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

[Anonymous]

surgeon mom who is 15 years into practice and finds her career very rewarding -

1) residency is really hard, especially intern year. there is a ton of adjustment to new responsibilities, tremendous learning curve, fatigue, etc. people have to remember it's a marathon. for the poster who said it's only 3 years, it depends on the field. can be anywhere from 3-7 years plus additional 1-3 years for fellowship.

2) i'm a little surprised with her disillusionment this far out as most medical students encounter this during clinical exposure and/or shadowing as a pre-med. the health system is very messy and easy to become jaded - it's important to shut down some of that noise and focus on the joys of helping the pts you can, doing something good in the world, and working on improving your skills to become the best doctor you can.

3) all specialties are valuable and worthy of respect. some have better lifestyles than others but good for those folks who prioritize life outside the hospital; doesn't mean they are not "real doctors". she needs to lose that attitude asap. i could not do my job without the amazing oncologists, radiologists, pathologists, and yes, dermatologists that i work with (i am in surg onc and treat melanoma pts).

4) family support can really help during residency, especially if she's interested in having kids. a supportive spouse is essential. local parents who can help with childcare is also great if feasible. we had an amazing nanny who helped with childcare for our 2 kids.

[Anonymous]

Anonymous wrote:

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.

I’m not sure why I’m surprised you are a man! Thanks for being a great and thoughtful brother.

[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.

People value your efforts if you do a good job. PAs/Nps have worked to achieve their role. A resident isn't there yet.

[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.

It's not a thing well only to brat residents who are entitled and have an over inflated sense of self.

[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.

I hate to say it but she does sound a bit spoiled like everything has always been easy for her and she's used to relatively instant gratification and praise. Also seems she wants the career for accolades. Not everyone is cut out for a career as a doctor residency helps sift out those. Otherwise pay your dues and hush.

[Anonymous]

1. As a high school teacher she is going to encounter the same problems with the general public as she is encountering at the hospital - but for a whole lot less money and for her whole career, not just a few years.

2. Sounds like her fiance is an issue and has no business being engaged to a professional woman. He wants a stay at home wife or wife with a low paying low stress job to mother him, not the other way around. Possibly dump him, if she actually wants to work.

3. Why not pursue an easier specialty? It will be so much better than being a teacher.

[Anonymous]

Doubt that she had the board scores for derm or she wouldn't be doing internal medicine

[Anonymous]

Sounds like her fiance is an issue and has no business being engaged to a professional woman. He wants a stay at home wife or wife with a low paying low stress job to mother him, not the other way around. Possibly dump him, if she actually wants to work.

There were a few women in my med school class married to guys like this. Once the novelty of saying "I married a doctor" wore off for these guys they were super resentful of everything: the hours, the emasculation, the absence from home. They wanted a "normal" wife (words from one of those guys). Honestly these were starter marriages and the lucky women dumped these guys early. The ones who stuck it out ended up divorced in residency, but that was still better than the few who made it through residency only to have the guys leave and file for alimony once she started making money. Real winners, these guys.

[Anonymous]

Anonymous wrote:OP here:

Also, "your sister is not cut out for medicine" is not needed or appreciated. I just can't tell if this is a passing fancy, or growing pains/adjustment. Aside from a year of research between college and med school, it is her first job.

This can't be concerned controlled on a free message board.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here:

Also, "your sister is not cut out for medicine" is not needed or appreciated. I just can't tell if this is a passing fancy, or growing pains/adjustment. Aside from a year of research between college and med school, it is her first job.

This can't be concerned controlled on a free message board.

OP here. This may be the case, but honestly, I am now realizing that my motivation was to get support from the DCUM community as how to approach the situation individually (i.e. myself) as, for a number of personal biographical reasons, I am a significant figure in my sister's life. And, her stress is also impacting my own academic work.

The hate is unnecessary. Her expressed intention for going into IM was the diversity of procedures, before specializing further. Now, I worry that is all in question and years of graduate education may be at risk. Not to mention, years of private school tuition.

So, for those who call my sibling "spoiled" – ask yourself, how does it feel were the same applied to yourself, your own sibling, or child? Seems like unnecessary hate to put out in the world. I asked for actionable, specific advice. Trashing people is not actionable, except engaging in projective identification on your own part.

Also, I will end by saying – is this forum populated entirely by women? The snark re "spoiled" or "entitled" seems heavily gender-coded in a way that would not be applied to a man. Are the three blonde ladies from the White Lotus on this thread? This isn't a matter of not being able to take the heat – I am simply asking: what are you contributing to this conversation? Why are women in healing professions expected to be sacrificial lambs, whereas a man might – to my imagination, at least – be seen as a martyr?

I'll take input from physicians, parents of physician children, or spouses of the same, but otherwise, I am not interested in the petty resentment of DCUM posters who, for whatever, reason, seem invested in speaking derogatorily about loved ones. I can pass comment on my sister's psyche; ya'll cannot. This may be a public forum, but whatever happened to decorum? This is why this country is falling apart.

And finally, given the program she matched into, the one thing I can assure you above all is that there is was no issue with her board scores. I think the main triggering factor is the fellow resident – a young female, in her same year – getting punched in the face. Like I said, I myself am a university professor so I think what I am now realizing I am/was trying to do is – how do I maintain credibility in supporting or advising her, when she is right to call me out, I work in a completely different milieu. That said, AGI may kill the social sciences before I make tenure, so part of my frustration is that she has guaranteed job security and these days, social science academics do not.

Once again, I would like to reiterate my gratitude, particularly to those physicians who were detailed and went point-by-point. I do think the fiancé is an issue, but that ship has sailed. To those of you who project your own insecurities or misery onto others – I wish you a most thoroughly unpleasant day.

[Anonymous]

Anonymous wrote:surgeon mom who is 15 years into practice and finds her career very rewarding -

1) residency is really hard, especially intern year. there is a ton of adjustment to new responsibilities, tremendous learning curve, fatigue, etc. people have to remember it's a marathon. for the poster who said it's only 3 years, it depends on the field. can be anywhere from 3-7 years plus additional 1-3 years for fellowship.

2) i'm a little surprised with her disillusionment this far out as most medical students encounter this during clinical exposure and/or shadowing as a pre-med. the health system is very messy and easy to become jaded - it's important to shut down some of that noise and focus on the joys of helping the pts you can, doing something good in the world, and working on improving your skills to become the best doctor you can.

3) all specialties are valuable and worthy of respect. some have better lifestyles than others but good for those folks who prioritize life outside the hospital; doesn't mean they are not "real doctors". she needs to lose that attitude asap. i could not do my job without the amazing oncologists, radiologists, pathologists, and yes, dermatologists that i work with (i am in surg onc and treat melanoma pts).

4) family support can really help during residency, especially if she's interested in having kids. a supportive spouse is essential. local parents who can help with childcare is also great if feasible. we had an amazing nanny who helped with childcare for our 2 kids.

Another physician mom here and I agree with everything this pp said. My DH isn’t in medicine but grew up with a parent who was, so in theory he “got” it, but it was still a really hard intern year (in terms of our relationship) when my hours were awful. He was the primary parent for my whole residency, although everything after intern year was much less rough.

If your sister is still unhappy in a few months, she could look into transferring. Maybe a different program in a different location and with a hospital that serves a different patient population might be a better fit. Also, there are primary care IM programs that focus more on ambulatory care and the hours aren’t as awful, which could be a better fit. Many family medicine programs have much better hours and limited overnight call.

Tdlr: it gets better, but if she’s miserable and doesn’t want to get through it, look into switching to another program or field.

[Anonymous]

I think she needs to dig deep and think realistically about what she thought a career in medicine would be.

residency is a given. The long hours and low pay are part of the deal. But unlike other degrees, she was given a job after finishing school that pays money and allows loan deferment.


Does she think that working in an urban area is for her? Did she think that she would only take care of young, healthy, white people without socioeconomic concerns? Because that isn't how the real world is.

Complaining about NPs and PAs and other doctors is a bad sign.

Healthcare is in a state of crisis and if she can't show up and give people her best, she needs to do something else. This isn't about her, it's about the people who need her.

[Anonymous]

Physician mom here too. It’s hard to see when you’re in the moment that this is but a chapter in your whole book. I remember wanting to quit too intern year at different points but now being an attending for nearly 20 years it’s more a distant memory. If it is getting to the point it is affecting your job you need to be honest about that with her.

Are there older mentors in the program that her program director can connect her with? It’s super helpful to talk to someone who is further ahead than you. I would strongly recommend even though she doesn’t want to at this point seeing a therapist. Some state medical societies even have free counseling for physicians only that are confidential.

Does she have a group of other resident friends? That can develop over time and having someone who is going through the exact same thing who understands is so helpful. I had a group I would regularly talk or go out with on times off.

I would advise her to at least finish intern year before making any changes. This is a big life adjustment. I’m happy I stuck it out
and also for specializing. Hard to do primary care well these days. Yes, I make good money, but I also get to really help people in an impactful way. That has been the most rewarding part.

[Anonymous]

PP who is a mom of an IM attending. Intern year is a slog, she is new and is learning 24/7. Now she has to apply her knowledge vs class work. It will get more difficult, especially when she has to work 24 hours shifts and simultaneously, studying for board exams. The good thing about residency is that the program will move her thru different areas of the hospital and working with different attendings. Some she will like and some, not. Such is life.

[Anonymous]

Anonymous wrote:Doubt that she had the board scores for derm or she wouldn't be doing internal medicine

+1. The specialties that are better lifestyles are incredibly competitive. Don’t suggest she switch. And everyone’s training is hard. Medicine is incredibly hard and a lot of it you just have to push through. Does she connect with the other residents? Having a group that truly understands and commiserate m, but keeps going will be more helpful than anything else.