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A council from one resident chief to another

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Bosses, remember, one of those interns is going to take your shoes in a few years. They may serve as role models for you in that role, so you want to raise them well! As a former head of residents, I have a lot of pearls for those who enter the residence. However, what I will tell you now is different than what I would have told you then. Since then I have learned that there are possibilities to create the results we want and not just follow the path we are told to take.

Recently, a former intern of mine, who became chief resident and later program director, tweeted that he received advice from another chief: “If you are not satisfied with the residency, you should adjust your expectations. He considered this suggestion to be a mixed bag. Can you see both sides?

Residents, who is responsible for your happiness? Is it the institution, the program, the program director, the chief resident, or you?

If the larger entity is creating a toxic environment that endangers your physical and emotional health, then simply changing your expectations and accepting what you are given is not the right thing to do. But if you expect it’s up to them to make you happy every day and you don’t have the responsibility for this too, I’d call it.

1. If you go into residence planning to be perfect and do A ++ work all the time, you need to adjust your expectations.

Many doctors are perfectionists and achievers. Think of all the praise mentors wrote in their recommendation letters: “detail-oriented,” “going the extra mile,” and “looking for more opportunities.”

We do things and we do them well. The residence is an opportunity to shine, but it is also a space to exaggerate and create exhaustion. Sure, you can do all of these things, but if you do them all the time at the higher level, you will start to weaken your skills and energy. Sometimes I would challenge you to do the B + job and agree with it to continue to be the ideal resident in the circumstances that matter most – in your interactions with patients.

Perhaps you don’t need to write the perfect note, but leave one that conveys what is needed to a minimum. Your morning report slides don’t have to be the best you’ve ever made. By doing this, you can create a more enjoyable experience during your residency.

2. If you enter the residence thinking that you will simply make it because it will be worth it when you finish, you need to adjust your expectations.

The residencies are long and not easy. For some, the years go by slowly and for others quickly. I’m sure he dreams of the day that he will finish and be an assistant, and “everything will be fine then”. If you sacrifice now to have everything you want when you “arrive” and do not enjoy the day to day, you will miss so many wonderful things along the journey.

Knowing what fuels and sustains you during this crucial time in your life can prepare you for the tools of resilience when you face challenges in the future. Not everything is pink when the residency is done. This is called the “arrival fallacy” and it can affect anyone, not just residents. So be sure to keep doing things to take care of yourself during residency.

3. If you enter the residence thinking that you have no control over your time and how you spend it, you need to adjust your expectations.

Expanding on the above thinking, there are long hours and commitments built into residency. True, you do not control the amount of time it will take you to provide patient care, fill roles, learn, and teach others, but not all of them are prescribed.

You may not have easily accessible hours to spend time with your family, exercise, read for pleasure, or watch Netflix every night. But that does not mean that they should be removed from your life during your residency years.

In Greg McKeown’s Effortless, he describes a strategy of having upper and lower limits for the important things that fill your time. He suggests setting a minimum and maximum number of minutes in which you will participate in those essential activities during a specified period.

For example, you are concerned that you will not be able to continue to function during residency, and it is a stress reliever for you. You are used to doing it four hours a week before residency. Ask yourself what is the minimum amount you need to benefit from it and make it your lower limit. Set an upper limit to have time for other things you want to do during that time. This upper limit is helpful too, so something doesn’t become a buffer or a distraction. By setting limits and expectations for protection, you can enjoy more during this time.

4. If you enter the residence thinking that you must follow the plan to the letter to be successful, then you need to adjust your expectations.

Lastly, many residences have a simple formula without much room for curiosity and exploration out of the box. Maybe there is something you want to explore during this time. Know that your curriculum might be different than your family’s support needs, your outside interests (like training for the Olympics), or your volunteering. How can you brainstorm strategies with your program to support your unique interests and create the happiness you deserve during residency?

I leave you with a tip from this now more experienced former head of residents: You control your own happiness through your thoughts and actions. You can enjoy happiness during residency by setting expectations that nurture you during this time in your life and career.

Marion McCrary is an internal medicine physician and can be contacted at Marion McCrary Wellness.

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