Sage Advice for New Residents

[Taco-tsubo]

Hello SDN,

Long time lurker, occasional poster, and newly minted doc starting residency soon. With the new stage in career/life, I've recently changed my username -- not that my last one was well-known anyway.
I was inspired by an earlier post about "What should I know so I don't harm patients?" as it reminded me of one of my more fun interview questions. (That is, a question that I got to ask my interviewers). Maybe this will be inspirational to other PGY-1s (and beyond!) too.

"If I never met you again, what is one piece of advice you would have for me in regards to life, EM, and/or life in EM?" Anecdotes, stories, etc. are welcome.

Most of the answers were, as you can expect, about "balance" and about how there's "more to life than medicine." Of course, all answers were elaborated on. But a points few stuck out:
"Find your place, wherever it is and whatever it might be."
"Roll with the punches."
"Pay it forward. Give back in the same way that was given to you" --gamerEMdoc
(Please forgive any paraphrasing)

-Taco-tsubo

P.S. Yes, I've read House of God. I'll just go ahead and assume that The Laws are already spoken for.

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[alpinism]

Always resuscitate before you intubate.

 

[alpinism]

Positioning is everything for procedures.

 

[deleted245139]

A few
1. See peds. A lot of peds. Get comfortable with peds
2. You can't see too many patients during residency. Push yourself
3. Find a niche.
4. Find a mentor
5. Set goals - and ones you can attain... To see one more patient the next shift, to get your charts done on time, etc... It's the only way you grow
6. Embrace what scares you. For me? Seizures freaked me out for whatever reason... So first month of intern year I saw every seizure possible.

Most importantly- enjoy yourself. I had a blast in residency.

 

[miacomet]

1. Save some money, even in residency.
2. Try and put some money in a Roth IRA (hopefully your income will never be this low again) or a 401k, especially if you are one of the lucky few with a match.
3. Sign up for PSLF- you may not end up using it, but if you do, you will be 3-4 years ahead of the game when you graduate.
4. Have kids whenever you want. Don't delay for financial reasons. This can lead to heartbreak.
5. Start thinking of an exit strategy and find a mentor who can help you.
6. Remember that debt is bondage, and you want to escape it ASAP. Start thinking of how.

 

[chrisjohn]

1. Keep your mouth shut.
2. Destroy the in-service exam.
3. Medicine is unforgiving. Tiptoe around staff.

 

[miacomet]

1. Keep your mouth shut.
2. Destroy the in-service exam.
3. Medicine is unforgiving. Tiptoe around staff.

Agreed. Hence, exit strategy.

 

[surely]

1. Keep your mouth shut.
2. Destroy the in-service exam.
3. Medicine is unforgiving. Tiptoe around staff.

Can you tell me more about the value of destroying the in-service exam? Is it just "makes you look better for chief and increases your chance of passing your boards"?

 

[Birdstrike]

Spend more time with your family and significant other than you think you and they need.
Spend less time at work than you think you need to.
Spend less money on a house than you think you need.
Save more money for the future than you think you'll need.
Exercise.
Take care of yourself.
Avoid drugs, excessive alcohol and cigarettes.
Wear your seat belt.
Be aware that the past wasn't as good as it seems, the present isn't as bad as it seems and the future will be better than it seems, if you commit to making it that way.

 

[RustedFox]

Spend more time with your family and significant other than you think you and they need.
Spend less time at work than you think you need to.
Spend less money on a house than you think you need.
Save more money for the future than you think you'll need.
Exercise.
Take care of yourself.
Avoid drugs, excessive alcohol and cigarettes.
Wear your seat belt.
Be aware that the past wasn't as good as it seems, the present isn't as bad as it seems and the future will be better than it seems, if you commit to making it that way.

... and take your vitamins and say your prayers like a good little Hulkamaniac should.

I couldn't resist.

 

[emergentmd]

You will learn the medicine part, it is easy.

Learn the business part of medicine
Learn how your high $$$ should allow you to slow it down in 15 yrs
Start on a Exit plan. You may never want to exit, but it is nice to be able to
Always have back up plans and options. You may think you have a great job today, but it doesn't hurt to have connections if that great job turns sour and it usually does one day.

 

[RustedFox]

You will learn the medicine part, it is easy.

Learn the business part of medicine
Learn how your high $$$ should allow you to slow it down in 15 yrs
Start on a Exit plan. You may never want to exit, but it is nice to be able to
Always have back up plans and options. You may think you have a great job today, but it doesn't hurt to have connections if that great job turns sour and it usually does one day.

Bolded, italicized, and underlined for truth.

 

[chrisjohn]

You should realize that the in-service is important because your program director thinks it's important, your residency program is rated specifically on how many residents become board-certified without any delays. The upshot is that high in service scores correlate with high board pass rate, your program director will like you and not give you any static.

Never saw anyone with good in service scores let go. Every resident I ever knew of who was canned had poor in service scores.

 

[bravotwozero]

You should realize that the in-service is important because your program director thinks it's important, your residency program is rated specifically on how many residents become board-certified without any delays. The upshot is that high in service scores correlate with high board pass rate, your program director will like you and not give you any static.

Never saw anyone with good in service scores let go. Every resident I ever knew of who was canned had poor in service scores.

Or at the very least, do well on the in service in the first two years of residency, to keep the PD off your back. I was right at the national average the first two years, but totally winged in service studying in my final year because of senioritis and tanked it. But by the time the scores came out, it was late in the game and you're almost about to graduate. Actually put in my time to study for ABEM after residency, and did fine.

 

[surely]

Thanks, everyone. I've fortunately always been a solid test-taker, so I think I'll do well as long as I put in the work.

 

[migm]

just to reiterate - that patient that you see check in with that complaint you're like "crap I hope someone else signs up for that" - see that thing until its boring to you. You will thank yourself later when you're the attending, and you don't have that feeling.

 

[Groove]

Keep your head down and don’t rock the boat. Grow thick skin and always remember that you only have to put up with residency for 3-4 years and then you’re done. Don’t be an idiot and do anything to jeopardize residency. Nail the in-service exams. Be a team player. Do what your told. On the bad days just focus on the light at the end of the tunnel. Life takes a dramatic turn for the better after residency...as does your paycheck.

 

[miacomet]

Keep your head down and don’t rock the boat. Grow thick skin and always remember that you only have to put up with residency for 3-4 years and then you’re done. Don’t be an idiot and do anything to jeopardize residency. Nail the in-service exams. Be a team player. Do what your told. On the bad days just focus on the light at the end of the tunnel. Life takes a dramatic turn for the better after residency...as does your paycheck.

I wouldn't say life is better after residency except for the paycheck. You end up having a ton of responsibility yet very little power.

 

[GonnaBeADoc2222]

Yes, you want to keep your head down, but don't let yourself get walked all over on by nurses and other staff. Stand up for yourself.

Don't just do above average on the in-service exam. Murder it. Attendings talk (oh, believe me, they talk) and they will trust you more on shift if they perceive you to be intelligent.

Never, ever give up an airway to a midlevel, paramedic student, etc. Yes, when you are a senior you will give up airways to your juniors as you are teaching them. Be extremely aggressive during your anesthesia month to get airways. Shut your mouth and learn from the anesthesia attendings (notice I said attendings) - they are better at this than we are. This is the most important procedure we do. If you mess up, people die.

Be that resident that when the attending sees your name on the schedule alongside their's, they say "niceeeeeeee!" instead of "shiiiiiiiiiiit."

 

[BoardingDoc]

I wouldn't say life is better after residency except for the paycheck. You end up having a ton of responsibility yet very little power.

I feel like this scenario is more a result of a poor work environment than the nature of EM itself. I have never shared this sentiment, but I also happen to love the shop I'm working at. It does raise the point (less for new residents, more for graduating ones) that it is extremely important to be selective about where you decide to work as an attending, and if you find yourself in a ****ty job, it is entirely normal to GTFO.

 

[miacomet]

I feel like this scenario is more a result of a poor work environment than the nature of EM itself. I have never shared this sentiment, but I also happen to love the shop I'm working at. It does raise the point (less for new residents, more for graduating ones) that it is extremely important to be selective about where you decide to work as an attending, and if you find yourself in a ****ty job, it is entirely normal to GTFO.

It's true some places are better than others. But I honestly think this is true for any hospital-based specialty. You are inherently replaceable as you don't have a patient panel that you can take with you, thus making an ED doc essentially powerless.

 

[Brigade4Radiant]

You only do two days of residency the day you start and the day you leave.

Residency is brutal just get through it and enjoy being an attending. If you can’t be satisfied with more free time and more money I don’t know what to tell you.

 

[s109442]

Call your mother. Have more sex. Exercise outside. Plan a trip to somewhere exotic - it’s not expensive

 

[Psai]

Call your mother. Have more sex. Exercise outside. Plan a trip to somewhere exotic - it’s not expensive

These are unrelated, correct?

 

[s109442]

These are unrelated, correct?

LOL!