What makes a great resident?

[MikMik6]

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Aside from having a strong knowledge base and high ITEs, what makes a person an exceptionally good resident. What characteristics do they have that separates them from the rest. @aProgDirector, any input from you would be awesome!

 

[Crayola227]

there are a lot of threads on this, many of which aPD has sounded out on

I suggest SDN search function. Also mimelim has a great post on being a good med student or resident, I can't recall, either way contrary to popular opinion there is actually overlap on the two

be safe, fast, pleasant, in that order
be honest, don't be arrogant, don't be a douche, keep your head down, don't make waves, work hard

I also have a post somewhere that suggests that rather than focussing on being a special snowflake, one should just focus on doing the best job they can, and it doesn't matter where that puts you relative to others, there might not be that much of a spread if everyone is doing all they can, amongst a group of high functioning individuals

doing right by your patients and giving them the best care YOU can give, is not necessarily something that can be measured against others, and I think comparing yourself to others is just a bad way to approach being a stand out resident.

 

[fasteddie911]

The 3 a's: available, affable and able, probably in that order as well. Residents who've always stood out are the ones who just get things done, it's a job after all. Being well-organized, on top of things, taking initiative or thinking ahead. Being a team player and a good person overall is a big plus now and down the road. It sounds simple but you'd be surprised how many people, even smart "accomplished" people, can't follow thru on this, or at least not on a consistent basis.

 

[Psai]

The 3 a's: available, affable and able, probably in that order as well. Residents who've always stood out are the ones who just get things done, it's a job after all. Being well-organized, on top of things, taking initiative or thinking ahead. Being a team player and a good person overall is a big plus now and down the road. It sounds simple but you'd be surprised how many people, even smart "accomplished" people, can't follow thru on this, or at least not on a consistent basis.

So true. We have so many people that are excellent on paper and can't get anything done. They can't find paper orders, can't seem to call consults on a timely basis, have no idea what's going on when they actually reach the consultant in the afternoon (now you have a pissed consultant), can't seem to follow up on any consultant notes, can't do assigned tasks without some weird resistance/delay, can't get their notes done by signout, can't be trusted to talk to other services in a coherent manner. I remember struggling at the beginning but once you're a few months in and have several rotations under your belt this stuff should be second nature. I don't expect you to be able to have all your work done before lunch if the census is full but if none of the tasks on the checklist are done, wtf were you doing all day? Don't get it.

The divide between the good residents and the crap ones is so wide. It's hard to predict. The worst part is that the bad residents don't take criticism well so they don't improve either. It's infuriating and I have newfound appreciation for my attendings.

 

[druncleauntie]

Great topic. I posted an entire youtube video on this. But the common themes are teamwork, hardwork, dividing the workload, inspiring others, empathy, and addressing problems


Sent from my iPhone using SDN mobile

 

[Medicinedoc100]

Work hard. Read every day. If you dont know something look it up. And most importantly, know everything about your patients and be responisble. You are no longer just observing. You should take ownership of your patients and follow up on everything. I rather have a responsible intern I can trust then a know it all intern who doesnt give a ****.

 

[Planes2Doc]

Not shirking.

 

[deleted547339]

Being 100% honest. Hard work. Good attitude. Accepting responsibility. Being organized. Being teachable/wanting to learn. Running things up the chain when things get off track.

I know that stuff sounds simple, but I’d take the resident above with 25th percentile ITE exam over 99% who thinks he knows everything and can do it all. Knowledge base is probably the last thing I care about. I’m here to teach you that stuff, you’re here to do what I teach you with a smile.

 

[GastriqueGraffin]

Being 100% honest. Hard work. Good attitude. Accepting responsibility. Being organized. Being teachable/wanting to learn. Running things up the chain when things get off track.

I know that stuff sounds simple, but I’d take the resident above with 25th percentile ITE exam over 99% who thinks he knows everything and can do it all. Knowledge base is probably the last thing I care about. I’m here to teach you that stuff, you’re here to do what I teach you with a smile.

If you have all those traits and have the knowledge base but act humble/respectful and don’t complain while seeking ways to be helpful without anyone asking then you are basically the ideal resident.

 

[Anicetus]

Being 100% honest. Hard work. Good attitude. Accepting responsibility. Being organized. Being teachable/wanting to learn. Running things up the chain when things get off track.

I know that stuff sounds simple, but I’d take the resident above with 25th percentile ITE exam over 99% who thinks he knows everything and can do it all. Knowledge base is probably the last thing I care about. I’m here to teach you that stuff, you’re here to do what I teach you with a smile.

You guys say this, but it takes knowledge to be efficient as an intern. Interns that know their **** don’t spend so much time thinking about the plan for a patient or spending all this time looking it up. If I don’t know something well enough it takes me so much longer and no one is happy. My cointern with a greater knowledge base is able to get stuff done much quicker as not much is foreign to them. If you have an intern who was spending too much time looking up which abx regimen or which beta blocker to start on, you won’t care how hardworking they are, it still takes them longer to get stuff done due to that lack of knowledge and residents see that as inefficient.

 

[deleted547339]

You guys say this, but it takes knowledge to be efficient as an intern. Interns that know their **** don’t spend so much time thinking about the plan for a patient or spending all this time looking it up. If I don’t know something well enough it takes me so much longer and no one is happy. My cointern with a greater knowledge base is able to get stuff done much quicker as not much is foreign to them. If you have an intern who was spending too much time looking up which abx regimen or which beta blocker to start on, you won’t care how hardworking they are, it still takes them longer to get stuff done due to that lack of knowledge and residents see that as inefficient.

No, I said what I meant. I don’t care how much my intern knows so long as they aren’t truly dumb / and thankfully my nurses usually keep dumb things from happening.

 

[qxrt]

You guys say this, but it takes knowledge to be efficient as an intern. Interns that know their **** don’t spend so much time thinking about the plan for a patient or spending all this time looking it up. If I don’t know something well enough it takes me so much longer and no one is happy. My cointern with a greater knowledge base is able to get stuff done much quicker as not much is foreign to them. If you have an intern who was spending too much time looking up which abx regimen or which beta blocker to start on, you won’t care how hardworking they are, it still takes them longer to get stuff done due to that lack of knowledge and residents see that as inefficient.

If, after your nth patient with a UTI, you still have no idea what antibiotics you'd use and still need to look it up every time, then there's something wrong with the "teachable" part of you. What you describe is not so much about knowledge as it is about how good you are at picking up routine stuff and retaining stuff you learn during intern year. Individual institutions can have different prescribing habits, and no one expects a fresh new intern to know anything. But it becomes a problem when they continue to not know anything halfway through the year. An intern with a solid work ethic and quick learning abilities introduced to a new hospital system and new EMR can quickly outpace an intern who was a medical student at the same hospital and already familiar with the systems but slower on the uptake, pretty quickly. Baseline knowledge at the starting intern level is not as important as what you can pick up on the job.

 

[Eyeronic]

The whole process is weird and I am so glad this phase of my life is in the rearview mirror.

There is far too much subjectivity, and far too much of it so early in the game. Also way too much of a luck factor on who you're assigned to work with and when. Being aggressive or fast does not make you "good", and yet year after year, I would see the interns with these traits get pats on the back and lots of positive gossip about them. Also, if you train at an intense program, there is definite bias towards those with aspirations and/or a strong interest in Cardiology / Critical Care, etc. In my own residency class, a few of the show-offs during intern year who were the program darlings became universally hated as senior residents for being lazy, unavailable, etc.

3 years is a long time. Take a back seat, keep your mouth closed, and just watch what happens. The cream rises eventually.

The best advice I can actually give is for Year #2 and beyond. If you think an intern is having trouble, for any reason at all, discuss it with him/her individually. Don't tattle to the chief resident unless it is extreme. And do not spread wild rumors about that intern to everyone else in your program.

 

[Marasmus1]

A resident who makes his/her attending happy by any means is considered good resident. What makes your attending happy depends on that particular attending. Some are happy when you finish notes on time, some are happy when you answer the questions right during the rounds, some are happy when you help them in their research without any compensation.

Residency sounds like an educational work but essentially it is work, education may or may not follow it depending your initiative. You are recruited by group of attending , you are neither the employee of the hospital nor the government. It may look so on the paper but you are essentially employee of group of attending. So if they ask you to treat pneumonia with chamomile tea, you have to do it. What you do is right or wrong is another topic of discussion.

So very simple. Make your attending happy and you will see that you ll be labeled as a good resident.

 

[jdh71]

I think being very good looking woman makes for a great resident these days. Like model hot.

Being a dude. Doesn't make you a bad resident per se. But you can't be a great resident anymore. Not on my service. I suppose there are some services where preferences are different. But then. You've still got to be good looking.

 

[Psych_hopeful]

You guys say this, but it takes knowledge to be efficient as an intern. Interns that know their **** don’t spend so much time thinking about the plan for a patient or spending all this time looking it up. If I don’t know something well enough it takes me so much longer and no one is happy. My cointern with a greater knowledge base is able to get stuff done much quicker as not much is foreign to them. If you have an intern who was spending too much time looking up which abx regimen or which beta blocker to start on, you won’t care how hardworking they are, it still takes them longer to get stuff done due to that lack of knowledge and residents see that as inefficient.

Speaking as an intern right now, but I've seen interns who have good step scores routinely get groans from the co-faculty because they either lie, don't follow up or end up not reporting something for 18 hours (which means your patient is in deep trouble). The ones that have the best outcomes may not know a lot, but they follow up on their patient and have a low threshold on when to ask for help. I've seen the latter get better and better while the ones with "high step scores", but nothing else fall behind.

 

[Marasmus1]

Speaking as an intern right now, but I've seen interns who have good step scores routinely get groans from the co-faculty because they either lie, don't follow up or end up not reporting something for 18 hours (which means your patient is in deep trouble). The ones that have the best outcomes may not know a lot, but they follow up on their patient and have a low threshold on when to ask for help. I've seen the latter get better and better while the ones with "high step scores", but nothing else fall behind.

I am assuming that you are referring to PGY1 inpatient rotations as a psych resident. Inpatient work is not for everybody and it requires team player skills and multi-tasking more than knowledge base. It is preferable to have a good knowledge base with team player skills as a resident but knowledge base could be a much more valuable asset as an outpatient psychiatrist later on. So I am not sure how much falling behind during intern year correlates with poor outcome as an attending especially in psychiatry.

 

[Psych_hopeful]

I am assuming that you are referring to PGY1 inpatient rotations as a psych resident. Inpatient work is not for everybody and it requires team player skills and multi-tasking more than knowledge base. It is preferable to have a good knowledge base with team player skills as a resident but knowledge base could be a much more valuable asset as an outpatient psychiatrist later on. So I am not sure how much falling behind during intern year correlates with poor outcome as an attending especially in psychiatry.

Nah. I changed my mind to internal medicine 😛. I'm too lazy to change my name. And I gotta say I'm happy here. 😀

And what I said applies to internal medicine A LOT. I've seen residents here who apparently have good step scores, but when it comes to team play, they end up sorely lacking. People who otherwise admit they don't know, but learn and then act as team player will have better outcomes for their patients. I've seen it happen quite a few times. And these are the people that end up as superstars in both knowledge and teamwork by the end.

Getting someone better is mostly about how well you can work as a team with the other members of the staff. Knowledge is important, but teamwork and just work ethic more so.