What It Takes To Be A Senior Resident
By Melissa Sparrow
late afternoon during a retreat at Nourse Farm, a rambling farmhouse on
an inlet of the Eastern Shore of the Chesapeake Bay, my colleagues and
I began to hatch a list of doís and donítís for senior residents. We were
about to become senior residents ourselvesthe third and final year
of our general pediatrics trainingand we felt both anxious and excited
about our new role.
One of the important aspects
of being a senior resident, at least at Johns Hopkins, is the close interaction
you have with interns. Throughout the entire year we would work by internsí
sides and watch them develop into responsible and deeply committed physicians.
To construct our list we solicited
ideas from the intern class behind us. We also benefited from our own
memories. What did our senior residents do that helped us when we were
interns? What might they have done?
I remembered Gail Addelstone,
one of my senior residents, an auburn-haired live wire with a penchant
for bringing delicious phyllo-wrapped leftovers to share on call nights.
When we started our first call night together in February, we sat down
together to take sign-out from departing residents. She looked me in the
eyes and asked, "How do you want to work tonight? Do you want to be totally
independent and page me with questions, or do you want to stick together?"††††††††††††
Gailís questions to me throughout
the month went on probing the level of interaction I wanted with her.
My changing answers reminded me of what protean creatures we residents
are. As we develop, we require frequent negotiation and clarification
by our mentors of their demands and expectations.
Hereís a list of pooled suggestions
for senior residents everywhere, as well as a few of my own thoughts:
- Donít talk all the time.
Save your words for when they are truly important and necessary. (Even
when you are teachingask questions.)
- Donít repeat work. It makes
the intern feel useless.
- Do give positive feedback,
specific examples, not vague praise.
- Be private with criticism.
Interns are already their own harshest judges.
- Thereís already a lot of
stress in a hospital. Thereís no need to take it out on interns, or
any member of the house staff for that matter. They donít have the psychological
pillow of sleep to soften the blows.
- Make sure interns eat.
Let them nap, even if thereís only a half an hour of down time in the
- Remember the interns who
have children. They donít need special treatment, just recognition of
the added demands on their lives.
- Recognize when an intern
is on the verge of tears.
- When assisting, donít ask,
"How can I help?" Just find what needs to be done, and do it. Interns
always feel guilty and as if theyíre supposed to say, "No, I donít need
help," when, in fact, they do.
- Laugh when ridiculous things
- Get mad occasionally and
let the energy of madness allow you to do something useful.
- Invoke change.
- When nurses ask questions,
always respect them.
- Break tacit rules sometimes
if itís in a patientís best interest.
- Stand up for each other.
- Avoid gossip. It leaves
your mouth tasting sandy.
- If youíre in a really bad
mood, let people know. Say, "Iím in a really bad mood," so others will
- Keep good wine and brie
in the refrigerator at home.
- Leave white coats far away
from delivery rooms.
- If youíre on birth control
pills, take them every day.
- Continue to ask why University
Health Service doesnít offer Depo Provera.
- Know paper scrubs are available
in the Emergency Department if
someone throws up on you.
- Motrin is available on
- Know that if house staff
go home with a code pager, you can always borrow a substitute from the
ground floor paging office.
- Have lunch occasionally
by the Phipps goldfish pond.
- Meditating in call rooms,
even for 10 minutes, helps.
- Set up rules at the beginning
of each rotation/service month. Introduce change kindly.
- When you feel like you
may explode with anger and say something nasty, ask for someoneís help.
Say, "Iím losing it."
- Smile. Not always, just
- If you are feeling like
you are stupid and everyone else is smart, know that you need a vacation.
- If you are feeling like
you are smart and everyone else is stupid, know that you need a vacation.
- Remember that doctors and
medicine are not the center of the world.
- Remember your center.
- Arrogance is toxic.
- Humility opens doors.