Residency Tips: The Basics
There’s a lot to delve into when talking about tips for the different aspects of residency. This post is here to offer general topics that I wish I would’ve known as an intern! Keep in mind a lot of these tips can be program-dependent so adjust things to work for you.
Routines:
Daily routines can drastically improve one’s quality of life[1] and help organize the chaos. Having a wind-down or nightly set of habits will improve sleep onset and quality, which, as any medical professional, is super important. I like to keep these same routines when I switch to night shifts, it helps the transition. For example, my phone is set to yellow tones 2 hours before designated bedtime, I walk the dog, drink tea, take a shower, and read a little bit (of anything!) then slip on the light-blocking eye-mask and go to sleep! If you live in a louder city white noise in the background may also be helpful. I repeat these same steps in the morning after a night shift!
Morning routines provide a “calm before the storm”. Starting the day with peace of mind affects how the day’s dynamics, and vice versa. Starting off discombobulated makes pre-rounding unnecessarily stressful. I typically try to wake up with enough time to walk the dog, get ready, pack the lunch box, eat breakfast and make coffee. While it should be illegal, you typically start the day before Starbucks opens (6 AM) so the Nespresso is necessary for coffee people. Mentally preparing for the day, or meditating if that’s in your wheelhouse, gives a center and direction for whatever the upcoming shift throws at you.
FOOD
Food, and this should go without saying, is a vital part of the day. Like most things, it takes some planning. Night shifts are infinitely worse if you rely solely on vending machine food for sustenance. Realistically packing lunch every day is difficult, but it will save money (our program does not have a meal plan or food allowance built-in), and will make you feel better than hospital food! Bring so many snacks (preferably things that are nutritionally beneficial) to both day and night shifts because you never know what sort of shift you’re going to walk into and if there will be time to get lunch! Most importantly, try to make lunch a priority. Taking those 20 minutes out of the day to recover from the chaos can really help restore and recenter, I know this isn’t always possible but it should be a priority. Here are a few snacks that don’t require refrigeration I’ve trialed this year:
• Wonderful Pistachios, chili roasted
• Angie’s BoomChikaPop Sweet and Salty Popcorn
• Hippeas White Cheddar Snacks
• Built Bars (chocolate orange is a personal favorite)
• High Key Cookies (in moderation because sugar alcohols can be uncomfortable)
Schedules and vacations:
At our program, the upper levels make the monthly schedule which can be very difficult especially when accounting for staffing issues and special requests. Everyone tries their best to make schedules that are equal, but if you notice something in your schedule, please bring it up! If you are working 16 days in a row, mention that. If you are coming off a 10-day stretch on your last rotation, make sure the scheduler knows so you can get a day off near the beginning of the month, etc. Unfortunately, sometimes schedules are rough and it’s no one’s fault, but if changes can be made to help, everyone will be on board! Don’t be afraid to ask.
For vacations, it’s ideal to take your allotted weeks off in blocks. I scheduled my vacations once every three months during my intern year. This makes it likely that you have an “easier” rotation at least once every three months and it very nicely splits up the year! Unfortunately, you aren’t guaranteed any holidays, but could potentially use the newly implemented personal days!
Switching from days to nights and back again
I think most healthcare professionals deal with shifting sleep schedules regularly, but it can be quite rapid in residency. For night shifts I typically can’t take a nap and end up staying awake for the whole day and night shift (~24hrs). I attempt to minimize caffeine intake on nights because sleeping during the day can be difficult. For whatever reason the hospital gods like to make it feel like a morgue at night, so fluffy socks or an extra layer might not be a bad thing. Comfort is the name of the night’s game! It’s worth it to bring a “kit” with travel-sized toothpaste, deodorant, and Tylenol or ibuprofen.
When switching back to days I will typically sleep about 2-3 hours on a post-call day and then stay as busy as possible till bedtime, avoiding any caffeine. That typically helps switch back to sleeping at night!
Summary:
In summary, a lot of these tips have to do with wellness and quality of life. These are areas I think wellness can be the most impacted in the smallest of ways. If anyone has additional tips or pointers I’d love to hear them!!
