Nervous to become a senior resident

[Noopers16]

Hello,

So I’m a family medicine intern about to be finished with intern year. I’m going to be completely honest here, I’m am so scared and nervous about becoming a senior resident next year. I just don’t feel like I know enough to lead a team of new interns. A little background about me, I did okay in med school. I passed all my classes and passed step 1 and 2 on the first try, but I was never a stellar student. Intern year, I feel like I was about the same. I got good evals from my rotations and from my faculty and PD, but I know I’m not the genius of my class.

I guess I’m just freaking out, because I still have so many questions about how to treat patients, and there are still things that I miss on patients. I’m constantly questioning the decisions I make in the hospital and I feel like I’m constantly asking my senior questions. At this point in my residency, I feel like my knowledge deficiency is just too large to lead a team. Like if I actually got called to a code and it was just me and my intern, I feel like I won’t know what to do in certain situations.

I’ve brought this concern up with faculty and my PD and they all tell me that I’m going to do fine and that they aren’t worried about me. I guess this is my imposter syndrome, but I just feel like they just being nice, and don’t know my actual knowledge deficiency because they haven’t been around me enough.

I don’t really know what to do at this point. The thought of leading a team next year actually keeps me up at night sometimes thinking about all the ways that I may fail them. Is this a normal reaction? I’ve searched all over for similar questions about being nervous to become a senior resident and I can’t seem to find any similar posts.

Also, my program is shutting down and I’m having to move to another program for my 2nd and 3rd year, so I think that may be where some of my anxiety is coming from as well.

Any input/advice would be much appreciated! Thank you

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[Raryn]

Hello,

So I’m a family medicine intern about to be finished with intern year. I’m going to be completely honest here, I’m am so scared and nervous about becoming a senior resident next year. I just don’t feel like I know enough to lead a team of new interns.

[...]

Is this a normal reaction? I’ve searched all over for similar questions about being nervous to become a senior resident and I can’t seem to find any similar posts.

It's a normal reaction. You think you don't know a lot and (compared to when you're done with your training entirely) you don't. But when the new interns come in, you'll realize just how much you have learned this year. No senior resident is completely on their own, and your attendings will be there to keep things on track.

Also, my program is shutting down and I’m having to move to another program for my 2nd and 3rd year, so I think that may be where some of my anxiety is coming from as well.

Any input/advice would be much appreciated! Thank you

Yeah.. that's a bit more of a concern when it comes to the transition. Your problem when you start is going to be systems issues - during intern year, you not only learn the medicine, but you learn that for XYZ service it's easiest to call ABC, you learn that nurses on floor Q are better than nurses on floor P, etc. Relearning that at a new hospital while transitioning to your new role is going to be tougher than average. That said, people do it all the time, and you'll probably be fine. Just expect to work long hours your first few months until you get settled.

 

[Donald Juan]

Just wait until all those dumb interns start in July. You'll be too annoyed with how little they know and having to check up after them to have time to worry about how little you know.

 

[lulu09]

Agree with the two posts above.

Once the interns start, you'll see how much more you know compared to them. As for leading codes, just approach them like you're answering a clinical scenario question on Step 3 or what not -- always try to stay one step ahead. Vitals, ox sat, cardiac monitor, monitor the airway!!

Your biggest adjustment will be from moving to a different hospital, but don't hesitate to ask questions and be nice to the staff.

 

[deleted859535]

As an attending: I never worry nearly as much about the people who are nervous about the next step as I do the people who aren't.

 

[Psai]

As an attending: I never worry nearly as much about the people who are nervous about the next step as I do the people who aren't.

I'm never worried.

 

[gutonc]

I'm never worried.

If I had to guess, I would say he was specifically referring to you.

 

[cbrons]

Like if I actually got called to a code and it was just me and my intern, I feel like I won’t know what to do in certain situations

I wouldnt worry too much about codes (as in code blues/cardiac arrest). By the time you get called to a code, the worst thing that could happen already happened (patient dead). You also can fall back on just reading off an ACLS algorithm card or paper.

What you need to be far more concerned about is knowing what to do at those stat teams/rapid response calls. Situations where what you do might determine whether or not someone will code.

 

[instantkarma]

when i began my pgy2 first day on the floor i arrived 2 hours early and reviewed the charts of all patients to be on my service (pgy1's and me) i made appropriate cards on each patient. it became second nature to check on everything my juniors were doing. i usually stayed longer every day reviewing charts/patients so hopefully nothing fell through the cracks. efficiency and organization are key as well as knowing what is important.

can never assume the pgy1's will do everything correctly or not overlook things. in time you will know who is stronger and who is not.

am sort of glad there was no internet then because barely enough time in every day as it was.

 

[instantkarma]

Agree with the two posts above.

Once the interns start, you'll see how much more you know compared to them. As for leading codes, just approach them like you're answering a clinical scenario question on Step 3 or what not -- always try to stay one step ahead. Vitals, ox sat, cardiac monitor, monitor the airway!!

Your biggest adjustment will be from moving to a different hospital, but don't hesitate to ask questions and be nice to the staff.

codes typically become second nature during the pgy1 year

 

[Raryn]

codes typically become second nature during the pgy1 year

Varies immensely from program to program. I didn't run a single code till I was a pgy2. I helped out as an intern - but it doesn't become second nature until you're the one in charge for a couple.