Transitioning to Residency in the Time of COVID
Posted by [email protected] on Nov. 20, 2020 / Subscribe 0
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Baptist Memorial |
Dear Soon-To-Be Intern,
I sense your disappointment and feel the disruption. Your clinical rotations are not what you thought they would be. Finding a place to do away rotations amidst a pandemic has been difficult. How can one get a true feel of a program with a virtual interview? The only thing certain about your transition from medical school to residency is uncertainty. “How do I make sense of this?” is a question that everyone is asking amidst our unprecedented public health crisis, and it's the same question you will wrestle with innumerable times in your training. I know you’re disappointed with how medical school has ended. You fear your training, at least how you imagined it, has been interrupted. Consider another perspective: the pandemic isn’t an interruption, but an intensification. You are uniquely positioned to learn out of the posture that many find difficult to assume day in and day out when they progress through training and into practice.
Our current moment has given you a head start in one of the hardest aspects of being a physician: you must tolerate intellectual uncertainty and scientific ambiguity. You have to wield this cumbersome task in the midst of caring for another human being who needs your help. You will have to learn to act in uncertainty, not in the absence of it. Hippocrates is credited for reminding us that while judgment is fallible, it is also necessary. You are going to make mistakes, and you must learn from them rather than be destroyed by them. The antidote to lifelessness in your work is an admission that your work is always a work in progress. When you falter, find rejuvenation in the practices of learning and apprenticeship that brought you to medicine in the first place. Continuous re-orientation to the profession of medicine and re-commitment to learning pushes back against stagnation, against the belief that the only cards to play are those we’ve already been dealt.
We all think, physicians and patients alike, that we are our plans. When your plans are up-ended like yours have been in the last several months, as your patient’s plans unravel due to illness or the treatment thereof, you are left with only yourself. While this self is lonely and quiet, even scary, relative to your curriculum vitae or your aspirations, it is often far richer than your plans. When your first young patient dies, when you complete the death certificate of a woman who reminds you of your grandmother, and when you make a mistake, whether of omission or commission, you need to learn to lament, to simultaneously grieve and hope. To honestly cry out at injustice and tragedy, to grieve without hope, will leave you unsettled, shaken. You will feel a number of different griefs – loneliness in the ICU call room; fear of wrong lasix dose at 2 AM; loss of normality as you realize you can’t remember what day of the week it is– and you will have to absorb these blows while also being hit by the grief of your patients: the loss of a child, an unexpected diagnosis, a horrific side effect or complication from something that should have been routine. You have endured your own hardships, but you may not be used to this kind of collective grief.
At Baptist, we are committed to our physicians and residents well-being, caring for them as people first and providers second. The tapestry of mentorship and support allows people capitalize on the intersection of their gifts, desires, and opportunities. Ultimately, your job is, and will continue to be, a difficult one. Our priority for our trainees is their well-being, not only in their job providing healthcare for rural Mississippians, but also in their personal lives. We want to get to know your story, learn who you are as a person. Only after we know you can we care for you. Again, we feel the disruption you feel, and we know in our line of work there will be disappointments to come.
I have found there is comfort and an impenetrable hope that comes from this; this is the life-hack, if you will, for residency: Seek the welfare of the program, the institution, the city where you will find yourself for training. For in its welfare, there you will also find your welfare. As you navigate the application process, let the foundation of your vocation be marked by the virtue of hope rooted in doing the little things with great love. This rhythm will help you in the transition into residency, and it will also allow you to thrive in the wake of this pandemic. We hope to see you at Baptist in Oxford soon!
Your friend and colleague,
Sumner
This was adapted from an article published by Dr. Abraham on KevinMD on April 7, 2020.
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