Tell me what you wish someone would have told you....

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

DocDiva

Full Member
10+ Year Member
15+ Year Member
Joined
Jul 6, 2007
Messages
14
Reaction score
10
In retrospect...any advice or words of wisdom you wish you had gotten before you started your residency? Besides "enjoy your time off now"

Books you wish you would have read? Things you wish you would have bought?

Members don't see this ad.
 
  • Like
Reactions: 2 users
A pgy-3 urology resident told me "Residency can take over your life if you let it. Pick a couple things you refuse to give up. For me it was exercise." I thought that was very good advice.
 
  • Like
Reactions: 5 users
Take full advantage of all psychotherapy training and supervision. You can always ready about a drug in a textbook/journal article/manual. It's hard to get additional training in psychotherapy after residency
 
  • Like
Reactions: 4 users
Members don't see this ad :)
Few pearls I've heard or experienced:
1) Find your passion and run with it - in psychiatry you should have the time. If it's fitness, traveling, research, teaching, or screen writing, make sure to take some time for it.

2) Bring/keep a spare pair of socks/underwear at work. Unforeseen storms happen and sometimes a fresh pair of socks makes all the difference after 24 hours on call for the trip home.

3) Read when you can (particularly if you take public transport), you'll get several free journals as a resident and you can always look up interesting cases. Reading books that have even the mildest relationship to psych can be great topics with better read attendings. Movies related to psych can be a big deal with relating to medical students as well.

4) Have friends in other specialties, it can really put things into perspective after a tough day and you'd be shocked at the amount of respect you'll get from neurosurgeons who literally work 2x as many hours as you.

5) Strongly bear in mind professionalism. Residents (and attendings) are almost never admonished for poor medical knowledge but any perceived or real lacks in professionalism can be a huge deal. Get notes done promptly, dress well, and care about your patients. Feel free to get down like a clown after work as long as it's a big enough city and those actions aren't tied into work, but keep it off social media!
 
  • Like
Reactions: 6 users
Thank you for the advice, really appreciate it.

I've been reflecting quite a bit on the interview trail (BTW- if that doesn't make you reflect on your past, not sure what will!). A lot of the mistakes I've made were because I didn't know better.
Hind sight is always 20/20 and I would like to approach residency as prepared as possible so gathering any and all info. Hopefully this thread will help others as well!
 
  • Like
Reactions: 1 user
Few pearls I've heard or experienced:
1) Find your passion and run with it - in psychiatry you should have the time. If it's fitness, traveling, research, teaching, or screen writing, make sure to take some time for it.

2) Bring/keep a spare pair of socks/underwear at work. Unforeseen storms happen and sometimes a fresh pair of socks makes all the difference after 24 hours on call for the trip home.

3) Read when you can (particularly if you take public transport), you'll get several free journals as a resident and you can always look up interesting cases. Reading books that have even the mildest relationship to psych can be great topics with better read attendings. Movies related to psych can be a big deal with relating to medical students as well.

4) Have friends in other specialties, it can really put things into perspective after a tough day and you'd be shocked at the amount of respect you'll get from neurosurgeons who literally work 2x as many hours as you.

5) Strongly bear in mind professionalism. Residents (and attendings) are almost never admonished for poor medical knowledge but any perceived or real lacks in professionalism can be a huge deal. Get notes done promptly, dress well, and care about your patients. Feel free to get down like a clown after work as long as it's a big enough city and those actions aren't tied into work, but keep it off social media!

Excellent work there mate.
 
Don't be afraid to push back on things when you can, if it's reasonable. You are the only person who values your personal time. Everyone else values their own, so will not hesitate to dump work on you under the guise of, "training" or, "learning opportunities".

Two, don't mistake legimate education and training for, "extra work" that frees up someone else.

Third, don't neglect to develop your EFFICIENCY in parallel with your PROFICIENCY.

Fourth, don't get too caught up in diagnostic labels. Ultimately, your diagnosis depends on what the patient tells you, and patients are biased and inaccurate in what they report. Concern yourself more with the symptoms they present with, the impairment or distress they cause, and what treatment methods make reasonable sense.

Fifth, it's never all biologic. Humans aren't that simple. Pay attention to the other stuff too.

Sixth, don't neglect your education in medicine. I cannot stress this enough. Don't go to your medicine wards saying, "Derp a derp I'm a psych intern I don't need to know nuttin!". The ER will try to admit psych patients with acute medical problems or patients with acute medical problems presenting with psych symptoms straight to you. You need to know enough to catch it. You also need to know enough that, when medicine or neuro, "rules out" any medical problems and tries to explain a patient's symptoms as psychiatric in nature, you understand when it isn't and can push back. Psych can sometimes become the default explanation for a bizarre medical presentation when people can't figure out exactly what's going on.

I'll reiterate the, "Three Rules of Psychiatry" a mentor once told me. I try my best to live by these rules.

1) The patient is the one with the disease
2) The patient is entitled to his or her illness
3) The psychiatrist goes home at 4:30
 
Last edited:
  • Like
Reactions: 18 users
Don't be afraid to push back on things when you can, if it's reasonable. You are the only person who values your personal time. Everyone else values their own, so will not hesitate to dump work on you under the guise of, "training" or, "learning opportunities".

Two, don't mistake legimate education and training for, "extra work" that frees up someone else.

Third, don't neglect to develop your EFFICIENCY in parallel with your PROFICIENCY.

Fourth, don't get too caught up in diagnostic labels. Ultimately, your diagnosis depends on what the patient tells you, and patients are biased and inaccurate in what they report. Concern yourself more with the symptoms they present with, the impairment or distress they cause, and what treatment methods make reasonable sense.

Fifth, it's never all biologic. Humans aren't that simple. Pay attention to the other stuff too.

Sixth, don't neglect your education in medicine. I cannot stress this enough. Don't go to your medicine wards saying, "Derp a derp I'm a psych intern I don't need to know nuttin!". The ER will try to admit psych patients with acute medical problems or patients with acute medical problems presenting with psych symptoms straight to you. You need to know enough to catch it. You also need to know enough that, when medicine or neuro, "rules out" any medical problems and tries to explain a patient's symptoms as psychiatric in nature, you understand when it isn't and can push back. Psych can sometimes become the default explanation for a bizarre medical presentation when people can't figure out exactly what's going on.

I'll reiterate the, "Three Rules of Psychiatry" a mentor once told me. I try my best to live by these rules.

1) The patient is the one with the disease
2) The patient is entitled to his or her illness
3) The psychiatrist goes home at 4:30

This is probably one of the best posts on this forum and quite succinctly dispels 90% of the BS you get.
 
  • Like
Reactions: 1 user
I'll reiterate the, "Three Rules of Psychiatry" a mentor once told me. I try my best to live by these rules.

1) The patient is the one with the disease
2) The patient is entitled to his or her illness
3) The psychiatrist goes home at 4:30
I would like to buy this as a framed poster for my home office please. Thank you.
 
  • Like
Reactions: 1 user
I'm loving this advice! Especially the 3 rules of Psychiatry - I would also like to purchase this framed!

Thank you :)
 
I would like to buy this as a framed poster for my home office please. Thank you.

I'm loving this advice! Especially the 3 rules of Psychiatry - I would also like to purchase this framed!

Thank you :)

I can't offer you a nicely framed version, but if you give me some time I could probably put together something reasonably professional looking that you could print out and buy a frame to place in. :)
 
  • Like
Reactions: 1 user
I can't offer you a nicely framed version, but if you give me some time I could probably put together something reasonably professional looking that you could print out and buy a frame to place in. :)
You have to buy yor own frame?! That's how they get ya.
 
  • Like
Reactions: 2 users
I'm scared that I'm going to look so dumb as an intern. I feel like I'm barely going to know anymore than the medical students who are under me, either on psych or off-service. Is this normal?
 
  • Like
Reactions: 1 users
I'm frightened as well but I'm pretty sure it's common to all interns to feel as though they've forgotten a ton of medicine.
 
  • Like
Reactions: 1 user
What I really wish someone had told me, before I decided to drop out of an already offered position...

"You've already been accepted into an Undergrad program, utilise the support systems the University has on offer, don't just decide to forfeit your placement, you might never get this chance again and you will regret it."

Hindsight is always 20/20 vision *sigh*
 
I'm scared that I'm going to look so dumb as an intern. I feel like I'm barely going to know anymore than the medical students who are under me, either on psych or off-service. Is this normal?
It's normal. It's also normal to feels your learning pace is too slow or minimal for a while. Often around PGY 3 it all starts to really come together and you'll look back and be amazed how much you've learned.
 
Last edited:
  • Like
Reactions: 2 users
I'm scared that I'm going to look so dumb as an intern. I feel like I'm barely going to know anymore than the medical students who are under me, either on psych or off-service. Is this normal?

I am also afraid of that. But I have come to realize that its sometimes better to look dumb with your mouth shut then speak and remove all doubt ;)
Obviously not in every situation, since there is weight in finding the balance to ask for help while not looking like an idiot. The smart phone REALLY help with that!
 
Never hesitate to ask more questions. Ex. It's one thing to know what labs to order, it's another to know what to do with the abnormals you get back. Why did you choose that treatment? What would you do next if ___ happens? and so on.

Billing and the business side of medicine. Learn about all of the coding, talk to those who actually do the billing, what they do if denied, how do they keep track of what is paid, how do they handle patients when they don't pay, etc . How much is the copay for this visit, how much does a patient pay for their meds, What can you do to reduce their costs? How to I run a PA for non covered meds, appeal a denial, etc?

Basically, go about each day pretending as if you are out of residency and on your own. What gaps do you have in order to have a successful practice? If they don't have this planned, request that your program teach this to all in your program.
 
  • Like
Reactions: 3 users
I'm scared that I'm going to look so dumb as an intern. I feel like I'm barely going to know anymore than the medical students who are under me, either on psych or off-service. Is this normal?
The nice thing about being the intern instead of the med student is that you can read up on what you want to talk to the students about ahead of time. ;)

Honestly, I have come to realize that in most medical education situations (and probably in most life situations period), it matters more that you are reliable, pull your own weight, and are friendly/easy to get along with. People care about that stuff more than they care about how smart you are.
 
  • Like
Reactions: 2 users
Top