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Residency Graduation 2016
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It’s that time of the year for most of podiatry’s current third year residents: graduation. Exciting and scary. This is what you’ve spent the last 11 years preparing for. Through college, podiatric medical school, and residency you’ve put literally thousands of hours into learning everything from taking an appropriate history to doing complex foot and ankle reconstructions.
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Now it’s time to enter….
THE REAL WORLD
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Yes, my new colleagues, you are now the doctor with all the rights, privileges, and responsibilities that entails. The safety net of your attendings is gone. Patients are no longer just procedures you get to scrub in on and walk away.
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If you’re a normal human you’ll realize pretty fast that your patients are no longer abstract ideas or the next cool procedure. In some cases, their very lives are in your hands, and you have the potential to help or harm them. You must understand at the outset that you won’t be able to cure everyone, and you won’t always have the best outcomes (despite how great you think you are). You are only human, of course, and you have limitations. Also, there are plenty of things you don’t know. Realizing that will help prevent you from making mistakes out of hubris. For example, at maximum the longest possible follow-up you could have had is three years (and that’s if you saw the patient on day one of residency and day 1,095 – graduation day). That means your experience is – at best – short term.
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Now, I don’t want to destroy your confidence. This year’s graduating residency class is the best trained one in the history of the profession. All of those who came before you shed a lot of blood, sweat, and tears to give you the scope of practice you have today. And they have been very successful. Through their work, and the work of all of your trainers, you’ve had the opportunity to become a true foot and ankle physician and surgeon.
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“This year’s graduating residency class is the best trained one in the history of the profession”
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So, to help as you start out, I’m going to give you some completely unsolicited advice.This from someone who’s been around a few years and has made mistakes along the way, as well as having a few successes too. In no particular order, here are my top 10 pieces of advice as you start to practice.
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Top 10 Pieces of Advice as You Start to Practice
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Stay involved. Join your local podiatric society. Become a member of your new hospital’s surgery committee. Find an interest that takes you into your local town’s community. Be part of something besides your medical practice. This will introduce you to your local podiatric and medical colleagues as well as potential new patients to build your practice. Participate in online forums like PRESENT e-Talk. There’s a national community out there that can help you succeed.
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Stay in touch. You’ve learned over the past three years from people who invested time and effort into your education. These attendings – now your colleagues – want you to succeed. If you have a question, call one of them up. Email them an upcoming case of a challenging patient. Having a discussion about a particular patient always broadens one’s perspective and leads to better patient care. You might also need references for things like hospital privileges or job opportunities. Who knows you better than your favorite attendings?
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Stay educated. Keep reading. Read about your patients. Read about new techniques and concepts. Don’t stop reading. Go to conferences. Read journal articles. Read our trade magazines. They’re all full of thought-provoking information to keep you up-to-date. Go to skills courses to learn new techniques you might not have been exposed to in residency. If you stop reading, you stop learning, which is the death of good medical practice.
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Embrace change. Starting practice will be different from residency, and that can be uncomfortable. That’s ok. Be comfortable with being uncomfortable. You’re going to have lots of new experiences and meet interesting new people, which can be fun and scary all at the same time. Embrace it and grow.
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‘Fake it till you make it’ is nonsense. That’s right – it’s BS You’re not a student anymore and can’t fake anything. You have to actually fix your patients. There is no faking it. If you don’t know how to do something, then find a colleague who does, and either have them show you or refer your patient to them.
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Charting is your shield. Don’t get lazy about charting. This is how you get paid and how you protect yourself during a malpractice case. Don’t forget the phrase, “If you didn’t chart it, it didn’t happen.” It’s the reality. Lawyers are going to dissect your notes to find something to use against you. That means your charting has to be immaculate. Specifically, chart events that demonstrate how much a patient loves you. If a patient says, “You’re the best doctor ever” put it in your HPI. If they bring you chocolates to thank you, then chart it. If there’s a complication, chart it. And be honest. NEVER lie.
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Don’t put your head in the sand. If your patient has a complication, do something about it. Don’t just say it’s nothing and hope it goes away. Go with your judgment. If something doesn’t seem right, it probably isn’t. Investigate, figure out what the problem is, and then create a plan to fix it.
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Be honest; be good. You didn’t become a physician to commit fraud. Don’t try to rip anyone off. Dishonesty will get you nowhere in the long run. Don’t fraudulently bill for services you didn’t perform. Don’t lie to your patients. There are plenty of dishonest doctors who are just out for the buck. Don’t be one of them, and you’ll be able to look yourself in the mirror every day.
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Take time for yourself. Professional life can be very busy – sometimes busier than residency – so try to take a little personal time for yourself and your family. De-stressing is important to help us cope with the rigors of medical practice. If you don’t do this, you’ll find yourself either burning out or becoming someone different from what you originally wanted.
and my final piece of advice is to...
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Embrace the adventure. The practice of podiatric medicine can be an amazing career with so much to offer and so many opportunities for you to give back. Let the good and the bad wash over you. Learn, grow, and become everything you looked forward to on day one of your residency.
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Good luck on your next step of the adventure. Enjoy every moment in health, wealth, and happiness.
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