Reflections – My First Year of Residency.

Hi everyone!

It’s been a while since I posted something new on here – partly due to time and a lot due do to writer’s block!

I am currently completing my Internal medicine rotation. Next week Tuesday I will be post-call and would have completed my intern year in Family Medicine! WHAT?!

Let’s reflect on my first year of residency. A lot of the year has been about me faking it till I made it.

–> First year has been scary. I had a gap between graduating from medical school and getting into a residency program. It was not easy. All the experience I accumulated before residency (studying, writing exams, clinical traineeships) was helpful but did not fully prepare me for what was to come & what was expected of me. Being IN a residency program where I am being evaluated, trying to figure out the system while I consciously and unconsciously compare myself to those who are Canadian medical graduates/recent graduates has been difficult.

–> Residency has been about learning to be comfortable with the UNcomfortable situations I had to encounter. Dealing with difficult patients/staff/colleagues, presenting patients and coming up with a diagnosis/management plan on my own and being wrong about it. Doing new procedures I am not confident about or have never done. Going through rotations and studying up on material that I really do not like but have to do. On call shifts where I have been up for 26 hours and be pimped in the morning about patients I had admitted 12 hours before. Day after day I have felt unease and discomfort – but I pushed through and over time it got a little easier. Easier to accept and easier to handle.

–> Match Day was amazing! Starting first year WAS exciting, but I eventually burned out. That excitement & novelty slowly declined. I felt guilty about it and did not open up to many people to discuss my feelings because of how long it took me to get to residency. I felt that I was being ungrateful. Shouldn’t I be thankful instead of complain? As the months went on more of us started talking about our feelings and it seemed a LOT of us felt it! When this happens our growth and productivity and eagerness to learn suffers.

–> This is connected to the reflection above – self care is important, whether it be through vacation time, finding a hobby, taking a wellness day, sleeping in, listening to music, walks, blog etc. Finding good support from my family and friends has been important. Breaks are refreshing and I am thankful to be present and in this moment. I do not want to go back in time.

–> This sounds obvious but the more I ate and kept hydrated, the more productive and efficient I was. Sounds stupid right? I know. Before thinking this way, I used to just go, go, go. I thought the more I could get done the better it was. It was the opposite. I was drained, I didn’t think clearly and worked slower. So now I make time, even if it is 5-10 minutes to grab some food, keep a water bottle in hand. Also, on call days – it is essential to know when coffee shops in the hospital closed in the night, so I had to make sure to get my coffee early.

–> There were days I felt like a rockstar and things were going great. Then the next day I fell flat on my face. This mainly happened when I would switch from one specialty to the next (IM, OBGyn, Peds, ER…). One block to the next. I always got anxiety before starting a new rotation – new speciality, new location, new ways of doing things at that hospital. I eventually accepted that it will take a few days, even a week to get used to how things are run there.

–> I grew thick skin over the year. There were “interesting” people/preceptors I met along the way whose way of teaching was to criticise and be demeaning. This type of teaching was rare (for most of my first year my preceptors were very understanding and supportive). It hurt initially but I eventually learned not to take it personally. Did this type of treatment make me a better resident? I am not sure. I learned to grow a wall/shield so that these negative comments bounce off of me now and don’t linger for too long. I learned that everyone has different styles of teaching and feedback.

–> Being a resident during this COVID pandemic sucked. I felt that my social life was very limited. I have a few good friends that I made during my first year but we rarely spent any time together in-person. Our social aspect was limited to Whatsapp messaging and bumping into one another in the clinic/hospital when we were in the same shift. I learned to savour these moments with my friends. Point of this being, I appreciate my good trusted friends that I can talk to, complain to, bitch about residency with – and THEY GET IT! My friends kept me sane and grounded 🙂

–> Professionalism, compassion, humanity in medicine. I have met patients who have yelled at me and been rude. I chose to act professionally and was rewarded with good feedback and having a clean conscience that I didn’t hurt my patient with words or actions. I took a little more time, especially with my elderly patients (even if it is just a minute more) to make them feel seen and heard. Day after day they are in their hospital beds with an illness – because of COVID, visitations from family/friends are infrequent. Patients who are limited in mobility require help to do things like pick up their cups for water, or pick up phone/dial numbers to talk to their loved ones. We healthcare professionals rush in and out of rooms to get our jobs done. Patients are more than just lab values/imaging results that need fixing. Even if it takes a minute more, it is important for me to know their names, touch their hand and ask them “how are you today? how can I help you today?” I intend to make sure I stay the same no matter how many years I practice medicine. I thank my parents, my preceptors, husband and kiddo for instilling this in me.

–> “MD – Make Decisions”. I still doubt my decisions but my confidence has improved over time. I can see this as I am completing my second block of internal medicine. I had IM in Sept/Oct 2020 and I see how much growth and progress I have made to now – June 2021. I am not afraid to say I don’t know something. Decisions that I used to second guess before, I make it now with confidence – always ensuring that patient safety is priority. I am not afraid to ask for help. Asking for help is not a weakness. Recognising key pertinent questions/signs/symptoms, seeing repetition & patterns in patient presentations helps to figure out the next step in their treatment/management. Accepting feedback is now seen as an important part of my growth, in fact I look forward to it, compared to a few months ago when I used to internally groan and fear it. I step up and ask whether I can do something/help with something to gain more knowledge and exposure.

–> Getting INTO residency as an international medical graduate is a challenge. Getting in didn’t mean the challenge ended, in fact it is quite the opposite. Being in the field of medicine is about life long learning, pushing myself to limits that I did not know I was capable of. There are days when I’ve had enough and think “Why couldn’t I have chosen any other field?” Then I wake up the next morning and get back at it again because I don’t think any other field is quite as exciting and amazing as it is in medicine.

–> Being a parent in residency has been the most challenging part of intern year. It took me many months to get a routine going. There were days I really thought I wouldn’t be able to get up out of bed and juggle multiple things to make it through the day – but somehow my husband and I would sit together, exhausted after running around the whole day and think “what just happened…? how did we make it through the day?” So new incoming interns who are Moms and Dads, don’t be surprised if you are in over your heads!!! This year has been the MOST rewarding year of my life – as a mother and as a resident.