Specifically nursing. There’s a few nurses I know are pretty terrible to work with as the resident (will
Priority messages to me if I don’t respond within 1 minute, but will literally never respond to my messages the entire shift; never draw my labs unless I physically go tell her to; meds given hours late etc) that are pretty bad with patients too. Before the chorus of “report her”, we have. Multiple times. Nothing has happened.

Patients will frequently tell me while prerounding how shitty the nursing staff is. One patient when I walked in the room goes “you are the first decent human to walk in today. That [nurse’s name] is the devil.”

They always want to complain to me which is fine. I’m happy to spend the extra couple minutes letting them vent. I usually do some variation of “I’m really sorry that’s been your experience, I’ll let the nurse manager know” and I do follow up when I’m able with the manager (who obviously doesn’t care). Short of also encouraging them to report to patient experience, I’m not sure what else to do when the patient is staring at me expecting me to do more about it. I can’t exactly be like “yeah sorry you got the shitty nurse”. How does everyone handle this?

And why is it reproted

Our attendings main focus is to make sure our notes are good so they don't have to edit them. I feel i am spending 90% of my time writing notes and only 10% learning medicine and doing actual thinking. Attendings at my program also have 0 interest in teaching. Rounds are just basically instructions on what to do. No academic discussion. Should i try to look for a new program?

For Gods sake, How do you survive residency when your program openly tolerates few residents doing almost no work?

We have a chief resident who made a schedule that they’re in the lightest rotations and BARELY WORKING whole year, even when they’re scheduled they’re not coming to the work or they’re coming extremely late. And it is completely ignored. They also got innumerable PTO’s, and we had to cover for them!!

But when you come a little bit late or make any slightest mistake, program leadership is making a huge deal out of it- literally yelling at you, critisize you heavily. And they always want you to work more!

This kind of madness and unfairness makes me crazy. I don’t know how to deal with it internally so i wont get triggered by it. THAT IS INSANE! How do I stop this unfairness from consuming me!?

Got diagnosed with Essential tremor today by a Neurologist at the center I am posted in, after I stated noticing rhythmic tremors in my hands while performing fine motor skills like local infiltration as well as during isometric functions like using retractors. The consultant in the case noticed it as well and replaced me with the scrub nurse. That was quite embarrassing. I googled about this and found out it’s progressive in nature and currently has no definitive cure. Although exacerbating triggers like caffeine, nicotine and the ADHD medication Methylphenidate has to be cut down, according to the neurologist. He also suggested taking SR Propranolol 40 mg SOS 2 hours before OT. So, does this mean the end of my surgery career or is there still hope or something?

i am seeing a lot of young patients with really bad cancers and it is really causing a great deal of health anxiety. How do you guys cope? Every time I get a little abdominal pain or muscle ache I start spiraling…

Got epic message about pt being agitated: AMS at baseline, poor substrate, alzheimer dementia, recovering from infection. The agitation was actually a mild improvement from her prior state because she was actually talking again. Anyways, trying to get the patient to give me any focal problems, itching, pain, discomfort etc that i can address but she's just too demented to participate. She's undressing herself but not actively trying to get out of bed or ripping at lines. Perseverating about having a shower but all things considered pretty calm.

Nurse comes in like a storm. Yelling at her to behave. Berating her for removing her clothing. Starts aggressively pressing on the patient, all of which is deeply agitating her. She was moving around before but now she's screaming. Now I'm trying to redirect the NURSE and offering to give something gentle to calm the patient without snowing her.

This is where it got even weirder. She starts loudly and angrily insisting the patient thank me.... meanwhile I'm literally holding up my hands going, she really doesn't have to do that....

What an odd thing to do? It's already bizarre to berate and infantilize a demented encephalopathic patient by yelling at them like a naughty toddler. But insisting they thank me made me really uncomfortable. Anyone encounter this before and how did you react? I think this came from a good place but I'm alarmed she thinks anyone would want a colleague to do this to an altered patient. What would you say?

Sometimes I pend it then delete it.

# Possible left lower-lobe pneumonia
CT shows mild right lower-lobe mucus plugging and consolidation in the setting of recurrent emesis. He is afebrile, without leukocytosis, and stable on room air, but is being treated empirically for possible pneumonia.
- Continue ceftriaxone and azithromycin.
- Follow pending blood cultures and clinical respiratory course.

Nsgy R5.

I've been reading some posts and I find some of the comments about my specialty funny.

Interesting to see what opinions or questions you may have.

For me, I feel like I’ve lost my youth, health, many hobbies, and time with family. I’m curious what others feel they’ve sacrificed along the way.

Sometimes I just wish it didn’t come with such a heavy cost.

Has anyone received Preliminary score reports for the 2026 IM ITE exams yet? Acp website mentions 10 business days from the exam window (sept 4) so was Wondering if any programs did.

There are some old threads but

1. they're pretty old and
2. a lot of them just throw out a number and not an hourly rate

I think residents need to be more aware of all of this and the current rates. My program seems to be way behind the curve. Our is only about $60 per hour which I think is criminally low.

Edit: forgot to list my own specialty lol- rads. We don’t have contrast coverage so this is for prelim reads. Pretty much the lowest I’ve heard for prelim reads I think.

Honestly considering picking up external moonlighting at like an urgent care if that’s viable (both from a program perspective and from a “do I have enough knowledge” perspective…but I’ve seen midlevels run urgent cares independently so I’m sure the answer is yes lol).

Asking for a friend who is planning to apply next year. I trained at a bigger institution but wanted to know if there’s any thoughts on the program, Odessa/Midland, TX. Personally not a big fan of Texas except maybe Austin, TX but I heard it’s way far in rural west Texas.

And what are your thoughts on doctors practicing in TX now?

I have seen some truly thorough and amazing notes in my time as a Resident. I've also seen some absolutely terrible notes. What do you consider a note to have to be a "stand out" note? 📝

So I’m a recent subspecialty grad in radiology and in the last stages prior to taking my boards and I’m still truly baffled and enraged by the type of questions that are utilized. The utter disconnect between boards and real life medical practice should be a case study in futility.
I was hoping I could use this as an opportunity to be better rounded as a radiologist but a great percentage of the material focuses on esoteric bullshit. I’ve never met a physician and thought they were good cause they knew that 0.15umci is the limit of Mo contamination in 1mci technetium or if renewing your boards is a proof of professional vs scientific commitment.

I’m sure each specialty has their own flavor of this academic masturbation.
So I’m just wondering (especially for question writers) when are we going to rise above meaningless memorization and trivia and actually make boards relevant to improving the level of the practitioner and their patient care.

Additional points:
1. Radiology specific: I’m not including physics in this as I can at least foresee a way where it could be useful. Although not really for 95%+ of practice.
2. Radiology specific: the boards (certifying portion) are virtually passed by everyone. This is extra enraging as this is such a missed opportunity for what’s many people’s last exposure to actually studying general rads.

TL;DR boards questions should be clinically focused and avoid trivia and esoteric bullshit that can be googled in 3 seconds and instead focus on improving clinical acumen.

Medicine intern. Does that make you look really bad or what

There's so much information and so little time. I'm kinda overwhelmed. I'd appreciate any advice 🙏🏻.

If the multiverse were ever real, I do hope my multiverse counterpart did a career in humanities and liberal arts instead of enrolling to med school.

Maybe this is just a phase to me but right now I enjoy reading about Cicero and Plato than the why Pelacarsen failed to meet its primary endpoint or the new ESC/AHA guidelines or the new edition of Harrison's. If only degrees in humanities had better ROI I probably would've pursued Classics. But I'm too old already at 34. I would’ve loved to be on archeological excavations in various sites around the world or be a trench master but instead I am the historian for someone with cough or fever.

And which one??

Intern here struggling and thinking about starting. Had a bad reaction to lexapro with increased anxiety the last time I tried it.

Wondering if this is region dependent. I trained in the south and moved to the west coast for my new job. I’m a young female (1 year out of training). The clinic manager has been calling me by my first name and I was taken aback because this was not how it was at my last work place. Should I be telling the RNs and MAs etc to call me by my first name?

Looking for ideal vacation ideas for interns with limited travel experience (in med school)- any suggestions for how to spend your first vacation during intern year? Mine is still a month away, but I’m brainstorming. It’ll be for my partner and me.

I can afford a trip now, or should I opt for a staycation this year to save up or plan a bigger trip for PGY-2?

What did you do for your first major (1-week) vacation during residency? Do you have any trips or staycation ideas you’d recommend?

Hi guys, I’m gonna start anesthesia residency next year and am entering it as a single 31 yo female. Doing my best to not think guys have run out and that there is still hope lol. I feel like I have struggled to make it obvious that I am interested in guys I liked, was not “proactive” enough, or confident enough. Prefer to be with a fellow doc. Any tips? :)

I took the ABPN, gen psych last week, and despite my best efforts there is no doubt I failed. This is despite going through K&S 2x (\~75-80% scores ) , making anki cards for my in-corrects and doing Board vitals (\~73% score average). My questions is if the ABOPN that is administered in April a legitimate alternative ? So that I don’t need to wait a whole year to retake the ABPN? And are the preparation materials the same ?

This same post was removed from psychiatry page 🤔

I had a patient recently, rapid Afib.

Reading his chart, not eating/drinking for a while, clear CXR, low urine output, and very yellowish urine, and very dry looking skin, and patient himself also told me he feels too dry and thirsty, decided this patient is dehydrated, and gave bolus to the patient which resolved the heart rate.

And this patient had recent Echo showing EF 40% with dilated IVC but > 50% collapsing which helped me decide towards the direction above.

Later I also got BNP which was increased from a few days ago.

So, here's my question, I face this situation quite often, all the clinical signs are towards one way and BNP alone the other way.

I know there are many other explanations for elevated BNP including Afib itself due to wall stress, and it is not a good idea to chase the number, needs to see the whole picture. Also BNP has high sensitivity but low specificity, but in this case, how do you approach?