Hi everyone,
At every annual program director’s meeting, I ask interns to tell me about their seniors. I want to know who stands out and who needs additional support. Most interns rave about their seniors. Here’s what they say the residents do:
Balance Autonomy and Oversight: Residents ensure their interns provide timely, safe, effective care. Though interns are the ones presenting on rounds and writing notes, the best residents know all the details: what the tests are showing, what consultants are saying, and how the patients are doing.
Share the Work Burden: Good residents are like lifeguards: they let their interns swim but they’re poised to jump in the water at the first sign of drowning. Interns swim through an ocean of notes, orders, forms, and phone calls. Discerning residents can distinguish between reasonable and unreasonable workloads; they know when to dive in and help.
Share the Emotional Burden: Good residents remember how hard it is to be a new doctor, making life and death decisions for the first time. Good residents are good listeners. They credit interns when things go well and share responsibility when things go wrong.
Teach: Interns love targeted teaching. They love it when residents invite questions, however small. They appreciate residents who use downtime to discuss anemia, review EKGs, and show them how use an ultrasound. Interns also appreciate residents who recognize when interns are swamped and need to finish their work.
Meet Interns’ Goals: Effective residents start each rotation by asking interns to discuss their goals, and they check in regularly to ensure the goals are being met. Effective seniors support graduated autonomy, encouraging interns to make decisions, run rounds, and lead codes as they prepare to become PGY2s.
Focus on Wellness: On most days, interns should stay until the end of the shift to give sign-out, practice procedures, and respond to emergencies. But it’s exhausting to stay until sign-out every night, so once or twice a week, thoughtful residents take over coverage once notes are done and patients are tucked in. They know that an early night allows interns to exercise, eat a healthy meal, socialize, and get to bed.
Cultivate growth: Interns are like flowers: they need rich soil, the right amount of water, and plenty of sunshine to grow. Effective residents are generous with their praise and gently honest with their critiques. They know interns need a healthy climate to flourish.
Say I Don’t Know: Our residents are well-read and sometimes encyclopedic in their knowledge. Many can quote papers as if they wrote them themselves, which is sometimes true. But it’s equally important for residents to admit they don’t have all the answers. Interns appreciate residents who say “let’s look it up.”
Set an Example: Effective residents collaborate with nurses, follow through on tasks, own decisions, and speak gently with patients. They lead with kindness. The best way for interns to become great residents themselves is to emulate the residents they admire.
I could go on and on extolling the seniors who make Yale as good as any, nicer than most. I am grateful for everything our residents do to teach, coach, and support our interns and for making it so rewarding to ask them to “tell me about your seniors.”
Enjoy your Sunday, everyone. I’m headed out for a long bike ride!
Mark
P.S. Happy Diwali!