Happy National Doctor's Day!

Photo credit: @coryjpopp

Happy National Doctor's Day! Thank you to all the amazing physicians out there who work endlessly and tirelessly, without expectation or hesitation to keep your patients safe and healthy. In celebration, I have finally put together this much-anticipated post answering all of your questions about being a physician, life in residency, and how I stay sane/healthy/balanced. Feel free to leave a comment if you have any more questions. I am happy to do more Q&As as well, from choosing my specialty (Physical Medicine and Rehabilitation) to earning my MBA and whatever else you want to know.

How do you remember everything?

Remembering everything takes time. Before I took my first medical licensing board, I turned to a friend and said, I believe this is the smartest I will ever be. I then finished the exam and celebrated with two large glasses of wine. It takes a lot of practice, rote memorization, and reading. I think of understanding medicine as a "see one, do one, teach one" process. If you can teach the subject to someone else, your have learned it really well and that is how a lot of medicine is practiced now. In addition, throughout medical school and residency, we practice a sort of socratic method discussing different patient scenarios and cases as well as our approach to medical management. There are several resources available for following the most up to date evidence based treatment algorithms as well. I also love Quizlet for flash cards. Several of the study tools I used are featured in my blog post here. Understanding the anatomy helps make a lot of things make sense too, especially in my field. I am a visual learner so seeing the muscles in cadaver lab helped me more than just studying pictures and words in a book.

How do you keep calm during times of chaos?

This is a great question! It is difficult not just during times of chaos but also when that chaos leads to a poor outcome. You have to continue working through your shift no matter what happened that morning or night. Having a great support network an strong staff members is key to emotional survival. I also have my Advanced Cardiac Life Support (ACLS) cards to ensure I have the algorithm on hand for when a patient codes (becomes unresponsive with the biggest concern being for cardiac or respiratory arrest). We train for this every year so it's pretty much memorized but it's a comfort to know I am as prepared as I can be for the worst case scenario. They say you should check your own pulse before checking the patients when it comes to these emergent situations. It is true, you have to take deep breaths, stay level-headed and know that you are the most equipped and capable person to handle the situation. Confidence is 90% of the job an clinical knowledge as well as physical exam skills is the other 10%.

How do you stay healthy with such a crazy schedule?

Staying healthy with this schedule can be tough. I started doing the at home 28 minute workouts with Cassey Ho of Blogilates my intern year because it gave me flexibility to accommodate my crazy hours. I love that I can do the exercises anywhere and I don't need anything (not even a mat really, although it is helpful). I did a few blog posts on this routine here and here.

I figure if I have time for social media, I have time to work out. A lot of it is mindset, time management, and knowing your health is just as important as your patient's health. You have to practice what you preach. There are a few other good sites like www.doyogawithme.com, which offers free meditation and yoga classes online. I also love finding new and sometimes free workouts around the city like The Bar Method at Rittenhouse Square. More recently, I have joined ClassPass because I discovered a great workout called SLT (Strengthen, Lengthen, and Tone), which I also featured in a blog post here.

Who is on call with you?

Photo credit: @coryjpopp

There are no other residents in my program on call with me. There is an attending if I ever have a question or need help. Some places have a senior resident and a junior or intern resident (like my internal medicine intern year). I work at a rehabilitation hospital that is stand-alone, meaning it is not connected to an acute care facility and we have to call 911 to send them to the Emergency Room if they are not stable enough to remain in rehab. I also work on a rehabilitation floor within an acute care hospital, which has other specialties and residents available in case a patient declines rapidly and needs higher care.

Can you sleep when you're on call?

Yes, I can sleep on call! Depending on the hospital site I am taking call at, I may get more sleep at one than the other. The site within an acute care facility has less patients and the nurses are more familiar with medically complicated patients. I average about six to eight hours of sleep with one or two pages interrupting it (on a good night). At the stand-alone rehabilitation hospital, I get about 5 hours of interrupted sleep. On a bad night at either site I could get less than two hours, if that. Not all specialty's are like this. Some take call at home and sleep through the whole night, others are busy their entire shift and get no sleep, and still others don't have to take call.

What happens after you finish residency?

You can go into fellowship (for me, I'm thinking Cancer Rehab or Sports Medicine) for one or two years. Of course, if you were doing say, a surgery residency, this would be longer. Other residents will graduate and go straight into general practice as attendings depending on their interests. Some physicians will also go into administration, research, teaching, or find another career path.

I hope this helps shed some light on what it's like to be a resident physician...it's not Grey's Anatomy but it's definitely fun to pretend like it is sometimes :)

PS: Don't forget to thank your doctor today!