I appreciate the authors for conducting the cohort study on "Association Between Electronic Cigarette Use and Smoking Reduction in France". Bedside: The Art of Medicine, by Michael LaCombe, MD. My kiddo and wife don't like when I work nights / weekends / holidays, so that's another thing to consider. Have never worked academic outside of residency and briefly afterwards (few months, tops). I'd also agree that in the private world it's WAY different: far easier to get anything done. Your fault for the multiple admits). I have all of my away rotations completed for EM and a sub-I + LORs for IM so both are still viable. When I was a student I wanted nothing more than ER. I know it was a lot of questions, thanks for your time. They can have long hours during residency and call can be brutal. That said, the life of an outpatient Internist is pretty tough. Internal Medicine-Critical Care Medicine (2) Pain Medicine (0) Pediatric Emergency Medicine (7) Practice For Sale - Emergency Medicine (0) Residency / Fellowship / Internship - Emergency Medicine (1) Sports Medicine (0) Surgical-Critical Care (1) Toxicology (1) Undersea & Hyperbaric Medicine (0) I was wondering if anyone could provide input: For example, what are some things that frustrate you most about your job? On inpatient rehab you are technically the primary and need a good foundation in medicine. 26 weeks off a year. It draws the best and brightest.” -- David Gremillion, MD, FACP Internal medicine physicians, or internists, are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate There was virtually no education (e.g. I had two sporadic days off, one of which I got called in for a meeting on. What aspects of work do you live for? It takes years of rigorous schooling and a nonstop, crazy schedule to finally make it. Other Internal Medicine subspecialties discussion forum. Not recommended. Lol at IM having a terrible lifestyle in residency. Completion of residency training in preventive medicine is an essential step to become certified in one or more of the preventive medicine specialty areas: Public Health and General Preventive Medicine, Occupational Medicine, and Aerospace Medicine. Related But for me, it sucked. I'm a current MS3 who hated third year and still doesn't know what to do. Threads 266 Messages 8.6K. What does the future for internal medicine look like for you? Having primarily been trained as an internist, I have an ability to evaluate my patients very well in … You do medicine without the social work and notes. The big problem in at least the (public) academic centers I worked in was the overall attitude of "no". When you call a consult as a hospitalist at a private hospital, the consultant takes over care of that problem. The Department of Internal Medicine offers a complete range of teaching — students, residents, fellows, research — and consultative and inpatient services covering all areas of internal medicine. Thank you for this post, tremendously helpful for someone about to finish undergrad (aka me). Residency sucks in general, no matter which specialty you go into. I know a lot of classmates who seemingly chose IM not because they love it or even liked it, but because they were undecided on what to do, and IM gives them a lot of options later down the line. As long as you have your phone with you go for it. It's much better even if hours are long. I don't know if it was because resources were limited (they were) or if because everybody is salaried and therefore with no sort of RVU-based incentives, but it was exhausting. The other docs were generally polite and professional, but they weren't there to make friends beyond encouraging people to send them good consults (i.e. Is this pathway relatively common? In other words, they start writing all their own orders. You didn't ask about IM subspecialities, but obviously if you want to do GI, cards, or the like, you gotta start with IM. I'm a bit outside one of the major cities in the Southeast, and most of the hospitalists are FMGs. phone calls from patients, colleagues, etc.? Great lifestyle and balance. A new Medscape poll probes doctor lifestyles. Burnout is a real thing: not too many people can manage an entire career there. Zero social network. The COPD patient who still smokes 1ppd and uses meds when he feels like it? Or dealing with the chronically ill that just end up in your ED. work hours/week, how much does work interfere with life outside of work e.g. I'm planning on moving out of the Hospitalist gig here soon - the lure of 9-5 m-f is strong once you've got school aged kids... Moving on to what, if I may ask? On inpatient rehab you are technically the primary and need a good foundation in medicine. The week on/week off gig takes some time to get used to. I'll say right now: where I am, if you are a U.S. medical grad, and went to a respectable residency, you should have no problem at all getting a gig as a hospitalist in a solid hospital. We couldn't have moved to Denver had I been ER without me working urgent care or freestanding. IM residents at my institution worked 6 days a week. Didn't match in our little town (wife was already in a residency program, so couldn't move), but it turned out to be the best thing that happened to me. I spent most of my first half of internship being really, really miserable. I'll bite. You set your schedule (other than your admit schedule usually) of when you see your patients. How willing docs were to see your patients as a consultant was directly related to their reimbursement. Sorry for so many questions, just very curious, thank you! In the private world I have more patients to see but it's fantastic. And you make more money. In 2004, the first electronic cigarette, a Chinese invention, came as a pathway to the reduction in yobacco smoking or tobacco harm reduction (THR) from the Rune Company and was marketed as a less harmful alternative to smoking (1). I was psych all the way, then somehow ended up considering med/psych, but my current med attending has banished such a silly idea from my head. Internal Medicine At UI Health, our internal medicine physicians specialize in the prevention, diagnosis and treatment of health issues that impact adults. It's literally just you doing whatever you want so long as you can get patients discharged on time. What is your perception of a career in EM? Can do either primarily inpatient or only outpatient or a mix of both. I had my August forward-stacked for an impending baby, and as a result have been working July 22 - August 16. I won't go into how the rest of the hospital feels about ER docs generally :P. As an MS4 who prefers his work and break time to be in large chunks, this makes me giddy. Fish’s Clinical Psychopathology Signs and Symptoms in Psychiatry 4th Edition Psychopathology lies at the centre of effective psychiatric practice and mental health care, and Fish’s Clinical Psychopathology has shaped the training and clinical practice of psychiatrists for over fifty years. Press J to jump to the feed. And you can set your own schedule every single day. The lifestyle is also decent (your shift is over and you go home). Like others have said, we're the machine that runs the hospital. This is not the first time this has happened. An 8-year residency in neurosurgery may not be as conducive to these plans as a three-year residency in family medicine (or internal medicine for that matter). what are you planning on moving onto? Most of the great leaders in medicine in general have come from internal medicine because of the breadth and depth of its academic and clinical work. You mentioned burnout and yeah, that can happen if you don't find a good fit, but the turnover also means an ample supply of jobs. I have thought about it but never really pursued either of them further just because histo and imaging were never things I was interested in. Did you have any leaning or feeling? Some of the IM fellowships were pretty happy but some of those were also pretty competitive, which is another thing to consider. What is life style like as an internist e.g. The Immortal Life of Henrietta Lacks, by Rebecca Skloot. This is a highly moderated subreddit. I'm doing a year of IM before Anesthesia and while I love my coworkers, the bs we put up with from patients and other specialties SUCKS. [ December 11, 2020 ] To all Residents: Here’s the latest on board certification. Getting anything done felt like a struggle, pulling teeth. Would you recommend students from pursuing internal medicine? 3rd year a grind fest and not necessarily an indication of how happy you'd be in that field as a doctor, though it can give you some idea. No malpractice (hospital should pay for it) or office staff to manage, no call, set hours. Press question mark to learn the rest of the keyboard shortcuts. Looks like you're using new Reddit on an old browser. Haven’t met a physiatrist attending or resident who regrets going into it. That is a pretty good summary of the life of a hospitalist. Switching residencies? You'll make less but you seriously have an ocean of free time. watching Netflix and playing PlayStation for a week. Need a surgeon to see your homeless undocumented immigrant needing I&Ds of multiple abscesses secondary to skin popping? During that same time period, the number of graduates specializing in internal medicine, pediatrics and family medicine dropped from 36 to 22. Basically punting on a career decision for now, like you mentioned in your OP. Not sure why anyone would want to do this for the rest of their lives. There are currently 72 accredited preventive medicine residency training programs in the United States. Press question mark to learn the rest of the keyboard shortcuts, MSc in Med|Psychiatry (EU) PGY-5|"Arbiter of Medical Discussion". Similar situation also for the notice aimed at finding two internal medicine doctors for the hospital Caracciolo of Agnone (Isernia). The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. You never have to round as an attending in PP if you don't want to. They are OK, don't get me wrong, but I'm kinda saying the field is wide open now. I have all of my away rotations completed for EM and a sub-I + LORs for IM so both are still viable. Residency training is the first opportunity to begin caring for patients as their doctor and is a challenging period filled with incredible growth. Physicians specializing in internal medicine are called internists, or physicians (without a modifier) in Commonwealth nations. Everyone wanted to come in, see their patients, fill out their billing, and leave. is this general doom and gloom and irrelevant, or do you see some trends going in this direction? Anything else and I think I could make it work. Yea, probably worse than FM/Psych, but way better than gen surg/ortho, right? Some results: rheumatologists are happiest, dermatologists are healthiest, 1/3 of docs were born outside the U.S., Toyotas are docs' favorite cars. Once you are making money, being treated like a real person, and having something resembling a life, it's hard to go back. Do you want to explore any other fields? Oh, agreed that the insurance company can fuck right off. According to Wikipedia, “Internal medicine or general medicine (in Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. I'm not violating the shit out of my work hour restrictions to have you disrespect my poor lifestyle choices! My two cents - I don't think you should do IM from the way you wrote about it here. Speaking for our team, I hope that you find it helpful, especially if you are looking to get an Internal Medicine book right now. I can't imagine being happy doing IM, FM, Peds, or EM. That and if the group is owned by the hospital you can likely qualify for PSLF and save even more coin. Laundry, cleaning, errands but there's some down time too. More like IM residents THINK they have a bad lifestyle. At this point I'm learning towards doing IM but I sometimes can't help but feel like I'm making a terrible mistake. CME, grand rounds, etc...) at the hospital, and people actively avoided discussing their patients to bounce ideas off of each other, or help each other with challenging differential diagnoses. and what do you all think about the forecast for hospitalist positions. That's a shitty lifestyle to be working at something you don't really like all that much in the first place. The one thing I have noticed with my group is the relative punishment you get for taking more than a week off (or 4-5 days depending on how your group blocks schedules). Most EM now is not like you see on TV: much less multiple GSWs and more like multiple patients trying to get narcotics. Some of you may know that I started out in an internal medicine residency and quit for physical medicine and rehabilitation (PM&R). Internal medicine doctors are the go-to source for your traditional wellness care, including annual checkups, screenings, and physicals. (outside of the military, and that is a separate discussion). So in summary, yes 7 days on 7 days off as a hospitalist at a private hospital is amazing. For the 11 years that I practiced general internal medicine, I did not have a good quality of life. You are seeing 5 patients per hour, and dealing with all kinds of insurance BS. Traditional outpatient inpatient blend? At BIDMC, we are committed to helping you not just survive residency, but truly thrive.. We have designed a program that allows you to thrive as a future academic internist or specialist, who will excel as a clinician, educator, researcher, and/or academic scholar. New comments cannot be posted and votes cannot be cast. Residency programs that combine basic internal medicine with other disciplines are available that broaden the clinical skills of trainees and usually allow completion of training in a shorter period of time than performing different residencies independently. True - the ER and the OR are the big revenue generators (along with infusions) - but who is gonna admit patients? At Weill Cornell Medicine, we believe that this unique experience of training must provide young Urgent care? easy consults for patients with insurance). When is that MRI gonna happen? I'm very grateful that some of my colleagues prefer it, but I would never go back to that environment again. Haven’t met a physiatrist attending or resident who regrets going into it. I'm a 'work to live' type of person and want medicine to be just a job. It's better for the hospital (gets to submit bills from 1 additional service), probably better for the patient too. These three probably do have the best lifestyle (almost all outpatient, regular … Blech. -reallyyyy hated rounds, the note writing and the daily grind but maybe if I got used to it and more efficient it wouldn't be as bad? This part of Medscape's annual Physician Lifestyle Report focuses on their responses to our survey questions about burnout and depression. Some of these books are core Internal Medicine textbooks for your library while others are great as a resource while on the go. Non clinics medicine? Welcome to /r/MedicalSchool: an international community for medical students. Burnout continues to be a pervasive issue among physicians. That all said, which 3rd year clerkship or rotation was your favorite? FM NBME Shelf Review, April 2018 Studying: • I highly recommend a combination of readings and questions o Readings: Step-Up to Family Medicine: Outline format, easy to get through in 4 weeks, written by the UC DFCM specifically to do well on the FM Clerkship and shelf exam. Being an academic hospitalist is an easy, easy job. I don't know why this would be specific to private hospitals, but it's never happened at the academic centers I've worked at: an insurance company sent a representative to the hospital to track me down in person and explain why they were not approving a diagnostic procedure (brain biopsy for suspected CJD) because treatment for the suspected diagnosis was supportive only, and thus, they did not believe it would alter management. And in addition to above questions, here are some more specifically for hospitalists: what do you do during your week/s off? Any plans on incorporating clinic to your practice? You obviously have to like teaching but the hours are usually ridiculously good. tl;dr I'm thinking IM because I'm incapable of making decisions and don't want to specialize too soon, but I've seen too many scary posts about how IM residents are so burnt out. Need to take care of something during a work day? Everybody wants something. They exist. Limited availability of subspecialists. At the Yale School of Medicine, the number of graduates choosing E-ROAD specialties rose from 17 in 1997 to 34 this year. Why? Seconding everyone who's suggested rads. While this makes things "easier" for you as the hospitalist, it fragments care, can create conflict when consultants disagree, it deflates your role in patient care, and overall makes things less personally satisfying. But if you find a great group of fellow workers it's a really good life. Between residency and my current academic job, I spent 1 year as a hospitalist at a small, private, community hospital. Go to the gym, travel, do things that better yourself and it feels much more worthwhile than watching Netflix and playing PlayStation for a week. R. Official 2020-2021 Rheumatology Fellowship Application Cycle. Programs are administered by schools of medicine, schools of public health, state or local health departments, or in federal government agencies or branch… I work 7-on, 7-off and even a couple years out keep trying new things in my free time. But Hospitalists aren't going away. I’m a 4th year medical student and can’t decide between emergency medicine and internal medicine 4 weeks away from opening of ERAS. In Molise, also in the past, several white coats have ignored the requests of the health company for the search for personnel. 5 Metcalf KM, Moriarty ME: A clinical study of epileptic children treated by ketogenic diet. Great lifestyle and balance. -not really interested in any of the subspecialties currently, -god i just hated third year and I don't want to be this depressed during residency too. Take a look at PM&R. Threads 1.1K Messages 23.4K. I realized I don’t know what life is like as an internist, especially in a community setting. I still enjoyed learning about medicine in preclinical years. How feasible would it be to pursue a fellowship after years working for a private group? Please read the rules carefully before posting or commenting. I can definitely see that being me in the future, particularly because I'm just not super passionate about medicine and patient care. Thank you for your interest in the Internal Medicine Residency program at Beth Israel Deaconess Medical Center (BIDMC). As for EM: it's all about what you like and can you deal with the patients. Nah. Just one of those rare times that they arrive at a reasonable decision through completely flawed means. I was at a level 1 trauma hospital until this year, when I moved closer to home / community hospital. southern california, and that it's becoming increasingly difficult to get the job you want, salary etc. I've heard word that the supply is catching up to the demand, esp in saturated markets e.g. You have to be passionate about medicine or at least really want to practice it to make it in the field. Plus its four years which is tough if you are already burnt out. How is life when you’re actually working? Mostly it's positive. It was a great learning experience as a brand new attending, but not so good for patients. Internal Medicine Residency Program Day in the Life of an Intern Our conference ends around 1:15 pm, and I spend the afternoon getting the rest of my work done. The work itself is good, but (especially if your group is employed by the hospital) expect to be the hospital's go-to for problem solving. Quick insights I would give students who are considering internal medicine: Physicians are truly blessed to be able to do the work that we do. Medscape's 2013 Physician Lifestyle Report provides physicians insights on how burnout may affect or not affect their lifestyle choices and experiences. Why? Personally, I wouldn't do this unless you at least liked IM decently well vs other clerkships. General IM is consistently at the bottom of a lot of physician happiness/satisfaction reports that I've seen, so that take that for what you will. Can do either primarily inpatient or only outpatient or a mix of both. I just whisper "non invasive vascular testing" to the EMR at 1400 and the result is on the chart the next morning. Hospitalists make 2x in places like Orlando, Jacksonville, Savannah than they do in super-saturated markets like NYC and Boston. I appreciate any advice you guys might have! Agree with this assessment. The best scenario is if your family is on an unorthodox schedule too - ie, I went to Breakfast and the beach on a Tuesday morning with my husband and toddler, since he's shift work as well. Duh. Plenty of IM attendings don't even do bedside rounds. Want surgery to see the patient quickly? Theoretically you can go back and do a speciality, but I've seen very few people do so. (Diabetic won't use insulin as directed and lives in the Hostess aisle of the supermarket: your fault for the HbA1c of 11. Addiction medicine, however, has given me an opportunity to have a much better practice lifestyle. Maybe. What does a normal day look like for you, and do you think you can continue this trend into the next few decades? They like teamwork, solving complicated problems, and direct patient care. The other doctors didn't really seem to care about improving themselves. Good luck with that. Hospitalist jobs are maybe the easiest to find jobs if you're looking outside certain areas. While there was nothing explicitly different than what you've described, I greatly disliked it. Like any job it depends on the market. The study found that the generation most happy outside of work is millennials … You are getting pressured constantly for "better outcomes", and blamed for things that are beyond your control. The American Board of Lifestyle Medicine began offering certification in lifestyle medicine in October 2017, and so far 300 doctors have received it. But entirely doable. The majority of emergency medicine programs is also 3 years, however other factors mentioned above effect your … This year’s Medscape physician compensation report reveals that emergency medicine physician salaries are on the rise, and they are one of the highest-ranked physician specialties in terms of job satisfaction. Oral surgery wants someone to admit their 26 yr old post op patient with no medical history? It's normal to not enjoy 3rd year, so don't let that fact weigh down on you too much. Every rads resident on reddit seems ridiculously happy though. If you don't mind me asking where are you practicing? Demand to sit for the exam is exploding, Dysinger says. The patients admitted to hospitals with fewer ICU beds had a higher risk of death, according to a study published in the summer in the journal JAMA Internal Medicine said. Doesn't seem like the right fit. Welcome from the Program DirectorCongratulations as you embark on this exciting and momentous time in your career as a physician. The money seems to be OK. I realized I don’t know what life is like as an internist, especially in a community setting. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Boston Medical & Surgical Journal 1927, 196(3):89-96. Just ask the LSW if we have a bed offer yet and walk away. Who is going to handle all the other issues? Want to live in a particular place and expect to pay for it. As an adult, a bunch of your off week is playing catch-up from the week on. Reasons why I feel like I'm making a huge mistake: -I'm just not really excited about the idea of going into IM as much some of my colleagues are. At finding two internal medicine residency training is the first opportunity to begin caring for patients as a at... The major cities in the prevention, diagnosis and treatment of health issues that impact adults go... To finish undergrad ( aka me ) like a struggle, pulling teeth of which I got called for... Be a pervasive issue among physicians exploding, Dysinger says IM, FM,,! Academic job, I did not have a much better even if you 're using reddit! Private hospital is amazing past, several white coats have ignored the requests of the major in! And so far 300 doctors have received it inpatient or only outpatient or a mix of both ’. Person and want medicine to be working at spent 1 year as a at... 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It ) or office staff to manage, no call, internal medicine lifestyle reddit hours work hours/week, how much work. So both are still viable is on the specific hospital you 're using new reddit on an old.. Good quality of life sucks in general, no call, set.... The work day look like for you undocumented immigrant needing I & Ds of abscesses. Not too many people can manage an entire career there old browser Metcalf KM, me. Bidmc ) also pretty competitive, which 3rd year clerkship or rotation was your favorite experience a. And kind care, including annual checkups, screenings, and that 's... Modifier ) in Commonwealth nations and internal medicine lifestyle reddit for things that are beyond your control can an! & Ds of multiple abscesses secondary to skin popping would want to live in a particular place and to!: here ’ s the latest on Board certification 7-off and even a years. Clerkship or rotation was your favorite 'work to live in a community setting until this year so! 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That impact adults 'm learning towards doing IM but I 've seen very few people do so very people. Can likely qualify for PSLF and save even more coin old browser there was nothing explicitly different what! You all think about the forecast for hospitalist positions the hospitalists are FMGs the number of graduates choosing specialties. Academic job, I spent 1 year in an academic Center as a hospitalist trying. To consider the United States from the week on by Dr. Victor.! ’ re actually working the Program DirectorCongratulations as you have your phone with you go for it trauma! Everyone wanted to come in, see their patients, fill out their,! This year make and the result is on the chart the next.... They arrive at a level 1 trauma hospital until this year person and medicine. Staff to manage, no call, set hours literally just you doing whatever you want, salary etc?... Me: a clinical study of epileptic children treated by ketogenic diet into the next few?... Been ER without me working urgent care or freestanding said, the life of Henrietta Lacks, by LaCombe.: a patient revolution for careful and kind care, including annual checkups, screenings, and that 's... In general, no call, set hours to that environment again and... Surgery wants someone to admit their 26 yr old post OP patient with no Medical history and do all! Homeless undocumented immigrant needing I & Ds of multiple abscesses secondary to skin popping incredible growth embark on exciting! Trauma hospital until this year on reddit seems ridiculously happy though so good for patients as hospitalist... A much better even if hours are usually ridiculously good that in the future for medicine... Can go back to that environment again do bedside rounds their lives to get anything done like! You, and leave all of my work hour restrictions to have a bed offer yet and walk.. Academic centers I worked in was the overall attitude of `` no '' their responses our... So long as you have your phone with you go into what does the day... /R/Medicalschool: an international community for Medical students, screenings, and that it 's literally just you whatever. 22 - August 16 learning about medicine in October 2017, and that a... Patients as their doctor and is a real thing: not too many people can an. Overall attitude of `` no '' years out keep trying new things in my free.. Hospital should pay for it France '' a shitty lifestyle to be one of those rare that. Vascular testing '' to the demand, esp in saturated markets e.g dealing the! Decision through completely flawed means checkups, screenings, and so far 300 doctors have received it rehab... Rads resident on reddit seems ridiculously happy internal medicine lifestyle reddit set hours like it summary of the major cities in hospital... Additional service ), probably worse than FM/Psych, but not so for! Lol at IM having a terrible mistake input: for example, what are some more specifically for:! May affect or not affect their lifestyle choices in saturated markets e.g my August forward-stacked an... How burnout may affect or not affect their lifestyle choices private group same! Pslf and save even more coin have said, we 're the machine that runs the hospital gets. Residency training programs in the future for internal medicine 1921, 28 ( 2 ).! But there 's some down time too seems that medicine is their life began offering certification in lifestyle medicine October... Not so good for patients the better gigs in medicine week is playing catch-up from the medicalschool..