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Surviving Residency – How You Can Help (from one Resident’s Perspective)

Surviving Residency – How You Can Help (from one Resident’s Perspective). Samuel Hughes Portland, OR May 20, 2011. The Nature of the Problem. Resident Employee Trainee Sibling. The Nature of the Problem. Co-ordinator HR person Enforcer Surrogate parent. Residents’ Concerns.

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Surviving Residency – How You Can Help (from one Resident’s Perspective)

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  1. Surviving Residency – How You Can Help (from one Resident’s Perspective) Samuel Hughes Portland, OR May 20, 2011

  2. The Nature of the Problem • Resident • Employee • Trainee • Sibling

  3. The Nature of the Problem • Co-ordinator • HR person • Enforcer • Surrogate parent

  4. Residents’ Concerns • Clinical care • Patient care • ICU procedures • OR techniques • Outpatient evaluation • Research effort • Techniques, etc. • Academic requirements • Writing • Personal life • “Three D’s”

  5. Real World Concerns • Clinical documentation • Maintenance of certification • Board certification

  6. How Residents See Themselves • Capable • “I can do brain (and spine) surgery!” • Efficient • “Have you seen our inpatient census?” • Effective • “Nobody dies unless I say so!” • Elite • “After all, aren’t only 7-21 of us?”

  7. How Residents Seem to Others • Sluggish • “Seriously, how long does it take to reply to an email?” • Slovenly • “Is it that hard to fill out one little form completely and turn it in?” • Sketchy • “Do you do nothing you say you will?” • Socially inappropriate • “Have you never had a job before?”

  8. Surviving Residency • Clinical duties • OR • ICU • Ward • Clinic • Medico-legal documentation • Dictation • Certification • Personal life • Three D’s

  9. ACGME Case log Hours AANS/CNS/etc. Deadlines for abstracts, etc. Medical Board Licensure Hospital/GME ACLS, etc. Department Evaluations Competencies Committees Etc., etc., etc. Barriers to Survival

  10. Barriers to Survival • Fatigue • Stress • Autism spectrum disorders • Personality disorders • Cluster A (odd): Paranoid, Schizoid, Schizotypal • Cluster B (dramatic): Antisocial, Borderline, Histrionic, Narcissistic • Cluster C (anxious): Avoidant, Dependent, Obsessive-compulsive • Not specified: Depressive, Passive–aggressive, Sadistic, Self-defeating

  11. Be direct in your communication Leave an excessive interval before deadlines Repeat your message at least once within the pre-deadline interval Expect failure to comply Expect ill-humor when confronting non-compliant individuals Keep your humor, especially with the humorless – they are the ones with the pathology How You Can Help

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