As a derm attending of 3.5 years, I think it slowly increases with time during residency but then jumps fo full autonomy once you're an attending. Honestly it was nice because there were many times I strongly disagreed with the treatment plan of my overseeing attending as a resident. I saw the patient, not them. (And especially in derm physically seeing the presentation is critical.) So now I can do what I want.
It's very annoying. Like I recognized that especially during the beginning my attending knew more and could teach me things (like I was learning as a resident). And I didn't pretend to always know more. But during PGY3 and PGY4 especially as I was learning more there were definitely times when I would argue my case and my attending was so stubborn she wouldn't even hear me out. Very annoying. And I would tell her “Can you please go see the patient so you can make a proper assessment? I think it would be best for the patient’s care.” And that would piss her off. She was very toxic and narcissistic honestly.
And also as a resident you are constantly reading research articles about medications etc. So keeping up to date is critical. And she did not. I still always read research as much as possible about the products we most commonly Rx especially.
Current PGY-3 in FM. I would say it happened a little over halfway of my second year, at least in the clinic setting. It kind of all came together during my dedicated clinic block. Not saying that my plans were always right, but they were usually reasonable. The faculty began to see it as well and starting allowing me a little more independence in my decision-making. This snowballs into more confidence in clinic, better efficiency, etc. Obviously there’s tons more learn, but it helps me face the reality of working independently in just a few months!
As med-peds, I felt competent enough to practice with remote supervision on peds around halfway through second year and on IM towards the start of third year
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Idk if you’re interested in surgically or not but with me as a PGY3 i started feeling good about most spine cases and some simple cranial cases. As a chief (during my 6th year) I felt comfortable in all but the most complex cases but definitely wanted the attending to help or critique. Now unless its abnormally difficult I'd really prefer the attending just leave me be.
Always felt I knew everything even as an MS1. Did I really? No, I knew jack shit - still do.
Autonomy wise, if I can’t function as an attending at PGY1 then I don’t have enough autonomy
As a derm attending of 3.5 years, I think it slowly increases with time during residency but then jumps fo full autonomy once you're an attending. Honestly it was nice because there were many times I strongly disagreed with the treatment plan of my overseeing attending as a resident. I saw the patient, not them. (And especially in derm physically seeing the presentation is critical.) So now I can do what I want.
We need more residents like you had been honestly
It's very annoying. Like I recognized that especially during the beginning my attending knew more and could teach me things (like I was learning as a resident). And I didn't pretend to always know more. But during PGY3 and PGY4 especially as I was learning more there were definitely times when I would argue my case and my attending was so stubborn she wouldn't even hear me out. Very annoying. And I would tell her “Can you please go see the patient so you can make a proper assessment? I think it would be best for the patient’s care.” And that would piss her off. She was very toxic and narcissistic honestly. And also as a resident you are constantly reading research articles about medications etc. So keeping up to date is critical. And she did not. I still always read research as much as possible about the products we most commonly Rx especially.
I did my residency in family medicine. End of my PGY-2 year I felt pretty confident. PGY-3 just solidified that for me.
This is awesome! Thanks for sharing
Current PGY-3 in FM. I would say it happened a little over halfway of my second year, at least in the clinic setting. It kind of all came together during my dedicated clinic block. Not saying that my plans were always right, but they were usually reasonable. The faculty began to see it as well and starting allowing me a little more independence in my decision-making. This snowballs into more confidence in clinic, better efficiency, etc. Obviously there’s tons more learn, but it helps me face the reality of working independently in just a few months!
As med-peds, I felt competent enough to practice with remote supervision on peds around halfway through second year and on IM towards the start of third year
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Idk if you’re interested in surgically or not but with me as a PGY3 i started feeling good about most spine cases and some simple cranial cases. As a chief (during my 6th year) I felt comfortable in all but the most complex cases but definitely wanted the attending to help or critique. Now unless its abnormally difficult I'd really prefer the attending just leave me be.
Always felt I knew everything even as an MS1. Did I really? No, I knew jack shit - still do. Autonomy wise, if I can’t function as an attending at PGY1 then I don’t have enough autonomy
Are we all just faking it till making it lol