Four long years after starting medical school, the contract is signed and your start date approaches. Residency is about to become reality, which can spark feelings of trepidation and excitement.
“It’s expected that you’ll be nervous,” says Caleb Scheckel, DO, who started his internal medicine residency at Mayo Clinic in Scottsdale, Arizona, in 2016. “That’s a normal part of the process in terms of transitioning from a medical student to the primary physician contact for a patient.
“But making that transition is also one of the most rewarding parts of your medical career. You’re getting the chance to do what you set out to do. You’re taking care of patients. And that’s exciting.”
Recognizing that intern year comes with a steep learning curve, Dr. Scheckel and four other DOs offer the following advice for new medical residents.
“An attending breast surgeon who I worked with told me to enjoy residency, because you go through it with such a sense of camaraderie with your other fellow residents,” says Mary McHugh, DO, a recent graduate from the Einstein Healthcare Network urology program in Philadelphia. “When you leave residency to join the ‘real world,’ it’s not the same, and it can get a little lonely.”
Be physically present
“When you work nights, you’ll often get calls, for instance, about a patient with shortness of breath,” says Kevin Hoffman, DO, a recent graduate of the emergency medicine residency program at Lakeland Health in St. Joseph, Michigan. “You need to get up and go see the patient. Not everybody does that, but it’s very important. You get a lot of information just by seeing the patient. How are they sitting in bed? Are they still, are they fidgeting?”
As a resident, Dr. Hoffman shared this advice with his new interns every year, in part because he believes it increases patient safety.
Give yourself a break
If he were starting residency over again, Dr. Scheckel says he would make sure to not be so hard on himself the second time around.
“Realize that you will gain the knowledge you need with experience and exposure,” he says. “Approaching residency is about having an eagerness to learn, not coming in with all the necessary facts. You will be exposed to things on the job, and you cannot learn these things from a textbook beforehand.”
Know that you’re not alone
As an incoming intern, you’re bound to have bad days from time to time, notes Tiffany Barkley, DO, a pediatric neurology resident at Children’s Mercy Hospital in Kansas City, Missouri.
“On bad days, you’re going to look at other people, and they are going to seem like they are fine and not struggling,” she says. “But realize that everyone is in the same boat. They just might not always show it. Never think you are alone, or that you’re the only one who has bad days.”
Get help if you need it
Many hospitals and residency programs offer staff support services that are often confidential, Dr. Scheckel notes.
“It’s OK to struggle,” he says. “Struggling is not a character flaw. It’s just part of going through a difficult process. If you feel you need help, use those resources. Having someone non-medical to vent to is an important part of self-care.”
Pursue work-life balance
Early in his residency, a mentor told Jesse Richards, DO, that the key to thriving in residency is finding non-damaging ways to cope with the stress.
“Whether it’s gym time, time with your significant other, or just quiet time on the couch, you have to find a healthy way to de-stress,” says Dr. Richards, who is an internal medicine resident at the University of Kansas in Kansas City.
Call colleagues by name
In the hospital, most staff will be wearing name badges. To avoid confusion and make your directives more clear, use staff members’ names whenever possible, especially when making requests, Dr. Hoffman says.
“This is really helpful when you’re working with nurses or staff who you haven’t met before,” he says. “If you say, ‘Sam, can you give me 0.4 mg of Narcan,’ that nurse will know he’s been given the direct order.”
Don’t put off long-term projects
Most residents will have several long-term projects to wrap up before finishing residency, such as quality improvement initiatives, research studies and online learning modules. It’s easy to put these projects off until later, especially in the chaotic first months of your training when you’re learning the layout of the hospital and the EHR system, Dr. Hoffman says. However, he personally wishes he had set aside more time earlier in his residency to tackle these projects. Instead, he devoted significant time to them during his last year.
“If I could start over, I would have carved out time once a week or once a month to work on long-term projects,” he said.