Monday, June 29, 2009

More Advice you Never Wanted to Hear: Residency

Holy shit, new residents are starting on Wednesday! Residency, for me, was such a far cry from medical school. When I started residency, it was back in the "dark ages" of medicine. Read: prior to the (oh so benevolent) 80 hour work week. That's right. I worked 120 hour weeks in my first 2 years. Uh huh. I'm the monsta. But seriously...I did have weeks when I was on call Monday, Wednesday, Friday, and Sunday. 36-48 hours on, 6-8 hours off. It was unbelievable. Surreal. I often fell asleep in my bed after a (much needed) shower with a Smirno.ff Ice or Be.er in my hand. I remember holding a retractor for a vag hyst, in an oncology case, at 9 pm, when I was post-call. I had tears streaming silently under my surgical mask. I thought I was going to die. But, guess what? I did not die. Not physically, anyway.

Residency isn't as hard as it used to be, but the principles remain the same. Work. Your. Ass. Off. I mean that. In order to be a good intern/resident, you'd better work (now turn it to the left). Pay attention in morning rounds. Make check boxes and lists. Make sure the labor and post-partum floors are taken care of when you are the OB resident. Be sure that all Gyn cases are covered, pre-opped, and post-opped when you are the Gyn resident. Be everywhere at every time. Seriously. I mean this.

A good resident knows his/her patients. Labs are checked often. Notes are written. Labor progress is always recorded. Gyn patients are rounded on 4 hours post op, AM, and PM. Know your patients better than the attendings know them. Be able to regurgitate labs, post-op blood loss, and diet orders. Help your fellow residents and interns. Don't throw people under the bus. Work as the team. If someone isn't sleeping, then *no one* is sleeping. Divide and conquer. Be nice to the nurses. Round on the floors and give universal "Wal-Mart orders" to the floors before you try to lay down (IE. if they can buy it at Wal-Mart ~heating pad, Tylenol, Tums, fan~ they can have it!)

Help your junior residents, and teach them how to run the board. There is no such thing as a "little" case. Scrub in on as many surgeries as humanly possible. I don't care if you have seen a million c-sections, scrub in on the next one....it may be a C-hyst. You need as much surgical exposure as humanly possible. Especially now in the restricted 80 hour work week.

If you have to do research for your residency graduation...do it NOW. Do not wait until your Senior year when you are trying to interview for jobs, study for written boards, and get licensed. Do the research early. Just suck it up and do it. Be good to your nurses, and they will be good to you. Don't whine. Don't ever let them see you cry. Stick up for yourself. Enjoy your time off. If you are considering a family, residency is a decent time to have a kiddo. Just be ready for the way your fellow residents will treat you. Especially if you are in a small program. No one wants to work more than they have to work, but you may never have so many people to cover your absence again. Don't delay your personal and family life for residency. Take care of yourself. Don't eat those fries with a grilled cheese at 2 am because you "deserve it." Exercise. Leave your job at work. Stay in touch with family and friends.

Learn as much as you can. When you go out into the "real world" you will wish that you did more surgery and paid more attention in clinic. Even when it sucks, you can do it. Even when you think you won't make it, you will. One day you will look back and 4 years of residency will be over...seemingly instantaneously. You can do it. One foot in front of the other. Life on the other side is good. Keep moving.

16 comments:

Prisca: said...

I am humbled by your residentcy experience and will try not to B**** about my crazy shifts anymore. You ARE the monsta! ;)

Taking Heart said...

Wow... thanks for mentioning twice, "Be nice to the nurses!" Doctors who treat nurses well, allow nurses to feel safe in their own practice... an approachable MD benefits everyone!

And... Universal Wal-Mart orders!!!!! Love. it.

Joy said...

Love it- "Walmart Orders"!!!

ER's Mom said...

Walmart orders are great for the residents smart enough to respect the nurses.

The residents who didn't learn that lesson early were still paged at ungodly hours...3 out of 4 of us in my class were never paged for stupid stuff. You can guess the attitude of the fourth. :)

Anonymous said...

Thank you so much for the inspiration! I am currently a pre-med student, but some of my older friends were trying to talk me out of becoming an ob/gyn, because I would let my life pass me by. Thank you for showing me the other perspective and saying that you are able to have a family if you really want to. You really show that life doesn't have to be on hold for over a decade, that you can pursue all your passions!

Anonymous said...

someone should also mention be good to a PA and a PA will be good to you!

Fat Doctor said...

Dang, I'm long past residency but this was so inspirational! I think I should be a doctor!

Anonymous said...

I agree with all the above. With regards to the "be nice to nurses and staff" mantra...this is also correct, but also expect respect in return...as a resident it annoyed me to no end when I was as nice as possible to unit clerks and nurses and all I got was a sneer and a snide remark. Stick up for yourself.

Anonymous said...

My senior told me, "listen to the nurses--they'll save your a*&" In my residency this was sometimes true, sometimes it was more like anon above--they didn't like female residents AT ALL. But it never hurts to be nice. After all, you're the better person that way.

Old MD Girl said...

Not sure why we wouldn't want to hear any of this.... it was all very good advice.

amanda said...

i like the bit about not treating yourself to the grilled cheese and fries because you deserve it....in my first two years i treated myself to lots of those, and told myself exactly that - and put on 20 pounds. starting third year now - and finally got rid of it - but only after skipping out on lots of midnight binges!

Anonymous said...

well said.

medobsession said...

Thanks so much for this post! I was lucky and got to start out in clinic. But in just a few weeks I will be on the floor and know what it's like to be a part of team. I esp. like the part about taking time for family too. I'm newly engaged and want to make sure that I can be a supportive wife. I'm saving this post to re-read before then!

ditzydoctor said...

this was so inspirational! :) there is hope on the other side after all :) thank you :)

Anonymous said...

I know you posted this a WHILE back, but I'm at the very beginning of my journey to OB/Gyn land (freshman in college!) and am grateful for ANY glimpse I can get at what could be my future life!!! Thank you!

Anonymous said...

Best post ever.