Residency training is often considered to be one of the most daunting experiences in a physician’s career. Each day comes with its own package of highs and lows. Every year is a new challenge, and a young physician has to adapt significantly as the journey unfolds. Having gone through this process over the past three years as an internal medicine resident, I thought it would be useful for me to share some pearls that I collected along the way:
1. You made it! These were the words that my program coordinator used to greet me on my first day. It summarized my struggles from the past several years beautifully. It made me realize that all those missed occasions, those sleepless nights, and those buckets of stress that I had endured had finally lead to fruition. My reward was the ID badge I had just been issued at my training program. Throughout my three years, I made it a point to repeat these words in my head whenever things got tough. These three words helped me power through several moments in which I felt overwhelmed.
2. Take care of yourself. At the end of orientation week, I asked my program director what would be the one piece of advice she would give to a young physician like me. I was expecting a lecture on hard work, or patient-centered care. However, the response I got was truly the most valuable piece of advice I have received throughout my training. She said, “Take care of yourself,” a phrase that immediately made me feel at home. It made me realize that my well-being would be a priority at this institution, and this would thus translate into excellent patient care. Additionally, it provided me with a blueprint of what good leadership looked like.
3. Best in the nation. During our ambulatory block, we would spend time learning about and contributing to the quality measures that were important in the outpatient setting. When asked about what the eventual goal is for our clinic, the chief patient safety officer at my hospital said, “Make this clinic the best in the nation.” Through him, I learned that the only barrier to our success was our imaginations. And while our clinic is currently far from being the best in the country, this response triggered a fascination within me to always dream big without worrying about the results. It taught me that when we aim high, our outcomes often surpass our expectations.
4. Do it because it’s the right thing to do. The above phrase was mentioned by a member of our core faculty during one of our morning conferences. We were discussing how sitting with the patient is an effective way of communication. A study was soon quoted that patients’ perception of the amount of time you spend with them changes for the better if you sit with them, compared to when you stand1. And while everyone else began nodding their heads since the approach appeared to be backed by evidence, one voice wisely broke the spell and said, “Do it because it’s the right thing to do.” This phrase lays down the moral framework for everything we do as physicians, and can often help answer tricky questions in the management of our patients.
5. Prioritize. While presenting a case to my chief resident during my ambulatory block as an intern, my problem-list kept jumping from one system to the other. The patient had presented with half-a-dozen complaints, and I wanted to address all of them. Upon the conclusion of my presentation, my chief smiled at me and said: “Prioritize.” This was an important piece of advice that I picked up from him, as it helped me organize my day in the months to come. We as physicians come across a myriad of difficult problems during our day, and prioritization is an important tool to use to deliver effective and efficient care.
6. I don’t know. The end of residency training is often the conclusion of formal training for a physician. Medical knowledge, however, keeps evolving, and healthcare systems offer new complex challenges on a daily basis. It is hence vital to keep an open mind, to absorb new information. The fascination associated with the acquisition of knowledge is hard to compare with anything else. I learned this important lesson on multiple occasions during our conferences, when our mentors used the above phrase more often than my colleagues, guiding us to the path of wisdom.
7. Look for inspiration along the way. This advice was given during the acceptance speech by an infectious disease doctor who had been nominated as Physician of the Year by the hospital. It resonated strongly with me and had been the crux of my training years. Inspiration lays every step of the way. Sometimes it is bold and obvious, while at other times it more subtle and requires a deeper dive. Inspiration is the fuel that can help us power through these turbulent years; hence it is important to be mindful of its existence. To avoid burnout, we should make consistent efforts in searching for inspiration from the time we enter the hospital to the time we leave it at the end of our shift.
Ali Rafiq is an internal medicine resident.
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