Tuesday, August 27, 2013

The Tipster: The Idiot's Guide to Residency

Going through residency more than once -- at least 1 and 1/3 of it all -- and having encountered a lot of roadblocks along the way, I think places me in a position somehow to give some invaluable tips on how to survive this kind of suffering that we doctors have brought upon ourselves.  This thing called residency.

     1.  Know how to unwind, de-stress, detoxify.   This is first on my list because, I believe that if we do not have any strategy to unload our stress, we would perform poorly in caring for others.  The environment of the hospital stinks of stress.  The type that is even palpable once you enter its premises.  During residency, the stress keeps on coming in, in almost every form, and in forms you would not even expect it would take.   Therefore, unwind when you can, de-stress, when you can, and detoxify when you can.  You may take on a hobby, or treat yourself to a whole body massage, or simply go malling once in a while to allow yourself a different view, hold a movie marathon with friends and family, or talk with friends over coffee or over a bottle of beer.  There are so many ways, and I am sure more than one of those would suit you.

     2.  Eye on the donut.   You will find yourself questioning your motives for being in residency a lot of times.  You will find yourself, questioning uuhhm, yourself, every week, every month, everyday, and yes, it could get worse, every single moment.  The best thing to do is to never take your sight off from your goals.  Why are you here? Why did you get into training in this hospital?  Answers would probably go like, because you wanted to be a good clinician, you have always wanted to be a doctor since you were little, and you were tricked by the glow of the white uniform, or for world peace.  Whatever brought you into residency -- your dreams, your loved ones, the fulfillment this profession brings, or the bleak promise of a bright future -- hold on to that.  It may be the only one that is left but one with the strongest power to make you hold on and brave whatever residency hurls at you.

     3.  Be organized as much as possible.  I am guilty of not doing this most of the time, but aren't we all a work in progress?  Residency almost always equates to a lot of paperwork, aside from demanding duty hours (and consultants) that will all attempt to suck the life out of you so define your game plan.  Get crazy with to-do lists.  Organize, organize, and organize.

       4. Maintain good work relations with the paramedical personnel. You all belong to one team with one goal to fulfill -- care for the patient.  It is only important that work relations are not tarnished and respect for each individual in the workplace is maintained.

      5.  Don’t lose touch with God, family, friends, and loved ones.  Yes, I am there.  Residency can be busy. I take that back.  Residency can be tough busy --- nnnoo..! Residency can be annoyingly busy, and it can be so good at that.  No matter how altruistic your motives might be, your patience and your endurance (not only the physical aspect) will be put to the test once in a while.  However one should try just as hard to strike a balance between one's professional and personal lives.  Of course, you love being a doctor, but you have other aspects of your life to live.  So go to church and attend mass for spiritual nourishment, take time to go out with friends from way back, take time to pause and stop on the dining table and talk with your family.  In other words, let people in your life who matter feel that they do matter.  Let love abide, and surely it will work wonders on you, and the positivity will reflect in your personality and in the way you go about your work as a physician.

     Residency training does not run out of trying times.  I had a considerable share of the pie of tears and doubts, sprinkled with garnishings of laughter, sighs of relief, smiles of fulfillment, and pats on the back.  I realized though that through the harshness of it all, what keeps me going is that, for each day of residency that I try to enjoy and endure, for each day that passes when I try to motivate myself to achieve more than I did the day before, and for each day I try to sharpen my clinical skills, I am preparing myself for that unpredictable moment when I will encounter the patient whose life I will have the rare or even sole opportunity to save.  There is some bit of heroic twist in there, I admit, but nevertheless, that is my silver lining.  More than enough to carry me on through each day, smiling, and probably whistling.  I am where I should be after all.  


  1. Good afternoon po Doc. :) I recently passed the board exam (March 2018). And I still can't believe that I am already a licensed doctor. During med school I already had the idea of going to Internal Medicine with an interest in Nutrition and Allergies. But right now, I feel like a blank piece of paper. I don't know what to pursue for residency. It seems like I always doubt myself in pursuing such a busy, stressful and demanding training. I do admit being a sickly person (asthma, allergic rhinitis, menstrual problems, so on and so forth). My place is like a pharmacy bec. I have a lot of medications. Some of my seniors would even ask me why did I enter this field knowing my health condition is quite poor. Being a doctor wasn't really my first choice bec. I was thinking that my health might not be able to cope up with the stressful environment as a physician. But when my late grandfather told me that he wishes me to enter medicine, I took a chance. I made a promise to myself that for every year that I pass med school, I shall continue my craft to be a physician. And so I did. But in between those success in passing are the days and even weeks that I am not feeling well. I even had instances where my allergies flare up during exam days, and I had no choice but to take medications. Sometimes I find myself sleeping during exam. Our Dean would always tell me that I am incapable of being a good doctor and just quit. But for every time I get through these exams and hear the words "thank you" from my patients, it lights up my eagerness to be a doctor. I accidentally found your blog po Doc while I was scrolling down at Google search for what should I do in choosing residency training. I have read a few articles just now and I was really inspired. I hope to hear from you po Doc. God bless po :)

    1. Hello Jesselyn!

      I am so sorry that it took me quite a long time to finally reply to your comment.

      First of all, I would like to thank you for taking time to read my entries. It does not matter that you found this blog serendipitously because that is how most readers found their way here. LOL! What matters is that you have found a companion, a confidante, as you begin your journey as a physician. There is nothing better than touching a person's life and I believe that somehow in my own little way, I have touched your life, and that is more than enough to inspire me to go on nurturing this blog.

      Second, allow me to congratulate you for passing the physician licensure boards. Congratulations, Jesselyn! You made it! It is undeniable, it is on paper, and the PRC can give proof that you are a licensed physician! This victory, this triumph, definitely cancels out all the discouragements you have encountered before earning your license. Do not waste time dwelling and fretting about what has been said to you then, those comments might have propelled you to where you are now and that's it, those comments have served their purpose, which is to challenge you so that you can prove them all wrong. So again, congratulations! Our journey as physicians is actually not without trials and frustrations (sorry to break your bubble with that) but those tribulations will only mold us to become better individuals and able physicians who can deliver quality care for our patients. You've surpassed all those hurdles in health, among the people around you, etc., it would not be impossible that you will overcome other trials in the future. Hard but not impossible. Besides, that is life, Jess. We will only stop encountering challenges once we join the flatliners. So congratulations again, and rejoice! Life throws lemons at you because you are alive and it knows you can make lemonade out of it.

      I could still remember that very first morning after the night when I knew I passed the medicine boards. The sun emanated an unusually pleasant glow. The meal I ordered at McDonald's tasted differently in a good kind of way, and lastly, I could not hold my smile. That's how victory felt.

      Now, as we enter this milestone, we are beset with a lot of choices, like multiple decks of cards laid and neatly arranged in front of you, each card almost silently screaming at you to take it.

      Well, how do I help you with this.

      This may sound cliche or cheesy but in this aspect, it would make sense - I say follow your heart. If you decide to go into a particular specialty for training, be sure it is the specialty that you see yourself practicing in the future. You have to set your eyes on the doughnut and not the hole. The journey to the finish line will be very challenging, I tell you, ( I found myself crying almost everyday when I was in training) but just think of your goal and your purpose. Just remember that short-term pains will lead to long term gains. However, let me emphasize that as much as possible, avoid setting money or being rich as your primary motivation. Of course, as doctors, we are assured of at least a comfortable life, but it is different when your mindset is, you became one because you want to be very rich. In my honest opinion, money as a motivation, will easily make you dwindle and wither specially with the harsh reality of this profession - the almost unattainable expectations from the patients, your colleagues, and the workplace in general. It will easily lead you to the thought that anyway, there are other ways to make money, and even bigger than being a doctor. In other words, commitment is key here. A consultant once told me that just do what is right, just give everything your best, and money will follow.

      I hope this helped, Jess. God bless you in your journey and who knows, by chance, we would meet somewhere sometime soon in one of our conferences.

      Mabuhay ka!


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