An Open Letter to Incoming Residents

Some Thoughts

To all who are about to start residency,

First, congratulations on your incredible achievement! By this point, you probably have heard many praises from friends and family members in celebration of this big step forward in your medical career. As someone who also went through the hardship of pre-med and medical school, I can honestly say that you should be proud of your labors. Those countless hours of studying and stressing out over exams have definitely paid off.

As you prepare for residency, I wanted to share some of my thoughts as I transition out of my time there. Things I wish I knew in the beginning, as well as things that I have learned on this journey. I hope they will help you through this phase of life.

1. Residency is Difficult

I know this is something you have heard this over and over again. But until you live the experience, no words can truly describe the full breadth of the difficulty of residency. You will be more tired, and more emotionally and physically drained than ever before. You will also function with less autonomy than you are probably used to, which can be frustrating.

There is a reason why the rates of depression and suicide amongst medical providers are twice that of the normal population. Even among those who have never experienced depression before, there has been documented evidence of increased prevalence after intern year of residency. Many turn to drugs, alcohol and other damaging behaviors as a coping mechanism.

I cannot overemphasize how important it is to be aware of the stress of residency. You will never be the only one feeling overworked and overwhelmed, even if it feels like it. Know that your co-residents will also experience similar feelings, and please ask for help when you need it. t

Hard at work

Hard at work

2. Help is Available

On the topic of help, you should seek it out. It took me a long time to figure this out. The hospital I worked at had free counseling sessions for any healthcare providers in need of mental health care, yet for almost three years I never sought out any care. Why? Well, frankly, I thought that “talking it out” would not help with my situation. I also thought I would eventually either get used to my stressful circumstances, or that I would figure out a way to “solve” the problems I was facing. And I felt I never had the time to go to a session.

After going through some counseling sessions on my own, however, I found that talking to someone outside of my residency program, in full confidentially, gave me an outlet that I needed. This makes sense, especially since my job involved always listening to others and never really being heard. Speaking audibly about my experiences, instead of just ruminating over them in my head, also allowed me to process and reflect in new and helpful ways.

So I am now a huge advocate for therapy. In fact, I believe that every resident should see a mental health counselor. Having a mental health provider is a requirement for many psychiatry residents across the country, but sadly awareness about mental well-being is lacking in other specialties. This needs to change.

For all new residents, I encourage you to look at your health plan and see what mental health coverage you qualify for. I hope you are able to go for free, but even if you need to pay a co-pay, please invest your money and time in your personal well-being. You will not regret it.

Don’t struggle in the shadows (Cambridge, 2019  ©  JOEL ANG PHOTOGRAPHY)

Don’t struggle in the shadows (Cambridge, 2019 © JOEL ANG PHOTOGRAPHY)

3. Stick to a Budget

Residency is expensive. I previously broke down my residency conference expenses which showed I spent about $10,000 just in required educational endeavors. As the interest on loans keep piling up, the last thing you want to do in residency is accumulate more debt than necessary. So I highly recommend you make a strict budget for yourself, and stick to it. To help you get started, I have a free spreadsheet that you can use. Feel free to modify it in any way you want to.

It is vital to keep track of your money. For residents on a tight income to expense ratio, budgeting is crucial. Since starting this blog, the most common advice I have given has not been about credit cards, but rather about budgeting. A lot of people want to save money by getting into the credit card and travel hacking game, but have no idea how much they spend each month. I do not think this is a wise strategy.

Conference “expenses” (New Orleans, 2019  ©  JOEL ANG PHOTOGRAPHY)

Conference “expenses” (New Orleans, 2019 © JOEL ANG PHOTOGRAPHY)

4. Enjoy Every Moment

This may be cliché, but residency goes by fast. Sometimes the days, weeks, and months felt painfully slow, but I am amazed that my three years went by so quickly. Looking back, the one thing I regret was being too busy. I always felt my task list could never be completed, despite the fact that I worked hard to get things accomplished. But because I was always focused on my task list, I know I failed at times of being present for those around me.

At the end of the day, medicine is about people. Yes, that means patients, but it also means you and those you work with. Even if you have ten clinic notes left, spend some extra time with the patient who is telling you about their beloved cat. Or with your co-resident who needs relationship advice. Or with a nurse who wants advice on which Christmas present to get for her daughter. Or with the janitor who works two different jobs so he can pay tuition for his son's college. Enjoy those moments, because those are the ones you will never forget.

Random people moments

Random people moments

Glad to be Here

At the recent national ACFAS podiatry conference, I got hear former Blue Angel pilot John Foley speak about his life experiences. His personal motto is “Glad to be here”, referring to the outlook he tries to have on a daily basis regardless of what he is doing. I hope you can embrace that same motto as you being your time in residency.