Deborah Deas, MD, Mark and Pam Rubin dean and chief executive officer for clinical affairs at the University of California, Riverside, School of Medicine, speaks to students on Match Day 2019. Credit: Carrie Rosema
Medical students nationwide are preparing to start a new chapter in their careers. And while their days in the classroom are limited, residency marks just the beginning of a lifetime learning process.
AAMCNews spoke to academic leaders from around the country to get their expert advice on how to navigate the often frenetic life of a resident.
“I wish I would have known just how much the experience is related to what you as a resident bring to the table,” says Roy Ziegelstein, MD, vice dean for education at Johns Hopkins University School of Medicine. “A lot of students, when they get that envelope, are really happy or they’re not, because they base it on the reputation of the place. But the experience has a lot to do with what the student brings.”
Here are nine pieces of wisdom that will help young medical professionals in residency and beyond:
1. Value your team.
As a new resident, it’s easy to get overwhelmed and forget to acknowledge the rest of the care team like nurses, technicians, and other medical personnel, says Laura Forese, MD, executive vice president and chief operating officer of NewYork-Presbyterian Hospital.
“I wish I had understood how critical team members are and that medicine is a team sport,” says Forese, who did her residency in orthopedic surgery at NewYork-Presbyterian/Columbia University Irving Medical Center.
Those other caregivers are also there to help, said Carol Bradford, MD, executive vice dean for academic affairs at University of Michigan Medical School and professor of otolaryngology-head and neck surgery.
“Rely on your team, be nice to everyone,” says Bradford, who did her surgical residency at Michigan Medicine. “They have your back.”
2. Ask for help.
“People take so much on themselves, but you should never worry alone,” says Edward M. Hundert, MD, dean of medical education at Harvard Medical School, who completed his psychiatric residency at McLean Hospital.
New residents often feel they have something to prove and will attempt to do things by themselves. But that’s not a recipe for success, says Suzanne Rose, MD, senior vice dean for medical education at the Perelman School of Medicine at the University of Pennsylvania.
“I think the one thing I wish I’d known is there would always be someone who could help me and support me,” says Rose, who completed her internal medicine residency at Case Western Reserve University School of Medicine. “To answer a question or assist with a procedure. I wish I really knew I was not alone.”
3. Carpe diem.
“I use the expression ‘carpe diem.’ It’s just an incredible transition point in their lives, they need to always remember it’s an incredible privilege,” Rose says. “The hospital experience is just magic. Seize the moment and listen carefully.”
And there is no need to rush through things — knowledge and skill will come over time, says Julie Ann Freischlag, CEO of Wake Forest Baptist Health and dean of Wake Forest School of Medicine.
“I wish I had known that I had plenty of time to master everything. I felt so pressured to get everything done as fast as I could,” says Freischlag, who did her surgical residency at Ronald Reagan UCLA Medical Center. “I wish I’d had a little bit more patience as I took care of my patients.”
4. Take time with patients.
New residents may feel inundated with new information on research and medical minutiae, but taking ample time with patients should always be a priority, says Augustine M.K. Choi, MD, the Stephen and Suzanne Weiss dean of Weill Cornell Medicine.
“Keep up with publications and journals daily,” says Choi, who did his residency in internal medicine at Duke University Hospital. “But investing time with patients is equally important and enables you to learn how to find greater compassion for your future patients, yourself, and your co-workers.”
And though it might sound obvious, residents and doctors should always examine the patient even if the answer seems obvious, says Robert Green, MD, a geneticist at Brigham and Women’s Hospital.
“When you’re overwhelmed and overworked you want to take shortcuts,” Green says. “Don’t skip that step.”
5. Remember that it gets better.
Though life as a doctor has plenty of stressors, being a resident is particularly grueling. But it’s important to keep perspective and remember that it won’t always be so difficult, says Karl Bilimoria, MD, professor of surgery at Northwestern University Feinberg School of Medicine.
“The first year is tough,” says Bilimoria, who did his surgical residency at the McGaw Medical Center of Northwestern University. “It does get better.”
And education doesn’t end with residency, says Shelley Collins, MD, assistant dean for medical education at University of Florida College of Medicine.
“Think of residency as the beginning of a long career with unexpected turns,” says Collins, who completed her pediatric and chief residencies at the Jackson Memorial Hospital. “It’s a constant journey that requires us to reflect back on what’s really important to us. It’s this ongoing growth of mind and spirit. Always learn.”
6. Find a mentor.
During a time of transition, one of the best resources is a good mentor, notes Choi.
“Find a mentor and then be a mentor. At this point in your career, a mentor is crucial to helping you reach your full potential,” Choi says.
Having access to someone with a wealth of health care knowledge provides a well-rounded learning experience, adds Fredric B. Meyer, MD, dean of Mayo Clinic Alix School of Medicine.
“Find the best mentors and role models,” says Meyer, who did his residency in neurologic surgery at the Mayo Clinic School of Graduate Medical Education. “Devote yourself to being the best physician you can be. It means learning about the art and humanity of being a physician.”
7. Explore future paths.
People just starting out in medicine are sometimes in a hurry to pick a path and stay on it, but it’s important to explore options, according to Green.
“What I learned over decades was there are many, many pathways that include industry, politics, policy, entrepreneurship, and investment, and that your medical education can be used in gorgeous ways,” says Green, who did both a neurology residency and a genetics residency at Massachusetts General Hospital, Brigham and Women’s Hospital and Boston Children’s Hospital.
The exploration doesn’t need to be broad — it can even occur within one specialty, Collins says.
“I wish I would have known how precious it is to be able to learn in a relatively low-stakes environment,” Collins says. “And I wish I would have recognized all the opportunities to learn about all the different areas in my specialty.”
8. Take care of yourself.
Taking care of oneself ultimately makes people better doctors, says Forese.
“It’s a little bit like in an airplane,” Forese says. “You have to put on your own oxygen mask before you help anyone else.”
That means tending to yourself both physically and emotionally and making sure you keep people in your life who love and support you.
“Exercise every day. It’s important on many levels,” Meyer says. “And don’t forget the significant others in your life. Remember your family.”
9. Be kind.
Being skillful and mastering the craft of medicine is an obvious priority, but there’s also something to be said for being kind to people, from patients to colleagues.
“Treat patients like you’d want to be treated,” says Ziegelstein, who did his own residency in internal medicine in the Osler Medical Service at Johns Hopkins Hospital. “They’re generally not at their best, so you need to be very tolerant and sensitive and compassionate.”
A simple touch of the arm and a thoughtful word can go a long way, says Hundert. “You come out of medical school and everyone is worried they might harm someone because they aren’t fully trained yet. You forget about the healing power of kind words,” he says. “I think it’s very easy to be in your head and not enough in your heart.”
Must read books for residents
Residents don’t just learn in the clinic — they can glean important lessons straight from the pages of a few top reads. Here are five recommendations from leaders in health care:
- Death Be Not Proud by John Gunther: Gunther writes about the death of his 17-year-old son, detailing the excruciating months of his illness. “It reminds me that we really need to stay at our roots and remember why we went into medicine: to help patients and to develop new sciences,” Meyer says.
- The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee: This book spans the first documented appearances of cancer thousands of years ago to the new innovations to fight it. “What it did so brilliantly was explore both the human side of having cancer and also tell the story, warts and all, about how progress is made in research,” says Green.
- Grit: The Power of Passion and Perseverance by Angela Duckworth: Duckworth, a psychologist, shows people striving to succeed that grit trumps talent on the road to achievement. “The message is that as you go up the ladder, you need to find a safe spot where you have resilience and grit,” says Freischlag.
- When Breath Becomes Air by Paul Kalanithi: A look at a terminal stage IV lung cancer diagnosis from Kalanithi, a neurosurgeon. “It reminds you that we’re all mortal,” Collins says. “You have to take advantage of your time here.”
- The House of God by Samuel Shem: This comedic book explores the lives of six eager interns who come from the top of their classes, and struggle through the residency experience. “It’s important to say that it’s not because you should emulate that, but more that you should see how things shouldn’t be,” Bilimoria says.