Medical interns: Navigating the first year of residency

The first year of residency can be one of the most physically and emotionally challenging years of your training. A chief resident offers tips for navigating this part of your education.

In this second post of a two-part series, Dr. Faton Bytyci, chief resident at Sacred Heart Hospital’s family medicine residency program in Allentown, Penn., provides insights to help you thrive throughout the challenges of your intern year.

When you start the first year, it’s important to recognize that there’s a lot you don’t know, Dr. Bytyci said. At the same time, don’t let that hold you back from learning everything you can. “It’s OK because you are being watched by every nurse, medical assistant, senior, attending, even the people who empty the trash,” he said.

• Know that you will make mistakes—and you will hear about them. “You will be paged by a senior resident or attending physician to ask you why you did this thing or that,” Dr. Bytyci said. “Don’t argue. Just say you’re sorry, then cry in the corner for a moment and get over it. You are not a bad person because you made a mistake.”
• Ask for help. “If you are completely over your head, admit it and ask for help,” he said. “Don’t pretend to be smart. Every residency is different and has specific regulations that you have to learn and follow. So focus on learning.”
• Be honest. “It’s very important for your senior residents and attendings to trust you,” Dr. Bytyci said. “It’s OK to say ‘I don’t know’ or ‘I forgot.’ Don’t lie. Everything starts with trust and builds from there.” Learn the key factors that build residents’ trust in interns.
• Don’t let fear stop you. “Procedures can be scary,” Dr. Bytyci said. “If you understand from the beginning that fear is a normal response to new situations, you’ll expect it and be ready to move through it. You can’t learn without getting outside your comfort zone.”
• Be nice to everyone. “Strive to be nice to staff, fellow residents, consultant services, patients, families, environmental assistants, clerks and everyone else,” he said. “It’s good for you, good for others and good for patient care.”
• Respect every team member. “Most nurses are deeply dedicated to their patients,” Dr. Bytyci said. “Every nurse in the hospital has more clinical experience than you. Nurses are your best friends. They can make or break your experience.”
• Be careful how often you complain.Dr. Bytyci warns that residency is full of sacrifice. “You will be grumpy. You will be exhausted,” he said. “Complain only to your friends and family. Nobody wants to work with complainers.” In an environment where everyone works hard, others can find it annoying if you repeatedly tell people how hard you’re working, he said.
• Learn to say yes. Dr. Bytyci recommends taking advantage of every learning opportunity. Say “yes” to participating in procedures and other clinical opportunities, conducting research, publishing and attending conferences.
• Keep your eye on the goal: Residency will transform you. “The most awesome thing about being an intern is that at the end of the year, everything that once seemed scary and difficult will become second nature,” Dr. Bytyci said. “You start out lost, scared, having no idea what to do, and in a short period of time, you turn into a well-informed, confident, professional physician.”

• Find out how to make it through residency on a budget
• Read about the Mayo Clinic’s unique approach to preventing resident burnout
• Discover the four building blocks for a successful medical marriage
• Learn about an initiative that could bring changes to the residency environment
• Read up on whether more flexible hours can help improve the residency experience