A new PGY2 needs advice.

[chicamedica]

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Ok all you seasoned residents out there. I just started PGY2. And I need some help on how to be an efficient resident.

1. How do you structure the day?

2. What do you use work rounds for? When do you walk round vs sit down round?

3. What are the things I should keep track of vs what the intern should keep track of?

4. What expectations do attendings have of residents (generally)?

In some ways, I find myself trying to be the intern i was a few months ago (which I got pretty comfortable and proficient at) in addition to trying to be the resident. I have caught multiple intern mistakes or things that had been forgotten in the past few days, but being so detail oriented is just too hard, and i probably end up not being as helpful to the interns as I could be. I also want to be more of a teacher than I have been--I've been too busy going through the to-do list and making sure everything has been done.

 

[orientedtoself]

hi chica,
it is a significant change in role going from r1 to r2.

structure of the day: i come in about the same time as the intern. i run all of the labs and vitals on the patients on the list to make sure nothing's horribly out of whack. then i try to see the 3-5 sickest patients on the service. i make sure that my intern knows to let me know if they are concerned about anyone.

i usually just run the list/ card flip rather than walk round with my intern(s), because we walk round with our attendings.

things to keep track of as a resident: you should have looked at everybody's labs and vitals. you don't necessarily have to write them all down, but it does help to have them written down to look at trends. i use the medfools scutsheet 2. i have printed them up on card stock and put them on a ring binder. it has room for a week's worth of labs, with the front side for their h&p info. also, residents dictate discharge summaries at my program, so keep track of procedures/ pertient studies/ dates.

some of your other responsibilities as an upper level resident are supporting your interns and teaching your team. i found it particularly difficult to change from the role of the intern, being taught, to the resident, who is supposed to be doing the teaching. it helps to come up with a couple of pre-planned talks on bread and butter medicine topics such as hyponatremia, chf. sometimes teaching works well on call days (when it's not busy) because the whole team is there. when you have an interesting case, take the time to print out a journal article on that topic while your intern is doing the work of admitting the patient. they will appreciate it.

think back to your favorite residents when you were an intern. my favorite residents taught me useful things about patient care, treated me like a human being, helped me when i was floundering or bogged down, gave me autonomy to make decisions, but also were available in case i had questions or wasn't sure what to do. some things i didn't like- lack of teaching by some residents, or being micromanaged. that's what i try to do- remember what i liked and didn't like about residents i worked with as an intern.

as far as the autonomy issue goes, you also need to get a sense of where your interns are. if they make good decisions and know when to come get help, you can give them more autonomy, but if you are concerned that they don't know what they're doing/ make bad decisions/ don't seek help, then watch closer. it is more than halfway through the year, so your interns should be up to speed!

hope this helps!
o2s

Ok all you seasoned residents out there. I just started PGY2. And I need some help on how to be an efficient resident.

1. How do you structure the day?

2. What do you use work rounds for? When do you walk round vs sit down round?

3. What are the things I should keep track of vs what the intern should keep track of?

4. What expectations do attendings have of residents (generally)?

In some ways, I find myself trying to be the intern i was a few months ago (which I got pretty comfortable and proficient at) in addition to trying to be the resident. I have caught multiple intern mistakes or forgotten things in the past few days, but being so detail oriented is just too hard, and i probably end up not being as helpful to the interns as I could be. I also want to be more of a teacher than I have been--I've been too busy going through the to-do list and making sure everything has been done.

 

[chicamedica]

Thanks o2s! that is really helpful info! a bummer is that the place i am rotating at, never has labs or vitals done around the time interns are prerounding. That is really annoying.

Also, what is your role in the admitting process? Do you have your interns present to you after they see the new patient?

Sounds like your style is to give your interns a lot of autonomy. That is nice, but how do you make sure everything was done? if something wasnt done, isn't it ultimately your fault?

Should i make plans to run the list with the interns at the end of the day?

 

[chicamedica]

um, there must be more residents out there that can offer advice. . .

or is it just applicant-talk this time of year?

 

[Rogue_Leader]

My resident brought coffee and donuts when we were on call on the weekend. I'd have taken a bullet for her 😉

 

[ANCAdoc]

My resident brought coffee and donuts when we were on call on the weekend. I'd have taken a bullet for her 😉

I did this when my IM team was on call during the weekends and I noticed it really brightened everyone's day. We all seemed to work better together on those days. It's amazing what little things can do.