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28 Lessons I Learned in Residency

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My 28th birthday fell conveniently on a day I was scheduled to work a 14-hour residency night shift in the pediatric ICU. On the 11th hour of a busy shift, I found myself finally sitting down to inhale a cafeteria cheesesteak. In the still of a cramped call room, I emptied my back scrub pocket, causing my night shift essentials to escape: pager — check, patient signout — check, miscellaneous peanut butter granola bar — check. I also found a folded sheet of paper. One side was littered with patient to-dos for the night. The other, a blank canvas. 

I pulled the cobalt blue pen from my wrinkled front scrub pocket and scribbled ‘Why’ at the top. 

Why was I spending my birthday in a cramped call room? Why was this the first time I was sitting down during my shift? Why is there a misconception that pediatrics is always this fun, sticky, playful specialty when it can be equally tragic, devastating, and heartbreaking? Why did I willingly sign up for such a demanding journey?  

A touch dramatic, perhaps, but the hustle and bustle of medicine often does not allow for much time to reflect. In this case, my time for reflection happened to come on a night shift when I was turning a new age, literally.  I will spare you the greasy, crumpled sheet of paper where I started to write my initial reflections on my journey in medicine. Instead, I'll share 28 (hopefully, less sleep-deprived) lessons I've gathered during residency — a period that has not only shaped my professional identity, but also my perspective on life and happiness.

If you're wondering whether this list is a form of self-reflection or perhaps a cathartic release from the demands of a busy PICU night shift, you're on to something.  If, in the process of reading this list, you find a nugget of wisdom that resonates with you, consider it a shared journey of growth and discovery on the tumultuous yet rewarding path of medicine. 

Here are 28 lessons I have learned during residency so far:  

  1. Your first patient is always yourself.
  2. Happiness is now. Happiness does not start when you get into medical school; when you get into residency; when you become a fellow; or when you get that attending job. Don’t postpone joy for career milestones.
  3. Appreciate health when you have it, not just in its absence. 
  4. Don’t let the demands of medical training sideline your other passions. Honor all your dreams along the way.
  5. Being a physician is more than patient care. Don’t underestimate your ability to advocate for others.
  6. Losing patients is never easy. It’s OK to grieve.
  7. Make it a practice to introduce yourself with your pronouns to your patients. 
  8. Residency can be all-consuming, so it is important to cultivate a support system. 
  9. Seriously, call your mom. 
  10. Express gratitude for the current moment (even if that current moment is in a call room).
  11. Treat medical students like you wanted to be treated when you were in their shoes (it really wasn’t that long ago). 
  12. Believe your patient’s pain. 
  13. Check your biases and actively seek to understand diverse perspectives. 
  14. Patients are more than their illness, their symptoms, and the notes you have to write.  Consider the whole person in your care. 
  15. Humor is a healthy coping mechanism. Actually, laugh out loud and laugh with your patients when you can. 
  16. Tater tots and a good cry are sometimes all you need after a tough shift.
  17. Therapy, too. 
  18. Use interpreters. Patients have the right to understand their medical care in their preferred language. 
  19. Be nice to the nurses. 
  20. You don’t truly understand something unless you’re able to teach it to someone else. 
  21. With that being said, get comfortable not knowing everything. 
  22. Life-work balance, not the other way around. 
  23. Apologize to your patients when you make mistakes. 
  24. Knowing your limits is a sign of strength, not weakness. 
  25. Acknowledge the potential for compassion fatigue and choose activities that replenish your emotional reserves. 
  26. Commit to one hobby that keeps you physically active. 
  27. Medicine is multidisciplinary. Ask nurses, respiratory therapists, clinical assistants, dieticians, and other team members their opinions on patient care.
  28. Remember your why. The initial reasons that led you to medicine can provide clarity and purpose during trying times. 

A career in health care can be filled with intense challenges and incredible growth. By honoring our dreams, finding balance, communicating honestly, nurturing friendships, and choosing happiness, we become great people, then great physicians. And, sometimes, you wake up from a 14-hour birthday night shift to the nurses bringing you a homemade pumpkin cheesecake (see point 19)!

What has helped get you through medical training? Share your experiences in the comment section.

Dr. Tasia Isbell is a pediatrician at Boston Children's Hospital and Boston Medical Center. She enjoys cycling, traveling, and exploring the world through cuisine. She tweets at @DrTasiaIsbell. Dr. Isbell is a 2023–2024 Doximity Op-Med Fellow.

Image by nadia_bormotova / GettyImages

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