6 tips for success in residency training

Recently, a few colleagues and I sat down with our six incoming interns during a welcoming round-table discussion.  Being the closest member of the faculty to these residents in age and time from residency, I was best able to relate to them and their current feelings.

I, too, sat in those chairs in a conference room that was last used for graduating our outgoing chief residents.  I, too, remember the feelings of anxiety as well as fear of the unknown.

Along with our program director and associate program director, we started a brainstorming session on items that must be thought about as each intern begins their journey through residency.  These tips for success are applicable to all residents, no matter what specialty, or location in the country.

1. “On your mark, get set, go!”

It is a marathon and not a race: “The days are long, but the years are short.”

There is truth to this, especially in the orthopedic surgery realm.  Five years is a long time, and it can go really fast, but you must pace yourself.  Keep in mind that there will be ups and downs, and one may experience a roller coaster of emotions throughout.  Be sure to have a solid grasp of your feelings at all times.  Ride the highs and seek help during the lows.  Understand that you must be on you’re A-game at all costs since other people’s quality of life may be hanging in the balance.  Get out of the gate quickly and maintain a steady-state throughout, but bear in mind that you must keep your focus and not let up.  Your academic and professional stamina will be put to the test.

2. Learn!

Be smart, but learn to be smarter.  While this may sound trivial, it is easily overlooked.  Realize that everyone is always watching.  As the newest members of the department or your specific institution, please realize that many others have way more experience than you.  Put that to good use.  When a clinical scenario arises, and a colleague or superior reaches out to you, understand there is likely good reason.  Nobody is in the business of wasting your time.  Respect their request for help and use it as a learning experience.  Each and every clinical encounter should have a purpose and lead to a positive educational point.  Learn from every consult; learn from every case and conference, and be prepared to give back.  Work hard and be efficient.  You will find a rhythm that will help maintain your success.  Learn at every opportunity you encounter.

3. Trust your gut

The more difficult option is more often the correct choice.  There is a reason we frequently advise others to listen to their gut instinct.  It is usually correct.  When the 2 a.m. page comes in, and you’re exhausted from a full day of operating, the easiest thing is to fight back and go to bed.  While that may seem satisfying at the moment, it may only lead to more trouble.  Instead, get out of bed, and fully evaluate the situation that is being brought to your attention.  The more difficult option is usually the correct one. Again, be smart and go the extra mile.  Go see and evaluate the patient.  Your efforts will pay off.

4. “Making a list, checking it twice.”

Pay attention to detail, and learn how to manage your time.  Write everything down.  Your time will fill up a lot more quickly than ever before, and more distractions will be thrown at you from all angles. You must stay organized and prioritize what needs to be done first, second, and third.  Be careful when multi-tasking. A word to the wise – it is much easier to finish one task really well the first time versus doing a mediocre job on three different items and then having to go back and double-check your work.  Of course, situations will arise when you must tackle more than one task simultaneously, but be sure to remember exactly where you left off on the first one in order to avoid having to retrace your steps.  Be facile and mold to the task at hand.  Function within your limits and be certain to reach out for help when needed.

5. Confidence, but not over-confident

Be confident; you deserve your new title. You have worked hard, but be sure to respect those around you.  Remember that you are a new entity.  There have been interns before you, and there will continue to be interns ahead of you.  You are not reinventing the wheel.  Recognize that those ahead of you may be able to provide guidance during certain situations versus leading yourself down a rabbit hole.  When questioned by your elders, superiors, or surrounding clinical staff and support team, be respectful and do not think that you are outsmarting them.  Most situations are easily solved without your input, and a seasoned nurse most likely already knows how to manage the acutely hypertensive gentleman in the ICU, but they are reaching out to alert you.  Do not respond with arrogance out of frustration.  They have a job to do, as well.

6. Integrity

First, do no harm.  Second, never lie.  This cannot be understated.  Once a liar, always a liar.  Realize that you will be interacting with some individuals in the hospital for many years to come.  If you undermine someone’s trust, you may never get it back.  If you don’t know the answer to a clinical question for an attending, senior resident, or peer, let them know the truth and that you will find out.  If you are asked about a specific patient, do not make up information if you are unsure.  Never lie to someone as this could lead down a path of devastation or misunderstanding and ultimately harm the patient.  If you make a mistake or act out of character, apologize.  No one is too proud that they can’t make amends for an error.

Be proud of this time.  You are in a situation with a degree and privileges that only a select few have.  You are granted abilities that nobody else has.  This is a time to fine-tune your craft and hone your skills and become the best orthopedic surgeon you can become.  With this comes great responsibility – to your profession, to your peers, to your institution, and most importantly, to your patients.  Realize that you are a representation of your institution at all times.  Do not let down those who have come before you or those who may follow in your footsteps.  Enjoy your training as you will never have this opportunity and safety net again.

Adam Bitterman and Randy M. Cohn are orthopedic surgeons.

Image credit: Shutterstock.com

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