Clinical, Featured, Intern Year, Internal Medicine
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Surviving Residency: 5 Tips You Didn’t Know You Already Knew

The following manuscript was submitted to the March 2017 s/p The Match — One Year Later Themed Writing Contest.

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. The rewards of the job are sometimes short-lived and unpredictable, but their depth have the capacity to outweigh the dull and monotonous daily drudgery. One year after the Match, and nearly eight months into residency, here’s my advice to surviving, thriving and enjoying residency.

Build a positive mindset.

The first year of residency and happiness are not always synonymous. In fact, being a happy doctor is sometimes an oxymoron — but it doesn’t have to be. It is entirely too easy to get sucked into the whirlpool of negativity during an average day in the hospital. You can’t control the events that happen around you but you can control how those events impact your mood. Arming yourself with positive mindset isn’t going to make your day any shorter but it might make it more bearable, dare I say even enjoyable.

Don’t neglect your mental or physical health.

Being healthy isn’t one big decision. It’s multiple small choices that you make every single day. Eating healthy and exercising regularly won’t be easy during residency. You’re going to be tired and going to the gym might not sound that enticing, especially in the beginning of residency. You aren’t going to have extra time in your day to exercise or meal prep — you have to make time. So take a dose of your own medicine and make your physical and mental health a priority.

In that same regard, remember that asking for help, whether it is for patient care or for your own mental health, is a sign of strength, not weakness. Mental health issues like depression, anxiety or stress management aren’t things that you can just shrug off or ‘snap out of.’ You wouldn’t ask a cancer patient to ‘toughen up’ or ‘fight through it’ and you shouldn’t accept anything different from psychiatric issues either. Seek out help early and often. It might save your career or your life.

Maintain your support system.

The corniest line of interview season, that your co-residents are the best part of residency, is also the truest. Just like during medical school, nobody else quite gets what you are going through. Your co-residents are with you in the trenches day in and day out. Whether you like it or not, you will spend more time with these people over the next few years than anyone else in your life. Embrace your new adopted family but also don’t forget about the family that helped you get to this point.

Make your friends, family and significant others a priority in your life and set realistic expectations with them. It’s unfair of you to agree to plans you know you can’t keep. Likewise, your loved ones have to understand your time constraints. Your relationships are two-way streets. Don’t let them crumble.

Just say, “I don’t know.”

A mentor of mine once told me that knowing what you don’t know is one of the most valuable characteristics of a good physician. On day one of residency, you will not be expected to know all of the answers. However, you are expected to be able to collect the appropriate information and find someone who can point you in the right direction. So when a patient, nurse, resident or attending asks you a question and you don’t know the answer, simply say ‘I don’t know.’ At the end of the day, everyone around you will be happy to hear you admit that you don’t know something instead of trying to make something up. It shows honesty, integrity, and a capacity to put your ego aside. Remember that the only thing worse than an overconfident resident is a dishonest one.

It gets better.

The first few months of residency are the worst. Everything is brand new and it’s terrifying. But it gets better. The next few months of residency come around and you realize that it’s actually still pretty terrible. Okay, most of intern year is literally the worst. But it gets better.

You figure out the EMR and stop getting lost in the hospital. You learn to coordinate with the social workers and case managers. You figure out how to diagnose and treat bread and butter illnesses more efficiently. You start to make friends in other specialties. You never stop being tired but you learn to function with less sleep. You calibrate to a new sense of normal and realize that the only thing different from day one of residency is you. Trust that with each passing day you are becoming a better physician.

Ultimately, none of this advice is Earth-shattering or anything you didn’t already know — and that’s exactly the point. You’ve been preparing for this moment for years and there isn’t much else you can do to prepare yourself for the year to come. So if you remember nothing else just remember to trust your instincts, stay hydrated, remember to eat, sleep when you can, and always do what is right for the patient. Now go save some lives, doctor.

Image creditIMG_3380 by nerissa’s ring licensed under CC BY 2.0.

Marc Katz, MD Marc Katz, MD (1 Posts)

Resident Physician Contributing Writer

Drexel University College of Medicine

Marc Katz is a first-year internal medicine resident interested in pursuing a fellowship in cardiology. He writes about the hidden curriculum of medical school and residency and about humanism in medicine.