To be doctorly

That feeling of being perpetually behind? It doesn't go away. Oh, what it means to be doctorly.General Surgery/Research Resident telling the story of her journey through medicine.

[eclipperton]

the first day you really become a senior resident is when you’re admitting someone and decide not to continue antiobiotics

[cranquis]

That’s pretty accurate, actually. It takes experience, self-confidence and grit to change another doctor’s treatment plan based on your own evaluation of the patient.

EDIT to add this important comment:

Document, document, document!

[intrainingdoc]

Resident physicians should have a say in their working conditions - STAT

Residents do much of the work in teaching hospitals yet have little or no say about their working conditions and lack bargaining power to improve them.

The founder and former editor-in-chief of in-Training writes on STAT about the need for collective representation for resident physicians, unmasked by COVID-19.

[cranquis]

If you are #medblr, take 10 minutes to read this article. We need to be aware of the history of power-imbalance against resident physicians, in order to fully appreciate how the current pandemic is revealing the rotten greed and politics which opposes them. A time of reckoning is coming for the institutions and administrators who continue to treat physicians as “heroic work-mules”…

[wayfaringmd]

What Cranquis said.

[whatwecallresidency]

Me “working on research”

[tobedoctorly]

Also, me “working on research” while “working from home” 

[tobedoctorly]

Research and Writing

What a relief to finally see nine months of work finally come to fruition and ToBeDoctorly MD as the first author. I am incredibly lucky to be on research/professional development time right now and blessed to have an amazing funded research position. Mentorship, support and time can go a long way--and I remind myself daily how lucky I am. Nonetheless, writing does not come easy to me nor is it something that I feel I particularly excel it. 

This week, I have been sitting in front of the same manuscript day after day. Most days, I sit, and even though I have a vague idea of what I want to say, I have no words to put down.

Other days, I reread what I have written the previous day, or return to old drafts and find myself rewriting everything.

But what I want to say is (to you and to myself), is to never stop writing. Because after staring at the screen for many minutes and the nth iteration of the same paragraph, maybe it’s starting to sound good.

I have spent most of this time during the pandemic wrapping up projects, writing manuscripts and grants. While each project still feels like scaling a peak of unknown height, the process and writing comes easier (even though I'm still staring at this half rewritten discussion...), especially as I think about where I was in the past, writing my first first-author manuscript. With each proposal, abstract, and manuscript, comes experience and a growing confidence in my written voice (or maybe, so I think 🤔?).

And so, to aspiring surgeon/physician-scientists (and anybody who wants to do research and/or write), don’t stop writing. It takes many “terrible” first, and maybe second and even third, drafts to polish any piece of work into something terrific.

[tobedoctorly]

Watched a couple of colonoscopies this morning. For all the reservations I have about GI and poop, they were pretty cool.

[tobedoctorly]

Seven years later, I’m in the middle of a general surgery residency and disimpacting patients on the regular. Who would’ve known.

[tobedoctorly]

Soooo... it’s been a minute (more like, three years) since I’ve last used this. Does anybody still use Tumblr?

[pervocracy]

child handling for the childless nurse

My current job has me working with children, which is kind of a weird shock after years in environments where a “young” patient is 40 years old.  Here’s my impressions so far:

Birth - 1 year: Essentially a small cute animal.  Handle accordingly; gently and affectionately, but relying heavily on the caregivers and with no real expectation of cooperation.

Age 1 - 2: Hates you.  Hates you so much.  You can smile, you can coo, you can attempt to soothe; they hate you anyway, because you’re a stranger and you’re scary and you’re touching them.  There’s no winning this so just get it over with as quickly and non-traumatically as possible.

Age 3 - 5: Nervous around medical things, but possible to soothe.  Easily upset, but also easily distracted from the thing that upset them.  Smartphone cartoons and “who wants a sticker?!!?!?” are key management techniques.

Age 6 - 10: Really cool, actually.  I did not realize kids were this cool.  Around this age they tend to be fairly outgoing, and super curious and eager to learn.  Absolutely do not babytalk; instead, flatter them with how grown-up they are, teach them some Fun Gross Medical Facts, and introduce potentially frightening experiences with “hey, you want to see something really cool?”

Age 11 - 14: Extremely variable.  Can be very childish or very mature, or rapidly switch from one mode to the other.  At this point you can almost treat them as an adult, just… a really sensitive and unpredictable adult.  Do not, under any circumstances, offer stickers.  (But they might grab one out of the bin anyway.)

Age 15 - 18: Basically an adult with severely limited life experience.  Treat as an adult who needs a little extra education with their care.  Keep parents out of the room as much as possible, unless the kid wants them there.  At this point you can go ahead and offer stickers again, because they’ll probably think it’s funny.  And they’ll want one.  Deep down, everyone wants a sticker.

[tobedoctorly]

Trauma drama is real. Don’t let anyone tell you otherwise.

[telep0rt]

Did you ever find yourself jealous of your friends who took easier classes than you or we're done school for summer earlier? Even though I love what I'm taking & learning sometimes it's soooo hard to study when your friends are done with school and relaxing and living life. Thoughts?

Absolutely. I’m still jealous sometimes of my friends who have normal 9-5 M-F jobs and have like 18 cool hobbies, keep up with what’s on Netflix, just have time to chill, read the news, and post on facebook. 

That said – I wouldn’t trade what I was doing in a heartbeat. All the delayed gratification has been (and still is) worth it. 

[tobedoctorly]

All the damn time. One year down, 4-6 to go. Maybe plus two more.

[tobedoctorly]

Hi, everyone.

I haven’t logged in since I last posted about the Match. Boy, how things have changed. Here are just a few:

I still feel uncomfortable calling myself doctor

But people actually listen to me (in general, for the most part, like when they aren’t withdrawing from heroin)

And I feel slightly more competent since July ‘16

Residency is long, but passes by so quickly

Like, where did intern year go?

So many 30 hour days

Residency life is not as glorified as Grey’s Anatomy makes it seem

[tobedoctorly]

Sorry for disappearing for the past two years...

I MATCHED!!!!!

[randommomentsdevida]

The day you start residency, you are held to the same standard of care as someone who is board certified in your specialty

(via randommomentsdevida)

I’m not certain I understand or agree with this quote. Residents are not held to the same standard as boarded specialists. A resident is always working under an attending. That attending is legally responsible for all actions of that resident. Also, residents are rarely named in malpractice lawsuits (Although they often testify). The main reasons is that as a resident you are essentially always acting on behalf of your supervising attending.

(via morebaffledlessbrooklyn)

Edit:  I have written, “Once you become a resident, you are fair game for a lawsuit” which is where I think the above quote was going.

(via randommomentsdevida)

Lies. Though my attending was legally responsible for my actions, I was personally named along with another resident in a malpractice suit. And my attending’s name was dropped from the suit long before mine was. Folks, do not believe that you can’t be sued as a resident because you ABSOLUTELY CAN. I’m there now. In my lawsuit, I was expected to explain my actions before a lawyer the same way my attending was. I was asked the same questions about diagnosis and treatment guidelines in my deposition. While I may not be held personally liable for the actions disputed in the case, I was absolutely held to the same standard of care as my attending.

(via wayfaringmd)

[whitecoatsandheels]

"When things are so stressful that you think you can’t take it anymore, just remember, there are a lot of people who wished they were in your place, and for some reason or another, aren’t. Be thankful for where you are and for the challenge you’ve been given."

— the best advice I’ve gotten during med school orientation (via whatshipsarebuiltfor)

[wayfaringmd]

Hello! Can you list some of the active medblr accounts you follow/just favs in general? if you have already done so please just excuse this message :) anywho happy new year!

The medblrs I follow are:

cranquis

md-admissions

aspiringdoctors 

morebaffledlessbrooklyn

princeton-medbloro

medicalstate

docedace

radiologysigns

thedifferentialdiagnosis

intrainingdoc 

gomerblogworld 

ermedicine

incisiontime

imaresident

thebiopsy 

thenotquitedoctor

jayparkinsonmd 

descantforhope

blue-lights-and-tea

themedicalchronicles

eclipperton

beyondtheoath

digiti-minimi

ladykaymd

coffeemuggermd

medschoolmanic 

mddiaries

lifealamed

medschoolbaking

baking-bull

modernathena90

realnursing

mademoisellepremed

ohheytherehi

dashedcircles

mylifeismedschool

idomedicine 

therunningpa

pa-c

surgeonator

scrubbedout

tobedoctorly 

This is certainly not a complete list, but I can’t handle following more than 150 blogs at a time. I probably need to cut back as it is ;). But check out the spotlight for more folks you might be interested in. 

[tobedoctorly]

A little late to the party, but feeling like a cool kid! Honored to make wayfaringmd's list! Check out the amazing company :)

[tobedoctorly]

Also, the child in peds clinic who told me that I was pretty was infinitely less awkward than the old man in my family medicine clinic who proposed to me.

[tobedoctorly]

Alive!

I'm alive, just an amazing and rough but educational and wonderful six months on primary care clinical/clerkships... And dropped phone into toilet, requiring a new phone and lost tumblr password. Last shelf of the semester and calendar year in a few days, but looking forward to much reflection over the much needed break!

[girlinwhitecoat-deactivated2017]

If thirst for knowledge and ambition is the engine of science, caffeine must be it’s fuel.

My pharmacology professor on 1,3,7-trimethylxanthine importance in life of scientist. (via girlinwhitecoat)