Five tips for surviving as a new doctor
Your how-to guide from physicians and residents on Figure 1
Every July, U.S. hospitals prepare for an influx of new doctors — medical students who have finally made the transition to intern or resident. There is a popular notion (known as “the July effect”) that patient safety is at risk during this time due to the mass arrival of inexperienced trainees. Although research on this subject remains inconclusive, summer can still be a source of anxiety for new interns and residents.
We surveyed Figure 1’s global community of physicians and residents for their insights on surviving your first day of residency. Based on their feedback, here are five tips for new doctors.
1. Know that your attendings have your back
The majority of survey respondents said that patient care is not adversely affected when new interns start. Many attributed this to the greater level of vigilance and supervision from senior staff.
“There have been studies debunking this myth,” said a family medicine physician. “Most residency programs are under high alert when the new interns start.”
One orthopedic surgeon said they pay special attention to new interns.
“I keep a close eye on interns as they work. They also ask more questions and are less bold than their seniors.”
An internist went as far as to say errors are ultimately on the attending, not the intern.
“It’s the responsibility of the head of the teams who are seasoned physicians with experience.”
While it can be nerve-racking to work under so many watchful eyes, rest assured that your patients’ safety will not be compromised. Your senior residents and attendings are there to guide you.
2. Accept your limitations
Remember that you are human. You can’t possibly know everything, especially on your first day.
As living proof of this, one internist on Figure 1 recounted their first day as a new resident:
“My first patient as a resident crashed while I was rounding on day one. I was alone and the rapid response team came and took over. Everyone was asking me questions that I was not able to answer. I felt bad for it.”
Now an attending physician, that same internist goes out of his way to ensure that interns feel supported. “I teach the interns that a hundred things can happen on their first day, but that’s why the seniors and attendings are there,” he said. “I also encourage the seniors to be more helpful to the new interns.”
Other physicians and residents on Figure 1 also had stressful and embarrassing memories to share from their first day as an intern. One internal medicine resident revealed,
“On my first day as an intern, my senior asked me how much glargine [long-acting, man-made insulin] I wanted to give my patient. My answer was, ‘Um… 1,000 maybe?’ I had no idea what a reasonable dose of insulin would be.”
An orthopedic surgeon recalled similar humble beginnings…
“I remember not eating lunch for the first week because I was so busy and being yelled at by a (now) colleague for missing a patient’s renal failure.”
…while a general surgeon expressed regret over taking his bad day out on a patient.
“I was taking blood samples from a 2-month-old. He was fragile and small, and as I struggled to get some blood from his already tortured veins, I found myself getting mad at this poor little kid. I regained my cool and swore that would never happen again.”
And sometimes, it’s not even the medicine that stumps you.
“I got lost on my first day trying to find radiology,” admitted an internal medicine resident.
As a physician, you will face uncertainty and you will make mistakes. Learn from each experience and move on.
“I remember being terrified, exhausted, and making mistakes. Somehow it all works out.” — OB/GYN
3. Ask for help
Admitting when you don’t know something can be hard. Do it anyway.
Survey respondents who did notice adverse effects on patient care in July said this was often because new interns don’t ask for help when it is needed.
“Always call for a second opinion when you’re not sure,” urged a neurosurgery resident.
“Ask questions and don’t be afraid to say ‘I don’t know’,” echoed an orthopedic surgeon.
While the general sentiment is to seek help from others, also make sure you’re asking the right questions.
“Don’t expect attendings and seniors to ‘transfer’ information and experience onto you. You need to read and formulate clinical questions based on new knowledge.” — General surgeon
4. Pay real attention to your patients
One body imaging fellow said new interns are so nervous on their first day that they often forget how to engage with their patients:
“They’re so wrapped up in the process — the notes, how to write orders — that they forget how to doctor.”
Listen carefully and communicate clearly. Knowing how to take a relevant history is of the utmost importance, according to several community members on Figure 1.
A family medicine physician recommended maintaining a healthy sense of curiosity when listening to your patients, while a pediatrics resident emphasized the importance of what you say in return:
“Don’t tell [patients or their families] diagnoses or prognoses without a proper understanding of the pathology and/or course.”
Your patients will likely have follow-up questions and you should be adequately prepared to answer them. Don’t feel like you know enough? Refer to the previous tip.
5. Listen to your nurses
Your colleagues are a valuable resource. This isn’t limited to fellow residents and staff physicians — you can learn a lot from an experienced nurse.
“Accept help from the nurses. They will make or break your first year,” advised an emergency medicine physician. “Show them respect and they will show you respect.”
Other members of the Figure 1 community echoed this point, emphasizing the benefits of incorporating nurses and other staff into care planning. But nurses can help you in surprisingly basic ways, too.
“There will be days where you don’t have time to eat,” said one OB/GYN resident. “If you’re good to your nurses, they might be nice enough to sneak you a cookie while you’re running from one patient to the next.”
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