Wanted hear some other IM residents experiences / thoughts about this.

I’m from a smaller community program. We have a fairly busy 18 bed ICU. It’s staffed by 1 senior resident who manages all issues overnight and does any new admissions / procedures needed. An intensivist is available by phone (theoretically) but we have no in-house overnight attendings or fellows.

I’m often finding myself managing extremely sick patients with little to no guidance and doing procedures I have little training in and feel uncomfortable doing.

Maybe 1 out of every 15 admissions an attending comes in to formally evaluate and discuss the plan on admission. The rest the attending may see the patient 24hrs later if at all. This just seems so wrong to me and borderline illegal.