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It is time that knowledge, capability and training you received in the medical school and during internship is utilized. The transition from medical student and medical intern to resident is one of the most stressful phases in our career. All new residents, to a certain degree, will experience the emotions related to the

of being ready. You may be the only physician directly assessing and communicating with a uncertaintypatient and his/her family. You will be writing prescriptions. You might have a sense of inadequacy and anxiety.

These are few common questions that all new

residents have in mind. But keeping in mind that all

doctors, even the best ones, have been in this

situation, will give you a sense of relief and

inspiration. Being afraid is a normal feeling. In fact,

this same fear can be your driving force to achieve

something you never imagined you could be

achieving.

How to Survive Your First Few Days

1. Familiarize yourself with administrative procedures. For example how to request and use materials and equipment, location of medical supplies, laboratories, etc.

2. Know where to go for handovers and on-calls. 3. Know the person who can give you the right

information. For example, in terms of prescription, the pharmacist is the best person to ask.

4. In case of emergency, remember what you learned in your training. If you’re in doubt, call for help right away.

5. Debrief after your first day. A cup of coffee with your fellow new residents can make you reason clearly.

Ward Rounds and Notes: What Do You Do?

1. Be prepared. Before the ward rounds take note of the following: a. Make sure that you are aware of all the patients (old and new) that are assigned to you b. Make sure that you review all patients and their notes c. Check if investigation results are available. Know them! d. Prepare all the needed forms

2. Use mnemonics for ward rounds and in taking notes (if acceptable by your team). Pay attention to the style that each consultant or immediate senior prefers and do as required. For example SOAP (Subjective, Objective, Assessment, Plan) when taking notes.

Practicing this profession requires deliberate practice to become an excellent resilient clinician with a fulfilling career. What you need to realize is that your reputation starts now. How you are is what will be membered.

Here are some useful tips on how to overcome those “feared firsts” in your medical career. One word that would describe how you survive and stay healthy during your residency is Moderation

 

Survive Your First Few Days Tips

ü Work hard. Be early. Be on time. Be honest. Knowledge will come.

ü Do not hesitate to ask for help and clarification. Asking can save time and can even save a life

ü Take time to know and learn the names of the people whom you will be working with. They will help you get through your first few weeks. . Keep a note of their names and contact numbers if necessary

Remember, “You shall overcome”

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3. Note all essential information and discussions during rounds. Names and relationship of the persons to the patient who are involved in the discussion should also be noted.

4. Have a clear management plan. 5. If you are in doubt about what has happened in the ward rounds, ask for clarification.

It is better to ask than to take a note of wrong information. 6. Document. Document. Document. As long as an issue was not officially documented, then it did not

happen. Procedures and consent notes are essential. Document them too. 7. Write your own notes. Copying and pasting others notes is strictly prohibited!

Handling On- Calls

Calls are great opportunities to learn. You will

experience procedures that you will need in your

career. It is also an ideal time to complete your

portfolio assessments. Make sure to make the most

of these opportunities to grow and learn. Success

might take time and needs effort. You should aim at

improving your performance. Be proactive and

come forward all the time; making mistakes and

learning from your mistakes is better than hiding

away.

Advice on Rotas:

ü Always be smart and careful in your requests for call schedule.

ü Inform the ones in charge about any problem you encounter. The Earlier you report your problems; the easier it is for the in-charge to solve them.

Night Shifts: How Do You Prepare For One? How Do You Recover From One?

§ The biggest preparation is scheduling your shifts ahead of time.

§ Have a routine that works best for you. Make sure that you have enough energy for your shift.

§ Try to nap just before your shift.

§ Have a good meal and a cup of coffee/tea and a bit of time with your family before your night shift.

§ Avoid Being “HANGRY” (Angry due to Hunger). Bring your own food for meals and snacking. Don’t

rely on finding time to go to the cafeteria or vending machines. It is important to take care of yourself.

§ Work as a team. Establish a good working relation with the staff that you will be working with

throughout your shift.

§ Involve your senior doctors when you need them. Don’t be afraid to ask for help when it is clearly

necessary.

§ Recovery is by SLEEP! Aim to sleep as soon as you get home. For residents who have children, ensure

good childcare plans so that your sleep is not interrupted.

Tips on Taking Good Clinical Notes

ü Patient details should be present in every page

of the notes (if not using a computerized

patient records).

ü Clear, concise, precise, accurate and

comprehensible are characteristics of good

clinical notes.

ü Make sure that all patients’ relevant

information is documented.

ü The time, date and title for all entries should

be indicated.

ü The name and grade of the clinician leading

the rounds and all the team members who are

present should also be documented.

ü Aim to make records on time or as soon as

possible. Always document if notes are written

late and the reason why you were late in

entering the notes.

 

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Here are some tips to sleep post calls/shifts:

ü Invest in blackout blinds

ü Turn off your phone or put in silent mode.

ü Inform your friends and relatives in advance that

you do not want to be disturbed.

ü Have a cool, quite place to sleep. Read a book or

listen to soothing music will help you fall asleep.

Tips on Communication

1. Being respectful to everyone helps solving tasks; so be polite and smile.

2. Be kind. Be tolerant. Be clear. Be prepared to repeat things.

3. Be confident. Organize your thoughts. Writing it down can do the job.

4. Don’t refer your self as “just the first year resident”! You are important and valued.

5. Working within a team is essential for achieving tasks. Meet your peers and distribute jobs evenly and clearly.

6. When talking on the phone with colleagues, seniors, or other health professionals, it is important to clearly state the following (SBAR): Ø Situation: your name, job title, the ward you

are calling from, and the reason you are calling

Ø Background: patient information (i.e. name, age, illness history, medication, tests results)

Ø Assessment: your diagnosis: what do you think of the situation based on your findings.

Ø Recommendations/Requests: your suggestions. Are they sound acceptable? If you are you seeking advice or you would like your senior to come and see the patient, state it clearly.

7. When discussing a patient over the phone, always have everything related to that patient in front of you; including results, medications, etc.

8. Documentation is highly important. Make sure to write down in the patient chart all the details of the person you spoke with (i.e. name, designation, time of call, contact details, and recommendations).

9. Be sympathetic when delivering bad news to patients or relatives. Say it clearly and avoid indirect wording (during your first few years of residency, this usually is done by your seniors).

Handling your on-calls Tips

Ø It is normal to feel scared the first time. Just

maintain your focus and poise and you’ll get

through it

Ø Prepare an on-call bag with stuff you would

need during your call along with a small

reference book (or Apps on your smart phone)

Ø Know your level of competence. Seek advice

from your senior for any matter even how

small the issue is.

Ø During handover; make sure that all patient’s

information is accurate: name, hospital

number, location and condition

Ø Have a clear understanding of the clinical

context of the patient before you conclude the

handover

Ø Check everything for yourself; do not

completely depend on others about a patient

Ø If asked to follow on a result, verify the plan if

the result is abnormal

Ø To help prioritize which patient to see first,

familiarize yourself with the system used by

your senior residents and nursing staff

Ø If phone calls/pagers come in successively,

take note of the number and call back one at a

time

Ø If you are asked to a see a patient at night, ask

for a fresh set of vital signs and any relevant

tests while you make your way to the patient

Ø Listen to patients. The majority of diagnoses come from conversations with them.

Ø Some hospitals can be cold at night, so bring a

jumper/jacket to wear during the night

Ø Stay polite and professional

 

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As a new resident, it is difficult to maintain healthy

habits and lifestyle at work, as there are many things

to take care of such as examining patients, preparing

discharge summaries, etc. However, with experience

things become easier and you will start to learn how to

manage things all together.

Here are some tips to assist residents acquire healthy lifestyle

It is important to ask for and listen to advice of others. But remember, things that work for others may not work the same for you. Take that advice and mold it to your own plan. Personalize your goals, plans and path.

Visit the Wellness and Performance unit at OMSB main building. We can help you.

Reference

BMJ’s guide for newly qualified doctors. July 2013. http://t.co/jmyoLrv9sU

De-Stressing

Most of your stress is from work environment issues, interpersonal and interprofessional interactions than from medicine itself. You need to look after your self. But How?

Primary Behavior for De-Stressing is:

Talking it out!

 

To all our new residents: always remember to grasp every opportunity to grow and learn.

As we survived residency, so will you. We wish you all the best in your training and career.

And finally, Set Your Own Path

 

Tips on Healthy Lifestyle

Ø Respect your self: remember, unless you take care of yourself, there is no way you can take care of your patients. Have something to eat and drink and cover your basic needs.

Ø Respect your loved ones: have balance when you are with them during this phase of your life.

Ø Respect your colleagues, your health care team members and administrative staff.

Ø Respect your patients. Be committed to their care.

ü Keep calm.

ü Exercise, workout and socialize with your

colleagues, friends and family.

ü Enjoy meals and family time.

ü Give your mind a break regularly. Neglecting it

makes helping others much harder.

ü Spare time for self-progress and education

ü Appreciate your achievements and be proud of

yourself

ü Enjoy both the good and bad parts of your

profession

ü Having a healthy support system. Talk things

through. Have people around you to talk and

listen to. Family, friends can offer insights,

support and love. It can help immensely.

ü Organize your annual leave early. Plan your

time off.

ü Reflection (considering alternate versions of an

event you went through) can benefit you.