It’s that time of year again, and though many of you started before today, and many will do so afterwards I wanted to wish you all a Happy Medical New Year’s Day. I also wanted to share some words of wisdom on this day of actual and symbolic change.
Many clinicians in new roles are afraid of being unprepared or left out on an island. The first exposure to a new program or rotation can go a long way in helping to ease the fears inherent in the transition process. Many trainees are exceptionally sensitive in the first days (even hours) of a new rotation experience. This discovery phase is filled with a lot of unanswered questions, many of them non-clinical (where’s the restroom?) The emotional – rather than the rational – centers of the brain are most stimulated at these times. It can be more difficult to weigh mixed information, thus small missteps or setbacks can leave the resident jaded, lost, frustrated and less likely to be open to learning in the future. The sooner that we as educators reward new trainees for their curiosity and drive, and guide them through the discovery phase, the faster they will acclimate to these jarring new clinical environs.
So, please don’t be jaded. Take your time and make sure that you answer questions and offer help in a non-judgmental manner. Don’t presume that a new trainee knows the answers just because they don’t ask. Maybe they feel like they are supposed to know how to manage asthma perfectly from day one. Remind them that it’s OK if they don’t – but reward them if they do.
Be patient. Understand that things may take longer and that there is a learning curve to more than just the nuts and bolts of medicine. July can be a frustrating time for many folks – patients and families included.
Remember the magic of discovery and diagnosis! I still fondly recall my first day as a “real doctor” more than 16 years ago. I was assigned to the Private Practice rotation and was paired with a Primary Care Physician who had been in practice for 20 years. One of the first patients we saw together had testicular pain. After doing my H&P and presenting my differential diagnosis we ventured into the room together. It was then that he pointed out the “blue dot sign” pathognomonic for torsion of the appendix testis (or appendix epididymis). After educating the family he went on to tell me that I probably won’t see it again until 5-6 years later. And wouldn’t you know it, I saw my next case as an Emergency Medicine fellow – nearly 6 years to that very day – this time with a brand new intern. Sounds a little too perfect? Ask some of your colleagues and many will share similar anecdotes.
The joy of learning something new – and then nailing the diagnosis – is something that I now mostly experience thorough interactions with my residents and fellows. You can be that impactful someone who leads an intern towards a diagnosis and then helps them make it by providing teaching and encouragement. During the discovery phase of early residency remember that what is familiar to you is new to them. Rediscover the “magic of medicine” through the eyes of someone who has not “seen it all” and, in turn rediscover for yourself why you signed up for this job in the first place.
And especially now, when we are dealing with a global pandemic and daunting inequalities in access to care remember that we are in this together. Be patient, show yourself and your colleagues a little grace. Remember that vaccines work, that black lives matter, that we are all equal, and that we, your teachers, will be there for you… No matter what comes next.
Happy New Year!