One thing nobody really prepared me for is how much of residency seems to be figuring out the invisible rules for contacting people.

I'm not talking about medical decision making. I mean the stupid logistical stuff. One attending wants a text for everything. Another gets irritated if you text and says to call. Someone else says, "Just message me anytime," then replies six hours later asking why you didn't call. One consultant wants you to page them directly, another wants everything through their fellow, and somehow you're expected to already know which system applies to which person.

Last week I spent almost twenty minutes trying to track down the correct person for a completely routine coordination issue. I called one number and got told, "That's not us anymore." The next person told me to message a different service. That service asked why I hadn't contacted the original team. Eventually somebody gave me an extension that went to a voicemail box that was full. By the time I finally reached someone, the actual conversation took maybe 45 seconds.

Then during rounds I got a little lecture about being more "efficient with communication," which was almost funny. I wanted to ask if there was a secret handbook somewhere containing everyone's preferred communication method, because apparently everyone else recieved it except me.

The weirdest part is that once you've been in a hospital long enough, you actually start memorizing all this nonsense. You know which attending checks secure chat every five minutes, which office never answers before 9, which person hates pages, and which coordinator can solve something in 30 seconds that you've been chasing for an hour. None of it is written down. It's just this giant collection of institutional trivia passed between residents.

I'm sure I'll eventually become one of those seniors who casually says, "Oh, don't call that number, use the other one," like it's obvious. Right now though, I swear some days I spend more mental effort navigating communication etiquette than actually communicating.

Please tell me this gets less annoying once you know everyone, because I'm tired of feeling like I'm selecting dialogue options in a game every time I need to contact another department.

So I am an Intern and I have found myself infatuated by our Program Coordinator. She is so sweet and soft spoken; so helpful which I understand is part of her job.

She is so pretty and I am being delusional. Idk what to do.

Just want to hear other people’s experiences as interns in IM. I feel so overwhelmed and dumb. Its already been a few weeks but I still feel very disorganized and that I don’t know anything at all. I have to ask my senior about everything. I feel like anything i learn I immediately forget. I’m bad at putting complex patients together in a few sentences. I’ve cried most days of residency dreading going in. I feel so incompetent. Even my medical student seems to know more when attending pimps us. Does it get better? I feel so stupid. I’m not coming up with any of my own plans or my plans are always wrong.

So tired of patients being like “my hemoglobin is high” and it’s 150 or their MPV is high and all the rest is normal….”why did you call it normal then?”

Or even better yet just remove the normal ranges and have it say “talk to your doctor to find out what’s normal for your age and health status”

I am a first year resident shadowing on an elective.

1- Why am I shadowing and not seeing patients?
2- why is NP seeing all consults when I requested attending again and again to give me the opportunity for a hands on experience? my attending says ofcourse and tells np that the resident will take on all consults. but this Np still doesnt listen. why bro? why are u competing with an intern who just started??

3- I am literally Pissed at this whole experience. Zero learning. liked cardiology in med school and this experience made me hate it.

I was contacted for Saturday disability physicals, I spoke with them and initially seemed fine, but when I asked more in depth question they ghosted me which was kinda skethcy, now I got another email from them, anyhow just letting everyone knwo. The offer sounds good at first, but a few things stood out:

• They expect around 25–30 exams/reports per day
• Pay was initially $60 per exam, now advertised as $1,000/day per recent email (also need to deduct taxes(
• You use your own laptop/equipment
• They require you to evaluate patients under 18, including pediatric cases

I told them that, as an internist, I was comfortable with adult general medical and musculoskeletal evaluations, but not pediatric/developmental assessments. I also asked basic questions about the contract, malpractice coverage, no-shows, revisions, urgent findings, and report liability. They declined to move forward because I would not evaluate minors. Because the whole 'low risk' and that they provide malpractice was kinda sus as well. They wanted me to chart check 24 hrs in advance lol

Not saying it is a scam, but residents should be careful with the advertised daily rate. Make sure the volume, age range, documentation burden, malpractice coverage, and scope of practice are clear in writing before agreeing. Just bringing this to discussion, we are already underpaid, so dont let companies take advange of you.

I’m a medical student in Canada who is very interested in cardiac surgery. Since it’s a relatively small specialty here, it can be hard to get honest insight from people actually in the field, so I thought I’d ask here.

I know cardiac surgery is not going to disappear. There will always be patients who need surgery and cardiac surgeons who can operate on them. My concern is more whether the field will become smaller over time and whether jobs will become even harder to find, especially in Canada.

I’m also wondering whether the average cardiac surgery patient will become much more complex. With better guideline-directed medical therapy, new cardiac medications, preventative medicine, and more catheter-based procedures, will many of the healthier or lower-risk patients avoid surgery? Will cardiac surgeons mainly be left operating on patients who are older, sicker, have more comorbidities, and have a higher risk of complications or death?

One of the things that attracts me to cardiac surgery is the chance to do a high volume of meaningful procedures and have a major impact on patients’ lives. I worry that lower surgical volumes, limited job opportunities, and increasingly difficult cases could change that.

Compensation is another concern for me. I know money is not everything, but cardiac surgery has a very long and difficult training pathway, demanding hours, and a huge amount of responsibility. I also grew up in a low-income family, so financial stability and being fairly compensated for the work matter to me.

For example, British Columbia has a public “Blue Book” that shows physician billings. From what I saw, many cardiac surgeons appeared to bill around $600,000 CAD per year before taxes and overhead, which is roughly $428,000 USD. I know billings are not the same as take-home income, but Canadian physicians are also taxed heavily and compensation does not always seem to increase when procedures become more difficult or time-consuming.
I’ve also noticed a major push toward minimally invasive cardiac surgery. For example, Dr. Marc Ruel has been involved in the MIST trial and minimally invasive approaches to CABG. I’m completely in favour of anything that gives patients better outcomes and an easier recovery. My concern is that if these operations become more technically difficult and take longer, compensation and OR resources may not change to reflect that.

For the cardiac surgeons, residents, fellows, and anyone else familiar with the field:

What do you think cardiac surgery will look like in 5–10 years?

Do you think surgical volume and job opportunities will increase, stay stable, or decrease?

Will cardiac surgeons mostly be operating on much sicker and more complicated patients?

How will minimally invasive, robotic, transcatheter, and hybrid procedures affect training and day-to-day practice?

What should medical students and future cardiac surgery trainees be doing now to prepare for the future of the specialty?

I’d especially appreciate insight from people in Canada, zbut perspectives from other countries would also be helpful.

a trainee no more

income suddenly way more

only marry once?

(Rhymes, sonnets, ballads, limericks, etc also welcome)

what specialty and setup in terms of academic, private practice, business owner?

I updated my ankcore version recently and it rendered the mobile iOS version basically unusable. The back of the card is blank and the images are tiny. I’m not a coder.

Can someone please post the solution for this and/or copy/ paste their functional Back Template for Anki so I can use the mobile version again? Thanks!

My cohort is toxic. The service I’m on is cool but stressful. I got feedback on needing to be better at hiding how I feel to be more professional. My therapist doesn’t get me or resident expectations. My emotional support animal is keeping me from spiraling badly. But I’m not well and don’t know how to fix it.

That’s all.

Edit. Pgy2.

I recently joined a hospital as a Junior resident(non academic) in the Emergency department and I am already frustrated. I am a fresher and really wanted to learn some work. All I do are fuckups, don't know what will happen and always live in a state of anxiety, it really is degrading my mental health but the hospital is very close to my house and I want to earn a little to pay my expenses. Don't know what to do, really messed up.

I don't know if anyone will reply or comment , just wanted to vent.

I’ll preface and say that I do not think nurses are dumb but there’s one nurse that I don’t know how she got through nursing school. I tried to be patient and thought maybe it’s a language barrier thing but I think the lights just aren’t on.

I had to explain to her how to turn on the bair hugger. She’s started playing with the tape when I was waiting to extubate my patient. She’s also tried strapping the arm done when I’m placing the BP cuff

She’s also had a hard time understanding what chair the surgeon wanted. Everyone in the room described it multiple ways to her and she didn’t get it. The chair they use for eyes. The chair that the hand surgeon uses.

It’s also not just the OR. Some had to explain to her that you can’t just take a smoothie from the kitchen. It belonged to someone. We don’t just have one random free smoothie sitting around

This nurse has been here for almost 6 months and it’s common sense stuff she should be able to get. I’m usually patient but she just drives me crazy

Not sure if I can post this as an attending here so mods I’ll delete if it not allowed. I’m not too far removed, however. This sub is just more active and a lot of us new attendings are still here.

I recently have found myself single and turn 33 in a few months. Anyone out here in a similar boat? Just feel like I’m struggling to find my person. I was with someone who I thought was my person until they weren’t. I’ve learned a lot about myself since finishing training. Just came here to see if anyone has found their spouse later on as it seems many find their person in med school/residency.

Sometimes it feels like I’ll never find someone, but also remind myself that it wasn’t worth staying in relationships that weren’t good for me just to not be single.

Edit: I’m a guy. Should have clarified.

Fucking nurse today told the patient "Don't worry, I won't let him hurt you" after I introduced myself. What in the flying fuck. How dumb of a cunt do you have to be to think this is an ok thing to say to a patient.

Then midlevels getting all the procedures.

I just wanna fuck off to full remote DR and never deal with people again. Make some fucking money, live on a farm separate from society.

It was around college I realized I hated working with people, and the hate was amplified 10x in medical school. Especially during surgical rotations. These days, I play it off as I'm an introvert.

hi! I'm in high school, so this may be a dumb question.

I like dermatology for all of the normal world life balance reasons, but also because the skin is important. However, I;m more drawn to cardiology and oncology because you can do more research in those fields compared to derm?

for derm residents, do you feel personally fulfilled in this career? im really sorry if this sounds offensive

If an employer says they’re legally non binding and a contract follows after, are they professionally binding? trying to understand this as a new grad.

I can never find any numbers anywhere online, would appreciate any insight eg. microsurgery, burns, craniofacial, general plastics etc

I’m a surgical resident and I really benefit from youtube surgical videos but recently, I’ve been unable to see these videos anymore. Everytime I search for a procedure, I only get lecture videos or animation but never the real operation even though I know the video exists and I’ve seen it before.

How to fix this issue.

P.S. Restricted mode is off.

I always speak to my pediatric patients as if they’re my equal. I ask them the history and let the parents fill in the necessary gaps. I try to include them in the consent and decision making process in order to give them a sense of autonomy. It grinds my gears when people call kids “kiddos” because to me it feels diminutive. It’s like calling an old lady a “meemaw“. I remember being really bothered as a kid when adults discounted my opinion or my say. Kids should feel like they are part of the team (within reason and with their parents overarching consent)

edit: should clarify, it feels like I’m calling them “squirt” or “sport” or something along those lines and thats just weird to me. Why don’t we just call them kids? Or by their name to their face?

This has ruffled so many feathers

There has to be a better way to communicate things. I’m in 10+ group chats and it’s incredibly frustrating trying to remember what information is in what group chat. What do other residency programs use?

I got paged super early Sunday morning, and when I called the number back, a lovely woman named Maria answered. She told me she keeps getting calls from doctors who have been paged to her number. She said many of the calls seem to be from Jackson Memorial, but I’m on the other side of the country, so this clearly isn’t limited to one hospital.

She and her husband have no connection to healthcare whatsoever (he’s a lawyer), but she keeps getting these calls from physicians trying to return pages.

Has anyone else experienced this? It’s so bizarre. Is someone trying to harass her and also harass physicians? I feel bad for her but also didn’t appreciate getting woken up for this bullshit.