Family Medicine Vital Signs

By Lauren Wood, MD

Hindsight is 20/20, right?  As the end of residency nears, and I think back on the last 2 ½ years, it has both flown by and been slow as molasses.  As the saying goes “the days are long, but the years are short”.  This definitely applies to residency!  Sometimes, things have gone smoothly, sometimes not – overall, though, residency has been a very positive experience and a time of immense, critical professional and personal growth.  There are certain challenges specific to each year of training.  While I can’t go back and do things differently, I hope that my reflections on the more challenging parts of residency can offer insight for residents in earlier years of training.

 

Intern Year

• Don’t feel bad if you are uncomfortable calling yourself Dr. So-and-so. It’s awkward and unrealistic that we go from being medical students to full-fledged physicians in one day.  And it’s not exactly true either.  That’s what residency is for.  Practice using your title (sometimes it comes in really handy!!) but don’t feel bad if it feels weird.  By the time you graduate residency it will be second nature.
• Expect the first week of any new rotation to include a bit of shellshock. Each month, you will change specialties, facilities and colleagues, especially in Family Medicine training.  You will go from inpatient pediatrics to labor and delivery to MICU at different hospitals with different EMRs and work alongside OB, Peds and IM residents, who have way more experience in their respective fields than you do. You will feel like you know nothing for a few days – you might curse, you might cry, but you will recover and you will finish that month with great skills and with a great evaluation to boot.
• Lean on your co-interns, they understand what you are going through and they will be there for you.

 

Second Year

• Our R2 year involves increasing leadership responsibilities. This is a new role for most residents and can be terrifying.  A major roles as senior resident is overseeing our inpatient service and two interns. While I was sort of excited about this role, I was also nervous that I wouldn’t be able to keep track of all the patients, know enough, be able to do enough. What if the intern asked a question I didn’t know the answer to?  In retrospect, this was all fine.  It actually went well and was fun.  Medicine is a team sport and we all learn from each other.  You will learn different and important management skills.  There may be crises or conflict that arise.  Ask your attendings or R3s for guidance.
• There will be long shifts. Sometimes longer than 24 hours.  And you will be REALLY tired and feel like you can’t think straight.  You’ll shift from day to night shifts.  And you will be REALLY tired.  Sleep when you can, but if you can’t or if the lack of sleep is causing you to feel depressed, irritable or anxious – reach out.  It’s OK to take a sick day for this or go to bed at 7 PM. Really, it is.

 

Third Year

• This blog post is three weeks late currently. I’m teaching a didactic session in two days and I have nothing prepared.  I need to email someone back from a few weeks ago.  I haven’t read the journal article for journal club tomorrow.  I have three notes from clinic yesterday that I need to finish. I probably shouldn’t be freely admitting these things, but I have found this to be my biggest challenge in third year.  In addition to usual clinical duties, typically 8-6ish M-F plus occasional weekends, evenings and early mornings, there are many assignments. This is partly a challenge for me, because when I’m not at work, I’m on mom duty.  But, children or no, all residents have friends, families, hobbies that can make it hard to stay on top of all these tasks.  I can’t speak for anyone else, but when I have time off I want to ski, hike, travel and hang out with my family and friends – not do more work.  But, this is still residency, so I try to start early and set aside specific time to get things done.  You can get a lot done in one hour if you put your mind to it.
• Your job search will be stressful, but it will be okay. Getting the CV up to par, dusting off the suit you haven’t worn since residency interviews and remembering a time when you worked with a team and things went well can feel overwhelming.  You’re a nice person and a good doctor and someone will be really lucky to hire you.  And someone will hire you.

 

If I had to sum this up in a few sentences, it would be these:

• Residency is hard, it makes you tired and stressed but it is an instrumental part of your development as an independent physician. You will look back on it fondly, although the thought of doing it over again will make you shudder.
• It will be okay, even when it feels like it won’t. ALL residents in all specialties have days, weeks and months when they feel like quitting residency.  If you ask a co-resident, I bet they have thought it too and knowing that can be helpful.
• Reach out if you need help. Try to get exercise.  Prioritize your health and your important relationships.  Make a to-do list and focus on one thing at a time. Hang in there, learn and enjoy!

 

Check – blog post complete.  Now off to read the journal club article for tomorrow!

Lauren Wood, MD is a Chief Resident in the Family Medicine Residency Program at the University of Utah School of Medicine