? Re: "Wisdom from my first year as an attending"

[dotcb]

searched for threads on this, but didn't find any.

coming to the end of my final year of residency. wondered if any experienced attendings could share wisdom of useful things (personally & professionally, not so much medically) they learned in their first year out as an attending.

thanks in advance.

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[WilcoWorld]

I can't post a full-text link, but I found the article "Now That You're a Real Doctor: Lessons for Years to Come" by James Roberts to be a good (and short) read, even if I didn't agree with everything he wrote. See if you can track down a copy.

Possibly the most useful thing to keep in mind is just how freaked out you were when you worked your 1st few shifts in the ED as an intern compared to how you feel as a senior resident. You'll go through a similarly frightening learning curve as an attending (at least I did). And, just like they did in residency, things better pretty quickly.

 

[dotcb]

thanks - link to the article mentioned:

http://journals.lww.com/em-news/Ful...u_re_a_Real_Doctor__Lessons_for_Years.25.aspx

 

[DrQuinn]

Once you're in the ED you'll be at as an attending, call all the other docs by their first name. Even the caridologists, the CEO of the hospital, whoever. You're on level playing ground with them.

Buy yourself something nice with your first paycheck.

Q

 

[Daiphon]

You likely already know this, but your nursing & ancillary staff can either sink you or save your *ss... bribery works. You're an attending now, so you have (at least some) extra cash... buy pizzas/donuts/whatever, esp after a bad shift. It never hurts, and can always help (plus, then you get pizza/donuts/whatever yourself).

-t

 

[BKN]

searched for threads on this, but didn't find any.

coming to the end of my final year of residency. wondered if any experienced attendings could share wisdom of useful things (personally & professionally, not so much medically) they learned in their first year out as an attending.

thanks in advance.

1. You are likely too slow. Most new graduates need to become faster at seeing routine stuff.

2. You will have much less backup. Your old faculty aren't around to talk too. If you are single covered your only resources are e medicine, up to date and your consultants (who are not interested in being called to educate you).

3. Given #2, I spent my first two years staring at the ceiling going over what I had done during my shift. Finally I gave it up because I wasn't getting any bounces and it was too late anyway.

4. This was before all modern imaging but second generation scanning for head bleeds. Since ai was generally successful, I conclude that you can train yourself to be a clinician who doesn't need to image everybody to be right.

BKN

 

[Arcan57]

Standing up to your consultants and admitting doctors early makes future interactions a lot easier. If you're in the community, knowing who the patient's doctors are is not optional. Little pisses off your consultants like having other doctors steal their business.

 

[roja]

1. Do not underestimate the importance of charting. DOCUMENT well. And clearly. It is worth the time, particularly your MDM. document consultations. Nothing is real unless you document it. As a resident you don't focus on this as much. Don't learn the hard way.

2. Make sure you have a 'tail' coverage in your malpractice

3. Get disability while you are a resident. Its cheaper. And you never know what is going to happen.

4. Don't go in with a chip on your shoulder. Be nice. This doesn't mean let your consultants walk all over you.

 

[The White Coat Investor]

Live like a resident for a couple more years. Makes all the diffference in the world financially. You've got a lot of catching up to do after a decade of no income and lots of debt. Give it a few years to buy the attending house and the attending car.

Watch your reputation.

Do what's right for the patient, but realize there are many ways to skin a cat.

Don't be afraid to tell the patients "no" when they request something that isn't good for them (more narcs, more radiation, admission etc)

Load the boat.