#pgy1

[emgoesmed]

1/30/2025

Snowy mornings & busy afternoons.

[this-is-mdness]

hi, residency is v hard. im pgy-2 ob. if u need anything lmk. it really sucks but you absolutely will get thru it and at the end of the day your prelim year is only one and then you'll actually be doing what you actually wanted to do with the rest of your life. ca years will also probably b v hard, one of my buddies from med school started ca-1 this year and she also is burned out and struggling. but she is doing it, and she is getting there, and you will too <3

OMG, I totally missed this! So sorry. I haven't been very active on Tumblr the last few months...

PGY1 is almost over. I'm starting to see the light at the end of the tunnel. I know that the CA years will still be hard--but hopefully some of the struggles will not be there or if they are, at least be more familiar.

I can do this. I will do this.

Tonight I met a MS4 who didn't match into anesthesia and SOAPed into EM. I told him: "the sun rises every day, and we make it through until things get better" and "I'm a big believer in the healing power of time, and that one day you'll look around and realize you stepped out of the darkness without having realized it."

That's advice to me, too.

[cranquis]

Wanted to send you a message - I'm from another country, but wanted to match into the US healthcare system for the longest time for several reasons. Followed you for the wisecrack insights, stayed for the soul.

I've matched into my dream Anesthesiology PGY1 spot this year <3

Thank you for all that you do.

I am so excited for you, my friend and colleague! Congratulations!!! Now keep your chin up as PGY1 year does its best to smother your dreams with scutwork and stress and lack of sleep.... this too shall pass!!!

[a-young-doctors-journey]

I’ve survived trauma. I spent most of intern year nervous about this awful month… but it came and went and I’m still alive!!!

[sooconfusedsomd]

One of my med school friends committed suicide today. He was one of the smartest person I knew, in a good residency program, happily married with a family. Fuuuuuuuuuuuuuck

Idk what to think or say.

[ontrackmind]

I am one month into residency. Here are a few things I've learned (mostly about myself):

1) I am, indeed, a textbook person. I always thought I was an uptodate person, but it's just not always the best resource for peds. I have looked things up in Red Book, Lange Neonatology, Bright Futures, and AAP Peds in Review multiple times this month already. They just seem to work better for me when I have the time. Uptodate is my second choice for on-the-go reading (like when walking to morning conference)

2) organization is key. I'm not sure what system works best for me on rounds since the handoff sheet we get is completely different from what we used at my med school. (Same info, just formatted differently on the page). But, I have found having a succinct cover sheet with all of my patients only and their to-do items for the day to be way more efficient than flipping back and forth in a big packet. I'm still working out how to make the handoff page work best for me during rounds though. One thing is clear though, if you're not organized, something will be forgotten. For me, keeping lists and check boxes is key.

3) if I don't write it down, it doesn't exist. How do people remember *everything*?? If I don't write it down within 5 minutes of doing it/hearing about it/being told to do it, it's forgotten in the abyss.

4) good sleep hygiene is my BFF. I probably have co-residents with wacky schedules, but I like my routine and I have noticed I do better when I'm well rested. I typically get 6-8 hours, but in order to ensure that happens, I have a pretty consistent routine in the evenings after work and the mornings before work (especially since I don't have a yard and have to walk my dog both times). I also like feeling well rested in the morning. I'm in a better mood, less stressed, and make fewer mistakes. (Maybe this one matters more since I don't drink coffee or soda so I don't get an extra boost from the caffeine?? I've debated energy shots, but I get heart palpitations with anxiety and they freak me out. I can only imagine what extra caffeine would do)

5) I 100000% prefer to work as a team than work alone. My last block was very team oriented and I felt like I thrived. We were always asking each other how we could help and getting lunch or snacks for each other when we couldn't go together as a group. It was very much a "we all lift each other up" kind of environment. I hope that carries into my other blocks, too. I'm going to do my best to continue to be a team player and help everyone with their workload.

6) I still feel pretty dumb and unsure of myself, but the imposter syndrome is WAY less than before. Idk if it's the new environment or what, but I just don't feel that same fear of being too dumb and undeserving and being the weak link like I did during med school. Sure, I have a lot to learn and I do sometimes forget things or freeze up (for instance, I completely forgot what DI was today during rounds. Literally could not have even told my fellow my name if she had asked.lol) and while I fell a little embarrassed, it's not the same as it was before. Maybe I'm in a better mental place for now?

7) Im somehow less stressed. Like, I work hard at work and sometimes I get frustrated or get stuck, but it's not the same as being a student. I read articles and do practice questions at home but it's much more leisurely. Despite the long hours, I find this WAY more enjoyable than med school. I don't feel guilty for taking time off or enjoying my hobbies and I actually enjoy studying and looking up stuff about my patients. Residency is hard, but I am so much happier than I was before. I hope it stays this way.

8) my dog is still one of the absolutely best part of my day. She's happy when we get up in the morning and happy when I get home in the evening. She will forever be the bright, sunny spot in my day. Its a lot of work having a dog while living alone, but holy crap is she worth it❤

[humanitymed]

Adventures of a PGY1

There are a lot of things I could say about my first few weeks of residency. At times it has been extraordinarily overwhelming, exhausting, and frustrating. We are often asked to do things that convenience other people, even if it means we have to work late to make up for it. (sure, I’ll stay until 8:30pm finishing the discharge paperwork for a patient because the nursing home “needs” to get him by 10am the next day...then the transport shows up two hours late...) There have been days where I’ve been interrupted by phone calls, pages, questions, and new tasks likely over a 100 times (every 2-5 minutes I’d guess). It makes finishing the mountain of paperwork on time nearly impossible. 

And there are sad patient cases. People with pain we can find no explanation for. People with cancer eating away at their bones. People who are struggling to breathe whose lungs have been chewed away by disease.

But the most depressing cases are the COVID cases. The patient in their early 60s with hardly any comorbidities, who takes only one or two medications, gasping for air on 10L O2 because they walked to the bathroom with COVID pneumonia. The patient in their late thirties who had COVID nearly a month ago, was never hospitalized, who is now in the emergency room with terrible post-COVID lung damage.

These cases were completely preventable with the COVID vaccine, which both of these patients were eligible for several months ago in my state, but had not received. It’s disappointing, disheartening...you just want to shake them.

A note for one patient reads, “they say they’ll tell all their friends to get vaccinated now.” 

[actuallyjomd]

How I survived Intern Year in a Pandemic (and sometimes didn't)

Intern year is ending??? ... everyone was right when they said:

"The days are long and the year is short."

I still feel like it's March 2021, or maybe 2020??

All this to say, just a couple of things I hoped to reflect on. Maybe share and be helpful to others despite the fugue I'm in. Full caveat, I'm a pediatrics resident, but have some good friends in Anesthesia, Med-Peds, Emergency Medicine and will hope that this brain dump is helpful regardless of specialty.

Be an intern: When I started, I was constantly worried about the milestones I was supposed to meet, deadlines I might be forgetting, people's expectations for projects and research. DON'T DO THIS. It's time wasted. Just be an intern. Learn how to do intern things - logistics of placing orders, calling consults, writing efficient notes, being a good team member. All the other things can wait, for 6 months at least.

If you love something, pursue it: For those who have vested interests in advocacy, subspecialty, research, feel free to run hard after those things. I think the general rule for residents is you're adults now and you should be a self-starter and initiate unless you're in a dedicated program or track. And don't let anyone make you feel bad about your passion. Love NICU? Go for it! Intubate, place lines! Love Nephrology? Go for it! Spin the urine, ultrasound those kidneys! Surround yourself with the things you care about

Take care of your body: I opted for the high-deductible insurance through my residency program... mistake. I went to the doctor far more than I expected simply because I was prone to dehydration, sleep-deprivation, and therefore more little mishaps. Got my first cavity. Got super ill and started having hives. Got norovirus. Because of this I cannot stress enough, get a good health insurance package and make appointments for your doctor, your Ob/Gyn, your dentist, your ophthalmologist, your psychologist. Your health in all respects will carry you through.

Be intentional with friendships: Your schedule is not normal. Normal is working weekdays with some overtime and having weekends and government holidays off. I worked every holiday except New Years Day. To form strong friendships in a new place, don't be afraid to reach out. I was surprised by the number of friend crushes I had reciprocated in my own residency program. And the friends I have outside of residency, I have done my best to plan ahead because I want to see them. Even on nights, on the long 13 day stretches of call. These relationships create a net, a cushion, a haven so you have a community to support you

Cry when you need to: Starting residency in a pandemic in a long-distance relationship was hard. There is grief in more ways than one - plus the emotional burden of personal struggles and the hard situations we encounter in our workplace. Feelings of inadequacy, exhaustion, loneliness, they can be really overwhelming. Don't ignore how you're feeling. Find a place to process, whether its journaling, taking a mental health day if/when you can, or call someone who loves you. On the regular.

Learn from your mistakes: They come in all flavors and it's hard not to think everything is ruined. I told the wrong family one time that their child had MIS-C and even gave him IVIG before my mistake was realized. His condition actually got better, but I still remember how intensely upset I was, that it was me who caused this father to sob, that I could have caused unintended side effects. I felt awful and sometimes I still do. It's not failure though. It's a healthcare system that cannot work 100% of the time and we are growing and figuring things out within it. The best we can do is to recognize that we must stay vigilant for our patients and rely on our team to keep us accountable to growing in that direction. I appreciated my seniors and mentors who helped me grow in weeks after that.

You are more capable than you think: I was asked to do things I hadn't done in a year (or ever) with little to no supervision. People would document "MD examined" and it was me who came to do the assessment. I would take sign out from transferring EMTs, answer phone calls from outside hospital attendings about transferring patients, called to Code Blues, Rapid Responses, pronouncing the time of death and people let me call the shots. We are backed up by our amazing colleagues and seniors to become confident even when imposter syndrome is raging through our veins and we're scared out of our minds. We aren't ever going to be completely ready but we stand on the shoulders of our mentors.

This is the moment you trained for. You're going to be great.

Message me anytime and would love to have more reblogs to add to this list from my fellow now PGY-2s.