Is it common? Do you think the shift work is associated with a lot of burnout? Does your group offer student loan payment? I see mostly patients discharged from the hospital, elderly patients usually. Cookies help us deliver our Services. Received from the Robert Wood Johnson Clinical Scholars Program (SIC), Yale University, New Haven, Conn; Section of Cardiovascular Medicine, Department of Medicine (HMK), Section of Health Policy and Administration, Department of Epidemiology and Public Health (HMK), Yale‐New Haven Hospital Center for Outcomes Research and Evaluation (HMK), Yale University School … By using our Services or clicking I agree, you agree to our use of cookies. Profound changes in the practice of medicine and delivery of health care have affected the roles and responsibilities of all physicians, including trainees and their teachers. 109. 68.2k I still enjoyed learning about medicine in preclinical years. Agreed. At this point I'm learning towards doing IM but I sometimes can't help but feel like I'm making a terrible mistake. For many medical trainees, transitioning from having a question for a research project to taking the next steps is difficult. Thank you so much for the writeup! Locations . Setting: Internal medicine residency program at a university-affiliated public teaching hospital. Attending physicians may also still be in training, such as a fellow in a subspecialty. Can do either primarily inpatient or only outpatient or a mix of both. So while dealing with the ED (usually 4-8 patients), they also have to deal with any emergencies with the admits. OBJECTIVE: To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. 1 At most academic hospitals today, attending physicians’ responsibilities extend far beyond the teaching of clinical medicine to residents and students. It really all depends on oneself; how much you want to work and how much you want to make. The work is usually interesting, hours are much more defined, no struggles with preauthorization, pay is better. The medicine consult service provides several services including preoperative medical evaluations, How do you show your commitment to medicine? -reallyyyy hated rounds, the note writing and the daily grind but maybe if I got used to it and more efficient it wouldn't be as bad? Do you think you have enough time per visit to address each patient's issues? Plenty of IM attendings don't even do bedside rounds. Before calling, consider how the consultant may change your management. I think everyone's having issues with mid-level encroachment now. Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through training! In your opinion what has been the best and worst part of IM residency? Can do either primarily inpatient or only outpatient or a mix of both. IM residents at my institution worked 6 days a week. This is a subreddit specifically for interns and residents to get together and discuss issues concerning their training and medicine/surgery. I appreciate any advice you guys might have! That all said, which 3rd year clerkship or rotation was your favorite? Seconding everyone who's suggested rads. (h) second- or third-year internal medicine residents or Design: Analysis of 731 evaluations of 99 attending physicians over a 1-year period. 112. Our county-level hospital's community EDs did not have an internist overnight. Monday evening, I am the primary medical attending at a teaching clinic where medical and pharmacy students see patients in teams as part of the medical students' introduction to clinical medicine. I see about 16-17 per day. Physicians specializing in internal medicine are called internists, or physicians (without a modifier) in Commonwealth nations. (Info / ^Contact), New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. That's a shitty lifestyle to be working at something you don't really like all that much in the first place. OBJECTIVE: To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. Welcome to /r/MedicalSchool: An international community for medical students. Tell me some of your successes? I'm also finishing up my MBBS at the moment and considering IM as a specialty. At my hospital, there is always 3 internists working at night, with 24 hour coverage from internists. Anything else and I think I could make it work. It's literally just you doing whatever you want so long as you can get patients discharged on time. Eventually gave that up and just practice hospital medicine now. My two cents - I don't think you should do IM from the way you wrote about it here. Haven’t met a physiatrist attending or resident who regrets going into it. According to Wikipedia, “Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. What is the most rewarding thing you have ever done? The type of insurance that your patient has can affect availability of referrals to specialty care, including psychiatric care. It draws the best and brightest.” -- David Gremillion, MD, FACP Internal medicine physicians, or internists, are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate They can have long hours during residency and call can be brutal. I don't really have time to address all issues for the patients; since I'm not really a PCP, I generally just have time to address the issues they were previously hospitalized for and related conditions. They like teamwork, solving complicated problems, and direct patient care. 29-1216.00 - General Internal Medicine Physicians. An Inern (1st year of residency/PgY1)- this person is the bottom of the pyramid in a medical team. What is the worst thing that has ever happened to you? I'm a bot, bleep, bloop. attending physician. A lot of ED doctors have complained about this. Most of the great leaders in medicine in general have come from internal medicine because of the breadth and depth of its academic and clinical work. how many patients do you typically see per day? Carlos Moreno, M.D. For example, a cardiology fellow may function as an internal medicine attending, as he or she has already finished residency in internal medicine. Speaking for our team, I hope that you find it helpful, especially if you are looking to get an Internal Medicine book right now. If the resources are available, 24 hour internist coverage is definitely optimal. 116. Do you want to explore any other fields? They exist. Reddit; Abstract. Personally, I was looking for a good work life balance, and just wanted to work the typical 40-45 hours a week. Do you wish you had specialized? What is the most pressing problem in medicine today? On inpatient rehab you are technically the primary and need a good foundation in medicine. Great lifestyle and balance. Is it normal for an upper level with only 1 month of ICU experience as an intern to work an ICU alone (20 beds) with no fellows or in house staff. Press question mark to learn the rest of the keyboard shortcuts. Thanks for the write up! Not sure why anyone would want to do this for the rest of their lives. Beneath them is the supervising resident, a physician in the advanced stages of their training. What are your feelings about this situation? Usually this is accomplished by rotating through various inpatient services and outpatient clinics throughout the 3-year residency. Clinical symptoms were studied in 69 consecutive patients below the age of 40 years who were attending the emergency unit because of unexplained chest pain. She earned her medical degree from Texas A&M Health Sciences Center, and thereafter completed residency at Florida Atlantic University’s program in Boca Raton, Florida. It's much better even if hours are long. Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through training! At least with the IM people I've met, it seems that medicine is their life. I'm a 'work to live' type of person and want medicine to be just a job. Provide care mainly for adults and adolescents, and are based primarily in an outpatient care setting. The overnight ED doc would get the patients on signout from 7p to 7a. Diagnose and provide nonsurgical treatment for a wide range of diseases and injuries of internal organ systems. 110. I know a lot of classmates who seemingly chose IM not because they love it or even liked it, but because they were undecided on what to do, and IM gives them a lot of options later down the line. I'm doing a year of IM before Anesthesia and while I love my coworkers, the bs we put up with from patients and other specialties SUCKS. Residency sucks in general, no matter which specialty you go into. Press J to jump to the feed. This is a subreddit specifically for interns and residents to get together and discuss issues concerning their training and medicine/surgery. During the three week block, both residents are present for the first week, and then one resident each is present for the subsequent two weeks of the rotation. Inpatient Medicine General Comments: ... At the top of the pyramid is the attending physician, a staff doctor who has ultimate responsibility for the patient. The term is used more commonly in teaching hospitals. Press question mark to learn the rest of the keyboard shortcuts. 111. How is midlevel encroachment at your hospital? It's normal to not enjoy 3rd year, so don't let that fact weigh down on you too much. Abstract. I have been practicing in internal medicine for 4 years now and I want to go back and train in dermatology. -broad training and knowledge base; I still enjoyed learning about medicine in preclinical years and I feel like IM will give me the skillset I want (diagnosis/treatment/management in adult patients), -lots of fellowship opportunities so I can postpone my life decisions, -tons of variety in terms of inpatient vs outpatient, procedures vs not, etc and you can make your lifestyle how you want it after residency, -generally nice/cool people (at least on my rotations). M4 here trying to make/solidify last minute decision on what to apply to. I can't imagine being happy doing IM, FM, Peds, or EM. 77.1k What would be your opinion on working as a hospitalist after residency (7 on 7 off)? internal medicine attending. At this point I'm learning towards doing IM but I sometimes can't help but feel like I'm making a terrible mistake. They exist. Our Internal Medicine Residency program is committed to excellence, lifelong learning, and caring for our community. Reasons why I feel like I'm making a huge mistake: -I'm just not really excited about the idea of going into IM as much some of my colleagues are. Participants: All medical residents (N= 145) and internal medicine attending physicians … I was psych all the way, then somehow ended up considering med/psych, but my current med attending has banished such a silly idea from my head. Great lifestyle and balance. Reddit; Wechat; Abstract. Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through training! Finding an appropriate mentor, getting ethics approval, collecting data, performing analyses, and writing up a project for publication are particularly hard when added to the pressures and stresses of medical school or residency. Yea, probably worse than FM/Psych, but way better than gen surg/ortho, right? Some of these books are core Internal Medicine textbooks for your library while others are great as a resource while on the go. Doesn't seem like the right fit. Lol at IM having a terrible lifestyle in residency. ... the care with your attending, there is little use in calling for a consult. Duh. Be confident:Speak clearly at the loudest volume appropriate to protect patient … This is a subreddit specifically for interns and residents to get together and discuss issues concerning their training and medicine/surgery. Biography. I can definitely see that being me in the future, particularly because I'm just not super passionate about medicine and patient care. As the presenter, you should strive to deliver an interesting presentation that keeps your team members engaged. The type of insurance that your patient has can affect availability of referrals to … Some of the IM fellowships were pretty happy but some of those were also pretty competitive, which is another thing to consider. Do you fear that NP's/PA's will occasionally creep into more shifts? If anything, I would have specialized in hematology, just because I think the cases are very interesting. Welcome to /r/MedicalSchool: An international community for medical students. How far you want to blend your life with your profession. Plus its four years which is tough if you are already burnt out. Thank you for your interest in the Internal Medicine Residency Program at Mount Sinai Medical Center. Take a look at PM&R. No, I like my job a lot as it is. Press J to jump to the feed. 115. internal medicine subinternship directors across the country, most of whom have spent many years teaching, evaluating, and advising students. Just ask the LSW if we have a bed offer yet and walk away. Find an IM program with a good lifestyle. As the largest private, independent, not-for-profit teaching hospital in South Florida, our 672-bed facility delivers the most advanced and highest quality care in the region. Oral case presentations are generally made to a medical care team, which can be composed of medical and pharmacy students, residents, pharmacists, medical attendings, and others. Someone has linked to this thread from another place on reddit: If you follow any of the above links, please respect the rules of reddit and don't vote in the other threads. I would say it's better to have an internist, but an emergency room doctor should be able to deal with the emergencies from admitted patients for the most part. You never have to round as an attending in PP if you don't want to. About Community Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through training! Family Medicine Number of categorical programs applied to 27.7 11.9 Honors Received: Anesthesia FCM Internal Medicine Neurology Obstetrics/Gynecology Pediatrics Psychiatry Surgery 20 20 29 23 21 16 23 17 43.5% 43.5% 63.0% 50.0% 45.7% 34.8% 50.0% 37.0% *Match Cohort includes applicants who matched into this specialty via the regular match process. Haven’t met a physiatrist attending or resident who regrets going into it. Not that bad right now, as they have not been super widely accepted in my state. Corresponding Author. tl;dr I'm thinking IM because I'm incapable of making decisions and don't want to specialize too soon, but I've seen too many scary posts about how IM residents are so burnt out. On inpatient rehab you are technically the Personally, I wouldn't do this unless you at least liked IM decently well vs other clerkships. I have thought about it but never really pursued either of them further just because histo and imaging were never things I was interested in. Did you have any leaning or feeling? If a consultant would add to the case, then GI could have been nice as well for procedures, but overall, I'm happy with just internal medicine. 64.2k On inpatient rehab you are technically the primary and need a good foundation in medicine. I'm a current MS3 who hated third year and still doesn't know what to do. You just want to get something out as quickly as possible to help you get into a fellowship. Especially night call ones? In those unusual circumstances when an attending physician or subspecialty resident writes an order on a resident’s patient, the attending or subspecialty resident must communicate his or her action to the resident in a timely manner;(Core) I.A.2.h).(6). A lot of people are happy with 7 on 7 off and take a lot of vacations! Take a look at PM&R. Analia Castiglioni, Richard M. Shewchuk, Lisa L. Willett, Gustavo R. Heudebert and Robert M. Centor, A Pilot Study Using Nominal Group Technique to Assess Residents’ Perceptions of Successful Attending Rounds, Journal of General Internal Medicine, 23, 7, (1060), (2008). Tell me some of your failures? New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. -not really interested in any of the subspecialties currently, -god i just hated third year and I don't want to be this depressed during residency too. 113. I'm not violating the shit out of my work hour restrictions to have you disrespect my poor lifestyle choices! 114. Who is the most influential in your life? Reddit; Abstract. You do medicine without the social work and notes. ]At most places, internal medicine training is hospital focused with ambulatory training somewhat tacked on. 3rd year a grind fest and not necessarily an indication of how happy you'd be in that field as a doctor, though it can give you some idea. More like IM residents THINK they have a bad lifestyle. No, I think they might for nurses, but not for doctors. This is a subreddit specifically for interns and residents to get together and discuss issues concerning their training and medicine/surgery. Internal medicine resident here and I just have a question for anyone else who may rotate through ICU in their programs. Here are a few things to keep in mind: 1. General IM is consistently at the bottom of a lot of physician happiness/satisfaction reports that I've seen, so that take that for what you will. Every rads resident on reddit seems ridiculously happy though. Basically punting on a career decision for now, like you mentioned in your OP. I began my career practicing traditional Internal Medicine: primary care and consults, manage patients in hospital as well. Dr. Stephanie Lucas is a board-certified Internal Medicine physician faculty member at Parkview Adult Medicine Clinic.