Auditions suck, I hated feeling like I was under the microscope all the time, and I HATED the pissy personalities of most of the residents I worked with.
I did an Sub-I style rotation in IM, it was literally one of the worst experiences of my life. I was miserable, literally the entire month. I kid you not, I nearly quit Med-school that month because I told myself “if this is what the next step is going to be like, count me out”. It was the end of 3rd year, so not an official Sub-I, but I was expected to carry 2-3 inpatients, I was given a pager and called for my own admits as part of the rotation on the team; and it was very much structured as a sub-I.
I don’t mind saying where: It was at Providence St. Vincent Hospital in Portland, Oregon. The residents were just plain toxic. The culture was terrible. I legitimately determined that I’d rather walk away with 6-figures of debt and no doctor salary than train there.
Examples:
1. Interns were so high strung and stressed that whenever seniors and attendings weren’t around they were advising me to run away, and not even consider their program. They were MISERABLE.
2. Senior residents who were either worthless and passive, or were worthless and hyper aggressive. The one I worked under the most was aggressive. The other was passive and uninvolved. The aggressive one wouldn’t let anyone get more than a sentence out in rounds before she was interrupting, accusing people of not knowing something, and disallowing the presentation to continue and saying “we need to talk more about this topic later” and just finishing the day’s plan with the attending while the rest of us just sat there wondering what the hell was going on. This teaching, which was supposed to occur “later” of course never happened, not even once. She probably couldn’t have taught us anyway, I didn’t get the impression she was capable of anything other than toxicity. This behavior was demonstrated with students, and interns alike. Attendings generally just sat there and signed charts or texted, they didn’t even seem to be paying attention to what was going on.
3. Zero teaching, I mean ZERO. Even teaching about the general quirks of their program and how they handled logistics of patient care etc. My residents would disappear for hours after rounds. More than once the senior would excuse us for breakfast or lunch and tell us to meet in the workroom in 30mins, I’d go grab a bite, take it to the workroom and wait; no one would show, and then no one would answer phone or text. They’d all meet up somewhere else and then be pissed that I didn’t know where they were and that I’d missed some bedside teaching or something. It’s hard to be somewhere if you aren’t informed of where to be.
4. At the end of it all I was sat down for a feedback session with an attending, and asked how I thought it went. I let fly with my impressions of the month, I literally didn’t hold back. I told them that I felt like I was literally set up to fail from day 1. That their interns were miserable, their seniors (at least the one I worked with the most) were toxic and all but impossible to learn from. That I felt like the month was a giant waste of my time and that I was just glad it was over, and that if I learned anything, it was that I needed to KNOW the culture of any future residency program I planned to rank. The attending tried to tell me I should have been more vocal about my concerns early on, that they would have liked to help, and I just laughed and told her: “You were freaking there on rounds when the senior resident wouldn’t allow me to present a patient without interrupting me over and over mid-sentence, through the entire presentation so she could try to “pimp” me. She didn’t even teach when she interrupted, then she’d act upset that my presentation didn’t flow well. You did nothing.
OP don’t stress it, which I know is easy advice to give and hard advice to follow. If this is your field, do your best, try not to show how jaded you are, and get out of there. But don’t let the politics of this particular program ruin you. Maybe all you’ll come away from this rotation with is a knowledge that you don’t want to train there; but that‘s actually valuable information.
But I agree, auditions/Sub-I’s are the worst.
