Chronically overworked

[honey0102]

M3 in a primary care clerkship right now, outpatient based.
It's a busy practice. We see patients q15 minutes. My preceptor has me write notes for everyone I see-and will sometimes make me see the next patient before I'm done w/ notes for the previous one. She leaves after the last patient is seen and makes me stay late (1-2 hrs) and finish the notes. At this point she herself, writes very few notes-I do the bulk of it.
She has this policy (note, NOT a school policy) that anytime any doctor in that clinic is in-house (4 total), I must be too. Which means, if she opens shop at 8, I must be there at 8-but when she leaves at 4 or 5, if another doctor (who began at 11 AM) stays until 8 PM-then so must I, writing notes for the other doctor. She opens at 6 to leave at 2 sometimes-and I must help her from 6 AM-2 PM, then the other doctors until whenever clinic closes.
On top of it, as I'm writing notes, she will pimp me extensively on minute details from online, or very specific "zebra-like" clinical scenarios beyond med student scope. It is overwhelming. I barely have time to think. Assigns me tons of readings too. at least 1/d.
On top of this...got shelf to study for.

I'm burned out and beginning to feel depressed and apathetic about just about everything. Do students deserve such little respect that we're literally used as unpaid labor? I know it's good to see patients/learn but at this point the practice is using me as free labor with this policy that anytime any doctor is in house, I must be their scribe-aren't people paid to do that, in gap year jobs? I went into medicine as I like to help patients which I definitely still do, but now I'm worrying about the hierarchy in the field, lack of respect until being significantly established...etc

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[sanfran256]

That's a lot of work , I'm sorry! At least you are getting efficient with notes, I didn't even write notes on FM
I would contact your school, pretty sure you are not supposed to be pulling 12 hour days on FM everyday

 

[Laradd]

how long is this rotation for? if its just a month just get through it

 

[Mad Jack]

M3 in a primary care clerkship right now, outpatient based.
Commute is anywhere from 60-75 minutes one way depending on traffic.
It's a busy practice. We see patients q15 minutes. My preceptor has me write notes for everyone I see-and will sometimes make me see the next patient before I'm done w/ notes for the previous one. She leaves after the last patient is seen and makes me stay late and finish the notes. At this point she herself, writes very few notes-I do the bulk of it.
She has this policy (note, NOT a school policy) that anytime any doctor in that clinic is in-house, I must be too. Which means, if she opens shop at 8, I must be there at 8-but when she leaves at 4 or 5, if another doctor (who began at 11 AM) stays until 8 PM-then so must I, writing notes for the other doctor. She opens at 6 to leave at 2 sometimes-and I must help her from 6 AM-2 PM, then the other doctors until whenever clinic closes.
On top of it, as I'm writing notes, she will pimp me extensively on minute details from UptoDate, or very specific "zebra-like" clinical scenarios beyond med student scope. It is overwhelming. I barely have time to think. Assigns me tons of readings too.
On top of this...got shelf to study for.

I'm burned out and beginning to feel depressed and apathetic about just about everything. Do students deserve such little respect that we're literally used as unpaid labor? I know it's good to see patients/learn but at this point the practice is using me as free labor with this policy that anytime any doctor is in house, I must be their scribe-aren't people paid to do that, in gap year jobs? I went into medicine as I like to help patients which I definitely still do, but now I'm worrying about the hierarchy in the field, lack of respect until being significantly established...etc

Sounds horrible. Make sure to mention it in your rotation evaluatioms

 

[libertyyne]

Respect beyond the basic human respect is earned not a given. also this is not disrespect, seems like you are getting a great education where you are seeing many patients, doing actual work, rather than just shadowing and doing nothing.


We have talked about this in your previous thread in terms of having a different perespective.




You have weekends off to study considering its FM.

You get to write all these notes, great you are now proficient at notes.
You get pimped on details? great you now are thinking about more advanced things. Advanced pimping usually doesnt even start until pass basic level pimping. And you will remember these questions since pimping tends to burn things in your mind.
Working 12 hour days? Seems like you are building stamina for real life or surgery rotation.
Have a 60 minute commute? Sucks. Audiobooks are great for long commutes.


If you are depressed, go see your doctor.

If you have some time read this.

 

[honey0102]

Respect beyond the basic human respect is earned not a given. also this is not disrespect, seems like you are getting a great education where you are seeing many patients, doing actual work, rather than just shadowing and doing nothing.


We have talked about this in your previous thread in terms of having a different perespective.




You have weekends off to study considering its FM.

You get to write all these notes, great you are now proficient at notes.
You get pimped on details? great you now are thinking about more advanced things. Advanced pimping usually doesnt even start until pass basic level pimping. And you will remember these questions since pimping tends to burn things in your mind.
Working 12 hour days? Seems like you are building stamina for real life or surgery rotation.
Have a 60 minute commute? Sucks. Audiobooks are great for long commutes.


If you are depressed, go see your doctor.

If you have some time read this.
View attachment 289219

What worries me is this: our school limits how many students can honor or high pass-and assigns class ranks. My classmates have a ton more time to study for shelf, a significant portion of our grade.
I admit had shelf/its contribution to grades not been a major concern I'd have 100% been all for this extra experience/longer hours

 

[libertyyne]

What worries me is this: our school limits how many students can honor or high pass-and assigns class ranks. My classmates have a ton more time to study for shelf, a significant portion of our grade.
I admit had shelf/its contribution to grades not been a major concern I'd have 100% been all for this extra experience/longer hours

there are probably some people who by the luck of the draw got more intense rotations, and you may get lucky on another rotation.
Life is unfair, sometimes you have to roll with the punches. The anxiety you are spending on worrying about this imbalance would be better spent studying.

Here is a personal example. I did 2 additional 30 hour calls compared to my peers on one of my rotations. I also ended up scoring ~20 points higher on the nmbe shelf compared to the average at my school and nationally. Take it with stride and work hard, and let the pieces fall where they may. Its not like you have any control over changing your current rotation schedule.

Build resilience, work hard and keep a decent perspective.

 

[ace_inhibitor111]

You shouldn’t be working for anyone except the main doctor. Also, it sounds like you’re just scribing for the other doctor while they talk to the patient and then writing up their note after, which is worthless for learning.

Tell the clerkship director this. I’m all for “rolling with the punches” but this is just being taken advantage off. And yes, life is unfair, but that doesn’t mean we shouldn’t make an effort to make it so.

 

[honey0102]

how long is this rotation for? if its just a month just get through it

a month but that said I have other primary care clerkships coming up and wonder if it could happen there too

 

[frog301]

Sounds like glorified scribing :/

 

[Mad Jack]

What worries me is this: our school limits how many students can honor or high pass-and assigns class ranks. My classmates have a ton more time to study for shelf, a significant portion of our grade.
I admit had shelf/its contribution to grades not been a major concern I'd have 100% been all for this extra experience/longer hours

One honors isn't making or breaking you my dude

 

[Mad Jack]

a month but that said I have other primary care clerkships coming up and wonder if it could happen there too

Unlikely, this is very unusual

 

[operaman]

I’m going to join the other contrarian above and say this sounds like a fantastic rotation and you’re fortunate to be in such a busy clinic where the docs pay attention to you and engage you in patient care. You are surely learning a ton and building actual skills that will pay dividends Later.

Sounds like you have plenty of time for study and you are likely getting a lot of experience that will also be shelf relevant. To my mind your rotation sounds infinitely more rewarding than some shadowing experience which is what passes for rotations all too often these days.

 

[MerYangBey]

As others have said the note writing experience will be helpful. I didn’t have to do very many clinic notes last year and I’m very clunky with them. The experience will also help with taking CS and efficiency in general.
When you feel run down just realize there is a benefit to you and your future preparedness. I wish my rotations were more practical and rigorous.

 

[Tenk]

Welcome to being a physician.

 

[honey0102]

I’m going to join the other contrarian above and say this sounds like a fantastic rotation and you’re fortunate to be in such a busy clinic where the docs pay attention to you and engage you in patient care. You are surely learning a ton and building actual skills that will pay dividends Later.

Sounds like you have plenty of time for study and you are likely getting a lot of experience that will also be shelf relevant. To my mind your rotation sounds infinitely more rewarding than some shadowing experience which is what passes for rotations all too often these days.

Actually, our school gives us lots of assignments/quizzes not directly related to shelf-when you add that to all the clinical hours, no it's really not plenty of time for studying.
Perhaps had this been a longer rotation (8 wks) where I could study more for shelf I'd not at all have minded

 

[psychapp121]

This sounds horrible

 

[akwho]

Wow 6am to 8pm (on some weekdays) schedule. Sounds better than residency.

Wow an attending who pimps you and gives you relevant medical literature assignments to read. Sounds better than residency.

Wow an attending who lets you write notes so you can actually learn how to write a billable note and work on your documentation efficiency. Sounds like something that we don't let med students do because it takes more time to correct their notes than just do the notes ourselves.

Wow an attending who has asked their partners if you could be in their clinic (likely slowing them down). Sounds like an attending who cares about your education.

Wow the commute sucks. Sounds like not your attending's fault.


You might have found yourself in the unfortunate situation of having an attending who actually cares about your education. You should definitely write them up in your post-course review so they lose the will to teach future medical students. Or you could embrace the "challenge" of a 60 hour work week. Diligently study pimp topics that are "above your level" so they are no longer above your level. You may actually find that all the hard work you are doing studying topics while in clinic, and the higher volume of patients you are seeing then your fellow medical students pay off with an excellent shelf grade.

 

[honey0102]

Wow 6am to 8pm (on some weekdays) schedule. Sounds better than residency.

Wow an attending who pimps you and gives you relevant medical literature assignments to read. Sounds better than residency.

Wow an attending who lets you write notes so you can actually learn how to write a billable note and work on your documentation efficiency. Sounds like something that we don't let med students do because it takes more time to correct their notes than just do the notes ourselves.

Wow an attending who has asked their partners if you could be in their clinic (likely slowing them down). Sounds like an attending who cares about your education.

Wow the commute sucks. Sounds like not your attending's fault.


You might have found yourself in the unfortunate situation of having an attending who actually cares about your education. You should definitely write them up in your post-course review so they lose the will to teach future medical students. Or you could embrace the "challenge" of a 60 hour work week. Diligently study pimp topics that are "above your level" so they are no longer above your level. You may actually find that all the hard work you are doing studying topics while in clinic, and the higher volume of patients you are seeing then your fellow medical students pay off with an excellent shelf grade.

I wrote my post respectfully and would appreciate some respect in return. If you have something to say contrary to what I said I welcome that-you can say it politely like some other users above-there is absolutely no need for sarcasm and condescension.
Like I said-I appreciate the clinical experience-but clinical rotations are truly a balance between that and studying-shelf studying really does help me learn the material, which helps me understand patient cases even more. I'm stressed because I have almost no time to study for shelf.

 

[psychapp121]

I wrote my post respectfully and would appreciate some respect in return. If you have something to say contrary to what I said I welcome that-you can say it politely like some other users above-there is absolutely no need for sarcasm and condescension.
Like I said-I appreciate the clinical experience-but clinical rotations are truly a balance between that and studying-shelf studying really does help me learn the material, which helps me understand patient cases even more. I'm stressed because I have almost no time to study for shelf.

bro, ignore all these people..this is SDN after all and most of these people are very nerdy/obsessed with work..you’re schedule is significantly harder than a typical outpatient rotation..I would definitely report this person to your school in the eval after the rotation so they can’t continue toabuse student. 6am-8pm is abuse as a student no doubt about it..the preceptor is just using you to do their notes so they can make more money..very bad situation..good luck it’ll be done soon

 

[akwho]

I wrote my post respectfully and would appreciate some respect in return. If you have something to say contrary to what I said I welcome that-you can say it politely like some other users above-there is absolutely no need for sarcasm and condescension.
Like I said-I appreciate the clinical experience-but clinical rotations are truly a balance between that and studying-shelf studying really does help me learn the material, which helps me understand patient cases even more. I'm stressed because I have almost no time to study for shelf.

I'm using sarcasm to make a point because I think you need to completely reframe the rotation in your mind. You aren't paying your school for time to sit and study for a test. You are paying your school for access to meaningful patient interactions that will teach you how to be a better doctor. It sounds like this family medicine doctor is providing this in spades and calling in favors to the other docs in the clinic to get you more opportunities.

Studying for the shelf is something you do outside of work hours. If you aren't violating work hours (typically 80 hours/week) for a medical student, then you don't have any room to write up your doc, and even then you should talk to them first so they have a chance to correct your work hours situation. You need to make your life outside of time at the office more efficient and effective so you have more time for shelf studying. Not complain about how hard your rotation is.

 

[honey0102]

bro, ignore all these people..this is SDN after all and most of these people are very nerdy/obsessed with work..you’re schedule is significantly harder than a typical outpatient rotation..I would definitely report this person to your school in the eval after the rotation so they can’t continue toabuse student. 6am-8pm is abuse as a student no doubt about it..the preceptor is just using you to do their notes so they can make more money..very bad situation..good luck it’ll be done soon

Thanks so much for your sympathy

 

[honey0102]

I'm using sarcasm to make a point because I think you need to completely reframe the rotation in your mind. You aren't paying your school for time to sit and study for a test. You are paying your school for access to meaningful patient interactions that will teach you how to be a better doctor. It sounds like this family medicine doctor is providing this in spades and calling in favors to the other docs in the clinic to get you more opportunities.

Studying for the shelf is something you do outside of work hours. If you aren't violating work hours (typically 80 hours/week) for a medical student, then you don't have any room to write up your doc, and even then you should talk to them first so they have a chance to correct your work hours situation. You need to make your life outside of time at the office more efficient and effective so you have more time for shelf studying. Not complain about how hard your rotation is.

First off it's actually IM not Family Med. My "upcoming primary care" clerkship that I mentioned earlier is FM.
I'm also not writing anyone up. There's a reason I'm only saying things anonymously.
And trust me, I'm making the most use of my time outside of work. But there are only so many hours in a day. And many assignments from school. I'm the one going through this and know how it is. If you have something truly constructive to say-like everyone else replying-I welcome it, whether or not I agree with it. But I don't have time for condescending comments and assumptions.

 

[sanfran256]

Why don't you ask the clinician directly? Just say you need time to study for your shelf. Can you work 8-10 hours instead of 12?

 

[akwho]

 

[honey0102]

Why don't you ask the clinician directly? Just say you need time to study for your shelf. Can you work 8-10 hours instead of 12?

That's a good call...would let me get good clinical experience + be able to read up on conditions, which will help for both shelf and understanding patient diagnoses. Thanks!

 

[honey0102]

Done arguing with you as it's quite frankly a waste of time, not helpful at all.
But to everyone else, thank you! Really appreciate your insight and perspectives

 

[Ho0v-man]

Had a similar experience on FM. Total beat down. Learned a lot though. Was totally burnt out at the end, but I think it’s better to get an experience like this now instead of later when people expect us to hang at that crazy pace. No pain, no gain I guess.

 

[FutureInternist]

Just make sure you wait till after she has submitted her evaluation to then complain about this to clerkship director.

 

[CherryRedDracul]

At least you're getting a taste of how primary care is nowadays: a grind.

It's better use of your time and money than glorified shadowing. While it is grueling, this is how residency is going to be unless you're in some relatively cush specialty. I hope this experience will give you a leg-up over your fellow classmates.

 

[honey0102]

Had a similar experience on FM. Total beat down. Learned a lot though. Was totally burnt out at the end, but I think it’s better to get an experience like this now instead of later when people expect us to hang at that crazy pace. No pain, no gain I guess.

I have FM coming up. This one was IM. I admit I learned a lot but would be nice to be able to study for shelf too. Oh well. Gotta be thankful for what we have

 

[honey0102]

At least you're getting a taste of how primary care is nowadays: a grind.

It's better use of your time and money than glorified shadowing. While it is grueling, this is how residency is going to be unless you're in some relatively cush specialty. I hope this experience will give you a leg-up over your fellow classmates.

Oh trust me, I'm very happy to be doing things vs. glorified shadowing. It's just the very long hours, being forced to work the schedules of multiple doctors so they always have someone there to write their notes (even while they go home)-and as a result not being able to study-that worries me. Had there been no shelf exam, or even just, a few more weeks so I could study, I'd be all for this.

 

[libertyyne]

I have FM coming up. This one was IM. I admit I learned a lot but would be nice to be able to study for shelf too. Oh well. Gotta be thankful for what we have

This is part of your IM rotation?
i easily was working 60-70 hour weeks during my entire IM rotation along with my classmates.

 

[honey0102]

This is part of your IM rotation?
i easily was working 60-70 hour weeks during my entire IM rotation along with my classmates.

Outpatient IM
Inpatient was long hours, but I agree, all of us had 60-70 hour weeks. The school intended for outpatient to be lighter so we could study for shelf.
Totally with you about inpatient being super long hours, not surprised.

 

[libertyyne]

Outpatient IM
Inpatient was long hours, but I agree, all of us had 60-70 hour weeks. The school intended for outpatient to be lighter so we could study for shelf.
Totally with you about inpatient being super long hours, not surprised.

our entire 7 week rotation was inpatient. No outpatient component, we got that through a separate rotation. And i was subsequently worked a lot on that as well.

 

[Lawpy]

There's a lot of good advice on this thread, but just posting here to help OP feel better since it feels that they are stuck in a pretty malignant place in general given their past experiences stated on here. I just wanted to let them know that SDN still serves as a support system, since there are a lot of people who agree MS3 isn't great but MS4/residency is a lot better.

 

[Dr. Doctor MD]

I wanted to echo the many people who stated that was is happening is not okay.

There is a difference between working hard, and being used as free labor. You are there to learn, and long hours and seeing lots of patients is an excellent way to learn. What is not okay and should not be happening is you being used for scutwork and notes. It is unacceptable for a doctor making 250k+ per year to leave and have a medical student who is spending 50k per year to be there stay late and write notes that he/she is billing for. That's not learning, that is abuse of the system and taking advantage of a vulnerable population. Very few community doctors are like that, but the ones that are should be reported and barred from working with students.

Working 60 hours per week as a med student is okay, but when a significant proportion of that time is used for scutwork/notes, that is robbing you of your education. You will have all of residency to write pointless notes to allow your institution to bill insurance for $$$; your third year of medical school should not be spent that way.

I'm sorry for your awful experience, and you deserve better.

 

[libertyyne]

OP for the sake of clarity could you tell me are you writing notes in the EMR? Or are you writing notes in word ?
Are you writing Medical student notes or are you writing notes under the Attendings login?
Also is this a different rotation than the one you were talking about in your previous thread?

 

[honey0102]

our entire 7 week rotation was inpatient. No outpatient component, we got that through a separate rotation. And i was subsequently worked a lot on that as well.

If you were able to handle everything, that's great. Congrats. Kudos to you. However, what I'm going through now is really stressful-not saying I'm in the worst situation anyone ever was in, as I know people have had it more rigorous. But, I'm really not here to compare experiences with people. It's not like I'm saying "I want to go home early to laze off/take it easy" etc. I'd just like to have time to study as well-for shelf but also, because it really does complement clinical learning and I feel would make me a more knowledgeable doctor.

 

[honey0102]

OP for the sake of clarity could you tell me are you writing notes in the EMR? Or are you writing notes in word ?
Are you writing Medical student notes or are you writing notes under the Attendings login?
Also is this a different rotation than the one you were talking about in your previous thread?

EMR. But the attendings don't want us using templates for many things.
Our system has it so we write notes under our login, but then they attest it-and that counts as the note for the encounter.
Nope, same one.

 

[honey0102]

There's a lot of good advice on this thread, but just posting here to help OP feel better since it feels that they are stuck in a pretty malignant place in general given their past experiences stated on here. I just wanted to let them know that SDN still serves as a support system, since there are a lot of people who agree MS3 isn't great but MS4/residency is a lot better.

Aww. Thanks so much. I really appreciate this. I'm trying hard to get what I can, be happy for the positives-and when negatives come up would rather not call anyone out, hence using SDN where it's anonymous

 

[honey0102]

I wanted to echo the many people who stated that was is happening is not okay.

There is a difference between working hard, and being used as free labor. You are there to learn, and long hours and seeing lots of patients is an excellent way to learn. What is not okay and should not be happening is you being used for scutwork and notes. It is unacceptable for a doctor making 250k+ per year to leave and have a medical student who is spending 50k per year to be there stay late and write notes that he/she is billing for. That's not learning, that is abuse of the system and taking advantage of a vulnerable population. Very few community doctors are like that, but the ones that are should be reported and barred from working with students.

Working 60 hours per week as a med student is okay, but when a significant proportion of that time is used for scutwork/notes, that is robbing you of your education. You will have all of residency to write pointless notes to allow your institution to bill insurance for $$$; your third year of medical school should not be spent that way.

I'm sorry for your awful experience, and you deserve better.

This. This exactly pinpoints how I feel about the situation. I love the learning/patient interaction, and understand some level of scutwork will be there-just that it's a little much now and I feel had I spent the time studying, I'd actually know more about the patients' conditions and get more from the experience.
Thanks so much for your sympathy

 

[libertyyne]

If you were able to handle everything, that's great. Congrats. Kudos to you. However, what I'm going through now is really stressful-not saying I'm in the worst situation anyone ever was in, as I know people have had it more rigorous. But, I'm really not here to compare experiences with people. It's not like I'm saying "I want to go home early to laze off/take it easy" etc. I'd just like to have time to study as well-for shelf but also, because it really does complement clinical learning and I feel would make me a more knowledgeable doctor.

Look, if you really think your rotation is inappropriate, you should talk to the doc. If that fails you should escalate it to your school. IMO asking you to work within the confines of acgme rules and document is not scut work.


Everyone would love to have more time to study for shelves.

 

[honey0102]

Look, if you really think your rotation is inappropriate, you should talk to the doc. If that fails you should escalate it to your school.

Writing notes for actual patient encounters you are having is not scut work imo.

Everyone would love to have more time to study for shelves.

Most other preceptors at my school have students see most but not all their patients, especially w/ a q15min schedule. Mine has me see them all-and do notes for them all- she goes home at the end of the day while I finish them. And like I said, has me do notes for other doctors too. Most outpatient docs work 7-9h/d, but if she comes in at say, 7 on a given day, and leaves at 3, I must come at 7, but leave after her partner (who came in much later) is done later in the evening.

I'm really not here to argue. I appreciate different opinions but what I find unacceptable is arguing, condescension and sarcasm.

Thanks for your opinion and have a good evening.

 

[Angus Avagadro]

There is a lot of very good comments, some supportive and some instructional. In medicine, it's hard to vent to non medical people. They will say, isnt this what you wanted? Medical people understand and we have all been there. Being smart helps, but you still have to grind through the work. This actually is helping you understand the rigors of Primary care and providing good experience.It's not a cake walk. There are many VERY busy practices who dont have scribes or med students to help. So the Dr. writes all of their notes and stays late to finish things up at the end of the day, all uncompensated time. You have an attending taking interest in you, asking questions and assigning reading. Many students AND residents dont get even that. My son doesnt. My wife is working this weekend, so she will work 12 days of 9 to 10 hr days with no break, calls in the evening. Who can she complain to? Me, that's about it as non medical people wont understand. She makes great money.
Medicine is hard. Period. I get you're tired and frustrated. Yoi cant see the benefit now, but you will in the future. Good luck and best wishes.

 

[honey0102]

There is a lot of very good comments, some supportive and some instructional. In medicine, it's hard to vent to non medical people. They will say, isnt this what you wanted? Medical people understand and we have all been there. Being smart helps, but you still have to grind through the work. This actually is helping you understand the rigors of Primary care and providing good experience.It's not a cake walk. There are many VERY busy practices who dont have scribes or med students to help. So the Dr. writes all of their notes and stays late to finish things up at the end of the day, all uncompensated time. You have an attending taking interest in you, asking questions and assigning reading. Many students AND residents dont get even that. My son doesnt. My wife is working this weekend, so she will work 12 days of 9 to 10 hr days with no break, calls in the evening. Who can she complain to? Me, that's about it as non medical people wont understand. She makes great money.
Medicine is hard. Period. I get you're tired and frustrated. Yoi cant see the benefit now, but you will in the future. Good luck and best wishes.

I don't mind the long hours by themselves. What stresses me is not being able to study for shelf, not being able to master material needed to be a good doctor.
Once I'm an attending with said info mastered-different story.

 

[Smurfette]

I get the obsession from students about focussing on their tests/shelf exams...this is what all the years prior to your clinical years have focussed on. It's ingrained in you.
The reality is that the clinical experience is far more valuable to learning and actually BEING a doctor. Patients don't present with the obvious info given to you to make a diagnosis; you have to figure it out and rule out other things it could be too. I've seen interns who barely can write notes and have a hard time picking out the important details from the unimportant ones. You'll have a huge leg up, you just can't see that now. With all the patient exposure you are having, it is helping you study for your exams, it's just not traditional book learning. It's basically the physician equivalent of "street smarts" that you are learning and this is what keeps you alive out there in the world of medicine. Residency is mostly learning the "street smarts" of medicine with immersive clinical exposure while having annual inservice exams and educational conferences along the way as sort of a quality control.

That being said, I do think it's a bit weird you work with others just for their extended hours after your doc leaves for the day.

 

[Lawpy]

I get the obsession from students about focussing on their tests/shelf exams...this is what all the years prior to your clinical years have focussed on. It's ingrained in you.
The reality is that the clinical experience is far more valuable to learning and actually BEING a doctor. Patients don't present with the obvious info given to you to make a diagnosis; you have to figure it out and rule out other things it could be too. I've seen interns who barely can write notes and have a hard time picking out the important details from the unimportant ones. You'll have a huge leg up, you just can't see that now. With all the patient exposure you are having, it is helping you study for your exams, it's just not traditional book learning. It's basically the physician equivalent of "street smarts" that you are learning and this is what keeps you alive out there in the world of medicine. Residency is mostly learning the "street smarts" of medicine with immersive clinical exposure while having annual inservice exams and educational conferences along the way as sort of a quality control.

That being said, I do think it's a bit weird you work with others just for their extended hours after your doc leaves for the day.

thanks, this is really insightful. although i'm more curious as to whether this further justifies the value of MS4 over MS3 especially if they're essentially acting as interns and aren't pressured by the shelf exams

 

[allantois]

There is a lot of very good comments, some supportive and some instructional. In medicine, it's hard to vent to non medical people. They will say, isnt this what you wanted? Medical people understand and we have all been there. Being smart helps, but you still have to grind through the work. This actually is helping you understand the rigors of Primary care and providing good experience.It's not a cake walk. There are many VERY busy practices who dont have scribes or med students to help. So the Dr. writes all of their notes and stays late to finish things up at the end of the day, all uncompensated time. You have an attending taking interest in you, asking questions and assigning reading. Many students AND residents dont get even that. My son doesnt. My wife is working this weekend, so she will work 12 days of 9 to 10 hr days with no break, calls in the evening. Who can she complain to? Me, that's about it as non medical people wont understand. She makes great money.
Medicine is hard. Period. I get you're tired and frustrated. Yoi cant see the benefit now, but you will in the future. Good luck and best wishes.

Seriously, writing notes is an uncompensated time for the physician? You are writing a note that other providers, insurance companies and perhaps lawyers are gonna use to judge you on. Having a student write ALL notes for you, is not a good educational experience in the least. If somebody needs help writing notes, they should hire a scribe.

 

[ciestar]

thanks, this is really insightful. although i'm more curious as to whether this further justifies the value of MS4 over MS3 especially if they're essentially acting as interns and aren't pressured by the shelf exams

It makes M4 so much better that’s for sure. At that point, you’re also more knowledgable and can contribute so much more to your team. I have a feeling that’s also why people get annoyed by M3’s, because you worry more about the shelf than the clinical side of things, which matter so much more. This happened during my surgery rotation and the residents got really irritated people whined all day about shelf exams and wanting to go home.

During my peds sub-i, i was legit an intern for all intents and purposes. I did all the the admissions and H&P’s, all SOAP notes, and all discharge notes. We could put in orders which were all hard checked by the resident/attending. We were there from sign out to sign out. Crazy hours but I learned soo much.