Congrats! You’ve matched into family medicine! Welcome to the best position in the world! You must be thrilled! But right about now, you begin to have questions.?What should I expect? What is expected of me? Is there more than just medicine? And then one of the most haunting questions I ever had:? “Will I kill someone?”. I had all the same questions… except… I never got any of the answers.
? ? ? ? ? ? ? ?Not until now. Now I know.
So I’ve decided to share them. I hope this post helps all of you about to start your 1styear of FM. Both to ease your mind.. or maybe even open it.
So what is it like to start family medicine residency? AWESOME, clearly. BUT, what are the hours like? I will say this… full disclosure… it depends on which rotation you are on, also depends on who your attendings are AND even on the program, you matched into.?This is the experience I have had at my program… yours may differ.
On average, expect to work between 8-13 hours a day. On outpatient rotations, you have weekends off. On inpatient rotations like ICU, Inpatient medicine, which my program calls adult medicine, and Emergency medicine… you will work 6 days a week, between 10-13 hours daily.
On outpatient rotations, you have clinic hours, 8-5 pm.
There will be days where you have clinic for half a day usually in the afternoon and you are on inpatient medicine, so you need to be in the hospital in the AM and then go back to the hospital after clinic is over to do your PM rounds, finish notes, check in on patients and leave everything ready for the next day. These days are the toughest because you have inpatient notes, AND clinic notes to finish. It takes time and practice to get better at time management. You’ll get there.
? ? ? ? ? WHAT IS EXPECTED OF YOU ? ? ? ? ? ?
Punctuality:?If you are on the dot…you are late. Be places 10-15 min early to allow yourself time to set up, turn on computers, sign on. Etc. It shows you respect your position, and respect those you work with. Their time is as valuable as yours.?
Accountability:?Hold yourself accountable for things you say you will do, for when you forget or order the wrong thing, and/or write the wrong thing. Hold yourself accountable. Admit your mistakes and doubts. This allows others around you to trust you and depend on you to follow through.?
Honesty:?If it’s in your notes, make sure you’ve actually done it. For example – if in your physical exam you say “no lymphadenopathy” make sure you’ve palpated the lymph nodes. Trust is not only important but crucial. Defensive medicine is NOT great, but… if your charts ever become used in legal situations, be sure you chart exactly what was done. The chances of you remembering what you’ve done at each patient encounter are low. You will one day refer back to these notes to remind yourself of what you saw, felt, and observed/appreciated. So be honest.?
Respect:?Be courteous to everyone around you, including cafeteria staff, cleaning staff. The environment you foster will benefit you in the long run. You want to come to work in a good environment. Respect others’ privacy as well as their boundaries! Don’t demand things or “order” things. Request, and then say thank you. You are a team.?
Read up on your patients:?The best way to learn is to read up on your patients. Treatment plans, options, side effects, benefits. Everything. It will help your patients in the future and help you help them. Also, it will make sure you know how to answer questions if you’re ever pimped.?
? ? ? ? ? ? ? ? ? ? ? ??WHAT TO EXPECT?? ? ? ? ? ? ? ? ? ? ? ? ??
Long hours:?As mentioned above, some days run as long as 12-14 hours and if you’re having fun you may stay later… I’ve done it. The average workweek is about 70 or more hours, with a limit at 80 hours a week. This means, if you hit the 80 mark.. you must go home.?
Some weekends off?You get 1 day off a week during inpatient rotations, and both weekend days off in outpatient ones. Make the best of them. Do what helps you keep your sanity! Whether it be the Gym, outdoor activities, family time, etc… Whatever it is. Do it and be present.?
Vacations days:?Each program is different. I have about 21 vacation days including sick days, so I plan wisely. I haven’t used a sick day yet.. but let’s not jinx it. Oh, and no vacations during inpatient services (ER, inpatient medicine, and ICU).?
Fatigue:?You will get tired. Very. Personally, when I get tired I get emotional, sensitive, and it takes me a bit longer to finish notes and documentation. Know yourself! Know how you react to fatigue, know what you need to help it, and adjust your workday and workflow to account for it. I need a hot bath with candles and meditation music, other times I just need a good cry, others a quick workout sesh is just what the Doc ordered. Depending on where I am at in my fatigue.. I know what I need. It is important to know these things so that it does not interfere with your work, patient care, and so you don’t BURN OUT. Recognize your fatigue and do things early on to help it.?
Support: Lean on those around you. Your co-residents, your family. Your attendings. Keeping things bottled up leads to BURN OUT. Don’t let yourself get to that point. You will be surprised how quickly you bond with your class. You will have a village supporting you whether you ask for it or not. That has been my personal experience at my program and I hope it is yours when you start.?
Fun:?Medicine is fun. It is detective work. And you will be doing it with other people who share your interest in it. Aside from that: downtime between patients, between work, between note writing and patient presentations… there will be time for fun. You will make friendships with people in the hospital. The nurses, the cafeteria crew, the cleaning crew, your co-residents, and even attendings. Even on your worst day, someone will make you smile. This has been my experience. And you also have weekends off, so you can definitely study…and go to the pool, beach, dancing, picnics, get-togethers, etc. And Church its something you need and value. Point is.. if its important to you, there will be time to do it.?
Now here is a tough question:
? ? ? ? ? ? ? ? ? ? ?WILL I KILL SOMEONE?
?A better question is:?
Will someone die while I am part of their care team.
The answer is yes. I have lost patients. In my 1stmonth as an intern, I lost a patient and it was very hard for me. Lucky for me, I had a family away from my family to lean on, to share with. If this happens and you find you’re struggling with it; talk about it: with friends, with family, with colleagues, and if needed a psychologist or psychiatrist. NEVER let these things fester in silence. You can’t help others if you don’t help yourself.
Bottom line is: Welcome to the life of a family medicine resident. My 1styear has flown by! Live the moment and love what you’re doing.? Cheers to becoming tadpoles! I am so proud of you. Now go do doctor things!