The rotations on adult medicine and critical care are probably the most challenging ones for the residents doing internal medicine residency. No matter how much we try, we tend to feel overwhelmed, fatigued and swamped sometimes. As we progress into residency, we not only gain knowledge and clinical skills but also learn to tackle the challenges of a busy schedule. Below are some of the tips that might be helpful.
1. Find out your day-off style early. I strongly believe that the first few months of the intern year are significant for knowing your style, your timing, and your pace. In the core rotations such as adult medicine and critical care, residents are given one day off per week. The purpose of this one-off day is to relax, rejuvenate and prepare your mind and body for the upcoming week. Some people like to hang out with friends or family, while others feel more refreshed in the work week if they had some “me time” on their day off. Sometimes, the entire day is gone in doing groceries and domestic household chores. One helpful tip that can save a couple of hours is doing the groceries the evening before your off day. This can save time for the groceries on the day off and can be utilized for exercise and reading.
2. Flashcards/notecards. Seeing patients earlier in the morning, rounding on them with the rest of the team, presenting the case well is indeed a daunting task, and the busy schedule barely gives any time to read medicine at home or the hospital. Whether it’s CHADs Vasc score or Stop Bang score, recent guidelines or diagnostic/therapeutic criteria, everything seems difficult to remember in the initial months of residency. Flashcards and notecards are something that can be helpful in such a scenario. Keep blank notecards in your pocket and write the quick guidelines or any scoring that you find difficult to remember. Keep the cards in your pocket for reference.
3. Analyze yourself. This is something often overlooked by the interns. We do ask our seniors for the evaluation and feedback, but it is equally important to analyze yourself at the end of each week. Are you doing good? How are you doing on your timing before the rounds? How much time are you taking on your notes? How are your notes? Are you improving your documentation and presentation? Are you feeling fatigued and overwhelmed? What can be done to overcome this?
4. Focus. Writing notes is another difficult task that interns find difficult to deal with. Focus is something that is needed while doing them. Time yourself and find your style of doing notes. Are you comfortable doing notes if it’s noisy in the resident lounge? Are you taking excessively long on finishing the notes on time? If yes, then you need a strong focus. Try to avoid distractions. Eating and making notes may seem like it’s saving you time while you are not able to focus on either of the tasks. Try to avoid multitasking — especially when typing your notes.
5. Gratitude. Develop a sense of gratitude. Have a gratitude walk as you walk out of the hospital daily. Think of the blessing of getting matched into residency. You surpassed all the hurdles, you faced all the challenges, passed the boards and aced the interview season and matched. Now you are seeing patients, providing excellent care to your patients and — most importantly — you are improving every single day. Sometimes a quick self-talk of gratitude is enough to take away the stress and fatigue or a busy rotation.
Abeer Arain is an internal medicine resident.
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