1. Be yourself and learn to be flexible. Don’t ever change who you are as a person. It’s OK to have a personality of your own. If you secretly listen to Taylor Swift’s Shake it Off on the way to work, it’s OK. As a junior member of the team it’s very unlikely your iPhone playlist will make the cut for the operating room (OR) entertainment anyway, so go ahead and keep it on your most played list. On the flip side, being successful means being flexible, learning new things, being wrong sometimes, and even changing the way you do things. It can be mind-blowing to learn that there is more than one way to accomplish the same goal. There may even be a more efficient way (compared to what you have been doing since you learned that one skill and have been doing it exactly the same way, every time, because it actually worked and it’s the only way you know).
2. Be professional. In all aspects of medicine. Sometimes it means dressing the part. Wear a clean white coat. Dress for success. See this article from the Harvard Business Review about how acting Like a Leader Before You Are One will help “demonstrate your potential and carve your path to the role you want.” Other times it means keeping your cool and maintaining a calm composure when all you want to do is scream. Never speak, tweet or otherwise post information about sensitive, personal, or private issues. This means don’t air your own or anybody else’s dirty laundry. Don’t gossip. Most importantly, never talk about patient related issues (including that awesome case you just finished) in public. If you’re not comfortable speaking that thought in an elevator full of random strangers, lawyers and/or your program director (or chair), then don’t Tweet, FaceBook or Instagram about it. Being a surgeon is the ultimate privilege. We get to see people literally inside and out.
3. Find a good mentor, or two, or three. We all need a good role model, yet we all have unique goals in life. Find somebody to mentor you about how to be a good resident (student, attending, professor, or whatever position you’ve just obtained). Find somebody to mentor you about how to get where you want to be (in 5 years, in this decade, in life). Find a life mentor … a research mentor … a specialty-specific mentor. The possibilities are endless. There are people who have completed the journey you are just beginning and would be more than happy to help you get through it. Realize that part of finding a mentor means being receptive. Set up goals early, schedule regular meetings and ask for feedback.
4. Do not be an a**hole. Ever. Be nice to everybody. Be nice to your patients, their families, nurses, physician assistants, advance practice nurses, medical students, residents, attendings, other services, OR schedulers, techs, transporters, the cleaning staff, and even strangers. Smile. You are a doctor, a surgeon. How can you not smile? No matter how bad your day may seem, realize you work in a hospital full of sick and dying patients. Count your blessings. Don’t let your sleep deprivation suck the joy out of your otherwise awesome life. Use manners. Please and thank you go a long way. Learn the names of your colleagues. This can be achieved by … remembering your manners. Introduce yourself, every time. For example, “Hey, I’m Sarah. I’m the PGY-3 resident on the trauma service this month. I’ll be scrubbing with Dr. AcuteCareSurgeon today. I believe we met before, what is your name again? Nice to see you again, if it’s OK with you, I’ll grab my gloves.“
5. Treat others as you wish to be treated. You should have already learned this one by now. If your mother didn’t teach you this one, well then let me explain a little. It goes right along with number 4. Treat every patient as if they were your family. Listen. Be kind. Stop rushing so much. Keep your promises or stop making them. If you tell a patient you will stop back in an hour, you better set an alarm because they will probably be waiting (maybe even with a family member at the bedside who changed their schedule just to be there when you come back). If you have a busy OR day ahead and aren’t sure about having time to do afternoon rounds, don’t say I’ll see you later. Be honest, always.
6. Admit your mistakes and be a team player. If you make a mistake, or when you make a mistake, own up to it. This goes back to the classic post on KevinMD.com, which highlighted a valuable statement, “I assume full responsibility and it won’t happen again.” This statement halts most chastising in its tracks. Help your colleagues out. Make your chief or co-resident look good. This is what they call roundsmanship. The team is only as good as the weakest link. Help him or her construct a reasonable plan. Never correct your chief (senior, or even your co-resident) during rounds, at least not publicly in front of the whole team. It is much better to quietly share the mistake with them off to the side (or with a timely text message) so that it looks like they realized their own mistake and shared it with the team … trust me.
7. Teach. Take every opportunity to teach somebody or to learn something new. Most procedural skills can be learned in the usual see one, do one, teach one fashion. I highly recommend using this method. It forces you to teach others how to teach, which is the core of academic surgery. Reserve sophisticated shaming only for those who truly deserve it, such as the comment above describing a surgical consult for fecal disimpaction. For all intensive purposes, read this article about fecal impaction before calling surgery, please. I have to admit, I have not mastered sophisticated shaming, so I would just try to make the best of the situation, use it as a teaching opportunity and show the intern and medical students how to do it.
8. Practice. Practice. Practice. Whether it is your knot tying skills, laparoscopic peg transfer, simulated bowel vascular anastomosis, your next morbidity and mortality presentation, etcetera. Just keep practicing.
9. Take care of yourself. Sometimes you have to be the patient. While you may not be able to take two weeks off to recover from the flu, it’s OK to use a sick day to see a doctor and get checked out. The best way to deal with illness, is preventative medicine. Choose a healthy lifestyle. Make time to exercise. Take the stairs. Don’t smoke (which should go without saying, doctor). Always prepare for the worst. I keep a small pharmacy in my work bag (Tylenol, ibuprofen, DayQuil, etc.). If you do come down with something, or when you do come down with something, drag your butt to work. Let them see how sick (and how dedicated) you are. After all, where is the best place to be when your sick? Exactly, the hospital! More than likely, there will be somebody to cover for you and you will be relieved of your duties for the day. If scheduling doesn’t permit you to leave work early, then you need to ask for help. Hopefully you’ve been nice to the nursing staff, or at least trained a student how to place a peripheral IV, because you cannot underestimate the benefit of a liter of D5 normal saline when you’ve lost all bodily fluids due to illness.
10. Take a chance. This one I’m stealing from a keynote lecture I heard at the 2013 AAS Fall Courses by Julie Freischlag, MD. Dr. Freischlag spoke about taking chances. Get involved in research. Do something new. Learn a new skill. Apply for a new position. Meet new people. I cannot stress the amazing opportunities that exist for networking in academic surgery. Don’t wait for somebody to introduce you. If you attend a lecture or conference and the presentation interests you, go ahead and introduce yourself to the speaker. You never know when you might end up on the executive committee of a new Twitter journal club. Engage with other surgeons on Twitter, click here to learn about how to tweet. Take part in an online monthly journal club, like The International General Surgery Journal Club on Twitter by following @IGSJC.
Sarah Bryczkowski is a general surgery resident. She can be reached on Twitter @sarahb_md.
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