Resident Lounge Insights on Residency

It’s an exciting time for final-year medical students in Australia. Exams are over. They’re in their last-ever clinical rotations, and they’ve finally found out in which hospital they’ll be starting their careers. Most are happy. Perhaps some aren’t, I dunno. But most are simply excited to finally start their intern year as doctors, having spent 8 or...

Physician wellbeing, burnout, and “work-life balance” are pretty common topics in training. We start at intern orientation, discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of a social life. It’s like we’ve forgotten the origins of our job title: “resident” or “house staff” — implying that, until...

“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-point scale. The cage represented the restriction of life and the boundaries within which he was...

“Medicine robbed me of my 20s.” I’ve heard the line many times in my medical training. It often comes accompanied by a long sigh, a slow sip of coffee, and a glazed stare off into the distance. “Imagine what could’ve been,” the seasoned physician muses, “if I had my 20s to do over, without medicine.”

“Oh, you’re here to take me to my test.”  I have heard this too many times to count, and I have come to perfect my response. “No, I am not patient transport, your social worker, or your nurse. I am your doctor.” After a moment of confusion, I usually see a facial expression signaling that the patient is reframing his or her initial thoughts. Maybe...

I recently attended the Australian and New Zealand Society of Nephrology’s (ANZSN) annual conference. I had a really good time. I had been to one of these before, when it was in Perth a few years ago, but that was way before I was accepted into the nephrology program. I remember the weekend being a whirlwind of getting out and back...

It’s that time of the year again — Halloween has passed (and with it, the best excuse for an adult to dress up in costume), and the winter holidays are just around the corner. I was in a store on November 1st, and Christmas decorations were being put up. Already. Whether or not you happen to celebrate a particular holiday...

Fall is finally here — the weather is changing, good TV shows are back on, and, for residency programs, interview season is fast approaching. That means it is time, once again, to choose the next class of interns to take the formative next step in their careers. In this process of selecting a few from many qualified applicants...

I had the fascinating experience of interviewing for residency at 20+ weeks’ pregnant. Although a number of people told me that I was doomed, I found the experience to be quite enlightening. Since I couldn’t hide the fact that life outside medicine was going to be important to me during residency, I felt empowered...

I run a clinic a couple of times a week as part of my nephrology training here at Barwon Health. I love my clinic. In addition to enjoying the longitudinal follow-up of patients and the relationships you build with them (one of the quintessential things that drew me toward physician training, and nephrology in particular...

I think you can tell a lot about how things are going in a hospital based on the amount of consumption of coffee by its employees. Visit the Starbucks, Au Bon Pain, Roasterie, Einstein Brothers, or whatever coffee shop inhabits square footage in your hospital, and I’d venture to say that you can take the pulse...

The day I met you was early in my second year of Internal Medicine residency. After much of my internship had been spent on arduous inpatient rotations, I was finally ready to lead my own team of young doctors and students on a high-acuity wards service...

Those were parting words from one of my physician mentors in medical school. I had asked him for wisdom in making the transition to residency. “In my career, I’ve seen hundreds of physicians who cannot bring themselves to say those words. They are generally the ones who get burnt out...

Well, we’re finally here. Somehow, an Aussie has sneaked onto a United States-based Chief Resident blog panel dealing with pertinent issues within medicine, and I actually have to think about what to write. (I’m being slightly facetious here, by the way.) So let’s start, shall we?

I recently completed my internal medicine residency training.  Three years, thousands of hours, thousands of patients, thousands of decisions.  I certainly learned a lot from the past 3 years: everything from what “HFrEF” means and how to manage it, to treating recurrent C. difficile colitis, to how to share decision-making...

What’s the big deal about Bitcoin and digital currency? For the past year, my husband (who has a business background) has been enthusiastically researching digital currency. Thus, the terms Bitcoin (BTC) and MaidSafeCoin (MAID) have become commonplace in my household for some time...

Why do I feel weird wearing lipstick in the hospital? Why do I have to announce myself as a doctor to gain respect from patients and other members of the hospital staff? In my short time as a physician, I have yet to find the answer to these questions, but they seem to lie in my set of XX chromosomes...

“What are we legally able to do? I don’t want to say the ‘quarantine’ word, but I guess I just said it. […] What would you advise, or are there any methods, legally, that we could do that would curtail the spread?”

During my first Cardiology fellowship interview, Dr. Schevchuck, one of the cardiologists on the admissions committee, opened the interview with the following question: “Guess how many guidelines there are in the United States?”

My dad died on May 11, 2003. It was Mothers’ Day. I was 18 years old. Those are the easy facts. The more difficult ones are those detailing the events that led to his death...

We all give up something, usually many somethings, to become doctors. It all starts with medical school where we spend hours listening to lectures, studying books, reviewing slides and reading notes... 

According to recent polling, approximately 4% of the population of the U.S. identifies as gay, lesbian, or bisexual, which equates to more than 10 million people scattered from coast to coast. In truth, this number likely underestimates the true prevalence...

I bleed blue and gold. No, I am not talking about Michigan, West Virginia, or Notre Dame. I am definitely not talking about UCLA Bruins (by the way, UCLA fans, a bruin is a brown bear). That’s right — I am a die-hard Cal Bears fan...

Hi. My name is Karmen, and I’m a fainter. It’s true. I am one of those people who occasionally falls victim (pun intended) to vasovagal syncope at its finest. It tends to happen at inopportune times and places. For example, the first time I passed out, I landed in a Christmas tree...

As I sit with one hand wrapped around a greasy diner cheeseburger, eating my feelings — I mean, my dinner — it sure feels like failure. It’s 7:22 pm, and the first patient with my name listed as the attending is being packed up to roll...

“Medicine Purple is now rounding at Room 202.” The announcement rang throughout the hallways on the lower pavilion. It was an announcement I had heard many times before, but this time it was quite different. As I glanced in the upper right hand corner of the electronic medical record of my first patient...

I began one of my PGY2 medical oncology rotations alongside my co-resident: an MD/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were “Harvard kids.” Needless to say...

Last month, as I was adjusting to my new role as a newly minted attending (affectionately referred to by many as a “pre-tending”), I had the opportunity to precept some of our strong upper levels in our ambulatory clinic. Luckily for me...

You are currently on inpatient wards and notice your chief medical resident has been demonstrating erratic behavior, frequently muttering about MEN syndromes and antibodies associated with rheumatologic diseases and has been reciting gene translocations. What is the most likely cause of her symptoms...

I will never forget Sunday morning, June 12. I was off that day. I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before. I was still half asleep when I picked up my cell phone to see what time it was...

A harsh reality I am coming to terms with, as a newly minted “pre-tending,” is that we don’t know the cost of the care we provide. There are recommendations for things like High Value Care, from organizations like the ACP. But how much do things actually cost?

As physicians, we generally attempt to separate our personal lives from our work. Some of this comes from modeling behavior of others during training, some comes with further experiences in coping with the patients we encounter...

It’s that time again — time to dust off your nicest suit and prepare for either residency or fellowship interviews. Being knee-deep in interview season for Infectious Diseases fellowships, my interview days...

This basic lifesaving medication is cheap to produce. It should not be a way to make a billion dollar profit. Should EpiPens be inexpensive and available? I say yes, and here are my reasons...

At the beginning of the year, I wrote about the rude awakening I was experiencing with regard to my own finances. I heard from more than a few other imminent or recent resident graduates who expressed some degree of similar feelings of being inadequately prepared in the financial realm.

I still remember the day I got the welcome letter from my medical school. I was super excited and proud. My dreams of becoming a physician were now a reality. So, I pushed myself during my two basic science years and awaited my clinical years...

Here are some questions that are still on my mind as I approach the tail end of my chief year. I’m thinking about the best ways to offer constructive feedback...

Living in Orlando, one cannot escape Disney. Disney movies are a delight, because one subconsciously anticipates that the happy ending is going to make up for the rest of the characters’ struggles. It works for me! Be it Simba, Cinderella, Snow White, Belle, or  Elsa...

I took my dog to the vet today. You’d think this would be a straightforward sort of thing for a medical professional. You’d be wrong.

When I woke my dog up at 5:15am (my new daily start time, as it’s apparently the only way I can find time to do board questions, and is also the excuse I use when I miss the majority of said questions), he seemed sleepy...

“May I never see in the patient anything but a fellow creature in pain.”- The Oath of Maimonides I am not immune to the post-election frenzy. Never in my relatively short life, nor in my even shorter existence on social media, have I seen people so divided. Shortly after the president-elect was named, I found myself […]

Questions for young physicians: Do you remember and recall the series of events that inspired you to become a healthcare provider? Are you satisfied with the field of medicine? Have you ever thought about your perceptions of healthcare before and after becoming a physician? Have you ever been a patient yourself? 

We had known Ms. B. for weeks. She was a “bounce-back” to the unit. Every day, an intern would enter the ICU room and ask, “How do you feel?” “OK.” Do you have any pain?” “No.” “Any trouble breathing?” “No.” “Tightness in your chest?” “No.” “No? OK.” I was the senior resident following the case, 1 […]

“Please don’t spoil the movie with your own soundtrack.” Remember hearing this message before the beginning of a movie in a theater and how most people turn their devices on silent to watch the movie? The cost of the movie ticket is considerably less than the cost of medical education, but I wonder if learners […]

I’m April, and I’m the incoming PGY-5 Chief for the Internal Medicine and Pediatrics Residency in Chapel Hill, North Carolina. Just last month, I had my 4th graduation from something since I finished high school. Residency, it turns out, is long and hard. I’ve spent tons of hours practicing the art of sphincter control each time that […]

NEJM Journal Watch is happy to welcome a new panel of Chief Resident bloggers for the 2016-2017 academic year. Here’s a sample of what our new bloggers will be discussing, starting on August 1! “Resilience” is defined as the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress. […]

“Oh no, she’s calling again.” I look at the caller ID in the Chiefs’ office where I sit with one of my co-Chiefs.  It is the Documentation Lady. Her call is as regular as BMs with C. diff: Profuse, excessive, associated with a lot of hot air and a bunch of crap, but inevitable. We play […]

Reflections and observations from my last day in Greece as part of the SAMS (Syrian American Medical Society) medical mission for Syrian refugees: 1) It rained during clinic hours. It was a bit inconvenient for the team. For the refugees, it was catastrophic. Their tents, already damaged, allow the drops of precipitation to find their ways in and soak […]

1) At one point today in the Idomini refugee camp, I was playing catch with a beautiful baby girl in between some of the tents. She could not have been much older than my own daughter and, like my daughter, would throw the ball backwards over her head instead of towards me and then would […]

1) The following are real conversations the team has had with patients/refugees in our short time here: Young lady who came in with urinary symptoms: “How old are you?” “I am 27 years old… I hope this is the last year of my life.”   Teenage male: “I have to get out of here. I’ve spent 3 months of my […]

I am participating in the SAMS (Syrian American Medical Society) medical mission in Greece. 1) Loneliness is truly the darkest consequence of this crisis. The Syrian people haven’t just been kicked out of their homes. They were stripped away from their neighborhoods, friends, and family via death, destruction, sickness, and tough decisions that they had to make about splitting […]

Note from the NEJM Journal Watch staff — Ahmad Yousaf is currently on a trip to help care for refugees in Greece. He is sending daily updates to share his thoughts; we will be posting them here daily.   The discomforts of travel are real. Stress, related to the unknown: flight times, traffic to the airport, crying babies, […]

“Be careful. He’s violent.” That was the way sign out began for Mr. T. The intern continued, “He has been in the hospital forever because he was kicked out of his nursing home. Good luck. And, oh yeah… he’s blind.” Puzzled, I looked at my list of patients and, not sure whether I should write […]

“Is he dead?” I stepped up closer. He was yellow. Bright yellow. Steve had been admitted to the hospital for altered mental status when his last PET Scan revealed that the pancreatic cancer had spread from the tail of his pancreas into his liver where it now blocked the ducts that carried the bile out of […]

The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER: 1AM: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s good, he’ll  get a cut.” 1:40AM: Patient is making inappropriate sexual comments and is verbally aggressive with medical staff. He […]

Notes from chief residents in family and internal medicine.

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from chief residents in family and internal medicine

Notes from 5 chief residents in family and internal medicine.

Notes from 5 chief residents in family and internal medicine.

Notes from 5 chief residents in family and internal medicine.