I sat down with a first year resident in pediatrics to find out what her life is like as a pediatrician in training. Here’s what she had to say.
I’m getting flashbacks of interview season but can you tell my readers a little bit about yourself?
Hello readers! I’m Sarah with an h, currently working as a 1st year pediatric resident at Cooper University Hospital in South Jersey. I’m a born and raised Jersey girl from a middle class family right outside of Philadelphia. I grew up playing soccer which I played at Widener University, a small private college in Chester, PA. The only medical blood in my family is my mother who is a NICU nurse. My original major at Widener was nursing, but halfway through my sophomore year I realized there was SO MUCH to learn and I wanted to continue my education past my four undergrad years. I switched to pre-med and it was at that point that my advisor told me about Caribbean medical schools, which accept applicants year round and geared more to the less traditional student like myself. I attended Ross University in Dominica, West Indies where I had the most amazing experiences and made lifelong friends. While I feel I did not get as many residency interviews as I would have liked because I went to a foreign medical school, through hard work, perseverance and constant contact with the programs I was interested in I wound up matching to my top ranked residency at Cooper back home in South Jersey.
So we’re about a quarter of the way through intern year and you’ve been a doctor for about four months. How’s it feel?
I feel like I’m finally settling into my role as a decision maker. The first couple months it was difficult transitioning from a closely monitored medical student to a doctor being pressed for urgent decisions and orders to be placed. I had to fight the urge to call a senior resident when being faced with medical decisions for several weeks before I felt comfortable in my new role. Even decisions I KNEW were correct, I suddenly became much less sure of when I was the one writing the order or telling the nurse which dose of medication to give. You are immediately thrown into the role as a team leader, which is daunting but extremely rewarding. I’m now at a place where I feel much more comfortable with my knowledge base, but know I have a long road to go.
What has been the most rewarding part of being a pediatrician?
Hands down seeing my patients’ laugh, smile or feel better. People always ask me what I love about my job, and it’s 100% the kids. The connections I make with children and their families make a 14 hour day all worth it. It can be one thank you, or one hug, or a colored picture and suddenly my hectic day where I haven’t sat down is put into perspective. It is so rewarding to be a part of the connections between the patients, to see the sigh of relief when they realize they’re not alone, and to be a part of an amazing team of medical personnel from social workers to physical therapists to nurses. Sometimes it’s surreal to think about what a critical role you play on that team. I am so grateful for the opportunity I’ve been given to positively impact children and there isn’t a day that goes by, even if it’s just for a brief moment, that I don’t remember that.
What has been the most frustrating part of residency?
I think a lot of frustration during residency comes from having a life and schedule that is no longer your own. Just know that for however long your residency is, mine being 3 years, you are more or less signing over your freedom. It sounds harsh, but when you look at it that way it makes you appreciate the time you do have off!
I went into residency with that outlook, and I found myself far less frustrated with the long hours.
The thing I would say I struggle with the most is disagreeing on medical care with other residents, more importantly my senior residents. Residency is a hierarchy, post graduate year 1 (PGY-1), PGY-2, PGY-3, and then fellows and then of course your attending. Medicine is also not black and white. Yes we have guidelines and peer reviewed articles, but in all honesty until I became a resident I didn’t realize how much of medicine was up to your own discretion.
Turns out, my treatment plan isn’t always the same as my senior residents. I think it’s important for interns to be prepared for differences of opinion and to know there is no one right answer in medicine. Like a bad USMLE question, it’s your job to choose the MOST correct answer, grapple with the opinions of other people around you, but ultimately do what is best for your patient. This is not as clear cut as you’d think, so pick and choose your battles and surround yourself with a strong support system.
What are you hours like? What’s a typical day for a pediatrics intern?
The hours vary depending on what rotation you’re on. There are more intense rotations which require 80+ hours and some less intense rotations where you work 40 hours a week or less. I feel that most programs do a good job of interspersing the two types of rotations so you have some time to breath in the middle of your tougher one.
For me, being on the “floors” or a pediatric hospitalist is the rotation that requires the most time and not only mental but emotional energy. Days start at 6am when you rush to get all of the vitals, history, updates and see all of your patients before rounds. The day ends at 7pm, but you usually have 2-3 hours of notes after that (14-15 hour days if anyone was keeping count). And you also have to remember you’re taking about two to three 12-hour weekend shifts per month.
But keep your head up! I’m in outpatient Behavior and Development now and I’m working a regular 9-5 (and some days less!).
What do you do outside of the hospital to keep your sanity?
Anything BUT medicine! I love doing guided meditation, which you can find on YouTube. I find the less time I feel like I have, the more that means I need to meditate. I hang out with my friends, I read non-medical books, I go to music shows, I go out to eat, drink and be merry. I travel on my vacation weeks. It’s so important to remember to do the things you love to do. So have a good idea of what makes you happy (outside of medicine) before you start residency and never lose sight of that.
What has been your most challenging aspect of residency?
Time management has probably been the most difficult for me. Not just in the hospital, but managing being a good resident, friend, sister, aunt and daughter. And going grocery shopping, keeping my apartment clean and bills paid. And on top of that studying enough to keep up with your own specialty, what you’re interested in, and preparing for the USMLE. It always feels like you should be doing more. Deep breaths throughout the day help.
The average medical school graduate finishes their schooling with roughly $160,000 of debt. How do you plan on paying it off?
The government really helps us out. They have amazing repayment plans you can enroll in now, which you can talk to your loan provider about. I’m currently enrolled in the Public Service Loan Forgiveness plan with an income-driven repayment plan. What that basically means is that if I work for a non-profit hospital and pay 10% of my income for the next 10 years, all of my loans are forgiven. It’s something to think about when ranking residencies, because this plan only applies to non-profit organizations. There are a lot of other plans available so definitely something to talk to your financial aid counselor or loan provider about!
You grew up playing soccer. In fact, that’s where we met! So you’ve always been an active person How much are you exercising these days compared to before residency started?
Significantly LESS. Like I say, if exercising is one of your passions, you really have to set aside protected time for it. I try to just work exercise into my daily routine. I set a goal of 15 sets of stairs a day when I’m on floors. 100 squats any time before I take a shower. Stretching anytime you have the space to bend. Drink TOO much water. Take deep breaths throughout the day. Even if you don’t feel like you can be your most fit self, you can always lean in the direction of health.
Do you strongly feel that there is anything you wish you did differently while you were in medical school that would have better prepared you for residency?
Honestly, no. I wish I could have done more elective rotations in the hospitals where I wanted to match, but for insurance reasons Ross University students couldn’t rotate in the states of NJ and PA. But it’s absolutely something you SHOULD do if possible. And if you have the opportunity to rotate in a hospital where you’d like to match, to try to be in the hospital on the floors because some of the subspecialties are pretty far removed from the doctors and residents who make up the bulk of the program.
Take your role seriously, because the type of student you are is the type of doctor you will eventually become. And every skill you’ve learned will help contribute to making you the best doctor you can possibly be, regardless of what rotation you’re on.
But most importantly I enjoyed myself. That’s something I tell all my medical students now, just take time to really enjoy your role and learning experience because it’s a big change once you enter residency.
What was your biggest fear going into intern year? Have they come to fruition? How have you dealt with those issues?
The biggest fear was that I’d be a bad doctor. I’m sure people want to know more specifics, but really just that I would not be able to help my patients, or know what to do, or what to say, or that I wouldn’t be as good as the other interns. Luckily, these have NOT come to fruition! Turns out, you know a lot more than you think you know. And a lot of what patients’ need to hear is that they’re going to be ok and you’re here for them no matter what. And the other residents aren’t my competition, they’re my biggest allies. I go to work every day knowing that I am here to do the best I can for my patients. With that motivation, a good team, and a lot of hard work, you have all you need to succeed. Never forget WHY you’re doing this.
What’s it like having the responsibility of teaching medical students?
As an intern, you feel so overwhelmed by your work and getting used to everything yourself, you almost feel like you don’t know enough or have enough time to really make any difference in their education. But I found that just carving out a little time to explain how I’m approaching certain patients or problems, or how I like to write notes can help contribute to how they will eventually practice. And every single one has been SO grateful for the time. If they ask me a question I don’t know, I say let’s look it up together. I try to incorporate them into the team, ask them something I don’t know that they might, or ask them to look certain things up so we can learn together. It’s so rewarding when you see a student you taught succeed on rounds or pick up new interviewing techniques they saw you do.
When do you plan on taking step 3?
I plan on taking Step 3 mid-April, which is a little more than half way through my intern year. I tried to coordinate taking the test with a month I was on a lighter rotation. I know people who took it before residency started which I commend. I knew I wanted that time to celebrate, travel, and enjoy myself so it was not an option for me. I feel like it takes a good 6 months to settle into your new role as a resident, so I would recommend sometime before or after that period.
For current medical students, what advice do you have for residency interviews?
Just be personable. I think the questions are just a formality. I really feel interviewers are just trying to see if you can hold a conversation and will fit well with the other residents. I would ask questions about the interviewer, “Where are you from? What do you like to do in the area? What brought you to this place/position?” Start a conversation. Be a real human. Actually get to know the person.
For the current medical students reading this, what general advice do you have regarding residency?
Take DEEP breaths as often as you remember and DRINK plenty of water !!!
Thank you so much for taking the time for this interview Sarah!