"So how long have you been a doctor?" my patient's daughter asks as I'm leaving the room.
"Two months," I answer with a grin.
This is how my 79-year-old patient came up with my new nickname: Old-timer.
The transition from medical student to doctor is unlike any other professional promotion. It occurs overnight, like a caterpillar emerging from a cocoon. A young physician may appear to have colorful wings, but inside, he feels more like a moth – pale, naïve, and flapping at every flash of his pager.
Staying Human During Residency Training: How to Survive and Thrive after Medical School, by Dr. Allan D. Peterkin, is the roadmap that attempts to ease the transformation. It's filled with useful tips for first-year medical students through chief residents. The overall theme is simple: Doctors are people, too, so don't let residency strip you of who you are. Don't let the study of medicine make you ill.
This book is a gumbo of guidance on topics ranging from staying fit to choosing a residency program. Lists and tables fill the pages for quick and easy access. And many sources are quoted directly. There are also links to websites and additional reading suggestions for further exploration. I would not suggest anyone sit down and gobble this book from cover to cover, but I would recommend flipping through the pages over your Thanksgiving break, as Peterkin has created a wonderful reference for all of us.
The beginning chapters discuss the many challenges and stressors faced by new physicians. The section on sleep deprivation is particularly interesting. Thankfully, times have changed, and attendings will remind us of that. The new work hours are a step toward a healthier culture of training. However, "time pressures, fatigue, and maintaining self-confidence tend to be...the most difficult...aspects of residency training." The key, as this book points out, is to create a balance between work and everything else. It may even be necessary to pencil time into your daily schedule for family, friends and maybe even some fun.
Reading a reference book can only take one so far. As Peterkin admits, "Finding a mentor may be the single most important step you take in obtaining professional support during residency." A good mentor is essential to survival; it's never too early or too late to find one. Many schools have formal mentorship programs. And many residencies, including the one I'm at now, have mentors assigned to each resident even before they start.
Toward the end of the book, soon-to-be interns can appreciate some practical tips. The most helpful ones include a section on making effective consults as well as a brief overview on the process of confirming death. Unfortunately, to reach the practical advice, the reader must navigate through lists of often repetitive principles and some not-so-helpful ones. In no particular order of absurdity: "Use gloves when examining genitals." Test-taking tip No. 1: "Get to know the material." And "Diaper changing is usually done without gloves but followed immediately by hand washing."
While this is the fifth edition of Staying Human During Residency Training, it may have benefited from additional oversight. One section assumes all people carry iPhones, and other chapters make suggestions that each resident request to carry a pager so that nurses or family can get a hold of them. Yes, an iPhone is helpful as both a resource and mode of communication, but really any smart phone will do (sorry, Tim Cook). And I can guarantee every hospital has a system in place for reaching its housestaff – without residents petitioning for more pagers.
So as I navigate my first year of residency, I take comfort in knowing: Even true old-timers were once interns.
Dr. Benjamin Lemelman is a PGY-1 resident in plastic and reconstructive surgery at the University of Chicago Medical Center.
Editor's note: TNP staff and American Medical Student Association fellows were given an opportunity to make suggestions for this edition of Staying Human During Residency Training prior to publication. Dr. Lemelman, however, is an independent reviewer.
Staying Human During Residency Training:
How to Survive and Thrive after Medical School
by Allan D. Peterkin, M.D.
- University of Toronto Press
- 255 pages