Anyone else feeling stupid yet?

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saintsfan180

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1 month into internship and I feel like I lack the basic knowledge of a 3rd year medical student. It's like as soon as I finished Step 2 my brain just dumped everything and no matter how much I study I can't get it back. I feel like all of my co-interns are way smarter than me and that my program is going to find out I'm a raging idiot and fire me. Am I the only one?

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1 month into internship and I feel like I lack the basic knowledge of a 3rd year medical student. It's like as soon as I finished Step 2 my brain just dumped everything and no matter how much I study I can't get it back. I feel like all of my co-interns are way smarter than me and that my program is going to find out I'm a raging idiot and fire me. Am I the only one?

I'm right there with you.
 
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1 month into internship and I feel like I lack the basic knowledge of a 3rd year medical student. It's like as soon as I finished Step 2 my brain just dumped everything and no matter how much I study I can't get it back. I feel like all of my co-interns are way smarter than me and that my program is going to find out I'm a raging idiot and fire me. Am I the only one?

I'll let you know next week when I start General Wards. Ambulatory these past few weeks just makes me feel like a 5th year medical student.
 
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I'll let you know next week when I start General Wards. Ambulatory these past few weeks just makes me feel like a 5th year medical student.

I'm with you too. I'm seeing clinic and I currently need to check out every single patient to the attending, who then repeats my history and physical in its entirety to make sure I did it right. This is supposed to go away at the end of the month, but in the mean time I look like a fraud at the end of every exam when I say "I need to go get my boss". With the complicated patients I can play it off as consulting with a colleage about their condition, but WTF do I say when I'm just doing a well child exam? Or even better, when the person I'm checking out to is the NP? 'I'm your doctor, but I need to go grab the nurse to double check my work'.

Its no one's fault or anything, I'd probably design the system the same way, but the situation kind of sucks.
 
No one trusts me with anything right now. But I'm sure it'll change with time. It's only been a couple weeks, and every couple days I notice my seniors give me a little more and more independence.
 
Its different with your name on the order. Simple stuff has to be checked and double checked. Should you give 1 mg Mg or 2? IV or PO? Does it matter? Wait, you ordered him for a cardiac diet not a renal diet? Why? Does he need a CXR in the morning or not? How frequently do you need a liver panal? CMP or BMP? on and on it goes...

Its not that you forgot anything, its just that now instead of watching someone else screw up and "learning" from their mistake as a medical student, you're now in the position of the intern and screwing up is part of our job description.
 
Yes I hate the double checking thing. I'll go give a history to the attending and he'll go in there and not just clarify but redo the entire thing while I watch like a jerk. I know it's probably not just me, I mean, I did ask those questions. Sometimes I wonder if they listen at all to your presentation. It just makes you look like a complete ***** in front of the patient. But I guess it's their job to make sure you weren't just lying and making up answers to the question, I don't really know.

And what is it with patients telling the attending way more? Maybe it's just that they remember more of their story after I go in, but I can ask the same damn question and they'll tell the attending the most clear and succinct answer when they gave me some vague bull****.
 
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And what is it with patients telling the attending way more? Maybe it's just that they remember more of their story after I go in, but I can ask the same damn question and they'll tell the attending the most clear and succinct answer when they gave me some vague bull****.

Get used to it. I think it's a combination of hearing the question a 2nd (or 3rd or 4th) time and having time to think about, together with the fact that the attendings are just better at this than you are.
 
Its different with your name on the order. Simple stuff has to be checked and double checked. Should you give 1 mg Mg or 2? IV or PO? Does it matter? Wait, you ordered him for a cardiac diet not a renal diet? Why? Does he need a CXR in the morning or not? How frequently do you need a liver panal? CMP or BMP? on and on it goes...

Haha...yup. I tend to err on the conservative side, but do give IV over PO if possible for better bioavailability. Diets matter long term, not acutely (in general) so doesn't matter much inpt. Labs...just order more comprehensively and more often if you're unsure. Imaging can be more dicey and I haven't gotten a good feel for that yet.
 
Imaging can be more dicey and I haven't gotten a good feel for that yet.

Which is hilarious since next year you'll be calling people to yell at them about the studies they do/don't order. Hopefully you'll remember this when the time comes around.
 
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Haha...yup. I tend to err on the conservative side, but do give IV over PO if possible for better bioavailability. Diets matter long term, not acutely (in general) so doesn't matter much inpt. Labs...just order more comprehensively and more often if you're unsure. Imaging can be more dicey and I haven't gotten a good feel for that yet.

Agreed. My hospital is all about saving money so they are super particular about justifying labs and imaging studies. We can't have a " everything and the kitchen sink" mentality when we work up patients. :thumbdown:
 
1 month into internship and I feel like I lack the basic knowledge of a 3rd year medical student. It's like as soon as I finished Step 2 my brain just dumped everything and no matter how much I study I can't get it back. I feel like all of my co-interns are way smarter than me and that my program is going to find out I'm a raging idiot and fire me. Am I the only one?

I feel pretty god dam stupid most of the time - in comparison to my peers. I keep telling myself that if none of my attendings are sitting me down for a talk about my deficiencies then i'm probably doing ok. But I'm an anesthesia transitional and on any given rotation I'm generally with a bunch of people who are actually going into that field, and seem to me obviously better prepared.

I too have a nagging feeling that i'm going to get found out and fired.
 
I've felt the same way since I started too-it gets frustrating because you feel like you should be at the same level some of your co-interns are at already
 
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Its different with your name on the order. Simple stuff has to be checked and double checked. Should you give 1 mg Mg or 2? IV or PO? Does it matter? Wait, you ordered him for a cardiac diet not a renal diet? Why? Does he need a CXR in the morning or not? How frequently do you need a liver panal? CMP or BMP? on and on it goes...

Its not that you forgot anything, its just that now instead of watching someone else screw up and "learning" from their mistake as a medical student, you're now in the position of the intern and screwing up is part of our job description.

I think 1 mg of Mg may be a bit too conservative. :p

Anyone have a good cheat sheet for lyte repletion?
 
Which is hilarious since next year you'll be calling people to yell at them about the studies they do/don't order. Hopefully you'll remember this when the time comes around.

Communication between med and rads tends to suck. It goes both ways a bit, but will definitely keep it in mind.
 
To this year's class:

Let me assure you that feeling this way is completely normal. I feel there are 4 stages to intern year:

1. Dear God, how did I have the hubris to think I could do this?
2. Intern job description: show up and make mistakes
3. Depression
4. Wait, the nurse just ask me for an order and didn't question me? (this happens when the new class arrive in July 2013)

Know that you're upper level residents have been through this. Talk to us. No question is too stupid. If you're having a hard time, let us know. This training is tough, but its what makes US doctors the best in the world. And as long as your uppers aren't complete jerks, they remember what intern year was like for them as well. Not that it's all amazingly better second year, but it still is better.

Final words:
In the land of SDN where MCAT, Step scores, and GPAs are outrageously inflated, there has yet to be anyone who says intern year was easy and they didn't feel stupid. That alone should tell you something.
 
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glad to have this little support group.

I'm on a consult service (cards), and though the hours are so much better than wards, I just feel so lost/stupid...and I thought I wanted to go into cardiology! Just hate feeling sub-par.
 
Well, I've been on for about 3 days and I feel like a complete idiot. Questions that I could have answered easily a months ago now just leave me with a blank expression on my face. Most of the time I feel slow and rushed. There hasn't been a day so far that I haven't thought about quitting. I had all these thoughts of fellowship, etc, but now I'll be happy to finish intern year. Luckily, I get my work done and haven't dropped the ball. I'm sure part of it is just that it's new and my high expectations of myself, but it's definitely bummed me out. I just mainly try to keep my head down and get my work done. Sigh.....4 more weeks.
 
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glad to have this little support group.

I'm on a consult service (cards), and though the hours are so much better than wards, I just feel so lost/stupid...and I thought I wanted to go into cardiology! Just hate feeling sub-par.

I wish I had a real support group. I don't have a single Inpatient month where I'm on with another Intern from my program. Everyone I see during my day is one of my various and sundry bosses (plus or minus a medical student). I have to save my complaints for the Internet.
 
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I wish I had a real support group. I don't have a single Inpatient month where I'm on with another Intern from my program. Everyone I see during my day is one of my various and sundry bosses (plus or minus a medical student). I have to save my complaints for the Internet.

Really?

You don't have a resident or a single co-intern?

How many patients are you covering?
 
Sorry Perrotfish, I'm feeling that now. I'm on medicine wards and at one of the other hospitals in our network, so not only am I with a bunch of people from another service, I'm not even at the same hospital as my ER buddies! I'm feeling so isolated and exhausted by this inpatient medicine. And discharge summaries are the worst! I'm so glad this is my last month to do this!
 
I'm feeling right there with you guys. On my 3rd day of Wards now coming off of outpatient clinic and since I am a prelim and just started, I had no pts and was just shadowing like a med student again last month. Feeling extra ******ed now since my IM co-intern, is on his 2nd month of wards and is completely schooling me. How did I forget so much medicine! I keep having recurrent nightmares of quitting or getting fired. ......Can't wait for prelim yr to end already!!!
 
I've gone through 5 days so far and each day I feel like quitting. I'm sure I can't be the only one. Are there any upper level seniors out there that also had this feeling or know someone else who had this feeling? What did you (or they) eventually do? Does it actually get better or do you know of someone who really quit. I'm a categorical Medicine intern, but if I remember correctly, my contract is really for one year and then gets renewed. Honestly debating whether I want to continue this.
 
I've gone through 5 days so far and each day I feel like quitting. I'm sure I can't be the only one. Are there any upper level seniors out there that also had this feeling or know someone else who had this feeling? What did you (or they) eventually do? Does it actually get better or do you know of someone who really quit. I'm a categorical Medicine intern, but if I remember correctly, my contract is really for one year and then gets renewed. Honestly debating whether I want to continue this.

You don't want to quit. You don't hate the job, you just hate being bad at it, and that gets better. We all feel the way you do right now. Everyone in my program has shared morbid fantasies of quitting and morbid fearr of getting fired. Every second year has told us they felt the same way. This is just a bad stretch.
 
I feel stupid only everyday, I feel like I don't remember anything from med school...it sucks.
 
For me, I have days where I feel like I've totally got the hang of it.

Then I have days where I feel like a complete idiot and want to bury my head in the sand.

I'm hoping for more of the former, less of the latter as the year goes on.
 
I'm really glad for this support group too, because my intern class isn't cohesive enough or able to hang out often enough to provide much of a sounding board for commiseration. I'm usually one of the lurkers on these forums but just had to respond to this one. I've been having really crappy feelings since residency started where I want to quit or change fields. It got to the point where I even got in touch with a former clerkship director to explore if it was even feasible. After seeking advice from some of my former med school's faculty members, I'm more at peace with these feelings. We're all coming from an environment where people knew us, we were 'top dog' as fourth year students, and we all have type A personalities and want to be the best at what we do. To be thrust suddenly into a new environment where nobody knows us, we're completely incompetent, and we're at the bottom of the totem pole again - it's natural to feel so damn sh*tty.

And boy do I totally identify with the feeling that I am not up to par with my co-interns. Everybody else seems to be more well adjusted, more enthusiastic about the field, and remember more from med school than I do. The best advice from a faculty member I got recently was, "That's all bullsh*t. We don't expect you to even know where the bathroom is for the first 6 months." I'm going to make a conscious effort to stop comparing myself to other people. It is such a dangerous thing to do. It makes you feel even MORE inadequate than you're feeling normally from being an intern.

In summary, let's keep commiserating here and being honest. We may need to put on a brave face during work but I, like some of you, don't have much of a support system yet in my immediate vicinity. This will have to do for now.
 
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I'm really glad for this support group too, because my intern class isn't cohesive enough or able to hang out often enough to provide much of a sounding board for commiseration. I'm usually one of the lurkers on these forums but just had to respond to this one. I've been having really crappy feelings since residency started where I want to quit or change fields. It got to the point where I even got in touch with a former clerkship director to explore if it was even feasible. After seeking advice from some of my former med school's faculty members, I'm more at peace with these feelings. We're all coming from an environment where people knew us, we were 'top dog' as fourth year students, and we all have type A personalities and want to be the best at what we do. To be thrust suddenly into a new environment where nobody knows us, we're completely incompetent, and we're at the bottom of the totem pole again - it's natural to feel so damn sh*tty.

And boy do I totally identify with the feeling that I am not up to par with my co-interns. Everybody else seems to be more well adjusted, more enthusiastic about the field, and remember more from med school than I do. The best advice from a faculty member I got recently was, "That's all bullsh*t. We don't expect you to even know where the bathroom is for the first 6 months." I'm going to make a conscious effort to stop comparing myself to other people. It is such a dangerous thing to do. It makes you feel even MORE inadequate than you're feeling normally from being an intern.

In summary, let's keep commiserating here and being honest. We may need to put on a brave face during work but I, like some of you, don't have much of a support system yet in my immediate vicinity. This will have to do for now.

Wow, this post sounds like it came straight from my mind. I share your thoughts perfectly. Another thing I've found myself doing is if an admission is toward the end of the day, and with my luck, my last three admissions have all been within 5-7 minutes before our "cut-off" time for that day. That just really makes me feel like quitting. I'm tired, I was hoping to go home, and now I have to deal with a patient interview, doing a half-assed presentation for my Attending (sometimes; other times I do a better presentation the next morning), putting in orders, writing my H&P, checking back on the patient, ordering more things if necessary, and finally updating sign-out and signing out. During these instances, I don't mind doing the interview and doing the physical exam, but I actually pray that my senior just tells me what to order and what to do. I'm so tired and I can't think straight by that time. I don't want to get pimped and I don't want to spend another 30 minutes going on uptodate or my pocketbooks to figure out what to order. I just want to tuck the patient in and sign out so I can get home at a reasonable time. Sigh.....at least I have off tomorrow.
 
I have two surgery services back to back. Took vacation smack dab in the middle of them! The resident on the first one was nice, but I could tell when I screwed things up or didn't know something it would annoy her. Still, she was nice about it. Then there were times she'd ask something and I'd be unsure of what to say or being too vague.

Here's what I've learned: 1) When you don't know, you don't know. 2) If the damn cell phone isn't working, ask them to repeat things. 3) Ask - that's why they're there. 4) Stupid mistakes will happen and there's nothing you can do about it.

From what I gather, they're trying to see if you can improve rather than be a master. If you show up every day, do a 'good' job, don't kill anyone, and learn something in the process, you're doing well.

One thing I really got hammered on was my assessment/plan writing and I think I've really become a lot better at writing them from even a surgical perspective despite being in a medicine track.

I still suck at codes. There are still things I don't know. There are things I didn't learn in medical school that I'm expected to. There is magical knowledge that will diffuse its way into my brain as time goes on. Just hang in there friends.

I doubt anyone who shows up, tries, does a decent attempt/job, and doesn't bitch too much fails. They've all been there. It's what, week 6 for most of us? Keep at it...
 
Yes, I think showing up and working hard is key. I'm on medicine wards right now and it is NOT my cup of tea, but I've made a promise to myself that I'll have a good attitude every day and work really hard while I'm there because I hate it so much. Kind of a reaction formation lol. It's nice to hear that other people feel the same way though. I can't bitch at work so it's nice to have somewhere to vent.
 
Hey, I'm feeling the same way. I feel at times that I remember absolutely nothing from med school and like most of you have said, thought one day I'll be called out as a fraud. So glad that I am not the only one feeling this way. So glad that I found this forum, totally lifted my spirits. Will definitely refer to it when I'm feeling low. Prayer, at least for me personally will also be very crucial to get through this depressing year. I definitely believe in hard work paying off, and I just hope my seniors can see the work I'm trying to put in daily.
 
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Almost every senior out there has felt totally inadequate at some time or another. Most have felt like total *****s, idiots, and incapable of doing even the simplest of tasks when they started. No one starts like a rock star that knows it all.

And, believe it or not, many of your seniors still feel like idiots at times. We are all continuing to learn, adapt, improvise, research. You just get better at it as a senior and you build on the experiences of your intern year.

I am in my final year of residency. I already signed a contract for work... and I am hoping I am up to the task. The residents who taught me and my attendings all think I'm more than ready. It is nice to know my fellow residents and those who were above me all felt the same way... nervous and in some cases downright scared. Even those who have gone on to fellowship are nervous, worried about their performance, hoping they are minimally competent but prepared to look like a bumbling buffoon for a little while until they get their feet under them.

Relax. Continue to work hard, learn from your mistakes, ask questions, and improve. That is all you can do and all that is asked of you. If, however, you continue to make the same mistakes all the time, endanger patients' lives, continually get in over your head without asking for help... then you are in trouble.
 
Agree with everyone above. We all went through exactly the same thing. It's a crappy year (particularly the first few months). Set your calendars, somewhere around January 2013 you'll suddenly realize that you're pretty competent at Intern-level work. It's a pretty awesome feeling!

I can almost guarantee that no one here will get fired. The people that are nervous and scared right now and feel incompetent are the ones that actually care and don't want to hurt anyone. The ones that are skating by and don't care are the ones that hurt people. Oh, and don't let alcohol affect your job performance, that gets people fired too...

One more thing, when you're doing subspecialty rotations (like Cards if you're medicine), you have to constantly remind yourself that the staff you're working with did an Intern year (like the one you're just starting), a residency, a fellowship in that specialty, and likely has been practicing for a while now. Of course they're in a different league from you! In my opinion, the best mindset to have during subspecialty rotations is "Later on, if I have a patient on the wards or in clinic with this complaint, how much should I work up on my own vs. when to refer to the specialist."
 
EVERY doctor out there was at your level at some point...some when they were 3rd year med students (smart ones) & some when they were 3rd year residents, (not so smart ones) yet they all became full fledged docs

Just make sure you read up on your patients everyday
Download the "Review" articles from NEJM on the topics which are excellent review & cover a lot of the Qs that the attending will likely pimp you on
Read MKSAP

Good Luck
 
Keep having to remember I'm a doctor now. Feels like a farce and someone will find out and turn me in any minute now.
 
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What I hate most about intern year is feeling stupid literally most of the time. Second guessing yourself when you think you know something and oh feeling ******ed when the patient says exactly opposite of what he said to you when your attending asks them.
Hoping this will turn around. Either I better get smarter or I'm in constant fear of getting kicked out.
 
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I am a ******ed 4th year medical student and doing IM-prelim starting July 2017 before moving to my advanced radiology program. Is there any value to studying before intern year begins. I have started a single pass through Pocket Medicine but feel as if its just making me even more ******ed. Am I going to be fed to the sharks?
 
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I am a ******ed 4th year medical student and doing IM-prelim starting July 2017 before moving to my advanced radiology program. Is there any value to studying before intern year begins. I have started a single pass through Pocket Medicine but feel as if its just making me even more ******ed. Am I going to be fed to the sharks?

You're a prelim IM going into Radiology. As long as you read up on your patients as they don't come and don't kill anybody you'll be fine.
 
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The only science course I took as an undergrad was Bio101. I found this forum looking for information on the way the intern/resident situation was set up 50 years ago, my thread was closed.
Yet this thread has numerous future doctors using the word "******ed" to refer to their feelings of incompetence and remains open.
First, that word is a medical term, referring to people with subpar I.Q., usually under 80. I would imagine that was taught in some undergrad class. It is socially unacceptable to use it towards a mentally competent person who feels incompetent or makes a mistake. This group should know that more so than any other.
Second, what did you think it was going to be like to be a "real" doctor? Did you think people were going to be coming in with textbook symptoms?: "I have a fever of 102 and severe pain by my right hip", " I'm a 60 year old man, I was shoveling my walkway and now I have a shooting pain up my left arm"
Of course you have to learn by doing, luckily most of the mistakes you make will be minor.
This is an old thread, but so many of you feel the same and repeat the word. This contribution will probably be taken down, I hope a few people get to see it. Don't use the word ******ed as a derogatory reference, even if it's towards yourself, learn as much as you can now, and don't for one minute think there will ever be a day when you have ALL the answers, because ask any doctor who is about to retire, that day will never come, the human body and brain are too complicated for any one person to master in their lifetime.
 
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The only science course I took as an undergrad was Bio101. I found this forum looking for information on the way the intern/resident situation was set up 50 years ago, my thread was closed.
Yet this thread has numerous future doctors using the word "******ed" to refer to their feelings of incompetence and remains open.
First, that word is a medical term, referring to people with subpar I.Q., usually under 80. I would imagine that was taught in some undergrad class. It is socially unacceptable to use it towards a mentally competent person who feels incompetent or makes a mistake. This group should know that more so than any other.
Second, what did you think it was going to be like to be a "real" doctor? Did you think people were going to be coming in with textbook symptoms?: "I have a fever of 102 and severe pain by my right hip", " I'm a 60 year old man, I was shoveling my walkway and now I have a shooting pain up my left arm"
Of course you have to learn by doing, luckily most of the mistakes you make will be minor.
This is an old thread, but so many of you feel the same and repeat the word. This contribution will probably be taken down, I hope a few people get to see it. Don't use the word ******ed as a derogatory reference, even if it's towards yourself, learn as much as you can now, and don't for one minute think there will ever be a day when you have ALL the answers, because ask any doctor who is about to retire, that day will never come, the human body and brain are too complicated for any one person to master in their lifetime.

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The only science course I took as an undergrad was Bio101. I found this forum looking for information on the way the intern/resident situation was set up 50 years ago, my thread was closed.
Yet this thread has numerous future doctors using the word "******ed" to refer to their feelings of incompetence and remains open.
First, that word is a medical term, referring to people with subpar I.Q., usually under 80. I would imagine that was taught in some undergrad class. It is socially unacceptable to use it towards a mentally competent person who feels incompetent or makes a mistake. This group should know that more so than any other.
Second, what did you think it was going to be like to be a "real" doctor? Did you think people were going to be coming in with textbook symptoms?: "I have a fever of 102 and severe pain by my right hip", " I'm a 60 year old man, I was shoveling my walkway and now I have a shooting pain up my left arm"
Of course you have to learn by doing, luckily most of the mistakes you make will be minor.
This is an old thread, but so many of you feel the same and repeat the word. This contribution will probably be taken down, I hope a few people get to see it. Don't use the word ******ed as a derogatory reference, even if it's towards yourself, learn as much as you can now, and don't for one minute think there will ever be a day when you have ALL the answers, because ask any doctor who is about to retire, that day will never come, the human body and brain are too complicated for any one person to master in their lifetime.

That's only in certain circles. I can think of more than one situation where jesting such as this is the norm. Actually, in certain US military circles with which I am familiar there used to be a saying, "Hire the handicapped. They're fun to watch." and other such "gems". As with anything else in life -- free speech is protected by the First Amendment in this country and if someone is offended, all they have to do is change the station/channel on the radio/TV, walk away from the conversation or just don't go to the forum. Whether or not the person chooses to express their sentiment regarding whether or not something is socially unacceptable is up to them.

Now, I agree that using common terms in a derogatory sense -- which by the way causes me to wonder if it would be socially unacceptable to say that someone suffers from supratentoral insuffiency when used in reference to others or themselves but I digress -- towards oneself can, over time, have lasting effects but that's an individual choice.....
 
Argue all you want about PC or free speech
My point was I asked a legitimate question, that was locked, but the moderator here sees fit to leave up a slur that everyone on this forum should know not to use. It's not as if this were a forum for Attorneys or Golf Pros.

A term that an eight year old knows is wrong, is okay on this forum, but me asking "Hey how did the resident/intern system work 50 years ago?" is taboo?
 
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That's only in certain circles. I can think of more than one situation where jesting such as this is the norm. Actually, in certain US military circles with which I am familiar there used to be a saying, "Hire the handicapped. They're fun to watch." and other such "gems". As with anything else in life -- free speech is protected by the First Amendment in this country and if someone is offended, all they have to do is change the station/channel on the radio/TV, walk away from the conversation or just don't go to the forum. Whether or not the person chooses to express their sentiment regarding whether or not something is socially unacceptable is up to them.

Now, I agree that using common terms in a derogatory sense -- which by the way causes me to wonder if it would be socially unacceptable to say that someone suffers from supratentoral insuffiency when used in reference to others or themselves but I digress -- towards oneself can, over time, have lasting effects but that's an individual choice.....


Well, perhaps if one feels so overwhelmed, and inferior to their peer group, then they have an insight to their limitations. If they were the proverbial "big fish in the little pond" then the case may be that they should pursue a career in a less challenging profession.
 
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Argue all you want about PC or free speech
My point was I asked a legitimate question, that was locked, but the moderator here sees fit to leave up a slur that everyone on this forum should know not to use. It's not as if this were a forum for Attorneys or Golf Pros.

A term that an eight year old knows is wrong, is okay on this forum, but me asking "Hey how did the resident/intern system work 50 years ago?" is taboo?

Totally agree. Pretty much the equivalent of "that's so gay" in maturity level. I lose respect for folks who can't think of a better word to use.
 
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