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In Depth

When Residents Sail Off Course

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Hi Everyone,

Wouldn’t it be amazing if every resident sailed serenely through training, avoiding storms, crazy currents, and rocky shoals? But many residents veer off course along the way. Some are cast adrift by low ITE scores and inbox tasks. Others are anchored by crises of confidence. For residents used to success, these struggles can feel strange and isolating, especially when everyone else seems to be thriving.

As a resident, I struggled with organization. My pockets bulged with scraps of paper, which were littered with names, labs, and checklists. I returned repeatedly to charts to see if I’d completed notes. I returned to the hospital from home because I couldn’t recall if I’d signed orders. I was exhausted from 36-hour calls, but my problem transcended fatigue. I eventually learned that to remember anything, I had to write down everything. To this day, I rely on clipboards, automated reminders, and the organizational app, Todoist.

You may be more organized than I am, but I’ll bet each of you faces one challenge or another, whether it’s keeping up with studying, mastering procedures, prioritizing tasks, finishing notes, building confidence, keeping composure, or staying healthy.

With time and practice, many of you will find ways to surmount challenges, but not all challenges resolve on their own and solutions may not be obvious. Some residents need structured study plans, others need extra procedural training, and some need help navigating conflict. Some issues are more complex: over the years, we’ve discovered ADHD and dyslexia, anxiety and depression, sleep and substance use disorders, cultural and language barriers, and homesickness.

Steering residents back on course requires a learning diagnosis, and making the diagnosis demands curiosity and open minds. We have many tools to help residents, including a state-of-the-art Sim Center, professional coaches, and medical and mental health resources. Our Academic Support Committee, chaired by Dr. Jacqueline Savage, provides a structured, deliberate approach to aiding residents who need extra support, for example by crafting individualized learning plans, adjusting schedules, or providing professional referrals.

We have a nearly perfect track record for helping struggling learners succeed, particularly those who embrace feedback. Many faculty you know well and respect had their own struggles during residency, including your program director. In each of our careers, even the most talented among us will face headwinds and choppy seas. Our mission is to ensure that each of us, without exception, navigates the waves of residency and ultimately sails safely into port.

Enjoy your Sunday, everyone. I’m heading out to the bike trail before sitting down for an afternoon reading personal statements.

Mark

P.S. If you haven’t sent me your Thanksgiving gratitude message yet for Thursday’s PD Note, now’s your chance! The deadline to be included is Tuesday night!

P.P.S. What I’m reading, watching, and listening to:

The Game

Article outro

Author

Mark David Siegel, MD
Professor of Medicine (Pulmonary)

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