Thanks for the share.

As a retire nursing supervisor, I recall that at the teaching hospital I worked in, there was a significant change in physician rotation. Based on peer reviewed research, that doctors should work no more than 6 hrs straight. There was a great deal of discussion, and change in "work life balance" amongst the physicians, as they had more shifts to complete within each month as compared to prior to the change. WHY, are you expected to work 24 hrs in row?

@nxtgenmd

6 ай бұрын

As part of the ICU training block, 24 hour call shifts are mandatory. I can’t speak to other residency programs across the country but I suspect that many residents on ICU are expected to do the same. Not all staff work 24 hours, but especially in rural parts of the country/province where physicians are in high demand - working 24 hours is not uncommon to keep the hospitals / urgent care centres open and running. From my perspective, I do understand the merit of having us there for these 24 hour shifts. Being placed in high pressure environments with support from staff physicians allows us to refine our skills and become better prepared for wherever we’ll end up working. It’s not fun, but it’s helped a lot with skill development for me personally. I appreciate the insight on your end though and agree that ideally, I probably couldn’t be doing more than one or 2 of these shifts per week 🤙

As usual great content

@nxtgenmd

6 ай бұрын

Thank you :)

Great content as always, Gianiuca! Do you plan on doing a 3rd year, or do you plan on starting office practice immediately? If yes or no, why? I'm a PGY1 FM resident considering PGY3 in emerg, but still having mixed feelings about an additional year. Thanks!

@nxtgenmd

6 ай бұрын

Hey JB great hearing from you :) I will be starting my own practice day 1 after graduation and will be doing full practice family medicine (minus OB) w/ rural emerg. The plan is 4 full days of office work per week and then 3-4 twenty four hour emerg shifts per month and a small long term care home roster as well. If I could, I’d have liked to do OB (deliveries) as well. But I couldn’t make all 4 fit into my schedule. I’ll definitely do a video about this in May or June before I graduate. My decision to start my own practice right away is so that I can build a roster and start building from a business perspective - doing the math, locum office work wasn’t something that I was interested in. As to why no +1 year in EM, I much prefer working in family medicine compared to emergency medicine. The centre that I will be working at has a mentorship program that will pair me with a rural doc for the first couple of months so that I’m well supported for the high acuity stuff in the beginning. I’m a huge fan of the +1 year - especially if you plan to be a full time emerg doc working at a busy rural centre. But for me personally, I decided to load my schedule with some high acuity electives in my 2 years of family and will go through the mentorship system for the type of emergency medicine that I’m interested in. Perhaps after a few years, I’ll challenge the exam myself. But for now, I’m excited to try it out. Best of luck with the rest of your 1st year of residency and be sure to keep in touch 🤙

@joannaigo5635

6 ай бұрын

@nxtgenmd Wow! You have it all planned out. Good for you! This is so informative. Thank you so much for sharing. I have followed you for a while, and I must say, you are one of the reasons I chose FM. Do you have any recommendations for electives for someone planning on going through the same path as you? I would really appreciate your input. Thank you!

@nxtgenmd

6 ай бұрын

@@joannaigo5635 I'm sure that I'll make adjustments as I go along, but at least its an approximate plan LOL. Yes, the core blocks that were most helpful for me were family, internal medicine, OB/GYN and peds (covers the basics of generalist focus), then I did core emergency medicine (3 months) + 1 month city emerg + 2 months rural emerg w/ family clinic split. 1 month of ICU probably isn't mandatory but was definitely helpful. Then 1 month of care of the elderly was really helpful imo as well. I'm really glad to hear you say that :) Thanks so much. I want to keep posting throughout my first year of practice and keep sharing tips for people interested in really making it as a FM doc. If you have more questions, feel free to ask.

@joannaigo5635

6 ай бұрын

@@nxtgenmd Thank you so much. This is very informative. I will keep this in mind. Thank you again for always being available to answer questions.

Are all shifts of 24 hours? How many hours/week usually residents and consultants work in ICUs in Canada?

Programs still do 24-hour shifts?

How does a doctor abd nurse manage to remember what IV line is what if the patient is hooked up to more than three or four lines?

@pretaxfrog4

6 ай бұрын

Labels and keeping the lines untangled.

@nxtgenmd

6 ай бұрын

You very carefully follow the lines back to IV bags and always double or triple check before giving any new medications :) this is especially true for central lines where multiple lines converge on a single thick catheter. However there are multiple checks and balances to prevent errors in terms of manual recording and machine checks

2 hours of sleep every day short of someone dying. Going beyond that and your body and mind pays a big price. Don't!!

@nxtgenmd

6 ай бұрын

Residency training is not an easy or healthy time for most people. Sleep deprivation is not good for the body but such is the current model of training. It’s amazing to see the results in terms of competency though - we get better with practice and that applies especially for the head ICU doctors. Most of whom are glad that the training programs have prepared them well.