Posts Tagged ‘Residency Tips’

How are you going to stand out from the rest of the crowd? Do you think you can do that by being the most-likely-to-regurgitate Harrison’s or Sabiston’s word-for-word? Probably not.

Watch this video and see if I can change your perspective a little bit (or maybe even flip your world upside down).

If pickup artists can get people to part with intimacy… And if con men can get people to part with their money… Then why are we having such a hard time helping people make healthy decisions?

Establishing rapport and trust does not take more time. (Neither pickup artists nor con men want to waste their time on their targets)

And being good at establishing rapport and trust is not something innate. It is learned and it is practiced. (Most people enter the pickup artist community because they lack social skills, not because they are already exceptional at them.)

So what about you? Are you willing to take some extra effort and to be a little more mindful in your interactions with patients, families, nurses, social workers, etc? You should be. It’s the key to a happier, more successful career.

If you’re a medical student, an intern, a resident or a fellow, then you can skyrocket your learning and your Boards preparation without adding time to what you do already.

You already go on rounds with your attending. You already attend conferences, classes, and morning report. You already go to Grand Rounds. And you might already go to Boards prep courses.

Well, check this out… with one tweak, your learning experience can go from okay to phenomenal.

If you want to get this amazing pen, you can order it from Amazon.

If you are an institution (a medical school, a residency program, etc) and you would like to learn more about how this concept can help your organization go from good to completely awesome, then go to NapkinRounds.com.

By the way, if you haven’t seen the changes yet:

Several times a month, I receive emails from patients and nurses thanking me for some of the videos I post with tips for medical students, interns, and residents. Well, recently, I received a moving message from a patient via my YouTube inbox. And she gave me a direct call-to-action to create a means for patients to offer advice from their perspective.

Well, this is the first step in that process. If you are a nurse, a patient, a caregiver, or really anyone who comes in contact with physicians, this is your opportunity to offer some advice. Over time, depending on the response, I will make this into a more robust, far-reaching project. I will select the best of them and redistribute them.

A word of caution… This is for sincere advice only. This is not a mouthpiece for attacking specific individuals, the healthcare industry or for lumping people into groups and labeling them. (There’s plenty of that in the news media) This is for sincere advice from one human to another.

Central Lines for Medical Students, Interns, & Residents

Placing central lines can be a pretty stressful part of medical school, internship, and residency… especially early on. Well, I’ve collected a bunch of videos and PDF files that you might find useful as you prepare for putting lines in yourself.

Let me know what you think of it.

Here’s another one of those internship tips videos for medical students, interns, and residents. Check it out… This one’s about the doctor-patient relationship:

One of my close friends objected to the term “rookie” in the name for this site. Here’s a short video about how taking the perspective of a rookie could help you in your medical school, internship and residency training. Check it out:

I just started posting a whole bunch of video pearls and tips for your training on various video sites (YouTube, DailyMotion, etc). Here’s the first tip. It’s under 2 minutes… check it out.

OK. I just posted a video for interns and medical students on how a mentor’s advice completely saved my career. When I started my internship I was burning out and actually looking for other jobs outside of healthcare.

Well, when this mentor pulled me aside, she gave me a new perspective on things. So, it was better than an individual tip or a single pearl… She gave me a strategy. And I’m giving that same perspective, that same strategy, that same insight today. Here’s the link:

Now that people are in the thick of the internship interview season, the stress of getting prepared for internship is starting. Because of that, I thought it would be a good idea to reference a blog post that I saw a while back. The original post comes from Mother Jones, RN and is entitled Revisiting the Intern’s Survival Guide. It’s basically some sage advice (mixed in with some humor) from a nurse to new interns.

Here’s the link:

Revisiting the Intern’s Survival Guide

And here’s what I posted in the comments section back in June:

Great post.

For many, the appearance of arrogance actually comes from an intense fear of failure and fear of being exposed as someone who somehow slipped through the medical education cracks.

Unfortunately, some people try to cover or hide the fear, rather than saying, “You know what? I’m nervous. This is new to me. What has been your experience?”

“Smart interns forge alliances with the nursing staff” – great quote. If interns and nurses don’t see their missions as the same, they’re missing the boat. There’s a difference between a mission and a role. Both play different roles in the same mission.

And yes, there are too many new docs who start internship with an air of arrogance and, at times, downright rudeness. But, there is also a large pool of nurses that start off assuming there’s a turf battle. And both of these continue the cycle.

This probably sounds a little fluffy, but it would all be a lot smoother if we assumed the best in others.

For interns:
– Don’t assume you have to know everything.
– Don’t be afraid to ask for help
– Nurses know their job better than your attendings
– Social workers know their job better than your attendings
– The more you understand others’ jobs, the better off you’ll be
– Ask
– And when you ask, be polite about it.
– Communication is everything… more than words said, communication is an exchange.

For nurses:
– Interns are nervous, & everyone expresses it differently
– Be patient with the new folks
– Be especially patient with new interns from other cultures
– Don’t start off assuming a turf battle… sure defend that last piece of pizza
– The more you understand about others’ jobs, the better off you’ll be
– Ask
– And when you ask, be polite about it.
– Communication is everything… more than words said, communication is an exchange.

Also, be on the look out for an awesome freebie coming from RookieDoctor.com… very soon. The quantities will be limited because I can only ship out so many (before I go broke .

Residency tips and pearls should be a little more accessible than having to ask all of the time. Especially because there are some questions people are reluctant to ask… like about stress. Here are some coping tips for internship and residency…

No baby yet, so I had time to address some questions… One question was posed (on a forum) about extreme levels of stress and anxiety in internship and residency. Here was my response. Some of these tips and pearls come from the free report you can signup for at the right (just put your name & email in there & follow the directions… easy-peasy). Some of the other tips & strategies come from RookieDoc members-only videos. And some of the others were specific to the questioner. Anyway, check out my response and let me know if it helps you.

Also, if you have a question for me, Just Ask.

What you have expressed is ultra-common. It is, by far, the biggest thing I deal with every year from May to about October. I give talks to and provide services for new interns… I’m not going to plug my stuff here, but I am going to give you some background and a little proof that it is common.

When I started internship, I came in pretty average or slightly below average. I felt like any minute I was going to be declared a fraud & that somehow this whole medical school thing was actually a mistake. I was also immensely fearful of hurting someone.

Because of those two things – harming someone & being declared a fraud – I was always the first one in… always the last one to leave… At night I was dreaming about my patients. During the day I had palpitations, fatigue, reflux, etc. And throughout the day I was dreading any situation in which I could be called on or humiliated. Now, I wasn’t paralyzed with fear and I did my best not to show it, but I was definitely burning out.

So much so, in fact, that there was an intervention. Two attendings pulled me aside and took me under their wings.

One & a half years later I was Resident of the Year, then Chief Resident, and now I hold a prestigious position at my institution. Now the unfortunate thing is that not everyone gets attendings to guide them through it all (despite the whole idea behind our training). The fact is, you’re right, many people do talk about specific interns behind their backs. Some even pigeon-hole them into categories and give them labels that stick with them throughout their training – passed from attending to attending.

So I started giving talks to new interns and started some web sites and services. In the process, I have interviewed or surveyed well over 1100 interns anonymously and as a coach/counselor.

And guess what? Most of them list those same two top fears that I said I had. (My surveys always ask for the 3 top fears… and these 2 are the most common) Fear of harming someone is always number one… and fear of being the weakest link or worst of your peers or exposed as a fraud – almost always number two.

So what you are feeling is more common than you think. Actually, it’s probably normal.

Now, is it as intense as you describe? Not usually.

Now, on to some things to help cope…

1 – You are not alone. You know when you’re sitting around with the whole team – the students, the interns, the residents, maybe fellows, and the attending? And you know when the attending starts throwing questions out to the group? At that moment, everyone is secretly hoping they’re not called on. Everyone is eager to blurt out an answer when they know it… because they want to be absolved from answering the ones they don’t know. (Incidentally, because of this fear, I always start with the students, then the interns, then the residents when I’m asking questions to my team)

2 – The 10-Year Litmus Test. Ask yourself, “10 years from now, will any of this matter?” And the answer is no. It will not.

3 – Strengthen Your Strengths. This might sound like an odd suggestion & maybe even unrelated, but it is not. Most people are worried sick about their weaknesses. But think about this… How are you going to stand out? How are you going to provide the most value to your program? How are you going to forge the career you want, that’s in line with your passions and goals? Do you think you will do these things by working on your weaknesses? No.

If you want to stand out… If you want the people around you to say good things when you’re not there… If you want to like the company you keep… and if you want to make an impact in your patients lives or even on the world at large…

Then you should strengthen your strengths. Provide value to your program and your patients and your fellow interns with the areas you are strong in. (Related to medicine or not)

4 – Compare Yourself To Yourself. Too many of us worry where we stand relative to someone else. Like you said, “i will compare myself to my class mates and convince myself that they are all so much better than i am”. You are comparing what you know of yourself to what you do not know of others. You have no idea what they are thinking… what their fears are… or even what attendings think of them… or the vibe that patients get from them… or whatever. The best comparison to make is “This is where I am now – am I better than a few months ago? And how much better do I want to become?”

5 – You Are Not At The End Of The Road. Just because you are a doctor doesn’t mean that you are done. You are not at the “end of your training journey”… you’re right in the middle of it. You’re in the middle of the process. Trust the process a little bit.

Thousands of interns have come before you and thousands will come after you. All have their strengths and their weaknesses. This process helps make those weaknesses into competencies (maybe even strengths depending on you and your program). But the ultra-successful ones will be the ones who leverage their strengths.

So trust the process and add value along the way.

6 – It’s All About Communication. It’s not about knowing the right answers or even ordering the right tests the first time around. Those things come with time.

The best doctors are the best communicators. (By the way, so are the best wives, husbands, parents, etc) More on this another time.

7 – Avoid Complainers – Steer clear of complainers. Complaining is infectious. And whining will get you nowhere.

8 – Avoid the backbiters.

9 – Laugh a little bit. Check out sites like GiggleMed.com’s Medical Humor Blog, Placebo Journal and Q-Fever. But find humor only in appropriate things related to work – not in individuals or demeaning things.

Anyway, I hope this helps.