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10 Ways to Start Your Residency Off Right

coffeeandresidencyTo all the fourth years out there, a hearty, extremely caffeinated congratulations on completing med school. (Cheers!)

You’re about to embark on the next chapter of your medical journey, and what better way to do so than to arm yourself with some tips for how to be successful in your residencies?

Regardless of where your residency is taking you geographically or the specialty you’re pursuing, everyone can benefit from getting a leg up early on with real-life survival tips.

Two of our chief USMLE tutors, Drs. Nicholas Rowan and Michael Coords — who are starting their fourth years of ENT and radiology residencies respectively — rose to the occasion and put their heads together to help you start strong and do well.

Without further ado, here are our Top 10 residency tips:

1. Get and be organized. Idiot-proof yourself from yourself.

This is probably the most important piece of advice. Put your pager with your keys, wallet, badges, etc…. Put them in the same place every single time, or leave them in your car. When you’re a robot going in to pre-round at 4 a.m., it’s hard to remember all of those things!

Make a system of checkboxes, different colored pens, basically whatever works, to keep track of things on the fly because as smart as you are, you will inevitably forget things. And believe me, forgetting things sucks. Now that you’re an MD and this is your job, forgetting things = more time in the hospital and potentially hurting someone.

2. First impressions, as always, are important.

Attendings, senior residents, co-residents and support staff will be judging you very early. Always be professional and keep your cool. Unreasonable requests will be made daily and people will be looking to blame you for things you had almost no part in. Keep your composure and be professional. Do what is right by your patients and NEVER screw over one of your co-interns. If that means staying late to not sign out a ton of stuff then so be it. You are all in it together and you do not want to be known as the resident who doesn’t work hard.

3. Realize that every moment is a teaching moment.

Regardless of how many times you’ve seen the diagnosis, read the chest X-ray, performed the operation, etc., there’s always something to gain. There is always something to learn even if you feel like someone is wasting your time. On that note:

4. People will inevitably try to waste your time. 

However, it’s up to you to have something to do when your attending is getting Starbucks and you’re looking to go to bed. I prefer to use Todoist which is a helpful app/website to keep track of what I need to get done.

5. Learn the power of “No.”

This is really really hard, but residency is also really really hard. When you take on more than you can handle, things will inevitably go south. Before saying yes to a project, an extra shift, etc., make sure you really can accommodate that and you’re doing what is best for you.

6. Try to maintain the 3 A’s: Available, Affable and Able.

The first two of these are the most important. Like Dale Carnegie’s famous book “How to Win Friends & Influence People,” striving for the 3 A’s is always important. Being Available, Affable and Able is important to any doctor’s practice, interns to attendings. While we may not necessarily be “able” all of the time (that’s what our seniors are for!) it’s important to be available and affable even when you’re getting a 3 a.m. consult for earwax removal. 

Also, don’t forget that you’re surrounded by people who are going through or who have been through the same thing. Don’t be afraid to be frank, and don’t be afraid to ask for advice.

7. Know your limitations.

We were all very solid med students, did great on boards and overall are very confident people. It’s ok to not know things and it’s important to not pretend to know more than you actually do. Reach out for help when needed. Yes, you will get an attitude from your senior resident who was sleeping if you wake them up, and no, your attending does not actually want you to page them at 2 a.m. but things will go very badly if you screw up with something you are not familiar with so ask for help when needed.

8. If you’re doing a surgical internship, get good standing shoes.

I like Danskos. If you’re doing medicine or other specialties, get good walking shoes. If your feet and legs are swollen at the end of the day, compression socks/stockings work well.

9. There are good nurses and bad nurses.

Learn who is who very quickly. When a good nurse pages you and says it’s important, then you need to get there quickly. The nurses who harass you all the time just to put “MD aware” in the chart… well, ignore them at your discretion.

Lastly, perhaps one of the single most important tips we can give you:

10. Always have a plan for food. Don’t allow yourself to skimp on meals.

You need to eat. Find something you like — such as healthy snack food — that you can eat in a minute or two when you have down time. One of our go-to choices was the CLIF Builder’s Bars. They don’t melt in your white coat pocket and have lots of protein. Or, in our humble opinion, PB&J (or Almond Butter & J) can be the best damn snacks out there. Protein, fiber, salty, sweet, BOOM.

Bonus: If you drink espresso instead of a regular coffee, you won’t have to run to the bathroom as much.

Just say no to the world’s largest cup of coffee, however tempting it may be. On a related imbibing note, just accept the fact that come July 1st (or whenever your residency begins), your alcohol tolerance is about to go way, waaay down. So when you do get your rare and blissful free/decompression time, party safely.

Here’s to a successful residency!