As I reflect on my own Match Day nearly two years ago, I am reminded of all of the different transitions I have experienced since that time. My two years as a triple boarder (a combined residency involving pediatrics, adult psychiatry and child psychiatry) at Brown University have gone well, but there have also been significant challenges and changes.
That shift from fourth-year medical student to intern is quite a big one. For me, I was moving to a new city, buying and renovating a house, and trying to get my feet underneath me as I was suddenly being referred to as ‘doctor.’ I felt surrounded by people who knew more than me and by people who had been around a whole lot longer than me. They knew the system and knew much more about pediatrics – the first phase of my triple board training. But I quickly realized that everyone had gone through a period of uncertainty too and with time, the systems, the layout of the hospital, and the roles and responsibilities expected of me became easier to handle.
Before I knew it, it was time to recruit the next batch of triple boarders and pediatrics residents, which was a strange feeling having just been in those applicants’ shoes. Suddenly I was answering questions about my residency program as if I was an expert, and I realized I was an expert in a certain way. I really understood the intern experience, as it was fresh in my mind. As I became more comfortable in my role, recruitment coincidentally came to an end, and everyone in the residency program became eager for Match Day.
Match Day marks a special moment in the life of interns too. Suddenly there’s a realization that intern year is coming to an end. A colleague of mine told me she wept tears of joy at Match Day because she knew that the reinforcements were coming and she would move on to a different role on the medical team. From there, you start to mentor and check in the new recruits before they even arrive. Similar to medical school, I was paired with a soon-to-be intern and started to answer her questions, though she was coming from Brown and truthfully had most things figured out.
Next, I transitioned from being a first-year resident to a senior and/or second year resident. For the first time, I felt like I had grave responsibility for children and their well-being and outcomes. I was a team leader and I was expected to know how to get things done. This was made much easier by the relationships I had formed over the past year – I had gotten to know nurses and other staff members, and had developed a collegiality with my co-residents. I knew where I could bring my tough questions and find answers.
As a triple boarder, I have a few more transitions too. There’s the usual change from month to month of what service you are working on in pediatrics, but that kind of switch becomes familiar fairly quickly, and resembles the way medical school clinical rotations worked. Over the past month, I have made the change from Pediatric Medicine to Adult Psychiatry, which has been a large shift in perspective. Now I’m dealing with parents who are the patients, rather than running things by parents for their children. While there were some chronic medical and mental health problems in pediatrics, they are much more of a focus in the adult population. In addition to seeking to understand them on their own, I am working to form a picture of when the depression, schizophrenia or anxiety started, and it frequently involves childhood. It has been a valuable experience so far, but it also comes with the need to learn a new system, and form all of those new relationships with other staff members. Right now I wouldn’t be able to talk a new recruit through the details of my rotation or the adult psychiatry program, but I am learning every day and should be ready by the time the new interns show up.
One more transition that hearkens back to my days at the UVM College of Medicine: I have also now turned back into test taker. Much of residency is blissfully lacking in testing – a major change from medical school – but now I am once again whittling away at question banks and study guides in preparation for Step 3 of USMLE, which I need to take by the end of the residency year in order to get my PGY3 pay bump. Match Day was certainly just the beginning of a journey that has taught me so much about medicine, and myself, and I am looking forward to the rest of my residency training and all that is to come.
