#pgy2

[iknowthisisnowhere]

I used to think, rather convincingly, that I would choose to do medicine again. That I didn't regret it.

Today, on a cold, dark morning, waking up at 5am to get to the hospital, with 24-hour call looming this weekend, I realize that I would never choose this again.

[a-young-doctors-journey]

Sharing a scary vulnerable post on Instagram, eep.

When I post to my page, I always wonder: how many of my co-workers follow my page? How many of my "enemies" know about this? Do my patients ever find me and recognize me as their treating physician?

[crazyinsomniacresident]

Took a break after so many days.. PGY2 schedule is so hectic

[med-engr]

What a day (NICU rotation, for context)

High of a delivery that I was head of bed for and baby did great

Low of rounds dragging on and on

High of feeling like a good doctor doing actual medicine on one sick baby and I think anotber baby is going home only because I advocated that she was eating enough and we could stop using her NG- fellow and attending were certain she would fail her PO ad lib trial and instead she did great

Low of all the not-exciting scut work that needed to get done still

High of attending buying lunch, noon conference being canceled, and a warm day, so we sat outside with tasty lunch and then got ice cream and ran into a therapy dog on our way back in to the hospital. Very #wellness

Low of fellow asking for feedback and giving us feedback as a team but anytime brought up things we wish would be better he would tell us why that couldn't happen or we were wrong or what we needed to change (literally told us we should read the 300+ page NICU handbook before we start the rotation and refer to it more, even when the examples we were asking about the resident HAD read the book and answers wasn't there), and when he shared feedback from the NP team and we brought up potential solutions (if they feel we aren't helping enough, try asking us for help instead of complaining to our fellow that we aren't team players)- his response was insisting again that we needed to offer to help more, even if we are busy, and reisdents should have better NICU orientation from the residency program and acted like our ideas were insane and not feasible

That truly sucked

It also happened in the middle of our resident sign out, and delayed things so much I left 90 minutes later than I should and the intern who is on his first NICU solo call got sub-par signout. Very frustrating on multiple levels.

Don't ask for feedback if you aren't interested in understanding someone elses point of view. If you just want them to share their thoughts so you can yell them they are wrong, that's not feedback.

And we learned he is on for another 2 weeks with us (the full month of our rotation). I have a 28 hour call with him tomorrow.

I gave myself a stress headache today after work just still being mad.

Rant over

Yay for getting myself to the grocery store and taking time to relax. The burnout is strong but still taking care of myself which feels good

5 of 12 days in a row complete

[wayfaringmd]

A new medical term

PGY2: the patient said he was stressed out about something but he didn’t want to say what it was.

Attending: well this note in his chart says they couldn’t start home health because he was in county lockup, so I bet he might be stressed about that.

PGY2: good to know. I’m gonna go ask him about his case of incarceritis!

[ambuhr]

Twenty-eight.

Today is my 28th birthday. Every year I come on here to reflect and wow there was a lot that happened in this past year.

Twenty seven was an okay year. I went through a lot of emotional turmoil and just intense feelings of burn out, but all of that fluctuated and eventually went away. It's tough because I think I learned a lot this past year, but it was hard to adjust to.

I have a really great feeling about being 28. I know I say that just about every year, but there's such a strong sense of pride and accomplishment that I feel right now.

In this last year, I finished PGY2; I went to Paris, the South of France, California, upstate New York, the Delaware beaches, Kansas City, Maine; I moved in with my partner; I grew.

In this next year, I hope I have a lot of clarity and just happiness. I am wrapping up my final year of residency!! The job search has already begun, and I'm just so excited. Everything feels calm and perfect. Onward and upward.

[haptureratch]

This hospital is just....not.

HMH had a GALA for nurses week smh.

But also who even cares bc all my former classmates are almost pgy2s and I'm lost, left behind, wrong, defective, not even in training anymore.

[iknowthisisnowhere]

Have I ever been so deeply unhappy

[psychokangaroo]

The neuro pgy2 is micromanager (literally telling me what order to do my notes in) who is treating me like a MS3.

[writer-in-theory]

Not me finding out you have to go to college to be a pharmacist 👀

OH YEAH FOR SURE !! i get this a lot bc a lot of people hear pharmacist and immediately think of the techs you see at the counter. which, seriously we love techs they're the actual backbone of the pharmacy. i worked as tech for 4?? years and wow ouchie.

without getting toooo far into it, the basic setup of a pharmacy team is like this:

Pharmacy Tech: Usually don't need extra schooling qualifications unless they're Certified, which means they passed an exam and are licensed with the Board of Pharmacy. They can count prescriptions, complete prescription handovers to patients, receive prescriptions, and complete intake paperwork for vaccine and covid-test appointments. They can also give vaccines if they take the certification course. They cannot answer any medical questions, check prescriptions, or review medical information on patient records for accuracy/safety.

Pharmacy Intern: a current PharmD candidate who is licensed with the Board of Pharmacy, and can do everything a tech can with some more additions. They can counsel patients on medical information, meaning they can answer medical questions and advise patients on how to take their medications. In some states they can do Control Counts (making sure the pharmacy has the right amount of controls consistent with the inventory number). They can do transfers of prescriptions between pharmacies (except controls), and can do some reviewing of patient medical records with pharmacist supervision. This is what I am.

Pharmacist: They have completed their PharmD (or BS, if earned prior to 2000) and have passed the NAPLEX and MPJE. They fill prescriptions, check for safety, accuracy, and check for any duplication/unnecessary meds. They are the supervisor of the entire pharmacy team and answer questions to ensure patient safety.

Pharmacist-in-charge (PIC): USUALLY, especially now that there's a major shortage, there's only one pharmacist on shift at a time. However, if there's multiple then there's a PIC who is in charge. They're also in charge of making sure all pharmacy laws are being upheld.

Pharmacy Manager: Someone who has completed their PharmD and required exams. They are more in charge of business operations. Inventory, policy, managing the team.

This also can vary by state as every state has their own Board of Pharmacy and their own laws. This is also for a community pharmacy, it can look different for hospitals. Such as often for a hospital position, it's expected you complete a PGY1 (sometimes and a PGY2) residency.

[mcatmemoranda]

I forgot to mention yesterday that my program is letting me stay and move on to PGY2. I'm happy because now I don't have to worry about trying to get into another program. They said they don't think I'm at the level I should be at quite yet (although I really do think I'm the same as my peers and I don't think it's a completely accurate assessment), but that I have shown improvement and that they are still going to have me do more inpatient medicine. I think I don't get enough exposure to emergencies because in our hospital, when a code is called, a bunch of people, including the ICU team, already show up and start running the code. Even one of the third years who is super, super smart said she feels she is not qualified to run codes or intubate people. It's because we don't do it enough. You need to practice more to get better. I just want to be a good doctor and do a good job. I don't think I want to do hospitalist medicine, but I know Family Med residencies still all require you to do inpatient, so I'd have to do it no matter where I were. I just want to do well enough to actually feel that I am and truly be a competent doctor. I mainly want to do outpatient, but I could change my mind at some point and do hospitalist medicine so I know I need to be able to show competency in inpatient medicine. I feel we also don't get enough procedures in my program. They're trying to fix this by having a procedure rotation where all we do is procedures. My program is still relatively new and every program has to start from somewhere. So I get the limitations. I don't think it's a bad program, I just worry about not getting all the experiences I need to be a good doctor. I just want to keep working hard and get through this program and then finally be working as a successful doctor. If I can do that, I'll feel so much better. I'm always afraid of failure and I didn't start off feeling confident about myself. I feel more confident than I did a few months ago. I decided to stay and keep trying even though I was threatened with not being renewed. A lot of people don't have that fortitude. I think I'm a very sensitive person, but also resilient. I wish things could just be magically easy for me. But it's not. I'm the type of person who has to try really hard. I think I'm intelligent and a good person and I deserve to be here and to be the doctor I want to be. So I'm going to continue working towards my goals and I hope that I can get through this without as much struggle from here on out.

[agatechile]

¿Merece la pena estudiar Farmacia?

Sí, la farmacia merece la pena. Las personas que te digan que no, sólo están buscando trabajos de farmacia tradicionales, y lo más probable es que se sientan atrapadas. La farmacia, como casi todas las demás profesiones, ha evolucionado y sigue evolucionando. Y los que se sienten atrapados no se han tomado el tiempo de evolucionar con la profesión y sólo miran hacia atrás a "los buenos viejos tiempos".

Permítanme darles un ejemplo. Cuando empecé a trabajar con mi padre, hace muchos años, en su farmacia independiente, varias cosas eran ciertas. No había ordenadores. Todavía se hacían bastantes compuestos. Mecanografía manual. No había genéricos. Un día ajetreado para dos farmacéuticos era de 150 recetas. Mucho, mucho, mucho trabajo de archivo. Muy pocos seguros, y los que había tenían un copago fijo. Cuando mi padre empezó a trabajar, los farmacéuticos no podían aconsejar a los pacientes sobre medicamentos, ni se esperaba de ellos que hicieran una revisión de la medicación para asegurarse de que no había interacciones medicamentosas graves ni alergias.

Si entras ahora en cualquier farmacia, casi nada de esto es cierto. Cuando me licencié, era muy viable económicamente entrar en una cadena de farmacias y ganar seis cifras. Aunque podías optar a una residencia, la mayoría de nosotros optamos por el dinero y ahora nos arrepentimos.

La farmacia ha evolucionado mucho en los últimos 10 años. Ahora hacemos la mayoría de las inmunizaciones fuera de pediatría. Se espera que seamos los expertos en medicación. Tengo pacientes que acuden a mí cada vez que ven a su médico para que "compruebe si lo que le han dicho es correcto". Tengo suerte. En mi tienda me consideran el "farmacéutico clínico", y paso al menos un tercio de mi tiempo hablando con los pacientes y consultando con los médicos. Hay muchos trabajos en los que ni siquiera tienes que pensar en vender o dispensar medicamentos. Y si la mayoría de los trabajos no empiezan con 6 cifras, están cerca.

Si tu pasión es ayudar a la gente con su medicación, te recomiendo encarecidamente que entres en la facultad de farmacia. Pero yo no recomendaría ir directamente a la fuerza de trabajo tan pronto como se gradúe.

Mientras estés en la facultad de farmacia, tómate tu tiempo para obtener la certificación en compuestos. Toma todas las clases optativas que puedas. Intenta informarte tanto sobre medicina alternativa como sobre medicina "tradicional". Aprovecha las tarifas reducidas por pertenecer a APhA, NCPA y ASHP y participa activamente en los grupos. Participe en concursos de asesoramiento. Ofrézcase como voluntario en ferias de salud. Ofrézcase como mentor de estudiantes de secundaria. Ofrézcase como voluntario para ayudar en los días de las carreras en las escuelas primarias. Sea tutor de niños en matemáticas y ciencias. Asiste a todas las conferencias que puedas (son más baratas o gratuitas para los estudiantes), incluidas las conferencias estatales/locales. Tómate tu tiempo para hablar con tus preceptores y con todos los farmacéuticos que puedas. No todos ellos te animarán a ser farmacéutico, pero sí lo harán aquellos que aún sientan pasión y no se hayan quemado. Tómate tu tiempo para hacer los dos años de residencia, para que realmente puedas dedicar tiempo a encontrar cuál es tu pasión en la farmacia. ¿Quieres empezar a pagar tus préstamos? La mayoría de los lugares te darán un horario fijo, así que puedes pluriemplearte en la farmacia del hospital o en una tienda minorista a tiempo parcial. (Tienes que obtener la licencia antes de empezar la residencia, así que esto sólo es una carga en lo que respecta a la gestión del tiempo).

Obtén una certificación de la junta en tu pasión (no tienes que ejercer durante dos años para hacerlo si te especializaste en ella durante tu año PGY2).

Obtén tantas certificaciones nacionales y locales como puedas en tantas áreas diferentes de la farmacia como puedas. Asegúrate de hacer inmunización, MTM y medicina del viajero. Hay otras en cosas como cardiología, anticoagulación. Conviértete en educador en diabetes.

Defiende que los farmacéuticos sean reconocidos como médicos. Cuanto antes ocurra, antes podremos hacer las cosas de forma independiente y no ser esclavos de "contar de cinco en cinco".

Toma clases de administración de empresas. No importa si vas a trabajar por tu cuenta, en un hospital o en una empresa minorista. La información básica te ayudará a ver lo que realmente ocurre.

¿Crees que puedes tener problemas para pagar los préstamos? Una vez terminadas las residencias, plantéate trabajar para el ejército, los Servicios de Salud Indígenas o en zonas desatendidas. Muchos programas te dan mucha ayuda para pagar tus préstamos, y algunos los pagan completamente si sirves durante 5 años.

Asegúrate de ayudar a la próxima generación y considera la posibilidad de participar en algunos proyectos educativos con tu universidad local.

No dejes de aprender NUNCA. Vaya más allá de los CEs requeridos para mantener su licencia.

Participe en las organizaciones profesionales locales y nacionales. Sigue asistiendo a congresos siempre que puedas. (Yo voy a una de nuestras convenciones estatales y a una convención nacional anual como mínimo).

Pregunta a médicos y otros proveedores si puedes ser su sombra. A medida que vayas dominando la farmacia, pregunta si puedes seguir haciéndolo. Puede que incluso se convierta en un trabajo para ti cuando termines.

Predigo que los cambios en farmacia serán más que el goteo que estamos viendo ahora. Dentro de 20 años, no reconocerás la profesión. Haremos mucho más trabajo de consulta e independiente y otros proveedores nos recibirán con los brazos abiertos como parte del equipo. (Ya lo somos, pero muchos veteranos preferirían cortarse la lengua antes que decirlo).

Entonces, ¿merece la pena la farmacia? Sólo si te apasiona ayudar a la gente con su medicación y no te dejas empantanar por los problemas cotidianos que están presentes en cualquier trabajo. Sólo si sigues aprendiendo y adaptándote a los cambios de la profesión. Sólo si te dedicas a la farmacia por una razón mejor que "es dinero fácil" (créeme, no lo es).

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[cesium-sheep]

she said there's still pgy2 slots potentially on the table so everyone had a bit of a group fuss about the future, he said he cannot move to california because of the climate which is totally reasonable I fuckin hate it too I'm just able to gear shift for it, he also said I can stay with him as long as I like if I don't want to return to california either (after an extended joke about throwing me out of the car at my mom at speed). if she ends up in boise he's more likely to pick up and come along since it's a less hostile climate and cheaper housing and still not that far from the rest of our lives. and she agreed when we pointed out the worst case is actually still pretty fuckin nice this time around, where she stays here and keeps the job she just got and we all move into a nicer place.

I made sure to tell him plainly that he's not obligated to come along or to let me stay, and I made sure to tell her that we're not asking her to choose between us or her career and we'll still be here even if we can't follow her. (I think it's easier for her to believe of me than him because I've just been around a lot longer and we're literally married.) she said it's mostly stressful because she doesn't have enough pieces to actually start planning but he and I are both compulsive planners and keep prodding around anyway.

[ambuhr]

Hello.

It’s been such a long time since I’ve come on here. Since I last blogged...

I worked through some terrible horrible shit. We are still trying to navigate how our lives are to this day but things are better.

I moved into the 2 bed/2 bath apartment of my dreams.

I stopped caring as much about what other people think and started doing things for myself.

I started treating weekdays as days. For so many years of my life, weekdays meant no fun and all work/studying. Now I go to baseball games and basketball games and restaurants and happy hours during the week, and it feels fantastic.

I went to France and fell in love with the country all over again.

I went to one of my closest friend’s weddings. How surreal is it to see your friend in her single days and then to be at her wedding!!

I explored all of San Francisco.

I ate some of the best food I’ve ever had in my life. From omakase to just fantastic pasta.

I finished six 24 hour shifts!!!!!!!

I am in the last 3 weeks of my PGY2 year and WOW. What a year it’s been. I’ll have to recap the whole experience when I’m nearing the end.

I started focusing on my own happiness. And whatever that means for me.

[wickerthoughts]

it's looking like i will be doing a 24h shift next wednesday which is technically against the residents union rules because of a series of unfortunate events which began when the person making call schedules (pgy2 int med) assumed that we all already know our rotation schedules as well as the names for the various obligatory attendence events more than a month before the official start date which is clearly not a given. She ends up dumping on me and i have to honestly say that it is unfair and could have been avoided if she was better at her job (aka resident coordinator which she took vonluntarily). That and i have 3 consecutive call periods in the following week. At this point i dont even know if i want to continue in medicine anymore. 5 straight years (and much further beyond) of forcing myself to do things. i dont even remember when i actually last laughed. my life is empty and it feels like im coherced into living even though i just want to cease to exist. i am sick and tired and i straight up want to take myself out of my misery

but im also so angry that things could just happen and that i still dont have any control over my schedule and that im forever taking shit from other people while constantly trying to not upset anyone and be accomodating when the same is not done for me

if i throw myself off a bridge id say it is in part because the medical system and its people is some of the most repugnant things id experienced

[iknowthisisnowhere]

PGY2 sucks and I hate everything and I hate this program and I wanna go home