10 Tips for New Residents

Group of newly matriculated residents, excited to be in the hospital

Everything you’ve heard about residency is true. It’s intense, exhausting, and, at times, very rewarding. 

In your new reality of 80+ hour work weeks and high levels of clinical responsibility, all of the hypotheticals you studied in medical school become real. You’ll witness the full spectrum of life and death, laughter and tears, and struggle to find your focus in your fatigue. 

Fortunately, many have come before you and not only survived their training, but thrived along the way. 

As you head into your new program, here are ten quick tips to help you maximize the standard of care you give your patients while also looking out for your own quality of life. 

1. Focus On The Horizon

Residency is a marathon, not a sprint. When you start your program, take the pressure off yourself by remembering that this is a years-long process.

It will take you at least a few months to know the building layouts and put names to faces. It might even be a few more months before you actually start to feel at home. 

Remind yourself that every day you show up, you are actively living your dream, and that now you’re the one helping patients. 

You’re the face of America’s medical future, and remember: futures are built one day at a time. 

2. Take Your Own Pulse

As a resident, you will have very little control over what happens around you. Instead, you’ll be constantly adapting to relentless demands, new tasks, and a seemingly endless list of responsibilities.

Though a hurricane is swirling around you, you still have your own locus of control. You’ll hear this over and over again in your training: the most important first step when you run into a code is to take your own pulse.  

Stress reactions are real. With a mounting workload and countless hours spent indoors, it can be all too easy for this to get exaggerated. That’s especially true when you’re tired—and you will be tired.

Checking your own pulse in a stressful situation will center you, ensuring you can provide the high level of care you’ve been trained to deliver.

3. Be Prepared

Successful residents walk the line between being humble and confident. They can freely admit when they don’t know the answer to something, and yet remain confident they’ll soon learn it. 

Preparation goes a long way toward enhancing that kind of grounded humility. 

While not knowing what’s coming next, residents must stand ready to adapt and learn to face tasks head-on.

As such, the demands on your preparation have escalated. When you were an M4, your focus was largely academic—impressing your attending and scoring well on exams.

Your responsibilities to your patients are now much more tangible. Attendings will start to trust your assessments and analyses. 

The habits you establish both at home and at the program will directly affect your preparation on the frontline. And a key part of that preparation requires…

4. Prioritizing Your Self-Care

Your self-care has a direct correlation to your patient care. We understand that your sleep schedule is outside of your control, so it’s even more important to focus on eating well and exercising.  

This all sounds nice in theory (and probably annoyingly obvious). So, how do you actually take care of yourself when your residency becomes a black hole of responsibility and time? 

You simply have to set time aside for it and make it happen.

When it comes to food, preparing meals at home can be seen as a time-sink. Instead, you can explore some of the many healthy meal delivery services available online, or you can look into doing your own food-prep so you have healthy options available.

When it comes to exercising, you can maximize efficiency by looking at close-to-home options. Many condo and housing complexes have gyms that you can access for free. Some hospitals also have equipment rooms or discount deals with nearby gyms. Look at your employee benefits to see if there is a health stipend to help you offset costs.

(Side note: As many residents will tell you, it’s imperative you take care of your feet. You’ll be walking and standing on them all day long, so be sure to invest in comfortable shoes that will go the distance.)

5. Lean On Your Listening

A resident’s job is to listen. As you’ll soon discover, your program affords you the opportunity to cultivate unparalleled listening skills. You’ll be taking in new information around the clock from your patients, colleagues, attendings, and support staff.

Most of the people you’ll be listening to have years (if not decades) of practical, hands-on experience. 

Listening also goes hand-in-hand with taking notes. When we are inundated with new information, we can only process slivers of it in the moment. 

Make sure you’re ready to write things down. By taking as many notes as you can, you create a paper trail that you will be able to reflect on after hours (or many months down the line). 

6. Focus On Your Patients 

It may sound like a paradox, but when your world feels like it’s imploding, you can help calm things down by focusing on your patients.

Interpersonal disagreements happen in high-stress environments. It’s part of being in medicine. When you focus your attention on the needs of your patients, you get out of the argument and center on someone you can help.

Empathy in a therapeutic relationship has been shown to improve patient outcomes. However, like many skills, it can also fade, as demonstrated in this study on surgical residents.

Focusing on your patients exercises your empathy while also refocusing disagreements.

7. Ask For Help

It’s okay to say “I don’t know.” You’re a resident, not a veteran doctor thirty years into their career.

Rather than wasting your time and energy trying to appear confident, embrace your role and ask for help. Don’t be afraid to ask the “dumb” questions. You can bet if you have a question, your fellow residents do, too. The purpose of residency isn’t to know the answer to every possible question, but instead, it’s about learning to find out the answers. The phrase “I don’t know, but let me find out and get back to you,” is very useful.

And when it comes to more sobering matters, like a patient death, don’t try to play the stoic hero. Losing a patient can be truly disorienting, and you owe it to yourself to let your emotions pass through you however they come.

Remember that you’re part of a larger team. No resident is an island. Use all of your available resources, and don’t hesitate to talk to your program’s leadership – they’re there for you.

8. Challenge Yourself

With med school behind you, you are now very much in charge of your pedagogy. 

In other words, you can find and create opportunities to continue learning outside the parameters of your program’s didactics. 

Go to the front lines and learn as much as possible. Ask for opportunities that excite and intimidate you. Look for opportunities to expand yourself as a physician. And if you can’t find them at your own institution, ask to take an away month and go to an institution that can. 

Your residency won’t last forever. Get the most out of it in order to explore as many potential facets of your future as possible.

9. Automate, Automate, Automate

Today, you can automate key parts of your life and save serious time and sweat in the process. Here are some of the things you should consider outsourcing before starting your residency program:

  • Groceries – Amazon, Whole Foods, and FreshDirect are just some of the many online vendors that will bring groceries to your front door
  • Housecleaning – MaidPro and Handy are two great options available nationwide
  • Ready-made meals – Freshly and Sunbasket cook and deliver straight to your home
  • Financial – Use your digital bank to automate your bill payments. If financial stress is a concern, consider a PRN Personal Loan.

Even if automation stretches your budget, the expense may well be worth it in terms of time saved and peace of mind.

10. Maintain Your Support System (And Take Breaks!)

It’s all too easy for your world to feel small in residency. As your responsibilities increase, your availability to see or talk with family and friends can diminish. 

However challenging it may be, do your best to maintain your life outside of residency. Invest in and protect your relationships, whether they’re near or far. That way, when your residency program ends, you’ll have a socially rich and vibrant life waiting for you on the other side.

And when the opportunity comes, take every vacation day that comes across your desk. You won’t regret it.

Conclusion

Settling into residency takes time. While these tips helped our team of physicians thrive in residency, they’re merely suggestions to help you get started. After a few months in your program, you’ll quickly establish the habits you need to maximize your quality of life.  

Ned Palmer, MD MPH is the Chief Operations Officer and Co-Founder of Panacea Financial, and a practicing physician in Boston. He is also working as a hospitalist at Boston Children’s Hospital and is on faculty at Harvard Medical School.

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