Working as a night attending has many charms; waiting for ED to call you right before your shift ends about a super sick patient you cannot pend for incoming attending isn’t one of those. While dreading the annoying ringtone, I decided to scribble a little today. Discussing a patient with a stroke with one of my residents somehow took me back to my residency days again. So how to residency part II it is:
The first batch of interns I like to think I helped train are graduating very soon. From hesitant, scared little creatures following their seniors only to realize that the senior is going to the bathroom to absolute beasts who would not tolerate an iota of compromise while running their code as PGY-3s, I have seen them grow. I feel proud. I distinctly remember my immediate juniors on the day they became PGY-2s. One of the many reasons I remember is that I was never a July intern. I started my residency in August. That meant I was a July PGY-2 twice; lucky me!! I could examine 1st hand if I had been a good PGY-2 one year back. How my current colleagues (my interns until the day before) treated their new fresh interns would tell me everything about my teachings.
My skills of articulation exponentially decline when I speak, so I can imagine how I might not have conveyed a lot of these messages to my interns verbatim. Still, heaven knows, I very much intended to show them that these matter. So here are some basic mental models that I believe would help us become a good PGY-2:
Absolute kindness is the only way to live. As a PGY-2, if you can be half of the senior you so desperately wanted during those first few months of your PGY-1, you understand your role.
You do not rise to the level of your goal; you fall to the level of your system. Epic (your EMR) is where you set your system up. Make sure no one knows Epic better than you, and be sure to teach everything you know to all your juniors.
Understand that no matter how invested you are in this job. It is just that, a job. But also remember that this job will be at least 1/3rd of your day moving forward until you retire. That means two things: 1) you better have a fantastic remainder, 2/3rd that you don’t care about this one-third, or 2) understand that you cannot take advice from any other profession and apply to a physician’s role. Your colleagues are/have to be your friends.
There are ways to make work enjoyable, and you probably knew what they were as an intern. You probably weren’t allowed to implement them, then. Now is your time.
The only way to grow as a PGY-2 or a 3 is to create an environment where interns can ask you a silly question with absolute certainty that you won’t think the question is foolish. Instead, you will direct that question to a learning point that will teach your intern but also pose a question, sending the group into the depths of an obscure, dusted review article searching for an answer.
As this batch graduates, I cannot help but feel old but also happy. They are a capable bunch. And I am sure their interns can attest that the list has grown much longer now.