A Letter to R1’s

By Dr. Nazia Sharfuddin

Congratulations on starting residency! This milestone is sure to be one of your most memorable, especially given that you start your venture as a physician during a global pandemic.

I remember the anticipation of July 1 astutely and it is a day that is similarly memorable for most. I acutely remember the combination of nerves and excitement the night before, unable to catch any proper sleep. It was certainly foreshadowing of the sleepless nights to come as an Internal Medicine resident. On July 1, what surprised me most was how seemingly ordinary the day was. I reported to my first rotation at 8 a.m., rounded on patients, read up on interesting cases and wrote down some orders. As the years would go on, most days would follow in a similar pattern.

As you begin residency, I ask you first and foremost, be kind to yourself. Residency is fraught with challenges, transitions and constant adjustments. It is also filled with growth, laughter and moments of immense fulfillment. Entering into medicine is an accomplishment and commitment to a profession that is one of a kind. Your success begins with that kindness to yourself, which will then extend out to genuine care for your patients, colleagues, friends and family.

Call can be grueling, but it is also the time when some of the best learning and skill acquisition occurs. There are nights where you will not see the inside of your call room, where codes seem to be the norm and where you will certainly qualify for an acute kidney injury if someone had ordered your serum creatinine. For me, those are the nights I cherished the most. They pushed me to the limits of my knowledge base, clinical skills and ability to connect with those around me. It was nights like those that helped form me into the type of physician I had always aspired to be. Nights like those are boluses for building up resiliency, confidence and clinical acumen. Nights like those also end; there is always light at the end of those calls and a warm bed awaiting you. For call, stay hydrated, have snacks available and whenever possible, sneak in a nap. The hours are long, but they are doable. And your post call days are critical in doing whatever you need to rest and recharge. Some spend their post call days working out, others enjoy a long nap and Netflix. I used to relish my post call days for catching up with my husband, eating a nice meal and relaxing. Whatever is important to you, let the post call days be a time when you invest in your well-being.

As Alberta begins its transition to Connect Care, a wholly paperless province-wide electronic medical system, you will find yourself rotating between sites that are either wholly paperless, completely reliant on paper or a hybrid in between. This can be a learning curve in adjustment but know that there is always help available. Be it a senior resident, preceptor, nurse or allied health. Cultivating good relationships with your team, especially the allied health and nursing members is paramount to your success. I remember many instances when it was a nursing colleague who helped me with an order during a busy night of call or navigating a new ward. Be proactive, ask questions and offer help. The help will come back to you many times over.

Residency is a great time to explore what the world of medical scholarship, education and leadership holds. As you progress through your training, you will naturally gravitate to the interests that most excite you and they will become your projects or focus of further exploration. We are fortunate in Alberta to have world renowned leaders and researchers amongst our faculties. Let yourself set up coffee meetings or Zoom calls to learn more about their field. I have met many of my mentors through an informal coffee meeting.

As lifelong learners, residency is just another chapter in our decades long adventure in medicine, albeit one of the most formative ones. I wish you all the best as you begin your journey. May you find success, kindness and fulfillment.

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Dr. Nazia Sharfuddin is an Internal Medicine resident physician at the University of Alberta.