Reflection on Week 1 of Residency - Josh Gruenbaum, DO, PGY-1
Residency has finally started, and with it came both excitement and anxiety. With my first week in the books, I can confidently say I made the right choice of specialty and program. My first block is emergency department nights, during which most of my shifts are overnights. Honestly, I was terrified for my first shift. I felt like I had not done any real medicine since January, which was, for the most part, true. I felt wholly unprepared to start being responsible for patients’ lives. Ready or not, residency had begun.
I have absolutely loved my first week. I don’t think I will ever forget how helpful everyone has been this week and I will pay it forward next year. This first week has provided the opportunity to help with multiple traumas, perform my first intubation of residency, and stabilize multiple sick patients. I didn’t feel prepared to take sick, critical patients at first.
Honestly, the first one I sort of picked up by accident. My naïve self signed up for a patient with the chief complaint of “Hypoglycemia,” thinking it was something simple like the patient didn’t eat dinner but still took their insulin.
I quickly found out it was an elderly patient brought in by EMS in status epilepticus (no history of seizures) with a last known well 2 days prior. I was uncomfortable, but I think it was best to be exposed to critically ill patients early to get the nerves out of the way and learn a lot. I was certainly terrified, but everything went great with all the support from fellow residents and attendings. After each critical patient I got more comfortable with managing them, and honestly it feels so rewarding to turn around the CHF exacerbation patient in a short period of time, making them feel much better in the process.
I am so glad that my program has senior residents and attendings who are very eager to help. They were constantly asking if I needed assistance, which really made me feel like I could ask anything at any time. I didn’t have a lot of confidence, especially during this first week, but being able to ask for help at any time really eased some of the anxiety. They were helpful for even the smallest things, such as how many views were needed to assess for a foreign body in a laceration to how to admit a patient to the observation unit. The first week would have been a lot more difficult and stressful without the support of other residents and attendings.
The last time I was in an emergency department, it was an ultrasound rotation as a student last October. I remember hearing people say that the rotating 4th year medical students know more than the new interns; there have been times this week when that definitely felt true. I remember an attending asking a medical student a random anatomy question, which he answered correctly. I had no clue what the answer to the question was (fortunately, I wasn’t asked). It’s crazy to think that I was in their shoes just a year ago. However, it is encouraging to see their eagerness and excitement to see every patient they can. I remember being on that side of it and getting bored when there was downtime and residents were documenting. But to any students out there that may read this, please take advantage of any downtime and look something up that you found interesting or that you want to learn about.
The first week has been full of excitement and anxiety, but I survived and have learned so much in such a short period of time. It has been a bumpy start, but with every shift I gain confidence and feel more comfortable with the flow of our emergency department. There is still a lot to learn, but I am confident that other residents and attendings will be there to help when I am not familiar with or am uncomfortable with a particular obstacle. I am so glad I matched at Mercy St. Vincent’s EM program and I cannot wait to see what the rest of this month and year have in store!