Navigating the complex world of transitional years and beginning your specialty feel overwhelming? Our latest episode features Matt McLean, a first-year resident in anesthesiology who just finished his internal medicine transitional year shares tips and tricks from his intern year and discusses all of the complexities of a transitional year and beginning the specialty that he matched into. Matt's candid experiences of applying to programs in New Jersey and New York provides a fresh perspective for those venturing on a similar path.
Effective communication can make or break your reputation in the healthcare industry. This episode takes this fact head-on by emphasizing the role of effective communication in shaping your professional identity. The art of balancing multiple residency applications, managing financial considerations, and staying open to unpredictability is all part of the game. Whether you are juggling your time during your intern year or working the challenging night shifts, we’ll show you how to stay efficient, alert, and how to maintain a healthy work-life balance.
As we take a deep dive into the world of medicinal residency, you’ll learn that preparation, adaptability, and a handy portable charger are your best allies. From the initial excitement of meeting new co-residents to tackling different rotations, you’ll hear about it all. Embrace the challenges, take the initiative, and remember that growth comes from being comfortable with discomfort. For those night owls, we share some unique tips and experiences about integrating into a team of night shift workers and surviving the long hours. We wrap things up with our discussion on managing time during your intern year, balancing hospital responsibilities with personal life, and why patient care should always be your priority. Get ready to be inspired, informed, and empowered on your journey towards a successful medical career.
Dedicated technology for medical schools, residency and health programs looking to optimize performance on in-service and licensure exams. Students get access to the content, questions, explanations, and all benefits of the SmartBank to help enhance their performances on high-stakes exams. TrueLearn provides national average comparisons, including score, percentile, and category weaknesses according to the exam blueprint.
Use code OFFWHITECOAT for $25 off your purchase.
Navigating the complex world of transitional years and beginning your specialty feel overwhelming? Our latest episode features Matt McLean, a first-year resident in anesthesiology who just finished his internal medicine transitional year shares tips and tricks from his intern year and discusses all of the complexities of a transitional year and beginning the specialty that he matched into. Matt's candid experiences of applying to programs in New Jersey and New York provides a fresh perspective for those venturing on a similar path.
Effective communication can make or break your reputation in the healthcare industry. This episode takes this fact head-on by emphasizing the role of effective communication in shaping your professional identity. The art of balancing multiple residency applications, managing financial considerations, and staying open to unpredictability is all part of the game. Whether you are juggling your time during your intern year or working the challenging night shifts, we’ll show you how to stay efficient, alert, and how to maintain a healthy work-life balance.
As we take a deep dive into the world of medicinal residency, you’ll learn that preparation, adaptability, and a handy portable charger are your best allies. From the initial excitement of meeting new co-residents to tackling different rotations, you’ll hear about it all. Embrace the challenges, take the initiative, and remember that growth comes from being comfortable with discomfort. For those night owls, we share some unique tips and experiences about integrating into a team of night shift workers and surviving the long hours. We wrap things up with our discussion on managing time during your intern year, balancing hospital responsibilities with personal life, and why patient care should always be your priority. Get ready to be inspired, informed, and empowered on your journey towards a successful medical career.
Dedicated technology for medical schools, residency and health programs looking to optimize performance on in-service and licensure exams. Students get access to the content, questions, explanations, and all benefits of the SmartBank to help enhance their performances on high-stakes exams. TrueLearn provides national average comparisons, including score, percentile, and category weaknesses according to the exam blueprint.
Use code OFFWHITECOAT for $25 off your purchase.
Hello everybody and welcome to the Off White Coat podcast. Today I'm bringing you one of my good friends back from St George's. He's been on this episode before, but it's been a year. He's finished up his first year of residency and now he's here to share with us. So, everybody, matt McLean, how's it going, buddy?
Speaker 2:What's up guys? Hey Jordan, thanks for having me back. You know it felt like just a year ago. You know I was just starting an internship. Now I'm done and it's just a whirlwind of emotions and I'm glad to be back and hang out with you because it's been a while.
Speaker 1:Yeah, dude, oh no. You got to tell me all your stories about intern year. Now that I'm going into it, you got to share with me some tips.
Speaker 2:Yeah, 100%. I got everybody listening, everyone listening today. Don't worry, I'll give you all the do's and do nots of intern year.
Speaker 1:It's funny that they call it an intern when you still get paid In the business world, and any other time that there's an intern I feel like they don't get paid or whatever. But in medicine we always have our own terms. You're getting paid $1,000 less than the other person but we're all an intern.
Speaker 2:Yeah, exactly.
Speaker 1:But yeah, so give us a breakdown, because I know last time you were excited and you had let us know that you matched, and you matched anesthesiology, correct?
Speaker 2:Yep.
Speaker 1:But you have to. A lot of people don't realize that when you do that you have to actually do an intern year in internal medicine and then you can actually do your three I think it's three years of your specific anesthesiology residency. So kind of just give everybody a breakdown of what you had to do to get into that residency spot to begin with, because you had to switch hospitals and everything. So just give us a little break.
Speaker 2:Yeah, so you almost had it because it's a little bit. It's a little different from what you explained. But basically with anesthesia there's the categorical programs where you can do all four years of the same hospital. You know my old roommate, carl Miller. He matched the categorical spot in SUNY Upstate so he's doing all four years there.
Speaker 2:Meanwhile, the program that I really I put number one on my list, st Joe's Medical Center in Patterson, new Jersey. I really wanted to go there. I rotated there, I love the attendings, the residents there and it's really close to home. So I ranked it number one. But they're not a categorical program. They were known as what we call an advanced program. I'm not really sure why they call it an advanced program, because it doesn't feel as it. You know it doesn't feel like that.
Speaker 2:But essentially when you're applying, you basically you'll have your rank list and that will consist of both your categorical and advanced programs, all of your anesthesia programs. But they're going to have a separate rank list called a supplemental rank list and that's just going to say if I match an advanced program now I also need to rank and match into a first year spot. Now that first year spot can either be an internal medicine prelim year, which I just did. It could also be a preliminary surgical intern year, which some people can do, and then there's, you know, transitional years and things like that. That I can't really speak to because I haven't really done them, but there's many different options on what you can do with that first year and you know it's just weird because each program differs. So you know, I'm talking with some of my incoming class and it seems like right off the bat we've already had some different experiences. So it's kind of interesting and I can't wait to meet them.
Speaker 1:You know, just yeah, yeah, it's very weird to even with all the different aspects of medicine, like where you have prelim surge and the surgery like they kind of want it's prelim surge, and then you're in categorical, but in other specialties there's a whole advanced and then other other programs don't have any of that, and so you really have to know the ins and outs, which is really difficult if you're not going through it all. And so, yeah, you've got to. It's very, very exciting, though, that I can't imagine someone going prelim surge and then doing all that up into their antecedent, like you know, like you're not going to be a surgeon, but you're having to do all that scutwork. I'm glad.
Speaker 2:I'm a scutwork yeah.
Speaker 2:That's what I only applied for internal medicine prelims. So I didn't do. I didn't apply for any surgical prelims or any. I didn't really know much about transitional years, so, where they call them TY's, I didn't really apply for any of those, you know, because there's so many programs out there. So for anesthesia I applied to, like all of them in the country, but when it came to my internal medicine prelims I only applied to the New Jersey and New York area, since I knew I wanted to stay in, you know, near home, you know.
Speaker 1:Yeah, and that's something I guess we need to explain too is that when you're doing the match process and we've kind of talked about it on this podcast, a little bit about, like how all that works but you have to apply to the programs you want for anesthesia, get into those programs, and then you also simultaneously, right, have to apply prelim IM to make sure you get into one of those as well, so that you can have both of those covered by the time it goes correct.
Speaker 2:Yeah, that's right. You know, like, like I mentioned there's, there would be two, there would be two rank lists for your anesthesia and your supplemental. Now, if you had all categorical anesthesia programs, then you wouldn't, you wouldn't really need that first, that supplemental list, because then, like Carl Miller, you could just do all four years at the same spot. No, no problems at all. But you know, then some people run into situations where maybe they only match advanced anesthesia position and they don't have a first year position, or the opposite, where they match a first year position and they don't match anesthesia, in which case they would have to reapply for anesthesia the following year.
Speaker 1:Yeah, exactly, but that was to say it's super ballsy to just go okay, I'm just going to do categorical and not provide my. I mean, people are. When you're doing this whole match process, it's nerve-wracking, as it is like you're putting out as many fillers as possible and so you're going to have to apply to essentially everything. So it's just crazy. So you have to pay for all of your prelim. Do you have to pay for the applications for the prelim, im and anesthesia?
Speaker 2:Absolutely yeah. So it gets expensive. So you know, with anesthesia I knew that was like my number one and only I knew that's what I wanted to do. So I didn't want to. I didn't care about the money in that aspect. I applied to all the programs, but with prelims. I figured you know there's a lot more programs. So that's why I kind of narrowed it down to like a regional area.
Speaker 2:So you kind of need to, when thinking about ranking or thinking about where you want to apply, when you're getting ready to that point you got to think how competitive am I? You know, what type of specialty am I getting into? You know you, sometimes you do have to consider what med school you go to, like you know for us, like we'll SGU, you know students, you know some. Some states, some regions are more IMG-friendly than others. But in this case I said, look, I'm going to put all my cards on the table applied to every single program.
Speaker 2:And even though I did, it's actually crazy. I only got interviews on the East Coast, I didn't get anything on in the Midwest and nothing in the Pacific Coast. So it's like it's a gamble. But at the end of the day, if you really want to get to the nitty gritty and you want to save money. You're really going to have to figure out those, those kind of concepts. How competitive is my specialty? What are my scores like? How you know how competitive am I? And you know what region do I preferably want to live in? But usually it's kind of a trade off. It's either I rather want to be in a very competitive specialty and I don't care where I want to be. You kind of you don't get both. You know what I mean. Yeah, you can either pick your location or pick how competitive you want to be.
Speaker 1:So exactly, yeah, you don't. I just buzz, I can't just be like, oh okay, I'm going to have this program and they're just going to fall all over me, because whenever match day comes, you're ranking this program and like, and they say it, I read this book or whatever. Or when I was going through the application process and it said 60% of all programs lie to the applicant about where they are on the rank list. So even if you're just so certain, pre-enduring the interview process, which you don't even know, you put out all these applications and send them to all these programs because you want it on day one and then they let you know if you get an interview.
Speaker 1:So, hem forbid, you only pick, you know, in New Jersey and you don't get an interview right away. Then you start putting out applications in other places. Well, you, you don't have it on day one now, you just wasted. So it. It's a weird role we have to play, like in medicine, where we're just like, especially during the match, like no wonder it's so stressful because you're having to, just like all the timelines are all set and you have to have everything in and it's really just a game you got to play. So it's better to know the game than to assume that you are the best player at it.
Speaker 2:Exactly. And so all the listeners out there you know, especially if you're like, coming at the end of your third year, start of your fourth year, I got to say it might seem like an expensive year but it's all relative, you know. You got to just throw whatever to the wall and see what sticks and don't worry about the money right now. Everything sounds like a lot right now but in time, you know, you'll pay everything off and you'll you know you'll make a decent salary. So I guess what I'm trying to say is just try to keep a pretty broad sense of you know. If you really want this certain specialty apply everywhere, you know, and if you don't get the location you're in, then you have to make a decision. But you'll be okay. Just try to put your name out there, you know, out into the universe, and hopefully something will happen.
Speaker 1:You got to, I did the same thing. I shot very wide or cast a very wide net, and that was the whole point of that was for one to get my name out there, because I didn't know what programs there were going to want me. And I was actually relatively surprised in the fact that a lot of the programs because I did my training either up North or Superdown South, like in Miami, and not in Georgia, not in Mississippi where I'm at, not in some of these other Southern places, and so I put those because those were like obviously closer. But I mean, I think I only got one specialty or one interview in Georgia at all, but I got a lot of other Southern states that wanted me to, you know, or wanted me to interview there. So it was you can't predict it at all Like I thought for sure, the one place that was right near my hometown.
Speaker 1:I was like, oh yeah, no chance, there's even, or there's got to be a chance, we have a person there that's speaking for me, blah, blah, blah. And then that didn't work out. But then there was all these other better programs, because I cast a wider net and it allowed me to pick the one that I actually really liked instead of narrowing it down because we don't know. You don't really know. First off, if you're a medical student, you don't know how they're going to treat. You may have done a rotation and you've seen kind of the inside, being a house officer and everything, and you can speak more to this too Like people are treating you differently than the medical students significantly, and there's a whole different role and there's a whole another bag of tricks that you gotta have. So, yeah, you gotta really just play the game.
Speaker 2:Yep 100% 100%.
Speaker 1:So, but walk us through. So you've officially finished that first year of residency. How was it, mike?
Speaker 2:It was a whirlwind of it's one hell of experience, let me put it that way. So I finished my internal medicine pre-lingure at Jersey Shore University Medical Center, which is part of, like, the Hackensack Meridian Network, if anyone isn't from the New Jersey, new York area. What I really loved about this place is that the people there were very welcoming and accepting, and I'm not even just talking about the residents, but I'm talking about the attendings, the nurses, all the staff. It was very welcoming experience. I started day one, july 1st, in the ICU. I think we remembered that we were speaking about that last time we were here and I was so scared it was my first day at you know, june 30th, I'm getting sign out for the following morning, on July 1st, and my hands shaking while I take sign out and you know, first thing in the morning I came in super early, 4 or 4 30 in the morning, and I go to one of the patient's rooms and you know he had OptiFlow on and everything like that, and I'm, you know, oh, good morning sir, how are you doing? And he's like, oh, chest pain. And I'm like freaking out, like, oh, my God, you know it. Just it all hits you at once.
Speaker 2:But you gotta just realize that I mean different programs. You know it can depend on how supportive they can be. But you gotta at first definitely look to your seniors. Don't necessarily depend on them for everything. Try to, like you know, figure stuff out on your own, because that's how you learn. But look to them because they've probably been in a very similar situation from you and maybe they won't fix your problem, but they'll tell you what to do and they can and they can help you kind of. So you don't need a panic, you know.
Speaker 2:So I was blessed in that aspect and once I started in ICU, I actually loved it. I don't. Icu was actually one of my favorite rotations. Everything else kind of seemed downhill from there and I was like, okay, cool, after you do like ICU, after you do your little, your night float rotation, what have you? You kind of feel like all right, the majority of everything I can kind of handle. And then floors, depending on where you're at, it, is a lot of social work. A lot of people are like I need to study, I need to do this, I need to do that. I think the best way.
Speaker 2:My first attending told me day one of ICU.
Speaker 2:He said, my expectations for you are very low.
Speaker 2:I don't care about how much you know, I just want you to learn the process, learn the routine and just get to know how the hospital kind of functions and you kind of feel like you have an idea at med school as a medical student on rotations, but it really becomes different in residency. So take it easy. Don't go crazy doing questions on your world and looking stuff up on you know, online med ed, because a lot of it it's just gonna come down to kind of like street smarts and I don't mean it like so informally, but a lot of it is kind of how do I get through these hospital problems? How who do I talk to, like you know, about certain issues like that and not so much about the medicine. You know the medicine is kind of like a lot of it you're gonna know already and if you don't, you can quickly look that up. So I would just say you know it's gonna take a little bit of time to get that like running start, but you should be good to go after that.
Speaker 1:That's the whole beauty of it is that most of it is you've been learning the medicine. You've seen it. There's gonna be some small cases, I'm sure I mean every time I've ever been in any rotation I've seen something that I wasn't very comfortable with, and then you keep seeing it over and over and over again. But eventually the biggest problem is not gonna be the just you not knowing enough. It's gonna be like what you're do when things get really sour, or who you go to, or, and so that's what I'm hoping that I can navigate well whenever my you know, in the upcoming year, because you know you gotta make, you gotta endear yourself to the nurses, you gotta do all this other stuff so that you don't get left out to dry. Yeah, and so we will. We shall see on that one.
Speaker 2:Yeah, and on the same token too, you know, especially with internal medicine again, I can't really speak to surgical prelims as much or transitional years but in internal medicine prelim you're gonna be speaking with a lot of different consultants, especially in the floors and in the ICU. The consultants always comes in. They always write their progress notes. You kind of follow along about the recommendations and if you have a question, sometimes you don't need to look it up, you can just ask them. They're part of the medical team and they're providing their treatment and their recommendations. So you can ask them wait, why are we doing this?
Speaker 2:Blah, blah, you know, and obviously introduce yourself. That's like the number one thing you need to do as an intern. Like some of the nurses, they would have like a bad impression of certain interns if they just started putting into orders and doing things without even introducing themselves. So you know, make sure I would always have, you know, some gum on me or something like that around during rounds, things like that hey, you want a piece of gum? Oh, what's your name? I'm Matt, things like that. Yeah, it's like it doesn't need to be so formal.
Speaker 1:Like hi, I am Dr McClain you know just be like hey, I'm.
Speaker 2:Matt, you want a piece of gum? Blah, blah, let's talk, how are you doing. And then they, when they get that good first impression of you, that's like an excellent running head start Because they a lot of the times it's like sometimes, like the nurses, are no more than what's going on with the attending sometimes, because they'll come to you and be like hey, matt, you should check this or you should maybe replenish that or something like that. But if they don't like you, they're not gonna remind you and they can make you look bad. So yeah, I definitely think you know it's the first thing in the morning, even if you're tired 4 or 4.30 in the morning, whenever it's time you get there, just be like hey, good morning, you know, I'm Matt, blah, blah, blah. And then from there people will talk and they'll be like oh yeah, that's like the really nice intern, you know, and that's how you want to be known.
Speaker 1:Yeah, that's a great piece of advice, because and they always say, endure yourself as a nurse, but you don't realize how much they will talk to once you're not there. Like everybody will continue to discuss your performance whenever you're not standing there. And the last thing you want is for the attending to be like well, I mean, I think he's pretty competent, and then a nurse go no, he's not, I've been doing whatever, or there's been these issues, and then they will definitely believe exactly what was just said to them over anything that you've done. And so the last thing you want is and I mean I would too if I was the attending I would trust the. You know like, just because you're showing me something, it's all the other people around you that are gonna attest to your leadership or how well you treat other people. And if they go oh, he's nice.
Speaker 1:That means the world for them. They go, okay, cool. Like he'll make it then Like, instead of them talking bad about you so.
Speaker 2:Yeah, and you know, sometimes the nurses always got your back. They've seen, you know so many different things. You know they've been in the field for you know some are just starting out, some been for decades, so they've seen a lot and they can really help you out. But on the same token, let's you know, sometimes you will get pages and the nurses like really questioning you, like you know, hey, why are we doing this? Are you sure we wanna be doing that? Or something like that.
Speaker 2:Sometimes you don't get defensive. You know a lot of people like yes, like they'll just like yes, we're doing this, that's final, we talked about it in rounds. Blah, blah, blah. Just be like what kind of questions do you have about it? And maybe you don't need to give them a lecture on it. Just be like yeah, this is the reasoning while we're doing this, that and the other. Once they have the reasoning, they'll feel comfortable with you making more decisions in the future. And then I'm like, okay, cool, he knows he's able to communicate his thoughts, as opposed to just saying, yeah, the attending told me to do it, or that's what we talked about in rounds. Cause then they're gonna feel like, oh, he's just like the messenger about what we're doing, but not can't give me the explanation itself herself.
Speaker 1:And it's amazing how just asking somebody without saying this is how it is, but you just asking somebody, even when you're speaking to patients and stuff like that too, like what is your concern with whatever's going on? Like, just please, because it may not be. Because sometimes we think way too hot, technical, and I know I'm a victim of this where if somebody's questioning something that's going on, I'm like, look, I know, you know, that's this, this, this, and they're like, well, I don't care about any of that. It's actually the fact that he can't pay for it or whatever. You know, it's like it has nothing to do with that.
Speaker 1:But if you start going on this preset rant about things because you think you're right, you almost prove yourself wrong. And so asking somebody what is their concern or what, why, oh yeah, like what, what would be your concern about this To a nurse or the patient or anything, and they they might just be like they might prove that it may be a teachable moment where you could help them and honestly, it could just be a way to endure yourself and not turn around and look, you know, like foolish, like they could be something.
Speaker 2:Exactly, and it doesn't need to be in a patronizing manner either. It's not like well, I learned this, this, and it's not. It doesn't need to be like that. Just be like oh yeah, we're doing this because this and this and that. You know what I mean. So it doesn't need to feel like I'm like superior to you. You know we're all in it together, so we don't need to. I think it's not even just what you say, but the how you say it. And you know sometimes, you know maybe in the middle of the night you're on night float, maybe you're a little cranky, but just try to keep in mind that they're also awake too, so they're also probably equally as cranky. And again, you know you got to work as a team and that's how it's gonna work. It's gonna work out well.
Speaker 1:That's the one thing I've learned about being married is, even if I'm in a rough spot, if I start acting cranky, that level that MB can get over me. If I'm rude, she can be worse. No, she can't. It's the same way in a hospital Like. If I'm like passive aggressive, I know for a fact that there is no like. Mine is super low level anyway. And so if somebody upset, I'm like, oh man, dude, I messed up there. I shouldn't have even poked that there. But yeah, so then, dude, so I'm glad you made it through, you survived. Are you happy to be switching to the new hospital?
Speaker 2:Because now, you have to do a whole. You have to move, yeah. So, luckily enough, I you know, when I gave my vacation preferences to the chief residents last year before I started, I kind of anticipated that I was gonna have to move. So I kind of told them look, I would prefer to have a few weeks of vacation in June or towards the end of the year, just so I can move. I know it's not really a far move it's about an hour from Neptune, new Jersey, to, you know, st Joseph's in Patterson, but I'm living near there, so it's not that far. But I knew that I was moving from like a small studio and now moving into a house. I'm actually moving back into the house I grew up in. I'm just gonna rent from my mom. So it's kind of a nice situation.
Speaker 1:And it feels like it up to you Coming for that rent dude.
Speaker 2:Yeah, right, yeah I know my mom's in North Carolina, so I'll have the house to myself, which is nice. But again, you know it's a house, so I'm gonna have a lot of responsibility. That's why nothing's really put together right now. And you know, but hopefully if we ever have another podcast together, it shouldn't look a lot better my mic set up and everything.
Speaker 1:You gotta ask the I guess it's not the renter. What do you call the person that owns the house? Whatever you gotta, hang some clothes and stuff.
Speaker 2:Yeah, yeah, yeah, so, yeah, exactly right. So it definitely feels really nice and, again, I really enjoyed my year at Jersey Shore. But you know, I know kind of like my personality and I know I would not be the best fit for internal medicine for the rest of my life. So I'm glad to finally be done, done with the progress notes and the discharge summaries and pre-rounding and all that stuff, you know, and you know it's great is that I'm still not that far. So I'm still friends with all of my co-residents and I've been trying to like organize a little barbecue here in my backyard. So it's cool. You know, even when you move on, you still make connections that last a lifetime, you know.
Speaker 1:Yeah, dude, it's, I've had that. You're like, ah, finally I can shake off like all the internal medicine. And I mean I'm glad that you're finally. I mean because essentially you were dead set on anesthesia. That's the weird thing about it, is you? You're like I want to do one thing and they're like, okay, cool, well, to do this, you've got to do this for a year.
Speaker 1:And you're like, oh, okay, this is totally not the job I'm signing up for, but I'll give you good insight on how the whole hospital and everything works and it's you know you're getting to speak to all these consultants, which I guess we didn't really talk much on. But it is amazing, the consultants like reading a book and then asking somebody who's been practicing for 30 years they are way better at whether it's reading X-rays or reading CTs and all that like imaging, just understanding the concept, like they've been doing it way longer they could they knock it out, no problem, and you'll learn way more than you ever would just dissecting a book. But the yeah, just I know that there's importance to it, but you've got to be living large now getting to go in and finally now you're it's funny because you were an intern but now you're technically starting off your first anesthesia.
Speaker 2:Yeah, so, like when I was like a medical student, I would ask someone like the anesthesia residents. I'm like, oh, what year are you? And they're like, oh, what do you mean? Like I'm a PGY3CA2. And I'm like, oh, what does that mean? You know? But so exactly. So now I'm going to be a PGY2 post grad year two, but I'll be a CA1, clinical anesthesia one. So you know, they just keep adding all that. So my last year would be a PGY4CA3, unless I do fellowship, you know. So that's kind of how it works.
Speaker 2:And you know a lot of people think you know a lot of these first year spots are kind of the same, but it really depends on, like, like I mentioned, the different types and location and things like that. I was just talking with my incoming class and they seem, we seem like we've had different experiences to like. Take my old roommate, carl Miller, for example, like I said, that he's doing a categorical program at SUNY Upstate. I think he mentioned he got about three, three months of anesthesia in his first year. I got zero days of anesthesia in my first year. So that's a huge difference right off the bat. And you know other people, you know they're doing way more floors like I did. I would have to think about it, but I think I did about maybe four or five months of floors. Some people might think that's a lot, some people will think that's a little bit right. I didn't have much elective time. I practically had no elective time.
Speaker 2:One thing that I really wish would change, because for anesthesia, prelimbs were required to do, even if we're at a categorical or not, I think it just by the ACGME, I believe we need one month of emergency medicine, which is what you're doing right. But again, that changes by program. And what I mean is, for example, here at Hackensack, maine, there's that actual emergency medicine residency program. When I was a med student I would see that anesthesia, you know, first year with the emergency medicine residents and they worked pretty cohesively together. But at George Shore for example and I'm not saying this to like point fingers or, you know, blame anybody, I'm just like giving examples of some different you know discrepancies in programs at George Shore, but still part of Hackensack Emergency Network, there isn't an emergency medicine residency program there.
Speaker 2:So I and the other anesthesia, you know, internal medicine prelimbs we would be with attendings directly and every day is a different attending and they all had different expectations. Some of us some of them wanted to wanted us to be like third year medical students getting an HPI and this and that and the other. The other ones were like hey, just go practice your lines, go, do you know, profile, whatever. So it didn't feel as cohesive and structured as I would say, for example, hackensack, maine, where you're working with residents. So it seems like you know what's the word, you know. It worked better, yeah, yeah the.
Speaker 1:It's weird how each hospital for one is drastically different, and one can be very, very beneficial for your learning and then the other one may like what you're saying, like you're there for anesthesia and actually you know the anesthesia sometimes plays a very critical role in the emergency room.
Speaker 1:Like sometimes you have to come down to come to like you could be doing that role, but instead you're because there is whether it is like there's not a whole program set up for teaching students, and that's probably what it is Like, because they know they have emergency residents and all that. They've got that whole program set up. They can go ahead and just allow the anesthesia people to do whatever they want. I know that that's the way I miss to be to like there's a lot of people rotating in the ER, as it is, along with the ER residents. So it's more like, okay, we'll just get our residents to do like the, the ER stuff, and then you can just do whatever. But if it's not that way, then they're expecting you to just do, well, essentially what the resident would do if they weren't there.
Speaker 2:So you'll get like different experiences and I'm not trying to change anything, but I think that you know anesthesia prevails.
Speaker 2:At least they should have like a rotation of just lines, whether that's ultrasound guided, ibs, a lines, central lines Because a lot of the times I feel really comfortable with intubations During this year I got to intubate during codes, during rapid responses I feel very comfortable in that aspect I don't feel comfortable in lines, and the reason why is because a lot of the times when you're the intern and during the day you're writing notes, you're talking to consultants and nurses, you're talking with families and then maybe you're on long call Now you got the phone, people are paging you the last last thing you have time for is to gown up, you know, get, get all the materials ready, sterilize, you know, and get ready to do a central line.
Speaker 2:That might take maybe, if you're not, you know, experienced with it might take upwards half an hour, 45 minutes, you know, and people are paging you and things like that. So I I felt like it would not be appropriate for me to do that and usually my seniors would be the ones that you know. They would have more time to get their hands on skills while I'm kind of answering the pages and things like that. So I think that you know if, if a program offers some elective time, I definitely think if there's any way that you can do lines and you're going into anesthesia, that that's definitely very beneficial you know, yeah, and it could just even be that the attendings in the ER or in these other places, they don't realize the, and it's no insult to them.
Speaker 1:They just might not understand like how and like how you would learn anesthesia, like how you what you're comfortable with, what you need to practice to be a good one to begin with, and so they're just. You know, that's like if you, if I go into an eighth grade, you know social science, social studies class, I'm like I don't know what you need to study right now. You know, I don't even know.
Speaker 2:Yeah, exactly.
Speaker 1:So even though I did that class and I know essentially what, I wouldn't know where you're, where they're supposed to begin. So I think that, yeah, like I think at least all be more aware now that you're saying, that if there is, if I have that opportunity, I definitely will try to think about that because the because if you're prelim anesthesia and they might just see as prelim IM, they may not even do as anesthesia.
Speaker 2:Mm, hmm.
Speaker 1:That they are. You're just an IM guy that's coming down there. They're not even paying any attention, and so you've got this. Yeah, like I don't know the best way to solve that one, but the. I think that it would be definitely conducive to your education to, because that's when you were an ER resident and you go to the ER, they're just going into bay as much as possible, like that's all we need you do, we don't need to do anything else.
Speaker 1:Yeah because that's what you're going to do when your job comes. You're not going to put lines, and so it should be the reciprocal should be back. You're giving back.
Speaker 2:Exactly, yeah, yeah, and so I guess that's.
Speaker 1:I mean that's I guess that's just something you got to be aware of is that and you do an IM to? There's a lot of like that was the one of the reasons I didn't like my IM rotation is that I am rotations because I was just I was just doing paperwork and stuff and I didn't do. There was a whole month, one time where I was doing and I did like one radio stick or something. I did nothing else beyond that and I was just running around the whole time like getting getting information, bringing it back to typing nodes, you know, calling somebody if they need it, and you're just running. I mean it's a lot to run that hospital and I understand it. Yeah, as far as me and you, we'd like to be more hands on. We want to do. That's why we signed up for the the gift, exactly, exactly.
Speaker 2:Yep and so I wonder if there's a better way.
Speaker 1:But being prelims are when you're running. I mean you get your hands on that. You would be. You would be dead. Yeah, I don't know if that's the best way either.
Speaker 2:Yeah, exactly, but yeah, so I was. I was gonna, you know, move on to the next you know piece of advice going into intern year, which I would definitely say is, you know, organization and efficiency, because I try to be very organized but sometimes you know things can get really busy really quick and then nothing gets done. So what I did, you know, to be honest, when I was kind of driving down there to kind of move in, I would kind of listen to like YouTube videos to just kind of hear like different pieces of advice to stay organized. So I probably wouldn't recommend getting those med student kind of H&P books. I don't think that would necessarily work, but I definitely think, you know color coded pens work, different kind of ways of getting your to do lists. I feel like when you print out, let's say, like your for internal medicine, you print out the list of patients and you put like a little square on one call, like little squares on one column of things to do and then put a line through it with different colors, just to keep make sure that you don't forget, because a lot of the times with interns the seniors are not going to remind you you're going to be, you know on rounds you're going to go over exactly what's going on, what the case is, and they'll expect you to be keeping tabs on what we're talking about. And then when you run the list later in the afternoon it's like hey, did you call this person to be? Did we get follow up on this and that? So the best way I would think is color coded pens, make sure that your list is updated and then try to make it neat, not too much extra, because sometimes I'll come with a big one liner maybe jot down some important stuff. You don't need to write the whole HPI on your list, you just need to know the most. You know important things because you can always just sign into the computer and look at.
Speaker 2:The other additional thing, and the other big thing I think is definitely like a portable phone charger, especially for long call. They didn't give us some programs give you like a phone. They only gave us a phone for like CCU and like certain rotations, and so to the most part we would get pages through an app on our phone called zip it, so it'd be our personal phone. So if your phone's almost dead and you can't just leave your phone on the charger and go to a patient's room. We need to keep it on you. You know what I mean. And again, I'm not, I'm not sponsored. I don't have any particular recommendations, but any. You know. If you read the reviews, see you know good, portable charger, that might work for you. But yeah, those probably the two main things. I think is definitely portable charger, go into color coded pens and a good system to write down your follow ups and follow up on them.
Speaker 1:When you have your color coordinated pen coordinated pens, do you have the little like where there's? Like a red, a blue and a yellow.
Speaker 2:I think those work the best because you don't want to have five different pens in your pocket. But if you have like one of those good ones, or you can just change it to red, to blue, to green, to those. I think they work great and you can make your own system exactly oh, green means completed or blue means completed, whatever works for you. But just so you don't forget anything, because sometimes when you're on long call and the short call interns says hey, follow up on this, that and the other oh crap, I didn't follow up on this H and H now have to rush, do it. You know, maybe write that in red, you know, so it stands out a little more. Just so, you know.
Speaker 1:So nothing gets, you know, missed on, you know and yeah, yeah, and you don't realize to like, and for anybody that's listening, this is Some of this work. You have it in your mind that you're going to do it. You immediately make a call and then it doesn't work out. You leave a voicemail. Now you're just waiting for the voicemail to go through and then to call you back. So it's like I understand it actually makes perfect sense, like where you could make, like you know, like I'm halfway through this task because, like, sometimes you see it again, you're like, oh, I've made that call now and it's just a lot to remember all at once. And then other people are calling you and you're still waiting. And if those people don't ever call and you forget to call them back, then you just you're sitting there looking like an idiot when everybody starts asking like what happened? And so, yeah, I think the color coordinated pens is great.
Speaker 1:I will say, when you were talking about the portable charger too, I've gone on just like Google and Google like top portable chargers or whatever, and there's so many reviews and everything where they listed all out Maybe don't click the first one, which would probably be an ad, but like, sort through it and find where they're ranking them and there's because what you want to, I found ones like. When I moved to Grenada I got one that was kind of hefty but it lasted for like four days and it could charge anything, but you wouldn't want to take that on shift with you. It was, it was bigger. So you want to find one that's kind of portable, that you can shove in your pocket, in your scrub pocket or whatever, and then also be able to yeah, that I can't. I didn't even think about the portable charger because I forget how many times they call your personal.
Speaker 2:They don't. I mean, maybe your program might give you an actual phone. Again, there's too many programs out there and there's so many different differences, so you just need to make sure that you're ready, you know, because maybe you might hear from your friend oh yeah, they give us this, that and the other, and you're, you know you're expecting that, but just try to not expect anything and then be prepared in that type of situation.
Speaker 1:Yeah, my phone stays about to die. I mean, it's probably about to die as we speak, so I definitely understand. Yeah, that's a very good one, are you? Are you excited to meet, like your new co-residents? Because, like you were saying, like there's all these different backgrounds.
Speaker 2:Yeah.
Speaker 1:And so. But now you're all going to come in and be like fresh in the pot. Yeah, exactly.
Speaker 2:Like my class at Jersey Shore. There's a 30 PGY ones. Now we're going where I'm going now in St Joe's there's only eight of us of the incoming CA ones. So it's pretty cool. I mean, I love, I still love, my, my, my PGY one class at Jersey Shore. We still have group chats, like I mentioned. We still talk and stuff like that. And even the new CA one class we have kind of a group chat, even though we didn't meet everybody in person, but we're kind of like you know talking about, you know when we should meet up and and hang out and get to know each other and stuff, you know, like T-shirt time. Yeah, exactly Right.
Speaker 1:Jersey Shore.
Speaker 2:Oh yeah, jersey Shore reference, but yeah, no, we were like thinking about getting like matching. You know what it is, patagonia's or whatever you know.
Speaker 1:Oh, dude, I could have sworn you were talking about getting matching tattoos. I was like. I was like, yeah, no, like this.
Speaker 2:You know some some of the classes do that. Really I like no one really wears those white coats. You know some of them do. But some of those hospitals are cold and sometimes those Patagonia's or North faces really keep you warm. The resident.
Speaker 1:Resident got to success. You're going to need a Patagonia or some kind of light fleece. Yeah, the name that says you're a doctor on it still. Yeah, I found that people don't. Even if you're wearing like a white coat, people don't assume you're the resident at all Like. But if you're wearing a light jacket and your scrubs as even as a medical student like, people would be like oh, are you the resident? And I'm like yeah, no, no, no, no, no, no, no. That's down there.
Speaker 2:Exactly. They kind of have like an impression of you when you're wearing your white coat. They're like, oh, look at this guy.
Speaker 1:Yeah, exactly.
Speaker 2:But everyone wears one on day one, it's no issue. I just thought that it was a hassle to keep clean. You know I didn't have time to go to the dry cleaners. You know a lot of the times I'm running from here to there. I don't want to lose it. So I just I to be. Personally, I never wore it. But I have a question for you. What do you think is for? I don't know anything about emergency medicine, like the residency program, but do they like break you up into rotations? How does that work?
Speaker 1:Yeah, so they definitely do that. So we have there's like 16 of us going into this program and we all start differently. Now there's going to be a couple of people and the first month we actually do this whole and that's why I had a little bit of free time that we could do this episode we have this first month where we essentially just do skills training, like we're not thrown into the fire, but then after that we're going to split up to where you've. I think we've got MQ, cardiology and I think trauma is second year. So maybe it's not then, but there is, yeah, you essentially do rotations throughout the hospital and I think but I'll start in the ER and we'll.
Speaker 1:You'll have like three or four months in the ER and then the rest of that whole year is going to be in different parts of the hospital, which is funny because you have the three years as an emergency resident and the first year, you know most of it, you're in a different area of the hospital. Anyway, you're not even in the ER. Yeah, you're getting training throughout that whole process with it, but it's just interesting. And then they. So we will like well, we'll do essentially the same thing with IAM, like where you bounce around and do rotations, and I think anesthesiology is a first year rotation, yeah, and then we'll. But I'm kind of excited to officially start in the ER One, because it I will be. It will give me a for one, a chance to get to understand how the system works and that's like where I'm going to be. But also the expectations will be at an all time low, like if you have, if you had to do all the other rotations first and then you went to the ER by month six. They're, they're expecting, they're like what are you doing? You know, like this is the first time I've ever been down here.
Speaker 2:Yeah, yeah, so, yeah. So it's almost a blessing when you get to start where you kind of want to be, because then you know you're going to get a little bit of extra help, a little bit more lenient, and you know all the, all, the, the, the flak won't be be put on you all the time.
Speaker 1:I mean it's still be tough, but you'll have a little bit more cushion you know, yeah, they will know that this is the first time that the interns are there. Like, yeah, there's a funny. My mom actually sent me this cause my mom's a ER doctor and she said there was a like a meme or GIF or whatever and it was Drake singing the song. What is it? Oh my God? Now I'm going to blank out, but it was centrally, you know, like, uh, like for no new friends or whatever he's like. I don't see anybody that I recognize, you know.
Speaker 2:Oh yeah, who did it? No, yeah, I just saw this. Yeah, yeah.
Speaker 1:And uh, yeah, yeah, I'm trying to. Now the song is coming to me but I'm not going to butcher it for everybody listening for me to sing it. But yeah, he's like.
Speaker 2:I know way too many people here right now that I didn't know last year. Who the heck? Yeah, yeah, exactly, dude, yeah.
Speaker 1:It's um, when everybody starts piling into the hospital, they're going to know that it's the you know everybody's new. But after a while, you know, people are going to start expecting you to be the doctor, yep. And so at least at that beginning point like there's, they understand that there's going to be problems with the system. But if you start having problems with the system and like month eight and stuff. People are going to have way less leniency for it.
Speaker 2:I think like the way you should do it is like kind of take on more responsibility on your own and not let someone give it to you, if that makes sense. Like some people, like I was running codes towards the mid to end of my intern year, usually in the beginning of the year. Honestly, the expectation for, at least for Jersey Shore was, you know, the interns would be the ones that are doing compressions, the ones calling families, you know, the ones writing the transition care note if they're going to ICU doing those types of responsibilities, and the seniors would be the ones, you know, uh, leading the code call, you know, talking to the fellow and things like that. But they should, your seniors shouldn't be having to ask you to do more things as the year progresses. You need to be like, willing to be like all right now I want, I feel comfortable. Obviously, if you do not feel comfortable doing something, don't and you know, don't just jump in and do that. But I'm saying, kind of take on a little bit more responsibility, start acting as if you're going to become the senior, because you are in a few months, you know what I mean.
Speaker 2:Um, at least here and my program around March. That's kind of the time where the third year is we're kind of coaching the second years on how to run rapid responses and things like that, you know, and everyone was kind of moving up a little bit right. So, as long as you kind of have that mentality, uh, let me, let me, let me learn how to do this, let me take it a little bit more, as opposed to let me just continue to do what I'm doing until someone tells me to do that. You know what I mean, because then it's going to be kind of a rude awakening because you're going to be burnt out and things like that, and you're not going to feel like, uh, like I feel like I'm rambling a little bit. But my point is, um, that, just be willing to, you know, uh, get comfortable being uncomfortable throughout the whole year.
Speaker 1:No, that's good advice.
Speaker 1:I, the one thing like I think I have going for me is, for one, I like being uncomfortable that's the awkward business about it.
Speaker 1:But the my mom is a ER doctor and so even though people are going to give me like, oh hey, we only expect this much of you, like I feel like I know what I expected myself and that is to be better than her, and that's a pretty big uh, and I don't even know if I'll make it there, but I'm sure it's hell going to try.
Speaker 1:And so I know that I'm going to probably be a little bit difficult in the regard, especially on myself to be getting this stuff and getting it well, because I guess I've kind of always been that way. But so I'm hoping that I am able to follow that advice and cause I want to yeah, I don't, I don't want it to be I want to go ahead and knock it all out and be way more prepared for my second year before that even comes. And then dad, on top of you know, going into my third year, because, yeah, I mean to be honest, like she's kind of a, you know a, she's a rock star when it comes to being an ER doctor. But I I'm also kind of like a competitive person where I see all the time and stuff and then they just like I can't be worse, so I gotta be, at least even better.
Speaker 1:And that's it. So it's a. At least I have that. It's probably not a good thing. It's probably like a lot of Settler, a lot of pressure put on me for no reason, but we're gonna see where I get the land, where I land after it.
Speaker 2:Yeah, they're all. All takes time, all takes time. I guess that's you know, that's part of the process yeah, yeah, yeah, and that's a.
Speaker 1:That's a good thing, even for, like, medical students coming up and and Stuff like that. Like you they say dress For the job that you want. Like if you want to do an anesthesia or you want to do a certain specialty, like get in there and try to do and like focus on what that. Like show people that you Want to do it and get in there and try to act like you are one those people, because you'll be there very quickly and I don't know. I feel like that's always worked out in my favor, like if I tried to Get in that role For whatever rotation or whatever I was doing.
Speaker 2:Yeah, yeah, I totally feel it. Now I was gonna tell you now my favorite rotation that I had this year and a lot of people probably wouldn't expect it. My favorite rotation was night float. Now some some hospitals they do have 24 hour call. Luckily enough, at my program there wasn't 24 hour calls, so you were either you know days, whether short call, or long call, long call meaning around finishing around 7 pm. And then there's nights where we just work seven to seven. It sounded like a lot but it really. It was six days, six nights on, two nights off, and what I loved about nights is One. I really hate typing. So no progress notes, right. No pre-rounding.
Speaker 2:It's not like if to wake up early and pre-round and get ready for rounds, get all your notes done, you don't need to wake up and call all these consultants and blah, blah, blah and all this.
Speaker 2:You know other stuff. You're kind of and you also have a little bit more autonomy to you get the sign out, you know what to follow up on. You kind, when you get pages and you encounter problems, you can kind of think about them on your own If you really need to. You always have seniors out there to help you, but you kind of feel a little bit more autonomous and you have more time to do lines, you know, get some procedures done too, and you have more experience with like rapid responses and codes and things like that. So I felt like a little bit more of like what I wanted to do as opposed to, you know, kind of sitting and you have a lot of down pound too. So you know you got to stay awake, so you, whether that's you know reading something or playing cards or something like that, just to keep you awake. So it's a good time to like bond with your co-residents and, you know, get to know them pretty well.
Speaker 1:Yeah, dude. So wait, when you say night flow, you mean just that that six on a or two days off every night, coming in at 7 p.
Speaker 2:Yeah, six nights, two nights off again. This is just at this program. I don't know how they do it at other programs and it was. We got signed out at 7 pm and we would sign out at 7 am, with some exceptions Because there's one team that covers a smaller hospitalist team, but they're also in the ICU and CCU. Obviously they have a senior, so they're kind of covering three teams with a little extra help from the seniors. But it's nice because then you're kind of in the unit for the most of the night. You get to encounter a lot of ICU related problems. You see how the senior response to them Maybe if it's a very serious situation, they got a call, the MICU, that you know the poem fellow Poemker fellow or the cardio fellow see their thought process and you're really figuring things out.
Speaker 2:You know watching them, observing them and figuring things out together. So I feel like a lot of learning happens at night. But you have to be, you have to be awakened, recepted, for you know, if you're saying, oh, I'm tired, I'm tired, I just want to just answer my pages and follow up what I have to, then you're probably not going to get as much out of it as you know You'd want. But if you're kind of engaged, you know and and ready to see, you know what, what happens throughout the night, then Then then I think you know it will work out.
Speaker 2:Like I said, I started with a month of ICU and then I went right into a month of nights and by so, by the end of August, I felt like I saw 90% of what I needed to see in those two months and I felt like all right, cool. And then I went in. When I went into floors, I was like oh wow, so I'm just really like these people don't seem as sick, you know. I like I know how to fix this, you know, and it becomes a lot of more social work issues and things like that, which you would have to learn. But, yeah, nights, definitely look forward to it, don't. Don't like you know, sigh, or like I have to do it. I think it'll be a good time, don't sleep on it, pun intended.
Speaker 2:Don't sleep on it. That's a great way to put it.
Speaker 1:So, besides just staying up, is there any other challenges that come with being that night shift doctor as opposed to Working the day? Like I know, you don't have to do the progress notes, but are there specific challenges that come with being in the night flow?
Speaker 2:Oh yeah, 100%, and so like, probably one of the biggest challenges that I had is Like when you're the admitting team, I again I keep saying this over and over that I don't know how all the other hospitals operate, but on my hospital Different teams would have a different night where they would be admitting new patients, from the ER to the to the you know floors, and Some days you're just getting blown up with a lot of admissions. You got to keep on on top of it because those are new patients. No one signed them out to you or like you are kind of getting signed out to them, but you have to be prepared to remember everything kind of what's going on and be ready to sign that out to the dating and you and there's a lot of things that can all happen at once, whether, oh, this person lost IV access and the nurses want you to do Old shun guided IV, but then another person shall leave AMA Another person you know the rates uncontrolled in the 140s and they want you at bedside. So you know it becomes a little bit just because you're one person and you need to be at a multiple different places at one time. So you're definitely gonna have those nights where you're just like, oh my god, like I need the phone to stop ringing.
Speaker 2:But for the most part, you know it's pretty, it's pretty good as long as you stay on top of it. You know, keep, follow, what you need to follow up. And and Don't, don't sleep. Yeah, I don't know if you're. If you're sleeping, I don't think you're gonna have a good time. We're gonna wake up drowsy when you really are needed and you're not gonna be able to think yeah, yeah, I completely agree like get your rest in, don't?
Speaker 1:Some people come into night shifts and they think, okay, well, I'll probably just news, and I know some people that are surgeons, like you just haven't left the hospital, so please take your rest when you can dude. But the yeah, the Best thing about Night shift for one is the camaraderie. But did you ever find out that there was like a lack of this Specialists, like a cardiologist? There's usually a ton of them at the hospital during the day, but was there ever a situation where you just didn't have Like specific specialists there at the time?
Speaker 2:Um, sometimes I would call, you know, like the cardio fellow Maybe he would be in a grumpy mood, maybe not so much, but usually they're very helpful and just say, like, run it by them, like, hey, you know, I got this person in AFib, rvr, this is what I did already, this is their past medical history. Like, what would you recommend in the situation? Something like that. Or, you know, if it's that serious, that you're in a really bad predicament and you're not really sure what you need, you know Need to do, talk to your senior or just call rapid response if you really think that the patient is, you know, in a detrimental, downward state where you're really worried about them. Because then when you have a rapid response, then you have everybody come in there to assess them and, and you know, come up with with solutions quickly. And at those times you can always call the on call the free for the consultant. You can call, like, the cardiologist service and they can page them.
Speaker 2:But make sure to ask them a question that you don't know the answer to. You don't want to be answering Asking questions that you kind of you know the answer to, but you just wanted to confirm with them or something like that because you know you really want to be. It has to be succinct. Let's put it that way. You need to be like this is this is what's going on. Obviously, give them a one-liner and this is my question, right? Not like, oh, I was thinking about this, but what about that? Just want to be like I got this issue. This is what's going on.
Speaker 2:I'm reaching out to you. What do I do need to right, especially at nighttime?
Speaker 1:they so, exactly as I say, especially at nighttime, because and now we'll be going to teaching hospitals, so they'll have either resident, like a cardio fellow or somebody there that has Is doing something. But, like, I can attest this because my mom, she I've mentioned it already that she's a ER doctor, but she works at a hospital and it's you know, it's not necessarily the biggest, and At nighttime too she prefers to work during the day, because at nighttime, when you call any surgeon or any of those people they may, they're more less likely to be in-house, and so you've got to call them, wake them up, get them over there, and so it better be important, or better be important, and if it's in the I'm.
Speaker 2:Most people are like oh yeah, I'll sure I'm in the hospital, I'll swing back down, I'll swing by.
Speaker 1:They come with a smile on their face and then they're like oh no, it's nothing, don't worry about it. Yeah, nighttime you call somebody and you get them out of bed and they come and it's not an emergency. You will be caught for sure. Yeah, and, and don't take it to heart.
Speaker 2:if they're upset, you know like they're obviously not personally upset with you, they're just quite being tired. I get that way too, you know what I mean out of bed.
Speaker 2:Yeah, yeah, like I had a bad situation one time where One of the patients that I had had a deal of FOI AVM in her stomach. She's ICU downgrade and the bleed was stable and then all of a sudden of course it always happens at nighttime she just starts vomiting large amount human, human temesis and I'm freaking out. I'm like, oh my god, is this patient gonna just exanquinate in front of me? Like I'm Petrified first thing I do. I jump on, call GI and they're just kind of like, yeah, mess, you know, do transfusion protocol, blah, blah, blah, don't worry about it, we'll be there, you know. Like they were kind of like, yeah, we saw this many times before and I'm like freaking out. So it's not like they were trying to be rude, it's just they. Again, you're gonna find a lot of people that has encountered this problem You've had before. You seeing this problem is not the first time. It's happened.
Speaker 1:Yeah, you know but when you, when someone's vomiting blood, you're like whoa dude, yeah, like oh my god, yeah, then just just go back to your basics.
Speaker 2:You know your ABCs, you know things like that, things that you know that you can do. Obviously, you're not gonna be able to fix this AVM per se, but you can stabilize the patient so that when the specialists come in they are ready to do what they got to do and they'll get it done.
Speaker 1:Do you have any tricks for staying up and being interested? Because the I think the thing that kills me is when there's like I can go all night. But if there's a low, like if there's a three hour low where I'm sitting there like you know, twiddling my thumbs and you know I got my feet rested up and then all of a sudden an emergency happens, I'm like whoa, whoa, whoa, you caught me slipping a little. Do you have a trick? I kind of keep your mind still going. I guess it also depends on the chemistry of, like, the people you're with.
Speaker 2:I had like really, really good chemistry with my coworkers. We played monopoly deal, which is like a little car game. It's really competitive, really fun, quick to learn and it's like a fast game. That kind of kept us awake. Sometimes, if it's really, you know, dull, we don't have that many follow-ups coming up. Sometimes in the resident lounge we'd actually just like connect Xbox and watch Netflix for a little while and have obviously have our pages and everything nearby, you know, right next to us.
Speaker 2:So it's like if you get something pause, you know answer it. It's not like really like neglecting, but anything that you know will definitely keep you awake. You know some people read books. Other people might, you know, get hired from, get more tired from reading the books. That's what I was saying. Yeah, so like whatever you think works best for you and even just like talking like this, you know if you have like a good you know co residents that you really vibe with and just like you know chatting in about your interest and things like that and really like connecting. Like when you're in this conversation you typically don't get like too tired and then maybe you get a rapid response. You're up, you're like jogging over to that room and now you're like all right, I'm awake again because I just kind of had to like get up and move around and things like that Look forward to lunchtime at like two in the morning, you know. So, those things, those things kind of help you stay awake as well.
Speaker 1:Yeah, that's what. That's one of the things I actually I enjoy nights One. I usually am up later at night anyway, so it allows me to justify that. But I love the conversation that switches around like one or two. Everybody starts acting either real goofy, yeah, or you know, and I start doing it myself and you're just trying to bypass the next five hours and it just it can be a lot more fun than when it's the middle of the day and you're afraid that you know administration is going to walk downstairs or something Exactly.
Speaker 2:Yeah, I had some of like the most fun times on that. It's just, you know, hanging out and you know, after like the first few nights you just get so accustomed to it like I don't know, I'm just a very like good sleeper. Doesn't matter, it's noisy, if it's light outside I will sleep, so they would. I would literally routinely like fall asleep at like 8, 8, 30am, wake up right like right on the dot like 535, 45pm, like like nothing, and then the whole night after a while I was wide awake, I wasn't tired at all. So it's just goes like first few days to that, maybe first week or so, where you're really trying to switch that schedule. That's the toughest, but after that it really it really comes, comes easy, nice.
Speaker 1:Yeah, I'm curious too about has went and it. I'm curious too about the fact that when you have a night shift working team, most of the actual staff nurses, techs, all that are night shift workers. Now they may fluctuate a little bit, but most of the time they are the night shift people and then there's a day shift people and all of the in-between, with you doing different rotations in different parts of the hospital. Then you're in nights, then you're in days. How did you bridge the gap of introductions and being part of the team? I mean, I guess you said with the gum, but did you have a good way of getting part and to being a part of team when you're constantly the new person in every rotation?
Speaker 2:Yeah, especially with nights too, like I mentioned, you're not really rounding unless you're in the ICU really getting to know those patients because you really have to keep a close eye on them. But when you're on general floors on nights there's just way too many rooms, buildings and staff for you to learn everyone. So after a few months and you've been around the block, different rotations they recognize you. You have small conversation but sometimes it's impossible to know everyone. But at least if you make that good impression they'll remember you. They'll be like oh, I remember you. You're like the tall one, I had a nice conversation with you, even if they don't remember your name, they don't remember anything about you. Or if you return their pages and you're very kind to them, they'll remember that too.
Speaker 2:And always when I'm writing supplemental note regarding an important page I got, I always say was kindly informed by RN. So instead of just saying RN page about this, when you say was kindly informed and they read that, they're like wow, okay, I wasn't annoying him and he actually took to what I said and he really listened to me. So and then they look at your names and notes and things like that. So when your name is kind of out there and notes and pages and things like that and they put a name to a face. I think that's probably the best way to get people to know you. So when you speak, when you write, just kind of try not to be passive, aggressive ever and just be like a friendly person.
Speaker 1:That's good advice, dude, yeah, and so I guess I just really because I'm curious also. I mean, I know that this is a little off topic, but because you were talking about how you sleep and you, how did you manage your time when you weren't in the hospital? Because I know you do this. You have your own YouTube channel. I don't know if you were even able to do those videos over the past year, but you do a lot of other things and then you also have this heavy responsibility to the hospital, so how did you manage that time?
Speaker 2:Yeah, yeah, that's a great question. To be honest, I put a lot of it on the back burner. Typically I work six days, maybe get one or two days off, depending what rotation like I mentioned, six nights to one, or if you're on days on floors, it's six days, one day off either Saturday or Sunday. I see you as the exception. You have a little more flexibility, but a lot of the times that one day off I had during the week I would just be doing laundry, cleaning, grocery store things like that, seeing my girlfriend, seeing my family, things like that. But I haven't had much time for the YouTube channel. Maybe I'm going to have maybe like one video this past year. I'm not like throwing it away. Hopefully with more time if I ever get more time, I'm definitely more likely to post more fun stuff, because it's good to definitely have hobbies outside of medicine. But yeah, I got to say I think intern year is probably going to be the one year where you're really going to have to sacrifice some of the things that you just enjoy.
Speaker 2:I love college football. A lot of the games I couldn't really watch. Maybe I would just like try to pull it up on Google, check some of the scores, but I really couldn't watch it and enjoy it like I used to. And that's not forever. Hopefully, with time maybe it's just intern year. That's really difficult, but just got to prioritize what matters most and, again, be efficient in and out of the hospital. If you get your stuff done out of the hospital quickly and efficiently, then you might have more time to do other stuff.
Speaker 1:Yeah, I think that for one, it's just about the managing and now I'm about to go through it. But I mean it's expected that you had to put some stuff on the bad burner, like. This is supposed to be one of the toughest years, so I think you'll have more free time coming up. That's kind of the one reason we had to knock this bad boy out now is because we both had this weird gap where we aren't being swarmed with, and also, not only did you have all the other stuff that you were just talking about, you had to study for step three, which is a test that you had to do, and a bunch of other things and you did that right.
Speaker 2:Yeah, I took step three in April. A lot of people tell me, take it before you start your intern year. I really think it's situational. It depends on what you're doing. If you're an internal medicine and you really want to go into a very competitive fellowship whether that's GI, cardiology, pulmonary, what have you yeah, maybe you definitely want to study really hard, maybe give it that the way, something like that, or you want to take it down the road and get some clinical experience in your belt.
Speaker 2:But for anesthesia, really, we just really need a passing score. It doesn't really matter as much exactly the score. So for me, I probably should have studied more than I did. But you do what you can. You don't kill yourself over it. And I passed and I was OK. That's it. Moving on, that's all about. Yeah, your patients are your number one responsibility. Your scores, all that is all secondary. So make sure that you're fit. Like I said, make sure you're efficient in the hospital. So if you do want to get a good step three score, make sure that you make time for it. That's not conflicting with everything else. And make sure you sleep. Get as much of sleep as you can. Don't feel guilty about it, you know, because you won't be able to work well if you're sleep deprived.
Speaker 1:Yeah, and I think the fact that, like I know, people really are very concerned with their test scores, like I know that it's essentially what got us to where we are and it's been a big part of all of our lives for so much, so it's hard to take a step back from that. But I think that you're, you know, like you're the people that are going to reach out for you in your residency and if, like, let's say, you're looking to get into a fellowship, I'm sure that they are going to consider your step three. But at the end of the step three, like there's no other tests like that are that besides the boards? And so you, they're going to go off your this is at least what I've heard is they're going to go off, like the people that are reaching out for you and their evaluations of you and all that other stuff, before they're going to just look at a solo test score, like it would have been in metal. You know, coming from medical school.
Speaker 2:Yeah, yeah, no, I totally feel that. And again like, for example, if you're going into certain specialties, whether that surgery like I know anesthesia has their own tests. Like I think I'm going to have my anesthesia basics at the end of this upcoming year, so you know, I'll take it all with a grain of salt. You're you're sorry about that. You're you're going to be getting tested for the rest of your life. That's the type of career that we've entered in. So don't, don't take exams so abrasively. Just, you know, as long as you're working hard and learning in the hospital, everything else should, once you get to the point where you're at residency, unless you're really really trying to do a very competitive fellowship, I think what really matters most is just making sure you're doing a good job day in and day out, and everything else will come with time.
Speaker 1:Yeah, man, well that's. I'm so glad that you were able to like share all of your like tips and everything, and I know that that you're going to do great in this next year and so I'm like excited you're finally going to get all the year you know, your actual skill set ready for actually doing anesthesia.
Speaker 2:So, yeah, I'm excited and I got to. I got to give a congratulations to you too. Man, like I, I didn't take a minute to sit down and say congratulations. You matched, like that's a big thing. I know we haven't talked much in this past year because you've been getting your applications ready and your interviews. I'm in my internship, my intern year and all that stuff. So you know, I think it's it's. We're always focused on what we need to do next, but we never just sit down and bask and just say like, wow, we did it, you know. So congratulations to you, to Jordan, you know, I know you're going to do an excellent job. And again, you know, you don't need to know everything on day one. You don't just take in the moment. Make sure you, you know, make, make as many connections as possible and and with time, you're going to start feeling really confident. By the end of your first year you're going to be feeling you're on the right path, 100 percent.
Speaker 1:Dude. Well, thank you so much. I really appreciate it, and I, speaking of getting behind and everything, I forgot to tell you have a birthday, so oh yeah thank you so much I literally just thought. I thought about it right before we got on, and then I thought about it at one point and then I literally just almost forgot about it again, dude, so yeah, no, it's all right.
Speaker 2:Yeah, my birthday is just this past weekend, 28. Now I'm getting closer to 30.
Speaker 1:I mean I did once you. Once it hits you, your knees are going to start hurting.
Speaker 2:Oh yeah, my knees hurt already. I'm feeling it.
Speaker 1:Well, dude, thank you so much for coming on. Everybody go check out. It's Matt's man cave, right?
Speaker 2:McLean's man cave.
Speaker 2:Or McLean's man cave, yeah, like M clean M C L E A N McLean's man cave. It's on YouTube. I don't post that often. I hopefully will as time moves on to have more free time. I'm finally, you know, moving to the house, maybe have a little studio, have a little bit more time. I just talk about anything fun. I like Star Wars, anime, video games, college football, anything you know. I get with a millennial type feel to it and if you just like nice vibes and with maybe a touch of medicine here and there, you know, come, come, take a listen. Yeah, and that's about it.
Speaker 1:No, you're great and it's going to. Yeah, everybody go check that out. We're so glad that you're able to give us a little bit of your time. I know you've been super busy this year, so thanks so much, matt.
Speaker 2:Yeah, and guys, don't forget to, you know, like the podcast subscribe to, you know, Off White Coat, this man, dr Abney, you know, he really puts everything out there. I, you know it's crazy how he gets these podcasts off so consistently and I really got to like applaud you on that because, like, I can't even stay on top of my stuff and he's really doing it for you guys, you know, because residency, you know, it's really kind of like something where you're an experience that you're going through, but he's kind of bringing you along with it with him and showing all the amazing faces along the way. But he's doing it for you. So, you know, definitely show your support to this guy and I can't wait to see what, what, what continues on with this podcast.
Speaker 1:Dude, I appreciate it so much. Yeah, I literally I started it so that we could get everybody into residency and now that we did it, I was like, oh no, I created a beast. I can't stop myself.
Speaker 2:Yeah, yeah, but now you know. Now you know exactly what to tell people because you made it. You're in.
Speaker 1:Yeah, yeah, exactly. But, dude, thank you so much and we enjoyed it, so we'll see you next time.
Speaker 2:Yeah, until next time, guys, everyone take care.