September 5th, 2019

Building Your Squad — Residency and Beyond

Ellen Poulose Redger, MD

Ellen Poulose Redger, MD, is a Chief Resident at Stony Brook University Hospital in Stony Brook, NY

At nearly every stage in our education and training, we find “our people.”  Maybe it’s your table-mate in kindergarten, or the kid with the really cool light up sneakers in preschool who becomes your best friend.  Maybe it’s your next-door neighbor who you play with after school, or a coworker from your first job in high school.  These people become part of our squad — even if their membership is only transient in this long journey of life.  What I’d like to talk (write) about though, is finding your squad in residency.

Match Day, MS4 year:

You nervously check your email or open an envelope to reveal your fate for the next 3-7 years.  After all the emotions of where you matched happen in rapid cycle, you think, maybe for a minute — who else is going to be there with me?  What happens to my best friends from med school — the ones I spent evenings and nights and weekends with in the library, and the ones who have been with me through the rough rotations and the brachial plexus and the formaldehyde and everything else?  How on earth will we move away from each other and be busy interns and stay in touch?  [Note to all MS4s — it’s called a group chat, and sometimes you put it on “no alerts” when you’re busy, and sometimes you realize you have 86 missed texts from these people, who will always be part of your squad.]

 

Orientation to Intern Year:

Everyone shows up, early, on day one and everyone is full of first day jitters.  Maybe you’ve moved to a new city or even a new country, maybe you’re still at the same place you went to medical school.  Regardless, you’re a newly minted doctor in a room filled with strangers, people you’re about to be in the trenches with for several years.  Everyone’s sizing each other up: who’s going to be the social chair?  Who’s the gunner?  Who’s the one who will have the bag with acetaminophen and ibuprofen when you get a migraine at work?  Who knows how to use this EMR system already?  If you’re anything like me, you’re trying to settle into a new apartment and figure out how to drive around a new city and do basic things like get groceries, while at the same time trying to make friends and a million other things.  You sit through hours of orientation (retirement accounts?  I haven’t even gotten a paycheck yet!  ACLS certification?  Controlled substance prescribing training?  I’m barely ready to give a colleague that ibuprofen I carry around, let alone give a stranger anything stronger!)  You might go on a retreat with your intern class.  It may or may not be a scavenger hunt with insanely hard clues.  But, by the end of these few days — you’ve found some people.  The ones you will be able to call a year later and go on a spur-of-the-moment “we have to go get a coffee or something stronger together before I go insane” date with.  [Note to all interns — these residency BFFs don’t have to be in your program, in your year, or necessarily even doctors at all, but you’ll need someone.]

Sometime in the Middle of Your Training:

Depending on what specialty you’ve entered, this may be your 2nd-5th year of residency.  You’re an old pro at things that used to scare you (ACLS and codes, anyone?), have navigated several rounds of medical students and new interns through the EMR, and calmly know how to push metoprolol to control afib with RVR.  You’ve learned how to have the difficult conversations on the phone at 2am with patients’ families, learned and forgotten more than you ever thought possible, and probably left the hospital at least once with the bodily fluid of a patient on you.  And you’ve done all of these things with a group of colleagues — friends, actually — who you literally can’t remember not knowing.  [Note to mid-term residents — this is a good thing, not a sign of early onset dementia.]

Panicked Thoughts in the Last Months of Residency:

Similar to how you felt many moons ago as a MS4, you’re now going to a fellowship or a “real” job as an attending somewhere, and again, you’re (I’m) nervous about how this is going to go.  Everyone I’ve been working with for years is moving on to something new, and many of us are also moving to somewhere new.  Again — how are we going to stay in touch?  How will we stay so close when we don’t see each other for months on end?  And, of course, what about the people at the next place?  We’re embarking on the next step in our journey, but, again, when we disperse across the country or across the globe, how will we stay connected?  [Note to new attendings — Again, it’s technology and social media: texts and direct messages and conversations entirely in memes.  And hopefully using vacation days to go see each other or meet up in a cool place.]

In each of these steps in our professional lives, just like in preschool and elementary school and every step before we made it to “being doctors,” we find our people.  The ones who it isn’t weird to text and ask for recommendations on compression socks.  Or the ones who you’ll complain to and get advice from when your career and personal plans diverge.  These people will be your squad, which will grow and shrink over the years and have people like your high school BFFs and your med school BFFs and your college BFFs and your residency BFFs and so many more people in it.  Because you’ll need a person you can ask for compression sock recommendations, but also someone who can recommend a good book for pleasure reading and also someone who can send you a great meme with uncanny timing when you’re having a rough day.  The days (and nights) might be really long in training, but the years are short — and they’re all so much easier to get through with a good squad at your side.

NEJM Resident 360

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