I Survived My First Month of Residency

Disclaimer: These are my views and my views only

Salam alaiykum everyone I hope you are in the best of health mentally, physically, and emotionally. Alhamdudillah, I cannot believe I am done with my first month of residency! It definitely was a transformative experience and I am surprised by the growth but man, it was so so so so hard. I wanted to talk about the rotation I started with, the positives, the negatives, and overall what I learned about what it means to be a resident.

Overview of my first rotation:

The first rotation of residency for me was cardiology, specifically the cardiac ICU. I would be covering patients who came in with a multitude of heart conditions such as pulmonary hypertension, ICD discharges, atrial fibrillation, ventricular tachycardia etc. As a resident, I was in charge of managing their care and coordinating with different parts of the healthcare team on different orders needed for them, procedures, and also having them ready to go when it was time for them to be discharged. If any patients were admitted to our service, we would be in charge of doing their orders and writing an admission note. I would have to work alongside my co-interns, the senior resident who was usually a second or third-year resident who was overseeing us, the cardiology fellow, and our cardiology attending. There were also third-year med students and a 4th-year student who was acting as a sub-intern on our term. My shift was from 6 am- 5pm for 6 days a week with one day off. And this could vary, there would be times when I would have to stay as late as 6:30 pm to make sure everything was done for my patients. 

Around 6 am I would come in and get sign out from the night team about all of our patients. Then my co-interns and I would divide the patients among us. It could vary but I would have 3-5 patients on most days. The sub-I would get their own patients which would be very helpful and the third-year med students would come in around 7 am and take some of our patients to cover. Rounding with the attending physician would start around 8 or 9 am, therefore we had three hours to see all our patients, come up with a plan for what we were doing for them that day, and hopefully have time to run it by the senior and/or fellow. Y’all some days were easier than others. If my patients were all stable, then pre-rounding would not be too bad. However if one of my patients was actively dying or a new admission suddenly came out of nowhere, the morning would be chaotic. Anyways, everything would have to be secured and ready to go before rounds with the attending.

Rounds can be stressful because you have to go through what the patient came in for, pertinent labs or imaging for them, physical exam findings, addressing each of the problems the patient had, and the plan you are coming up with. Sometimes the attending may agree to the plan and sometimes they may add something to it. It can be challenging when you are presenting and the attending interrupts you, asking you about something you previously mentioned. I would always have to say a little prayer to get me through rounds, esp on a service that I have little to no knowledge on, like cardiology.

Rounds can go on for 3-5 hours where everyone sees the patient and discuss what they want to do. After rounds, we (try to) get lunch, and then finish our notes. Around this time I relax the most because it will be about 1 pm which means 4 more hours until the shift is over! However, I try not to relax too much because things can hit the fan. The patients I was covering were very unstable. They could discharge as they are or die in an instant. I never knew what I was going to get and it would leave me very anxious. Also sometimes patients from other hospitals can transfer to ours and we would have to manage and work them up. This can take me up to 3 hours because I really did not know what I was doing. 

Around 5 pm the night team would come and we would sign out to them. This could take 30 minutes to an hour. However, after we are done doing that we are free to go! 🙌🏾 

I was on this rotation for 5 weeks. Normally, it is 4 weeks, however, because it was my first rotation, my residency program has this thing called transition week where you work an extra week on rotation before July 1st. Ngl I do not like cardiology and if you read my previous blogs, I never liked cardiology so it felt like I was on that service for a year. Each day brought a new challenge and now instead of looking at someone else for help sometimes, all eyes would be on me. 

✨What do you want to do, Doctor?✨

Man, I do not know. 😭 

Highlights:

Let’s start off with the positives before I get into the nitty-gritty. My cohort, especially my co-interns have been absolutely amazing. They have been so kind and willing to help out. They would make sure that I was able to handle certain tasks after they were done with theirs. They would make me laugh and make me feel as if I was apart of a team. I truly appreciate them from the bottom of my heart.

My senior was also very great. She is doing med-peds residency and this was her first time as a senior. However, she did an incredible job. She was very nice and willing to help out. Whenever I felt overwhelmed and wanted to cry because of all the tasks I would have to do, she would try to calm me down and tell me that it would get better. She genuinely made this experience more tolerable and I truly appreciate her. Definitely hope I can be like her when I am a senior.

Y’all the medical students?! Chef’s kiss! I did not even realize how much I contributed to the team when I was a medical student. I always felt like a burden. However, now that I am on the other side, I can truly see the assistance. There would be some days when I would be so tired and overwhelmed that I did not want to present some of my patients. Who would come to the rescue? The medical students! They would highlight all the key aspects in their presentations and do an amazing job. And after rounds when I would feel too tired to finish my notes, they would write them for me. There was one time I almost cried when I saw that the hospital course for the discharge summary of one of my patients was completed by one of them. I would be so sad on weekends when the medical students were not there. Truly life-savers.

I was so grateful that two of the cardiologists were Black! This was the first time I worked with a Black physician on an internal medicine service and it was good vibes! Both of them were really nice and supportive. One of them was a great teacher and taught me so much about how to do well on my presentations, ask pertinent questions to patients, and perform a stellar physical exam. Truly grateful that my first attendings were pretty great. 🙏🏾

I really appreciate some of the staff, especially the nurses. I am sure it is hard for them to navigate new interns who do not know what they are doing. However, some of the nurses were really sweet and would always try to help out when something acute would happen to our patient. Tbh I sometimes felt like giving up my white coat and handing it to them because they sure knew better than me what to do. 😭

And of course, I would not be a doctor without my patients. It was soo hard seeing some of my patients who were very sick. However, I am grateful for the bonds I created with them. What I love about internal medicine services is that you can see your patients every day throughout your time on the service. And when you see them get better than when they were admitted, it truly is a beautiful sight to see. One of my patients who was discharging asked me if I could keep seeing her even after she left cause she said she would miss me 🥺 ♥️ that tore me up ngl. I am so humbled and grateful to be apart of their care, and I felt like I was playing a bigger role now as a resident instead of a medical student. 🙏🏾

Obstacles:

I do not think I was prepared for how challenging residency was going to be. One of the hardest things for me was giving up my weekends. Even though medical school was really hard, especially because I had a two-hour daily commute, I always looked forward to the weekends to relax and catch up on sleep. However, this was different now. For five weeks straight, I worked 60-70 hours a week with only one day off. That took a huge toll on me mentally. I could feel myself getting deeper and deeper into a dark hole to the point where I dreaded coming to work the next day. I was just hoping I could sleep forever and ever and wished that I did not have to come in and work another long shift. I felt like I was a robot sometimes just doing my work endlessly and not having any emotion going into it. It was the trenches.

Another challenging thing was that now I was actually the one who was “in charge”. As a medical student, I always had the resident and the attending to look to whenever a difficult scenario or question arose about a patient. Now, as a resident, there were times when I had to figure it out on my own. It was especially scary because some days my senior and fellow would both be off, leaving my co-interns and I to kind of figure things out on our own. I sometimes felt like I was a headless chicken, running around to different rooms, hoping I did not miss anything. I felt like if I did not mention something or forgot something, then my patient would be affected by my mistake and everything would be my fault. My anxiety would be through the roof sometimes and I would have to calm myself down or else I probably would have had a panic attack. 

One of the hardest things for me mentally, physically, and emotionally was seeing my patients die. One of my patients who I had been following during my first few weeks on the service who I thought was pretty stable ended up having a horrific episode that caused him to die during the end of my shift. Seeing him in his last moments with his family member was too much for me to handle. I watched as they removed his lines and life-saving procedures before he breathed his last. After I left that day, I felt very numb. Another one of my patients slowly started to fade away and made the decision to transition to comfort care. Seeing him and his family during their last moments was also too much to bear. That night I sobbed and cried myself to sleep. 

I even helped perform CPR on a patient who eventually died. That was probably the most traumatizing experience I had to witness in residency. After it was over I felt myself getting nauseous and dizzy, about to pass out. I had to walk around for 30 minutes to clear my mind. Even recalling this now is bringing me chills.

I have broken down so many times during my five weeks on this service. There were times were I felt so overwhelmed and did not know what I was doing or how to do it. I felt incredibly stupid and wondered if I even made the right decision to pursue medicine. I did not think I was fit for this position and that someone else was worthy of having it over me. It also did not help that I was the only Black hijabi in my whole team. I felt like I stuck out like a green thumb. I did not know how I would get through the five weeks because each day definitely felt like a battle for sure. 

Y’all my body was literally taking a hit. I do not check my weight but I am sure I lost some pounds. I also got pretty sick and I developed a constant headache that would not go away (it did when I was done with this service). I was in a funk and complained all the time to my family and my friends. I generally disliked how I was becoming and I did not know how to stop it. 

Residency is really really really really really hard. There are some people who may try to downplay it or hide what they are going through but best believe everyone who went through residency would never ever want to go through it again. It’s a break-you-down and build-you-back-up experience. It’s definitely not for the weak-hearted. And honestly writing about this has been challenging because I am re-opening wounds but I feel like I have this duty to tell people who are not in medicine the reality of what being a doctor entails. It is not fun and games. It’s not dressing up in your white coat and stethoscope and taking pictures for the gram. It’s real people and real scenarios that involve life or death. It is truly something to think about and consider before one embarks on this journey of medicine.

How I tried to cope with the obstacles:

Thankfully, my residency program is now 10-15 minutes away from my family so I am so grateful for that. I decided to live at home and while some give me a major side-eye for that, I could honestly care less, especially given how difficult the first month has been. It is so nice to go home after a rough shift and find meals prepared for me. I feel like had I been on my own, I probably would have lost more weight than I already have. I also appreciate talking to some of my family members of the struggles I went through in residency. Although they do not really understand it because they are not in medicine, sometimes it’s nice to have someone to talk to.

At the beginning of this rotation, I would work 6 am-5 pm, go home, eat, sleep, wake up, eat again, pray, and then sleep. That was not good for me and it was definitely taking a toll on my mental health. I felt like my life was slipping away from me. Therefore, instead of sleeping right after my shift, I would try to do things until my bedtime. This would mean taking walks on campus and on different trails, riding scooters, getting food with friends, hanging out with my family, shopping etc. I even attended a wedding! I tried to do anything so I could avoid falling asleep. It was hard because I would be so EXHAUSTED after my shift but in order for me to feel sane and feel as if I were not missing out on life I had to do it.

I also have the most amazing, sweetest, kindest, genuine best friend in the whole world. We became super close in med school and she matched at a program in a different state for residency. Ngl not having her here in the same state as me has been really hard on top of starting residency. However, we still try to keep in close contact. We text every day and some days I send her super long voice notes (sometimes an hour long) just detailing how rough my rotation has been and navigating being a resident. She would validate me and give me space to be myself. I honestly do not know how I was blessed to have a friend like this but I am truly so grateful to Allah (swt) to have her in my life. She definitely made going through residency much better.

Of course, being Muslim has helped me so much during this challenging time. Every time I pray, I literally ask Allah (swt) to help me through any challenge I am going through. During rounds, I would be super stressed and I would try to say prayers to get me through them. I would ask for strength to get me through the day, the week, and the rest of the rotation. I would take Fridays off to attend Jummah prayer and being there has really helped me spiritually. God is truly the only one who knows how I struggled during this rotation and He is definitely the only one who can allow me to get through residency and beyond.

Overall:

If you have not noted the theme already, it’s that residency is very hard. No matter what program or specialty one goes through, the heat will definitely be felt, unfortunately. The system is designed in a way that makes sure that everyone suffers from it. I am very appreciative of the program I go to however, there are things that they cannot change about how residency is done. It makes me really sad but I am hoping that residency gets better for the next generation of physicians. We lose too many bright, beautiful minds because of how residency is built and it needs to change. I really hope that this post and so many other experiences on what residency is like can be a means of modifying it.

Anyway, grateful to Allah (swt) that I got through this first month. On my last day of the service, I was running around until almost 6:30 pm. When I got to my car I ghetto-cried for 5 minutes. I could not believe I had gotten through my first month. Alhamdudillah!

I am constantly praying that He gets me through this and more inshallah. Alhamdudillah right now I am currently on a clinic block and I really enjoy it. I have my weekends (yay!) and I am right up my alley. Truly with difficulty comes ease. However, after this month, I go to the ICU. 😩 Y’all keep me in your prayers, I really pray I make it to the end inshallah!

Please keep the people of Palestine, Congo, Sudan, and all the oppressed people in the world in your prayers now and always! 🤲🏾

Be on the lookout for the next blog inshallah 😊