How do you do the presentation as an intern? I am so stressed not about presenting but each preceptor has different expectations also the third year residents too have different expectations some prefer full fledged and some prefer only pertinent history. How to deal with this. I am so tired of all this. Please help.

Four months into residency and I need to get this off my chest.

I’ve honestly had a great experience with almost every senior I’ve worked with. They teach, they have your back, they make the long days easier. But there are two who I just don’t get. All they do is talk about other people. Every single shift it’s who messed up, who’s lazy, who doesn’t know anything. And somehow they have a problem with 18 out of 20 residents. At some point you have to ask yourself if the problem is everyone else or if it’s you.

The worst part is it never stops. Every question turns into “well, if I were you I would have done it this way.” Every conversation turns into tearing someone down. I’ve been thrown under the bus more than once, and I know the second I walk out of the room I’m the next topic.

Be the senior people actually want to learn from. Teach. Correct people to their face, not behind their back. That’s it. That’s the whole job.

Bc dusro ke hisse ka gaali bhi mei hi sunn rahi hu.

Very long rant ahead!!!
I’m so fucking tired of this system. I have ADHD and work in an extremely cognitively demanding specialty and somehow one of the most exhausting parts of my month is accessing the medication I’ve been prescribed for years. I have been on a medication for a long time before moving states for residency but after switching insurance, I had to switch to the generic because the brand wasn’t covered. Fine. Except now the generic is constantly unavailable, on backorder, or only in stock at some random pharmacy over an hour away. So every month, I get to play this stupid fucking game of calling pharmacies, figuring out who has what in stock, hoping they still have it by the time my prescriber sends the prescription, and then praying that insurance actually covers it. And because it’s a controlled substance, there are additional restrictions and hoops to jump through at practically every step. if the generic isn’t available? Well, the brand is excluded from my formulary. I ended up paying over $700 out of pocket for two months of medication because I literally could not get the alternative my insurance supposedly covers.

When I called insurance to explain this, I was basically told there was nothing they could do. Oh, and apparently I could just ask my doctor to switch me to a different medication. Because that’s how medicine works, right? Just randomly switch medications that someone has been stable on because an insurance company decided it doesn’t want to pay for them. The irony of being a physician and having to explain this to a health insurance company is genuinely fucking insane.
I’m already working ridiculous hours, constantly switching between days and nights, studying outside of work, and trying to function on whatever sleep I can get. I work in an environment where I feel like every single shift is an evaluation, every decision is being scrutinized, and every mistake could potentially be used as evidence that I’m not meeting expectations. You’re expected to show up and perform at 100% every single day. You’re expected to be efficient, confident, knowledgeable, emotionally regulated, professional, and somehow immune to exhaustion.

Having a bad day? Better hope nobody notices.
Struggling? Better not let it affect your performance.
Need time to take care of your own health? Good fucking luck.
Meanwhile, I’m spending what little free time I have calling pharmacies and insurance companies, trying to appeal coverage decisions, coordinating prescriptions, and figuring out whether I’ll even be able to get my medication next month. And here’s the part that makes the whole situation especially ridiculous: ADHD affects executive functioning. So I’m expected to use the very executive functioning I struggle with to navigate an unnecessarily complicated system just to obtain the medication that helps me manage it. I also don’t have a partner or family member who can take over these tasks for me. There’s nobody I can ask to call five pharmacies while I’m at work or spend hours fighting with insurance. It’s all on me, on top of everything else.
And throughout all of this, I’m still expected to show up to work, take care of people, make sound clinical decisions, and never let any of it affect me. I’m just so fucking tired of being expected to function like a machine while being treated like my own health and well-being are an inconvenience.

Anyway, that’s my problem but needed to just let it all out somewhere.

1. What specialty are you targeting and why? Is it the same as what you are studying / certified in your home country?
2. How are you managing daily study targets?
3. When are you planning to sit the exam?

I'm a radiologist in my home country currently preparing for the USMLE. I find it challenging to take out the time to practice sufficiently for the exams. Hope to hear from people in a similar situation.

Thank you!

Hi all, I’m a Uk radiology resident planning to come to the states once I’ve completed training. There’s been a lot of pessimism regarding AI and its impact on future pay. Just wondering what your thoughts are.
Thanks!

IM intern here,
I struggled a lot with IM
I worked with ton of colleagues, by far im the worst, even other rotators/prelim ( I mean even people who dont like medicine are doing better). I hate being heavy on my team or to put extra load on my senior/attending, i feel embarrassed every single day. Especially when i got asked about one of the patient and i dont know the answer while my senior knows.

My biggest problems are attention and memory, i forget major things immediately after i read them which consume my time. I also found myself feeling down and stressed

For people who went to the same problem, what did you do ? Did you quit ? What happens ?

The title.

I feel like I'm at the bottom of my class.I don't know the percentile for rest of my cohort but i'm pretty sure i'm at the bottom because I asked one of my co-residents and they were at 33rd.

I feel like I do not have imposter syndrome, in fact i am just dumb. I don't think I deserve to be a doctor anymore. I can't be compromising patients' life because i am just stupid.

Do programs kick you out for this?

I’m an experienced attending in a surgical field. I have found more and more every resident argues or debates every medical decision. They never come to see follow ups.

can someone explain this?

Am an atheist but patient asked me to pray with him. Faked it but it meant a lot to him. Am a terrible person.

I am a family medicine intern and finished my first month of inpatient. Got a feedback that I am not quite there yet and not where they expect me to be at this point in time.

I did a lot of outpatient family medicine clinics before this.

not sure how to take this feedback.

feedback was from 2 third years assigned to work with me.

it looks like I am critiqued for minor things. One time I forgot to order morning labs. The other time I said I could do a Pap smear before watching a video and got critique for not being procedural. Then I forgot to replete magnesium one time.

I can't help but compare myself to my co-intern. She's so smart, efficient, and always on top of her patients. Attendings and seniors are always praising her while I'm just there lol. I feel like I'm barely surviving each shift and trying to get my orders in, while she makes everything look so easy.

I'm genuinely happy for her, but it makes me feel like I'm so behind. I know I shouldn't compare myself to others but it's hard not to. Anyone else feel this way during intern year? Any advice?

I don't know if I'm even allowed to ask this question here, but it would be good to get some feedback from actual medical residents. My girlfriend is doing residency right now, she's in her last year of family med. We're both in our 30s. 

It feels like she has two modes - stress at work and disassociating from life. She comes home from work and immediately escapes by playing video games during pretty much every waking hour outside of work. She'll put in 200 hours over a couple of weeks. 

Her mom, who is staying with us, and I do 90% of the chores like dishes, laundry, and food prep. 

On inpatient and night shift rotations, it's definitely like this. Even during other rotations, this pattern is there. 

I get it. I'm a gamer myself...and I for the most part want to support whatever she needs to destress. But I also feel like I want to connect with her, do things with her, and talk about life and the future (we do have things to figure out) and there's no space for that.

I don't know... is this normal? How do I support her while also considering my own needs? How do I distinguish real residency stress from her reaction to life while under stress? I've had stressful jobs working 60+ hour weeks... but I feel like I still managed my time outside in a certain way - a lot of me time, but also doing chill things with my partner and friends/family. I'm not sure if residency is simply a different kind of brutality.

I will update my post to provide further details:

I was a diagnostic radiology resident at an ACGME-accredited program, and my contract was not renewed before my final year of training. It's a complicated situation, but I'll try to summarize what happened and why I believe the decision was unfair.

The program cited deficiencies in several ACGME competency areas, including Medical Knowledge, Practice-Based Learning, Systems-Based Practice, and Professionalism. They alleged issues with my clinical performance, efficiency, productivity, responsiveness to feedback, educational participation, and compliance with departmental expectations.

I acknowledge that the program had raised concerns about my performance previously and that I had been placed on remediation plans. However, I strongly dispute several of the allegations used to justify the final non-renewal decision, particularly because I believe some are contradicted by documentation.

My main concerns are:

1. Inadequate evaluations and feedback: Throughout my training, I was not consistently provided with formal CCC assessments or milestone evaluations for review. During a substantial portion of my final year at the program, I also did not receive timely written evaluations documenting my performance. I believe this made it difficult to understand exactly where I stood and what specific improvements were expected.
2. Inconsistencies regarding my training progression: At one point, the program decided I needed to repeat a year of training. However, the initial communication regarding this decision was unclear, and there were inconsistencies between my official training classification, rotation assignments, and how the program subsequently treated my progression. I also have concerns about whether appropriate written notice was provided.
3. Disputed productivity and clinical performance allegations: The program raised concerns about my workflow, efficiency, and reporting turnaround times. However, based on the available records, my clinical productivity was comparable to, and sometimes exceeded, that of other residents. I was also routinely assigned substantial senior-level clinical responsibilities, which I believe raises questions about how the program characterized my overall performance.
4. Professionalism allegations and inconsistent enforcement: Some of the allegations involved departmental practices, including workstation usage and participation in educational activities. I dispute several of these claims and believe certain expectations were not applied consistently among residents. I also have documentation that I believe contradicts some of the allegations.
5. Concerns about the remediation process: Although I underwent remediation, I believe the process lacked clear, consistently communicated, and objectively measurable expectations. In my view, I was not given a sufficiently transparent opportunity to understand how my improvement was being assessed before the decision to end my training was made.

Eventually, the program issued a formal non-renewal notice. I challenged the decision through the institutional grievance process, presenting my concerns about the evaluations, procedural inconsistencies, and factual inaccuracies. Unfortunately, my grievance was denied.

Despite the non-renewal, I subsequently obtained an official letter from my program director confirming that I had successfully completed my documented training through the preceding postgraduate level. I also have a completed preliminary year in internal medicine and have passed all three USMLE Steps on my first attempt.

What makes this particularly frustrating is that I was extremely close to completing residency, yet the decision effectively prevented me from pursuing board certification through the usual pathway.

I understand that residency programs have considerable discretion in evaluating residents, and I'm not claiming that every concern raised about my performance was baseless. However, I believe the final decision relied partly on disputed allegations, inconsistent expectations, and a process that lacked sufficient transparency and timely feedback.

My main goal isn't financial compensation. I simply want an opportunity to complete my remaining year of residency and become board-certified.

I've already explored the internal grievance process and consulted legal counsel, but I'm now trying to determine whether pursuing litigation or negotiating reinstatement would be realistic.

I'd especially appreciate hearing from anyone who has dealt with residency non-renewal, successfully challenged a similar decision, or has experience with attorneys handling these cases.

Took my pediatric boards today, and I’m already remembering so many questions I got wrong. I’m feeling nervous, scared, and honestly disappointed in myself. I keep replaying questions in my head and worrying that I didn’t do enough to pass.

Let's write down PGY level, ITE percentile and percentage so that we can look at correlation

Reposting here for more exposure -

Now that I’m a physician, I’m very aware of the fact that my phone number and address can be easily found online. After hearing about that pediatric intensivist that was recently killed because someone broke into his house in the middle of the night, I’m trying to get my info off the internet so my patients can’t find it. Has anyone done this before? Did you do it through paid services and if so which ones? Thanks!

I really try not to tell docs I’m a resident bc I don’t want them coming in with assumptions. That being said I’m pretty sure it’s on my chart because they all know. Anywho PLEASE FOR THE LOVE OF GOD STOP ASKING ME WHAT I WANT TO DO JUST TELL ME. I am at your office because I DONT KNOWWWWWW. Literally hate when they’re like well what do you think. Girl I don’t wanna think right now. If I had an opinion I would bring it up. Let me be a patienttttt.

pgy3 65 % correct correlating to 22 percentile. My program takes percentiles very serious.

Need some encouragement and plan to pass ABIM. Thanks

Recently finished a week of nights and am stunned by the phone call volumes and constant interruptions. It’s honestly unsafe how frequently we get interrupted and most certainly leads to missed findings, report errors, and delayed reads. I’ve started to ask people to call me back especially if it’s for a wet read, but often this isn’t enough. I’ll just get another phone call in 2 minutes from a tech or someone else who needs a wet read.

Next night float I’ve been considering just not answering the phone until I’m finished reading the current study I’m working on. It really just doesn’t feel safe to be interrupted constantly and I don’t understand how it’s normalized for us to be phone monkeys while trying to make critical findings. The team will come in person to us for cases like trauma which of course we drop what we’re doing and prioritize.

I've seen a lot of topics asking about specific resources but theough my search I found like a thousand resources.

I'm usually used to use one resource and that's it, but apparently for residency there's way too much.

I just want to see what you guys would recommend as studying material for a junior radiology (PGY2/R1)

Do we get the email ?

Hi Did anyone receive their ITE results?

I feel giving handoff is the hardest part? Any help how to do that efficiently? Any one here on same boat?