How Can I Fit In as a Resident?

Benjamin S. Bryner, MD

Disclosures

December 04, 2012

Question:

How easy or difficult is it to develop relationships with your fellow residents when starting a residency? How do you become accepted as part of the group?

Response from Benjamin S. Bryner, MD
Resident in General Surgery, University of Michigan Health System, Ann Arbor, Michigan

The residents you work with will be an important part of your life. People talk about their co-residents as family, and it's not much of a stretch. You will end up seeing your co-residents more often than your family.

You'll become attached to the more senior residents who teach you what you need to know and who help keep you from doing something dumb in the hospital. They are like the older siblings who kept you from wearing something embarrassing to school. (I never had older siblings so I embarrassed myself all the time growing up.)

The residents in your cohort who train alongside you are most important. They're the ones you can talk to when you need advice, or an answer to a dumb question, or just to vent for a while. You'll feel protective of and responsible for the junior residents who follow you into your program, and you'll learn from them as well.

The dynamic between co-residents varies between specialties, depending on the length of the program and the number of residents each year. For example, if you're in a several-year surgical training program with only 3 or 4 new residents each year, you just have to get along with all of them, period. If you're in a program with dozens of residents each year, you can probably find a smaller group of friends within the program while still working with nearly all of them during your stint.

When you start a residency, the best way to fit in with all of your co-residents is to be the best intern you can. That may seem obvious, but there's no question that it's the most important factor.

If you're a good intern, your senior/chief residents will look out for you. They'll tell you what they know, they'll trust you, you'll get more responsibility, and you'll feel like one of them. You'll enjoy residency a lot more.

That's not to say that being a good intern means you can never make a mistake; the way you react to and learn from mistakes, and how hard you work to avoid mistakes the next time, is what defines your caliber as a resident.

But the question of how to be a good resident is another topic. So let's assume that you're reading, practicing your procedural and diagnostic skills, working hard, and paying attention to detail. What else can you do to feel accepted? I have a few suggestions:

Be social with your fellow residents. I'm reluctant to go to a lot of social occasions because I have a family that I don't see enough. But even so, I think it's important to not be a total recluse. I'm not saying go out every night or every weekend. Maybe what your fellow residents are doing isn't your favorite thing, but that's not important. Pretend to enjoy a couple of things you'd never do on your own if your co-residents are doing them. At the very least, go out often enough that your fellow residents don't think that you hate them.

Go to the residency recruitment events. Every fall during interview season, attend as many as you can, especially the informal social occasions. If you're working that night, try to stop by during the interview day.

I like to see junior residents involved in these, not because I want them to be cheerleaders for the program, but because I want to see them excited about the good points of the program while honestly admitting the areas for improvement. I'm happy when they see the program as their own, as something they're invested in.

Know something about the outside world. Be able to talk with other people about nonwork topics. Discussing work has its place. But whether it's politics, sports, food, or something else, having another dimension besides work will help you fit in.

I used to like movies, which I've given up as time has become scarce. Now it seems like I find time to watch an entire movie about as often as they reboot the Spider-Man franchise. I have started to follow the news more closely. That's also a good idea because conversation in the operating room or in the clinic workroom often turns to current events.

Another thing I do is listen to new music while I'm driving to work or studying, partly because I like it, and also because I'm exposed to so much terrible music from the operating room's radio. Having something else to suggest on the infrequent occasion that I pick the music is crucial.

The point here is not to win arguments about the local Senate race or about the relative merits of Nickelback or the Dirty Projectors; you just want to sound like you have some idea of what's happening outside the building. (And let me refer to an earlier point: Nobody wants your Oscar picks if you're a terrible resident.)

Have a practical hobby. This is an area where I really should take my own advice. I'm always impressed with anyone who can maintain a meaningful hobby during residency. If you're a fourth-year med student, now is the time to lay the groundwork for something like this.

I started getting interested in cooking when I became a resident. My rationale is that there are so many things you have to stop doing when you become an intern, but you can't stop eating. Doing something you enjoy and can be proud of is important. It's a bonus if you can share the results with your colleagues.

Work really hard the first few weeks. The first couple of rotations will really cement your reputation. Focus on learning the system and working within it; postpone as many of the little things as you can until later. Again, if you're a good intern, you'll eventually be treated like a second-year, and so on.

Know your role. As an intern, if you have a question or a suggestion about what to do, or if you see something that will adversely affect a patient, speak up and share it on rounds.

If you disagree about the way the service runs, or have a personal issue, talk about it in private. As an intern you shouldn't be abused or be made to do something that's unsafe. But short of that, don't complain. No job is beneath you as an intern. Do what's asked, and soon enough you'll be beyond it.

Find a senior resident who can be an informal mentor. This person won't replace a good faculty mentor, but it's nice to have someone you feel you can ask dumb questions. I know it helped me: As an intern I had more stupid questions than I had patients (and I was taking care of many patients). I was lucky to find mentors among the chief residents and will always be grateful to them.

Look out for residents who are in your same year. Treat each other as equals. Make sure they're not getting taken advantage of. Sure, you have to listen to your senior residents and do whatever they ask, and you have to teach your junior residents and make sure they progress. But you have a special obligation to your own class.

I'd guess that most disagreements between class members arise over scheduling. So when you're making your schedule, decide what few occasions are the most important and insist on getting those times off, but don't insist on everything.

That's my advice. For me, the people I work with are the best thing about my job. They've had high expectations but have also been welcoming since day one. I hope you find the same.

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