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Residents: It’s Time to Get Comfortable with the Uncomfortable

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“Can you do it?” my attending asked while unscrubbing from the O.R. and leaving me to finish the case. Six months into my PGY-2 year — but more importantly my first year as a urology resident — I was entrusted with closing the incision site after a radical orchiectomy.

That question, “Can you do it?” (or more accurately, “Can I do it?”) was what I have been asking myself for the past year. As I continued to learn new techniques, to study new topics, and to push myself to meet my colleagues’ expectations, all with less sleep and personal time than I have ever had before, that question was the theme. Can I obtain the skills to be comfortable operating on my own? Can I acquire the knowledge to make decisions for my patients without someone else’s help? Can I do all of this?

Although I had spent the last year operating and managing patients as a general surgery intern, starting my urology residency was a whole new experience. It was the culmination of my last 10 years of undergrad, work, and medical school, and I was finally doing what I was passionate about. For that reason, I was putting an incredible amount of pressure on myself to succeed, and I was seeking perfection, especially in the operating room.

I was, and still am, a new surgeon, and I know that I will make mistakes. I know I will encounter new and uncomfortable scenarios that force me to think on my feet and test the depths of my knowledge. Earlier this year, when situations like these arose, I struggled with keeping calm and thinking clearly. As I continued to operate, however, I started to take note of how my attendings and my more-senior residents were able to keep calm during the direst of situations and reach a safe resolution. These were skills that I admired and doubted I would ever acquire. “Can I actually do this?” I would ask myself day in and out.

After several months of urology training though, my perspective started to change. What I began to understand is that residency is truly about acquiring the confidence in your knowledge and skills to overcome challenging and unknown scenarios. This confidence is not acquired by repetition of cases and scenarios, but by a continuous accumulation of all of the new experiences you are thrust into as a resident. Starting off like I am now, everything seems new and unknown. The transition is difficult and the learning curve is steep because every case, every patient, and every complication is something you have never seen before. You need to train yourself to adapt to — and be comfortable with — the unknown. Little by little, this exposure provides you with more confidence in your ability to react appropriately in times when the solution may not be so obvious.

Quite simply, residency is about getting comfortable with the uncomfortable.

Coming to terms with that realization, I embraced the situation I was in and focused on how I confronted and reacted to difficult scenarios. I soon recognized that no matter how long you have been practicing, every case and every patient provides you with an opportunity to learn more and grow more as both a physician and an individual. With time, I started to improve and feel more competent as resident — more competent as a physician overall.

“Can you do it?” my attending asked while unscrubbing from the O.R. and leaving me to finish the case.

“You bet I can.”

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