¶ GOP Cuts on Student Loan Forgiveness
Another F around and find out time Y'all see that GOP may cut off student loan forgiveness for 4.8 million health care workers . So the government giveth and the government taketh away . I think that people always need to be on plan A and plan B .
On plan A and plan B If you think something that you can't control is the thing that you're gonna peg your life on . You need a plan B because you cannot control the PSLF .
Let's shift gears . Let's get into our next topic Real quick . Actually , this is a very quick topic I wanna talk about in residency and stress . So one of the best parts about podcasting over the last nine years almost we're getting close to 10 years next year is being in contact with the folks who listen to the show .
They keep me young , they help me think about where I was during their time , because we have residents who listen to the show .
We have med students who listen to the show , and one of the residents who listens to our show , just you know , reached out to me and said that they're taking some time off and you know I'm not going to name any names or anything like that , but they ended up being in a very good situation .
That's very healthy for them and also healthy for the residency program and kudos to them and kudos to them . But it had me thinking about residency and stress and where I was close to almost 15 years ago and I'm going to tell you something right now . I did not realize that I let residency change my personality .
I didn't realize that I didn't realize how much of a different person that I became during residency and even after residency and yo .
I'm going to tell you something right now .
I'm going to tell you something right now . Y'all folks don't know , like even the 80 hour work week right which we have right now , that is a tough thing . Right In surgery and OB , whatever specialty that you're in , it is a very tough thing .
I remember my second year of residency which , at my program , the second year is mainly run the ICU and that you know , when you have a program that doesn't have many residents but you still need coverage , that second year was , first of all , I think , a lot of the , the administrative , the way in which we policed ourselves .
We should not have been allowed to police ourselves right , like the way in which the person starts at a certain time at seven o'clock in the morning and then we'll go till the next morning and then that person writes the notes for the next , you know , the next day . That didn't make any sense whatsoever . That was the stupidest thing .
Like I'm gonna tell you something right now . Like you know I didn't know better , but I kind of knew I was like this doesn't make any sense I get it the person who's coming in fresh . The person who's coming in fresh should be writing the notes or there should be some responsibility split between the person leaving and the person coming on .
So , just for context sake , if you started at seven in the morning , you didn't write the notes that morning but you rounded with the attending and you rounded with the person who was finishing that night , right . And then for the entire day you know you're taking care of you coming in fresh , fresh . You're taking care of all the issues that are going on .
You're responding to trauma calls , you're taking care of the general surgery patients that need to go to the ICU , and then at night you're the senior in-house , right , and then there's an intern there also and then if someone needs to go to the OR , you're calling the attending and if the patient needs to go to the OR , it's you and the attending and you're
also handling the ICU . And then you know five o'clock comes in the morning . You got to start writing notes because you are rounding at seven o'clock . You do that over and over and over again . I think my mindset was just so focused on I'm getting through this program .
There's nothing that's going to stop me that you start to just accept bullshit and that right . There was something that I really look back on .
I'm like man , but when you're not in control , see , this is the key thing , though when you're not in control , you kind of have to play the game to get through the game so that when you go back , you can change it and look back and say , yo , this didn't make any sense .
That's where I was , and that was a lot of stress that I had during that time , and then that carried on with me into third year and things started to look better into fourth year and , obviously , into fifth year , but I definitely felt like looking back .
The one thing that I wish I could have changed was that second year rotation , you know , because I think that it's a it's an unnecessary stress that you put on residents to have that type of lifestyle , you know , just so you can have coverage in the ICU because nobody else wanted to in any of the other levels .
So , you know , I , before I asked you , the question I was going to ask is have you ever felt like you need to take time out during residency ?
is have you ever felt like you need to take ?
time out during residency .
Yeah , I did , man , I definitely felt like it , but I wouldn't let myself kind of , I wouldn't let myself really take those thoughts seriously , I wouldn't let myself really kind of just explore it , because I felt like if I did , like I would go down this rabbit hole that I wouldn't come back from , you know , but I don't know , I wouldn't do residency again .
I'll tell you that right now I wouldn't .
I would not . I would not do residency again either Um yeah , cause you changed you changed big time yeah . Yeah , right , you wish I changed .
You did .
Ava yeah , right , you wish I . You definitely changed during residency . I saw the size of you .
What did I change ?
Tell people that let's talk about that you were , just Because we don't talk about anything Like what . You were just more transactional .
What was I like before ? What was I like before ?
You were more . I mean you were still a pain in the butt .
Don't get me wrong , no you weren't suave . Never .
Gregarious . Yeah , okay , you just . Are you going to go down the vocabulary list of words now ?
Are you shocked by ? That Is there a word of the week Magnanimous , magnanimous Is there the magnanimous .
Okay , no , I mean I think before you . I mean you were always . You were always uptight . Don't get me wrong , you're always uptight . Yeah , when it came to your education you were always uptight about that , but but you were definitely more relaxed . Um , your first year of residency . I noticed it right away that you were on edge all the time .
You were on edge all the time . There was not a time that I spoke to you in residency that I felt like you felt relaxed .
There wasn't a time Relax . I never felt relaxed in residency . I felt like I felt like I would always get found out . I felt like mad imposter syndrome . Um , I just never felt comfortable there . Not like , not like , um , I don't explain it . Like nobody , nobody said yo , you about to be out ? Nobody ever said that I , just for me .
I just never felt comfortable .
Well , I think that first year in particular , because you were a categorical in a program that had prelims and categoricals that you were always afraid that you would have gotten downgraded .
So that first year , and then the second year , when you took your in-service exam I remember that because you , I don't do well on this in-service exam , they're going to make me a prelim and I don't want to do that and it was just like , oh my God , like what the hell is happening . Like , yeah , you God . Like what the hell is happening .
Like , yeah , you changed a lot in residency . You were almost unrecognizable yeah , you were , but I loved you anyway . So , yeah , dumb ass me , but whatever .
You came out nice . You came out nice right . You got your loans paid off right .
You know , a little bit of mental trauma is high you got that fat rock on your finger .
I mean come on .
Yeah , cause you know that makes up for everything .
Look at your lifestyle now . Look at the background , look at what you got . Yeah look at that look at that mic you got . Come on now . Okay , listen , it was all worth it .
You know , I think , just that residency I think residency does do things to people takes people to dark places that they've never been before .
Is that residency's fault , or is that the person's fault ? Because I I struggle with that a lot where I'm like I should not have let . I should not have let , because you know what you know . I'll be honest with you .
Like what happened , which a lot of people do , right , is you start to realize , look , the only way I could survive is like you start taking on like your captors mentality . Right , you start taking on the , the traits of your captors , because you're like yo , if they're doing this and they're surviving , I gotta do that also .
That's yeah , you're like , I'm the captain now , look at me . Sure , I'm the captain now what ?
you know that's not healthy , and I definitely took that on . I wonder , though , that's my fault , though , right like no , the game is trying to finish and try to remain as true to yourself as possible .
I don't look at it as fault more than I look at it more as just kind of circumstantial . I mean , you can't fault a person for going into a dark place , right ? Because most of the time they don't even know that they're going there place , right , because most of the time they don't even know that they're going there .
I don't even think you knew you were going , where you were going , because , you know , whenever I said something to you , whenever I kind of tried to bring it to your attention , your response to me was but you don't understand , you don't understand , you're not here , you don't understand , right , and so it was like your coping mechanism to be able to essentially
make it through a tough program . But I will say this I think that residency programs don't do a good job at checking in with residents and making sure that residents you know are okay . I don't know if that's the residency's job to do .
¶ The Government's Role in Student Loans
What if the resident is not okay ? What is the residency supposed to do ? Right , because I'll tell you Right .
Which is why I said I don't know if it's their job . That's why I said I don't know if it's their job to do . Right , because I'll tell you employees right , the maintenance workers are employees , like they would have to check in on everyone .
Now I understand that we're a different category of employees and that we're employees and trainees , but at the same time , it's like well , ultimately we're getting paid to be there , so does does the residency program have an obligation to us to check in on our mental well-being ?
I don't I don't know the answer to that . What happened to the chief wellness officers and all that stuff ? Did I go the way of like DEI also and shit ?
No see , chief wellness officers , just be . You know , there's a gym downstairs that you'll never use because you're so freaking tired .
You should go walk on the treadmill Like wait , what I sniffed that out in the beginning of the video . I'm not falling for this chief wellness officer thing . This don't make no sense to me , but anyway , let's move on .
Chief wellness officer . I'm like you know what the chief wellness officer should be doing Giving out mani-pedis , that's what they should be doing . Coming to the floor giving out mani-pedis , that's what they should be doing . Rubbing on my temples Okay , giving me a massage ? Me , don't start . What Inside joke . Giving me massage , that's what they should be doing .
Taking my call , taking away my pager , picking up , how does get my tiger text forwarded to them how does somebody who is struggling , how do they take the steps to let someone know that , like y' , they need help , like that's a tough one .
It's tough Um , because I think oh , how about this ? How do you ?
recognize ? How do you recognize that Maybe you need help ? Is this like one of those things where people tell you like yo , bro , that's what I was going to say .
So I , so I had a resident . I had a um , a junior resident who we were a little bit worried about and I spoke with her and I asked her flat out . I was like , do you want to be here ? And she's like yeah . And I said , okay , I said , because it doesn't seem like you want to be here . Now I'm going to tell you this .
I don't know if she took it as a challenge or she took it as the concern that it really was right , because that's kind of the the conundrum , right . Well , if I say no , I'm not all right , what does that mean ? What was that ?
going to . Yeah , that's like sending a medical student home early .
Right , okay .
What do you mean ? You should I take this and go home early , or should I stay ?
Or should I stay Right ? So it's like , well , you know , so till this day I don't know how she took it Right , but the reason , the reason she's still practicing yeah , ok , she's a good doc , she's a good doc .
But I mean there were points , and she , she was a first year , but there were points at which I saw in her things that I saw in me in my first year and other people saw it too , and it was actually other residents who asked me to speak to her , I guess , cause I'm a , I got a big mouth , but I was like it doesn't seem like you really want to be
here yeah . You know I . You know , so I don't . I don't know I . I don't know Cause you know , so I don't , I don't know . I don't know . Because I think you asked a really good question . How do you recognize that you actually have a problem before you even tell someone ? Or do you ?
Are you so competitive with yourself that you're like , no , I can do this .
I can do it . I'm in a dark place but I can do it . I can do it . I figured out quick . I figured out quick . I told you one of my resident , or one of my , one of my upper levels , flat out came to me we were signing out . He's like yo , did you take a shower ? And I knew , because there was , I would go several days not taking a shower .
That's not like me , but because you know you going into depression you get to work at five in the morning and you don't leave till like eight o'clock at night . That's an exaggeration you probably don't leave till , like you know . And then you , you stay up all night , you're studying .
You stay up all night you're studying , and then you wake up and you're like you pass out .
It's like you wake up and it's like two minutes , you know , five minutes before you're supposed to be on the highway and you're like , oh shit , you know you got to get to and you just start doing it over and over and over again and you're on edge and then you realize , oh snap , I haven't taken a shower or somebody else has noticed Right .
Or like I remember getting a phone . You know my mom tried to reach me in the OR , nurses picked up the phone and my mom is mad apologetic because I guess I've been snapping , Didn't realize this . Right . You start to realize , yo , you got a problem . So you know , it's just .
Yeah , I think it's okay to say that sometimes residency got you acting a way that is highly abnormal and that you may need to check in and get some help , whether that's seeing a therapist , whether that's talking to a loved one , whether that's talking to a trusted one .
You know , I don't even know if you can talk to someone in your residency , if that's possible , because that's scary , right ? You think that that may get me . I might be used against you . You know what I'm saying .
Right , or that person invalidates Right Because they themselves have not recognized that within themselves . You know they might invalidate , like what you mean , like , yeah , you , you got to just come on , come on , you just got to do it . But I will say this if someone approaches you , take what , is it the olive branch ?
It's not really our branch , but you know what I mean . Yeah you're not good at colloquialisms no , no , you're not good at colloquialisms , but heed the warning , essentially right . Heed the warning if someone is so Heed the warning . If someone is take a shower , If someone comes to you , if someone comes to you .
You know how embarrassing that is . Yo Like yo , we behind the you ain't take a shower , it's not embarrassing , though it's not .
It's not embarrassing , right ? You know me , I say so . The way that I approach a lot of things about you in our marriage is that you never had to tell me that I didn't take a shower , because I take showers . I'm not talking about taking a shower . Nii , I'm talking about just human interaction in general .
When someone you know says something to you that's a little off kilter , is that you have to when you recognize that someone is off kilter Right . Or if someone says something to you that someone is off kilter right .
Or if someone says something to you that you're like wait what you know , there's got to be the understanding that there is concern , more than there is anger , behind what is being said .
Oh yeah .
Right , so I have to be . If you start acting crazy in this house , I can't . Just . I don't know why me is you know blah , blah , whatever . I don't know why he's doing that , why he don't pay those bills , why he , you know , why is he out all night ? Why is he , you know , just acting strange ?
Y'all see how she talked financial . Immediately , though , right Financial .
Yes , I did . But if you start , if I noticed that there are things about you that you're you're just not doing like , oh , he didn't take care of the car Like he usually does . Oh , you know X , y and Z , I have to start being concerned about you .
Oh , he won't get his car fixed . He driving with , uh , the passenger . Uh , what was it ? The passenger window is just yo y'all .
I'm not talking about this .
People are going to be like yo , you was depressed in residency . I'm not saying shit .
I'm sure you were . I'm actually very sure that you were depressed in residency . But you have to be more concerned about somebody than you are angry with them , and I think that that's really important because it allows you to give a person some grace .
And if the person who's receiving that understands that when you approach them about that thing , that they are actually more concerned about you than they are upset with you , then it might be a little bit easier for that person to recognize in themselves that , hey , I'm going down a dark , you know path . I'm going in a deep , dark place .
That was your problem . Was that you never ?
it's hard to accept when you want to see a sharks .
When you want to see a sharks , it's hard to accept . I'm through . You know my personality , where I come from and all that stuff . It's it's it's kill to be killed , you know . So for me it's like I made it too far to get killed . So I was just like , look , whatever y'all say , I'm gonna make it .
You know , but you don't realize that it's changing you . So I think that definitely some malignant behavior that occurred and stuff and I'm glad that you stuck with me because I can't front like I . I did change and I became mad , annoying to deal with and so forth . On the real , I became mad , annoying to deal with and stuff , even though I was fine .
You know what I'm saying . Like in the inside , I was on the what , even though I was fine . Look at this . You think I wake up like this . This takes work . I was fine .
Oh , okay , I was about to say yeah , isn't it . Alfred , you gotta go to work on Myra's feet . Mm-hmm , oh , ooh , ooh , she's making it .
Oh , I love it , even though I'm fine , I think inside you know like I was struggling and stuff and I think that you know in a situation where particularly see .
This is the part when you're trying to get , when someone is trying to give you advice in the program , like you don't even know if they're like trying to get at you , if they're trying to snipe at you or if they , like you said , given a proverbial olive branch because you feel like yo , you want to see a sharks right .
Like you feel like like I'm in the lines then and you're not going to knock me out . You know what I'm saying . So it's really tough to accept those things and I just wanted to and we probably should end the show on this end , because I know there was other things that we wanted to talk about .
But before we go down and make the show too long , you know to the resident who reached out to me , I heard you , I appreciate you sharing that and you know , sometimes you just got to take a mental break , shout out to the programs that are out there , that are given the students and the residents the space to kind of say this stuff , because you know a lot
of times you're just going to have to take , you're going to have to make an uncomfortable change right In order to see effective change in your program .
Right , a lot of people are going to have to get uncomfortable with .
Maybe they have to take an additional call to allow their you know , their fellow resident to take time away that they need so that when they come back they come back stronger , Right ?
That's the type of change that people talk about and say , well , our healthcare system is broken , but then you don't have the time , you don't have the patience to deal with the inconvenience , to deal with the healthcare system changing .
Right , If you want it to change , there's going to have to be some inconvenience , there's going to have to be some pain that comes with that . I'm going to leave it at that . I don't know if you want to say anything about that .
Yeah , I mean . The only other thing that I will say about that is you know , let us not underestimate that if one resident is feeling that way , that potentially more residents are feeling that way in the same program , and so you know , when you do end up giving the other residents that extra call , you might be snowballing the effect as a program .
So I'm hoping that those programs actually find a different solution than to pile on to the other residents who are remaining .
I mean , at this point it's like stop being exclusionary with shit . Y'all need to accept more residents , simple as that . So I think that's the easiest problem .
I mean , yeah , that's the easiest problem . I mean , yeah , that is easy .
We got a doctor shortage . We got a doctor shortage , right .
We got a bottleneck . We got a bottleneck . We got a bottleneck schools going on right now .
And you know obviously this is from a federal government level Like there needs to be more funding for residencies to be out there . But Residency can be out there , but you can't be like having low-income seats .
I'll be a resident for locums .
You crazy as hell . Would you do that ? Hell yeah , hell yeah , hell yeah . I would Hell not .
I charge like crazy , but yeah , I'd do it .
The question is would you be cool with taking orders from people ? I'll take orders from people too , for a certain amount , for like $150 an hour .
For what ? 200 an hour .
You know what I'm saying 200 an hour .
You don't make 200 an hour . Now . Wait more than that .
Residents are going to look at you like yo , I only make like 50 Gs yo .
You make how much ? Nah , man , listen , let me tell you something . If I had to do locums in residence , like as a resident again , like yo , it would definitely be more per hour than what I charge now .
definitely , okay , I'm like you gonna make me go through that pain again . It's gonna cost you , nope , nope , all right , y'all . Yo thanks for listening to docs outside the box . Everybody who writes in lets us know how you feel , let us know how you feel in the show notes . You can send us emails , you can send us text messages .
Everything is in the show notes , everything is in the show description if you want to get in touch with us . But once again , thank you again for listening to Docs Outside the Box . Let's let Dr Renee get that sleep . Go get your sleep on , and yo , we'll catch you guys in another episode , y'all Good . Go catch you guys in another episode , y'all .
Good night .
Peace y'all .