Things I Wish I Had Known Starting Residency

It is the first Monday of the month… You know what that means!?!  It is Medical Monday.  Use the handy-dandy button below to check out other medicine related blogs of all sorts involved in the blog hop!

Today, I decided to do a top ten sort of post.

I have had a chance recently to think about some of the things I wish I had known before starting residency.  But, when thinking about that, I realized that most of this stuff was actually stuff I had been warned about or stuff that I learned the hard way in med school too (I made a list of things I wish I knew starting med school last year). Clearly, I am a bad listener, at least on the advice front.

  1. Carry snacks and change for coffee in your pockets.  There are many, many times when you may have a delicious lunch waiting in your locker, but you just can’t get to it.  And you will get hungry.  And pre-syncopal.  Have food on-hand.  And be ready to buy coffee or snacks when you pass places that offer that opportunity.  Today was a no lunch until 2pm day and I really wished I had a snack with me… I had a single Cert.  Suboptimal.
  2. Have a pen and paper with you always.  You will get paged to see someone.  You will forget that person’s name or location should you not write it down.  Writing it down will also ensure you do get that info.
  3. Sleep when you can, eat when you can, pee when you can.  You would think it is obvious.  But, there are a million times where I could have laid down for a nap and wasted time reading blogs and wound up staying up the rest of the night with a sick patient.  Or when I had time to grab food or run to the washroom, but I waited because I would have more time in “a while,” but “a while” was a long while.
  4. On the way to a code, the first thing you should do is check your own pulse.  A tidbit from The House of God.  It is true.  You panic sometimes in the crazy situations.  Taking your pulse for that second on the way down the hall makes you focus on something aside from you nerves.  Especially those first few times.
  5. Don’t be afraid to call for help.  This is something I really struggle with.  I like to figure things out on my own.  But, when people’s lives are at risk and when you get stumped, it is better to ask for help sooner rather than later.  Lots of people know plenty about plenty of things… RTs are fabulous with helping with ventilation, nurses are a wealth of knowledge and radiologists can help you figure out all kinds of weird films.  Not to mention there is always a senior or a staff person available when things get hairy.
  6. With the power to write your own prescriptions and orders comes power… And fear… And signficantly more phone calls.  To minimize calls, it is useful to write legibly, add details where needed and discuss complicated orders and regimens with the people involved.
  7. Make time for yourself, your spouse and your friends.  It feels like you have time for nobody except work, but time with these people, even if brief can make you feel a world of better.
  8. The salary stinks.  Compared to the hours worked, you still make no money.  At least you can pay rent.  But, until you get the same pay for a 60 hour per week rotation for a 90 hour per week rotation, you realize it.  That and the fact that it still is tight for money.
  9. People don’t get residency.  They don’t get med school fully and residency is, in a sense even more bizarre because you are neither student nor staff physician.  Just get used to it.
  10. As dumb as you feel, everyone else felt approximately just as stunned (or they were cocky and potentially dangerous).  The stupid feeling is what protects you from doing far more stupid things.  Part of growing in knowledge is learning what you don’t know.
  11. It does get better.  I keep hearing this.  I do believe it… I think.

What residency wisdom do you have or did you wish you had?

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14 thoughts on “Things I Wish I Had Known Starting Residency

      • Hey Trish, thanks for your blog! I am an editor for a medical student blog in-training.org. We have an advice column and I wanted to ask if we could repost your piece “Things I Wish I Had Known Starting Residency” for a greater medical student audience. We would definitely link it back to your original post. Please email me if you’re interested!

  1. You’re so right! I’m always telling my husband to hurry up and go to sleep before his pager goes off!!!
    Thank you so much for linking up with us for Medical Monday!!! 🙂 I look forward to exploring your blog and reading more!

  2. My sister has would definitely agree with number 9. She had a few eye-rolling moments when she was in Kentville for the month and even the nurses weren’t sure what to do with a resident because they don’t usually have one. This is let alone explaining to the general public what a resident is and does!

    • I am sure!
      When I was in med school, I did an Internal Medicine rotation at a rural hospital in NL and they had no clue what the difference between a med student or resident was… I was there a week before I realized they kept taking verbal orders from me.

  3. So interesting to read your perspective! I’m always thinking about the things I have learned as the spouse of a resident, but boys (i.e. my husband, the resident) don’t talk about feelings/lessons learned as much 🙂 I think by now he has gotten #1 though – an item which I anticipated in advance and kept pressing protein bars and trail mix on him. Finally he listens and carries them! And big time yes to 8-11.

    • You are a good spouse to push the snacks! Essential, they are.
      11 is still a mystery to me because it is still so early on… But I embrace it most of all.

  4. Actually, there are some attendings that really ARE psychopaths and get jazzed thinking of destroying YOU. Read “Snakes In Suits” by Robert Hare PhD. Psychopaths exist – and they like to be around vulnerable people – and residents are vulnerable. Sorry, Charlie, but the world’s not all peaches ‘n’ cream.

  5. Pingback: How Did That Happen? New Series | At least we made it this far...

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