Be a Doctor on Your First Day of Residency || I'm Not Ready

Summary

Sean Darmal, MD, recounts his challenging transition into residency, reflecting on feelings of self-doubt and the pressure to adapt quickly. He recounts a comforting interaction with a senior resident that helped him cope with the stress of being a new doctor responsible for patients. Darmal reassures new residents that initial anxieties and feelings of inadequacy will ease with experience and time. As they progress, tasks become reflexive, but he urges them to maintain a deeper understanding and empathy towards their patients.

Highlights

• Sean felt out of place starting residency, doubting his abilities. 😟
• A comforting chat with a senior resident turned his day around. 🤗
• Transitioning from student to doctor overnight is a major adjustment. 🩺
• Responsibilities increase significantly with real patient care. 🏥
• 'Fake it till you make it' is a common strategy among new doctors. 😅
• Residency starts with stress but eventually leads to confidence. 💪
• Teamwork with co-interns and seniors helps navigate challenges. 👥
• Maintaining empathy towards patients is crucial despite the stress. ❤️

Key Takeaways

• Starting residency is daunting but normal. Feelings of inadequacy will fade. 📉
• Support systems like mentors and teams are essential for getting through tough times. 👥
• It's important to push beyond survival mode to truly understand medical practices. 📚
• Always maintain empathy and remember the human side of medicine. 🧡
• Adapting to new responsibilities will eventually come naturally. 🌱
• Residency is about learning, growing, and gradually finding comfort in your new role. 🌟

Overview

Starting residency can feel like being thrown into the deep end of the pool. Sean Darmal, MD, describes his own tumultuous transition into this phase, recalling the self-doubt and the intense pressure to perform. Once a medical student, now suddenly a doctor with real-life responsibilities, the shift is overwhelming.

But there is light at the end of the tunnel. With words of encouragement from a seasoned resident, Darmal persevered. The camaraderie and shared understanding among colleagues proved invaluable. Despite the initial feeling of panic, there emerges confidence and competence with time and repetition.

Darmal advises residents to stay empathetic and curious. Even as the routines become second nature, it's crucial to delve deeper into medical understanding and remember the human element of healthcare. Residency is not just about surviving but thriving and growing into a competent and caring doctor.

Chapters

• 00:00 - 01:00: Doubts and Reassurance The narrator recounts a moment when they arrived at the hospital early in the morning, reflecting on their dedication and self-doubt. A senior resident questions their early arrival, and the narrator justifies it as necessary for survival and keeping up with others. This incident triggers self-reflection about their capabilities and place in the medical field, questioning if they truly belong as it seems more natural for others.
• 01:00 - 03:00: Starting Residency: Challenges and Adjustments The chapter titled 'Starting Residency: Challenges and Adjustments' discusses the feelings of doubt and inadequacy that new residents may experience. The protagonist reflects on their struggle to remember everything they learned in medical school and contemplates quitting. However, a more experienced colleague reassures them by sharing that it's normal to feel this way and that things often improve in the second half of the internship year.
• 03:00 - 05:00: Responsibility and Overcoming Fear The chapter 'Responsibility and Overcoming Fear' relays a personal anecdote about the speaker's intern year and a pivotal conversation with a senior colleague. This encounter provided crucial, timely advice that greatly impacted the speaker, instilling resilience and perseverance. The senior's supportive words helped the speaker navigate the challenges and self-doubt experienced early in their career. As a result, the speaker emphasizes the value of mentorship and encouragement, aiming to offer similar guidance to others embarking on new professional journeys, particularly those beginning internships.
• 05:00 - 08:00: Role Transition: From Student to Doctor The chapter delves into the emotional and psychological journey of transitioning from a medical student to a resident doctor. It emphasizes the initial feelings of panic and fear that many new doctors experience, reassuring them that these feelings subside over time, specifically suggesting that by December, one might feel more settled. The narrative compares this transition to the challenging start of medical school, yet highlights that residency, while tough, is slightly less stressful as it marks reaching a significant milestone in a medical career.
• 08:00 - 11:00: Building Confidence and Seeking Understanding The chapter 'Building Confidence and Seeking Understanding' focuses on the transition from being a medical student to becoming a fully responsible doctor. It captures the initial stress, fear, and responsibility that comes with suddenly having to manage multiple patients. The narrative emphasizes the emotional and physical pressure experienced by new doctors, illustrating this with personal anecdotes of constant sweating and anxiety. The chapter highlights the overwhelming challenge and the journey to build confidence and seek better understanding in the medical profession.

Be a Doctor on Your First Day of Residency || I'm Not Ready Transcription

• 00:00 - 00:30 so there's this one time where i was walking into work um and it was like 4 10 4 20 something like that and one of my senior residents was working nights he sees me you know walking into the hospital and he's like looking at his watch he's like dude what are you doing here four o'clock in the morning and i just looked at him and i was like i need to i need to do this just to be able to survive just to like be able to keep up with everybody at that point i was like am i even good enough to be in medicine do i do i belong here really this seems so natural for other people but not really
• 00:30 - 01:00 natural for me how is everybody remembering everything that they learned when for me it feels like that was 10 years ago it wasn't a good look it just didn't feel right but there were moments where i was like yo i should just walk out of here and not come back and right then and there he was like oh i know exactly what you mean the same thing happened to me he was telling me that he felt the same exact way that he was filled with doubt but then he told me he said the first half of your intern interneer is very different from the second half
• 01:00 - 01:30 of your intern year and he told me things that i needed to hear at that exact time and it was my first time talking with him too awesome senior and i gave him a big hug i was like dude i needed to hear that thank you and i went on about my day but i i held on to what he said just prayed that that got me through it and that really helped me out that's why i want to be the one to tell you you're starting out in july july 1st you're starting out congratulations it's going to be tough you're going to make mistakes and you're going to feel like you don't belong there you are not good enough to be there that
• 01:30 - 02:00 feeling that you get deep down where you feel like you can't breathe and you're panicking and you're scared that goes away give it till december and see how you feel because i promise you you'll feel like a completely different person transitioning into residency was probably the hardest adjustment i've ever had to make throughout my medical career okay aside from my first few months of starting medical school in the first because that was very tough starting residency was just as hard just in a different way it's a little bit less stressful because you kind of made it to the finish line so you're exactly
• 02:00 - 02:30 where you wanted to be four years ago but it's real responsibilities and there's real people that you're taking care of but that transition from just one day being a medical student and then the very next day you are referred to as a doctor you're responsible for your patients and not just like one patient eight nine patients at the same time it's so stressful you're just scared and you're panicking for the first couple months and do you know how much i was i was sweating every single day that i went to work i was just sweating all day my biggest fear was i just didn't want
• 02:30 - 03:00 my attendings to find out how clueless or how stupid i actually am that that whole fake it till you make it thing is is very true actually and you'll realize that in residency in in the first couple months you're doing whatever you can to survive on a daily basis you realize just how many deficiencies you actually have and that's the tough thing about intern year there are so many things you want to brush up on and you you feel like you need to be a little bit stronger a little more familiar with the material because you're seeing it in real life you're like man i should really know the
• 03:00 - 03:30 ins and outs of this disease you really have a desire to learn all that stuff but there's absolutely no time to actually sit down and read and study but yeah there there comes a point where you're absolutely clueless you have no idea what you're doing and you're just scared and you're panicking for 12-14 hours a day and so that takes a toll on you on your soul and kind of numbs you to everything you know for the last four years my only responsibility in reality was take a
• 03:30 - 04:00 damn test study enough to know enough not forget enough just to take a test so you could forget it in like two weeks okay i'm referring to myself here but when i was a medical student it was just regarded as just that there's like a little little stench around you and even when you're in your third and fourth year like going through clinical rotations you're not very needed in in a hospital you know what i mean like you being there is extra work for people you're like stuck in a weird position and it sucks you're trying to be helpful you're trying to be resourceful and you're trying to make a good impression but
• 04:00 - 04:30 you're also not trying to drive your seniors and your your attendings crazy but you also need that recommendation letter you know you know what i mean and then all of a sudden with absolutely nothing changing in between those time periods okay now you're a doctor now it's your responsibility to take care of everything you know nothing has changed i'm still the same person that was annoying just six months ago and then now i'm oh doctor we need you what do we do doctor you know how many questions you get from nurses on a daily
• 04:30 - 05:00 basis they're looking to you to to solve those problems and to have the answer in your first few weeks when a nurse asks you a question you're gonna be like well what do you guys normally do in this situation oh okay that sounds good to me too you know all of a sudden you're what is this but do you not do you not see how weird that is i can't be the only one who's thinking this yes it will be tough no matter where you are or what you're practicing you got to realize there are a lot of checks and balances that have been put in place to make sure you you get to that point where you start feeling comfortable to be
• 05:00 - 05:30 practicing on your own you're working with a team of residents you usually have a co-intern that's with you but you also have seniors sometimes two seniors second year or third year that's how you get through the day to day that's how you answer all those little questions all the meticulous things that goes into being a practicing physician and then you also have an attending who teaches you the concepts you you run everything through these chain of command just to make sure you're not accidentally killing a patient or something like that you know what i mean and i promise you things that would make you sweat before it just becomes natural it becomes
• 05:30 - 06:00 reflexive and i never thought that would happen for me that that how does something like that become reflexive but by the second or third time that you're seeing the same disease you know exactly what you're gonna study you know exactly what orders you're gonna put in you know exactly what medications you're gonna start and at that point you stop sweating while you're talking to a patient and gathering information for your hpi you're already generating a list of assessments and plans that you have for the patient in your head while you're talking to them so that's how it kind of becomes automatic just one thing i like to emphasize or warn you about
• 06:00 - 06:30 although in your first year you're doing whatever you can to survive just after you start feeling a little bit comfortable like after the six months just start pushing yourself to try to gain a deeper understanding of everything that you're doing being able to justify why you're putting in every single order don't just do certain things just because you've seen other people doing it the same way always question why why are you choosing one medication over another medication why you're doing these studies exactly what are you trying to figure out or what are
• 06:30 - 07:00 you trying to rule out just don't lose sight of that don't lose sight of the bigger picture and secondly don't forget that the person that you're treating is is a human being that is somebody's mom dad son daughter brother sister just don't forget that's a human life sitting across from you who has a life just as complex and interesting and important as your life yeah don't don't forget that that's that's somebody's grandma you know sitting across from you you'll want to work for that patient and you'll want to do everything in your
• 07:00 - 07:30 power to make that patient better and in the process you'll become better [Music]