Residency

I’ve been trying to think about how I’ll integrate writing into residency and having some difficulty. There are certainly a number of stories that would be worth sharing, but of course I can’t share any details of specific patients that would identify them. And some healthcare bloggers have gotten into trouble in the past for things they had written. Roughly one year ago an interesting survey was posted that looked into different things relating to social media that would get physicians in trouble. Most of them are common sense - don’t post patient narratives with identifiable information, don’t post photos of medical treatment without patient consent, don’t try to date your patients.

So rather than try to think about how to integrate writing into residency, I think I’ll just do it.

It’s hard to believe, but I’m already six months into residency. The entire program is five years long, so that already means we’re ten percent of the way through. I’ve done close to one hundred procedures in the OR already, and that includes roughly three to four months of time on night float, SICU, and other non-operative rotations. One of the reasons I was so attracted to this particular program is that the chief residents graduate with a very high number of cases - well above the average. And I’m definitely on track to be there when I graduate. The ACGME requirement is that residents do a minimum of 750 cases in order to be able to graduate from a residency program and sit for their board certification exam. Many programs I interviewed at last year touted 900 cases as a lot. At our program, the chiefs are graduating with 1300-1400 cases. It’s amazing. All of the graduating chiefs felt well-prepared to operate independently, which is unfortunately not true at a lot of programs where residents operate less.

One of the other reasons I was attracted to the program was how closely-knit all of the residents and faculty appeared. And that has turned out to be even more true than I realized at the time. We’re treated like true colleagues, and our attendings all work hard to foster an environment very conducive to learning. They give us instruction appropriate to our level, and respect what we have to say. Opinions of residents are heard and discussed openly. It sounds like a great place to be - and it is. It’s really a gem of a program.

Some of my family members got a kick out of me recently saying that doing a hernia repair is a relaxing activity. But it is! Certain surgeries lend themselves better to doing more as an intern, and hernias are one of the cases often called intern-level - even though they can be quite complicated. The anatomy is straightforward (although it’s fun to quiz the medical students on it and remember what it was like to be in their shoes just a year or two ago), and the cases are often done on an outpatient basis. In many cases, the patients aren’t sick, and they go home just a few hours after we’re done.

And probably most importantly, I feel that I’ve done enough of them that I really know the steps and the anatomy well - which is probably the biggest contributor to why they’re relaxing cases. It’s just like how you get to Carnegie Hall…