Tommy became my patient about halfway through my PICU rotation. He arrived as a transfer from an outside hospital due to concern for liver failure, and on a morning when we already had four admissions, he became another checkbox on my to-do list.
I had such difficulty explaining to my family and friends not in medicine the concept of the match. I finally settled on a lottery-Bachelor fusion to explain it. Just replace the aspiring lovers with program directors and medical students, and roses with Match Day letters.
My early idea of what it meant to be a intern came from a combination of pop culture physician idols (i.e. ER) and a handful of actual medical experiences. A dive headfirst from a shopping cart at young age earned me my first trip to the emergency room.
Residency is hard. Anyone who tells you differently needs a stat GI consult because they’re full of it. You will be tired physically, mentally, and emotionally, regardless of what specialty you enter.
From the moment I set foot in the hospital as an intern on June 24, 2016 at 4:55 a.m. to the present as I write this reflection, my life feels as though it were playing in fast forward. It is hard to believe Match Day was almost a year ago.
March 18, 2016. I had been anticipating this day for months and I could not believe that it had finally arrived. I woke up that morning, sat on my couch, and began to journal as I do pretty much every day.
“Daddy, time to wake up! It is morning time!” I open my eyes to our four-year-old daughter at the foot of the bed smiling, her hair meticulously braided. I get up and wake her younger brother from his crib and carry him downstairs. The baby is still sleeping.
“Bunny!” my mom shouted from the foot of the steps, hurrying me out of bed the morning after my medical school graduation. She used the childhood nickname that came from my brother who was unable to pronounce “Dominic” as a toddler, a name that had stuck well into adulthood.
At this stage in our training as residents, we are at high risk for making mistakes. These mistakes can vary in range and type. It is impossible to go through residency without making an error, no matter how big or small.
In medical school, competence was defined by studying the course pack, that stack of crucial lecture notes, and memorizing the details therein. Especially in the first two years, my classmates and I spent virtually all of our waking hours reading text books, attending lectures, highlighting and underlining every word of the course material because we were told that all of it, every word, was important. This understanding of competence reflected the clear but unspoken end game: to have the best score on the exam possible, or at least a better score than the other half of the class.
Some time ago, you walked across the stage and received your first white coat. More recently, you walked across another stage and became hooded into your profession as a physician. Congratulations. You are now the owner of a piece of thick paper that allows you to medically manage acutely ill patients and alter the course of a patient’s treatment.
Realizing that we have both inpatient and outpatient months, which require different skill sets, I feel that it would be better to split these lists into both outpatient and inpatient suggestions. After a few month of being on outpatient rotations, here is my list of eight things to master in order to break the successful intern barrier in the outpatient world.