Initially appeared on doktorko.com 7/13/2005.
Almost two weeks ago as of today, i unceremoniously made the transition to full-fledged Residency. There were no parties or ticker-tape parades; just a silent passing of the torch to the a new batch of physicians who just finished the initiation year called Internship.
These are really just semantics - an "intern" is also a "resident," only at the bottom of the food chain, doing more paperwork, more second-guessing, and more running around trying to tie up loose ends. To a certain extent then, i guess becoming a second-year resident is a kind of promotion.
I say "kind of" because there are no added benefits or perks. There is less 24-hour call (approximately 2 per month), which - while it seems good on paper - ALSO means that's there's no post-call status and that i have to come in every day to round. Then there's the added responsibility: having gone through a year's worth of US clinical experience, i'm now expected to know more than the tyros, to know what to do in most situations, to be a fountain of knowledge to the new interns who are still tripping all over themselves just trying to find the bathrooms. I'm expected to be more proactive with patient management, to make major management decisions and run the patient service like it was my own.
Unfortunately - i don't feel all that smart. The more i read and study, the more i realize that there's a wealth of knowledge out there that i still need to learn. With great power comes great responsibility. Well, here's the RESPONSIBILITY - where's the POWER?!
To wit: if i'm expected to know so much, how come i feel like i know so little? I hardly know anything.
But then there are moments like this: like my call on the 4th of July when someone came in with a GI Bleed, a history of CAD, and Afib. No other Residents around; just me and my Intern. She takes her time doing the history and physical; i waltz in and finish mine in 15 minutes. She putzes around trying to figure out what's going on; i synthesize the data and formulate my differentials almost immediately. She wonders aloud what she needs to do; i rattle off the appropriate diagnostics, drug doses, and consults off the top of my head. She asks me a pathophysiologic question; i answer with a confidence and nonchalance that surprises even me.
When the dust settles, i step back and survey my handiwork. Everything covered, nothing missed. Staff with the attending, and he agrees.
I stop for a moment as it dawns on me what i've become, and i smile. Wow.
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