Man. that's a hard question to answer. Very open ended too.
Agree with what Ipp06 said above. don't over think it.
Also, people write books about residency. Read them if you haven't already. I still do, all the time.
house of god (it's a satire though, so careful with that one), atul gawande's complications (i think that's the one he wrote while still a resident). More I can't think of right now off the top of my head.
Apart from that, there are a few things I wish i knew before going into med about residency. (Not necessarily medical school)
1. The learning never stops.
You don't know everything once you reach residency. My final year self could have told my first year self that. residency is also learning. It's work, but it's learning to work like a 'doctor'. yes, med school is a bit like that too. but it's not the same as working full time with resident hours and having the responsibility of looking after multiple patients a day for long hours. Each task may be easy and simple on their own, but juggling multiple things for multiple patients under time pressure, not so much.
You cannot hope to know everything there is to know about medicine in 4 short years. They seem like a long time. they're not. Scares me how much I don't know. At the same time, it means there's still challenges, there's still more levels to achieve. that's addictive too.
Research is always changing the field too.
So everyone is constantly learning new things too, or building on the old.
2. sacrifices.
your life is not your own.
i wish my family could understand that too, they do to a degree, but not fully.
I have..a family member that is in the profession. It makes me cry sometimes realizing that they completely understand the lifestyle and demands. they told me it would be hard to live as a doctor. i never knew what that meant until i became one. I mourn over the fact that, because of the path I chose to take, I may never be the parent i wish to be for instance. Time is greatest thing you can give to a child, but as a doctor, I'm always low on time.
We're still people and patients and staff understand that. But having to prioritize is hard. My patients need me too, it's weird in that sense. i often see them on the worst days of their lives or their families' and that's never lost on me. When they need my help, they sometimes really need it. Some days I go home on time, some days i go home hours after i'm suppose to. You run into emergency situations far more often in the hospital setting than you would in most other situations or jobs. with some exceptions.
My energy is not the same at home either.
Couch surfing and sleeping are now major hobbies of mine.
Most days at work are an adrenaline rush, so very naturally, on coming home I eventually crash. This may not be fair to family.
I may not call my mother as often as I should for instance. And no, she doesn't like it.
I don't pay as much attention to the millions of other small important things to my non-medical friends and family. which brings me to..
3. Some of your values and principles will change as you shift from being a 'normal' average Joe to a 'resident'.
some of my co-resident friends get married on a Saturday and it's back to work on Monday. There's no honeymoon. at least not directly after a wedding. It's a big deal to say most people. But it's one of those things that may become less of a deal as a resident. I don't know how to fully describe it. But my own values and principles on certain things shifted. i've changed. It has to be said that seeing life and death on a daily basis, sorta living on a knife's edge will change how you see a lot of other things. No honeymoon? big deal, no one's dying. If i was to really boil it down as an example. You end up trivializing many things that matter to those who have jobs that are not as intensive. It can clash with the expectations of the non-medical people in your life.
I've also lost track of the number of times i've had no time to eat. literally, no time. other things take priority. It's not deliberate much of the time, it's just that i forget. Is it healthy? no. I find strategies eventually, everyone does. like a big breakfast, because..as one surgeon told me on rotation, that's the only time you may have control over your own time. One guy I knew kept a bag of carrots and celery sticks in some random pocket.
4. medicine is not for everyone. not everyone will survive.
but most who survive medical school will survive residency. as in..8 or 9 out of 10. that means 1 in 10 probably not.
depends if you're glass half full or half empty. 1/10 can be a lot or not. as posted above - the reasons can vary for leaving residency.
this is why it's almost cliche, the saying of don't go in for the money, the prestige or for family.
It should be for you. Loving medicine and the learning of it, is a protective factor. A psychologist I met on rotations once told me that (as in, one that was on the psych team I was part of, not one I was personally seeing).
even then, i've met people who leave residency, even though they were brilliant doctors and went into it for the right reasons.
To be honest, that's okay. It's not a waste if you had the opportunity to experience a 'dream'. For these guys, the regret of not trying would be greater. And they gave it their all and realized it's not for them. And moved on in their own journeys, closer to what makes them happier.
Honestly. i'm at the point now too, where if I had to leave my career for whatever reasons now, I could survive it. I'd be sad, but it's a different kind of 'sadness'. It would be nice to be able to say..focus on my family for a change or travel, have more time for hobbies. There's a lot of possibilities still out there. this life is very draining of all my time and energy as it is, but I don't mind, i love what I do. But it comes at a cost. so, it's not the end of the world to me for me if I were to lose it. (not that i want to, I'd still probably have a melt down, but just saying - I could recover, I have other things that are important to me outside of medicine)
5. Never go into medicine unless you cannot picture yourself doing something else.
or the flip side. do it because it is the one thing in your life that will make you truly happy and satisfied and nothing else will.
quoting steve jobs, you spend 70% of your life working. Do something you're passionate about.
we say that because the pressures of work are hard. it's hard to envision that strain of looking after the sick and dying and knowing that you're responsible for that. (or in other words 'your skill set' makes you responsible, which you've been trained to have and you've been hired by a hospital for) if you don't enjoy it, it will break you. even for those who do love it..sometimes it does.
6. emotional toll
mistakes:
As a student, failing things, missing a question on a exam can seem like a big deal. And it can be, as it affects your career. Not downplaying this. But mistakes as a resident/doctor are not the same. I feel callous telling students it's not a big deal if they missed that question on that exam or if their school wrote it wrong etc. But some of the mistakes I make as a resident can be deeply painful. I'd rather have made a mistake on an exam than one that affects my team or my patient and their families. i can't take them back either. It happens when you grow to care about your patients and their families. they also haunt you. But they make you a better doctor too. because you'll remember every time you come across a similar case (which is often). even the small ones. If you're going to make mistakes (not that we all plan to) do them as much as you can as a student. As in..try things. Do as many practice questions as you can. Ace the exam not for yourself alone, but for your patients and co-workers of the future. See as many patients as you reasonably can as a student. It's not going to be the same once you're a resident. People also have very different expectations of you.
Cost:
It's often said of this career that you must love what you do (to a certain degree at least).
And that you must be caring (at least to a degree). what they don't tell you is the cost of that is your own pain. How you feel when things go wrong and they'll go wrong a lot - people are sick. whether it's in your control or not. I don't get attached to all my patients, but i get attached to some. I still cry over some cases. I get thicker skin over many 'small' things, like getting flak for mistakes, getting over 'small things'. big things never get easier. I've lost track of the number of times I've 'seen' death or new diagnoses of cancer. But unexpected or 'bad death's never get easier, although death as a whole does. Unexpected terminal diagnoses in the young, never get easier.
7. working with people in a close, intense environment is not easy.
there's always going to be work place politics, and it will never be formally taught to you as a student.
self explanatory. everyone can have bad days, grumpy days etc. you deal with it. you learn to be mature about it. and you learn to keep your own personal problems and personal life separate, or at least the degree that it doesn't affect your work and how you treat others at work. it's being professional. it's hard sometimes. it's easy to write about or say. for every emotion or reaction i may have, i think about it and then respond if even a response is necessary. it's important to remember this in communicating with staff and other disciplines. particularly those with different training.
if you flip to other threads, communication with nurses comes up as important to the intern year. it seems easy. you realize it's not once you're working. it's different training. they always outnumber you too. also, they're actually stuck with your patients. you spend maybe a tenth of the time they do with your patients. making their lives easier, will make your life easier too.
patient interactions can vary. it does get exhausting how much energy i need to pour into making therapeutic relationships fast. It could be simple as making some kind of connection. But I need their trust for me to treat them and convince them that for instance, they have diabetes and that needs to be treated even if they don't 'feel' they have high blood sugar. Or high blood pressure etc. i need their faith that they require treatment of some kind and that i know what I'm doing. it's also hard to explain complex things, and churn it into layman terms, but sometimes that becomes the easy part. You don't always have as much time with your patients as you think you will as a resident. Unless your patients are very sick.
*Addit: People will take things out on you sometimes, because of the nature of the job and the environment. Whether it is your fault or not. whether fair or not. I try to look at the bigger picture - I'm dealing with people's lives. It makes it high stakes and thus high stress. It's not fair that my patients are sick either, it's not their fault necessarily (arguably anyway). So, emotions can run high. Anger can get misplaced. It's a reminder that we're human after all. it's hard to know how to react sometimes and harder still to absorb that and respond appropriately or respectfully. It's important to not blame yourself, to move forward and to be able to forgive. To take every situation as a lesson whether in becoming a better doctor, or more a compassionate one. It's hard to explain.
8. Coping.
everyone has their different mechanisms. What worked for me, will not be same for everyone.
In general, the ability to debrief over matters that upset me is essential. Whether it be through a mentor (someone above your level) or peers (coresidents etc.). Some prefer to keep their coping mechanisms and personal lives completely separate from their medical lives/work, so they may choose not to have their support networks be medical based. I needed the ability to talk to someone who understood what I was going through. And vice versa for some of my co-resident friends. It helped to hear their problems. It helped to know I wasn't alone, it was therapeutic too to say I'd been through the same. To say, here are the strategies that worked for me. Let's get through this, together.
Never let yourself be isolated as a resident. This life is hard for many reasons, you are human, and you need human connections to make yourself feel grounded. To have resilience. this job, can make you feel less than human. the personal connections you foster, whatever they are, will remind that you are human and it's okay. mistakes happen. someone cares for you. etc. etc.
Having hobbies is important, lost track of how many times this was told to me. interests outside of the job, to get your mind off the job is important. you're not a machine. Medicine should not be your life entirely. Again, there's always the inherent risk of losing your job. try to imagine and have things, that can fill your life outside of medicine. The hobbies also keep you sane.
Ability to separate yourself from your job.
remembering and recognizing your own needs is perhaps essential to knowing how to cope.
There's a balance to things, that i'm still trying to figure out.
9. The intern year can be mind numbing.
You literally feel like you have no idea what you're doing. there's whole threads on this.
Scrubs parodies this in its first episode, as does Grey's anatomy.
TL;DR: Living the life of a resident or doctor is hard in ways you may never know until you experience it.
ie. emotional tolls on the job, workplace politics, intense environment, life or death situations that change who you are inside, and constantly having to choose between what matters to the job and things outside of it. Family may end up taking a second place a large proportion of the time. It's ironic in a way, when coping requires having strong support networks. A connection or reminder that you're human and you're still you. it's easy to get lost and become forgotten, when you become a cog in the machine.
Disclaimer - my own reflections, may not reflect every other resident's. it really depends on your own outlook and experience.
It's another one of those cases where everyone will have a different take.
Edited for grammar/clarity
