Is it supposed to be THIS bad? And what can I do to make it better?

[jcmnancy]

My sister is in her first year of residency. We come from a poor immigrant family and it was my parents' dream to have their daughters become doctors. My sister did not want to go into the medical field but she didn't want to disappoint her parents and now that she's started working, she absolutely hates it. Now, I know that the first year of residency is a ****show and everyone hates it and it gets better, but she really REALLY hates it. She's halfway across the country, living on her own away from family and friends. Every convo I have with her, she talks about how she's an idiot, she hates her life, she hates the medical field, she doesn't know anything. Her talk has gotten progressively more hopeless and negative over this past month. She consistently gets every pimp question wrong, day after day. She is too tired to study after work, and I also think she feels too hopeless to attempt to strengthen her knowledge base. Her first patient died (not her fault) and she didn't feel any sadness. Basically every day she feels stupid, alone, uninterested, and trapped. She has zero passion or interest in what she's doing with her life and no free time or energy to pursue hobbies to get her through this year. Also, she's turning 30 and single and my mom (typical immigrant mother) is pressuring her to get married, but the guys she dates don't want to get serious with her because she's too busy (and, I suspect, her negativity about her life path bleeds into the rest of her personality). I try to tell her to stay positive, to stop putting herself and her intelligence down, to choose happiness over self pity and misery, but nothing is working. I'm only a 3rd year medical student and rotations haven't started yet, so I don't have much authority to tell her to "hang in there."
Everyone I've talked to who is past their first year of residency says that residency sucks and she'll be OK, but I don't feel comfortable telling them the details above because there's no anonymity. So is it really supposed to be THIS bad? I can only see her getting worse, more jaded and bitter about her life. She can't just quit medicine, because there's over $200K of loans built up from undergrad and medschool that she needs to pay off. She's not a very philosophical person, so the positive thinking thing doesn't stick. My sister means the world to me. I have no idea what to do and I'm very worried. Genuine advice would be appreciated.

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[VentJockey]

I think intern year sucks for most people, unfortunately. But it sounds like your sister is having a particularly rough time. For me, there have been lots of stressors involved in learning about the systems and the way things get done in my hospital, and I expect that these stressors will diminish as time goes on. But at the end of the day, I really love medicine. I'd recommend that you offer her reassurance that as time goes on she will get more comfortable and competent in her environment. Also, if she's having a problem with a particular attending or resident, those things change as rotations change.

 

[Perrotfish]

My sister is in her first year of residency. We come from a poor immigrant family and it was my parents' dream to have their daughters become doctors. My sister did not want to go into the medical field but she didn't want to disappoint her parents and now that she's started working, she absolutely hates it. Now, I know that the first year of residency is a ****show and everyone hates it and it gets better, but she really REALLY hates it. She's halfway across the country, living on her own away from family and friends. Every convo I have with her, she talks about how she's an idiot, she hates her life, she hates the medical field, she doesn't know anything. Her talk has gotten progressively more hopeless and negative over this past month. She consistently gets every pimp question wrong, day after day. She is too tired to study after work, and I also think she feels too hopeless to attempt to strengthen her knowledge base. Her first patient died (not her fault) and she didn't feel any sadness. Basically every day she feels stupid, alone, uninterested, and trapped. She has zero passion or interest in what she's doing with her life and no free time or energy to pursue hobbies to get her through this year. Also, she's turning 30 and single and my mom (typical immigrant mother) is pressuring her to get married, but the guys she dates don't want to get serious with her because she's too busy (and, I suspect, her negativity about her life path bleeds into the rest of her personality). I try to tell her to stay positive, to stop putting herself and her intelligence down, to choose happiness over self pity and misery, but nothing is working. I'm only a 3rd year medical student and rotations haven't started yet, so I don't have much authority to tell her to "hang in there."
Everyone I've talked to who is past their first year of residency says that residency sucks and she'll be OK, but I don't feel comfortable telling them the details above because there's no anonymity. So is it really supposed to be THIS bad? I can only see her getting worse, more jaded and bitter about her life. She can't just quit medicine, because there's over $200K of loans built up from undergrad and medschool that she needs to pay off. She's not a very philosophical person, so the positive thinking thing doesn't stick. My sister means the world to me. I have no idea what to do and I'm very worried. Genuine advice would be appreciated.

Its tough to tell if this is typical or worse than usual. When you're reading a second hand account on the internet its tough to tell the difference between a standard Intern year and clinical depression. Anyway my advice to Interns having a hard time:

1) It really does suck. She doesn't necessarily have a bad attitude and there's probably nothing wrong with her, it just sucks. Everyone feels dumb, everyone's tired, no one ever really leave work, and everyone's a little angry. No one has time for a relationship and most people get frustrated seeing their friends who are beginning to start families. It especially sucks if you don't have anyone in the area to lean on, and non-doctor family and friends rarely get it. I remember explaining to my family that I hadn't called in four weeks because my last day off was 28 days ago and they were all 12 hour shifts. They would not believe me.

2) Seek feedback frequently. Every Intern screws up, and I don't mean once in a while. I remember on my first day on wards the pharmacist had to call me four times because I just could not manage to calculate the does for TYLENOL correctly. Most of us started actually feeling a little like doctors around December. Your sister's attendings, and to a lesser extent her senior residents, are in a much better position to judge how your sister is doing than she is, and in most cases she'll probably get better feedback from them than she was expecting. On the other hand if they really DO see problems, they can usually pinpoint a few areas to focus on.

3) Health is the first priority. Get at least a little bit of exercise (20 minute exercise videos if necessary) every day. Buy or steal time (eat 2 meals at the hospital, splurge to buy prepreared meals to avoid cooking time, etc.). Make sure she has a completely dark, quiet room to sleep in during night shifts. This is a marathon, not a sprint.

4) Have a LOW threshold for seeking help from psych. A lot of people need someone to talk to, and often meds, to get them through this. Tell your sister that if she starts feeling like this misery isn't the kind that improves on her day off, or if starts sleeping through rounds because she just doesn't care anymore, or if things just don't seem to be getting better, then its time to seek some help.

 

[Dejavu]

Its tough to tell if this is typical or worse than usual. When you're reading a second hand account on the internet its tough to tell the difference between a standard Intern year and clinical depression. Anyway my advice to Interns having a hard time:

1) It really does suck. She doesn't necessarily have a bad attitude and there's probably nothing wrong with her, it just sucks. Everyone feels dumb, everyone's tired, no one ever really leave work, and everyone's a little angry. No one has time for a relationship and most people get frustrated seeing their friends who are beginning to start families. It especially sucks if you don't have anyone in the area to lean on, and non-doctor family and friends rarely get it. I remember explaining to my family that I hadn't called in four weeks because my last day off was 28 days ago and they were all 12 hour shifts. They would not believe me.

2) Seek feedback frequently. Every Intern screws up, and I don't mean once in a while. I remember on my first day on wards the pharmacist had to call me four times because I just could not manage to calculate the does for TYLENOL correctly. Most of us started actually feeling a little like doctors around December. Your sister's attendings, and to a lesser extent her senior residents, are in a much better position to judge how your sister is doing than she is, and in most cases she'll probably get better feedback from them than she was expecting. On the other hand if they really DO see problems, they can usually pinpoint a few areas to focus on.

3) Health is the first priority. Get at least a little bit of exercise (20 minute exercise videos if necessary) every day. Buy or steal time (eat 2 meals at the hospital, splurge to buy prepreared meals to avoid cooking time, etc.). Make sure she has a completely dark, quiet room to sleep in during night shifts. This is a marathon, not a sprint.

4) Have a LOW threshold for seeking help from psych. A lot of people need someone to talk to, and often meds, to get them through this. Tell your sister that if she starts feeling like this misery isn't the kind that improves on her day off, or if starts sleeping through rounds because she just doesn't care anymore, or if things just don't seem to be getting better, then its time to seek some help.

This.

I spent four years in the Marine Corps, and I would rather do those four years over than do my internship year over again.

As for feeling stupid on rounds during pimp questioning, believe me, I've been there. Every day I felt like the idiot of the village. Other interns would grab trivial facts out of the air and know stuff about my pts that I should have. I never was able to do that.

Feeling alone is part of this. Be sure she knows that she is not the only one feeling like this.

It must be said that if she truly doesn't want to become a physician, she shouldn't, regardless of debt, but it is early in the breaking in process that is internship. Like anything, she will become accustom to the pace, and will find out that, with a little build up of experience, she will become more comfortable with all this.

 

[cerebral edema]

its probably program specific. i'm an intern now and its not that bad. plenty of time to study, workout, hangout with family. upper level residents are great, too.

i feel bad for the old timers who really had it bad.

 

[Substance]

Sounds like a bad deal.

If you are very worried about her, go pay her a visit or move out there for the year if you can. She sounds lonely and like she needs someone to hang out with.

Intern year sucks. It is the last legal sweatshop in America. Hospital admins have coyly twisted the oath of the physician into a Hell gauntlet for the purpose of saving money.

 

[gutonc]

Intern year sucks. It is the last legal sweatshop in America. Hospital admins have coyly twisted the oath of the physician into a Hell gauntlet for the purpose of saving money.

I'm not going to argue that internship (residency in general?) doesn't suck. But I don't know of any sweatshop jobs that pay $50K+/year.

 

[hrandani]

I'm not going to argue that internship (residency in general?) doesn't suck. But I don't know of any sweatshop jobs that pay $50K+/year.

Work out the hourly wage once you subtract sallie mae's cut, then revisit your opinion. I think in a lot of places that's going to be less than federal minimum wage.

 

[e30ftw]

Work out the hourly wage once you subtract sallie mae's cut, then revisit your opinion. I think in a lot of places that's going to be less than federal minimum wage.

I was an intern a month ago and my salary of $45k/yr felt like a lot of money, regardless of compounding interest.

intern year was a lot of work but overall not the most difficult year of my life by a long shot. Most of my college years where I worked ~30 hrs a week in addition to school full time were overall similar in free time but overall less fulfilling than intern year. As an intern you're finally learning to be a physician, you earn respect one medical decision at a time, and you get paid a decent amount of money. I felt like big balla shock colla last year, took vacations, ate steak and, even if you account for the large purchase of one diamond engagement ring, still put ~$15k in the bank.

you choose your attitude. Plenty of people have been in the same situation as OP's sister and managed to keep a balanced life and positive attitude. It's possible but change begins from within.

exercise, keep up your relationships, focus on learning your profession while at work, take advantage of your free time.

that is all.

 

[dozitgetchahi]

I was an intern a month ago and my salary of $45k/yr felt like a lot of money, regardless of compounding interest.

intern year was a lot of work but overall not the most difficult year of my life by a long shot. Most of my college years where I worked ~30 hrs a week in addition to school full time were overall similar in free time but overall less fulfilling than intern year. As an intern you're finally learning to be a physician, you earn respect one medical decision at a time, and you get paid a decent amount of money. I felt like big balla shock colla last year, took vacations, ate steak and, even if you account for the large purchase of one diamond engagement ring, still put ~$15k in the bank.

you choose your attitude. Plenty of people have been in the same situation as OP's sister and managed to keep a balanced life and positive attitude. It's possible but change begins from within.

exercise, keep up your relationships, focus on learning your profession while at work, take advantage of your free time.

that is all.

Yeah, I was gonna say...I've been on wards he last two months and it's really not THAT bad. Granted, this may be related to the fact that my program seems fairly cush, but still. I have a reasonable amount of time off, I exercise nightly, I cook my own meals and bring lunch from home, I can do a lot of things I like to do. I'm able to read when I get home unless it's a long call night.

A lot of it really is program specific, and a lot of programs out there are either malignant or simply work the hell out of their interns. Most interns I meet are definitely working hard, but they aren't as miserable as the OP - some of whose misery seems to be secondary to homesickness and apathy about medicine in general.

 

[Kahreek]

being single and away from the family seems to be the most pressing issue for her.
tell her to sign up this forum, sometimes writing about your predicaments can be therapeutic.


Going away was very difficult for me, as i was clueless, alone in this city, all the family , old friends were far.
Objectively things didnt get much better, but my outlook is much more positive right now, i developed little routines, friends. All the little things started to matter much more. More enjoyment of the field also grew. Life is never how you think it will be.

 

[Law2Doc]

Intern year is hard but getting through it comfortably is 90% related to your mind set and attitude. Those that look at it as an ordeal are more likely to have a horrible time of it than those who look at it as a lot of trivial nuisances heaped together over an otherwise cool existence. Don't let it eat at you, keep your mind compartmentalized, find the dark humor in the bleakness. Just because 90% of every day is a pain doesn't mean that 10% isn't pretty cool and what you can focus on. The guy stacking shelves at Walmart would trade jobs with you in a second, so have some perspective. Also blaming intern year on not having the time to be happy outside of the hospital, and the frustration of not having a life outside of the hospital bleeding back into your life at work is a vicious circle and you need to stay out of that loop by drastically adjusting your attitude. You get to do a cool job -- most others watch doctors on tv and fantasize about what it would be like, but you live it. And you collect a pay check to learn -- pimping is like a game show where you still get a prize even if you get the wrong answer. and internship is only a year, while all your friends outside of medicine with jobs they dislike probably don't see much change from year 1 to year 2.

 

[rkaz]

How is your sister doing now? Any improvement? I'm just wondering if she was dealing with adjustment or if she is having clinical depression. I hope the situation has improved.

I am an MS4 who will be single next year and moving to a new part of the country (most likely, as my favorite programs are far away from home). Just wanted to know how people were able to effectively transition to a new situation (especially if they have lived in one area for all of their lives before residency and now are living in a new part of the country and don't have a spouse for emotional support). How did you effectively prevent loneliness and depression in your intern year?

 

[ruralsurg4now]

I'm not going to argue that internship (residency in general?) doesn't suck. But I don't know of any sweatshop jobs that pay $50K+/year.

I think they're referring to hourly wages. I think someone once famously calculated (pre-work hours restrictions) that as a resident you make less than people made at Taco Bell, hourly. It was actually far below minimum wage (which I don't believe in anyways, but that's just a point of reference).

 

[ruralsurg4now]

How is your sister doing now? Any improvement? I'm just wondering if she was dealing with adjustment or if she is having clinical depression. I hope the situation has improved.

I am an MS4 who will be single next year and moving to a new part of the country (most likely, as my favorite programs are far away from home). Just wanted to know how people were able to effectively transition to a new situation (especially if they have lived in one area for all of their lives before residency and now are living in a new part of the country and don't have a spouse for emotional support). How did you effectively prevent loneliness and depression in your intern year?

It is difficult to do so and really the only determining factor is you. It's like when people go to college and some people become extremely homesick while other people are excited to be there. You can't prevent it. The issue with the OP is that, what people are ignoring is that the sister doesn't even really want to be a doctor. It's the same reason everyone on here tells people not to pick a speciality based on pay. If you told the pre-meds on here "yeah, I'm a resident and I hate it," they wouldn't understand and would just say "what's wrong with you?" Similarly, sometimes someone will say "I'm a Cardiologist and I'm miserable" and everyone will say "what? You have it made, what's wrong with you?" (Before someone over-reacts, that's not a dig at Cardiologists, if you want to stick in "Surgeon," go right ahead.) That right away makes things much less tolerable. Similarly, the external pressures from her family on her personal life are contributory. It's a big issue with children of immigrants, who are well-known to do what their family has done. There are expectations first for performance in school and then for a profession and then for a marriage and then for grandchildren. Then you die.

As for advice for the OP, it's hard to say if it's supposed to be that bad. Some places are malignant, so it can make her intern/residency experiences markedly worse than other peoples', even if she didn't have her underlying external issues. Also, most training programs blow at actual training. Like, the prevailing attitude is "if you don't do well on the in-service exam, our 'assistance' is to fail you and then kick you out," which is similar to the laypersons version of "the firings will continue until morale improves." (My personal theory was always that, if I'm in a training program, then just being there every day should get me at least a half-decent score on the in-service exam or else the program is wasting my time, but that's another issue altogether and I seem to be in the minority for some reason. That only leads me to believe that people are brain-washed Kool-Aid drinkers.) There's not much she can do, other than (a) ride it out and hope it gets better or (b) recognize early on that she really hates medicine and bail. (B) is harsh, but it's basically the only way out. What is particularly disenheartening is that you have apparently shown much more concern for her well-being than your parents, who I presume would basically disown her if she left medicine.

 

[michaelrack]

The guy stacking shelves at Walmart would trade jobs with you in a second, so have some perspective.

Don't be so sure of that. The hourly pay is roughly the same. Not everyone wants a high-stress, intellectually challenging job- not everyone wants a job where a mistake can kill a person. On the other hand, the guy stacking shelves at Walmart would probably want to get in on the training that leads to an attending physician salary in a few years.


If I was in my mid-20's again, and assuming no effect on my future career, I would much rather work at Walmart for a year than do a year of internship ( my perspective might be a little different than those who did internships in later years, when they became a little easier).

 

[ruralsurg4now]

If I was in my mid-20's again, and assuming no effect on my future career, I would much rather work at Walmart for a year than do a year of internship ( my perspective might be a little different than those who did internships in later years, when they became a little easier).

Seconded. If you told me I could work at Wal-Mart instead of having had done internship, I would have started doing cartwheels and dry-humping your leg until we both got uncomfortable.

 

[Law2Doc]

Seconded. If you told me I could work at Wal-Mart instead of having had done internship, I would have started doing cartwheels and dry-humping your leg until we both got uncomfortable.

I didn't say ask someone on the medicine side if they would trade with the Walmart guy, I said the exact reverse. That's my point -- you have to have some perspective because most of the world would love to be in your seat even if you would rather not be.

 

[ruralsurg4now]

I didn't say ask someone on the medicine side if they would trade with the Walmart guy, I said the exact reverse. That's my point -- you have to have some perspective because most of the world would love to be in your seat even if you would rather not be.

I doubt that the Wal-Mart guy would trade places with me. If he would, he wouldn't be working at Wal-Mart. Which is not a knock on Wal-Mart. I'm just saying that if he had any drive whatsoever, then he wouldn't be in a low-skill, low-wage job. It's like saying "I would love to trade places with an NFL player." Well, yeah, in terms of salary. But not anything else.

 

[Law2Doc]

I doubt that the Wal-Mart guy would trade places with me. If he would, he wouldn't be working at Wal-Mart. Which is not a knock on Wal-Mart. I'm just saying that if he had any drive whatsoever, then he wouldn't be in a low-skill, low-wage job. It's like saying "I would love to trade places with an NFL player." Well, yeah, in terms of salary. But not anything else.

Not everyone with drive gets to be what they want. Some people with drive but not "book smarts" or maybe no ability to afford college while helping support a family etc end up working their way up to manager of a Walmart, but never get to see the opportunities if higher education (bear in mind im using Walmart just as an example of the many nonprofessional paths). If you haven't met people who are jealous of your opportunities you haven't met many people outside of your preprofessional circle. They may not know all the stresses you face, but they have their own set of stresses and disappointments and would love to be in your shoes. That's just life. The reality doesn't always match the imagination but I promise you there are thousands of people watching Greys Anatomy or whatever medical show is en vogue and daydreaming about how good a doctor they would have been. You rarely find doctors daydreaming about being the manager of the third biggest Walmart in the state some day. So you have to have some perspective. It's really like the proverb "I was crying because I had no shoes until I met a man with no feet". First world problems.

 

[ruralsurg4now]

It's really like the proverb "I was crying because I had no shoes until I met a man with no feet". First world problems.

This isn't a rip on you, personally, but it's really ******ed how people throw that phrase around these days. I first ran into it just a few months ago and now it's like everywhere I go someone is throwing it around. It's an idiotic phrase that attempts to diminish the problems of people in America like "ooo, you couldn't find your car keys this morning, so you were late for work? FIRST WORLD PROBLEMS. Try talking to the guy whose sister just got raped in Darfur." So what? Is someone in Darfur saying "ooo, your sister just got raped? Well, there's some guy in the Ivory Coast who was burned alive you need to see"? I really don't give a s**t if someone in the third world has worse problems than I do, or that someone in Compton has worse problems than I do. I also don't give a s**t that I have worse problems than Katy Perry or Justin Bieber does. Someone should find the ****** inbred who came up with "first world problems" and follow him around and if he ever complains about anything ever in his entire life, kick him brutally in the nuts until he throws up in agony and collapses into his vomit and asphyxiates. Then you call his family and tell them "guess what? YOU FINALLY HAVE THIRD WORLD PROBLEMS CONGRATULATIONS FTW."

 

[Law2Doc]

However you want to phrase it, the point is a matter of perspective. Some people are whining about internship like it's the sukkiest job on the planet. It isn't, by a long stretch. And even if it were, it's only a one year stepping stone and then you are on to bigger, better things. Some people are in jobs that are never going to get better. The phrase "first world problems" is meant as exaggeration. It just means the troubles you are whining about are things others dream to be whining about. Basically the guy whining about having to drive his BMW because his Porsche is in the shop. To the guy in Walmart (or another low level low pay track), internship is a shiny new car. Or at least a stepping stone to owning one. If you think you have to go to the extreme and talk about rape in Darfur, you are being way too literal and not getting the sarcasm inherent in that quote.

 

[Mace1370]

However you want to phrase it, the point is a matter of perspective. Some people are whining about internship like it's the sukkiest job on the planet. It isn't, by a long stretch. And even if it were, it's only a one year stepping stone and then you are on to bigger, better things. Some people are in jobs that are never going to get better. The phrase "first world problems" is meant as exaggeration. It just means the troubles you are whining about are things others dream to be whining about. Basically the guy whining about having to drive his BMW because his Porsche is in the shop. To the guy in Walmart (or another low level low pay track), internship is a shiny new car. Or at least a stepping stone to owning one. If you think you have to go to the extreme and talk about rape in Darfur, you are being way too literal and not getting the sarcasm inherent in that quote.

I don't think these people lack perspective. They are complaining about internship, which sucks. They want to vent. Why do you have a problem with this? Should people not complain about being in a sucky situation? There will always be someone who has it worse and there will always be someone who has it better. That's life and it doesn't invalidate your experiences.

 

[Law2Doc]

I don't think these people lack perspective. They are complaining about internship, which sucks. They want to vent. Why do you have a problem with this? Should people not complain about being in a sucky situation? There will always be someone who has it worse and there will always be someone who has it better. That's life and it doesn't invalidate your experiences.

To be fair, this was actually just a very minor tangential point on a larger post I made above, that another poster chose to focus in on. I was telling a poster a way to cope, and that surviving internship was mostly about having the right mindset. As a side note, I referenced that a lot of people would love to have this opportunity. That wasn't really my thesis.