 So I've been a fully independent doctor for the past two months. Here are the biggest lessons and surprises that I've taken away in this episode. We're going to talk about tons of things, including schedule, money, comfort, and of course, happiness. Hey friends, if you're new to channel, my name is Lakshman, internal medicine physician. And here on the MD journey, we make content to help people on their medical journey like you succeed and doing it with less stress. Today, I really wanted to just break down the biggest takeaways that I've had after spending my first two months as an attending internal medicine physician as a hospitalist. I made an episode on breaking down exactly what a hospital says, the pros and cons and also the unique schedule. So if you guys are interested, it's been very popular across the channel, so I'll link it down below. But for today's episode, I'm going to break down my experience as a brand new doctor in four categories. One is just going to be comfort level in general. Numbers two is going to be my schedule. Number three is going to be money and the things that come with it. And then finally, the number four is going to be happiness and overall fulfillment. So let's start with comfort. As a brand new baby doctor, I knew that going in there was a good chance that I could just feel like I was trying to just notch around the amount of things that I just didn't know what to do for my patients. The first thing that I learned is that I am much more comfortable than I thought it'd be. Just like in medical school and residency, where you have kind of a three to six month new period where you're just trying to figure out the ropes and you just don't know what you're doing. I thought I would have the same as an attending. And after two months, I can confidently say that I know what I'm doing. And even though I'm a young doctor, that does not mean I'm an inexperienced doctor. There's a sick patient in the hospital or in the ICU. I feel comfortable taking care of them because I've had tons of experience and patient encounters during residency that were just as sick, if not sicker. So my comfort level is pretty good. And so while that was an initial fear, two months down the line, I can go to work and say, I pretty much know what I'm doing. Yes, there are things that I don't have quite of a good grasp on, especially if I'm taking care of like post-operative surgery patients, stroke patients, which was not as profound in my residency training. Those I have to take a little bit of reading and just make sure I'm doing the right things. Those patients who I've seen hundreds of times at residency, I can go in and feel like it doesn't matter that I'm just 29 years old as a brand new doctor. I know what I'm doing for you. I'm going to happily help you. I know who I need to call. If I don't know the answers and again, much more comfortable than I thought it'd be. So pleasant surprise. Number two is that patient rapport is super underrated in my past videos, especially with residency. That's a big tip that I give to medical students and residents is that you just want your patients to trust you and you want to get experience overall, go in that room and just make a good first, second, third impression. So it doesn't really matter if you don't know all the answers. If the patient believes and trusts in you and has some confidence in you, they feel confident that you can find out those answers. As an attending, I thought that people could read through me, especially when I didn't have the answers because now I'm the ultimate decision maker. Same thing though. If I don't know the answer, if I don't feel as comfortable with giving that patient a response to their question, if I've built a good rapport with them, I feel a much bigger sense of trust where they feel okay. Dr. T, which is sometimes my short name for patients, if they can't say my last name, Dr. T is going to figure out what he needs to do for me, but I trust that he'll figure it out well and he'll do it quickly and he's going to do it in my best interest. And often, and this is not to, you know, to my own horn, lots of patients have essentially spoken to the rapport in my bedside manner, which was something I really highly valued and perfecting and trying to improve as a resident. And now they do it as an attending. And that means that they are experiencing other physicians, other care providers who may not be providing that level of rapport building. And that doesn't speak against to them. Maybe they're busy. Who knows. But if you do that, again, it makes your job so much easier. But if you're focused on that rapport building, that patient interaction becomes so much easier and your job just becomes smoother. Your patients complain less. They usually are on the same page. They know the information. They ask you questions because they know that they can speak to you and that you'll listen, but they don't try to waste your time. You know that you're there to take care of them, but you also have other patients who are depending on you. So they usually let me leave the room without like spending 10, 20 minutes talking about nothing. Again, patient rapport super underrated. Glad that I learned how to do that well in residency. And I'll continue that as an attending. Number three is that the hard days in attending are much, much easier as a resident. As a resident, it was very easy to have a hard day where you have tons of admissions, but also complicated admissions. For me as an attending a hard day, I can have tons of admissions, but a lot of them are simple and usually a hard day is where I get a late admin. Maybe I'm working till seven and I get an admin at like 648. That sucks. That's a hard day. You know, my day is going to go longer. My hours are going to be longer. And maybe I have a longer or larger patient senses than I was used to you on the prior days. But frankly, I go home and my work is done. No one's going to bother me. As a resident, sometimes you are still doing tons of work and you still have to show up early the next day. There are lots of difficulties for a resident where it's easy to have tough few days stacked in a row. For me as an attending, I found that over the past two months, if I do have a hard day, I usually have two or three easier days stacked after it. And it just happens on when you get your admissions, how difficult those admissions are. But I would say for every one to two difficult patients you have, you usually have three to four that relatively simple. You've seen tons of time. They're like your bread and butter cases. And then finally to round up the section of comfort and being a brand new attending is the section of dispositions. This essentially means my biggest job is to get somebody home or to get them to the next site after the hospital. Either they're going to a rehab center, they're going to a nursing home, they're going to a short-term facility or they're just going back home. But to arrange all the care, there are a lot of bumps where I'm not doing anything medically for them. And maybe I'm getting bored because this person from pneumonia has now been treated, but there's a waiting for a facility to go to. And you're just having to see this person daily. Again, nothing against that person, but there's no medical aspect happening as a physician, you're going into the field to practice medicine. So if I'm just going to go into a room multiple times for a week, because somebody's insurance can't approve their facility that they're trying to get to, that's not as interesting. And if you have tons of those patients on your list, those are days where you just feel like the day is tracking on. So the thing that I knew going in, but it's definitely a prominent part of my job, depending on who is on my list. But other days I have tons of movements where people who are sick are getting better, they're going home, their facilities are taking them, their chances are not being a pain in the butt. So again, it varies on a week to week basis, but not the biggest thing, not the biggest issue in the world. Category number two is schedule and getting into schedule. Schedule as a hospitalist is very, very nice. Obviously the week off and if you haven't watched that video or the episode on what it's like being a hospitalist, I break down the schedule, which is against seven days in a row for most people and then seven days off fully where no one's bothering you. Those seven days off are very nice. Personally, I'm spending a lot of that spending time with my dog and my wife, but also doing things that are important to me, like working on the YouTube channel, working on the empty journey and also training for a marathon I have in December. So tons of free time to be able to schedule all those as well, just feel like nicely rested during that week. What I was really surprised about is that my week on, it's frankly not that bad. Again, in that episode as a hospitalist, I break down what my schedule looks like, depending on the institution that I'm working for. But usually as a quick breakdown, the days are from seven to seven, but I don't have to be in the hospital till 7 p.m. every single day. Unless I'm part of the team of physicians who is taking admins from the ED and other hospitals from three to seven, I'm not part of that group. If I've been admitting patients throughout the morning up till 3 p.m. If I'm done with everything and everyone looks stable, I can go home and take messages and pages and texts and put orders from home, which is really nice because that means I can come home, still spend time with my loved ones. But if there is some downtime where I just want to watch a TV show while I'm just like looking at people's labs and results, I can do that. Or if I want to work on something and answer some emails, I can do that or I just want to rest and chill. I can do that as well. So that's definitely one of the biggest surprises in my first two months is that compared to a resident where you work seven days in a row and you definitely feel it here, I definitely feel it for the hours. But I don't feel like I've been mentally pushed from seven to seven all the time. The next part of the schedule is one thing that I was really concerned in is that as a hospitalist, you're admitting patients throughout the day. So I was really worried about if I go into the hospital and my patients are sick and then I'm getting an admin from the ED and maybe a transfer and maybe I'm the person who's taking these calls for admissions and transfers. How about balance style, especially as a brand new doctor? You're not learning how to do that in residency. We're trying to manage old and new patients and trying to figure all that out. It's not as bad as I thought it was going to be. But frankly speaking, majority of the time when I do get an admin, they're not very complicated. I don't have to worry about going into the hospital and feeling like I'm going to get tons and tons of complicated patients back to back to back. Often again, you get one complicated patient, maybe a few pretty easy ones. And again, there's a flow where if I get an admin and then you're next in the list, you and the next group of doctors are going to go in a round robin style. I know that there's going to be at least a time delay between the admission I just got now and the next one. So if a patient is really sick, obviously I'm going to make sure that I take care of them first, but if somebody is like relatively straightforward where I can just put orders in and see them when they come to the room from the emergency room, now I can focus on all those old patients, see them, write notes on them. And then by the time that I'm done, that patient is now in their room. I can take their full history and feel like my day is still progressing. So this frantic nature of there's so much to do. I don't know how I want to balance it just naturally works out depending on the complexity of who you're taking care of. Now let's go ahead and go to the next category that you guys are always interested about, which is money. And there's always comments on the YouTube section about very aggressive requests to share my exact salary. And the reason I don't break down the exact number is that, frankly, you're going to have to look up how much you make in the institutions that you work for and the cities that you work for. And so all those people who are aggressively requesting a number in the comments section, first of all, I'll need to chill. And number two is your salary is going to depend on the institution you're working with, the schedules you have, how your compensation structure is based. And again, I go over that in the first episode, not exactly how much we make depending on different categories. And then two, like what suit you're in. So if I say that I'm making two hundred and fifty thousand dollars in central Texas and you're going to easily put a comment saying, I've heard so and so it makes X amount in Midwest, like it doesn't matter. Figure out what the salary is and the range of the places that you're looking for. But most hospitals, and again, this is a range make anywhere from two hundred and thirty to three hundred thousand dollars. Again, how much you work, where you work, the institution you work and what your schedule is like. So it may not be seven on, seven off, but maybe you make more. Maybe you see more patients, too, than I do. So lots of variables. One of the biggest things after two months of being a hospitalist is that I'm easily making more than four times is what I was as a resident, which is like mind blowing. The main reason is that one, never seen that much money in my life. But two, as a resident, my wife and I were very good at budgeting appropriately and still being able to live what their means without feeling like we were really tight on the budget. So for those of you guys that follow the channel for a while, you know that even when my wife was working, if she had her own salary plus side gigs that she was doing, we only lived on my resident salary just to be safe. That way, if we made more or less, we could always use this money for investments and just spending it on us, but that resident salary was definitely fixed. Now as it's attending, although my salary has gone up, we haven't really changed our cost of living very much. Now we are renting a house, so it's about an extra thousand dollars per month. But more or less the rest of our food budgets, our monthly budgets, our insurances are about the same. I would say the electric bill for the house is a little bit more. So all in all, we're probably spending about 12 to 15 thousand dollars more than we were when I was a resident while having four times of a higher salary. And so biggest takeaway financially is while we're making more, it's really nice to see a bank account, the investment accounts and the opportunities to put money to other places to help it grow for your future goals really happen now where resident, you're just kind of hoping that you can have a few hundred dollars at the end of the month to put into something meaningful. And as a second category of money, the nice part about having a nice schedule where I can work seven days off is I can now work on more side projects, obviously like the end of the journey, but also kind of have my ideas and my visions of what future investments, what future directions do I want to take myself or my family as well as the business. So having that extra time can definitely help in a future monetary aspect. Maybe I'm not necessarily making more money in those weeks off, but that extra time and extra week off can be used to work on skills and future projects that may bear fruit in the future. And then finally, we have to talk about the section of happiness, which is doing this. Is this something that I could see myself being happy with? And the biggest thing that I realized is I feel like I can go to work and have an occupation and joy because again, the things that I really care for, the patient interactions, working with other staff members, being both colleagues, social workers, physical therapists, people that now get to know you and respect you because you're not just a resident that they get to kind of like stomp their feet on. You're the tending who helps make their decisions. And then from my perspective, saying, you know, I don't want to be like the bossy person that is commanding things. I want to work as a team and people are definitely perceptive of that. So it's very easy to go to work. I have a job I enjoy when I do take care of people and I see them get better. There is a satisfaction of that. And then having that extra week off and having that schedule that is very nice, the parts of my life that also still make me happy. My wife, my dog, working on side projects like the MD journey, working on videos like this for you guys. All of those are now included into my daily and weekly schedule, where I do feel like my happiness is much higher than it was when I was in residency, but mainly because I have time for all those. I love my job, but I definitely always consider being a doctor's occupation, not necessarily calling something out to do 24 seven. It comes with the balance of including all those other things that really value my life. And right now, two months in, I can say that all of those are checked off. So if you haven't seen that full breakdown of what a hospital is, what my schedule like, what the pros and cons are, make sure you definitely watch that episode and video down below. I'll link it. And if you're listening to this thing, I would one day want to be in your shoes, but also be happy and fulfilled on my journey. Make sure you check out all the free resources that we have down below. Something you probably will enjoy is the med school success handbook. It's 30 plus tips that I've included on everything that I wish somebody would have just told me at my first day of medical school and whatever part of your medical journey you're on. Ideally, those tips help you. So studying, time management and so much more included in there for absolutely free. So if you guys are interested, link that down below. And you can see all of our other programs that we work with here at the MD journey and the medic night programs. Those are all linked down below. Now, if you made it to the end and you enjoy the content, I'll ask is hit that like button, show your support, hit that subscribe button notification bell if you haven't done so already. If you're listening to this as a podcast and hit that like or follow or subscribe on the platform that you're listening to, as well as leaving knowledge review on that specific platform. And if you enjoy this episode, you'll enjoy this episode right here on that full breakdown of being a hospitalist as well as this episode right here on my favorite strategy, on change the game for me on my medical journey, hopefully helps you too. Always my friends, thanks for being a part of my journey. Hopefully I was a little help to you guys on yours. I'll see you guys in the next one. Peace.