How do I advise/support my sister who is a burnt-out PGY1 medical resident? (

[Anonymous]

I don’t have advice but I’ve never heard of a lack of respect for MDs because of PAs. I feel it’s the opposite, but maybe others can chime in so you know that’s an unhelpful narrative she’s made up.

[Anonymous]

Being a teacher is also a crappy job but for a lot less pay. It’s the same money she’s making now but for the rest of her life.

[Anonymous]

Anonymous wrote:Wow. Sorry to hear that OP. My kid just started residency too so I understand how touch it can be. It sounds like she is worrying about "everything" at this point. If my kid asked for my advice, I'd probably tell them to "shrink your universe" meaning worry about things you have control and can do something about it and don't worry about things out of your control. I wonder if your sister is in the same hospital as my kid. Good luck.

+1. She sounds somewhat idealistic. I think this here is good advice. You do the best work you can in a very imperfect system.

[Anonymous]

Anonymous wrote:I don’t have advice but I’ve never heard of a lack of respect for MDs because of PAs. I feel it’s the opposite, but maybe others can chime in so you know that’s an unhelpful narrative she’s made up.

Former resident here. There is a ton of tension between PA/NPs and residents. For many services PAs function similar to residents except they get paid more and they work way fewer hours. For example, they work say 4 days a week 8-5 and no weekends while residents work 12 hour days with only 4 days off in a 28 day period. We also work holidays with no extra pay (and they get overtime). The real issue is that the path to being a doctor is long and if you stop at any point it’s all for nothing (you can’t be licensed without residency) while PAs do 2-3 years of school and no residency. Plus people prefer PAs (that’s what you all say on here at least) so it hurts to do so much and work so hard and for people not to value your efforts.

[Anonymous]

She needs to be more pragmatic to survive.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t have advice but I’ve never heard of a lack of respect for MDs because of PAs. I feel it’s the opposite, but maybe others can chime in so you know that’s an unhelpful narrative she’s made up.

Former resident here. There is a ton of tension between PA/NPs and residents. For many services PAs function similar to residents except they get paid more and they work way fewer hours. For example, they work say 4 days a week 8-5 and no weekends while residents work 12 hour days with only 4 days off in a 28 day period. We also work holidays with no extra pay (and they get overtime). The real issue is that the path to being a doctor is long and if you stop at any point it’s all for nothing (you can’t be licensed without residency) while PAs do 2-3 years of school and no residency. Plus people prefer PAs (that’s what you all say on here at least) so it hurts to do so much and work so hard and for people not to value your efforts.

Thanks for explaining. I’d never see a PA. One glossed over my mom’s cancer.

[Anonymous]

Anonymous wrote:First of all, I debate the timing you mentioned. Don’t MOST residencies begin July 1st? So, she’s really only been a resident for 5 weeks. Next, salary for residency have always been low. They are a student and moaning that NPs and PAs make more is not comparable. My DS was a resident during Covid so tell her life could clearly be worse. She seems to have a lot of issues (complaints) for someone so new to the process. Has she always been this dramatic? Not everyone is cut out to be in the hospital setting.

Mine started June 10th. It was common in Philly at the time.

Also, agree w other PP re NP/PA strife. Our hospital also decided that residents cld be involuntarily called in off jeopardy to cover shifts if an NP didn’t show up. And we didn’t get paid for that, either.

[Anonymous]

BTDT. 1 and 2 get better with time.
3....you either become almost numb to it or you realize you need to work in a completely different setting. I spent 9 years working with a population that was largely homeless and/or had various addictions. You got used to it, learned how to manage them, built relationships with them. I also had coworkers who knew it wasn't for them and went to settings that didn't have a large amount of that population.
4. I never had to deal with issues re: MD vs NP/PA. As for the system as a whole....you become despondent after awhile. Our healthcare system is an absolute disaster. I can't change the system but I will operate as my own person and use my own morals to provide the best care I can under the impossible situations we are in . I will caution she has to be very careful not to get caught in the "I'm the MD, I'm in charge" mentality. In a hospital setting, the nurses and aides are spending far more time with the patients than the doctors are. The nurses are the ones who alert me when something is off. The nurses are the ones who contact me advocating for orders for their patients. I have seen many residents have a miserable time because they think they are above others. It's a team.
5. Ties into 3. It's not the right setting for her. There isn't much that can change. People abuse the system but you can't assume that's what they are all doing.
6. This is a husband problem. Marriages don't always survive residency.
7. Yeah have no suggestion for that. You just learn to live with exhaustion.
8. You just have to keep encouraging her. Don't let her bully you into being her sounding board.
9. It'll fall on deaf ears. She knows there are other specialities. She'll eventually either decide on something else or she will learn to deal with her decision.

She sounds like she's in the phase of wanting to prove herself but also being still in that naive stage of the medical field where people think it's all about helping people and making the world a better place and they are slowly realizing how messed up the system is.

[Anonymous]

She will be just as disillusioned with teaching. Or possibly with anything.

I have seen this type of personality and they end up stopping and restarting 3 careers and THEN when all their friends are happy and established by 35, they get very sad they have fallen behind and not made their way in a field.

She should complete her training since she has already invested the time, money and effort. Once that’s done, she can re-evaluate and determine next steps.

[Anonymous]

If she’s in NYC, that’s particularly rough on IM residents (unionized nurses who are so incredibly mean - both to each other and the trainees - it’s just shocking how mean they can be).

Residents just have to suck it up - it’s only 3 years. Hard to get therapy because there’s no time or money for that. There’s a Reddit residency subreddit where residents vent. Lots of our residents are on there - I see it on their phones.

[Anonymous]

Anonymous wrote:If she’s in NYC, that’s particularly rough on IM residents (unionized nurses who are so incredibly mean - both to each other and the trainees - it’s just shocking how mean they can be).

Residents just have to suck it up - it’s only 3 years. Hard to get therapy because there’s no time or money for that. There’s a Reddit residency subreddit where residents vent. Lots of our residents are on there - I see it on their phones.

Imagine my wife having to deal with residency for 7 years and then 2 more for fellowship (while having 2 kids during the process)!

Throwing out another resource for the OP - https://forums.studentdoctor.net/forums/. I was on there daily while my wife was going through the med school/residency/fellowship process and it helped immensely.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If she’s in NYC, that’s particularly rough on IM residents (unionized nurses who are so incredibly mean - both to each other and the trainees - it’s just shocking how mean they can be).

Residents just have to suck it up - it’s only 3 years. Hard to get therapy because there’s no time or money for that. There’s a Reddit residency subreddit where residents vent. Lots of our residents are on there - I see it on their phones.

Imagine my wife having to deal with residency for 7 years and then 2 more for fellowship (while having 2 kids during the process)!

Throwing out another resource for the OP - https://forums.studentdoctor.net/forums/. I was on there daily while my wife was going through the med school/residency/fellowship process and it helped immensely.

Former resident PP here. I had two kids during training. My husband who has his own professional career did EVERYTHING so that I could focus on training. Drop offs, pick ups, sick days, groceries, house maintenance… I was basically a warm body at home. If you have a wife in residency, that is your life and not all men can handle it.

I will say that you have to finish. She has to. Otherwise all her hard work is a waste. I tried to quit so many times but I was reminded that my income potential would plummet as an MD without residency is pretty worthless. When I went on the job market though I was super protective of my future work life balance and I got what I wanted so now I feel like finally it’s worth it. Good luck to her!

[Anonymous]

She will have to make these decisions on her own.
You’re literally not equipped to assit her triage her life.

Suggest therapy.

[Anonymous]

Anonymous wrote:Are you her sibling or parent? Weird ps. Anyway. I know you don't want to hear it but maybe medicine isn't right for her, maybe she needs time off to grow up a little. Sounds like she's been pampered a bit and this is her first does of the real world. Maybe part of the problem is you and her parents etc have always fixed things for her.

OP here. Thanks for the needless ad hominem – very original. Has it ever occurred to you that there are circumstances where parents are out of the picture, or literally no longer with us on this earth? I do not appreciate you trash-talking my sister. Or anyone for that matter. My request for input was earnest, and very clear.

To others – yes, you are correct, it is in fact two months in, not three. IM started in June.

Generally, however, thank you all for the detailed and context-aware responses. I'm in academia so I'm trying to figure out how to be a supportive brother given that, at least by comparison, my trajectory appears [to my sister, to be; but also objectively] plush. Research and publishing are their own sort of grind, but I do not anticipate being punched in the face at a conference while presenting a paper.

[Anonymous]

OP, I know people put premiums on "happiness" but I think she needs to tough it out on this one. She came too far and invested too much to question her decisions. I'd ask her to focus on her work and take it one day at a time approach. This shall pass.