On Match Day, you are assigned to a new family for the next three to seven years. This will be the city where you might buy your first home, the city where you may meet the people who will speak at your wedding. An algorithm shuffles you into your assigned place in a new family tree.
For Duke medicine-pediatrics, this meant that six of us met virtually via email and WhatsApp after matching — three women and three men, all from different medical schools in different states. We dubbed ourselves “The Med-Peds Bunch,” a more diverse parallel to the well-known Brady Bunch. In the 1970s American sitcom, a widowed man with three brunette sons marries a woman with three blonde daughters, creating a blended family with perfect symmetry. For us at Duke, this symmetry was captured in a recent surprise baby shower for one of us six who is due next month. From Harry Potter-themed cupcakes to iron-on custom onesies, we each brought part of who we are to the mix, knowing we were tackling the first month of intern year together.
At residency interviews, residents and faculty alike tell you that it is the people that make “X” program so special. This makes sense — after being assigned a residency spot for a finite duration, people adapt and find value and commonalities in their new family. While our expressed preferences via our rank lists inform the process of creating this “family,” the pedigree that you join can seem random or even surprising to some. But there is no turning back; the Match has the final say.
After the potential shock of matching into a family tree you did not think would accept you or into one you did not anticipate, the bewilderment begins to fade and you find yourself in a new hospital in a new city with new family members. Adaptations are necessary, and you begin to see value in those around you, seeking meaning in where fate or God or computer algorithms have placed you. This goes for both sides: residents and program directors — both must become accustomed to their new family members. Unlike the Brady Bunch, our med-peds bunch hasn’t grown up knowing our program director or associate program director (parents of sorts in the metaphor) — everyone is new to each other.
Our internal medicine program director introduced us to the term #dukefamily during orientation as she reminded us how important our new colleagues would become as our support system through these difficult training years. Phrases like “blood is thicker than water” and “you can choose your friends, but you can’t choose your family” came to mind as I sat there listening to her.
Residency, however, turns those phrases upside down — we don’t really choose in the Match process who our potential friends or “family” are. But it is in choosing to accept our newfound home and surrounding colleagues as family that meaning is created and belonging is found. In our larger cohort of internal medicine categorical residents, there may be enough people to choose who most closely matches your interest — to choose your friends — but in an intimate six-person med-peds class, a sense of family naturally emerges, even if we are not genetically related.
In fact, the phrase “blood is thicker than water” is commonly misinterpreted. Instead, the covenant made between two “blood brothers” is stronger than the water of the womb. In other words, when we are in the trenches writing notes and admitting patients late into the night with our fellow residents, that bond could become stronger than the genetic one that links us to our family.
It is a beautiful experience to find family in others. In my column this year as a Duke med-peds intern, I plan to explore month-by-month how co-residents can form a support system, a family, amid one of the most stressful and tiresome years of our training. The House of God describes intern year with sarcasm, depicting the dehumanization the author felt decades before. Recent literature on resident burnout and depression have made wellness a national concern, supported by ACGME in a variety of ways, including redubbing duty hours as “The Learning and Working Environment.” A sense of family this year very well may be prophylaxis for burnout.
In light of recent press on resident burnout and depression, The Med-Peds Bunch explores the lived social support systems of a current Duke resident. Come join Austin as he begins his med-peds journey and reflects on feelings of family in residency.