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FORUM
The Transition from Residency to Real LifeIs that a new patient for you?" my primary-care clinic preceptor asked me last week. I had just seen a 7-year-old who was new to the clinic. "Because you probably won't see him again unless there's a problem. By the time his next yearly physical rolls around, you'll be long gone. You're going to have to start saying good-bye to your patients." It was the second month of my third and final year of residency, and it hit me for the first time that the years were slowly drawing to a close. "Do you remember internship year?" my husband and coresident asked me a few days ago. "There were so many hurdles, so many hard months ahead of us that it was too overwhelming to think of all of them. But we're finally getting through it." CountdownSlowly, my focus is shifting. Even a few months ago, it was inconceivable to me that I would ever finish residency. Whenever senior physicians asked about my postresidency plans, the answer felt abstract. Maybe primary care, maybe something else. But now, my resume is updated, my cover letters are written, and I've started looking for my first job. For years I've dreamed of getting a puppy at the end of residency. Now I have a dog calendar to mark off the remaining months.The grueling residency schedule has given relentless structure to my life. Every minute is accounted for, and the overnight call in the hospital leaves me exhausted. Yet every day I know exactly what I have to do. I find the rare free afternoons overwhelming. Should I do laundry? Should I relax? Should I catch up on reading? I have wasted whole afternoons vacillating between the various possibilities. The intense daily routine has given me permission to put the rest of my life on hold. During medical school, I exercised daily, I wrote a book, I planned a wedding. But during residency, I became a one-dimensional person. My life was about learning to be a doctor. I didn't have to write. I couldn't. I gave myself permission to relax my workout schedule. I spent entire evenings watching TV guilt-free when I was too exhausted to do anything else. Now I want to pick up those pieces again. I'm out of shape. I want to write another book, but I'm struggling with the topic. I'm out of practice in being a whole person. "The transition to real life was actually pretty stressful," said a colleague who had finished residency two years earlier. "You get so caught up in where you are in the call cycle—on-call, post-call, and swing [when your nights are free]. Without that order to my life, I didn't know what to do with myself," she said. As a senior resident, I now teach the new interns and students. It offers me the opportunity to reflect on where I once was. I remember how I looked up to my senior resident first as a medical student and then later as an intern. I couldn't possibly ever learn that much. As I counted my remaining training time in years, I enviously watched as the senior residents effortlessly completed their final months and weeks. Trading PlacesI was late to my first rounds as senior resident. When I walked into the conference room, it was already crowded with two senior staff physicians, four interns, four medical students, and several nurses. All eyes were on me, waiting for me to direct the morning rounds, to offer guidance on how to care for the children, to model how to be a good doctor. As I looked around, I felt the fear of those first months of residency and medical school all over again. Here I was on the other side, not at all as confident as I had perceived my former senior residents to be.Yet, as I work with the new interns and medical students, I realize how much they have to learn. "We deserve combat pay for this," my co–senior resident remarked after a long day trying to direct the interns while at the same time giving them the independence to test their own skills. I remember a senior who commented to me when I was an intern, "One year difference, and you can empathize. Two years, and you're like, 'What planet is this person from?'" At the time, I was offended because I thought he was telling me I had done a bad job. I still feel offended, but at least I can understand the sentiment. I have felt residency as a hulking presence on the horizon for years. My life was stalled in its shadow, caught in an everlasting adolescence of education. Now I'm excited to move on. While the path has been predetermined for the past 28 years as I moved inevitably from college to medical school to residency, the next 28 years will be what I make of them. —Ellen Rothman, HMS '98, a third-year resident in pediatrics at Children's Hospital in Boston |
