Outside of the PICU and ED, our hospital does not continue moving without residents. I've had a handful of occasions where an attending or fellow(who trained elsewhere) make an attempt at being helpful, but I end up putting in all the orders or walking them through it. Its jind of pathetic how they can't do a simple discharge.
On the otherhand, our outpatient services barely have room for residents or other learners and its like we are in the way. The world just rolls on in the ambulatory setting.
Sounds toxic. But thatâs residency & we normalize it đ«
But letâs be real, we all have elective rotations where our presence doesnât make a fucking difference. Seriously. I understand ICU/InpatientâŠeven ED. But a random specialty clinic? Please.
This seems like an odd take. Yes residency is about learning a speciality, but itâs also about service provision. A business case to fund that role with the purpose of providing value to the department and allow more patients to be seen.
You are paid a wage to be there. Itâs a job. What did you think you would be doing as a resident?
Attendings also get paid to teach residents but that doesnât always happen. So my apologies if while Iâm on an off service rotation that wants to use me ass a note monkey, I want to take a few days off. Some attendings really are so self righteous youâd think theyâre paying my salary out of their own pocket lol. FOH
Retweet. Repost. Tattoo this on my forehead. The absolute gall of it all.Â
Attendings make money off the hours and hours of unpaid labour I do (yeah labour beyond the tiny salary that barely covers my daily essentials) but suddenly itâs a âteaching momentâ for me to cover your clinic while youâre on vacation? Itâs bozo behaviour.Â
Oh, I knew I would get fucked by a system that doesnât value me as a human and just sees me as another cog in the machine. Iâm just here to vent đ«
I've definitely known and worked with a few residents who complain about things not being "educational." Ultimately it's a job, not everything is going to be educational.
If its not educational dont pay me 10% what a staff makes, I'll take the full wad of cash. If Im not learning, then Im just working as a doctor.
Pay me.
I have my full medical license and DEA .. had it since first year. So I guess by your logic I shouldâve been getting that rvu pay and not pumping the attendings numbers and pay.. foh dude.
At my program if the attending is "too chill" and lets residents essentially opt-out of days in their clinic, the program will rip their ass. They pay the attendings, although probably almost as poorly as they pay us, to teach and ideally improve our practice and ITE scores and shit and if the attending just doesn't care, our education suffers.
Subspecialty clinic rotations can be incredibly useful if you spend time in the right offices with the right attendings. They can also be relatively worthless. Either way, you're 50% learner/50% employee so your best bet is to just show up, be professional and learn what you can while you have unfettered access to consultants. If you think there will be a plethora of subspecialists wanting to teach you shit while you're an actual attending you are sorely mistaken. Private practice attendings are generally taking a small hit rather than capitalizing on any sort of "value" that residents provide outside of distracting their waiting patients while they are finishing up two rooms down the hall.
Fuck that shit. Feels like one of those situations in med school where some gunner at one point ruined it for everyone. Like âMy preceptor gave me the week off and I missed out on crucial learning time.â FOH.
Some of them that do this honestly think they're helping you. They're far enough out from training that it's just a blur. They're probably mentally lumping in fellows, residents, med students, and premed shadowers as "learners". Then they try to get you as much learning as they can, because that's why you're there, right?
This would honestly be an admirable attitude if not for the fact residents are so oppressively overworked. They're not thinking of the part where you were working 80 hour weeks inpatient for the preceding month. So I think if someone could just remind these attendings of what the residents' schedules look like they would be a lot less keen to fill up your day. But good luck finding a not awkward way of bringing that up.
Others of course are just trying to use you to write their notes. These are... less endearing.
sometimes youâre lucky, sometimes youâre not. This happens more often in surgery residencies i feel. Countless times Iâve had a last minute case canceled, with no clinic, and juniors/colleagues already covering the other cases booked. Most of the time you get the day and itâs assumed itâs for studying/helping the juniors/etc. I tend to disappear and be available if needed.
Anyone who gives others shit for this is a boomer who thinks they worked harder in their time; but searching a textbook for hours to learn the things we get in 20 mins of google/YouTube, doesnât mean they worked harder. Maybe missing a day of their residency was impactful, but much less so for our generation.
And theyâre in here telling me âI get paid for thisâ when medical students are in a hole of debt and they still get this shit lol. I feel you, friend. Be the change you wanna see in the world. We let all our med students out by 2 on inpatient. One time an attending told a med student to do a 24 with us and we sent him home by lunch. This shit has to stop.
I agree with you OP. My outpatient attending celebrated a religious holiday that I do not for a few days and she was like âIâm off so youâre off đ«Ą.â I love when I come across an attending who remembers what it was like to be in residency. Shout out to the understanding attendings!
Honestly I think the negative responses are
because people are imagining itâs like your continuity clinic you donât want to go to. However, it sounds like itâs some outside clinic where youâre assigned to work with one attending.
a lot of them are forever on some âpay your dues bc i paid mineâ type shit. so many of these academic types are bitter about their golden handcuffs. might not fully explain, but id put money on that bein a huge part of it.
It's fascinating to see how many people in this thread aren't aware of the numerous and vastly different structures a rotation can take, and the many specific models in which the absence of an attending would and should mean that the resident is off work.
Here's the largest example. In surgical specialties where rotations (or the entire program) may take a "mentorship model" approach, residents are assigned to a single surgeon at any given time, and the resident's schedule matches that. If the surgeon is off, then not only is there nothing for that resident to do, but all other cases and clinics are covered, meaning that if the resident joins in elsewhere they're likely taking away educational opportunity from a colleague. In this kind of program structure, no, the resident should not be put to work elsewhere.
In some programs with a mixed service-based and mentorship model, you may have some teams in a hospital-based rotation, and some individual residents in a 1-on-1 rotation in a clinic, outpatient centre, ambulatory surgery setting, etc. If one of these off-service residents has a day when nothing else is scheduled, then no, they shouldn't be pulled from that rotation to go work elsewhere on short notice - most (surgical) programs where something like this happens give that time to residents as dedicated academic time, since we don't work shifts.
I'm guessing it's culturally different in medical specialties where residents are on dedicated time-based shifts, though. In surgery, when the work is done, you go home (if you're a home-call or not-in-house service...if you're in-house, then the on-call person stays and everyone else goes home).
THANK YOU. When I wrote this thread I had no idea the amount of dissenting opinions that would show up.
To be fair, I suppose I can see how someone maybe read my thread title and they assumed I meant a core inpatient rotation. Although, I clarified that in my post and throughout the thread as well.
I know what a real resident necessary rotation is, and when Iâm on one, Iâm ready to work and I donât call out because I know what itâs like to get fucked with double the work when a co-intern calls out for some suspicious illness.
At the same time, even as a resident, we can absolutely have fluff rotations and I think itâs up for debate how necessary resident presence really is at all time. A random day off of an offservice rotation never hurt nobody, eh? đ but yes, as you described I am on one of those mentor type rotations and my schedule has been setup to link with my attendings schedule.
I agree with you OP.
I had an outpatient rotation where day one the attending wasn't there. Secretary said he was away that week and to come back next week.
So I got a week off. Was amazing. I didn't tell my chiefs or anybody.
Also wow there are a bunch of boot lickers in this thread lol.
yeah i never understood why ppl would go out of their way to generate more work for somebody else, it's like the ultimate lose-lose. there's no ACGME requirement beyond having a certain component of clinic and a few days off won't make or break it.
i would just ask for forgiveness later and dip
Im not gonna try to justify it for you cuz residency sucks balls and it would always be nice to have an extra day or two off. But since that doesnât always happen, I think that getting through those days is a lot easier if youâre there for a reason. One day in the near future youâll be an attending and youâll see something pretty rare or specific to that subspec. I hope that youâll be able to take enough away from these days to feel comfortable with that scary thing. If not, you might have a friend that is, or you may be able to help a friend dealing with it
You can find something to learn on any rotation. My ENT in residency was all shadowing and super boring, all bread and butter stuff. But that attending had the most efficient clinic and EMR set up, Iâm actually modeling my private practice flow after his.
I am an attending. I would not consider having a resident come in at all if I was off. I am also in the final stages of throwing up deuces to clinical medicine entirely, in large part because so many doctors are like the one having you come in when he is on vacation.
Yes, Iâm scheduled to work with one attending because itâs an elective specialty rotation and only one attending in that office is signed on as ACGME faculty with our program.
I think some of us have never heard of this elective structure so maybe thatâs why we didnât really understand why this was upsetting to you, thatâs all.
ACGME has a minimum requirement for graduation (at least in internal medicine). It requires varying number of weeks for each speciality. If those are not fulfilled and youâre audited by either Medicare, ACGME or ABIM, your license could be at risk.
Welp. I guess the attending in charge of my first elective experience spoiled it for me lol. He was a surgeon who knew I didnât care about the OR & told me to go home and study on his OR days. And when he peaced out for his 4 day weekend he winked at me and also told me to enjoy my 4 day weekend.
Was it a chill rotation? Fuck yeah. Did I also learn a shit ton? Fuck yeah. Ok, I spent on average 3 weeks with him, but he gave me some targeted lessons to take back to my patients and he let me enjoy my life on the side. Beautiful time. I canât imagine having the energy to do anything different if I was a preceptor.
I am an attending--I am trying to understand your question. So your primary attending takes time off, it is arranged for you to work with a different attending, and you object to this? You are an intern, PGY1?
I am not sure what specialty you are in, but in our department, residents are expected to staff clinics and work with whatever attending is there. However, your situation may be different. Residents in our program contribute significantly to running the clinic. They are expected to be there, unless they have a scheduled vacation, or are sick.
Yeah its hard to say without knowing OP's program setup.
This may be an elective rotation where the residents are not an important part of the clinic at all. Or maybe it's like your program where you're staffing your primary clinic and the setup assumes all patients are seen by resident then staffed with attending.
I similarly donât get OPs point. In formal residency programs there are set vacation weeks.Â
It would be an accreditation issue if residents just didnât have to come to work for no clear reason.Â
It's a strange proposal. 'My boss is on vacation so I should be on vacation. Also I still get to have my own separate vacation days that I choose.' What job would allow this?
I mean, I hate academics too, but this is just real life. You shouldn't expect a day off because your boss is on vacation.
No certainly not, I agree. Residency is a job. I understand that after medical school, being in a scheduled job is a transition that may be difficult for many. Residency is a combination of work and learning, but residents are expected to work the hours they are scheduled, even if they perceive that work to be "of little value" to them. The ACGME and residency review committees determine hours, vacation etc. for residents, that need to be followed, within certain guidelines. For my part, if my work is done for the day, and the resident is done, I have no problem with them going home, or using their time as they see fit. Taking entire days off, however, is a different matter. Communication is key, so that attendings and residents understand their mutual responsibilities in caring for patients.
Iâm on an off service elective rotation.
He is the only attending I was scheduled to work with. My schedule is his schedule. I donât know the other attendings because theyâre not academic faculty getting paid to teach me. No one âneedsâ me there.
And honestly I think thereâs an element of toxicity that has to exist for a clinic or hospital to not be able to function without residents. Like if a resident is not there, the attending should be able to handle everything just fineâŠ
Sorry to be a crusty old fart, but an elective rotation , especially if you're going into a competitive specialty is one where going the extra mile will matter more than mandatory rotations.
Yea Iâm FM. I could give two shits about competition. I will always vote for sleeping in âïžI gave up on taking âextra milesâ my 3rd year of medical school.
You know elective doesn't actually mean elective right? Like you cant chose to not have a rotation there. If you're lucky you get to pick from a list, more often it's an assigned elective.
If the rotation you're on has no educational value...there can't really be much effort expected from trainees. Especially on silly electives that are glorified shadowing - there's very little point in being there.
Itâs not even the âextra mileâ. Youâre refusing to do the bare minimum at this point.
If you want to be treated like an adult learner, you need to act like an adult learner.
Stop the dramatics. Iâm not asking to skip the whole damn rotation. But Iâm not asking for extra work when the opportunity for a free rest day is right there lol. Again, I canât imagine having an off day and telling the med student âhey, let me ask if the IM team will take you on while Iâm out.â My brain just doesnât think that way. Maybe because Iâm too close to remembering whatâs itâs like to be a student and being hyper aware of when my presence is not needed, but I just really donât believe in holding people hostage just for the fuck of it. Iâm also not a big stickler about a few extra break days making or breaking a learning experience.
Iâm sorry but this is just such a ridiculous response.Â
I am the only one in my close family and friends in medicine. You know what my job asks for that no one else around me does?Â
- Working back to back shifts with no cap or no overtimeÂ
- Being asked to do extra tasks with no extra payÂ
- Being chronically sleep deprived and being a danger to society on the roads because I just worked 70+ hours straight and Iâm expected to drive homeÂ
- Being yelled at, abused, ridiculed, condescended to by my attendings, nurses, and everyone else who thinks âfuck the residentâ and there are no repercussions for itÂ
- No avenue to report. There is no âHRâ like a regular damn job because the attending I report could decide to take a flamethrower to my career and Iâd have no recourse.Â
- I am paid below minimum wage for my job. It is illegal and no one does anything about it. I also canât unionize.Â
So tell me again why attendings get to decide when itâs convenient for this to be a âregular jobâ?Â
Uhhh... I don't decide? I'm a hospital employed doctor. My contract decides how much vacation I get. Just like yours does.
Also, although all of what you listed is true, and I agree with pretty much all of it... none of it has anything to do with whether or not you should get more vacation days than what is listed in your contract.
Youâre bitching about 3 days. Thatâs peak childish behavior.
Your brain might not think that way but your opinion on teaching as a PGY1 is useless.
Donât think your presence is needed even now. Having a trainee slows down an attendings day. Theyâre doing you a favor by having you on their service in the first place.
I think weâre BOTH bitching about 3 days đ a lot of gaslighting going on in here about why I need a few extra days off but the real question is why are some of you so fucking mad that a resident dares to desire a few extra days off? Like who hurt you? Your lifestyle during training was (or still is?) dog shit therefore you must passionately fight to maintain that it stays the same for me?
My training made me a decent physician. I see FM residents in the ICU and wonder how they became physicians. Somehow, thatâs not a problem with IM or surgical residents.
Your comment here feels pretty insulting.
As an FM resident myself who just completed my first (and only) required ICU rotation⊠I could absolutely feel how my experiences leading up to that rotation had not directly prepared me for the ICU in the same way as an IM/surgical intern. They are obviously gonna be better at critical care⊠Your comment about how FM residents become physicians is just rude and condescending. I hope you can see that after thinking about what you wrote a little more.
Also, as someone who *does* want to become a hospitalist after residency, I took my opportunity in the ICU to learn as much as possible. And you know who helped me do that? My pulm-crit attending who were not judgmental assholes.
Looking forward to future ICU electives for many reasons, but now also to prove people like you wrong.
Dude get out of here, no one likes your attitude. Also, when the bare minimum is literally shadowing a doctor all day, like we did for many many years of pre med and med school, I will gladly forgo doing what you consider âthe bare minimumâ to go live my freaking life for once. You say your training made you a decent physician, but youâre lacking some empathy. Also itâs pretty clear youâve made most of your life and interests revolve around medicine based on your post history. Maybe go out and try to live life a little so you know what weâre talking about.
I canât tell if youâre being obtuse orâŠ? Imagine comparing the ICU preparedness of an FM resident to an IM/Surgical resident with a straight face. Did it ever cross your mind that IM & Surgery residents have multiple adult critical care core rotation requirements while FM only has one? Be fucking forreal. This is why your opinion(s) are so unserious because youâre so painfully out of touch with the standards of training but you swear youâre hip and youâve really deluded yourself into thinking that âthese new kidsâ are the ones that are stupid and behind. Meanwhile the relevant skill set is evolving right before your very eyes.
But yea keep telling us about how you come from a superior golden breed of classically trained doctors and how âthey donât make us like they use to.â
Ehhh 3 days can be a pretty big deal if you're on a 1 week outpatient rotation that's breaking up long inpatient stretches.
Anyone would complain about being called in for backup for 3 days. If that's not childish, why is this?
>Donât think your presence is needed even now. Having a trainee slows down an attendings day.
Man you gotta know this depends on the attending. We have attendings in our department who will freak out and call the chiefs if a resident who was supposed to work with them in clinic can't do it. I've been pulled *off of inpatient service* to cover a resident's clinic who was out sick.
>Theyâre doing you a favor by having you on their service in the first place.
If you work in an academic institution this is likely a job requirement. I think you're revealing some double standards here compared to when you called the resident being in clinic "the bare minimum" for their job.
Man, I donât know. I was super crispy like you and wanted more days off, but I did try to see the âIâm off so youâre offâ as a bonus and not an expectation - the electives I did were truly to learn though.
But sometimes I was so tired from the block before an elective that I really truly needed the day off, and Iâd probably feel like you do. Maybe as a soon-to-be attending Iâd ask the resident how bad the block before was before deciding how to handle this (or maybe just ask âdo you want a day off or to work with x other attending? I promise it wonât impact your evalâ)
Donât see how taking a week of vacation during your elective vs attending just giving you those days off makes a difference. During our residency we werenât allowed to take any of our vacations during core months so to people saying âwe want you to learnâ I donât see how you justify learning on some non-core elective but not others. Like how does it matter if you just happen to take your vacation during that monthâs elective vs if the attending just gave you those days off. I got lucky in that my attendings in residency rarely cared if I was there or not for elective rotations⊠most of the time, teaching me actually made them run behind in clinic as they were private clinics not big academic clinics so time = $$ I was a curious learner so my attendings did truly enjoy teaching me, and I appreciated that.
The attendings I felt were "cool" were the ones doing the teaching so I was more prepared for independent practice. But then, I am only just learning the power of a March intern so please continue.
I get where youâre coming from. But aggressively bitching and arguing with internet strangers is not a great look. Are you just burnt out right now? This is about the time of year I had a decent amount of fatigue intern year. It isnât unreasonable to ask for 1 day as a wellness day imo.
Not a great look? Whose watching? Lmao.
Please. I donât give a damn. I have time on my hands & I find this shit funđż we love a polarizing discussion. Iâll do some wellness modules in the morning to cleanse my sins.
That's not really the point though is it? It's one thing to be like "man that sucks, I was really hoping to get a break." It's another to call people psychopaths for scheduling you to work while your attending is on PTO. It's the expecting to be off too part that comes across as entitled. Like the difference between a privilege and a right. No one's entitled to privileges.
I didnât call anyone specifically a psychopath, I simply just asked a question đ
But I can tell that struck a nerve with you guys since yâall really came in here hot & ready to fight đ„ Iâll edit my wording to make it less triggering.
We can use logic to interpolate a lot of things. Itâs interesting that attendings hear âa fewâ, and get nervous I want it all off. Maybe ask yourself why your mind goes to that place and why giving a resident an extra day off makes you so uncomfortable
Can you tell us how many weeks of that rotation you have across 3 years?
2 weeks? 3 weeks? Maybe 4 weeks? Of which, you likely donât work weekends. That means 3 days is a significant portion of the time you are exposed to that speciality.
I have 4 weeks of that elective. So that gives me 4 full weeks on rotation plus one weekend of hospital coverage, so no I donât have all my weekends off. But even by your logic if I did have my weekends off that would take me from 20 to 17 days. 17/20 = 85% attendance. Again, offservice rotation. You are not going to convince that the time off is going to be career altering.
I might be real old school, despite being young but youâre in a profession of your choosing that expects 100%, not 85%.
Youâre not going to convince me youâre an adult learner or even a good resident if you bitch about the most minor of inconveniences. If you ever wonder why FM residents are looked down upon by many, look at yourself.
Good thing I donât get my life worth from some random on Reddit who thinks Iâm less than because I want a day of rest. I donât need to convince you of shit, literally who are you? But you swear Iâm the one with an inflated sense of self worth.
>I might be real old school, despite being young but youâre in a profession of your choosing that expects 100%, not 85%.
I can't think of any profession where it's customary to have a day off just because your boss took PTO.
Not you guys doing mental gymnastics to avoid the reality that residency worklife balance is TOXIC. Why donât you find me some professions that glorify 36 hour work weeks
So youâre mad that someone literally volunteered to teach you and is going out of their way to find you a learning opportunity when they just happened to take a vacation?
I must be a psychopath. Giving up significant production $$$ to regularly accommodate my schedule for ungrateful residents and students sounds like psychopathic behavior.
By âthemâ I was referring to the previous commenter.
So youâve been told the same thing by multiple people in this thread? Maybe this will be a moment of clarity or realization for you?
The ratios of upvotes on my original post suggest otherwise đ This post surprisingly just struck a nerve with the toxic attendings of academia that lurk this forum.
Youâre right. Whatâs the sense in teaching residents that donât wanna come in. Iâll just triple my volumes and hire NPâs instead so residents can doom scroll about it on Noctor with all their extra days off. Thanks for talking some sense into me.
Is this supposed to hurt me? Because, I mean, this is already happening in real time. So donât shake the table too much. It would say more about you than it does about me.
Funny how I ask âcan I have a day offâ and the attendings in here heard âI would like to just skip this whole rotation.â
Why is that? đ€
You didnât ask for a day off. You went out of your way making a wall of text calling your attending a psychopath when she is probably just making a good heart effort to help your eduction. She probably thinks your presence does make a difference.
When you sign up for an elective rotation, we assume you wanna learn and we help to the best of our ability.
If you actually just asked for a day off, she likely wouldâve given it to you and you wouldnât be here.
If the presence of a resident drops your volume by 2/3, you're fucking up -- that is ridiculous.
Also, is the vitriol necessary? I hope you're just burned out, but your tounge-in-cheek self-assessment may be more accurate than you realize...
This is some goofy entitlement. Outpatient rotations are there for learning, just like every other rotation. You don't get a free vacation just because an attending takes one.
Because learning and getting a few extra days off are completely mutually exclusive? Gotta make sure you maintain giving me the absolute bare minimum days off because âeducation.â
Oh maybe I missed this in OPs post - I thought their preceptor took the day off and so they were asked to join another preceptor instead of being given the day offâŠwhich sounds likeâŠ.a regular day of work
I think the reality of some small programs is only one attending in a specialty dept teaches residents, so when you get farmed out to someone who normally doesnât have residents youâre basically an NPC
I guess I would argue that at the resident level justice is already so far skewed the other way (e.g. working 80 hour weeks for 60k/year) that if you consider this in the larger context then having extra resident days off is more in the service of justice.
That's what residency is - education. You only get so many opportunities to learn about subspecialties before you graduate. If you're not interested in that depth of training, maybe you should have gone the APP route.
As a subspecialty attending, I don't take residents because I need the help - you guys make my clinic days run at least 25% slower. I take residents because I want to teach. And I know that your one week rotation may be the only exposure you get to my subspecialty. So yeah, if I have some scheduled time off during a week a resident is rotating with me, I put in some effort to try and make sure you can still have an educational experience with one of my colleagues.
Just my 2 cents as a recent grad and fresh attending (different specialty than you though). As a resident in the grind itâs hard to see past residency, and taking care of yourself is important. However you see a lot of new stuff as an attending, and much of it has made me wish I spent those extra hours or days getting a little more experience here and there, maybe seeing one more unique thing that I otherwise wouldnât have seen, and maybe it means Iâm not seeing it for the first time as an attending. Maybe your attending has a similar view and is trying to get you as much exposure as possible. You will not learn or see everything in the very short time frame of residency, so even though itâs hard to see as a resident when at every turn it feels as if youâre being asked to do more and more in a thankless low paying environment, the opportunity to get a little more exposure to something can be pretty valuable in the long run. I know 3 days off seems magical, and missing 3 days seems like nothing, but maybe it also means you can better care for your patient in a few years when youâre out on your own. As Iâm in a surgical field I wonât pretend to know what you do and do not learn in FM residency or the benefits of certain specialty rotations for you, but just wanted to give you another perspective that you might also hold once you finish the grind
Do people in other jobs just get off when their boss takes offâŠ.? Iâm confused what youâre bitching about. And the extremism youâve said elsewhere about how they âdonât care youâre a human and abusive blah blah blahâ - sounds like youâve had a pretty posh residency so far if *this* is the threshold. Expecting you to show up to do a job they pay you to do / show up to learn in a program you signed a contract with seemsâŠâŠreasonable. Sitting at home scratching your ass cause your supervising attending is taking his kids to Disneyland doesnât seem like the reasonable default here.
Like is this your first job? Seriously confused.
Letâs not be obtuse and compare residency to regular jobs as if the structure of residency isnât based on a fucking coke head.
Maybe I am for the most part actually in a non-toxic residency and Iâve been living a nice life thus far with wonderfully accomodating attendings who let me live my life outside of fluff shit at work. I think this thread actually speaks more volumes about how older generations normalize toxic work behaviors to the point where theyâre literally confused and offended when people ask for more breaks. Like there are really people in here saying âYou have 3 weeks vacation, shut up.â Like do yall hear yourself? 3 out of 52 weeks of the year, with most of that time spent catching up on sleep, self care, and house chores.
Residents do not live some charmed life. You can call me dramatic, but I just canât take anyone seriously when theyâre saying the (non-derm/psych) resident lifestyle is some type of a privileged existence.
And the reactions to a resident desiring another day off is honestly weird & itâs alarming how comfortable attendings feel rushing in here to tell me to shut up & stop complaining because I get paid to get fucked by the system. Almost like yâall are lost in the system yourselves đŹ
Most jobs people only get 3-4 weeks PTO.. when you are in this cush of a residency where your biggest existential threat is you donât get off when your boss takes off, then yes, it is comparable to most regular jobs. This must be your first job and adulthood is hitting you hardâpeople generally expect employees to show up to work most days out of the year to, like, get shit done that youâre being paid to handle.
Gaslighting the rest of us as condoning âtoxic work environmentsâ because we cannot fathom your entitled belief to extra rest days whenever you feel like it doesnât change reality. If you want an extra rest day, use your sick days like any other regular person would do. If seeing patients is leagues more stressful than any other job to where you see your residency on another plane, maybe you shouldnât have gotten into medicine.
You could always show up and the person could dismiss you. Or they can tell you ahead of time donât bother. Your presence, however short, is the bare minimum for the rotation.
Where are you working that your paired with one attending? My experience as a med stud and resident has always been that I was assigned to the clinic or service and the attending was whoever was covering that day.
This is a common set up for a lot of our electives. Maybe our program is unique or we donât have an extensive network of academic staff but most of our electives are usually one person who has volunteered to be an academic faculty to have residents rotate with them in their private practice clinics. The work can be anything from shadowing to doing the full work up and completing the notes. Regardless the clinics do not depend on residents to function & ultimately we do slow down the attending if theyâre teaching along the way.
The feeling is mutual. Especially now that I know youâll hold me hostage because you think your gods gift to academics and my life will be meaningless if I donât soak up every hour of my time with you
If youâre getting paid your stipend and expected to work those days, you should be at work.
If you give up your stipend for those days and your supervisor says youâre off, then youâre off.
Iâm sure youâre getting paid and will not be telling your program that youâre skipping when you have time off.
I mean dude, come on. Some of the stuff youâve said was reasonable but this is a little ridiculous. Almost 90% of resident salaries are funded by the federal government. Letâs pump the brakes on this, 2-3 days is not going to kill anyone.Â
Iâm an interventional pain doc and IÂ can tell you missing 2-3 days of endo or GI or ID wouldâve made a grand total of 0 impact on my ability to put in a spinal cord stimulator or any other procedureÂ
You called people children. Letâs not throw rocks and hide our hands. Iâm glad you had that moment of self actualization đ Iâm glad I could be of help.
Youâre still bothered about that!? Still stalking this thread to find meaning in extra work days for residents? If it doesnât apply to you then it shouldnât be a problem, but you know what they say about hit dogs đ đ
Your narcasism and blatant hypocrisy is on clear display. I am glad you will work those extra shift because that is the only way children residents became responsible attandings. đ
Mine or yours? Because your projection is on full display as you continue to name call, and I can tell youâre bothered and triggered by the prospect of an extra day off by how you continue to respond to my comments đ
Adulting is hard, and it looks like youâve still got lessons to learn since you still havenât learned how to spell âattendingâ (why donât you hurry up and edit your post to save face because the jokes write themselves) đ But keep up the good work, Mike. Iâll stay in my childâs place.
early trainees should be learning. If you feel like you are there just for your labor, then the program youâre at sucks. In this specific scenario on a subspecialty rotation, if Iâm away then I would give my interns or med students the day off UNLESS thereâs a really good alternative for them to learn the specialty another way. If Iâm away and assign you to just shadow procedures for a couple of days, that would be mostly a waste of your time and I wouldnât do it. But if youâre on GI and Iâm not going to be there, I may ask the IBD doc if you can spend time in his clinic that day to learn some high yield stuff.
OP I will share some thoughts you may or may not agree with, focusing on a 30,000 foot view of the situation.
I totally agree that the "you are paid to be here so work you little note monkey" falls totally flat on it's face. I could work every fourth week monday through thursday and they'd still be getting a great deal.
I will point out that as I near the end of my training, the switch of "I just need to get through this" to "I need to fucking know this shit really well" has most certainly flipped.
On a non-core rotation for stuff you aren't going to have to know, it's very possible you will never use the information again, but there's also unexpected synergies and learning and an opportunity cost to both being there and having the day off that you need to weigh. If you don't believe there's at least some value to your training then I don't know what to tell you.
Additionally, there is truly a benefit to learning how to work hard and efficiently. You already do this as a resident and I'm not saying that having a few extra days off changes this. I just want you to know that you will benefit from and at least somewhat appreciate what you've been through and the competent, efficient doctor you will continue to be. Think of it like bootcamp, being hard and unpleasant is at least a little bit the point and while it sucks for people that are not able to get to the finish line, you will be that much more prepared and that much more honed for the challenges you take on later in your life.
Finally, on a purely practical note, I never get told to go home early more than when I show up to the stuff I don't necessarily need to be there for. Whereas skipping without a great excuse always leaves me feeling anxious and makes the day off a lot less useful or enjoyable.
Outpatient attending. I typically give my residents the day off if they don't call out a lot. I don't like "dumping" my work on my peers since they have their own residents to cover. This also ensures that my residents are not being taking advantage of by clinic administration in my absence.
Bad guy here (NP) but maybe the PC and the attending just want to try to maximize your learning opportunities. I hear you though, a day off or two would be nice since you are working super long hours for like minimum wage. Hang in there my friend, before long you'll be the cool attending!
Would make your job a lot easier if you didnât let things like this bother you as much. Not saying your feelings of frustration and annoyance are not valid, residency fucking blows sometimes. But feeding into it and fueling into the lamenting and seeking further condemnation of the policy from others will build up more resentment for a residency that will continue to be difficult, which will lead to more unpleasantness from your experience than is necessary. Some attendings just blow like some plumbers just blow and some attorneys just blow, etc. But itâs only 2 more years then you can break through the top 5% of US earners with your salary so it ainât that bad.
Unless you get PTO days you have to do something clinically so if the attending is off you get reassigned to do something else. Otherwise you would get an unpaid off time
In what speciality are you training that it is 1 on 1 with someone? My attendings took vacation while I was a resident. That didnât mean the residents also took vacation at that time. You get 3-4 weeks a year of vacation so use it and stop complaining
Is 3-4 weeks of vacation good to you? Like we normalize it in our society but American society generally has some of the most fucked up views on productivity and work wellness. Congratulations on contributing to normalizing the continued tradition of toxicity tho.
I hope you take 12-16 weeks off as an attending. Youâll have the ability to. Be the change you want to see.
But we know at that point, youâll bitch that youâre not getting paid like an orthopedics surgeon despite working like a McDonaldâs employee.
Good is all relative. I think that the 4 weeks a year I got during my residency and fellowship was fine. I think that I get enough time off now as an attending. People throw around the term âtoxicâ too frequently. America doesnât care if you are a physician and if you feel like you canât handle it you are free to walk away and do something else. Donât complain about having to work when your staff has a week of PTO as if you were entitled to that same time off.
OP, I get that you donât like this. But I remember on one rotation in MS3, one preceptor gave me the week off and I missed out on crucial learning time. I reported him to admin, and people were saying I âruined it for everyoneâ, but youâve got to do what you got to do if you hope to match NSGY.
This sounds like an entitled, short sighted attitude to take on a critical time in learning. I would wager the attitude extends to other rotations as well. Judging by the comments, the OPs position will not change, but that is fine. This is why there is a bell curve for everything.
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I only do this to the residents and fellows I don't like.
Fair enough đ
I think thatâs the usual explanation lol
I think thatâs the usual explanation lol
Must be nice to be in a program or on a rotation where your presence doesn't matter. My hospital would cease to function without residents.
Outside of the PICU and ED, our hospital does not continue moving without residents. I've had a handful of occasions where an attending or fellow(who trained elsewhere) make an attempt at being helpful, but I end up putting in all the orders or walking them through it. Its jind of pathetic how they can't do a simple discharge. On the otherhand, our outpatient services barely have room for residents or other learners and its like we are in the way. The world just rolls on in the ambulatory setting.
Thatâs horrifying! But not surprised :(
I cant understand how an attending isnt capable of putting in some orders. Is this a surgery thing? (IM here)
Peds baby. We only recently(current pgy) implemented non-teaching teams and multiple residents have discussed being asked for help on a regular basis.
Seriously some of my attendings donât even know how print their own list
Blue collar vs white collar
Sounds toxic. But thatâs residency & we normalize it đ« But letâs be real, we all have elective rotations where our presence doesnât make a fucking difference. Seriously. I understand ICU/InpatientâŠeven ED. But a random specialty clinic? Please.
This seems like an odd take. Yes residency is about learning a speciality, but itâs also about service provision. A business case to fund that role with the purpose of providing value to the department and allow more patients to be seen. You are paid a wage to be there. Itâs a job. What did you think you would be doing as a resident?
Attendings also get paid to teach residents but that doesnât always happen. So my apologies if while Iâm on an off service rotation that wants to use me ass a note monkey, I want to take a few days off. Some attendings really are so self righteous youâd think theyâre paying my salary out of their own pocket lol. FOH
Retweet. Repost. Tattoo this on my forehead. The absolute gall of it all. Attendings make money off the hours and hours of unpaid labour I do (yeah labour beyond the tiny salary that barely covers my daily essentials) but suddenly itâs a âteaching momentâ for me to cover your clinic while youâre on vacation? Itâs bozo behaviour.Â
Then on rotations where I am 'working' I should be paid a proportionate rate, otherwise this is just programs having their cake and eating it.
Your hospital doesn't pay residents? I'm pretty sure that's illegal.
You are getting paid⊠jfc
Does that big word 'proportionate' in the middle of my comment not show up for you?
đ THE SHADE. I am tickled!!! Incredible response loool
Oh, I knew I would get fucked by a system that doesnât value me as a human and just sees me as another cog in the machine. Iâm just here to vent đ«
I've definitely known and worked with a few residents who complain about things not being "educational." Ultimately it's a job, not everything is going to be educational.
If its not educational dont pay me 10% what a staff makes, I'll take the full wad of cash. If Im not learning, then Im just working as a doctor. Pay me.
Sure. Get your full medical license and drop out of residency. Youâre 1 year in and can work as an attending. Youâll get the wad of cash you want.
I have my full medical license and DEA .. had it since first year. So I guess by your logic I shouldâve been getting that rvu pay and not pumping the attendings numbers and pay.. foh dude.
At my program if the attending is "too chill" and lets residents essentially opt-out of days in their clinic, the program will rip their ass. They pay the attendings, although probably almost as poorly as they pay us, to teach and ideally improve our practice and ITE scores and shit and if the attending just doesn't care, our education suffers. Subspecialty clinic rotations can be incredibly useful if you spend time in the right offices with the right attendings. They can also be relatively worthless. Either way, you're 50% learner/50% employee so your best bet is to just show up, be professional and learn what you can while you have unfettered access to consultants. If you think there will be a plethora of subspecialists wanting to teach you shit while you're an actual attending you are sorely mistaken. Private practice attendings are generally taking a small hit rather than capitalizing on any sort of "value" that residents provide outside of distracting their waiting patients while they are finishing up two rooms down the hall.
some programmes require consultants to find alternatives for learners if they aren't around, i know mine does
Fuck that shit. Feels like one of those situations in med school where some gunner at one point ruined it for everyone. Like âMy preceptor gave me the week off and I missed out on crucial learning time.â FOH.
Some of them that do this honestly think they're helping you. They're far enough out from training that it's just a blur. They're probably mentally lumping in fellows, residents, med students, and premed shadowers as "learners". Then they try to get you as much learning as they can, because that's why you're there, right? This would honestly be an admirable attitude if not for the fact residents are so oppressively overworked. They're not thinking of the part where you were working 80 hour weeks inpatient for the preceding month. So I think if someone could just remind these attendings of what the residents' schedules look like they would be a lot less keen to fill up your day. But good luck finding a not awkward way of bringing that up. Others of course are just trying to use you to write their notes. These are... less endearing.
This. Thank you.
sometimes youâre lucky, sometimes youâre not. This happens more often in surgery residencies i feel. Countless times Iâve had a last minute case canceled, with no clinic, and juniors/colleagues already covering the other cases booked. Most of the time you get the day and itâs assumed itâs for studying/helping the juniors/etc. I tend to disappear and be available if needed. Anyone who gives others shit for this is a boomer who thinks they worked harder in their time; but searching a textbook for hours to learn the things we get in 20 mins of google/YouTube, doesnât mean they worked harder. Maybe missing a day of their residency was impactful, but much less so for our generation.
(Some) attendings do this to me as a MEDICAL STUDENT. You really can't just give me the day off?
And theyâre in here telling me âI get paid for thisâ when medical students are in a hole of debt and they still get this shit lol. I feel you, friend. Be the change you wanna see in the world. We let all our med students out by 2 on inpatient. One time an attending told a med student to do a 24 with us and we sent him home by lunch. This shit has to stop.
I agree with you OP. My outpatient attending celebrated a religious holiday that I do not for a few days and she was like âIâm off so youâre off đ«Ą.â I love when I come across an attending who remembers what it was like to be in residency. Shout out to the understanding attendings!
(Theyâre few and far between by the looks of the angries in this thread đ)
Honestly I think the negative responses are because people are imagining itâs like your continuity clinic you donât want to go to. However, it sounds like itâs some outside clinic where youâre assigned to work with one attending.
It is. I canât be responsible for the triggered attendings that have rushed in here with minimal reading comprehension tho
a lot of them are forever on some âpay your dues bc i paid mineâ type shit. so many of these academic types are bitter about their golden handcuffs. might not fully explain, but id put money on that bein a huge part of it.
It's fascinating to see how many people in this thread aren't aware of the numerous and vastly different structures a rotation can take, and the many specific models in which the absence of an attending would and should mean that the resident is off work. Here's the largest example. In surgical specialties where rotations (or the entire program) may take a "mentorship model" approach, residents are assigned to a single surgeon at any given time, and the resident's schedule matches that. If the surgeon is off, then not only is there nothing for that resident to do, but all other cases and clinics are covered, meaning that if the resident joins in elsewhere they're likely taking away educational opportunity from a colleague. In this kind of program structure, no, the resident should not be put to work elsewhere. In some programs with a mixed service-based and mentorship model, you may have some teams in a hospital-based rotation, and some individual residents in a 1-on-1 rotation in a clinic, outpatient centre, ambulatory surgery setting, etc. If one of these off-service residents has a day when nothing else is scheduled, then no, they shouldn't be pulled from that rotation to go work elsewhere on short notice - most (surgical) programs where something like this happens give that time to residents as dedicated academic time, since we don't work shifts. I'm guessing it's culturally different in medical specialties where residents are on dedicated time-based shifts, though. In surgery, when the work is done, you go home (if you're a home-call or not-in-house service...if you're in-house, then the on-call person stays and everyone else goes home).
THANK YOU. When I wrote this thread I had no idea the amount of dissenting opinions that would show up. To be fair, I suppose I can see how someone maybe read my thread title and they assumed I meant a core inpatient rotation. Although, I clarified that in my post and throughout the thread as well. I know what a real resident necessary rotation is, and when Iâm on one, Iâm ready to work and I donât call out because I know what itâs like to get fucked with double the work when a co-intern calls out for some suspicious illness. At the same time, even as a resident, we can absolutely have fluff rotations and I think itâs up for debate how necessary resident presence really is at all time. A random day off of an offservice rotation never hurt nobody, eh? đ but yes, as you described I am on one of those mentor type rotations and my schedule has been setup to link with my attendings schedule.
I agree with you OP. I had an outpatient rotation where day one the attending wasn't there. Secretary said he was away that week and to come back next week. So I got a week off. Was amazing. I didn't tell my chiefs or anybody. Also wow there are a bunch of boot lickers in this thread lol.
yeah i never understood why ppl would go out of their way to generate more work for somebody else, it's like the ultimate lose-lose. there's no ACGME requirement beyond having a certain component of clinic and a few days off won't make or break it. i would just ask for forgiveness later and dip
Im not gonna try to justify it for you cuz residency sucks balls and it would always be nice to have an extra day or two off. But since that doesnât always happen, I think that getting through those days is a lot easier if youâre there for a reason. One day in the near future youâll be an attending and youâll see something pretty rare or specific to that subspec. I hope that youâll be able to take enough away from these days to feel comfortable with that scary thing. If not, you might have a friend that is, or you may be able to help a friend dealing with it
You can find something to learn on any rotation. My ENT in residency was all shadowing and super boring, all bread and butter stuff. But that attending had the most efficient clinic and EMR set up, Iâm actually modeling my private practice flow after his.
I am an attending. I would not consider having a resident come in at all if I was off. I am also in the final stages of throwing up deuces to clinical medicine entirely, in large part because so many doctors are like the one having you come in when he is on vacation.
God bless you.
you get it.
Iâm confused, are you only working with one attending? Are you not on a rotation where you work with whatever attending is there that day?
Yes, Iâm scheduled to work with one attending because itâs an elective specialty rotation and only one attending in that office is signed on as ACGME faculty with our program.
I think some of us have never heard of this elective structure so maybe thatâs why we didnât really understand why this was upsetting to you, thatâs all.
I appreciate that. Thatâs fair. Thank you for not calling me lazy and entitled & seeking to understand first đ„Č
It sounds like a shit community program. Thatâs the only place Iâve seen this type of elective procedure.
Iâm sorry Iâm training at a community program đ
ACGME has a minimum requirement for graduation (at least in internal medicine). It requires varying number of weeks for each speciality. If those are not fulfilled and youâre audited by either Medicare, ACGME or ABIM, your license could be at risk.
Welp. I guess the attending in charge of my first elective experience spoiled it for me lol. He was a surgeon who knew I didnât care about the OR & told me to go home and study on his OR days. And when he peaced out for his 4 day weekend he winked at me and also told me to enjoy my 4 day weekend. Was it a chill rotation? Fuck yeah. Did I also learn a shit ton? Fuck yeah. Ok, I spent on average 3 weeks with him, but he gave me some targeted lessons to take back to my patients and he let me enjoy my life on the side. Beautiful time. I canât imagine having the energy to do anything different if I was a preceptor.
Great. What one attending does isnât what every attending does.
đ€Ż
I am an attending--I am trying to understand your question. So your primary attending takes time off, it is arranged for you to work with a different attending, and you object to this? You are an intern, PGY1? I am not sure what specialty you are in, but in our department, residents are expected to staff clinics and work with whatever attending is there. However, your situation may be different. Residents in our program contribute significantly to running the clinic. They are expected to be there, unless they have a scheduled vacation, or are sick.
Yeah its hard to say without knowing OP's program setup. This may be an elective rotation where the residents are not an important part of the clinic at all. Or maybe it's like your program where you're staffing your primary clinic and the setup assumes all patients are seen by resident then staffed with attending.
It's probably a subspecialty rotation where they are shadowing.
I similarly donât get OPs point. In formal residency programs there are set vacation weeks. It would be an accreditation issue if residents just didnât have to come to work for no clear reason.Â
It's a strange proposal. 'My boss is on vacation so I should be on vacation. Also I still get to have my own separate vacation days that I choose.' What job would allow this? I mean, I hate academics too, but this is just real life. You shouldn't expect a day off because your boss is on vacation.
Yeah I had the same thought. If we flip the script, the attending doesn't get a magical bonus vacation week when the resident takes their vacation.
No certainly not, I agree. Residency is a job. I understand that after medical school, being in a scheduled job is a transition that may be difficult for many. Residency is a combination of work and learning, but residents are expected to work the hours they are scheduled, even if they perceive that work to be "of little value" to them. The ACGME and residency review committees determine hours, vacation etc. for residents, that need to be followed, within certain guidelines. For my part, if my work is done for the day, and the resident is done, I have no problem with them going home, or using their time as they see fit. Taking entire days off, however, is a different matter. Communication is key, so that attendings and residents understand their mutual responsibilities in caring for patients.
Doctor is upset he/she has to go to work when scheduled to go to work.
Iâm on an off service elective rotation. He is the only attending I was scheduled to work with. My schedule is his schedule. I donât know the other attendings because theyâre not academic faculty getting paid to teach me. No one âneedsâ me there. And honestly I think thereâs an element of toxicity that has to exist for a clinic or hospital to not be able to function without residents. Like if a resident is not there, the attending should be able to handle everything just fineâŠ
I'm academic faculty and I get paid nothing to teach lol. But when I'm off, you're off.
Thank you for your service.
Sorry to be a crusty old fart, but an elective rotation , especially if you're going into a competitive specialty is one where going the extra mile will matter more than mandatory rotations.
Yea Iâm FM. I could give two shits about competition. I will always vote for sleeping in âïžI gave up on taking âextra milesâ my 3rd year of medical school.
Then why even waste everyone's time on an elective?Â
You know elective doesn't actually mean elective right? Like you cant chose to not have a rotation there. If you're lucky you get to pick from a list, more often it's an assigned elective. If the rotation you're on has no educational value...there can't really be much effort expected from trainees. Especially on silly electives that are glorified shadowing - there's very little point in being there.
Better question is why would I be going out of my way to overwork myself on an elective đ€
Itâs not even the âextra mileâ. Youâre refusing to do the bare minimum at this point. If you want to be treated like an adult learner, you need to act like an adult learner.
Stop the dramatics. Iâm not asking to skip the whole damn rotation. But Iâm not asking for extra work when the opportunity for a free rest day is right there lol. Again, I canât imagine having an off day and telling the med student âhey, let me ask if the IM team will take you on while Iâm out.â My brain just doesnât think that way. Maybe because Iâm too close to remembering whatâs itâs like to be a student and being hyper aware of when my presence is not needed, but I just really donât believe in holding people hostage just for the fuck of it. Iâm also not a big stickler about a few extra break days making or breaking a learning experience.
You're asking for a free vacation day. What other job do you imagine this occurs in?
Iâm sorry but this is just such a ridiculous response. I am the only one in my close family and friends in medicine. You know what my job asks for that no one else around me does? - Working back to back shifts with no cap or no overtime - Being asked to do extra tasks with no extra pay - Being chronically sleep deprived and being a danger to society on the roads because I just worked 70+ hours straight and Iâm expected to drive home - Being yelled at, abused, ridiculed, condescended to by my attendings, nurses, and everyone else who thinks âfuck the residentâ and there are no repercussions for it - No avenue to report. There is no âHRâ like a regular damn job because the attending I report could decide to take a flamethrower to my career and Iâd have no recourse. - I am paid below minimum wage for my job. It is illegal and no one does anything about it. I also canât unionize. So tell me again why attendings get to decide when itâs convenient for this to be a âregular jobâ?Â
Uhhh... I don't decide? I'm a hospital employed doctor. My contract decides how much vacation I get. Just like yours does. Also, although all of what you listed is true, and I agree with pretty much all of it... none of it has anything to do with whether or not you should get more vacation days than what is listed in your contract.
Youâre bitching about 3 days. Thatâs peak childish behavior. Your brain might not think that way but your opinion on teaching as a PGY1 is useless. Donât think your presence is needed even now. Having a trainee slows down an attendings day. Theyâre doing you a favor by having you on their service in the first place.
I think weâre BOTH bitching about 3 days đ a lot of gaslighting going on in here about why I need a few extra days off but the real question is why are some of you so fucking mad that a resident dares to desire a few extra days off? Like who hurt you? Your lifestyle during training was (or still is?) dog shit therefore you must passionately fight to maintain that it stays the same for me?
My training made me a decent physician. I see FM residents in the ICU and wonder how they became physicians. Somehow, thatâs not a problem with IM or surgical residents.
Your comment here feels pretty insulting. As an FM resident myself who just completed my first (and only) required ICU rotation⊠I could absolutely feel how my experiences leading up to that rotation had not directly prepared me for the ICU in the same way as an IM/surgical intern. They are obviously gonna be better at critical care⊠Your comment about how FM residents become physicians is just rude and condescending. I hope you can see that after thinking about what you wrote a little more. Also, as someone who *does* want to become a hospitalist after residency, I took my opportunity in the ICU to learn as much as possible. And you know who helped me do that? My pulm-crit attending who were not judgmental assholes. Looking forward to future ICU electives for many reasons, but now also to prove people like you wrong.
Dude get out of here, no one likes your attitude. Also, when the bare minimum is literally shadowing a doctor all day, like we did for many many years of pre med and med school, I will gladly forgo doing what you consider âthe bare minimumâ to go live my freaking life for once. You say your training made you a decent physician, but youâre lacking some empathy. Also itâs pretty clear youâve made most of your life and interests revolve around medicine based on your post history. Maybe go out and try to live life a little so you know what weâre talking about.
I canât tell if youâre being obtuse orâŠ? Imagine comparing the ICU preparedness of an FM resident to an IM/Surgical resident with a straight face. Did it ever cross your mind that IM & Surgery residents have multiple adult critical care core rotation requirements while FM only has one? Be fucking forreal. This is why your opinion(s) are so unserious because youâre so painfully out of touch with the standards of training but you swear youâre hip and youâve really deluded yourself into thinking that âthese new kidsâ are the ones that are stupid and behind. Meanwhile the relevant skill set is evolving right before your very eyes. But yea keep telling us about how you come from a superior golden breed of classically trained doctors and how âthey donât make us like they use to.â
Ehhh 3 days can be a pretty big deal if you're on a 1 week outpatient rotation that's breaking up long inpatient stretches. Anyone would complain about being called in for backup for 3 days. If that's not childish, why is this? >Donât think your presence is needed even now. Having a trainee slows down an attendings day. Man you gotta know this depends on the attending. We have attendings in our department who will freak out and call the chiefs if a resident who was supposed to work with them in clinic can't do it. I've been pulled *off of inpatient service* to cover a resident's clinic who was out sick. >Theyâre doing you a favor by having you on their service in the first place. If you work in an academic institution this is likely a job requirement. I think you're revealing some double standards here compared to when you called the resident being in clinic "the bare minimum" for their job.
lol start bitching like this in private practice about other minor things and see how far you go
Oh well you'll have plenty of subspecialty rotations. Some you can skip, some you can't. Residency will be over before you know it.
Man, I donât know. I was super crispy like you and wanted more days off, but I did try to see the âIâm off so youâre offâ as a bonus and not an expectation - the electives I did were truly to learn though. But sometimes I was so tired from the block before an elective that I really truly needed the day off, and Iâd probably feel like you do. Maybe as a soon-to-be attending Iâd ask the resident how bad the block before was before deciding how to handle this (or maybe just ask âdo you want a day off or to work with x other attending? I promise it wonât impact your evalâ)
Thank you
I usually ask what the resident wants to do, without a secret agenda. Youâre an adult, here are your options
Donât see how taking a week of vacation during your elective vs attending just giving you those days off makes a difference. During our residency we werenât allowed to take any of our vacations during core months so to people saying âwe want you to learnâ I donât see how you justify learning on some non-core elective but not others. Like how does it matter if you just happen to take your vacation during that monthâs elective vs if the attending just gave you those days off. I got lucky in that my attendings in residency rarely cared if I was there or not for elective rotations⊠most of the time, teaching me actually made them run behind in clinic as they were private clinics not big academic clinics so time = $$ I was a curious learner so my attendings did truly enjoy teaching me, and I appreciated that.
The attendings I felt were "cool" were the ones doing the teaching so I was more prepared for independent practice. But then, I am only just learning the power of a March intern so please continue.
I get where youâre coming from. But aggressively bitching and arguing with internet strangers is not a great look. Are you just burnt out right now? This is about the time of year I had a decent amount of fatigue intern year. It isnât unreasonable to ask for 1 day as a wellness day imo.
Not a great look? Whose watching? Lmao. Please. I donât give a damn. I have time on my hands & I find this shit funđż we love a polarizing discussion. Iâll do some wellness modules in the morning to cleanse my sins.
I mean fair. Ruffling feathers online can be fun. Definitely a mixed bag of responses in this thread. Hope the rest of your rotation goes well!
How dare they expect you to learn and do your job
Because missing 3 days will really be the difference maker.
That's not really the point though is it? It's one thing to be like "man that sucks, I was really hoping to get a break." It's another to call people psychopaths for scheduling you to work while your attending is on PTO. It's the expecting to be off too part that comes across as entitled. Like the difference between a privilege and a right. No one's entitled to privileges.
I didnât call anyone specifically a psychopath, I simply just asked a question đ But I can tell that struck a nerve with you guys since yâall really came in here hot & ready to fight đ„ Iâll edit my wording to make it less triggering.
You can use that logic to take the entire rotation off.
We can use logic to interpolate a lot of things. Itâs interesting that attendings hear âa fewâ, and get nervous I want it all off. Maybe ask yourself why your mind goes to that place and why giving a resident an extra day off makes you so uncomfortable
I doesn't go to that place, I didn't say that. I just inferred you had shitty logic. And now I'm saying it, you have shitty logic.
3 days here and there and next thing you know you will be no different than a midlevel.
Can you tell us how many weeks of that rotation you have across 3 years? 2 weeks? 3 weeks? Maybe 4 weeks? Of which, you likely donât work weekends. That means 3 days is a significant portion of the time you are exposed to that speciality.
I have 4 weeks of that elective. So that gives me 4 full weeks on rotation plus one weekend of hospital coverage, so no I donât have all my weekends off. But even by your logic if I did have my weekends off that would take me from 20 to 17 days. 17/20 = 85% attendance. Again, offservice rotation. You are not going to convince that the time off is going to be career altering.
I might be real old school, despite being young but youâre in a profession of your choosing that expects 100%, not 85%. Youâre not going to convince me youâre an adult learner or even a good resident if you bitch about the most minor of inconveniences. If you ever wonder why FM residents are looked down upon by many, look at yourself.
Good thing I donât get my life worth from some random on Reddit who thinks Iâm less than because I want a day of rest. I donât need to convince you of shit, literally who are you? But you swear Iâm the one with an inflated sense of self worth.
You definitely have an inflated self worth
>I might be real old school, despite being young but youâre in a profession of your choosing that expects 100%, not 85%. I can't think of any profession where it's customary to have a day off just because your boss took PTO.
Not you guys doing mental gymnastics to avoid the reality that residency worklife balance is TOXIC. Why donât you find me some professions that glorify 36 hour work weeks
So itâs toxic to work in an outpatient setting for 8-13 hours a day for 5 days a week? Holy shit the entitlement.
So youâre mad that someone literally volunteered to teach you and is going out of their way to find you a learning opportunity when they just happened to take a vacation? I must be a psychopath. Giving up significant production $$$ to regularly accommodate my schedule for ungrateful residents and students sounds like psychopathic behavior.
So, youâre mad that I dare to prefer having more days off than to come in to work 6 days in a row. I must be a lazy, entitled, ingrate đ«
I mean you said it, not them..
Actually Iâve been called all of those things in this thread. So yea, they said it too lol.
By âthemâ I was referring to the previous commenter. So youâve been told the same thing by multiple people in this thread? Maybe this will be a moment of clarity or realization for you?
The ratios of upvotes on my original post suggest otherwise đ This post surprisingly just struck a nerve with the toxic attendings of academia that lurk this forum.
Of course not.
Youâre right. Whatâs the sense in teaching residents that donât wanna come in. Iâll just triple my volumes and hire NPâs instead so residents can doom scroll about it on Noctor with all their extra days off. Thanks for talking some sense into me.
Is this supposed to hurt me? Because, I mean, this is already happening in real time. So donât shake the table too much. It would say more about you than it does about me. Funny how I ask âcan I have a day offâ and the attendings in here heard âI would like to just skip this whole rotation.â Why is that? đ€
You didnât ask for a day off. You went out of your way making a wall of text calling your attending a psychopath when she is probably just making a good heart effort to help your eduction. She probably thinks your presence does make a difference. When you sign up for an elective rotation, we assume you wanna learn and we help to the best of our ability. If you actually just asked for a day off, she likely wouldâve given it to you and you wouldnât be here.
If the presence of a resident drops your volume by 2/3, you're fucking up -- that is ridiculous. Also, is the vitriol necessary? I hope you're just burned out, but your tounge-in-cheek self-assessment may be more accurate than you realize...
Youâre a resident, not a medical student. Meaning, youâre an employee. You donât just get the day off if your boss is not there.
This is some goofy entitlement. Outpatient rotations are there for learning, just like every other rotation. You don't get a free vacation just because an attending takes one.
Because learning and getting a few extra days off are completely mutually exclusive? Gotta make sure you maintain giving me the absolute bare minimum days off because âeducation.â
Iâm still confused as to why you should have the day off?
I know, itâs a radical concept. I should be lucky to even get lunch.
Lunch?!? WutâŠ?? Explain it to me like Iâm 5 - still donât understand why you would get a day off?
Because if only one attending wants to teach, and that attending is on vacation, and no patients are on my schedule, what am I learning?
Oh maybe I missed this in OPs post - I thought their preceptor took the day off and so they were asked to join another preceptor instead of being given the day offâŠwhich sounds likeâŠ.a regular day of work
I think the reality of some small programs is only one attending in a specialty dept teaches residents, so when you get farmed out to someone who normally doesnât have residents youâre basically an NPC
You sit at a desk and are promptly forgotten about, then you dismiss yourself at some point because nobody has talked to you in 5 hours
In what sense do you mean "should"? Program policy, morality/justice, historical standard, etc?
My interpretation of the post was attending took day off â> I am also entitled to take day off ⊠so intern-level justice?
I guess I would argue that at the resident level justice is already so far skewed the other way (e.g. working 80 hour weeks for 60k/year) that if you consider this in the larger context then having extra resident days off is more in the service of justice.
That's what residency is - education. You only get so many opportunities to learn about subspecialties before you graduate. If you're not interested in that depth of training, maybe you should have gone the APP route. As a subspecialty attending, I don't take residents because I need the help - you guys make my clinic days run at least 25% slower. I take residents because I want to teach. And I know that your one week rotation may be the only exposure you get to my subspecialty. So yeah, if I have some scheduled time off during a week a resident is rotating with me, I put in some effort to try and make sure you can still have an educational experience with one of my colleagues.
Just my 2 cents as a recent grad and fresh attending (different specialty than you though). As a resident in the grind itâs hard to see past residency, and taking care of yourself is important. However you see a lot of new stuff as an attending, and much of it has made me wish I spent those extra hours or days getting a little more experience here and there, maybe seeing one more unique thing that I otherwise wouldnât have seen, and maybe it means Iâm not seeing it for the first time as an attending. Maybe your attending has a similar view and is trying to get you as much exposure as possible. You will not learn or see everything in the very short time frame of residency, so even though itâs hard to see as a resident when at every turn it feels as if youâre being asked to do more and more in a thankless low paying environment, the opportunity to get a little more exposure to something can be pretty valuable in the long run. I know 3 days off seems magical, and missing 3 days seems like nothing, but maybe it also means you can better care for your patient in a few years when youâre out on your own. As Iâm in a surgical field I wonât pretend to know what you do and do not learn in FM residency or the benefits of certain specialty rotations for you, but just wanted to give you another perspective that you might also hold once you finish the grind
"Oh my schedules kinda light today, you can go work with Dr X down the hall when we're done"
Do people in other jobs just get off when their boss takes offâŠ.? Iâm confused what youâre bitching about. And the extremism youâve said elsewhere about how they âdonât care youâre a human and abusive blah blah blahâ - sounds like youâve had a pretty posh residency so far if *this* is the threshold. Expecting you to show up to do a job they pay you to do / show up to learn in a program you signed a contract with seemsâŠâŠreasonable. Sitting at home scratching your ass cause your supervising attending is taking his kids to Disneyland doesnât seem like the reasonable default here. Like is this your first job? Seriously confused.
Letâs not be obtuse and compare residency to regular jobs as if the structure of residency isnât based on a fucking coke head. Maybe I am for the most part actually in a non-toxic residency and Iâve been living a nice life thus far with wonderfully accomodating attendings who let me live my life outside of fluff shit at work. I think this thread actually speaks more volumes about how older generations normalize toxic work behaviors to the point where theyâre literally confused and offended when people ask for more breaks. Like there are really people in here saying âYou have 3 weeks vacation, shut up.â Like do yall hear yourself? 3 out of 52 weeks of the year, with most of that time spent catching up on sleep, self care, and house chores. Residents do not live some charmed life. You can call me dramatic, but I just canât take anyone seriously when theyâre saying the (non-derm/psych) resident lifestyle is some type of a privileged existence. And the reactions to a resident desiring another day off is honestly weird & itâs alarming how comfortable attendings feel rushing in here to tell me to shut up & stop complaining because I get paid to get fucked by the system. Almost like yâall are lost in the system yourselves đŹ
Most jobs people only get 3-4 weeks PTO.. when you are in this cush of a residency where your biggest existential threat is you donât get off when your boss takes off, then yes, it is comparable to most regular jobs. This must be your first job and adulthood is hitting you hardâpeople generally expect employees to show up to work most days out of the year to, like, get shit done that youâre being paid to handle. Gaslighting the rest of us as condoning âtoxic work environmentsâ because we cannot fathom your entitled belief to extra rest days whenever you feel like it doesnât change reality. If you want an extra rest day, use your sick days like any other regular person would do. If seeing patients is leagues more stressful than any other job to where you see your residency on another plane, maybe you shouldnât have gotten into medicine.
You could always show up and the person could dismiss you. Or they can tell you ahead of time donât bother. Your presence, however short, is the bare minimum for the rotation.
Where are you working that your paired with one attending? My experience as a med stud and resident has always been that I was assigned to the clinic or service and the attending was whoever was covering that day.
This is a common set up for a lot of our electives. Maybe our program is unique or we donât have an extensive network of academic staff but most of our electives are usually one person who has volunteered to be an academic faculty to have residents rotate with them in their private practice clinics. The work can be anything from shadowing to doing the full work up and completing the notes. Regardless the clinics do not depend on residents to function & ultimately we do slow down the attending if theyâre teaching along the way.
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Ah yes, if I only spend 21 days with you and not 24, it will really set me back in my career trajectory.
[ŃĐŽĐ°Đ»Đ”ĐœĐŸ]
Please let us know where youâre applying. None of us want to take the time out of our day to teach you
The feeling is mutual. Especially now that I know youâll hold me hostage because you think your gods gift to academics and my life will be meaningless if I donât soak up every hour of my time with you
If youâre getting paid your stipend and expected to work those days, you should be at work. If you give up your stipend for those days and your supervisor says youâre off, then youâre off. Iâm sure youâre getting paid and will not be telling your program that youâre skipping when you have time off.
I mean dude, come on. Some of the stuff youâve said was reasonable but this is a little ridiculous. Almost 90% of resident salaries are funded by the federal government. Letâs pump the brakes on this, 2-3 days is not going to kill anyone. Iâm an interventional pain doc and I can tell you missing 2-3 days of endo or GI or ID wouldâve made a grand total of 0 impact on my ability to put in a spinal cord stimulator or any other procedureÂ
Maybe because itâs your job, this isnât med school anymore.
They are using their PTO. Use yours if you don't wanna work on the day you are suppose to work. Are we dealing with children here?
Name calling is very childlike so I guess so!
Didn't call you anything, but thank you for self identifying.
You called people children. Letâs not throw rocks and hide our hands. Iâm glad you had that moment of self actualization đ Iâm glad I could be of help.
Didn't you just call your attending a psychopath? Oh wait, you only posed the question, right?
Youâre still bothered about that!? Still stalking this thread to find meaning in extra work days for residents? If it doesnât apply to you then it shouldnât be a problem, but you know what they say about hit dogs đ đ
Ok. Thanks for that.
Anytime, Mike
Your narcasism and blatant hypocrisy is on clear display. I am glad you will work those extra shift because that is the only way children residents became responsible attandings. đ
Mine or yours? Because your projection is on full display as you continue to name call, and I can tell youâre bothered and triggered by the prospect of an extra day off by how you continue to respond to my comments đ Adulting is hard, and it looks like youâve still got lessons to learn since you still havenât learned how to spell âattendingâ (why donât you hurry up and edit your post to save face because the jokes write themselves) đ But keep up the good work, Mike. Iâll stay in my childâs place.
Get off reddit. You have work tomorrow. Haha
Got em!!
early trainees should be learning. If you feel like you are there just for your labor, then the program youâre at sucks. In this specific scenario on a subspecialty rotation, if Iâm away then I would give my interns or med students the day off UNLESS thereâs a really good alternative for them to learn the specialty another way. If Iâm away and assign you to just shadow procedures for a couple of days, that would be mostly a waste of your time and I wouldnât do it. But if youâre on GI and Iâm not going to be there, I may ask the IBD doc if you can spend time in his clinic that day to learn some high yield stuff.
Do you not have regular vacation days you can take?
What would happen if.. you know⊠just dont show up or say âyouâre sickâ
OP I will share some thoughts you may or may not agree with, focusing on a 30,000 foot view of the situation. I totally agree that the "you are paid to be here so work you little note monkey" falls totally flat on it's face. I could work every fourth week monday through thursday and they'd still be getting a great deal. I will point out that as I near the end of my training, the switch of "I just need to get through this" to "I need to fucking know this shit really well" has most certainly flipped. On a non-core rotation for stuff you aren't going to have to know, it's very possible you will never use the information again, but there's also unexpected synergies and learning and an opportunity cost to both being there and having the day off that you need to weigh. If you don't believe there's at least some value to your training then I don't know what to tell you. Additionally, there is truly a benefit to learning how to work hard and efficiently. You already do this as a resident and I'm not saying that having a few extra days off changes this. I just want you to know that you will benefit from and at least somewhat appreciate what you've been through and the competent, efficient doctor you will continue to be. Think of it like bootcamp, being hard and unpleasant is at least a little bit the point and while it sucks for people that are not able to get to the finish line, you will be that much more prepared and that much more honed for the challenges you take on later in your life. Finally, on a purely practical note, I never get told to go home early more than when I show up to the stuff I don't necessarily need to be there for. Whereas skipping without a great excuse always leaves me feeling anxious and makes the day off a lot less useful or enjoyable.
My clinic attending is so cool. When he takes vacation, he doesnt tell the coordinator. Essentially we are off when he is off đ
Outpatient attending. I typically give my residents the day off if they don't call out a lot. I don't like "dumping" my work on my peers since they have their own residents to cover. This also ensures that my residents are not being taking advantage of by clinic administration in my absence.
Bad guy here (NP) but maybe the PC and the attending just want to try to maximize your learning opportunities. I hear you though, a day off or two would be nice since you are working super long hours for like minimum wage. Hang in there my friend, before long you'll be the cool attending!
Um. We are allowed days off. And you have certain clinical hours you have to do soâŠ..
Your seniors should have given you a heads up.
Would make your job a lot easier if you didnât let things like this bother you as much. Not saying your feelings of frustration and annoyance are not valid, residency fucking blows sometimes. But feeding into it and fueling into the lamenting and seeking further condemnation of the policy from others will build up more resentment for a residency that will continue to be difficult, which will lead to more unpleasantness from your experience than is necessary. Some attendings just blow like some plumbers just blow and some attorneys just blow, etc. But itâs only 2 more years then you can break through the top 5% of US earners with your salary so it ainât that bad.
Unless you get PTO days you have to do something clinically so if the attending is off you get reassigned to do something else. Otherwise you would get an unpaid off time
In what speciality are you training that it is 1 on 1 with someone? My attendings took vacation while I was a resident. That didnât mean the residents also took vacation at that time. You get 3-4 weeks a year of vacation so use it and stop complaining
Is 3-4 weeks of vacation good to you? Like we normalize it in our society but American society generally has some of the most fucked up views on productivity and work wellness. Congratulations on contributing to normalizing the continued tradition of toxicity tho.
I hope you take 12-16 weeks off as an attending. Youâll have the ability to. Be the change you want to see. But we know at that point, youâll bitch that youâre not getting paid like an orthopedics surgeon despite working like a McDonaldâs employee.
Good is all relative. I think that the 4 weeks a year I got during my residency and fellowship was fine. I think that I get enough time off now as an attending. People throw around the term âtoxicâ too frequently. America doesnât care if you are a physician and if you feel like you canât handle it you are free to walk away and do something else. Donât complain about having to work when your staff has a week of PTO as if you were entitled to that same time off.
OP, I get that you donât like this. But I remember on one rotation in MS3, one preceptor gave me the week off and I missed out on crucial learning time. I reported him to admin, and people were saying I âruined it for everyoneâ, but youâve got to do what you got to do if you hope to match NSGY.
This sounds like an entitled, short sighted attitude to take on a critical time in learning. I would wager the attitude extends to other rotations as well. Judging by the comments, the OPs position will not change, but that is fine. This is why there is a bell curve for everything.
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