Your day begins before sunrise when you arrive at your designated floor and are greeted with a flurry of activity — from nurses bustling around to patients needing assistance. Monitors beep urgently as you dive into rounds, discuss patient cases, review lab results, and create treatment plans — in a never-ending stream of tasks. You push past exhaustion and carry on late into the night, tending to emergencies, connecting with patients, completing paperwork, and preparing to do it all again tomorrow. Such is the life of a resident.
No amount of training can prepare you for the residency learning curve, according to Ashley McKenzie, MD, a rising PGY-2 specializing in internal medicine at Saint Joseph Hospital in Denver. While you may not know what to expect in residency, which begins on July 1 for most programs, residents should take steps to organize the rest of their lives before diving into a higher level of training, McKenzie said.
McKenzie and other residents across the country in various stages of training shared their tips for surviving and succeeding in the phase between med school and full autonomy as a physician.
Navigate the Transition Period
McKenzie wishes she had learned to meal prep before residency for the times when she had harder rotations. Having a fridge or freezer full of meals can carry you through long days and late nights when the time and energy to prepare a meal are scarce.
Tyler Ramsey, DO, a rising PGY-3, is preparing to enter his final training year. Ramsey shares that newly matched grads should brush up on the basics before entering residency. “You probably didn’t have as many rotations, or they weren’t very intensive in the 4th year of med school. You may have forgotten how to collect patient information and present it,” said Ramsey, who is specializing in internal medicine at Mountain Area Health Education Center in Asheville, North Carolina. “Be proactive before the first day; practice presentation to a senior resident or attending.”
Prioritize Your Health and Personal Life
Ramsey said that busy residents often overlook their wellness when learning to care for others. “Intern year is very labor-intensive. Take time for yourself, even if you just carve out 20-30 minutes of going to the gym.” You have a lot of responsibilities as an intern, and it’s easy to neglect yourself, which can contribute to burnout, in Ramsey’s opinion.
“Get the loose ends of your life tied up. Go to the dentist. If you have a pet, go to the vet because you are going to be very busy. Better to get it [personal wellness] out of the way while you have time,” he told Medscape Medical News.
A social life, while last on the priority list during residency, is essential. “Whether it’s a vacation or a wedding or taking off for a weekend, it requires a lot of planning ahead ’cause you don’t have a lot of time off,” Ramsey said. Incorporate social events occasionally because you can be isolated if you don’t.
Because many residents move away from their families and friends for residency, McKenzie believes having a support system outside medical training is important for “sanity, mental health, and wellness.”
“With the hours we put into residency, you can wrap up your whole identity in being in medicine, being a resident,” she said. “You are more than just a resident. You are more than just a doctor.”
Leah Colucci, MD, PGY-4, chief emergency medicine resident at Yale New Haven Hospital in New Haven, Connecticut, believes residents need an outlet beyond their training.
“One of the biggest things I tell juniors is to find things you are passionate about, and you can always fall back upon that.” Colucci cites her advocacy work with the American Academy of Emergency Medicine (AAEM) and her review of residency programs for the Accreditation Council for Graduate Medical Education. She is the immediate past president of AAEM’s Resident and Student Association.
“My passion projects make me feel like I’m contributing to the specialty and giving back.”
Hone Your Learning Style
After nearly two decades of education, including 4 years of graduate-level training, residents should stick to the learning style that worked best for them in med school and not experiment with new techniques, Colucci said. “Whatever study style you’ve been using, trust you know what you are doing…By the time you’ve become a resident, you have taken a lot of tests and passed them, and [have taken] multiple board exams,” she said.
Colucci believes she learns best with practice questions. “For me, answering 10 questions is more productive than sitting down and reading a textbook. If reading textbooks works, get textbooks.”
She encourages residents, especially those in their senior year, to volunteer for extra shifts teaching juniors. “Once you are an attending, you are on your own license, and you won’t have the learning opportunities.”
Ramsey said that residents in their final year should try to master the fine details of their specialty.
“It would be better for me to work on the oncology floor of a hospital or in an oncology clinic instead of doing general medicine because that [oncology] is what I’m going to apply to and hopefully do.”
Senior residents should also make sure they are prepared to enter the job market, Ramsey said. They should ask their attending if they can take the reins during the last few months of residency.
Don’t Be Too Hard on Yourself
“Imposter syndrome” — when someone doubts their skills — is common among senior residents, Colucci said. Residents shouldn’t sell themselves short because they wouldn’t have made it this far in residency if they didn’t have the skills to become a doctor.
McKenzie said interns shouldn’t be afraid to ask questions of their senior residents. “Senior residents were in your shoes.”
Ramsey admits it was difficult at the start of residency to not be hard on himself. “There is so much perfectionist drama. It’s really hard for us to say: ‘I don’t know’…and say, ‘I’m going to find the answer’,” he said.
He also encourages residents to ask for help when they need it. “When you are feeling overwhelmed, communicate with the senior resident, chief resident, or program director that you need a break. It’s important for your success as a resident. There’s a lot of pressure on residents. We don’t want to show weakness, but that’s how you grow.”
Prepare for Life After Residency
Senior residents are also great resources when applying for a job. “Ask them what they like or don’t like about their job. Talk to physicians, attendings, and team leaders about what their work style looks like,” said McKenzie.
Colucci said residents should lean on their network and talk to current residency chairs and department leaders to understand contract negotiations, which are different whether doctors work for a hospital, a staffing company, or a contract management group.
Ask those in your network to be references. “Do not be afraid to be fully transparent.” Residents applying for a job should also weigh the benefits. “We focus so much on salary, but there are other things to consider,” said Colucci.
She also added that her priorities are different when applying for a job vs a residency. “The advice I’m giving myself is to consider family and long-term plans. While for medical school, the goal was to land the best education, and for residency, the goal was just to match.”
Job applications tend to be more geographically focused, and you may want social support with your first job, Colucci noted. She also advises residents to look at their quality of life. How much time will you have for friends and family? How respected is the hospital system? Will you have access to mentorship? Is there career development, or are you just a cog in the wheel?
Residents must also decide if they want to focus on academics, teaching, administration, or serving patients in a community. When finally going into practice or a fellowship, there are many choices and decisions to consider. Take the time to envision everything that’s important to you as you make choices.
Roni Robbins is a freelance journalist and former editor for Medscape Business of Medicine. She’s also a freelance health reporter for The Atlanta Journal-Constitution. Her writing has appeared in WebMD, HuffPost, Forbes, New York Daily News, BioPharma Dive, MNN, Adweek, Healthline, and others. She’s also the author of the multi-award–winning Hands of Gold: One Man’s Quest to Find the Silver Lining in Misfortune.
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Publish date : 2024-06-19 09:09:06
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