COMMENTARY

The Most Common Mistakes to Avoid During Residency

Rosalyn E. Plotzker, MD, MPH

Disclosures

November 19, 2018

Professionalism Mistakes

Lying

Don't lie. Not even white lies. If you aren't sure whether a patient had labs or imaging, if you don't know the result of those labs or images, or if something didn't get done that was supposed to, just say so. Trust is easy to lose and hard to regain.

Following bad examples

Don't adopt the bad habits of your superiors just because they are your superiors. While it's important to be open to learning from seniors, it's equally important to distinguish what is appropriate behavior and what is inappropriate. Being abusive, mean, coercive, or humiliating toward anyone, especially your juniors or nurses, is never appropriate. Stand your ground when it comes to ethics.

Letting your ego get in the way

Arrogance early or ever is a fast way downhill. It repels potential mentors, colleagues, and most people whose help you will probably need at some point. It's also a major contributing factor for mistake number one: not asking for help when you need it. Stay humble, and you will grow into a better clinician.

Not having a self-care routine

Self-care is necessary and not negotiable. A routine doesn't have to be a complicated regimen of meditation sessions, yoga, perfect organic meals, and weekly massages. But do cover the basics: make sure to sleep enough, have good food, and get some form of exercise. Make it a regular part of your life. Consider it as much of a priority as the work you do in the hospital.

Being glued to your phone

Cell phones are addictive. Make a concerted effort to put your phone away when you need to be listening. People can see you swipe. Also, don't text patient identifying information.

Collaboration Mistakes

Getting mad at nurses

Remember that nurses are your allies when it comes to a patient's care. They grapple with frustrations related to incomplete medication orders, discharge paperwork, and rely on you in many ways to be able to do their job. Be patient and communicative.

Calling a consult without a specific question

If a patient has a condition that is outside your scope of knowledge, it's fine to recruit someone with more expertise who can ensure that condition is appropriately managed. However, "we just want you on board" isn't a question. It is up to you to come up with an initial rough-draft plan for the patient's condition, and identify a specific knowledge gap or uncertainty where you need an expert. This approach helps your consult better understand how they can help you. Plus, thinking things through first is a great opportunity for you to expand your own clinical knowledge.

Not communicating with radiologists about impressions that seem confusing

Actually look at images yourself. You can call a radiologist if you have a question. They are usually happy to talk things through, and can make a better diagnosis if they have more clinical information.

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