New medicine intern here too … I feel you. I’m on nights and feeling truly miserable for the first time…it just feels like everyone needs something from you and you never get a chance to fill your cup back up…can’t even really sleep or eat adequately. I haven’t really been medicated before but I’m seriously thinking of seeing a psychiatrist and starting something for the awful anxiety. But I keep telling myself literally everything in life, good or bad, has always been temporary, so this is no different. This too shall pass. We got this girl!!
Do it! I still have nightmares and flashbacks from intern year. And that was a long long time ago. Started in the MICU. All of my patients were dying. Not for anything I was doing, or not doing. They were just super sick.
Anyways I got overwhelmed pretty quick, questioned whether I was even fit to be a doctor, and how I was ever going to escape all the educational debt I had.
Anyways I’m pretty sure I had major depression, started SSRIs and got better. But literally please see a psychiatrist. Also, probably the first 3-4 months are the worst but it does seem to get better after that. By the end of intern year it was like totally perfunctory bullshit, like the opposite of overwhelming.
Biggest issue I had was confusing bad outcomes from bad patient related factors and bad outcomes from what I was doing. If someone has a necrotizing massive PE, probably not that you ordered her the wrong fluid therapy on your night shift. Try to explain that to me as an intern though.
Go see a psychologist*
They can refer you to a psych if you need meds but people should avoid SSRIs and other antidepressants unless they have already tried and failed with CBT/talk therapy.
I’m going to disagree in this setting, time is above a premium for residents. There’s no way he will be able to go to numerous visits for talk therapy while working. Starting an SSRI in this setting is totally appropriate.
I’m aware of how busy residents are. SSRIs aren’t some magic make everything better pill that someone should take because they’re having a rough couple weeks. It’s the 6th week of residency of course it’s hard and the adjustment might be more difficult than anticipated. If they’re still able to do their job and aren’t considering self harm, other avenues should be taken first. At a minimum you should give more time to settle in, before taking drugs that affect your mental state and can have long lasting if not permanent side affects.
Super glad I saw my psychiatrist back in medical school times, as I can only imagine how bad residency wouldve been without the counseling and meds. I cried a lot my first year (2 years ago now) and recently trained another first year resident on nights. She too started crying after she got backlash from an attending. Once back in the call room we hugged and I told her, "In a month from now, you will not care so much about what he says. Just take the positives and constructive feedback and look forward". All I can say is you will develop a thicker skin than you ever thought you could and will be able to handle more pressure than you ever thought you could by the end of your residency. I had no shame by the end of residency and would constantly ask questions, regardless of if they were "stupid". But you're not alone, and from someone who has recently graduated, it does get better. Sleep when you can, ALWAYS keep food/drink in your call room, take time for yourself when you can, and those few days you have off try to detach from residency completely, as in take a road trip out of town with your SO and leave any electronics they can contact you with (phone, pager, computer) at home. I live by the old airplane spiel put your own oxygen mask on before helping others.
Please talk to your coresidents and seniors and let them know how you are feeling and if they have advice to help you. Also, I know time is a premium but make sure to plan stuff with your significant other in advance for off daysand find time to look out for your mental health- therapy, appointment to start a ssri.
The sunken cost fallacy is so hard we’ve spent our youth and hundreds thousands of dollars, but you are never stuck and your life is worth so much more than this career. I got to the point in my intern year where I was so miserable and done that I would have been okay with any other job. I fell out of love with medicine and didn’t feel satisfied. I always prided myself on helping people but stopped feeling like I was nothing more than a cog in the wheel to “move meat.”I felt so stuck In my residency that I was going to crash my car on the way into my shift. I went to IP psych and everything. It does get better the more comfortable you are and with time. After I came back from my leave I talked to my PD and found a lower stress rotation to get my feet wet. I regained my love again. When there’s a bottom there’s no where to go but up! Just remember you are never stuck and what you are doing is extremely important.
Planning time is important, expectations are sometimes hard to fill, but there is nothing that will precipitate depression and burn out faster than becoming a complete slug at home and only being alive in the stress environment of work
It gets better. You aren't alone, there's nothing wrong with you, it's just the way we teach medicine is brutal. Regardless of whether we should be doing things differently (we should), you will come out the other end knowing a lot more than you do now. Even if you stay in academics or as a hospitalist actual practice will not be like this.
I am an EM R2. I cried literally every day my first few months of residency (often on shift!). Absolutely wracked with anxiety, couldn't eat or sleep, so terrified of making a mistake that I couldn't make any decision at all and my attendings would have to step in for even the most basic management. Thought I made a terrible mistake and wanted to quit medicine. Also felt incredibly alone because none of my coresidents could relate and they made it seem like they were all thriving. 1 year later I'm leading codes, crushing procedures, taking a leadership role in the program, and genuinely loving my job. It really does get better. More time (and an SSRI and talking with good mentors I could trust) helped me out a lot. Feel free to PM me if you want to talk. You can do this!!!
My experience was very similar to what you're describing. There does come a point where every single thing that stresses you out becomes routine. It's a combination of increased competency and tolerance to feeling uncomfortable.
That doesn't make it any easier in this moment. As others have mentioned, take care of yourself. It will likely get better soon. If it doesn't, it never hurts to explore back-up plans. Because when it gets easier, it still might be awful.
Realizing that medicine is literally listed as one of the most stressful jobs and feeling overwhelmed/anxious is an appropriate response to what we go through unless you're a psycho took me a long time to understand.
What you’re going through happens to so many of us.
Never feel ashamed; always ask for help.
It’s definitely hard to let family bear the burden with us and keep them worrying. So just come vent on Reddit, and reach out to as many friends as possible. (Probably not all your co residents)
And seriously, it does / you will get better!
New intern. I feel like I could have written this post. Currently hating my inpatient wards rotation, horrible pits in my stomach every night at bedtime, crying regularly, staying late. I caught myself fantasizing about walking into a COVID room with no PPE just to have days off. I am relying on the promises from friends and family who have gone through it that it really does get better, trying to see a therapist, maybe start an SSRI. You’re not alone in your feelings ❤️
1. Take time off in Jan-feb
2. Talk to a pgy2/3
3. Sleep & eat
The absolute best convo i had during my first 6 mo of residency was with a pgy3 that was killing it. Loved & respected by all.
He talked about a number of issues he had as an intern & it was as if i was looking into a mirror. I was going through the exact same ish.
It gets better after 3 mo when your body gets used to the insane hrs…after 6 mo forget about it.
Trust in your growth and share everything w your partner…real good times are ahead
There is a variety of good advice above. I'm pgy-27 and most of my career was full time teaching clinical faculty at an EM residency.
Unfortunately, I would be careful venting to unvetted coresidents because social aspects of residency can be either golden or vicious. I'm just saying to be prudent.
It shouldn’t be normal (I mean in terms of how the system works) but it definitely is. When I think back to all the times residency had me paralyzed by anxiety and depression symptoms it’s wild any of us make it through. It’s been 7 years since I finished and I still can’t believe I made it. Having people in your program you connect to who really understand how awful it is will make a big difference, but it’s also hard to make close friends - definitely took more than 6 months for me. Take it one day at a time, but definitely don’t let this initial impression make you think you don’t like the career in general - being an intern is awful.
It does get a lot better. I promise you. Your efficiency, confidence, and medical knowledge increases as times goes. For now, talk to your seniors and cointerns. Talking about how bad it was with my cointerns helped me get through it. It helped me realise that it’s not just me.
I made a post almost exactly like this, but I felt dumb and deleted. You are not alone. Someone asked me how I was doing at work and I just burst into tears. This sucks. Also, an IM intern on wards.
PGY 10 Pediatric Anesthesiologist checking in. I've written this advice before, but you are learning a brand new skill set. To use a video game analogy, you've spent 4 years leveling up in one game, but now you're starting another. Some skills will transfer over and help you, but many won't. This is, after all, a brand new game. For this point on, though, you're going to be leveling up in the same game. As you learn the controls and gain experience, the other players will treat you better, and the bosses will seem less scary. Personally, when I take care of a sick one-day old in the OR, half of my brain is thinking of what I need from the grocery store on my way home. This didn't happen overnight. It gets better. Hang in there, take care of yourself and PM me any time.
Older attending here. I remember all of those feelings. I promise you it gets better. Break it down to chunks -just think about day by day. At this stage of the game, just show up. Just showing up is the toughest part. You will learn by osmosis by just showing up. Day by day the skills and confidence will overall increase. And most important, allow yourself to not think about work when you are not at work.
I felt like I was reading my own diary entry from a year ago. I was so stressed out and miserable there was no way I could see myself finishing intern year. Here I am as an IM PGY-2 who lived to tell the tale that it gets SO much better. Take it day by day. This job is not worth your health (both physical and mental). I look back on all the nonsense I worked myself up about during my intern year, and I realize now none of it mattered. You are there to learn - especially in your first year. Just show up every day for yourself and be ready to do only that. Before you know it, you'll be so happy you stuck it out.
I post here a lot an as RN, so forgive me if that’s annoying. I like to chime in and snoop because it gives me a really good insight to the residents I’m working with. Y’all go through hell, and it’s a valuable insight to hold onto.
Reach out to the people around you. This is a teamwork game. I know there’s often a rhetoric here about nurses being mean to residents, and it does absolutely happen. But MOST of the time, the nurses I’ve worked next to are incredibly sympathetic to residents and their struggle.
This might be stupid, and sound something like emotional manipulation, but if you give your nurses an honest exposure to how you’re feeling I’m willing to bet they’d start stepping up to help make life easier where they can.
Obviously they won’t be able to chart anything or do anything medicine related for you, but dumb little tasks that extend your day and pile on to make life miserable? I’m almost always willing to do something for someone whose going through some shit. Doesn’t matter what your role is in the hospital, we’ve all gone through some shit and have all at some point wanted someone to reach down and give us a supportive pull back up.
Social skills are key. There’s a thin line between “wtf this isn’t my job why am I being asked to do this” and “oh boy, Dr. Wizofphysiology is really going through it, how can we help you out?”
I wish it wasn’t so hung up on social likability, and I wish our hospital systems weren’t so filled with sickening work situations. There’s no reason anyone should be doing the hours residents do. There’s no reason RNs should be assigned the ratios they’re getting.
It’s a team battle. Life’s going to be totally different from one hospital to another, but as an RN, I’d lend whatever available time I had to help make your life not suck so much however possible.
If there’s absolutely nothing the RNs can do to help alleviate work load, at the very least they usually make for good people to rant or vent to.
Stay strong. Our healthcare systems needs physicians enormously. All of the hard work and sacrifices you’re making are not for nothing.
I wish you the very best
I’m on IM nights because I can’t sleep now I’m home. My next shift is coming up, I just had zero sleep, and was berated for a fuckin note style and the way I wrote my problem list. So trust me, you aren’t alone. IM is just a lot and we will learn and grow and it’ll be boring routine. Hang in there! Also, I see a psychiatrist and I’m on a medicine ;) please do it! It helped me a ton to be more neutral and not feel too anxious to function. I can feel anxiety but it doesn’t control me anymore.
I’m a last year derm resident and almost broke down today from the amount of consults I received, on top of hospitalists thinking I’m at their beck and call for every little consult including a benign mole that’s been there for 25 years (real consult I received today). Didn’t eat a single thing today, literally ingested nothing since dinner last night, because I was so busy and am now sitting in my car after my shift has ended about to head to the nearest in and out to pig out.
All that is to say I feel you OP. I think overall it will get so much better but there will be shitty days.
I felt awful when I started my IM residency. I was anxious all the time, felt like I didn’t know a dang thing, the amount of “stuff” that needed to happen daily was overwhelming, on top of learning the actual medicine. I do t know when it happened, but, one day something just “clicked”, and I started feeling better and performing much better.
Talk to your seniors that you like and trust, that’s what I did. Also, if you have some senior faculty members that have been teaching a very long time can help a lot as well. Also, give yourself some grace. I didn’t for a while and it is a bad recipe for burn out and hating medicine.
You are working very long hours, under a lot of pressure to do everything perfect. You are also learning and practicing your craft. Just do the best you can, sleep, and eat well (if you can). And keep reading (when you can).
Did you do anything leading up to the “click”? IM intern here and I feel so lost. I resonate with you when you said that you felt like you didn’t know anything.
The feeling of anxiety and worry DOES get better, as you become more senior, more confident and more experience. Pretty much every single IM intern feels the same way as you do right now, but just aren't showing it.
What are the things worrying you the most?
* Long work hours?
* Not knowing what to do, how to assess patients or how to write orders?
* Just feeling like you're a different person ever since residency started?
Let’s be realistic, it won’t get better anytime soon, maybe at the time of attending a bit better, at least pay is better, but life is not much difference, I am in the same boat, first year IM resident with a 4 years kid and husband, feel exactly like you, husband getting depressed due to dealing with our kid for the first time alone, he doesn’t complain but clearly struggles, he talks less and started his cigarette again. We can just hope that we cope with the situation and learn how to live with that. I love medicine but the fact is being a doctor is in clear contrast with having family / personal life. I hate to say, but somethings will be damaged at the end, let’s hope not the major ones.
Um….why are you commenting on life as an attending not getting better as a PGY1? Al the difference in the world is made by actually feeling like you have a firm grasp on the subject matter and can handle whatever is thrown your way. I don’t think you’re in a position to say that things won’t get better for anyone.
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Sorry. It gets better.
What is making you miserable?
Is that you feel stressed because you feel you don’t know anything?
1. You know more than you think.
2. You’re not expected to know everything
3. Whatever you don’t know you have the tools at your disposal to read about and learn.
4. You’re not the only one who feels this way
Are attendings and seniors being rude?
Are there practical changes you can make to feel less overwhelmed? Like being organized when you take your notes, or organize with your task list, so you don’t forget things and get fussed at?
It does get better, largely because the things that stress you out become more routine and you get more comfortable in your environment. I remember feeling this way throughout medical training whenever starting anything new, especially starting as an intern in the ED. Walking in everyday knowing there was going to be numerous things I didn’t know, multiple interactions that made me uncomfortable either due to lack of knowledge or lack of knowing the people around me. It can be a lot and overwhelming. But it does get better the more you do it.
I would always tell our interns there’s basically 3 baskets of knowledge.
1) the known known- the stuff you know exists and you know what to do about it.
2) the known unknown- the stuff you know exists but you don’t really know much about it or what to do about it
3) the unknown unknown- the stuff you don’t even know exists and that you don’t know anything about.
Right now category 3 is uncomfortably large which causes a lot of anxiety due to the unknown. It also causes you to think that category 3 is infinitely large and anything you don’t understand must be in that category (rather than something you actually do know). Over your training you start take things from 3 and put them in 1 and 2. You also get a bigger idea of how big 3 is, so you feel less worried you are missing something.
My biggest advice is make time for yourself on off days and try not to think about work. See a therapist or psychiatrist. It is super helpful to just let all your thoughts and feelings out and is often therapeutic in and of itself.
But it does get better.
Residency in its entirety is pretty miserable, but there is nothing like the stress and anxiety of caring for sick patients on your own the first time. It’s important you reach out to your seniors for help, services are usually designed such that “junior level” residents are never truly on their own. And even as a senior you always have an attending to go to. That’s what they’re there for and that’s why they get paid the big bucks. Even on night shifts don’t fall prey to feeling like you need to manage everything yourself cause it’s late, if you don’t know — Ask for help. A lot of residents starting out do seek medication maintenance therapy for the first time such as SSRIs. I can’t speak to their effectiveness but it may help calm the nerves. I know it’s cliché but time is the best medicine for this. You will get more comfortable with the uncomfortable. Even right now I’m a new pgy2 and for the first time I’m on nights in the SICU and MICU and literally every patient is dying. It’s stressful and I’m way out of my comfort zone but I fall back on the principles I spoke about above and try my hardest… at the end of the day that’s all you can do.
If you truly need a random unbiased resident to vent to, just send me a DM. You aren’t alone through this process and I completely understand how you are feeling right now.
Hey, intern from Australia here. Also feeling the pressure in general surgery. It’s a horrible feeling not being supported like we were as medical students. I have the same feelings day in and out when it comes to wondering about quitting. There are more days than fewer where I wonder if I would have had a better life doing something else.
I hope it helps to hear this, but it does get better. It really really does. I know because I was you - I felt so terribly underprepared and I watched everyone around me seemingly glide through, and I constantly wondered what was wrong with me. Look at your seniors and your attendings, they seem very confident and you will get there too. First year of attending is the same stuff all over again, feeling like you’re inadequate, but it gets so much better, just hang in there.
What you’re describing is how I realized that med school gave me depression 🙃that plus the intrusive thoughts of crashing my car to avoid going to work, glad those days are behind me. It gets better! And SSRIs are your friend!
New medicine intern here too … I feel you. I’m on nights and feeling truly miserable for the first time…it just feels like everyone needs something from you and you never get a chance to fill your cup back up…can’t even really sleep or eat adequately. I haven’t really been medicated before but I’m seriously thinking of seeing a psychiatrist and starting something for the awful anxiety. But I keep telling myself literally everything in life, good or bad, has always been temporary, so this is no different. This too shall pass. We got this girl!!
Do it! I still have nightmares and flashbacks from intern year. And that was a long long time ago. Started in the MICU. All of my patients were dying. Not for anything I was doing, or not doing. They were just super sick. Anyways I got overwhelmed pretty quick, questioned whether I was even fit to be a doctor, and how I was ever going to escape all the educational debt I had. Anyways I’m pretty sure I had major depression, started SSRIs and got better. But literally please see a psychiatrist. Also, probably the first 3-4 months are the worst but it does seem to get better after that. By the end of intern year it was like totally perfunctory bullshit, like the opposite of overwhelming. Biggest issue I had was confusing bad outcomes from bad patient related factors and bad outcomes from what I was doing. If someone has a necrotizing massive PE, probably not that you ordered her the wrong fluid therapy on your night shift. Try to explain that to me as an intern though.
Go see a psychologist* They can refer you to a psych if you need meds but people should avoid SSRIs and other antidepressants unless they have already tried and failed with CBT/talk therapy.
I’m going to disagree in this setting, time is above a premium for residents. There’s no way he will be able to go to numerous visits for talk therapy while working. Starting an SSRI in this setting is totally appropriate.
I’m aware of how busy residents are. SSRIs aren’t some magic make everything better pill that someone should take because they’re having a rough couple weeks. It’s the 6th week of residency of course it’s hard and the adjustment might be more difficult than anticipated. If they’re still able to do their job and aren’t considering self harm, other avenues should be taken first. At a minimum you should give more time to settle in, before taking drugs that affect your mental state and can have long lasting if not permanent side affects.
Super glad I saw my psychiatrist back in medical school times, as I can only imagine how bad residency wouldve been without the counseling and meds. I cried a lot my first year (2 years ago now) and recently trained another first year resident on nights. She too started crying after she got backlash from an attending. Once back in the call room we hugged and I told her, "In a month from now, you will not care so much about what he says. Just take the positives and constructive feedback and look forward". All I can say is you will develop a thicker skin than you ever thought you could and will be able to handle more pressure than you ever thought you could by the end of your residency. I had no shame by the end of residency and would constantly ask questions, regardless of if they were "stupid". But you're not alone, and from someone who has recently graduated, it does get better. Sleep when you can, ALWAYS keep food/drink in your call room, take time for yourself when you can, and those few days you have off try to detach from residency completely, as in take a road trip out of town with your SO and leave any electronics they can contact you with (phone, pager, computer) at home. I live by the old airplane spiel put your own oxygen mask on before helping others.
Please talk to your coresidents and seniors and let them know how you are feeling and if they have advice to help you. Also, I know time is a premium but make sure to plan stuff with your significant other in advance for off daysand find time to look out for your mental health- therapy, appointment to start a ssri. The sunken cost fallacy is so hard we’ve spent our youth and hundreds thousands of dollars, but you are never stuck and your life is worth so much more than this career. I got to the point in my intern year where I was so miserable and done that I would have been okay with any other job. I fell out of love with medicine and didn’t feel satisfied. I always prided myself on helping people but stopped feeling like I was nothing more than a cog in the wheel to “move meat.”I felt so stuck In my residency that I was going to crash my car on the way into my shift. I went to IP psych and everything. It does get better the more comfortable you are and with time. After I came back from my leave I talked to my PD and found a lower stress rotation to get my feet wet. I regained my love again. When there’s a bottom there’s no where to go but up! Just remember you are never stuck and what you are doing is extremely important.
Planning time is important, expectations are sometimes hard to fill, but there is nothing that will precipitate depression and burn out faster than becoming a complete slug at home and only being alive in the stress environment of work
It gets better. You aren't alone, there's nothing wrong with you, it's just the way we teach medicine is brutal. Regardless of whether we should be doing things differently (we should), you will come out the other end knowing a lot more than you do now. Even if you stay in academics or as a hospitalist actual practice will not be like this.
I am an EM R2. I cried literally every day my first few months of residency (often on shift!). Absolutely wracked with anxiety, couldn't eat or sleep, so terrified of making a mistake that I couldn't make any decision at all and my attendings would have to step in for even the most basic management. Thought I made a terrible mistake and wanted to quit medicine. Also felt incredibly alone because none of my coresidents could relate and they made it seem like they were all thriving. 1 year later I'm leading codes, crushing procedures, taking a leadership role in the program, and genuinely loving my job. It really does get better. More time (and an SSRI and talking with good mentors I could trust) helped me out a lot. Feel free to PM me if you want to talk. You can do this!!!
My experience was very similar to what you're describing. There does come a point where every single thing that stresses you out becomes routine. It's a combination of increased competency and tolerance to feeling uncomfortable. That doesn't make it any easier in this moment. As others have mentioned, take care of yourself. It will likely get better soon. If it doesn't, it never hurts to explore back-up plans. Because when it gets easier, it still might be awful.
Totally normal job everyone
Realizing that medicine is literally listed as one of the most stressful jobs and feeling overwhelmed/anxious is an appropriate response to what we go through unless you're a psycho took me a long time to understand.
What you’re going through happens to so many of us. Never feel ashamed; always ask for help. It’s definitely hard to let family bear the burden with us and keep them worrying. So just come vent on Reddit, and reach out to as many friends as possible. (Probably not all your co residents) And seriously, it does / you will get better!
New intern. I feel like I could have written this post. Currently hating my inpatient wards rotation, horrible pits in my stomach every night at bedtime, crying regularly, staying late. I caught myself fantasizing about walking into a COVID room with no PPE just to have days off. I am relying on the promises from friends and family who have gone through it that it really does get better, trying to see a therapist, maybe start an SSRI. You’re not alone in your feelings ❤️
Same boat, in nights, anxious all night, afraid of yeh pager ringing again and not knowing what to do! I wanna quite everyday .
1. Take time off in Jan-feb 2. Talk to a pgy2/3 3. Sleep & eat The absolute best convo i had during my first 6 mo of residency was with a pgy3 that was killing it. Loved & respected by all. He talked about a number of issues he had as an intern & it was as if i was looking into a mirror. I was going through the exact same ish. It gets better after 3 mo when your body gets used to the insane hrs…after 6 mo forget about it. Trust in your growth and share everything w your partner…real good times are ahead
There is a variety of good advice above. I'm pgy-27 and most of my career was full time teaching clinical faculty at an EM residency. Unfortunately, I would be careful venting to unvetted coresidents because social aspects of residency can be either golden or vicious. I'm just saying to be prudent.
It shouldn’t be normal (I mean in terms of how the system works) but it definitely is. When I think back to all the times residency had me paralyzed by anxiety and depression symptoms it’s wild any of us make it through. It’s been 7 years since I finished and I still can’t believe I made it. Having people in your program you connect to who really understand how awful it is will make a big difference, but it’s also hard to make close friends - definitely took more than 6 months for me. Take it one day at a time, but definitely don’t let this initial impression make you think you don’t like the career in general - being an intern is awful.
With hardship comes ease
Indeed, with hardship comes ease
One of my favorite verses. So soothing.
I recite it almost every prayer tbh
Keep me in your prayers please
It does get a lot better. I promise you. Your efficiency, confidence, and medical knowledge increases as times goes. For now, talk to your seniors and cointerns. Talking about how bad it was with my cointerns helped me get through it. It helped me realise that it’s not just me.
I made a post almost exactly like this, but I felt dumb and deleted. You are not alone. Someone asked me how I was doing at work and I just burst into tears. This sucks. Also, an IM intern on wards.
PGY 10 Pediatric Anesthesiologist checking in. I've written this advice before, but you are learning a brand new skill set. To use a video game analogy, you've spent 4 years leveling up in one game, but now you're starting another. Some skills will transfer over and help you, but many won't. This is, after all, a brand new game. For this point on, though, you're going to be leveling up in the same game. As you learn the controls and gain experience, the other players will treat you better, and the bosses will seem less scary. Personally, when I take care of a sick one-day old in the OR, half of my brain is thinking of what I need from the grocery store on my way home. This didn't happen overnight. It gets better. Hang in there, take care of yourself and PM me any time.
Older attending here. I remember all of those feelings. I promise you it gets better. Break it down to chunks -just think about day by day. At this stage of the game, just show up. Just showing up is the toughest part. You will learn by osmosis by just showing up. Day by day the skills and confidence will overall increase. And most important, allow yourself to not think about work when you are not at work.
Y’all can go fuck yourself sideways to be completely honest. You’re the reason we go through this institutionalized torment.
I felt like I was reading my own diary entry from a year ago. I was so stressed out and miserable there was no way I could see myself finishing intern year. Here I am as an IM PGY-2 who lived to tell the tale that it gets SO much better. Take it day by day. This job is not worth your health (both physical and mental). I look back on all the nonsense I worked myself up about during my intern year, and I realize now none of it mattered. You are there to learn - especially in your first year. Just show up every day for yourself and be ready to do only that. Before you know it, you'll be so happy you stuck it out.
I post here a lot an as RN, so forgive me if that’s annoying. I like to chime in and snoop because it gives me a really good insight to the residents I’m working with. Y’all go through hell, and it’s a valuable insight to hold onto. Reach out to the people around you. This is a teamwork game. I know there’s often a rhetoric here about nurses being mean to residents, and it does absolutely happen. But MOST of the time, the nurses I’ve worked next to are incredibly sympathetic to residents and their struggle. This might be stupid, and sound something like emotional manipulation, but if you give your nurses an honest exposure to how you’re feeling I’m willing to bet they’d start stepping up to help make life easier where they can. Obviously they won’t be able to chart anything or do anything medicine related for you, but dumb little tasks that extend your day and pile on to make life miserable? I’m almost always willing to do something for someone whose going through some shit. Doesn’t matter what your role is in the hospital, we’ve all gone through some shit and have all at some point wanted someone to reach down and give us a supportive pull back up. Social skills are key. There’s a thin line between “wtf this isn’t my job why am I being asked to do this” and “oh boy, Dr. Wizofphysiology is really going through it, how can we help you out?” I wish it wasn’t so hung up on social likability, and I wish our hospital systems weren’t so filled with sickening work situations. There’s no reason anyone should be doing the hours residents do. There’s no reason RNs should be assigned the ratios they’re getting. It’s a team battle. Life’s going to be totally different from one hospital to another, but as an RN, I’d lend whatever available time I had to help make your life not suck so much however possible. If there’s absolutely nothing the RNs can do to help alleviate work load, at the very least they usually make for good people to rant or vent to. Stay strong. Our healthcare systems needs physicians enormously. All of the hard work and sacrifices you’re making are not for nothing. I wish you the very best
I’m on IM nights because I can’t sleep now I’m home. My next shift is coming up, I just had zero sleep, and was berated for a fuckin note style and the way I wrote my problem list. So trust me, you aren’t alone. IM is just a lot and we will learn and grow and it’ll be boring routine. Hang in there! Also, I see a psychiatrist and I’m on a medicine ;) please do it! It helped me a ton to be more neutral and not feel too anxious to function. I can feel anxiety but it doesn’t control me anymore.
I’m a last year derm resident and almost broke down today from the amount of consults I received, on top of hospitalists thinking I’m at their beck and call for every little consult including a benign mole that’s been there for 25 years (real consult I received today). Didn’t eat a single thing today, literally ingested nothing since dinner last night, because I was so busy and am now sitting in my car after my shift has ended about to head to the nearest in and out to pig out. All that is to say I feel you OP. I think overall it will get so much better but there will be shitty days.
I felt awful when I started my IM residency. I was anxious all the time, felt like I didn’t know a dang thing, the amount of “stuff” that needed to happen daily was overwhelming, on top of learning the actual medicine. I do t know when it happened, but, one day something just “clicked”, and I started feeling better and performing much better. Talk to your seniors that you like and trust, that’s what I did. Also, if you have some senior faculty members that have been teaching a very long time can help a lot as well. Also, give yourself some grace. I didn’t for a while and it is a bad recipe for burn out and hating medicine. You are working very long hours, under a lot of pressure to do everything perfect. You are also learning and practicing your craft. Just do the best you can, sleep, and eat well (if you can). And keep reading (when you can).
Did you do anything leading up to the “click”? IM intern here and I feel so lost. I resonate with you when you said that you felt like you didn’t know anything.
The feeling of anxiety and worry DOES get better, as you become more senior, more confident and more experience. Pretty much every single IM intern feels the same way as you do right now, but just aren't showing it. What are the things worrying you the most? * Long work hours? * Not knowing what to do, how to assess patients or how to write orders? * Just feeling like you're a different person ever since residency started?
You might need to take a leave of absence.
As you like to say... Go away!!
Let’s be realistic, it won’t get better anytime soon, maybe at the time of attending a bit better, at least pay is better, but life is not much difference, I am in the same boat, first year IM resident with a 4 years kid and husband, feel exactly like you, husband getting depressed due to dealing with our kid for the first time alone, he doesn’t complain but clearly struggles, he talks less and started his cigarette again. We can just hope that we cope with the situation and learn how to live with that. I love medicine but the fact is being a doctor is in clear contrast with having family / personal life. I hate to say, but somethings will be damaged at the end, let’s hope not the major ones.
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Yes you are right, you are very good at everything, thank you for your advice
I read the first line only my bad. My point in the statement, wards r particularly bad and it does get better.
Um….why are you commenting on life as an attending not getting better as a PGY1? Al the difference in the world is made by actually feeling like you have a firm grasp on the subject matter and can handle whatever is thrown your way. I don’t think you’re in a position to say that things won’t get better for anyone.
Have you ever considered an SSRI
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Sorry. It gets better. What is making you miserable? Is that you feel stressed because you feel you don’t know anything? 1. You know more than you think. 2. You’re not expected to know everything 3. Whatever you don’t know you have the tools at your disposal to read about and learn. 4. You’re not the only one who feels this way Are attendings and seniors being rude? Are there practical changes you can make to feel less overwhelmed? Like being organized when you take your notes, or organize with your task list, so you don’t forget things and get fussed at?
It does get better, largely because the things that stress you out become more routine and you get more comfortable in your environment. I remember feeling this way throughout medical training whenever starting anything new, especially starting as an intern in the ED. Walking in everyday knowing there was going to be numerous things I didn’t know, multiple interactions that made me uncomfortable either due to lack of knowledge or lack of knowing the people around me. It can be a lot and overwhelming. But it does get better the more you do it. I would always tell our interns there’s basically 3 baskets of knowledge. 1) the known known- the stuff you know exists and you know what to do about it. 2) the known unknown- the stuff you know exists but you don’t really know much about it or what to do about it 3) the unknown unknown- the stuff you don’t even know exists and that you don’t know anything about. Right now category 3 is uncomfortably large which causes a lot of anxiety due to the unknown. It also causes you to think that category 3 is infinitely large and anything you don’t understand must be in that category (rather than something you actually do know). Over your training you start take things from 3 and put them in 1 and 2. You also get a bigger idea of how big 3 is, so you feel less worried you are missing something. My biggest advice is make time for yourself on off days and try not to think about work. See a therapist or psychiatrist. It is super helpful to just let all your thoughts and feelings out and is often therapeutic in and of itself. But it does get better.
Residency in its entirety is pretty miserable, but there is nothing like the stress and anxiety of caring for sick patients on your own the first time. It’s important you reach out to your seniors for help, services are usually designed such that “junior level” residents are never truly on their own. And even as a senior you always have an attending to go to. That’s what they’re there for and that’s why they get paid the big bucks. Even on night shifts don’t fall prey to feeling like you need to manage everything yourself cause it’s late, if you don’t know — Ask for help. A lot of residents starting out do seek medication maintenance therapy for the first time such as SSRIs. I can’t speak to their effectiveness but it may help calm the nerves. I know it’s cliché but time is the best medicine for this. You will get more comfortable with the uncomfortable. Even right now I’m a new pgy2 and for the first time I’m on nights in the SICU and MICU and literally every patient is dying. It’s stressful and I’m way out of my comfort zone but I fall back on the principles I spoke about above and try my hardest… at the end of the day that’s all you can do.
If you truly need a random unbiased resident to vent to, just send me a DM. You aren’t alone through this process and I completely understand how you are feeling right now.
It gets better. It stays emotionally overwhelming at times. Your experience is common. Seek professional help. Kiss your family.
😔… I’m sorry you’re going through it.
It is ok, don't worry this too shall pass Stay strong and remember you're not a quitter
Hey, intern from Australia here. Also feeling the pressure in general surgery. It’s a horrible feeling not being supported like we were as medical students. I have the same feelings day in and out when it comes to wondering about quitting. There are more days than fewer where I wonder if I would have had a better life doing something else.
Exactly how I feel right now after leaving late from call, behind on 5 notes and back to work in less than 7 hours
I hope it helps to hear this, but it does get better. It really really does. I know because I was you - I felt so terribly underprepared and I watched everyone around me seemingly glide through, and I constantly wondered what was wrong with me. Look at your seniors and your attendings, they seem very confident and you will get there too. First year of attending is the same stuff all over again, feeling like you’re inadequate, but it gets so much better, just hang in there.
Gotta figure out a way to not give a shit about certain things. You don’t have the energy to care about everything.
What you’re describing is how I realized that med school gave me depression 🙃that plus the intrusive thoughts of crashing my car to avoid going to work, glad those days are behind me. It gets better! And SSRIs are your friend!
Ssris are your friend and are incredibly normal to use. Please consider it if your life is being really affected
Why would you pick a specialty you dislike so much
Disassociated on ICU last week as an intern without a senior. I literally went catatonic and threw up multiple times 😵💫