From Junior Clerk to Junior Resident

Posted on September 18, 2017 

By Dr. Nabeela Nathoo

The first residency program originated at the Johns Hopkins Hospital, created by none other than the great Canadian physician Sir William Osler in the 1890s. At the time, residents were also called House Officers, living in the hospital and basically putting aside the rest of their lives to focus on their medical training. Although much has changed in the last 125 years, some things have not. As resident physicians in the present day and age, we still carry significant responsibility, and in essence, we are the primary care providers of patients on our services overnight whilst on call. However, we also dare to try to have lives outside of the hospital, working on that ever elusive work-life balance that continually creeps into conversation and that is seen all over social media.

As the most junior of junior residents, only having completed two and a half blocks so far, my residency experience would be best characterized as a series of firsts. On my first day of residency, I nearly passed out looking at an infected gunshot wound and had to excuse myself from the patient’s room. I witnessed my first code called by someone else. Then I called my first code. I pronounced someone dead for the first time. But not all of my firsts have been so morbid. I introduced myself as Dr. Nathoo for the first time. I wrote my first order (of now many orders) that didn’t require a co-sign. Possibly best of all so far, I witnessed endovascular therapy for an ischemic stroke for the first time, after which the patient had an incredible recovery.

I know that many firsts have yet to come, both good and bad. But I am more comfortable to take on all of these firsts knowing that I am surrounded by wonderful residents who are going through the same things. In particular, I feel a strong sense of camaraderie when I continually run into the same residents on other services in the emergency department, all of us sharing in the chaos that is overnight call.

Although I am extremely early on in residency, a few things have continually come up in conversation from senior residents and staff mentors that I am aiming to keep in mind. I am hopeful that these will also resonate with you, no matter what stage you’re at in your residency journey.

1) Wellness, wellness, wellness.

Such a buzzword. What does wellness even mean? I think it means whatever we each want it to mean, to put ourselves first. Whatever helps us keep our sanity when doing 1 in 4 in-house-call or 1-in-3 home call. It can mean going for a long run, getting a massage, or grabbing some post-call brunch (my personal favourite). You can read that chapter of Harrison’s later. As the adage goes, you can’t take care of others unless you take care of yourself first.

2) Soak it all in.

When you’re at work, actually be present. Do your best while you’re on a rotation, even if it doesn’t align with your interests. You never know when things you learned off-service will come in handy. This is our chance to take it all in and to develop into the best physicians we can be. This mindset held true since the start of formal residency programs in the 1890s, and is what we should continually strive for to this day as residents in 2017.

3) Remind yourself of why you’re here in the first place.

Residency is it. We are living the dream of actually practicing medicine. This is what we had envisioned as pre-meds and medical students. Although residency can seem insane at times, we have now transitioned to being the primary care providers for patients. We are the ones who talk to patients and their families about their prognosis with an untreatable cancer. We (you surgery residents!) are the ones who fix that bowel obstruction or perform a nerve graft. We have this great ability as residents to truly affect peoples’ lives and try to cure them of their ailments, or at least improve their quality of life. And that is something to always remind ourselves of and to take great pride in.

May the 2017-2018 residency year bring you lots of amazing cases and learning opportunities, laughs and memories with fellow residents, and wellness in whatever ways bring you happiness.

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Dr. Nabeela Nathoo is a PGY-1 in Neurology.