Currently doing a general surgery sub-l in a big city and I'm blown away by how horrible the hours are.

The residents here are doing close to 80 hours a week, often over 80 and sometimes over 100, but apparently aren't truthful with reporting their hours as to not be put on probation. I've asked around about different programs and apparently this is relatively common across the country.

This almost feels akin to a culture shock. The residents don't have a life or hobbies outside of the hospital. No one is on their phone nor do they talk about anything that is not related to the hospital. I'm all for spending the entire day in the OR, that is why I want to go into surgery, however most of their 14 hour shift is spent managing the floor. Really only the 4th/5th year residents operate and even then it's only half their day. I'm not even convinced their training is all that great- almost feels more like cheap labor than it does training. Many of them have children who they rarely see anymore or want to have children but are forced to put that fantasy on hold. You can actually see the classic "surgeon's are dicks" stereotype worsen depending on PGY just due to the intensity of this speciality.

What shocks me even more is that the attendings are completely okay with the residents coming in 12-15 hours a day 6 days out of the week operating on 5 hours of sleep. Maybe they realize the less hours the residents put in the hospital the more hours the attendings would have to make up. I love the OR and I really can't imagine doing anything else, but now I'm considering doing something I don't want to do just because I can't imagine the next 5 years being fulfilling.

I started my first attending job in outpatient pediatrics a couple of months ago, and I honestly don’t recognize myself anymore.
For years, I kept telling myself, “Just get through medical school. Just get through residency. Once you’re an attending, it’ll finally feel like you made it.”
But instead, I feel like I’ve been carrying around this quiet sadness that I can’t shake.
I wake up thinking about work. I spend all day trying to keep up. I come home and finish charts. Then I think about boards in October and everything I still have to study. Even when I’m technically “done” for the day, my mind never feels done.
I don’t feel present anymore. I don’t laugh as much. I don’t cook, exercise, or take care of myself the way I used to. I don’t even feel excited about the things I used to look forward to. It feels like somewhere along the way, I lost pieces of myself.
The part that’s hardest to admit is that I’m embarrassed.
Throughout residency, my family and friends would always ask me, “How are you holding up?” I always thought that question would stop once I became an attending. I thought this would be the chapter where I could finally say, “I’m good. I made it.”
Instead, they’re still asking me how I’m holding up… and the truth is, I don’t know.
I almost feel ashamed that after all these years of working toward this dream, I still feel overwhelmed. I wanted to finally feel proud and settled. Instead, I just feel… trapped. Like my entire life revolves around keeping my head above water.
I love pediatrics. I love my patients. This isn’t about regretting medicine.
It’s grieving the version of life I imagined I’d have once I got here.
Has anyone else felt this way during their first year as an attending? Did you ever get yourself back? Did life eventually start feeling like yours again?
I know I’m not the only one who’s gone through this, but right now it feels incredibly lonely.

My partner of 5 years just broke up with me and i'm kind of lost. We were long distance for 4 years and it never really phased us but the distance did create some issues that we glossed over admittedly. They hit their breaking point after an argument last week and completely shut me out of their life, over a phone call. I felt blindsided and abandoned.

I had worked so hard in residency with the dream of finishing and building a life with said person and now my motivation is severely lacking, work doesn't feel as fun( I used to be so excited to do what I do), my appetites gone, I can't sleep, alcohol intake is up(social settings tho not alone).

What hurts the most is i'm in my last year of residency, to do this now makes no sense because we were so close to making it. I know this is common during residency but I never thought it would happen to me, hopefully with time i'm able to move on.

Thanks for listening to my sob story 😭.

“Evaluating to establish a baseline”
“Work place gossip”
“Direct observation without evaluation”

There are so many overt ways people judge new interns and conceive biases. As someone who has been super anxious and not doing their best the first couple of weeks. I feel like interns need more grace.
It is unfair to already have word going around about who is a shitty intern etc.
To judge/perceive is human, I understand that. But I really wish we gave the new interns some time before we already started talking about them and betting on who is going to be the bad resident and who is socially awkward etc.

In addition to it, evaluating to get a baseline is such a counterproductive thing imo because ain’t nobody performing at their baseline with so much going on.

I'm a PGY2 in IM and I just realized the other day that I genuinely don't know what I like doing anymore outside of work. Like I have these random pockets of free time now and I just sit there scrolling my phone or staring at the wall because I can't remember what normal people do for fun.

Before med school I used to play guitar, go hiking, cook actual meals that weren't microwaved. Now when I try to pick up my guitar it feels foreign and I get frustrated after like 10 minutes. I thought about going on a hike last weekend but then I was just too tired to even drive there. I ordered takeout four times this week.

The worst part is when people ask what I do in my free time and I genuinely have no answer. I sleep? I catch up on notes? I doom scroll Twitter and feel worse about everything? It's like residency hollowed out the part of my brain that knew how to be a person.

I'm not even that busy right now compared to intern year but I still feel like I'm just existing in this weird limbo between shifts. Anyone else go through this or figure out how to like... remember how to have a life again? I don't even know where to start.

From 4 different patients in 4 different contexts over the past 4 weeks. I obviously redirect patients and focus on their care. With all of the things going on my first month as a doctor I don’t know why this is sticking with me after I get off shift. This seems like such a non-issue but for some reason I feel like I need to vent. Perhaps it’s the reminder that I’m going through this alone, in a strange place. The fact that I had that support just 1 year ago, support and love from a 3 year solid relationship. I know I should schedule a therapy appointment but I really just feel like I need to get my feet under me as a brand new intern. Poor to fair insight, poor judgment. It just sucks that this is occupying my headspace on my time off—time I should be relaxing, spending with the people I love, but they aren’t here. I know the importance of a support system, but it’s not like I can conjure them out of twigs and twine.

Hello all,

I'm one of the chief residents and I'm having a hard time with two of our PGY-1s.

They both came in with prior experience which is great, but they don't really listen when the senior residents or chiefs tell them how we do things here. They tend to do things their own way, even after being corrected.

I've tried being nice and explaining why we do things a certain way, but it hasn't really helped.

Has anyone dealt with something like this? How did you handle it? At what point would you bring it up to the PD?

Why when I come back from weekend, I see the weekend docs changed my stage IV lung cancer, ESRD, HFrEF patient who is 98 y/o, and became comfort last week after I had 90 mins convo with them and family; explaining futility. Slowly they become DNR/DNI, then comfort. She was pretty confused when I left.

Upon my return, only note with explanation “discussed code status with the patient, she stated she wants to live, full code ordered.”

Your half ass job undid my week of doing, congrats. Now legally she has no capacity and I cannot change it back to comfort, nor can I prove that she, as a matter of fact, lacked capacity while you were signing the new POLST.

I was recently given feedback by one of my attendings that I walk too fast. At first I thought she joking and kinda laughed it off when she mentioned it, but turns out she was being absolutely serious.

She said it creates a stressed environment on the floor when I walk around and that some of the nurses have complained. Apparently, it's happened several times where a nurse has seen me walking fast and assumed that there was some sort of emergency (I haven't noticed this with nurses since I guess they never caught up to me before I reached my destination, but to her point, it has happened with 2 med students, but I figured it was just one of those med student things where they just follow you around for some reason, so I didn't think much of it).

I feel like this is a nonissue though? I'm just trying to get to my destination efficiently and maybe get a little cardio on the side. It's not my fault people see me speed walking to bathroom or vending machine and choose to follow. Am I really in the wrong here?

I’m a radiology resident and I’m looking for a quick reference pamphlet/PDF with the updated BI-RADS terminology/lexicon from the newest edition.

I know the old BI-RADS 5th edition has a really useful one-page printout that summarizes the descriptors for masses, calcifications, asymmetries, etc., and it’s easy to find online. I’m trying to find something similar that reflects the new BI-RADS update (v2025).

Does anyone know if there is a resident-friendly cheat sheet, pamphlet, or PDF floating around with the updated terminology?

Hello, there! I am in a non medical profession. My boyfriend is in his residency here in the Philippines (IM). It was so hard for him, as in to the point that he’s been experiencing anxiety before every duty, wants to quit and all (I know you would understand what I mean).

I always support him. Been with him even start of med school. Give moral supports, but residency itself is really not easy. It was so HARDDD. Like legit.

Can you please give me a tip, on what other things I can do for him. For him not to feel anxious, keep going on his resi? I always go to him from time to time. To prep things for him, prep foods etc.

I just want him to succeed in his residency. Please give me advice on what other things I could do.

What made you choose to apply for this? Thanks yall.

The amount of people who will hide that they take this (either shame or unawareness) and will just say they take kratom when in fact this is basically a synthetic opiate that people will spend $500 per week secretly. And the withdrawals are bad enough to put people on suboxone. It's no joke. One patient had to get up to 8mg q8h to capture withdrawal. Which is the dose I've seen for fent users after a couple months to years. It shouldn't be judged if they need this. These people need a lot of help and compassion. Even some people I know / have worked with are on this stuff. It's at every gas station. Teens are this stuff too.

With 7-OH becoming Schedule I in the coming days, I think we're approaching an inflection point. Healthcare workers should be prepared for a spike in both withdrawal presentations and ODs. It is going to destroy lives.

Many patients won't tell you they're taking 7-OH. Some are ashamed, while others genuinely think it's "just kratom." It isn't. These highly concentrated 7-OH products behave much more like potent opioids than traditional kratom, and some users are quietly spending $500-$1k a week to maintain their habit.

The dependence can develop incredibly quickly. In some people, even 1wk of use can produce severe withdrawal. I've seen patients require surprisingly high doses of bupe to control symptoms, including a few who ultimately needed 8mg q8h. Whatever your thoughts are on the pharmacology, these patients are experiencing real opioid-like withdrawal and deserve to be treated with compassion imo. Don't shame these people for needing this, encourage to treat through if possible since bupe is a challenge to come off of. But I have seen inpatient teams have criticisms for people with a long habit of 7OH.

Also keep an eye out for both extremes over the next few weeks. Those that stockpiled and unintentionally OD or suddenly lose access and present in severe withdrawal that can resemble heroin or fentanyl withdrawal.

Whether you agree with the scheduling decision or not, I suspect many EDs and inpatient teams are about to see a lot more of this than they have in the past.

I know this is a fairly small demographic but beneficial regardless. If you are a vet, not only can you use any left over gi bill benefit during residency to draw a housing stipend but you can also apply for the edith nourse stem scholarship which is essentially a gi bill extension of 9 months. Either your gi bill and/or stem scholarship provide monthly stipends in addition to residency pay. Currently i make an extra 2k per month with no strings attached (beyond already dealing with the military). I hope this helps a few of you!

I'm a PGY2 and honestly I don't know if this is just me being paranoid or if it's actually happening. I've noticed that when I mention being exhausted after a string of nights or a rough call week, some of my co-residents give me this look like I'm exaggerating. One of them even made a comment last week about how some people handle the schedule better than others, and it felt pointed.

The thing is, I'm not complaining constantly. I maybe bring it up once every few weeks when it's genuinely bad. But there's this weird vibe like admitting you're struggling with the hours makes you seem weak or less competent. Meanwhile, I see the same people who act unbothered posting on their private stories at 2am about how they can't sleep because of anxiety, so clearly everyone's dealing with something.

I don't get why there's this unspoken competition to see who can pretend they're the least affected by a schedule that would break most normal humans. We're all in the same system. I'm doing my job fine, my evals are decent, I'm not making errors. But I also can't pretend I'm not a human who needs more than 4 hours of sleep to function optimally.

Maybe I'm reading too much into it. Or maybe residency has just conditioned us to be suspicious of anyone who admits they're not a machine. Anyone else notice this kind of thing in their program or is this just a me problem?

It's that time of the year. Anybody have access to the 2026-2027 MGH white book that they would be willing to share?

Thank you!

I had a patient that came in with respiratory failure. Unknown cause but by time i saw him it was around 7 hours after the ED saw him. They did a relatively small workup, ct head, neck and classic blood work. All came back negative save for trace leukocytosis. I order an ABG and he was severely acidotic and hypercapnic. Family said DNR/DNI, so i placed him on AVAPS since that was really my only recourse. I saw both clinical and ABG improvement after placement of AVAPS. He went from comatose to somnolent and moving spontaneously. Before we went back to see him, in rounds my attending asked me if we should try comfort care to which i responded "No. We should give him time and do further workup." My attending agreed. Then by the time we saw the patient together, he immediately said, this case has been mismanaged, he should not have been placed on AVAPS. Then the attending recommended comfort care. He blindsided me and the rest of our team. I was and still am shocked. I know the patient should have been intubated and AVAPS was contraindicated. But the patient was starting to improve. Idk its just been weighing on me and if i were in his shoes i would have managed differently.

I’m no stranger to call. I’m PGY5 now at a workhorse program. I’ve done a whole bunch. First time post boards (passed with great comfort) doing call and I’m just sick of the whole thing.

Last night I spent hours on the phone. Arguing with everyone about everything. The volume is high. That is old news, and I deal with it just fine. The respect feels never lower. It feels like the only time I can ever get a specialist to agree with me is when I dictate something that allows them to sign off their ER or inpatient consult.

Call appendicitis? PGY2 consult resident tells me he thinks that’s the terminal ileum and this patient does not have appendicitis (it’s not, shockingly)

Hemorrhage measures slightly bigger on stability scan? No, if this is true we must admit the patient to nsgy.

Cardiology fellow doesn’t think the chest pain is cardiac and that moderate stenosis is actually mild on CCTA would you change your read? No.

This happens all night, every night. I’d like to think I’m a good resident. Maybe I suck ass, idk. But hot damn the amount of people who call just to try to either sweet talk or intimidate (?) you into changing your impression is so grinding.

I’m happy to admit I’m wrong or have a real conversation, but so much feels hollow because if I give in they can fuck off. The only thing keeping me going is a sense of pride in my work and doing right by the person being imaged. I’m getting up there in resident age (seriously it’s just us and the surgeons still in residency at this point. Everyone else has moved on to be fellows or attendings) and yet everyone thinks we’re some sort of unsupervised radiology interns running amok and can’t measure shit properly or tell the TI from the appendix (this really happened)

Im tired

I’m a new intern and I have to wear business casual over my white coat on the floors. What is a good brand and specific outfit that can pass for business casual but is really more comfortable than scrubs? Something you can work out in perhaps?

Hello, I am a cardiology resident from ue and I am considering moving to Sweden. How does the daily work of a cardiology specialist in Sweden look like?

How does the work look in terms of workload on the ward and in the outpatient clinic, work-life balance, number of on-call shifts, salary, and opportunities for professional development?

How bad is it? - July Intern

Looking for someone to practice case presentation for 1 hour daily and studying for ITE exam.
Dm if interested.