80 hours/week on the wards, 30-hour calls every 4-5th night.
If I could make 1/2 the money I'll make in medicine (which might not even be much under Obama-care) playing music, I'd leave you in a heartbeat.
Thursday, July 8, 2010
Friday, May 21, 2010
3rd Year in the Can
It's over. 3rd year. It kinda sucked as a whole: you're the lowest on the food-chain, you don't get respect from patients, residents, attendings, or even nurses and NPs. Did I mention that I fucking hate mid-levels? Anyway...reasons why 3rd year sucks:
-You show up as long as any resident, so depending on the rotation, this can be well into the 60s and 70s of hours. I know of several colleagues who had topped out over 80, and then were bitched at by their surgery attendings for complaining that they went over. The thing is that you are not paid, since of course, you are in school. So you get to sit around idle for hours watching everyone around you scurry and get work done, at least getting the money made, while you spiral into debt. An investment for the future? Of course? Tough at times? Yeah.
-No respect: noone respects you, and why should they? You're there to learn, and many patients are reasonable to understand that they are contributing to honing the mind of a future doc, but many people are just frustrated with the extra time it takes to deal with us and the way we can never answer questions or always have to defer thigns to our higher-ups.
-Scutted out. You get all this shit work dumped on you. On one of my surgery rotations, the PA dumped all the services' discharges on me every afternoon. Monotonous hand-written orders for the patients, and this was a busy service, too. What's the utility in this? Where's the education? I guess the argument can be made that we will be residents soon, and that doing anything they do has some educational value. But when you're there, in the hospital, tired because you got up at 4:15am that morning, and terrified of the end-of-rotation exam, you really want to just learn useful information and not be sent on endless missions of scut work.
I'll go over all of my specific rotations in the next posts. Believe me, I could write an entire book on any one rotation.
-You show up as long as any resident, so depending on the rotation, this can be well into the 60s and 70s of hours. I know of several colleagues who had topped out over 80, and then were bitched at by their surgery attendings for complaining that they went over. The thing is that you are not paid, since of course, you are in school. So you get to sit around idle for hours watching everyone around you scurry and get work done, at least getting the money made, while you spiral into debt. An investment for the future? Of course? Tough at times? Yeah.
-No respect: noone respects you, and why should they? You're there to learn, and many patients are reasonable to understand that they are contributing to honing the mind of a future doc, but many people are just frustrated with the extra time it takes to deal with us and the way we can never answer questions or always have to defer thigns to our higher-ups.
-Scutted out. You get all this shit work dumped on you. On one of my surgery rotations, the PA dumped all the services' discharges on me every afternoon. Monotonous hand-written orders for the patients, and this was a busy service, too. What's the utility in this? Where's the education? I guess the argument can be made that we will be residents soon, and that doing anything they do has some educational value. But when you're there, in the hospital, tired because you got up at 4:15am that morning, and terrified of the end-of-rotation exam, you really want to just learn useful information and not be sent on endless missions of scut work.
I'll go over all of my specific rotations in the next posts. Believe me, I could write an entire book on any one rotation.
Tuesday, May 18, 2010
3rd Year Just About Done
3rd year SUCKED.
I finished my very last clinical day of 3rd year today - YES. I just have the exam on Thursday, then a meeting Friday morning for a few hours and I'm officially a 4th year! So tonight's gripe will just be a quick bitching about how much I hate being in the O.R. Most people who don't go into surgery at least liked being in the O.R., but just didn't want a career in it. Well I hated the O.R., you know why? (Caviat: The OR experience is much different as a med student because you can't really do anything, and anything that you do do is going to be "scut"ish work, like holding retractors for hours on end. Being a resident and doing surgery actively would probably help. Still...)
-Sterile environment. Annoying. You can't scratch your balls if you needed to, or, more commonly, annoying itches on the back of your head. Can't scratch them, you just have to wait it out.
-Standing. Hours of it. Tiring. And you got up at 4:30am that morning on 5 hours of sleep if you were lucky. It hurts.
-Mean attendings. They yell and curse and make you retract for hours...
-Retracting - tiring. Hold your hand out in front of you for 2 minutes straight. Hurt? Do it for 30 minutes, an hour...you'll sweat and panic.
-Mask, gloves, gown, hat - annoying. I feel trapped, hot, and suffocated.
And worst of all...
-Bitchy Nurses. Seriously. Seriously. Get over yourselves. Yeah, I know, the attending surgeons are mean and they dump on you all the time. They berate you, humiliate you, yell at you, and take their anger out on you. You chose this profession, so deal with it. Stop transferring that frustration down to the only people you can: us medical students. Stop actively going out of your way to find something wrong with my sterile technique...I was not standing "too close" to your fucking mayo (instrument) tray.
Stop giving us the 'tude. Changing your tone of voice as soon as we ask you a question or ask you to help us gown isn't going to help anyone. Just shut your trap and treat us like you do everyone else, which usually isn't very nice, anyway.
You who disrespected me when I walked into the room and bitched me out because you had to take my name down to enter into the computer for the records; screw you.
You who made me change out and back in for stepping one step outside of the curtain when everyone else was walking around the entire room for the entire case; screw you.
And this isn't OR related, but to you who bitched me out over the phone because you were to lazy to get information out of the chart that my resident needed; fuck you.
Do your fucking jobs. We all hide behind this facade of professionalism so the patients and others at the hospital think everything's dandy. But behind it all, everyone (even residents and sometimes attendings) can be real big cocks. But most of all I take it from nurses. Some of you are amazing, really, and to that I salute you. But I've experienced a lot of shit, and to those who have been shitty enough to dish it out; go fuck yourself.
I finished my very last clinical day of 3rd year today - YES. I just have the exam on Thursday, then a meeting Friday morning for a few hours and I'm officially a 4th year! So tonight's gripe will just be a quick bitching about how much I hate being in the O.R. Most people who don't go into surgery at least liked being in the O.R., but just didn't want a career in it. Well I hated the O.R., you know why? (Caviat: The OR experience is much different as a med student because you can't really do anything, and anything that you do do is going to be "scut"ish work, like holding retractors for hours on end. Being a resident and doing surgery actively would probably help. Still...)
-Sterile environment. Annoying. You can't scratch your balls if you needed to, or, more commonly, annoying itches on the back of your head. Can't scratch them, you just have to wait it out.
-Standing. Hours of it. Tiring. And you got up at 4:30am that morning on 5 hours of sleep if you were lucky. It hurts.
-Mean attendings. They yell and curse and make you retract for hours...
-Retracting - tiring. Hold your hand out in front of you for 2 minutes straight. Hurt? Do it for 30 minutes, an hour...you'll sweat and panic.
-Mask, gloves, gown, hat - annoying. I feel trapped, hot, and suffocated.
And worst of all...
-Bitchy Nurses. Seriously. Seriously. Get over yourselves. Yeah, I know, the attending surgeons are mean and they dump on you all the time. They berate you, humiliate you, yell at you, and take their anger out on you. You chose this profession, so deal with it. Stop transferring that frustration down to the only people you can: us medical students. Stop actively going out of your way to find something wrong with my sterile technique...I was not standing "too close" to your fucking mayo (instrument) tray.
Stop giving us the 'tude. Changing your tone of voice as soon as we ask you a question or ask you to help us gown isn't going to help anyone. Just shut your trap and treat us like you do everyone else, which usually isn't very nice, anyway.
You who disrespected me when I walked into the room and bitched me out because you had to take my name down to enter into the computer for the records; screw you.
You who made me change out and back in for stepping one step outside of the curtain when everyone else was walking around the entire room for the entire case; screw you.
And this isn't OR related, but to you who bitched me out over the phone because you were to lazy to get information out of the chart that my resident needed; fuck you.
Do your fucking jobs. We all hide behind this facade of professionalism so the patients and others at the hospital think everything's dandy. But behind it all, everyone (even residents and sometimes attendings) can be real big cocks. But most of all I take it from nurses. Some of you are amazing, really, and to that I salute you. But I've experienced a lot of shit, and to those who have been shitty enough to dish it out; go fuck yourself.
Wednesday, May 12, 2010
Pricks
You know what is funny? This happens to everyone in medicine. We come in all doe-eyed and ready to save the world, and by the end of 3rd year our cynicism peaks and we're angry, jaded bastards. It's hard to keep a blog when all you want to do is bitch. I'm nearing the end of my 3rd year...actually 8 days from the end. I'm wrapping up OB/GYN rotation, which is the very last thing in my surgery block. The 4:30am mornings out of bed, the 7:00pm and later arrivals at home, the endless standing in the OR's srcubbed in. I shall write about it at some point, for it has been months of intense madness and often misery. But now I'll just do a random bitching.
Subjective evaluations. They count for most of your grade. It's how the system is set up and it is complete bull-shit. Medical student A works his ass off and because his resident or attending is a jerk, or just has a given style/philosophy of grading, he'll get a harsh evaluation. Student B might mess around all rotation and since his resident is really chill, he might get a far better evaluation. That is the system in a nut-shell.
I've ran into a lot of dick holes. One was a GI doc during my surgery rotation. He wasn't evaluating me, but he was a dick hole nonetheless. One of our patients was status-post gastric bypass, and as you'd expect, had a host of metabolic and nutritional issues from mal-absorption. Yeah, it's kinda hard to absorb Fe and Vitamin B12 without your gastric antrum(?) intact. She was going really anemic during her stay and her hemoglobin was in the range of I think 7.0-7.9.
This asshole asked me, "why do you think she's anemic?"
I'm like, "well...we've been drawing blood from her every single morning and she's also missing her gastric---" he cut me off and replied in a frustrated tone,
"you're supposed to be a medicine doc! What are they teaching you! She's had a gastric bypass surgery, of course she's anemic, she is having trouble with Fe absorption" etc etc and he walks ot of the room.
My attending comes in and I ask him, "Why does [patient] have low hemoglobin?"
"Oh, well its because we've been drawing her blood every day."
Fuck you, shit bag GI fucker.
Subjective evaluations. They count for most of your grade. It's how the system is set up and it is complete bull-shit. Medical student A works his ass off and because his resident or attending is a jerk, or just has a given style/philosophy of grading, he'll get a harsh evaluation. Student B might mess around all rotation and since his resident is really chill, he might get a far better evaluation. That is the system in a nut-shell.
I've ran into a lot of dick holes. One was a GI doc during my surgery rotation. He wasn't evaluating me, but he was a dick hole nonetheless. One of our patients was status-post gastric bypass, and as you'd expect, had a host of metabolic and nutritional issues from mal-absorption. Yeah, it's kinda hard to absorb Fe and Vitamin B12 without your gastric antrum(?) intact. She was going really anemic during her stay and her hemoglobin was in the range of I think 7.0-7.9.
This asshole asked me, "why do you think she's anemic?"
I'm like, "well...we've been drawing blood from her every single morning and she's also missing her gastric---" he cut me off and replied in a frustrated tone,
"you're supposed to be a medicine doc! What are they teaching you! She's had a gastric bypass surgery, of course she's anemic, she is having trouble with Fe absorption" etc etc and he walks ot of the room.
My attending comes in and I ask him, "Why does [patient] have low hemoglobin?"
"Oh, well its because we've been drawing her blood every day."
Fuck you, shit bag GI fucker.
Tuesday, March 9, 2010
Fuck.
I'm just fucking sick of this already. Standardized patients' report comes in to the effect of:
-"Student was purely clinical, not personal. Came off as cold and uncaring, only smiled once at end of encounter."
-"Try to build rapport...I didn't feel like I wanted to share any extra information with you."
And my clinical evaluations always fault me for interpersonal skills (or lack thereof). Every time it's that I'm too quiet, or don't develop a good team dynamic. Well fuck. I won't sit here and say that they are wrong...they are right. But I don't know what to do with myself. I honestly believe I just have some traits/elements of Asperger's or something, because I am not able to relate to others fluently and naturally like most people.
So it is. I do what I can and get through the rotations. I'll get my passing score and move on. I'll take my shitty eval time and time again. I'll try to improve and get burned every time. "Student lacks initiative, student is quiet." I've had a number of actual patients complement me on my "bedside manner" for what its worth. I don't know what the truth is, I just think it really sucks. Just fuck it, you stop caring after awhile.
-"Student was purely clinical, not personal. Came off as cold and uncaring, only smiled once at end of encounter."
-"Try to build rapport...I didn't feel like I wanted to share any extra information with you."
And my clinical evaluations always fault me for interpersonal skills (or lack thereof). Every time it's that I'm too quiet, or don't develop a good team dynamic. Well fuck. I won't sit here and say that they are wrong...they are right. But I don't know what to do with myself. I honestly believe I just have some traits/elements of Asperger's or something, because I am not able to relate to others fluently and naturally like most people.
So it is. I do what I can and get through the rotations. I'll get my passing score and move on. I'll take my shitty eval time and time again. I'll try to improve and get burned every time. "Student lacks initiative, student is quiet." I've had a number of actual patients complement me on my "bedside manner" for what its worth. I don't know what the truth is, I just think it really sucks. Just fuck it, you stop caring after awhile.
Sunday, February 14, 2010
Sucked
So I had a stint on a urology team at the most "intense" hospital on our campus. The way this month works is, I do urology for 10-12 days, then anesthesia for 12, then urology again for 12 days. Thankfully, my 2nd urology stint is at a different hospital. The children's one, even.
But seriously, that team was horrible. The hours were crap as you'd expect: show up at 5:15am to help the intern with pre-rounding scut work, then round at 6:00am until time to hit the OR, watch a bunch of operations all day, then eventually more scut work and afternoon rounds. After fighting evening traffic, I'd get home at maybe 5:30 or 6:00pm and "enjoy" my few hours before I had to think about getting some sleep before another 4:30am awakening.
Ok, fine. Expected hours for this block. I have 3+ more months of hours like this. It's the team specifically that I didn't like. Your typical surgery types: white, sporty, butch-haired males all the way from attending to intern. Even though urology is generally considered the happy-go-lucky lifestyle specialty, it's different in academics and at a huge, tertiary care hospital. It's still surgery residency, and you have residents working 80+ hour weeks and what-not.
I was pretty much blatantly ignored and treated like an uninvited pet dog. Part of it was because they are a busy, busy service. The inpatient roster was around 23-28 with 2-5 consults the whole time, and they had to round and operate and round and call consults and write orders like mad. So I get it. But I felt completely disrespected by some of them, like they didn't even bother to pull me aside 1 minute and say "hey, sorry we're so busy, but you could do this or this". No, it was just irritated glances and "do this" "do that".
I haven't been to this particular hospital at all since I started 3rd year 8+ months ago. I noticed off the bat that it was a more intense, serious place, with frankly ruder staff. It didn't help that I was on one of the busier surgical teams (probably second next to transplant). In the OR, I didn't enjoy the procedures. I would scrub in and stand there for 5 1/2 hours while they did their lymph node dissections and ileal loop thing. I get it, you're all busy, there's no time to deal with the med student. But I've had a great third year up until now, you could at least show some effort.
Anyway, whatever. I start anesthesia tomorrow at a much better place. After that, more urology at the children's hospital, then off to somewhere (I don't know yet) for 5.3 weeks of general surgery. I'll get used to the horrible hours, I only ask that where I'm placed has a bearable atmosphere.
Yukers signin off~
But seriously, that team was horrible. The hours were crap as you'd expect: show up at 5:15am to help the intern with pre-rounding scut work, then round at 6:00am until time to hit the OR, watch a bunch of operations all day, then eventually more scut work and afternoon rounds. After fighting evening traffic, I'd get home at maybe 5:30 or 6:00pm and "enjoy" my few hours before I had to think about getting some sleep before another 4:30am awakening.
Ok, fine. Expected hours for this block. I have 3+ more months of hours like this. It's the team specifically that I didn't like. Your typical surgery types: white, sporty, butch-haired males all the way from attending to intern. Even though urology is generally considered the happy-go-lucky lifestyle specialty, it's different in academics and at a huge, tertiary care hospital. It's still surgery residency, and you have residents working 80+ hour weeks and what-not.
I was pretty much blatantly ignored and treated like an uninvited pet dog. Part of it was because they are a busy, busy service. The inpatient roster was around 23-28 with 2-5 consults the whole time, and they had to round and operate and round and call consults and write orders like mad. So I get it. But I felt completely disrespected by some of them, like they didn't even bother to pull me aside 1 minute and say "hey, sorry we're so busy, but you could do this or this". No, it was just irritated glances and "do this" "do that".
I haven't been to this particular hospital at all since I started 3rd year 8+ months ago. I noticed off the bat that it was a more intense, serious place, with frankly ruder staff. It didn't help that I was on one of the busier surgical teams (probably second next to transplant). In the OR, I didn't enjoy the procedures. I would scrub in and stand there for 5 1/2 hours while they did their lymph node dissections and ileal loop thing. I get it, you're all busy, there's no time to deal with the med student. But I've had a great third year up until now, you could at least show some effort.
Anyway, whatever. I start anesthesia tomorrow at a much better place. After that, more urology at the children's hospital, then off to somewhere (I don't know yet) for 5.3 weeks of general surgery. I'll get used to the horrible hours, I only ask that where I'm placed has a bearable atmosphere.
Yukers signin off~
Wednesday, February 3, 2010
Surgery Clerkship
If any of you clicked on my blog, wondering what's up, then here. I'm in 3rd year of medical school. During that year, you have to "rotate" through all the different major medical specialties...at about a rate of a different one per month. Such as my schedule would have it, all of my surgery specialties have come last in the year. And so, between now and late-May, I'll be dealing with the "worst" of third year, if not the worst of medical school.
So I'm now on surgery. My hours are very, very long, and my days start very, very early. I don't have the luxury of weekends anymore; they will be chopped in half at best. But in general, days are expected to be 12 hours long. In my case right now, this is my expected routine:
4:30am - Wake up
5:15am - Bet at hospital to help intern do scut work (dirty work, paper work)
4:30pm - Supposedly when I get out
6:00pm - Later end of when I get out
Mind you, I don't have a "safe haven" of Saturday and Sunday. I should get one of those two days off a week. This coming weekend I have a feeling I will work straight through, because my team doesn't give a shit that I'm there and they just want me there to do work while they have me.
I will be online as I can be. I'm not sure just yet how waking up at 4:30am will affect my body, but it will surely wreak some amount of havok. I can only imagine that to arrive home 13-14 hours later, I'll be dead-tired, even though it'll only be 6 or 7 in the evening. How I'll deal with sleep and how I distribute sleep is to be seen. But I put friends absolutely first, so I won't be falling out of touch w/anyone; that is my priority.
I can only say that going through this is just as much physical as mental and emotional strain. I will do my best to cope.
So I'm now on surgery. My hours are very, very long, and my days start very, very early. I don't have the luxury of weekends anymore; they will be chopped in half at best. But in general, days are expected to be 12 hours long. In my case right now, this is my expected routine:
4:30am - Wake up
5:15am - Bet at hospital to help intern do scut work (dirty work, paper work)
4:30pm - Supposedly when I get out
6:00pm - Later end of when I get out
Mind you, I don't have a "safe haven" of Saturday and Sunday. I should get one of those two days off a week. This coming weekend I have a feeling I will work straight through, because my team doesn't give a shit that I'm there and they just want me there to do work while they have me.
I will be online as I can be. I'm not sure just yet how waking up at 4:30am will affect my body, but it will surely wreak some amount of havok. I can only imagine that to arrive home 13-14 hours later, I'll be dead-tired, even though it'll only be 6 or 7 in the evening. How I'll deal with sleep and how I distribute sleep is to be seen. But I put friends absolutely first, so I won't be falling out of touch w/anyone; that is my priority.
I can only say that going through this is just as much physical as mental and emotional strain. I will do my best to cope.
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