The Frontier Psychiatrists is a daily-enough health-themed newsletter. Healthcare in America has a new year, just like a regular calendar. It's July 1. On this day, residency training programs for medical doctors begin every year.
Today's column is addressed to those new doctors.
Welcome to the most difficult year of your life. That is, until the next most difficult year of your life. The hours are unreasonably long. The strain that will take on your relationships is more than your non-physician friends will understand. This will be a formative year. You've heard that term before, formative? That means it forms you. It forms you in the same way that tremendous pressure forms rock. Or, perhaps, the tremendous heat and pressure form the molten iron and nickel at the center of the earth. If I were to tell you that these were not overstatements, you wouldn't believe me. Next year, you will.
1. Support your Residency Classmates.
Have you already met your Residency classmates? Those people are the difference between your life being good and maybe death. There will be shifts you would rather not cover. There will be days you just can’t. Your classmates can pick up the slack for you…or not. The way you earn their respect is to support them, first. Before they ask. Before they show weakness…and are eaten alive for it. These are relationships that might last the rest of your life. These people? They are the doctors in medicine you will know the most about the knowledge, skills, and hearts. They will be the ones you feel most comfortable referring to, especially for those closest to you. Treasure and nurture these relationships.
2. Learn the names of the nursing staff.
The most important people in your life are now the nurses in the hospital. Lord, be kind to nurses. They can choose to page you at midnight, and 3 AM, and 4 AM again, repeat. They've also been doing this work longer than you have. They know more about the hospital than you do. They can save you. Or they can destroy you. It's your choice.
It's hard—I know—but it is worth it. If you want to go that “extra mile,” get to know who they are as people, and find whatever way you can be kind. Then—I know—do that kind thing. These are often basic—food, the ability to rest, and the bottom of Maslow’s hierarchy. These small kindnesses will also keep you alive, later.
3. Read the House of God (amazon affiliate link).
I’ve written about this book before. It’s a crucial read, for the culture of the house of medicine where you now reside.
4. Sleep > Food
If you have to choose between sleeping and eating, choose sleep. Bring Nuts—they don’t go bad, they have a lot of energy, and are relatively healthy. But missing sleep is easy, and you will miss a lot of it already, and the difference between despair and learning at work is often adequate sleep.
5. Don’t Kill Yourself, and Don’t Let Your Colleagues Do So Either
When I say, “alive,” I mean it literally and figuratively. The next year of your life, intern year, one of the most common times for physicians to feel suicidal. It is extremely high-risk year. Respect it like you’d respect a bear in the woods or a venomous snake in your hands. Except—you can’t drop it or run away.
I write all the time about effective treatments for depression. The short version for you, new doctors, is that someone in your life—likely a colleague—will need this information. The shortest version of the correct answer is probably Acacia Clinics. If you have a physician in crisis, send them there. We take great care of our colleagues.
If there is a clinic in your neck of the woods that provides TMS, learn where it is, and maybe even get to know the doctors who work there. Better still if it’s outside of your health system.
6. Spend time with your patients.
You're there to learn from your patience. It may seem like you're there to do paperwork. It may seem like you're there to do it Attending physicians tell you to do. Both of those things are also true. It's a yes/and. But the people who teach you how to be a physician, overwhelmingly, are patients. They will teach you what illness is. They will teach you why you're doing your daily paperwork. They will teach you why you sacrifice.
You will learn less by spending time listening to their stories, not just “evaluating them” so you can get written. If you can fit in an extra 10 minutes a day just listening to one patient, you'll have a year of remarkable experiences and life-changing stories to draw from. Ten-minute exchanges in which you focus on that other person and their experience? These are the most valuable minutes in your day and, possibly, your career.
Happy New Year.
Not just the nurses. The social workers can make your life much easier when it comes to complicated discharges. The techs can save you from being attacked. Being nice to the janitorial staff means your trash can is always clean and desk is free of dust. The pharmacist knows more about dosing and interactions than you're probably forgotten. List goes on and on.
Thanks! My daughter's first day as a resident in family medicine. Let's hear it for primary care!