u/neurosci11

New internal med intern in the US.

Holy fuck is it different. I arrive at 5.45am, round on my 10 patients and develop plans etc. Take nights handover at 6.30. I start prepping documentation and the attending arrives at 8.30am. While that sounds like a ton of time, it's actually completely used up as I am presenting these patients to my attending as if I'm their attending. Everything needs to be accounted for and at least mentioned.

Present the patient outside their room, then we walk in and the attending examines, then proceeds to ask me a myriad of questions as he sees fit. E.g had HF exacerbation patient w/ pulm nodules + hypercalcemia. Asks me to list as many causes of Hyper Ca2+ as I can, we proceed to discuss Vit D metab and also zollinger ellison. Then i'm questioned on what I should be concerned for post lung biopsy and what exactly I would do to. PGY2/3 puts in the orders etc while I'm being quizzed.

This doesn't just apply to your 10 patients, you may be quizzed about the other interns patients - although less detail.

Rounds take 4-5 hours, grab FREE unlimited high quality lunch. Go write your single note for the day for each patient, those this is a massive note but largely copy + pasted, finish anything not done by the PGY2/3. See all patients again, report imaging issues/update patients. Paper round around 3pm, usually everything is now done and someone can go home while the other 2 stay till 6.30pm for night handover.

This is roughly the day to day, it's a lot less 'work' than the UK but goddam it's like pure pressure as you have to cover absolutely everything and you're being quizzed on effectively everything - including surgery. My entire day is centered around me learning and it's clear that my actual role is to just learn.

These Attendings are absolutely excellent I have to add, jesus their knowledge is miles ahead of some of the ones I worked with in the UK. Also to address the 'what do specialists actually do question'; in the US specialists only use their skills which are unique to them.

TLDR: US is pure learning, UK is doing the job.

Matched and about to start but there's no reciprocity with my drivers license and the drivers license tests are booked out 2 months in advance and even then they're only from like 8am till 11am..

I can't uber for months on end, I can get a ride from a colleague sure but does anyone have any practical solutions?

Moving to AR, I understand I need someone with me when I go for my practical test, I just moved here and don't know anybody so what's the work around?

Been driving for over a decade otherwise.

General question that might help a lot of people.

What apps are crucial to life in America? Uber/Lyft I imagine and I've heard of something called venmo which is for splitting like dinner bills etc with friends?

What else are some needed apps?

What the fuck is happening with stocks? They only go up? My money is afk earning more than I do sweating my balls off at work on 14 hour shifts, what's the point?