22 February 2016

Residency Update: Discovering Efficiencies

Updates are sparse of late, in part because when one works at home there isn't a lot of mischief to write about and in part because I haven't felt inspired to write. But that certainly doesn't mean that an update isn't called for. Occasionally I think to myself, "I really should vlog." It seems simpler to turn a camera on and start talking about life, which could lead to more frequent updates, and then a video would be much more fun to edit. But then I remember that I started my blog because I love to write. By far the easiest and most exciting life event to write about right now is Dr. Chandler's residency.

Since December, Scott has had rotations in the hospital and in the NICU (Newborn Intensive Care Unit). Both of these rotations were designed to be a little less demanding on interns - the rotation in the hospital involved only seeing family medicine clinic patients who are admitted to the hospital. So in theory if the doctors in the clinic are doing their jobs right, they won't have many patients admitted. The NICU rotation is more observation than responsibility, to allow doctors to see what conditions would require intensive care and how those babies would be treated.

Even though these rotations were touted as low-key, Scott has felt pretty overwhelmed over the last three months. In addition to learning about and having pop-quizzes on new conditions for each rotation, he still see patients weekly in the family medicine clinic. Scott described a day for me, where he wakes up at 5:30 Am, gets to the hospital by 6:30 Am, looks over the charts of patients he knows he will see that day to prepare for rounds, rounds with attending physician, returns to take care of patients, triages care for any new patients assigned to him, calls in orders, writes notes; and then rushes over to the clinic to see his afternoon patients, which calls for more orders, prescriptions, follow-up with previous days labs, and notes from today's clinic visits. This full day of work is a lot to juggle, and he still has administrative responsibilities - keeping up with emails, residency training sessions, meetings, studying, trying to be ahead of the fellowship game, etc. Occasionally Scott needs to bring his work home in order for him to feel like he is home that day. He writes notes while he watches a basketball game, records his work hours online, completes evaluations.

That one time Dr. Chandler had to respond to a
page while we were on a date.
The other day Scott said that some of his colleagues had recommended him to be a junior chief during second year. Nominations are considered and then the potential candidates are interviewed and some number of junior chiefs (no idea) are selected for year two. It is certainly an honor to be considered, but Scott felt overwhelmed by the idea. Chief residents, in addition to having all of the above responsibilities that any other resident would have, also administrative responsibilities that would take up time during the work day and outside. Scott has a great personality for that, and being a junior chief would look great on his resume for fellowship applications. But how can you approach thinking about an opportunity like that when work hours are maxed out as it is.

I'm not pushing Scott to take on any more responsibility, though when he initially told me about the nominations I said I thought he would be successful as a junior chief if he chose to go that route and was selected. I'm not worrying about Scott's resume either. Sure, there's a lot more he could do to put himself at the top of the pack and match into a coveted fellowship spot, but at what cost? He knows how much he can handle, and I don't think he's so overwhelmed that he would ignore a clear impression to move forward.

So that's what residency life is looking like at the moment. Luckily Scott has some Fridays off this month, which helps him to feel like he has a work/life balance again. He can sleep in at least one day a week and commit a whole day to studying at leisure, if that's his choice. Whatever floats his boat.