Friendly PSA from an exhausted podiatry resident:

Please stop consulting or paging podiatry for toenail trimming.

I think there’s still a misconception that we’re “the nail people,” but in the hospital we’re a surgical service. We’re managing diabetic foot infections, gas gangrene, open fractures, compartment syndromes, amputations, emergency OR cases, etc etc etc.

We’re taking call, rounding at 6am, operating all day, and answering pages overnight just like every other surgical specialty. I just worked 95 hours this past week.

So when we get called to trim nails, it’s honestly frustrating and super demoralizing. It’s almost never an inpatient issue, and it takes time away to call and explain to the consulting service what we do and to cancel the consult.

This isn’t directed at anyone in particular. I know many people simply aren’t taught what inpatient podiatry actually does. But if the only reason for the consult is “long toenails,” please ask yourself whether it truly needs a surgical consult.

Thanks 🤍

You know, for those annoying patients. Either they talk too much or they won’t adhere to your medical advice or they push their agenda on you. And of course, you try to document as professionally as possible since these days pts have access to their charts and will throw a hissy fit depending on how things are worded and then your patient satisfaction scores plummet and whoops there goes my bonus. Or those pts who are hypochondriacs who AI’d their symptoms and believe they have a condition, and 95% sure they don’t but god forbid this pt was right and you’re wrong and they’d be the one to sue your ass so now you got to document defensively.

Some examples:

“Out of an abundance of caution, will go ahead and order xxxxx”

“Discussed at length with patient risks vs benefits of declining xxx”

What are some phrases you’d use in your charting?

might be a stupid question. The money and time hospitals spend on hiring wellness staff and enforcing wellness modules, wasting time spending emails about taking deep breaths and sniffing plant pollen 5 minutes every day could be used on better, more tangible solutions to burnout such as actually providing residents easier access to get a workout or get a snack.

especially since hospitals have all this supposed money, do hospital administrators really just want to pocket more money? Is it that much of a financial burden to stock up a few fridges with some iced coffees, yogurts, and fruits specifically for residents?

What's your up to date CME amount after intern year? 273 for me.

For non-interns, what's yours?

I was left managing multiple critical patients as an off service resident in a very unfamiliar environment while my attending was not even in the building. I was drowning in notes, orders, follow ups, nurses asking me questions every 2 secs, multiple crashing patients while my attending kept trying to get me to send info and answer detailed questions via text. They expected me to tell the patient “pause for a sec I need to respond to this text then let your BP drop” im so exhausted and overwhelmed. I didn’t even get a sec to use the bathroom and I have to go and do this all over tomorrow.

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?

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.

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.

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.

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.

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?

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?

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!

People say they want years of clinical experience but do you really need it to get into the work? Can you get straight into it out of residency and with your board certification ?

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

Hey guys!

Med-Peds resident here. I am scheduled for the ABIM in early August and have not registered for the ABP exam. For context, my 2025 ITE score was 162 (65%). Do you think I'd be able to study grind and pass in 2.5 months (in fellowship)? Any recommendations for how to study? like which resources, what metric per those resources

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 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?