Saturday, June 28, 2014

The Fastest Longest Year

Farewell to intern year, the fastest longest year ever!  It's certainly been a crazy ride full of up and down roller coaster emotions.  And boy did the year finish with a bang!  Time to muse on a few thoughts:
1.  Doctors incognito
I've noticed an interesting trend among us "newer" physicians: we never let anyone in public know that we're doctors.  At least not initially.  We never introduce ourselves as doctors, we never use our hard-earned titles in public, and when asked what we do for a living, we'll say something along the lines of "I work in the medical field" or "I work in the hospitals," but almost never will we say outright "I'm a resident/doctor."  Why is that?

In a twisted way, it's almost like a sense of shame or being marked.  Open your mouth and say that you're a doctor and people instantly treat you differently.  Either they ask you about your opinions on this or that (I get the "Should I get a flu shot?" question A LOT), or they ask you about homeopathic remedies, or their negative experiences with doctors comes out.  I mean, I don't go to someone who says he/she is a lawyer and say, "Man, I really hate all lawyers.  They're all scum."  Or "Are you the kind of lawyer who stands in a courtroom and all that?"

As such, I'm never offended if someone calls me "Mr." instead of "Dr."  Although, an interesting thing to note that in Britain, "Mr." is a title ascribed to surgeons whereas "Dr." is a title ascribed to physicians.
2.  The misunderstood adolescent
I may have said this before - I'm one of the few pediatricians who actually enjoys interacting with teens.  Not all teens, mind you, but in general yes.  Anyway, this bodes well especially if I'm really intent on pursuing peds rheumatology (which skews heavily toddlers and teens).

This may be coincidence or it may be intentional, but most of the teens in my continuity clinic are males.  They're such amusing creatures.  I can get most of them to open up at least somewhat (and a handful almost way too much, lol).  I think it helps to understand where many of them are coming from.  And I may be a bit too . . . liberal in my advice to them.

Anyway, there are 3 things I always iterate to every teen guy: 1.) wash under your foreskin (most of them where I am are uncut - good for them, lol), 2.) monthly testicular self-exams, and 3.) ALWAYS USE CONDOMS.
3.  Rising seniors
As interns we are the lowest person on the totem pole that matters (sorry med students, the hospital functions very well with or without you).  We're often abused - intentionally and unintentionally - by senior residents, attending physicians, nursing staff, etc.  It's a frustrating place to be.  But at the end of every intern year is the promise of becoming senior residents and FINALLY stepping out of the intern role.

And at the end of each intern year, it's an opportunity to reflect on the kind of senior we aspire to become.  I've had the good luck to work with one of the best and by far the most hilarious senior residents I've ever known.  Although the last month was rough, he made every day go by quickly and with enough laughter to sustain us.  I can't say I want to exactly be him, I will aspire to carry on aspects of him.

In less than a week, I'll be considered a "senior resident" and I'll have no idea if I'll be a good one or a bad one.  The best advice I've heard was, "Remember what you liked in your senior residents and do that.  And especially remember what you hated done to you as an intern and don't do that."


fan of casey said...

Good luck as your career progresses. Whether you are "good" or "bad" -- do you best, learn as much as you can, even errors will be good lessons for you.

naturgesetz said...

The advice at the end sounds good.

Good luck as a senior resident and beyond. You've endured a lot and achieved a lot to get where you are.

Biki Honko said...

I can't even imagine what it must be like to be in the trenches of medicine day after day. How on earth you can remember so much is truly amazing.

As we age there tends to be areas of awkwardness where we dont feel like an adult, or a fully fledged member of our professions, etc. Not introducing yourself as a doctor could be "growing" pains. However, it does seem to be a trend of the newer PHD's and MD's to not introduce oneself as Dr. And really if you're not at work, why do so? It just opens you up to endless questions or complaints about the medical establishment.

Thats super you are pushing your patients toward condom use. I think hearing a doctor say it, does carry more weight, than a teacher at school or even a parent.

You will be a great Senior! Great compassion lives within you.

tracy said...

Dear Aek,

Once again, i hope you can forgive me for all the mean things i wrote on your blog about becoming a Doctor....after, what am i , but a wannna be?

But i want to ask you a giant favor and i have not idea how to ask.....for many years now i have been a "suppoter" . an "allie" of gays and lesbieans, ect, but i have no idea of how to get "involved", if there is such a thing. Can you help me??????????

My email is tracy

Thank you so very much!

Aek said...

fan of casey, naturgesetz, Biki: Thanks!

Tracy: You can probably get involved by looking up and contacting your local LGBT Center. A lot of cities have them and are quite welcoming to any volunteer or whatnot they can get!

madmanMD said...

Congrats on finishing intern year! Sounds like it was tough (duh) but the weird thing is you'll always look back on it kind of fondly. And then you'll catch yourself saying "when I was an intern..."

Completely true about 1. Even moreso for women so I hear. Revealing our profession just always takes the convo in a direction that is so tedious to me. It puts us on an unnecessary pedestal.

2. When I was a med student doing peds I wondered how much my counseling to adolescents would be remembered. Have you been able to tell or do you just send them off into the wild hoping for the best?

3. It sounds like you'll be a great senior. That last bit of advice is how I try to approach supervising. I would add just trying to remember to actively do some quality teaching will really have you remembered as a good senior because we always forget about that in the busyness of the day.

Aek said...

madmanMD: I get through to some teens. I seem to have some success with asthma. I haven't seen enough of my teen patients back for follow-up to know if they retained what I said at the last visit.

R said...

I always thought 'senior resident' is like someone in at least PGY3+ position? I'm not sure about how it is in the US. Here in Australia it's intern year (PGY1), then you're a 'resident' as long as you're in prevocational training (not in a specialty training program). Once you're in a training program and registered with a specialty college, you become a 'registrar'. And then there are junior and senior registrars depending on your experience/exposure. Although I do know some that are still technically 'residents' but already signed up to a college and undergoing formal vocational training.


And yes it's the same in Australia too (and probably NZ as well)! Once you qualify as a specialist surgeon and get your FRACS you can revert back to Ms/Mr! :) Homage to the times when surgeons were only barbers with only the title 'mister', recruited by 'proper' doctors.

As a current resident (and potentially a junior registrar next year! ^_^) I always treat my interns well. I hate any form of workplace bullying. It's pathetic and unnecessary.

All the best

Aek said...

R: It depends on the program. For 3-year programs, anyone above PGY-1 (or intern level) is considered a senior resident. For something like a surgical program (which is at least 5 years), the "senior resident" starting at PGY-3 and above makes more sense.