Date: June 17, 2019
One thing that surprised me about intern year was just how much had to be done throughout the day. Not just a few things to check off. I’m talking the front and the back side of papers, full of to-dos.
A senior resident told us on the first day—and I’ll admit I didn’t pay it much attention—to be organized. I thought that getting through the day, being a good intern, and taking care of patients depended on how well I could interpret the labs or do an exam, and how much medical knowledge I possessed. I was wrong. As the first few weeks and months went by I started to appreciate just how valuable a bit of organization would be.
Once I found a method to manage my day, I had seconds, minutes, hours become suddenly available. And the time that I was still working was at a much more relaxed pace. I was able to observe things which I overlooked before. I was able to really make my presentation complete. I was able to connect better with my colleagues. I felt more confident and in control.
So how can you jump start this?
Didn’t I just say it wasn’t about medical knowledge? That’s still true—let me explain.
We all know being a physician is no longer a multiple-choice exam. With that being said, the really good residents find a way to pick out the most important and pertinent info and to discard the rest. They do this by beefing up their knowledge as intern year goes on. Medical school is about amassing a huge amount of knowledge. Now, it is mainly about retrieving and applying that knowledge as a resident.
You won’t have time to sit down and read. You’ll just fall asleep. So, how can we study throughout the day? In tiny doses. When walking in, do three questions on the U World app for Step 3. When waiting for the elevator, do one more. When afternoon lecture gets dull, take out Read by QxMD. You can look at the most popular journal articles for whichever specialty. It’ll link in with your hospital so you’ll have access to more or less everything. And when you’re commuting home, listen to a YouTube lecture (like these ones from University of Louisville) or check out some popular Podcast episodes (like these ones from the Curbsiders).
I didn’t feel like I was really learning because I wasn’t in a soundproof cubicle at the library. But to my amazement, I found myself bringing up things I’d heard or read throughout the day. All that passive listening wasn’t too passive after all. When it is super focused, such as from a question brought up on rounds, or something a particular patient asked, then it is much easier to remember. And to think it was acquired while I was combining learning with daily activities like walking in, waiting in an elevator, or driving home.
Ok, so now you’re acquiring knowledge by seeing patients, doing UW questions, reading journal highlights, and listening to YouTube videos and podcasts—how do you actually consolidate all of it? And then retrieve it?
Use Evernote or SimpleNote. Just jot down notes in your own words. That means whatever you read, you must translate it into your own words. That way, you won’t have to reinvent the wheel every time you see a certain diagnosis. It makes you faster (and more complete) for things you’ve seen before and also shows you can quickly pick up on things you haven’t seen many times.
Just open up the chart on your EMR on one side of the screen. On the other, have Evernote or Simplenote open. When you’re walking to see the patient, take out your phone and quickly review your notes.
In intern year, I forgot it was my birthday one day. Hey, working that many hours will do strange things to your mind. It was nothing to me (my brother reminded me) but what if it was something more important – like my bills?
Organization helps here, too. Go to your bank’s app and schedule ‘automatic’ payment for your credit card. Then, make an automatic reminder every month on your phone which alerts you to pay your landlord. For everything else like car insurance, car payments, water bills, internet, just sign up for automatic payment. You have more important things to worry about than paying bills. Like where can you grab some free food somewhere in the hospital.
Paying bills via an automatic method sounds super simple, and it is. But when you don’t know what day of the month it is, the simple things aren’t so easy to remember.
If you’re like me, you’ll size up your year according to which blocks you are on during which months. It is easy to get bogged down on the busier months. And it is tempting to try and play catch up with everything in our life on the lighter ones. I found this to be less than ideal.
Instead, I use Trello to create a board which lays out what I want to get accomplished throughout the year. Each column could signify something different—personal, research, a hobby. It reminds me visually to take a step back and see where I am and where I want to go. It gives me specifics on how to get there. For example, for a hobby, I might write down the newsletter I want to read, the date of a certain race, or when something goes on sale. So every now and then I’ll look at my Trello board and check in.
Trello and other similar organizational tools help you prioritize and ‘make time’. And look at what happens when residents had actual time to do research. A study observing over 200 senior and recent radiation oncologists found that the sole determinant of first author papers was designated research time. This factor beat out having a Ph.D., presenting at an international meeting before residency, and number of publications before residency.
So if research and publishing are important to you, then look at your Trello board, and find ways to ‘block out’ time for research. Either ask for it in advance or squeeze it in during the lighter months.
And if something pops into my head during the day—say a chance encounter with an attending who offers to work with me on a project—I’ll put it on the board.
Email. Ugh. In my mind, there are two types of messages: those from important people and those from non-important people (in the nicest way possible). Said in another way, ones I want to reply to immediately. And then the others.
But how can I automate this? I mean, I don’t want to scroll through my inbox all day and decide which pile to put them in. Lucky for us there is an app which does just that.
It is called Spark. The neat thing is, it learns from your behavior. Say you always respond to your PD. It knows the PD’s name and email address. So when your PD emails you it will alert you, make a special sound, and put it in the ‘important’ folder.
Responding in a prompt manner, and with an organized email, shows you are professional and that you really care about the other person.
In conclusion, maybe you’ll hear the recommendation to ‘be organized’ during orientation. And now, you’ll know how to be organized. These apps and programs save seconds. Pare seconds can make you a better resident and a better you. And of course, your team and patients will benefit as well. Our Thalamus software organizes the interview season and facilitates scheduling in that part of the medical journey. For the next part, you’re on your own—we hope these tips will help.
Oh, and if you found this article helpful then there’s this other app which you should download called Venmo where you can send money for people who write things…. I kid.
Team Thalamus is a grassroots collaboration of applicants (past and present), program directors, program coordinators and other GME leadership who wish to share our collective journeys through managing and participating in years of residency application cycles. While we offer a byline to all of our contributors, many wish to write under a pen name, which we have collectively defined as Team Thalamus. Becoming a physician is a long and winding road, filled with sacrifice, dedication, complexity and uncertainty and our team is her to help!
Thalamus is the premier cloud-based interview management platform designed specifically for application to Graduate Medical Education training programs. We are the experts in the residency and fellowship application processes. Learn more about Thalamus.
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