with the Board of Pharmacy, and can do everything a tech can with some more additions. They can counsel patients on medical information, meaning they can answer medical questions and advise patients on how to take their medications. In some states they can do Control Counts (making sure the pharmacy has the right amount of controls consistent with the inventory number). They can do transfers of prescriptions between pharmacies (except controls), and can do some reviewing of patient medical records with pharmacist supervision. This is what I am.

Pharmacist: They have completed their PharmD (or BS, if earned prior to 2000) and have passed the NAPLEX and MPJE. They fill prescriptions, check for safety, accuracy, and check for any duplication/unnecessary meds. They are the supervisor of the entire pharmacy team and answer questions to ensure patient safety.

Pharmacist-in-charge (PIC): USUALLY, especially now that there's a major shortage, there's only one pharmacist on shift at a time. However, if there's multiple then there's a PIC who is in charge. They're also in charge of making sure all pharmacy laws are being upheld.

Pharmacy Manager: Someone who has completed their PharmD and required exams. They are more in charge of business operations. Inventory, policy, managing the team.

This also can vary by state as every state has their own Board of Pharmacy and their own laws. This is also for a community pharmacy, it can look different for hospitals. Such as often for a hospital position, it's expected you complete a PGY1 (sometimes and a PGY2) residency.

#ask jay #anon

[mcatmemoranda]

Here's an idea: decrease no show rate by sending reminders 5 days in advance, 3 days in advance, and 1 day before. Or send reminders for diabetes checks and see if that decreases hgba1c. Idfk. I just need to do something for research project. But that's not my priority. Right now, my priority is surviving and getting through pgy1. If I can get through this, then I'll start worrying about my research requirement.

#QI #research

[larynx-lover]

Residency Update

Hey everyone! Long time no write (like since PGY1).

Just wanted to let everyone who is still here know... I'm about to be a PGY5! And I have matched to an AMAZING laryngology fellowship! So after chief year, I will be specializing in voice, airway, and swallowing disorders. I'm so excited about finishing up residency and moving forward with the next phase of my career!

I'm hoping to be more active here again, but I have to be careful because Duke has pretty strict social media rules.

#if you really want to keep up with me #follow me on insta #way more active there #laryngology #otolaryngology #ENT #shENT #fellowship match

[this-is-mdness]

09.25.2023

I am still alive.

Made it through another rotation--emergency medicine. Had horrible shifts and bad shifts and a few good shifts. I survived and so did all my patients (to my knowledge).

I recognized(?) 2 sick patients, went and got staff, patients were immediately sent to the high-acuity area of our ED. I sewed 2 lacerations (with supervision). I did too many rectal exams (never found blood). I did 2 pelvic exams, with minimal supervision on the last one and found the cervix(!) and my patient didn't seem too uncomfortable. I ate so many snacks from the ED fridge--Uncrustables, crackers, apple juice boxes, even tried a dry turkey sandwich for the heck of it.

EM, never again. I hate you and have no desire to return, but I think I can say I have had the experience.

#personal #pgy1 #emergency medicine

[wickerthoughts]

Residency so far is not going well for me mentally. Even as a family med resident, I begin in in-hospital cardiology (only one to do so out of the 4 residents in our clinic) and I take calls from internal medicine. The first week was essentially introduction and classes so my actual first day was on friday when I realized that I forgot a lot of how to function in hospital (eg. how to write a note). I also realized that it's still very difficult to understand what is going on with a patient who often times have complicated medical history and whose notes are written in unreadable handwritting by the attendings. Then, the second week was nights alternating with day back in fam med. The first night, I was called constantly for the entire 12 hours I was there. I called attendings in the middle of the night to ask some possibly avoidable questions because I have no idea what I'm doing and am not confident enough to trust my judgement. A 90yo woman died (wanted no resuscitation should her heart stop beating). As I was acertaining that death has occured, even though her heart has stopped beating I could feel a pulse in her neck which was presumably my own. I had to speak to the family even though I know next to nothing about her only to tell them what had happened. The other night shift I was a little more grounded and there were less calls. I have another 12 hr shift tomorrow on a sunday and I spent today saturday dreading what is to come because I have 3 days worth of 12 hr shift in a row sunday to tuesday coming.

I was naively hoping that things would feel better in residency but it seems like I have even less control on my life and schedule than I did as a medical student because I get imposed calls and 12 hr shifts without a single say to exert some kind of decision-making that I do not feel competent in making as a fresh new PGY1. I feel alone, abandoned and utterly stuck.

I feel on the verge of giving up on everything. I want to quit medicine and by extension life because at this point I have debt and I don't even know if I can find work that can support myself outside of medicine. I feel coerced into submitting to a fate of forcing myself through more and more unpleasant things and having to just keep doing things that I don't want to do. I have now spent virtually my entire life forcing myself to do things that I don't want to do for some future gains or at least to make the future better. So far the future as it becomes the present is only ever more misery to endure. I already know that I am afraid of the physical pain of taking my own life and so I feel helplessly stuck in this existence that I did not ask for. I don't know what to do. I just hope to make it through the coming week. I try to have something to look forward to next weekend at least.

#personal

[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

[a-young-doctors-journey]

Sitting at the airport in Greece, attending our mandatory residency program orientation, thinking about how life is going to change so drastically in a few short days. Everything I've worked so hard for: it's within reach. There's so much paperwork, so much to be done, and I feel overwhelmed -- but at the same time, I'm cautiously excited.

#residency chronicles #medical doctor #medicine #medblr #emergency medicine residency #pgy1 #pgy-0 #pgy0

[ontrackmind]

So, I've been checking off as much as possible on my pre-residency to-do list before I move.

I've officially been everywhere on my med school city bucket list except for one place that I just can't make happen before I move. Overall, not bad.

All of my pre-orientation items are done except for signing up for parking, which I can't do until mid June anyway.

I've been reviewing the NRP book periodically. I start in the newborn nursery, so it feels nice to be reading something helpful. It had made me feel a little more prepared and (a little) less nervous. I'm definitely not trying to seriously study before starting residency, but since it's going to be well over 100°F here every day this week, I needed something to mull over in the midday heat -- especially since everything else is packed up already.

Seriously, it's so hot my dog even voluntarily declined an evening walk today. She's never done that before.

#medblr #medical school #medical student #future doctor #studyblr #med student #md/mph #med school #medicine #personal #pgy1 #resident #medical resident #thoughts #medical blog #studygram #study blog

[medlyfe]

Audition #3 Recap

What I liked: The options of different clinics is nice. The housing is walking distance from the hospital and not too expensive. The PD is a DO and the program is very DO friendly, welcoming and nice. The residents joke around.

What I didn’t like: The clinics are all 20+ minutes away from the hospital, gas money and car wear and tear. The medical hierarchy is strong, meaning PGY 1s were expected to max out before seniors helped, many jokes about the PGY1s. There is morning (7:30) report every day. driving around was annoying because of the road infrastructure and SO MANY stop signs, which seems like a dumb thing to talk about here but thinking about living there does not sound fun. They are not osteopathic recognized which I didn’t know if I cared about until rotating here. 

What I Learned: Having a close clinic is important. I should probably get a new car in residency. Osteopathic recognition is a must for me. Even when they say “you can take call from home” you probably won’t do that.

Sidebar: I think 3 auditions was all I should have done. I have 1 more and this one tired me out. I have traveled 3 different states and I like the travel but the pressure to impress and “be on” all the time is a bit much. It’s not as bad now that I have interviews so I feel a bit more relaxed but I think scheduling 12 weeks of auditions is the most I would recommend. 

#family medicine #medschoollyfe #Auditionstudent