An Advice Potpourri

Hi everyone,

I began writing Program Director’s Notes to save time. Instead of repeating the same advice over and over, I decided it was better to broadcast the same message to everyone at once. So today, I’m serving up an advice potpourri:

• For PGY3s: Register for the Boards now if you’ve haven’t already. Then, study. Almost everyone passes, but you need to study. I love MKSAP because it’s efficient and well-written and because the questions mirror what’s on the test. Some residents love UWorld, and that works too. Whatever your tool, aim to finish studying by June so you can focus on fellowship or your new job. If you finish the questions by June and use the summer to review, you’ll be golden.
• For those applying to fellowship this summer: Now’s the time to ask for letters. Most of you need four: one from me, one from a scholarship mentor, one from a clinical mentor, and one wildcard- usually a second clinical letter but sometimes a second scholarship letter if you’re pursuing a research track. It’s also time to update your CV and plan your personal statements. Finally, let me and the Rising Chiefs know if you’re applying. I typically write more than 30 letters a year and the Chiefs need to plan the schedule so everyone has time to interview. Please give us a heads up.
• For rising PGY2s: Becoming a senior is a bigger leap than becoming an intern. The best advice is to prepare now, using your current seniors to guide you. Many of you are already doing this, but if not, the time has come to start writing discharge summaries, attending care coordination rounds, teaching the students, running RRTs and codes, leading rounds, taking charge of signout, and mastering core IM procedures like ABGs, paracenteses, NG tubes, and ultrasound-guided IVs. Before you know it you’ll be the senior at night with interns turning to you for leadership. You’ll all fly, but it helps to prove it to yourself before June. I’ve attached our Intern Milestones guide so you can identify personal learning goals.
• Note writing: Please commit to excellent notes. Good notes are short, accurate, and timely. Brief, readable notes are better than data dumps. Please don’t copy and paste old, inaccurate information, which is misleading and dangerous. When you sign a note, your credibility is on the line: you’re vouching for whatever you wrote- the day’s events, your exam, the latest test results, your assessment, and your plan. Finally, please document all patient encounters, however brief. If you assessed a patient, ordered a test, started a medicine, began a drip, titrated oxygen, or changed a code status, please enter a note to prevent gaps in the record.
• Personal updates: With recruitment season ending, I need a break. This week, I’ll be completing the rank lists. Then, on Thursday night, Heide, Gabrielle, and I are flying to Mexico for a brief getaway (sadly, I’ll miss the Winter Ball). Then, from March 15 to June 15, I’ll be taking an overdue triennial leave. My plan is to write a book. I’ll still be around, sometimes in person, sometimes on zoom, but I’ve cleared my schedule for writing time. But since we have the world’s best Chiefs, APDs, and residents, I know this awesome program will keep racing along.

I’ll be spending today finishing the rank lists. But first I’m going to lace up my boots for a hike up East Rock!

Mark

P.S. What I’m reading: To Cure Burnout, Embrace Seasonality