The challenges of residency

29 Jun

Thursday workout:  60 minutes elliptical.

I was only going to do a 30-40 minute workout, because it was already 9:30, but then I got hooked on the TV show I was watching and wanted to finish the show.

I’m now adding running back into my routine, but not too much, because it still definitely aggravates the plantar fasciitis.  The ironic thing is, is that this past year I’ve really concentrated on trying to land more on the ball of my foot instead of my heels when running, and I wonder if that put too much strain on my arches/plantar fasciitis?

~

It’s almost July, and that means all the new residents and fellows will soon be in the hospitals!  I’ve actually heard, though, that Septemberish is a more dangerous time at the hospital, because when the new interns are starting out, they are insecure and still have a lot of supervision, but by the time they’ve been around a couple of months, they get more (overly?) confident and have less supervision.  I have no data to support this,  just theorizing, so don’t freak out if you or a family member ends up in the hospital between now and September.

Speaking of residency, the other day I was talking to some of my fellow residents, and we were talking about some of the aspects of residency we have found stressful/difficult adjusting to.

Here are some of my self-reflections on the challenges of (radiology) residency:

1.   First year of radiology residency is not hard from a workload standpoint, but it can be difficult emotionally.  Why?  You (well, speaking for myself at least) will feel absolutely, incredibly stupid.  To become a radiologist, you must go through four years of medical school, a year of internship which involves various months spent caring for patients on medicine, surgical, and intensive care services, 4 years of dedicated radiology training, and then usually a year of fellowship in a specialized area of radiology.

So, when you start the first year of your radiology residency, you’ve just spent four years going through medical school and then an intern year of residency, and you are finally starting to feel somewhat knowledgable and confident about taking care of a patient.  Then you are thrown into the world of radiology…something you’ve had no training in, and all of a sudden, you feel as dumb as you felt your first year of medical school.  It’s an adjustment, and the amount of knowledge you have to learn can seem daunting and overwhelming.  In radiology, you basically have to learn all of the body’s anatomy, all of the potential pathologic process that can occur at any one body part, and how all those potential pathologic processes will look on different modalities of imaging (MRI, CT scan, ultrasound, xray).  So as a first year radiology resident, you feel dumb and overwhelmed.  Additionally, as I have come to learn, radiology is one of those fields that becomes much more rewarding and interesting the more you know, so it takes awhile to obtain a sense of gratification from your work.

Glioblastoma multiforme. The deadliest of brain malignancies. I see a lot of these right now, because I’m currently rotating in neuroradiology.

Source

2.  You will get negative feedback, but you will rarely get positive feedback.  You can’t take it personally.  I’m usually good at this.  I like constructive criticism.  I am motivated by it, and it drives me to strive to be better, but sometimes the lack of positive feedback can make me paranoid.  Do they think I’m a horrible resident?  Am I doing really poorly?  Am I going to flunk out of residency?  Ok, maybe that last one is a little dramatic, but it has crossed my mind before!  It can be hard at times, but I think it’s important to remember that the purpose of the feedback is to make you a better radiologist, not to bring you down.

3.  You will make mistakes.  Learn from them, but don’t beat yourself for them.  This is something I am NOT good at.  I have never been good at this.  When I used to figure skate competitively, I used to get infuriated with myself when I missed a jump.  I would beat myself up and become so focused on my mistake that it would sometimes remain a distraction longer than it should have.  I find myself sometimes reacting the same way in residency if I get a case wrong.  I have to remind myself that we are expected to make mistakes (I’m not referring to life-threatening, malpractice types of mistakes; those are never acceptable).  If we were already perfect and never made mistakes, what would be the point of residency training?

4.  It can take awhile for yourself and your relationships/significant others to adjust to your schedule when you are forced to work nights.   I hardly saw Dean when I was on nightfloat.  He would want to see me after his work day before I left for work, but I would just be waking up and totally groggy, so I wasn’t the most social of people, and if I saw him in the morning after my shift, I was so burnt out from the long night that I could barely form sentences.  I’m sure he probably took it personally at first, I know I probably would if my boyfriend didn’t feel talking to me during the little time I got to see him!  Ha. It’s all good though.  Dean’s used to me and my fatigued-burnt-out-I-don’t-want-to-talk-to-anyone moods : )

So, I know I’ve just talked about some of the negative things about residency, but each month, I enjoy residency more and more.  I really, really love the choice I made for a specialty.  Seriously, and as I get closer and closer each day to the completion of my training (2014 for residency, 2015 for fellowship), I find myself getting more and more motivated to try to learn as much as I can in order to be as prepared as possible.  Also, I have been really lucky in that my fellow residents in my class are fricken awesome residents AND persons.  I think we all get along really well.

That’s it for now.  Dean is getting anxious for us to go on our bike ride to Whole Foods to pick up our favorite  beer for the night.  TGIF!!  Time to finally relax!

QUESTIONS:

If are/were in residency, what was the hardest thing to adjust to?  Whatever job you have….what’s the most challenging part of it?

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5 Responses to “The challenges of residency”

  1. Adrianna June 30, 2012 at 9:49 am #

    I’ve been reading for awhile but haven’t commented…big fan :)
    this post couldn’t have come at a better time, as I just started my optometry residency Monday, and it’s all so overwhelming! I was working for 3 years and decided I wanted to specialize in peds, so I took a leap, ended up matching, and here I am. it’s not easy getting back to student mode and not knowing sh*t! but it’s reassuring to know it gets better and more manageable.
    btw, I went to optometry school in Chicago, and I love your pics…makes me miss it a lot!

  2. justgngr June 30, 2012 at 12:27 pm #

    #2 and 3 definitely resonate with me, and I think that surgery residency may take the cake on negative feedback. There are so many times when it feels like all that is noticed is every mistake or every problem that occurs. There are very few instances in which one hears “good job”, although these tend to become slightly more frequent with more operating experience. I’ve certainly attended Morbidity and Mortality rounds at other institutions and been struck by how aggressively residents are not only criticized but attacked outright. Fear may be a great motivator, but at some point that becomes an environment that is not conducive to learning or achieving one’s full potential.

    Mistake will always be made; it’s what you gain from them that is more important. As physicians, the majority of us are type A personalities who arent used to getting things wrong in school and generally hate being wrong. But there is so much to be learned from the errors and mistakes we make, both the big and the small. Even the life-threatening and malpractice type mistakes are potential learning points, although I agree that avoiding them is generally the best rule.

    • Julia July 18, 2012 at 6:55 am #

      Totally agree. Mistakes, although you obviously hope they don’t happen, inevitably do and are great learning opportunities. What I’ve learned from mistakes I will never forget. It sticks with you.

      The surgical environment is tough. Definitely have to deal with the most constructive and not-so-constructive criticism.

  3. Losing Lindy June 30, 2012 at 9:11 pm #

    my current job is a bit frustrating, but I refuse to talk about via the whole world

  4. Sohana June 5, 2013 at 9:44 am #

    My significant other is about to start his intern year (also going for radiology) and his first month is night float. I’m also in a profession with long hours and thus, I anticipate very little interaction with him during the weekdays. I was wondering though, in terms of sleep schedule, do you recommend sticking to the day sleep/night awake schedule during the weekends if/when you don’t have to report to night float? I’m asking also in the context of a relationship, as I’d be awake during the day and he’d be sleeping.

    Thanks! Interesting reading your blog! Very helpful insight.

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