Resident Survival/Success Tips

"Learning is not compulsory, but neither is survival." - W. Edwards Deming


GENERAL SURVIVAL/SUCCESS TIPS

Approximately 1 week before each new rotation starts:

  • Contact your preceptor by email or phone to establish contact, provide your current ePortfolio URL, find out about pre-readings not posted on one45, arrival time/place, other special instructions

On the first day of each new rotation (after doing rotation orientation with preceptor)

  • Figure out which other residents are on site and MAKE THE CONNECTION for networking, support, lunch, consults, etc.
  • Notify preceptor of all scheduled meetings, ADS, and events that will take you away from the rotation
  • Ask your colleagues about upcoming grand rounds, pharmacy rounds, social activities, etc.

Stages of development:

During some rotations, residents sometimes say they feel overwhelmed, “like I don’t know anything”, “like there’s no way I can do this”.  It often helps at these moments to take a step back to see the bigger picture.  Nothing illustrates what might REALLY be going on better than the model below:

 
 

Think of the Stages as WEEKS in your 4-week rotation.  Think of them as QUARTERS in your residency year. 

Week 1: “Unconscious incompetence” - you don’t know what you don’t know/can’t do

Week 2: “Conscious incompetence” - you’re realizing how much you don’t know/can’t do (this is often the most painful part... this will pass)

Week 3: “Conscious competence” - you’re starting to realize there are some things you can do.  It is reasonable to not go beyond this step in a 4-week rotation.

Week 4: “Unconscious competence” - you know and do things without having to think really hard about what you’re doing.  This stage isn’t often reached during a clinical rotation, which is understandable.  This could take years for a clinical specialist to develop.

This model applies equally well to your residency year overall.  Think about it.  Realize that what you’re going through is NORMAL, that things CHANGE... you PROGRESS.  Also realize that it is normal to experience SETBACKS.  You’ll go through this process REPEATEDLY throughout your residency.  This is all good for you and leads to you being a “Performer” by the end of your residency year.

Read more about Tuckman’s Stages of Group Development.

 

The Dreyfus Model of Skill Acquisition is a powerful way to think about how you’re progressing throughout the program, and in relation to individual skills.  The model describes the stages of skill acquisition and is one of the rubrics used in our evaluation process.

  1. Novice
    - "rigid adherence to taught rules or plans"
    - no exercise of "discretionary judgement"
     
  2. Advanced Beginner
    - limited "situational perception"
    - all aspects of work treated separately with equal importance
     
  3. Competent
    - "coping with crowdedness" (multiple activities, accumulation of information)
    - some perception of actions in relations to goals
    - deliberate planning
    - formulates routines
     
  4. Proficient
    - holistic view of situation
    - prioritizes importance of aspects
    - "perceives deviations from the normal pattern"
    - employs maxims for guidance, with meanings that adapt to the situation at hand
     
  5. Expert
    - transcends reliance on rules, guidelines, and maxims
    - "intuitive grasp of situations based on deep, tacit understanding"
    has "vision of what is possible"
    - uses "analytical approaches" in new situations or in case of problems

EVALUATIONS

  • Your one45 “To Do” list keeps you apprised of evaluations you need to complete. 
  • Do your evaluations as they are due.  Please do not procrastinate.  Not only does this erode the usefulness of your evaluations, but it prevents others from receiving timely feedback.

eDocs, Reference Management

Consider developing your own e-documents collection containing primary literature.  Information management is a key to success in the residency and in professional life.  An eDocs collection is a good method for keeping this information organized.  Some recommended reference managers and PDF organizers to try include Mendeley, Zotero or Papers.  UBC Library also offers Refworks.

Employee & Family Assistance Program

The Employee Assistance Program is available to you should you require access to any sort of counselling or support services and is provided by Morneau Shepell.  They offer a wide range of confidential and voluntary support services to assist with everyday challenges to complex issues. The program is completely confidential within legal and regulatory requirements.  

Please refer to their brochure and FAQ documents.

To begin counselling or initate support services, please call their toll-free hotline at 1-844-880-9142 or visit https://www.workhealthlife.com/ and sign up using Employer name "Fraser Health" for full access to the EAP services and resources.

Please do not hesitate to use this program if the need arises.