Wednesday, May 12, 2010

End of the Road

After a busy week, today I handed off the call pager. I also thanked the 4 medical students who worked with me, and wished them well. After all, this is their final week of medical school. In a couple of weeks, their names will be forever changed (corny as this might sound, and though I'm not a fan of having people call me Dr. Vagus outside of work, this is the truth. Even some of my neighbours call me 'Doc'). I took it as a compliment when Ben asked me what advice I could give them to enable them to be a good teacher like me. I had 2 things to say:
"Time", I told him. Because the truth is teaching always takes more time. As a resident I always thought that I was making my attending's life easy and I was doing all the scut. Now I realize that I round in literally 1/3 the time if I had no resident or medical students. It's tempting to do speedrounds and not discuss cases, to correct mistakes or misconceptions, explain rationales for treatment. But these are bright young minds full of potential; the passing of knowledge from one (academic) generation to the next is vital for bilateral growth. And so I try to make time to teach.
The second thing I told him was, if you have a teacher you found effective, try to emulate him/her. Ask yourself what about her that made her a good educator, and what it would take for you to adopt that trait. I think my style probably emulates a good dozen teachers I've had in medschool/residency/fellowship. I think I picked up Dr. Lemaire and Dr. Bahn's respect for students and how they were always keen to hear our explanations even if we were wrong, and how she patiently corrected us. My sense of humor with students/patients probably reflect that of that Scottish surgeon Dr. Preshaw. My habit of coffee-breaks midrounds (yes, I end up buying the coffee) for some impromptu round-table teaching probably came from Dr. Lee.
I really don't know how well I teach (after all I've been a student before- you always tried to kiss ass in a rotationlaughing smileys ).
But I hope I did a good job. For a month from now, these guys will be out on their own.
Steve asked me for some final advice. I shared with them my pearls of wisdom from residency:
  1. When oncall, eat when you can, sleep when you can. Never think it's too early for bed, just because it's 8 pm. You never know when that pager will go off, and if you'll get to see the callroom again for the rest of the night
  2. You're human. You'll screw up (I still do). Learn from it. Forgive yourself for it
  3. If you have to, use the Hide-In-The-Bathroom-To-Cry trick. I've had to employ that several times in my internship. Remember, even the worst day ever will eventually end
  4. You're going to be (almost) perpetually tired for the entire year. Life goes on outside the hospital, so have a balance. Have a social life, even if you don't feel like it
  5. Never piss off the nurses. If you do you'll never get a good night's sleep. There is never an excuse to be rude or obnoxious
  6. Nurses may not have had the training you have, but they've had the experience. If they ask you to come to the floor because a patient doesn't look well, come stat!
  7. The learning never stops. Having said that you'll have way too many journals to read, and soon they'll stack up and will only make you guilty. If you have a 3-month old medical journal you haven't already read, you probably never will. Get rid of it. Pick and choose the type of journal and article you'll read, get rid of the rest
  8. Lastly, never say no when a consultant offers free food or coffee (no, seriously)

To those of you who complete this stage of your career this week, I wish you all the best.