As someone who has been part of many research projects, I have to say the menacing inflection in the tone was piece de resistance in delivery. It was bloody brilliant and fantastic to hear. 😁
I'm about to start med school and will soon be housemates with second year residents who are YOUNGER than me (lol, my billions of gap years in research) so you can imagine their relief when they heard I could help them with their research projects they don't have the time for!
My little brother's Dress syndrome was diagnosed by a doc fresh out of school, who actually did their thesis on it, hence how they knew what it was. It's a very rare and severe reaction to medication with a roughly 10% mortality rate, so we're very thankful that this doc had been able to diagnose it and treat him.
@@karthik_silkroadsDRESS = Drug Reaction with Eosinophilia and Systemic Symptoms. Usually huge rash, organ involvement and eosinophilia. Lymph nodes usually involved.
Actually studies have shown that beginners do better in diagnostics. As a patient you have the ideal treatment if a beginner does the diagnostics and an experienced doc does the therapy.
ER Nurse here. I will say with confidence that newer docs actually do a lot more shit for a pt. Sometimes unecessary labs but they will work up every patient that comes in. Which in a way is very annoying but as far as care goes, they really do cover a lot of the bases
As a pt used to be dismissed for very real issues I can confidently say that most of the drs that have actually pushed to give me care and a diagnosis, have been newer drs. (And once you have that diagnosis the olders drs cant dismiss you as easily).
As a patient, I love getting seen by newer doctors. I’ve spent decades seeing doctors, having my concerns dismissed. Residents have actually listened to me, provided care, and even helped me get diagnoses for problems that my doctors had been minimizing for decades. My life has improved substantially because of the care that new doctors have provided.
I know right! Same! I would be an entirely different annd probably more miserable person without the care I received from my family doctor when she was still a resident
As a current med student, as the years go by, we are taught to value the patient above all else. I can’t speak for MD schools, but my DO school is VERY strict about humanistics and they teach us that while you don’t need to order every test in the book, you do need to fully investigate a patient’s complaint when they come in and take an active partnership with the patient. Our professors would regularly tell us “take your hand off the door and EXAMINE THE PATIENT”. So hopefully as time goes on, the new generations of doctors will be more and more dedicated to finding answers and providing top quality care.
@@PhoenixRoseYT I think that your generation of healthcare workers can completely change how women and especially POC view and interact with healthcare. One good interaction can’t undo decades of trauma, but it will certainly make a huge difference for the patient and they may be more likely to seek care (especially from you) in the future. That is huge.
@@PhoenixRoseYT Love this. This is a big part of why I plan to go to DO school. It makes sense that practitioners who are helping keep palpation alive would also appreciate the broader importance of being present with the patient and properly SEEING them. I don't suppose you happen to feel like sharing which DO school you're at and how you're enjoying it, do you?
It was a younger, newer doctor who diagnosed my fibromyalgia off the bat even though it took a year and a half to get an official diagnosis. Most importantly: shew gave my father and I the vocabulary to describe what we thought was happening to older, more stubborn doctors, some who didn't even believe fibromyalgia was a real thing. I'll always remember and be grateful to her, even though I didn't see her long enough to learn her name.
Seriously, I was hospitalized for an severe allergic reaction on July 1st once and it was one of the most compassionate healthcare experiences I’ve ever received. I felt super safe despite having just experienced a life-threatening event, and my mom remarked “damn, they’re training those residents well.” Best of luck to all the new interns starting this month!
“You just took a journal club right to the face, Doc!” Has got to be one of the most inspiring student comebacks I’ve ever witnessed. 👏👏👏 Thank you as always for your service.
As a grad student I am absolutely folding this into my everyday vocabulary. Source contradicts my findings? I can’t get access to the paper I need in time? Someone already wrote the paper I wanted to write? “Oh man, I just took a journal club right to the face.”
Thank you for this! A family member's cancer diagnosis was diagnosed by a first year resident (after multiple previous ER visits), so junior learners shouldn't be dismissed for lack of experience
Exactly! It's the ones who become jaded and calloused that are truly dangerous. And the ones that refuse to retire and are still practicing medicine at 80 despite cognitive decline.
I get my primary care through the resident clinic. The residents are enthusiastic and close to the current literature. I have seen residents and med students catch thinks missed by other doctors because they still do a complete physical exam. Plus I get the attending. Two doctors for the price of one.
"Do you have any research projects I could help you with" - as someone who's been hunting for research opportunities for the past year - I can conclusively say that is your best closing statement doc!
My mom's office just got a new med student a few days ago. First day they're there, patient had something really weird going on with their poop, med student immediately (and correctly!) knew what rare worm they have. New docs are treasures! They remember all the esoteric stuff that med school teaches.
Glad to see the Support_Bill army expanding. His mom, the med students, hopefully the new interns and junior residents. Hope he gets a break..... atleast for a cup of coffee.
btw I think some seniors like Psych and Palliative Care is supporting Bill too in their own ways - is just he has problems with Cardiologist and Surgeon ig
The most amazing physicians I’ve had have been straight out of fellowship. I know that’s a far cry from a new resident, but what it means to me is they’ve had that time to safely make mistakes, learn their specialty and subspecialty, and come out with fresh new information and ideas, while still open to learning. I confess the stigma scared me when I learned the new (and only) subspecialist for my son’s rare bone condition was fresh out of fellowship, but he’s been honest about what he does and does not know, actually read the inch-high stack of research papers I presented at our first visit, and even planned to travel with us to observe when my son needed surgery that was going to be out of state. Then, found an expert on this rare and difficult to treat bone disease, and arranged for them to come up to Alaska so we wouldn’t have to leave. So bring on the fresh minds and open thinkers. The ones who know they don’t yet know, but are still ready to learn. And congratulations and welcome to the profession, Drs.
@@angelokeke5376 thank you, that’s very kind ❤️. He had to have surgery and his leg is healing slowly, but the surgeon isn’t worried yet. But my son runs around in his brace like everything is right with the world, just as wild as ever. I’m so proud of him 🥰
I’m a pharmacy student. One of my classmates brought a really good recommendation to an attending to which he replied “I hope you remember that when you’re filling bottles at Hy-Vee.” She then told it to a new intern and it ended up being changed. Thank you to all the nice interns!
Wow, as a new starting intern who definitely jokingly made the same statement of “stay away from the hospital patients! We’re here!”, it was actually kinda nice to hear this
This definitely hit the spot today for me!!! I'm an R.N. and my husband is seriously ill, in the hospital right now. Today the rounding team had a new physician. I could tell that she has been "battered and torn." She had an extremely defensive attitude of trying to impress me with how much she knew, but she was lacking in compassion, and not interested in hearing anything from family. So often I have seen that happen as a personal defense mechanism in young physicians. We need to concentrate more on emotionally nurturing the young ones coming in.
Emotions just don’t exist in doctors, in my personal experience. Unfortunately your experience is the normal for patients, every day, and I’m sorry you had to go through it, but it’s just the status quo. I’ve been experiencing it for 12 years now, and nothing has changed in that time, things have only gotten a million times worse.
When your mind is focused on solving problems quickly, a lot of the time it bypasses the compassion circuits. There's only so much mental bandwidth, and it's hard to have external compassion when your body is devoting so many resources to internal self care. Maintaining one's ego WHILE doing all of this eats up every last scrap of bandwidth.. It's self preservation. Once the unfamiliar becomes familiar and the body is less consumed with self protection it can focus more on the care elements. Let's be honest, when it comes to priorities there's a reason it's called Health Care, not Care Health. Doesn't matter how much you cared for your patient if they're dead.
@@Lucky9_9 my mind and body are constantly over worked as well as over run with exhaustion. I always do my best to still be kind, caring and compassionate to others, even when I’m beyond wits end. So they have no excuses in my opinion. They should all try having chronic daily pain for ten plus years, then come crying to me about how difficult it is, to be them. Edit: And I do it all, without any ego, half the size of theirs.
@@CaitS34 So your points are that 1) because YOU are always overrun with exhaustion and can still maintain a compassionate attitude, then everyone else should be and to too 2) you suffered in pain for a decade, and propose that others should also suffer in pain. 3) When people tell you they are in pain and suffering, you will have no compassion, instead you will show them your condescension and disdain that they would come to "cry about it" to you (I assume because you believe that this would be justice?) 4) AND you're incredibly humble.. (But, you're preach-bragging here so... I doubt you're half as humble as you purport) Yeah... I don't appreciate your response. Not everyone is you, clearly everyone has a different approach... I sincerely hope you aren't in any customer care field because you sound insufferable... Your perspective sounds like 100% ego talking and you don't even see it...
Let's just say thank heavens for seasoned nurses, every July we'd welcome the new residents and help them on their way, we'd look out for them and make sure they didn't make mistakes. We'd watch them grow and we knew which ones were going to make it through, which ones would fail, and which ones would become fantastic doctors. Residency was absolute hell on these doctors, and I was honored to back them up.
Omg closing with asking about research projects hit me hard 😂 So true, I used to go begging to work on projects with docs Thankfully, my paper was just published today 😊❤️
A med student doing residency at my rheumatologist diagnosed my at that time rare chronic illnesses of hEDS, at age 6. I'm thankful to that doc every day, even now in my 30s.
Hello fellow unicorns! I also have hEDS. I only discovered this two years ago at 66yo. I’m not the only one in my family. Only one person was officially diagnosed. I had to figure it out on my own.
@@joanhoffman3702 always nice to find each other in the wild! My diagnosis was early because I was in intense ballet training and about to join the professional company, but my knees hurt all the time. I had completely destroyed both knees and they’re just bone on bone with pretty much no cartilage. They told me if I ever danced again I would be permanently in a wheelchair by age 18 so I stopped dancing. I did go and get 3 black belts after, though!
Years ago in July, the ER was incredibly busy, but the attending took the time to ask if I'd be okay waiting. There was a particular resident they were worried about supervising, and my injury was about as clean and straight a cut as could be hoped for. It was like getting stitches from a hyped up golden retriever puppy. They were completely slammed, and the attending and multiple other docs and fellows still took the time to make sure this kid who was determined to be the "BEST. DOCTOR. EVER!!!" didn't maul a patient in his enthusiasm. Yeah, the kid totally screwed up a few times. I was the first patient he'd ever worked on. Of course he made mistakes, but with solid supervision it was perfectly safe and I received a very high level of care.
lol I had a med student at my local ER stab me 6 times and failed to find a vein for IV drip, with the last one resulting in fluids going into places it really shouldn't go (ouch). Not really their fault as my veins are tiny and hard to see. That's when the nurse had to step in. One shot, just eyeballing it, perfectly. The med students were gobsmacked. I laughed and told them it's just experience, which they'll get in time.
It’s so wonder that you allowed the pup to have you as a patient, and I promise you he’ll remember you through his whole career. I remember the first patient I had who was all mine with no one else but me in charge… well technically the second. The first patient I was ever in charge of all on my own was dead when I entered the room 🤣🤣🤣. Now that was awkward, but once I did all the paperwork and signed the transport orders, then I got to go see my next patient, and I will never forget him or his totally run of the mill wrist injury, because he let me take care of him. Thank you, Russell, wherever life has taken you the last 24 years.
@@pembrokelove I do like puppies. They're sweet. I have been worked on by a number of residents over the years, but that kid stands out in memory as the only one who was quite so enthusiastic or that any of the attendings worried about quite so much. He was a good kid.
@@matasa7463 except they might not because docs don't normally do many injections, the nurses or phlebotimists do it. I trained in ireland and the nurses at that time normally did not do blood draws, or IVs or ABGs or male caths...the junior docs did ALL of them. When there's two medical interns on call for a 300+ bed hospital you just run from bed to bed all night doing bloods and re-siting IVs. Got really, really good at it after the first few thousand ;)
True story- did PGY1 (then still called intern year) at 1 hospital, moved across the country (Hubby wanted to go to grad school) to do 2&3; a week before I left, was doing paperwork in ICU & Cards walked by bitching about "having to train new interns next week"; 2 weeks later was on ER in New hospital when a.pt comes in with TIA. Pt from out of town, & guess who his cardiologist was?😁 I called him & said, "you have 12 perfectly good new interns, you don't have to send pts across the country to me "
Kick some ass, kids. We nurses are rooting for you! Just don't steal our pens, don't forget to check your pain med orders due for renewal, and please be nice when we have to page you at 3am because you forgot to renew your pain med orders. 😘
Sorry to nurses worldwide for the pen all those pen we accidentally stolen. Id be smiling if i go to work with one pen and yet goes home with 2 pens or more. Like its tiring, but definitely a fruitful day, in some way.
and DON'T EVER, EVER tell the nurses "because I'm a doctor and youre a nurse and because I say so.' Unless you feel like getting paged every 15 minutes throughout the night.....
From my experience as an intern and professional, sometimes you want the new guy: They're up to date on the newest information/practices in the field, they're usually excited to share what they know with anyone who will listen, and they're trying to make a good impression so they have a tendency to go above and beyond the bare minimum.
As a RN, I have to say that July was the hardest, most rewarding, most exciting, part of working in a teaching hospital. 1st, the hard part: switching from teaching patients to teaching new residents. 2nd, the rewarding part: gaining the trust of residents as they learn that nurses are not a doctor's handmaid but, instead, are a separate specialty that can, and does, practice independently, as they learn the values of collaboration with nursing. 3rd, the exciting part: being an active part of collaborative health care and influencing future generations of medical partners! True story; a 1st year in the ER was tasked with starting an IV by the attending (typically, a task delegated to nursing). The 1st yr confided in me that they had never started an IV and only knew theory. So, I took the 1st and some supplies to a quiet corner and let them have their first experience by starting an IV on me. The 1st was floored (and, succeeded with guidance) that I (a RN) would do that for them. I explained that RNs are patient advocates. My primary responsibility to the patient is to prevent harm. Sometimes, that means intervening before a medical partner causes undo pain or harm to a patient. The resident DID start that patient IV without harming the patient and, I hope, took a life lesson away with the experience! Bring on July!
This is awesome. I love that you did that and that you're part of new doctors' training. You're exactly the sort of critical yet supportive influence they need. I'm a bit shocked that a new resident was in that position, though. I don't know what's normal for med schools as far as practical skills training, and maybe I'm used to fields that prioritize hands-on work more than others (my exposure so far has been in veterinary med then manual med then emergency response, so) ... but I'm personally blown away that any med school student could graduate and match into residency without having at least placed an IV. I barely have any venipuncture practice but at least I've had _something_ besides theory, and I certainly don't want to go to any med school that would let me graduate without getting a little more practice 😳
As an intern in the 3rd week of my residency, these comments are warming my heart and making me tear up 🥲 Thank you all for believing is us and being patient while we learn
As a pharmacist I'll say that brand new interns are about the most accepting and teachable people on the planet. I find more problems during their first few months but it never makes it to the patient because that's my job. I call them and we talk about the issue and they learn, or sometimes I learn. Either way the patient is fine
This is true! Pharmacist here as well and I do feel like I see way more incorrect orders though because most aren’t familiar with order entry in the EHR and not solely from a lack of knowledge/experience.
Thanks for always sticking up for residents! Residents fresh off rotations have saved my father's life twice because they spotted uncommon medical issues that specialists ignored, and I'm always grateful to see residents applying their knowledge and energy to their practice.
I had surgery on my eyes several years back. My surgeon let me know that he would do one eye and his student would do the other, under his supervision. All the outcomes for the eye done by the student were better. Not because he was a better surgeon, but because between the student and the teacher, a lot of care went into everything he did during that surgery. It's logical that residents are careful and carefully supervised. The same cannot always be said for doctors with decades under their belts.
That's certainly scary but got to learn somehow. I just know how much it would screw up my life if it went wrong and I lost depth perception. Happy it went well for you.
I'd argue the month of june is more dangerous than july because in july you've got fresh med students with very little bias towards patients, trying their damn hardest to not harm. Whereas in june you've got beat up interns whom after a year of medicine gain a false confidence in themselves which leads to more mistakes.
I love this one, and have to say I actually really like working with new residents. I just spent this last week training residents on how to use our EHR, and they were some of the most enjoyable classes I got to teach. Residents are so attentive and willing to learn, showing them all the ways they can save time when documenting is very rewarding.
My doctor's office has a residency program every time I have an appointment, I meet a new resident. It's really great to all these people working towards their medical profession.
•Please be nice and civil to the all healthcare professionals at the hospital, especially the interns. Being a new doctor can be quite overwhelming. Everyone is just trying their best to make it through the day. Patients are stressed and scared...and, to varying degrees, so are the people. providing care. Note to fellows and attendings , please be kind to the interns and residents. Teaching is hard and it can get frustrating , but remember...you were once in their position, being pimped and so much more. At the end, we are all in it together to get through the wild ecosystem known as "the hospital". •As someone who has been in hospitals many times over the years AND as someone who has read the info/data referred in this video , throughout the year, all over the country, I have to say that July is NOT a standout month. The only times of the year where there may be issues with care , as stated here, is during the holidays and weekends , in general. Hospitals will always provide standard of care. But it is tougher to do, with a smaller staff for so many are taking time off on those days. Even with that, you eventually will be seen and taken care of.
In my experience of chronic illness and seeing mostly residents at the hospital, I can say that I have never felt like I was getting sub optimal care. If anything they care so much about helping you in the best way possible that they are willing to take more time and guidance from whomever their attending or consult is. I can’t say enough good things about residents ❤
I watch your channel for the laughs, but this is one of the skits that just makes me respect you even more. If I could double subscribe I'd do it right now!
I’m an ICU nurse and almost all new docs are humble and eager to learn from everyone. On the rare occasion I’ve got a cocky one who insists on something inappropriate, I go over their head to the Fellow and let them deal with it.
Congrats to all the newbies out there! It’s a G-damn tough job. Stay kind to your support team and they’ll work their butts off for you and your patients. ❤️
I enjoy every single thing you post, but your bit on waiting for match day, the scramble and this one for new residents were so very kind. I appreciate what you do. I’ve been a family doc for 30 years, I’ve been married to an ER doc for 25 years, my brother in law is a radiologist, my best friend is a neurologist, and my fabulous nephew is in his 4th day of an emergency medicine residency so these have been especially timely.
It took a significant medical event for my Dad to finally listen to me when I explained for the 50th time in something like 20 years that the "Teaching Hospital" at the University in town was not having their Medical Students run wild on their own without supervision.
I actually am supposed to get my gallbladder out this month and at the beginning of your video I was thinking “maybe I should move my surgery…” but at the end I felt a lot better. Thanks for making a great point.
Thank you for posting this! Perfect timing! I'm supposed to haver surgery in July and a friend was telling me to watch out for this very thing. It was not something I had never heard before and really didn't need to add it to my list of worries. I'm going to forget all about it now.
as a fellow colleague and as a patient, I can vouch for the amazing empathy and honest interest that freshly graduated medics have shown towards me and my multiple rare conditions. They took their time to get a good history and they actually listened when I explained my health conditions. I always felt I was more care for when I had an intern and a resident caring for me that when I was pushed to be under the care of the attending since (depending the specialty) they didn't even bother to acknowledge the patients during rounds. Heck some didn't even acknowledge me when I was doing rounds with them when I was the register clinical dietitian in charge of the floor. 😒
I would say that new residents, in my experience, are more likely to spot something the experienced doctors miss, because they are paranoid about missing something. I've seen a new resident, a week in, realize a patient was presenting with a rare series of symptoms linked to a slow bleeding brain aneurysm. Saved the patients life as the on duty doc wrote it off initially as heat exhaustion and PMS, which in fairness, the symptoms DID match, and you typically wont jump to the extreme conclusion. Quick Head CT, and the patient was off to surgery ASAP.
I worked in a academic hospital for 20 years (neuro IR tech) July is when the support staff catch all the mistakes before it reaches the patient. That month puts everyone on their toes and refreshes their memories on the basics......like CPR recertification. On the topic of neuro specialties, the clash between neurosurgeons and neuro interventionalists is pretty epic. Don't get me started with vascular IR and neuro IR......the disdain between those two is palpable. As a neuro IR tech scrubbing in a vascular case it is similar to a neat freak living with a slob......the bubbles in the syringes makes me twitchy
July. I have rather fond memories for making massive amounts of coffee for the new interns when I was a humble clerk in Pediatrics. And the residents making jokes about "How long have you had this discharge?" (You had to be there.)
I'm a chronic pain patient, organ, not neurological. nothing but opioids works. I've tried everything including celiac plexus blocks. But your videos are so pithy and on point. I hope your fellows watch. You are hilarious. And you accurately lampoon the entire hospital system. Keep it up. You give me some hope that via humor something might change. Be well.
So while yes the "July effect" in at large does not seem to affect mortality it has in some cases been linked to morbidity (greater incidence of postoperative thromboses and surgical site infection), longer hospitalization and slower ER turnarounds. That being said, it's normal. Everyone has to start somewhere. The more senior staff is aware, and we generally try to avoid situations were the fresh out of med school R1 will have to make a life or death situation. But it's also more draining for the rest of the staff to try to catch all the mistakes made in July-August. As an ICU pharmacist working this 1st of July weekend, I did have to gently explain prescription rules to the new R1 who decided to prescribe chemotherapy cause he read it on uptodate.
Congrats to the new docs! As a radiographer all i ask is that you please write a proper clinical summary for your xray requests (no pain is not sufficient) and for the love of medicine send them round with a wristband on 😅
Don’t forget about the nurses! We look over a lot of the orders new docs put in and assess their appropriateness! New docs are also more open to suggestions and actually put in their own orders 😂
Dude you are on fire right now, these recent videos are absolute gems!! I keep showing your videos to other students/physicians when some dumb stuff happens and is a burden on them - good thing you provide material describing so many different situations, it is really relieving PLUS it is funny as hell. Thank you so much, keep doing what your doing humor-bro.
New interns are great and we were all there once, but as an attending, July might be a safe month but damn is it exhausting. Yes you do have to double check EVERYTHING. Great interns let you know everything they do which makes our job so much easier, but it is the ones that think they know it all or can practice independently that give attendings a run for their money. I have caught a lot of things just this past week and all I can emphasize is if you don’t know then ask. If you think you know, PLEASE ASK. We def shouldn’t say that patients are any less safe in July but to the friends and family of attending doctors everywhere…please understand why we may be a little extra exhausted (more than normal) over this next month or so.
Damn… he really hit hard with that If anything, I would imagine there would be increase of quality work because you now have more eyes looking at you and taking care of you.
I just avoid hospitals on July 4th weekend because there are too many people who think explosives are toys, too many people who aren’t responsible with alcohol, and too many people who drive recklessly. Often a combo of the three. I’m not worried about interns, I’m worried about people making poor life decisions clustered on the same weekend dragging out ER wait times. This goes into Tuesday for all the people who refuse to go to an ER on a holiday. Interns are willing to learn, which this medical zebra greatly appreciates.
While I totally agree with your points, if you need the ER, do you really have a choice as to when you go? My ER visits have unfortunately been urgent type things. But you may be talking about elective surgeries and then I gotcha.
Had kidney stones last year and it was the residents who swung by that treated me the best. On duty nurse literally told me to stop belly aching while I was struggling through the pain with 0 medication. When they finally gave me morphine they ended up giving me too little for my body weight and it took the new guys to figure out
@@claw836 after tearing their senior apart, they’re now asking for a favour from him. It is common for junior doctors to supplement work with research to increase their standing when applying for future positions.
@@claw836 You need to submit one research to complete residency training.Bill is now in his second year of training if he still have zero research going i can assure you he is f that rhyme the ducked.
Genius. Pure genius! We Stroke attendings are used to very close behind the scenes resident supervision 24-7-365. So, July is no different than any other month.
The closest I stray to the medical world is my long expired Wilderness First Responder cert…. But I will say that as a patient, I am always super happy when my doc asks if she can have a student sit in for my visit or observe when I’m in the ER for something stupid… Like hell yeah bring them in, they gotta get that experience and I love to be a part of that. Always felt super confident that I was still going to receive top notch care. I’m even pumped when they want to bring students in for my Children’s wellness visits.
This hits real close to home for me because I was in the ER who was later admitted into inpatient in early August of this year. A PGY1 was part of my team as well as a med student.
I actually always thought the opposite. Getting a younger, possibly newer doctor makes me feel like they're more interested and fresh into the field so they'd be more inclined to listen to me and run different tests. Older and more experienced doctors are fine too, I just prefer someone who's less likely to be burnt out.
As a nurse, we watch orders regardless. Doesn't matter if you're an intern, or a senior attending, or a nurse; none of us are perfect, and we are all looking for best outcomes. Had an attending order 1L 40 mEq K NS wide open, I hung it at 250 an hour, and asked the doc to fix the order. Good outcome, respectful communication both ways, everyone wins.
A fresh doctor actually helped diagnose a condition for my uncle once. He had no idea what’s wrong with his eye sight (started having tunnel vision on one eye) for months after visiting all sorts of hospitals. One day he went to a larger university hospital and the doctor still had no idea. As soon as he was leaving the floor, a young resident who was helping the doctor on the side rushed to him showing a text book page saying that this might be somewhere we can start looking into. Tbh it was a nerve problem that doesn’t have a real cure but they found out that it should be something that would get better with time. My uncle is now fine and the resident’s knowledge relieved a lot of stress off him while he was recovering his vision!
I would rather go to a teaching hospital where at least four or five docs are going to stop by my hospital ER bed every twenty minutes than go to a regular ER where you see one doc that's too busy to actually realize your 200/100 BP should probably be treated before streeting you! If there's one complaint it's that your waiting room visit is going to be so much longer because every patient is going to get a thorough work up...even if you just came to get an emergency prescription because you ran out of your blood pressure medication!
These was a study which showed improved patient outcome during conference weeks; it was postulated that it is because all the senior people are at conferences giving presentations so patients get more up-to-date care from junior attending and RESIDENTS ( dum..dum..dum.. Suspenseful music)..Very interesting results
My last hospital stay was at a teaching hospital and I preferred it; a student is more likely to have recently learned something so they are more likely to look at more possibilities than a doc that's been around for a while. Not to mention that even experienced staff is more likely to let the student perform/order more diagnostics than they would as a teaching exercise.
I did my pre-registration training in a hospital and we knew when the new junior doctors started writing prescriptions as we'd get the same type of error over and over again until we phoned all of them and some really odd and strange errors as well. But we caught them and fixed them, it was kind of annoying, but we knew they had a lot to learn. Also it made great evidence for my own training.
I had a child receive a heart&lung block transplant the first of July. That meant they had the Surgeon who pioneered the procedure, the 3rd year Fellow and everyone else down to the intern assigned to their case, at surgery, and doing rounds daily. They lacked for nothing.
Ironically, I had never heard this narrative before watching this and am now only cautious about visiting the hospital in July because I watched it... 😬🤷♂️
Don't be concerned. #1, not every hospital is a teaching hospital. #2, these newbies are on the workup side of your treatment (ordering tests, etc) and have to clear any treatments with their attending before it gets to you...plus, your Nurse is also there doing the helicopter parent role ;-)
My mom is a nurse and I recently started working at the hospital with her. All year she was reminding me about the July 1st effect, and then this morning she ends up in the ER!
When I go for my check up because of my high blood pressure twice a year, they almost always ask if I’m ok with the nursing/med students from the local college sitting in. I always say yes because they are learning! People need to learn, never bash someone who is attempting to learn.
Honestly it's not the patient that suffers with the new docs. It's their co-workers, in pretty much every service. Especially if you're at a hospital where the attendings are not paying enough attention to their residents. Everything still gets scrutinized and corrected but the other services are now having to do even more work because they have to help correct and teach the new docs. It's necessary and important but that doesn't make it any less annoying. Especially if you work at a large trauma hospital. Since it's trauma season.
Exactly my experience as an ancient RN. The close supervision can be sparce, and it's the team having to pick up all the gaps and deal with educating evry single new doc that yes Nurses do that,yes we need an order for that, no not that. The whole orchestra has to be alert because the conductor hasn't ever actually used the baton before. So i never minded helping and teaching till you hit the residents with God complex and would hear nothing from the experienced staff. Thankfully those are the rarer types except I notice more female residents have it now. So then it's protect the patient, find a supervisor.
Yeah Im not even working with the same power dynamics (I work in Pt transport the important distinction is how many hours you do, full time up top and volunteer at the bottom, and your overall experience) still it's exhausting whenever we have someone new to train or even just doing a trial day bc we just don't have time but you need time to let them do stuff themselves without stress and close supervison to make sure no one gets hurt (and the job is dangerous if you mistep once on the stairs while carrying there are 3 badly injured people) . It gets even more stressful for me when Im "the one in charge" and my partner pushes both the newbie and the responsibilities on me (My favourite collegues to be partnered with are ones dont need any distinction in rank to know what everyones job is, with some of em its almost mind reading and it just works so flawlessly and effortlessly). I like showing the newbies and building up their skills and confidence as well as their love for the job, it is fun and most collegues are really great but doing it in a risky enviroment is absolutly not advisable. Making sure it is safe and they get to try doing stuff too while we manage the days pensum is desperatly exhausting though. Ego trips don't happen thankfully (from newbies) most people need a ton of encourgment to feel confidence in doing anything and even if it did happen Im the one with "rank" I get to pull in that situation as the supervisor.
OB nurse & I have always dreaded July. My problem isn't the mistakes because, I can go over their head. My problem is the I know everything I am the Dr attitude. Until they are in over their head. my fav quote, "get the Dr!"
Never thought the phase 'do you have a research projects, we could help you with' could sound so menacing
As someone who has been part of many research projects, I have to say the menacing inflection in the tone was piece de resistance in delivery.
It was bloody brilliant and fantastic to hear. 😁
Aaaaaahhhhhh Noooo!
I'm about to start med school and will soon be housemates with second year residents who are YOUNGER than me (lol, my billions of gap years in research) so you can imagine their relief when they heard I could help them with their research projects they don't have the time for!
Perfect ending. Toddlers.
@@veraserah Well hello, Jonathanesse to be. Let them pay coming and going.
My little brother's Dress syndrome was diagnosed by a doc fresh out of school, who actually did their thesis on it, hence how they knew what it was. It's a very rare and severe reaction to medication with a roughly 10% mortality rate, so we're very thankful that this doc had been able to diagnose it and treat him.
what was the reaction? glad it worked out!
@@karthik_silkroadsDRESS = Drug Reaction with Eosinophilia and Systemic Symptoms. Usually huge rash, organ involvement and eosinophilia. Lymph nodes usually involved.
Was his name Jonathan?
That doc was probably so excited that she got to care for a patient that had the syndrome she did her thesis on.
Actually studies have shown that beginners do better in diagnostics. As a patient you have the ideal treatment if a beginner does the diagnostics and an experienced doc does the therapy.
This feels like those times when you come up with a great comeback way after an argument ends, so you made it into a youtube skit instead.
I just realized that was an option! I'm off to make comics about every witty remark I thought of days after the conversation
@@mausm7534 Im pretty sure this is like 90% of how all writing works, so go for it! The rest is making up names for things.
@@bamidele4383 Can you explain further?
ER Nurse here. I will say with confidence that newer docs actually do a lot more shit for a pt. Sometimes unecessary labs but they will work up every patient that comes in. Which in a way is very annoying but as far as care goes, they really do cover a lot of the bases
"Why the hell did the damn intern order an -- oh shit, it's positive."
As a pt used to be dismissed for very real issues I can confidently say that most of the drs that have actually pushed to give me care and a diagnosis, have been newer drs.
(And once you have that diagnosis the olders drs cant dismiss you as easily).
Hey a lil out of topic, but since u are a fellow ER nurse,
Do u guys treat Med student like shit over there too ?
@@reynardop7615 as a med student, I wanna ask. Why do you do this to us? We just want to learn.
The goddamn lactics and blood cultures.
As a patient, I love getting seen by newer doctors. I’ve spent decades seeing doctors, having my concerns dismissed. Residents have actually listened to me, provided care, and even helped me get diagnoses for problems that my doctors had been minimizing for decades. My life has improved substantially because of the care that new doctors have provided.
I know right! Same! I would be an entirely different annd probably more miserable person without the care I received from my family doctor when she was still a resident
As a current med student, as the years go by, we are taught to value the patient above all else. I can’t speak for MD schools, but my DO school is VERY strict about humanistics and they teach us that while you don’t need to order every test in the book, you do need to fully investigate a patient’s complaint when they come in and take an active partnership with the patient. Our professors would regularly tell us “take your hand off the door and EXAMINE THE PATIENT”. So hopefully as time goes on, the new generations of doctors will be more and more dedicated to finding answers and providing top quality care.
@@PhoenixRoseYT I think that your generation of healthcare workers can completely change how women and especially POC view and interact with healthcare. One good interaction can’t undo decades of trauma, but it will certainly make a huge difference for the patient and they may be more likely to seek care (especially from you) in the future. That is huge.
@@PhoenixRoseYT Love this. This is a big part of why I plan to go to DO school. It makes sense that practitioners who are helping keep palpation alive would also appreciate the broader importance of being present with the patient and properly SEEING them. I don't suppose you happen to feel like sharing which DO school you're at and how you're enjoying it, do you?
It was a younger, newer doctor who diagnosed my fibromyalgia off the bat even though it took a year and a half to get an official diagnosis. Most importantly: shew gave my father and I the vocabulary to describe what we thought was happening to older, more stubborn doctors, some who didn't even believe fibromyalgia was a real thing. I'll always remember and be grateful to her, even though I didn't see her long enough to learn her name.
Seriously, I was hospitalized for an severe allergic reaction on July 1st once and it was one of the most compassionate healthcare experiences I’ve ever received. I felt super safe despite having just experienced a life-threatening event, and my mom remarked “damn, they’re training those residents well.” Best of luck to all the new interns starting this month!
“You just took a journal club right to the face, Doc!” Has got to be one of the most inspiring student comebacks I’ve ever witnessed. 👏👏👏 Thank you as always for your service.
I definitely shouldn’t send full professors multiple review articles showing why I’m right. But if I ever do, I’m using that line.
@@elycanada6051 it's all about having it and not needing it
As a grad student I am absolutely folding this into my everyday vocabulary. Source contradicts my findings? I can’t get access to the paper I need in time? Someone already wrote the paper I wanted to write? “Oh man, I just took a journal club right to the face.”
Thank you for this! A family member's cancer diagnosis was diagnosed by a first year resident (after multiple previous ER visits), so junior learners shouldn't be dismissed for lack of experience
Exactly! It's the ones who become jaded and calloused that are truly dangerous. And the ones that refuse to retire and are still practicing medicine at 80 despite cognitive decline.
@@3mwa So true. Good to see others realize this as well.
I get my primary care through the resident clinic. The residents are enthusiastic and close to the current literature. I have seen residents and med students catch thinks missed by other doctors because they still do a complete physical exam. Plus I get the attending. Two doctors for the price of one.
"Do you have any research projects I could help you with" - as someone who's been hunting for research opportunities for the past year - I can conclusively say that is your best closing statement doc!
it’s so accurate 😂😂
My mom's office just got a new med student a few days ago. First day they're there, patient had something really weird going on with their poop, med student immediately (and correctly!) knew what rare worm they have. New docs are treasures! They remember all the esoteric stuff that med school teaches.
Glad to see the Support_Bill army expanding. His mom, the med students, hopefully the new interns and junior residents. Hope he gets a break..... atleast for a cup of coffee.
Or a real salary
btw I think some seniors like Psych and Palliative Care is supporting Bill too in their own ways - is just he has problems with Cardiologist and Surgeon ig
Me too!
The most amazing physicians I’ve had have been straight out of fellowship. I know that’s a far cry from a new resident, but what it means to me is they’ve had that time to safely make mistakes, learn their specialty and subspecialty, and come out with fresh new information and ideas, while still open to learning.
I confess the stigma scared me when I learned the new (and only) subspecialist for my son’s rare bone condition was fresh out of fellowship, but he’s been honest about what he does and does not know, actually read the inch-high stack of research papers I presented at our first visit, and even planned to travel with us to observe when my son needed surgery that was going to be out of state. Then, found an expert on this rare and difficult to treat bone disease, and arranged for them to come up to Alaska so we wouldn’t have to leave.
So bring on the fresh minds and open thinkers. The ones who know they don’t yet know, but are still ready to learn. And congratulations and welcome to the profession, Drs.
I hope ur boy is ok now... Best of health to him.
@@angelokeke5376 thank you, that’s very kind ❤️. He had to have surgery and his leg is healing slowly, but the surgeon isn’t worried yet. But my son runs around in his brace like everything is right with the world, just as wild as ever. I’m so proud of him 🥰
I’m a pharmacy student. One of my classmates brought a really good recommendation to an attending to which he replied “I hope you remember that when you’re filling bottles at Hy-Vee.” She then told it to a new intern and it ended up being changed. Thank you to all the nice interns!
Wow, as a new starting intern who definitely jokingly made the same statement of “stay away from the hospital patients! We’re here!”, it was actually kinda nice to hear this
This definitely hit the spot today for me!!! I'm an R.N. and my husband is seriously ill, in the hospital right now. Today the rounding team had a new physician. I could tell that she has been "battered and torn." She had an extremely defensive attitude of trying to impress me with how much she knew, but she was lacking in compassion, and not interested in hearing anything from family. So often I have seen that happen as a personal defense mechanism in young physicians. We need to concentrate more on emotionally nurturing the young ones coming in.
Emotions just don’t exist in doctors, in my personal experience. Unfortunately your experience is the normal for patients, every day, and I’m sorry you had to go through it, but it’s just the status quo. I’ve been experiencing it for 12 years now, and nothing has changed in that time, things have only gotten a million times worse.
When your mind is focused on solving problems quickly, a lot of the time it bypasses the compassion circuits. There's only so much mental bandwidth, and it's hard to have external compassion when your body is devoting so many resources to internal self care.
Maintaining one's ego WHILE doing all of this eats up every last scrap of bandwidth.. It's self preservation. Once the unfamiliar becomes familiar and the body is less consumed with self protection it can focus more on the care elements.
Let's be honest, when it comes to priorities there's a reason it's called Health Care, not Care Health. Doesn't matter how much you cared for your patient if they're dead.
@@Lucky9_9 my mind and body are constantly over worked as well as over run with exhaustion. I always do my best to still be kind, caring and compassionate to others, even when I’m beyond wits end. So they have no excuses in my opinion. They should all try having chronic daily pain for ten plus years, then come crying to me about how difficult it is, to be them.
Edit: And I do it all, without any ego, half the size of theirs.
@@CaitS34 So your points are that
1) because YOU are always overrun with exhaustion and can still maintain a compassionate attitude, then everyone else should be and to too
2) you suffered in pain for a decade, and propose that others should also suffer in pain.
3) When people tell you they are in pain and suffering, you will have no compassion, instead you will show them your condescension and disdain that they would come to "cry about it" to you (I assume because you believe that this would be justice?)
4) AND you're incredibly humble.. (But, you're preach-bragging here so... I doubt you're half as humble as you purport)
Yeah... I don't appreciate your response. Not everyone is you, clearly everyone has a different approach... I sincerely hope you aren't in any customer care field because you sound insufferable... Your perspective sounds like 100% ego talking and you don't even see it...
@Caitlin I don't think it was trying to start a pissing match of who has it worse. It was an explanation of why it might happen.
Let's just say thank heavens for seasoned nurses, every July we'd welcome the new residents and help them on their way, we'd look out for them and make sure they didn't make mistakes. We'd watch them grow and we knew which ones were going to make it through, which ones would fail, and which ones would become fantastic doctors. Residency was absolute hell on these doctors, and I was honored to back them up.
Also, as a UK final year medical student who literally found out yesterday that I'm now a junior doctor, this was really reassuring, thank you😭
Congratulations! Welcome to the scariest, most exhausting year of your life. My one piece of advice is to always ask for advice!
Literally same here, just another country 😅 Congrats 🥳
And meal prep - make sure you are eating at least 4 healthy meals a week.
Congrats! :D
My condolences. A tough time in the NHS
Omg closing with asking about research projects hit me hard 😂
So true, I used to go begging to work on projects with docs
Thankfully, my paper was just published today 😊❤️
Congrats!
A med student doing residency at my rheumatologist diagnosed my at that time rare chronic illnesses of hEDS, at age 6. I'm thankful to that doc every day, even now in my 30s.
Took til I was 40 to get my dx of vEDS and still docs look it up quietly.
Hello fellow unicorns! I also have hEDS. I only discovered this two years ago at 66yo. I’m not the only one in my family. Only one person was officially diagnosed. I had to figure it out on my own.
@@joanhoffman3702 always nice to find each other in the wild! My diagnosis was early because I was in intense ballet training and about to join the professional company, but my knees hurt all the time. I had completely destroyed both knees and they’re just bone on bone with pretty much no cartilage. They told me if I ever danced again I would be permanently in a wheelchair by age 18 so I stopped dancing. I did go and get 3 black belts after, though!
Years ago in July, the ER was incredibly busy, but the attending took the time to ask if I'd be okay waiting. There was a particular resident they were worried about supervising, and my injury was about as clean and straight a cut as could be hoped for.
It was like getting stitches from a hyped up golden retriever puppy.
They were completely slammed, and the attending and multiple other docs and fellows still took the time to make sure this kid who was determined to be the "BEST. DOCTOR. EVER!!!" didn't maul a patient in his enthusiasm.
Yeah, the kid totally screwed up a few times. I was the first patient he'd ever worked on. Of course he made mistakes, but with solid supervision it was perfectly safe and I received a very high level of care.
lol I had a med student at my local ER stab me 6 times and failed to find a vein for IV drip, with the last one resulting in fluids going into places it really shouldn't go (ouch). Not really their fault as my veins are tiny and hard to see.
That's when the nurse had to step in. One shot, just eyeballing it, perfectly. The med students were gobsmacked. I laughed and told them it's just experience, which they'll get in time.
It’s so wonder that you allowed the pup to have you as a patient, and I promise you he’ll remember you through his whole career. I remember the first patient I had who was all mine with no one else but me in charge… well technically the second. The first patient I was ever in charge of all on my own was dead when I entered the room 🤣🤣🤣. Now that was awkward, but once I did all the paperwork and signed the transport orders, then I got to go see my next patient, and I will never forget him or his totally run of the mill wrist injury, because he let me take care of him. Thank you, Russell, wherever life has taken you the last 24 years.
@@pembrokelove I do like puppies. They're sweet.
I have been worked on by a number of residents over the years, but that kid stands out in memory as the only one who was quite so enthusiastic or that any of the attendings worried about quite so much. He was a good kid.
@@matasa7463 except they might not because docs don't normally do many injections, the nurses or phlebotimists do it. I trained in ireland and the nurses at that time normally did not do blood draws, or IVs or ABGs or male caths...the junior docs did ALL of them. When there's two medical interns on call for a 300+ bed hospital you just run from bed to bed all night doing bloods and re-siting IVs. Got really, really good at it after the first few thousand ;)
@@matasa7463 I have tough veins too. Several times they have to bring in " the specialist" to get an IV started or to take blood
No fun.
True story- did PGY1 (then still called intern year) at 1 hospital, moved across the country (Hubby wanted to go to grad school) to do 2&3; a week before I left, was doing paperwork in ICU & Cards walked by bitching about "having to train new interns next week"; 2 weeks later was on ER in New hospital when a.pt comes in with TIA. Pt from out of town, & guess who his cardiologist was?😁
I called him & said, "you have 12 perfectly good new interns, you don't have to send pts across the country to me "
I hope the cardiologist consulted the burn unit after that one, damn!
Kick some ass, kids. We nurses are rooting for you! Just don't steal our pens, don't forget to check your pain med orders due for renewal, and please be nice when we have to page you at 3am because you forgot to renew your pain med orders. 😘
The pen thing…so true…Hospitals are war zones when it comes to pen X)
Oh gosh I just found a pen in my pocket with someone else’s name( must be one of the nurse’s) and I don’t even remember taking it 😂
Sorry to nurses worldwide for the pen all those pen we accidentally stolen.
Id be smiling if i go to work with one pen and yet goes home with 2 pens or more. Like its tiring, but definitely a fruitful day, in some way.
That is soooooo true. All the way from Nigeria 🤣🤣🤣😜
and DON'T EVER, EVER tell the nurses "because I'm a doctor and youre a nurse and because I say so.' Unless you feel like getting paged every 15 minutes throughout the night.....
From my experience as an intern and professional, sometimes you want the new guy: They're up to date on the newest information/practices in the field, they're usually excited to share what they know with anyone who will listen, and they're trying to make a good impression so they have a tendency to go above and beyond the bare minimum.
As a RN, I have to say that July was the hardest, most rewarding, most exciting, part of working in a teaching hospital.
1st, the hard part: switching from teaching patients to teaching new residents.
2nd, the rewarding part: gaining the trust of residents as they learn that nurses are not a doctor's handmaid but, instead, are a separate specialty that can, and does, practice independently, as they learn the values of collaboration with nursing.
3rd, the exciting part: being an active part of collaborative health care and influencing future generations of medical partners!
True story; a 1st year in the ER was tasked with starting an IV by the attending (typically, a task delegated to nursing). The 1st yr confided in me that they had never started an IV and only knew theory. So, I took the 1st and some supplies to a quiet corner and let them have their first experience by starting an IV on me. The 1st was floored (and, succeeded with guidance) that I (a RN) would do that for them.
I explained that RNs are patient advocates. My primary responsibility to the patient is to prevent harm. Sometimes, that means intervening before a medical partner causes undo pain or harm to a patient.
The resident DID start that patient IV without harming the patient and, I hope, took a life lesson away with the experience!
Bring on July!
❤
This is awesome. I love that you did that and that you're part of new doctors' training. You're exactly the sort of critical yet supportive influence they need.
I'm a bit shocked that a new resident was in that position, though. I don't know what's normal for med schools as far as practical skills training, and maybe I'm used to fields that prioritize hands-on work more than others (my exposure so far has been in veterinary med then manual med then emergency response, so) ... but I'm personally blown away that any med school student could graduate and match into residency without having at least placed an IV. I barely have any venipuncture practice but at least I've had _something_ besides theory, and I certainly don't want to go to any med school that would let me graduate without getting a little more practice 😳
That's epic, bless you
❤️❤️❤️
You are amazing!
As an intern in the 3rd week of my residency, these comments are warming my heart and making me tear up 🥲 Thank you all for believing is us and being patient while we learn
As a pharmacist I'll say that brand new interns are about the most accepting and teachable people on the planet. I find more problems during their first few months but it never makes it to the patient because that's my job. I call them and we talk about the issue and they learn, or sometimes I learn. Either way the patient is fine
This is true! Pharmacist here as well and I do feel like I see way more incorrect orders though because most aren’t familiar with order entry in the EHR and not solely from a lack of knowledge/experience.
Thanks for always sticking up for residents! Residents fresh off rotations have saved my father's life twice because they spotted uncommon medical issues that specialists ignored, and I'm always grateful to see residents applying their knowledge and energy to their practice.
I had surgery on my eyes several years back. My surgeon let me know that he would do one eye and his student would do the other, under his supervision. All the outcomes for the eye done by the student were better. Not because he was a better surgeon, but because between the student and the teacher, a lot of care went into everything he did during that surgery.
It's logical that residents are careful and carefully supervised. The same cannot always be said for doctors with decades under their belts.
That's certainly scary but got to learn somehow. I just know how much it would screw up my life if it went wrong and I lost depth perception. Happy it went well for you.
2 pairs of eyes are always better than just 1. sorry you have lopsided results lol
I'd argue the month of june is more dangerous than july because in july you've got fresh med students with very little bias towards patients, trying their damn hardest to not harm. Whereas in june you've got beat up interns whom after a year of medicine gain a false confidence in themselves which leads to more mistakes.
1000% agree with this!
Actually that would make a great study!
Meh. The transition sucks. I hate having a care plan for a patient just fir it to be reworked by the incoming.
Waste of money.
@@t.k.3895 then leave teaching hospitals. Residents have to be there, you do not.
I'm always happy to see student doctors and nurses as they tend to pay far more attention.
I love this one, and have to say I actually really like working with new residents. I just spent this last week training residents on how to use our EHR, and they were some of the most enjoyable classes I got to teach. Residents are so attentive and willing to learn, showing them all the ways they can save time when documenting is very rewarding.
My doctor's office has a residency program every time I have an appointment, I meet a new resident. It's really great to all these people working towards their medical profession.
Got a thyroidectomy scheduled in a couple weeks - got really stressed to feeling better about it than I already did. Thanks, Dr. G
•Please be nice and civil to the all healthcare professionals at the hospital, especially the interns. Being a new doctor can be quite overwhelming.
Everyone is just trying their best to make it through the day. Patients are stressed and scared...and, to varying degrees, so are the people. providing care.
Note to fellows and attendings , please be kind to the interns and residents. Teaching is hard and it can get frustrating , but remember...you were once in their position, being pimped and so much more.
At the end, we are all in it together to get through the wild ecosystem known as "the hospital".
•As someone who has been in hospitals many times over the years AND as someone who has read the info/data referred in this video , throughout the year, all over the country, I have to say that July is NOT a standout month.
The only times of the year where there may be issues with care , as stated here, is during the holidays and weekends , in general. Hospitals will always provide standard of care. But it is tougher to do, with a smaller staff for so many are taking time off on those days. Even with that, you eventually will be seen and taken care of.
In my experience of chronic illness and seeing mostly residents at the hospital, I can say that I have never felt like I was getting sub optimal care. If anything they care so much about helping you in the best way possible that they are willing to take more time and guidance from whomever their attending or consult is. I can’t say enough good things about residents ❤
I watch your channel for the laughs, but this is one of the skits that just makes me respect you even more. If I could double subscribe I'd do it right now!
I’m an ICU nurse and almost all new docs are humble and eager to learn from everyone. On the rare occasion I’ve got a cocky one who insists on something inappropriate, I go over their head to the Fellow and let them deal with it.
Congrats to all the newbies out there! It’s a G-damn tough job. Stay kind to your support team and they’ll work their butts off for you and your patients. ❤️
Those are spicy interns. Doc's gonna need some milk
Ooooh self-burn! Those are rare!
Plastics will definitely need to see him for reconstruction after that😂
"On wednesdays we wear pink scrubs"
I want the Med Student Mafia to use this line once. Thanks in advance!
I enjoy every single thing you post, but your bit on waiting for match day, the scramble and this one for new residents were so very kind. I appreciate what you do. I’ve been a family doc for 30 years, I’ve been married to an ER doc for 25 years, my brother in law is a radiologist, my best friend is a neurologist, and my fabulous nephew is in his 4th day of an emergency medicine residency so these have been especially timely.
It took a significant medical event for my Dad to finally listen to me when I explained for the 50th time in something like 20 years that the "Teaching Hospital" at the University in town was not having their Medical Students run wild on their own without supervision.
I actually am supposed to get my gallbladder out this month and at the beginning of your video I was thinking “maybe I should move my surgery…” but at the end I felt a lot better. Thanks for making a great point.
Oh I love when the students have Bill’s back!
Thank you for posting this! Perfect timing! I'm supposed to haver surgery in July and a friend was telling me to watch out for this very thing. It was not something I had never heard before and really didn't need to add it to my list of worries. I'm going to forget all about it now.
as a fellow colleague and as a patient, I can vouch for the amazing empathy and honest interest that freshly graduated medics have shown towards me and my multiple rare conditions. They took their time to get a good history and they actually listened when I explained my health conditions. I always felt I was more care for when I had an intern and a resident caring for me that when I was pushed to be under the care of the attending since (depending the specialty) they didn't even bother to acknowledge the patients during rounds. Heck some didn't even acknowledge me when I was doing rounds with them when I was the register clinical dietitian in charge of the floor. 😒
I would say that new residents, in my experience, are more likely to spot something the experienced doctors miss, because they are paranoid about missing something.
I've seen a new resident, a week in, realize a patient was presenting with a rare series of symptoms linked to a slow bleeding brain aneurysm. Saved the patients life as the on duty doc wrote it off initially as heat exhaustion and PMS, which in fairness, the symptoms DID match, and you typically wont jump to the extreme conclusion. Quick Head CT, and the patient was off to surgery ASAP.
I worked in a academic hospital for 20 years (neuro IR tech) July is when the support staff catch all the mistakes before it reaches the patient. That month puts everyone on their toes and refreshes their memories on the basics......like CPR recertification.
On the topic of neuro specialties, the clash between neurosurgeons and neuro interventionalists is pretty epic.
Don't get me started with vascular IR and neuro IR......the disdain between those two is palpable.
As a neuro IR tech scrubbing in a vascular case it is similar to a neat freak living with a slob......the bubbles in the syringes makes me twitchy
July. I have rather fond memories for making massive amounts of coffee for the new interns when I was a humble clerk in Pediatrics. And the residents making jokes about "How long have you had this discharge?" (You had to be there.)
I’ve never looked into journals or actual research but I’m more distracted by the beautiful color coded bookshelf 😂
I'm a chronic pain patient, organ, not neurological. nothing but opioids works. I've tried everything including celiac plexus blocks.
But your videos are so pithy and on point. I hope your fellows watch. You are hilarious. And you accurately lampoon the entire hospital system. Keep it up. You give me some hope that via humor something might change.
Be well.
So while yes the "July effect" in at large does not seem to affect mortality it has in some cases been linked to morbidity (greater incidence of postoperative thromboses and surgical site infection), longer hospitalization and slower ER turnarounds.
That being said, it's normal. Everyone has to start somewhere. The more senior staff is aware, and we generally try to avoid situations were the fresh out of med school R1 will have to make a life or death situation. But it's also more draining for the rest of the staff to try to catch all the mistakes made in July-August.
As an ICU pharmacist working this 1st of July weekend, I did have to gently explain prescription rules to the new R1 who decided to prescribe chemotherapy cause he read it on uptodate.
Congrats to the new docs! As a radiographer all i ask is that you please write a proper clinical summary for your xray requests (no pain is not sufficient) and for the love of medicine send them round with a wristband on 😅
Patient ID should be admissions and nursing staff responsibilities, not Drs. It is in Australia anyway.
Thank you for being a wonderful, supportive mentor to all of us in the medical field!!
Don’t forget about the nurses! We look over a lot of the orders new docs put in and assess their appropriateness! New docs are also more open to suggestions and actually put in their own orders 😂
Dude you are on fire right now, these recent videos are absolute gems!!
I keep showing your videos to other students/physicians when some dumb stuff happens and is a burden on them - good thing you provide material describing so many different situations, it is really relieving PLUS it is funny as hell.
Thank you so much, keep doing what your doing humor-bro.
New interns are great and we were all there once, but as an attending, July might be a safe month but damn is it exhausting. Yes you do have to double check EVERYTHING. Great interns let you know everything they do which makes our job so much easier, but it is the ones that think they know it all or can practice independently that give attendings a run for their money. I have caught a lot of things just this past week and all I can emphasize is if you don’t know then ask. If you think you know, PLEASE ASK. We def shouldn’t say that patients are any less safe in July but to the friends and family of attending doctors everywhere…please understand why we may be a little extra exhausted (more than normal) over this next month or so.
Damn… he really hit hard with that
If anything, I would imagine there would be increase of quality work because you now have more eyes looking at you and taking care of you.
This needs to be a real thing in every hospital AND they definately need to help out poor Bill more, he could use the breaks.
I just avoid hospitals on July 4th weekend because there are too many people who think explosives are toys, too many people who aren’t responsible with alcohol, and too many people who drive recklessly. Often a combo of the three.
I’m not worried about interns, I’m worried about people making poor life decisions clustered on the same weekend dragging out ER wait times. This goes into Tuesday for all the people who refuse to go to an ER on a holiday.
Interns are willing to learn, which this medical zebra greatly appreciates.
While I totally agree with your points, if you need the ER, do you really have a choice as to when you go? My ER visits have unfortunately been urgent type things.
But you may be talking about elective surgeries and then I gotcha.
You call it "July 4th weekend", we call it "another day in the south".
Had kidney stones last year and it was the residents who swung by that treated me the best. On duty nurse literally told me to stop belly aching while I was struggling through the pain with 0 medication. When they finally gave me morphine they ended up giving me too little for my body weight and it took the new guys to figure out
“Do you have any research projects we can help you with” 💀💀
Someone explain why this is funny !
@@claw836 after tearing their senior apart, they’re now asking for a favour from him.
It is common for junior doctors to supplement work with research to increase their standing when applying for future positions.
@@claw836 You need to submit one research to complete residency training.Bill is now in his second year of training if he still have zero research going i can assure you he is f that rhyme the ducked.
Genius. Pure genius! We Stroke attendings are used to very close behind the scenes resident supervision 24-7-365. So, July is no different than any other month.
The closest I stray to the medical world is my long expired Wilderness First Responder cert….
But I will say that as a patient, I am always super happy when my doc asks if she can have a student sit in for my visit or observe when I’m in the ER for something stupid… Like hell yeah bring them in, they gotta get that experience and I love to be a part of that. Always felt super confident that I was still going to receive top notch care. I’m even pumped when they want to bring students in for my Children’s wellness visits.
This hits real close to home for me because I was in the ER who was later admitted into inpatient in early August of this year. A PGY1 was part of my team as well as a med student.
I love how every book behind him is color coded!! I love organization!!
I actually always thought the opposite. Getting a younger, possibly newer doctor makes me feel like they're more interested and fresh into the field so they'd be more inclined to listen to me and run different tests. Older and more experienced doctors are fine too, I just prefer someone who's less likely to be burnt out.
As a nurse, we watch orders regardless. Doesn't matter if you're an intern, or a senior attending, or a nurse; none of us are perfect, and we are all looking for best outcomes. Had an attending order 1L 40 mEq K NS wide open, I hung it at 250 an hour, and asked the doc to fix the order. Good outcome, respectful communication both ways, everyone wins.
A fresh doctor actually helped diagnose a condition for my uncle once. He had no idea what’s wrong with his eye sight (started having tunnel vision on one eye) for months after visiting all sorts of hospitals. One day he went to a larger university hospital and the doctor still had no idea. As soon as he was leaving the floor, a young resident who was helping the doctor on the side rushed to him showing a text book page saying that this might be somewhere we can start looking into. Tbh it was a nerve problem that doesn’t have a real cure but they found out that it should be something that would get better with time. My uncle is now fine and the resident’s knowledge relieved a lot of stress off him while he was recovering his vision!
how wonderful!! what a sweet young resident!!!
Lord, I just started working at a teaching hospital (RN at Loma Linda) and have been forewarned. July babies, bring it on!
“You just took a journal club right to the face, Doc”😅😂😂😂😂😂
I love all your videos, but Med Student Mafia ones are hands down my favorite.
July- The month we ED nurses teach new nurses how to label CSF and tube Color’s of tests that are only once a year.
"Do you have any research projects we could help you with?" Yep, sounds right, i did it just yesterday.
I would rather go to a teaching hospital where at least four or five docs are going to stop by my hospital ER bed every twenty minutes than go to a regular ER where you see one doc that's too busy to actually realize your 200/100 BP should probably be treated before streeting you!
If there's one complaint it's that your waiting room visit is going to be so much longer because every patient is going to get a thorough work up...even if you just came to get an emergency prescription because you ran out of your blood pressure medication!
Thank you so much for this. Just finished my first duty as a 4th year med student and.. it’s an adjustment.
I seriously love new doctors and teaching hospitals. This is where things happen and people actually get diagnosed.
These was a study which showed improved patient outcome during conference weeks; it was postulated that it is because all the senior people are at conferences giving presentations so patients get more up-to-date care from junior attending and RESIDENTS ( dum..dum..dum.. Suspenseful music)..Very interesting results
All that new blood also does mean there are now more hands on deck.
My last hospital stay was at a teaching hospital and I preferred it; a student is more likely to have recently learned something so they are more likely to look at more possibilities than a doc that's been around for a while. Not to mention that even experienced staff is more likely to let the student perform/order more diagnostics than they would as a teaching exercise.
I did my pre-registration training in a hospital and we knew when the new junior doctors started writing prescriptions as we'd get the same type of error over and over again until we phoned all of them and some really odd and strange errors as well. But we caught them and fixed them, it was kind of annoying, but we knew they had a lot to learn. Also it made great evidence for my own training.
so excellent, never forgot my first July as intern. Chief Surgical resident just said " as long as you try and I can fix it, no worries...."
I had a child receive a heart&lung block transplant the first of July. That meant they had the Surgeon who pioneered the procedure, the 3rd year Fellow and everyone else down to the intern assigned to their case, at surgery, and doing rounds daily. They lacked for nothing.
Thank you!! I’m a brand new intern and I appreciate you ❤️.
Thanks for believing in me when I don’t entirely believe in me.
Dang! Been a while since we've had a med student mafia! Keep 'em coming!
Residents if you are reading this every word is true. Your students for your back 💯.
Thanks for all you do for us
SLP here. SLPs have something similar to a residency, but it's only nine months long. Thank you much for saying this.
'Do you have any research projects we could help you with'
I choked on my coffee.
I love the Med Student Mafia's passive-aggressive approach!
I love the Med student mafia. Can we get an episode where they call in Jonathan for reinforcements?
Another great video from the doctor. Thanks
Ironically, I had never heard this narrative before watching this and am now only cautious about visiting the hospital in July because I watched it... 😬🤷♂️
I’ve actually gotten better care from new doctors, than older ones. They’re more likely to investigate issues instead of dismissing them out of hand.
New doctors tend to hear their patients better.
Don't be concerned. #1, not every hospital is a teaching hospital. #2, these newbies are on the workup side of your treatment (ordering tests, etc) and have to clear any treatments with their attending before it gets to you...plus, your Nurse is also there doing the helicopter parent role ;-)
My mom is a nurse and I recently started working at the hospital with her. All year she was reminding me about the July 1st effect, and then this morning she ends up in the ER!
Slap in your face!!🤣😂🤣😂 you are so smart doc!!👏👏👏👏👏👏
Always good to get fresh eyes on a patient
When I go for my check up because of my high blood pressure twice a year, they almost always ask if I’m ok with the nursing/med students from the local college sitting in.
I always say yes because they are learning! People need to learn, never bash someone who is attempting to learn.
In the UK the new junior doctors always start on the 1st Wednesday in August. We jokingly refer to it as Black Wednesday
Seriously hospitals doesn’t have attending like him ,I’m a med student and my biggest fear is getting embarrassed by attending questioning us…
Honestly it's not the patient that suffers with the new docs. It's their co-workers, in pretty much every service. Especially if you're at a hospital where the attendings are not paying enough attention to their residents. Everything still gets scrutinized and corrected but the other services are now having to do even more work because they have to help correct and teach the new docs.
It's necessary and important but that doesn't make it any less annoying. Especially if you work at a large trauma hospital. Since it's trauma season.
Exactly my experience as an ancient RN. The close supervision can be sparce, and it's the team having to pick up all the gaps and deal with educating evry single new doc that yes Nurses do that,yes we need an order for that, no not that. The whole orchestra has to be alert because the conductor hasn't ever actually used the baton before. So i never minded helping and teaching till you hit the residents with God complex and would hear nothing from the experienced staff. Thankfully those are the rarer types except I notice more female residents have it now. So then it's protect the patient, find a supervisor.
Yeah Im not even working with the same power dynamics (I work in Pt transport the important distinction is how many hours you do, full time up top and volunteer at the bottom, and your overall experience) still it's exhausting whenever we have someone new to train or even just doing a trial day bc we just don't have time but you need time to let them do stuff themselves without stress and close supervison to make sure no one gets hurt (and the job is dangerous if you mistep once on the stairs while carrying there are 3 badly injured people) . It gets even more stressful for me when Im "the one in charge" and my partner pushes both the newbie and the responsibilities on me (My favourite collegues to be partnered with are ones dont need any distinction in rank to know what everyones job is, with some of em its almost mind reading and it just works so flawlessly and effortlessly). I like showing the newbies and building up their skills and confidence as well as their love for the job, it is fun and most collegues are really great but doing it in a risky enviroment is absolutly not advisable. Making sure it is safe and they get to try doing stuff too while we manage the days pensum is desperatly exhausting though.
Ego trips don't happen thankfully (from newbies) most people need a ton of encourgment to feel confidence in doing anything and even if it did happen Im the one with "rank" I get to pull in that situation as the supervisor.
OB nurse & I have always dreaded July. My problem isn't the mistakes because, I can go over their head. My problem is the I know everything I am the Dr attitude. Until they are in over their head. my fav quote, "get the Dr!"