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Shadow Me Next!
Shadow Me Next! is a podcast where we take you behind the scenes of the medical world. I'm Ashley Love, a Physician Assistant, and I will be sharing my journey in medicine and exploring the lives of various healthcare professionals. Each episode, I'll interview doctors, NPs, PAs, nurses, and allied health workers, uncovering their unique stories, the joys and challenges they face, and what drives them in their careers. Whether you're a pre-med student or simply curious about the healthcare field, we invite you to join us as we take a conversational and personal look into the lives and minds of leaders in Medicine. Access you want, stories you need. You're always invited to Shadow Me Next!
Shadow Me Next!
16 - A Conversation About Resiliency in Medicine with a Pediatric Resident Physician | Beatrice Garrido, DO
Join us on a journey through the compelling story of Dr. Beatrice Garrido, a resident physician whose path to pediatrics and global health is as unique as it is inspiring. Listen in as Dr. Garrido shares how her early dreams of becoming a veterinarian led her to the intricate world of human medicine, fueled by a pivotal moment with her mother. Her choice to pursue a Doctor of Osteopathic Medicine degree showcases a commitment to a holistic approach, which she passionately integrates into her practice. This episode promises to enlighten listeners about the profound impact of diverse healthcare roles, including her invaluable experience as a medical interpreter at the NIH, and how these roles enriched her journey as a compassionate caregiver.
From handling the emotional rollercoaster of medical school to navigating the challenging match process, Dr. Garrido opens up about the highs and lows of pursuing a career in pediatrics. Discover how the early struggles and the realization of her true calling shaped her path. Through personal anecdotes, she reveals how mentors provided guidance and support, helping her overcome the hurdles of medical residency specializations. The episode captures the essence of resilience, the strategic pivoting from initial interests in surgery and emergency medicine back to her roots in pediatrics, and the gratifying moment of securing a residency position against all odds.
Peek into the demanding world of a pediatric resident as Dr. Garrido shares her routines, the intensity of hospital rotations, and the strategies she employs to combat burnout. This episode offers a candid exploration of the personal toll of burnout and the techniques she uses to maintain mental health and provide optimal patient care. Learn from Dr. Garrido’s experiences about the importance of self-care, support systems, and staying true to one's passion in the field of medicine. Whether you're an aspiring medical professional or simply intrigued by the human side of healthcare, this episode offers insights and encouragement to navigate the challenges and celebrate the triumphs of a medical career.
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Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-health student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at Shadow Me Next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests.
Ashley:Today on Shadow Me Next, I am so pleased to introduce you to Dr Beatrice Garrido, a resident physician with a passion for pediatrics and global health. Dr Garrido has a very unique story, both in her path to medicine and in her journey as a pediatric resident physician. Before stepping into her role as a physician, dr Garrido built a fascinating foundation in healthcare. She's worked as a clinical technician, assisted in laboratories and even gained hands-on experience as a veterinary tech. Most impressively, she also had an incredible experience as a medical interpreter at the NIH, helping Spanish-speaking patients navigate the complexities of our healthcare system. In this episode, we'll talk about how dreams can change, the pivotal moments that led her to medicine, her experiences working in different healthcare roles and how to care for yourself as a healthcare provider. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company.
Ashley:This is Shadow Me Next with Dr Beatrice Garrido. Hey, dr Garrido, thank you so much for joining me on Shadow Me Next this evening. I am so excited to hear about what you're doing in medicine right now, and you are past midpoint in your residency journey right now, which is a huge accomplishment. So congratulations on that. But I think at this point, you have so much experience under your belt and so many amazing things that you have learned, whether they're good or bad, they are amazing and they're really shaping you as a clinician and they are allowing you to shape us. So thanks for being here, thanks for joining us. I'm just so excited to have you. Thank you for having me. Thank you so much. So first tell us what you do, tell us your title now, and then, if you can take us back, take us back to the moment you first started realizing that maybe medicine was going to be in your career path medicine was going to be in your career path.
Dr. Garrido :Yeah, so currently my title is I'm Dr Beatrice Garrido and I'm a DO, so I'm a doctor of osteopathic medicine, which is just one of the two pathways you can take to be a physician in the United States. So DO versus MD, which is the what you've traditionally heard doctor of medicine, we practice essentially the same. Our training is just a little bit different. Where in DO school doctor of osteopathic medicine we take time to learn osteopathic manipulative medicine, which is where we work with the body. So we put hands on the body and we work with manipulation of the body to help the body heal itself, but we do more of a whole body perspective. So I did not always want to be a physician, or I think I didn't know that I wanted to be a physician until I graduated college. I always wanted to be a veterinarian. That was my life goal. I went to college, I did my veterinary medicine courses. I was pre-vet. I did get lucky when I decided to be a physician, because pre-vet has you do more science courses as requirement than you do as a pre-med. So I had all my prereqs plus some more. I finished college, I applied, or during my third year of college to fourth, I applied veterinary medicine. I didn't get in to veterinary schools. I had so much experience. My whole undergrad was working at veterinary hospitals being a veterinary tech. I had so much experience. My whole undergrad was working at veterinary hospitals being a veterinary tech, doing all the hands-on things. I love that.
Dr. Garrido :And you kind of start thinking like, well, I'm a person who's a doer. I'm like, okay, let's go again, go get her. I said, okay, didn't get in, let's do it again One more year. I mean, I was devastated, but let's do it again. And my mom, being the wise woman that she is, would often, toward the end of my college career, she kind of started pondering. She'd be like are you sure that's what you want to do? Are you sure you want to be a veterinarian? Is there nothing else you want to do? Like you sure you want to do that for the rest of your life? And I'd be like, yeah, of course I love science, which I always have. I've always wanted to be some sort of like a doctor. But in veterinary medicine I like biology, I like how the body works, like it's just incredible to me. And I'd just be like, yeah, kind of like blow her off, it's like nothing else. And then sometimes I'd be like, well, you know, now that you're asking, I mean I love kids Like if I'm not a veterinarian, I would go into medical school and be a pediatrician and we would kind of just like randomly talk those things.
Dr. Garrido :I never thought it was possible. Like I thought I couldn't deal with human medicine and with kind of just caring for humans because it like I didn't think I was capable of it. And so that last summer that I didn't get in, we have a family friend that had done an internship for Hispanic college students and we put them in government agencies to do an internship. So I applied for them. My mom's like apply for that, it's going to be great. I literally applied a week before the deadline, got all my letters of rec in and a week after the application I get a phone call saying hey, we're reaching out to you from the National Institutes of Health.
Dr. Garrido :You have a pre-interview, because the National Institutes of Health always does a pre-interview with various people before their interview to see if you qualify, to see what they think of you. And I'm like, ok, I didn't know what the age was, by the way, because I was in medicine, I had no idea. And I'm telling my mom and she's like do it. I'm like it's weird, it's in DC and I don't know, it's human medicine, I don't like it. And she's like do it. I said okay, and I get on the phone and it is two wonderful interpreter women who went to school for interpreting. And this is Spanish English interpreting. I'm bilingual in Spanish and English and they're they're literally just like drilling me. They're like all right, we're going to have a conversation. I'm the doctor, she's the patient and you are the interpreter. Go and I'm like so I ran through all of that and like okay, thank you, we hang up. And then what, not too long later they called me back, like okay, you got it.
Ashley:So I was like well, I'm going to BC for the summer. Here on shadow me next, we have a segment called quality questions, which is where we discuss some of the most memorable interview questions with these amazing leaders in healthcare. Keep in mind that there's more interview prep, such as mock interviews and personal statement review, over on shadow me nextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions. Dr Grado and I did not discuss a quality question. However, her experience with the National Institute of Health brings up a perfect example. A lot of times during an interview, an interviewer will ask you tell me about a meaningful experience that you have had that has led you to your interest in medicine, and this is a perfect example. This was an internship that Dr Greedo took and will explain that actually ended up changing her path from veterinarian to physician. These experiences, I understand, can be really hard to come by, but if you keep your eyes open and your heart willing, then sometimes these experiences might just offer you the same opportunity.
Dr. Garrido :In my mind I was still going to be a veterinarian. So I went to the National Institutes of Health that summer it was in 2015 and I spent two months interpreting for them, and that is where I felt that calling to be a physician.
Dr. Garrido :So I'm a Christian and I went there and I was, you know, wow, this is weird. I'm going for human medicine, but I've always wanted to be a veterinarian. Is this those conversations my mom and I used to have about? Hmm should, do you really want to be that? And while I was there, you know, I did lots of pondering, I mean lots of praying, of course, and I felt a huge, like weight of this. This is what you have to do. And while I was there, I told them hey, I, I'd like to see kids, I'd like to interpret for families with kids and they would give me lots of families with kids.
Dr. Garrido :And it was just mind blowing, wow, the difference that the NIH made in those families of bringing people.
Dr. Garrido :I mean, these are people with diseases that are incurable, diseases that you'd never heard of, and they come to the National Institutes of Health from all over the world. As an interpreter, I was providing them the ability to receive care in a language they understood, without like, like they were just able to receive care as if they were home. And the mission that the NIH had of bringing these kiddos and well, all families from all over the world and providing care for them interdisciplinary work. So you had physicians, physician assistants, nurse practitioners, RNs, and you had interpreters. You have medical students, you have fellows, geneticists, just plain PhD researchers coming together to work on one family. And family would get care, from dental care to physical rehab to genetics conversations, and they would spend a week or months, depending on the trial that they were there, just receiving care for free to figure out what they had and how we could develop treatments for these patients. And I was like this is it? I was like this.
Ashley:This is it. That's amazing. What an incredible story. First of all, I just want to highlight the power of your mother and her voice, because you know, we all need voices like that in our lives, voices that support us literally no matter what, but that also challenge us to see perhaps another angle and to see other things. And we might write them off, like you said earlier, we might just listen to them, because they are our mother, but at some point, I think the Lord just opens up a door for us and we recognize what's in that door because of some things that somebody, one of our mentors, one of our loved ones, has said to us in the past. And you know, I believe in speaking truth over people, even before they realize it is their truth. And that's like literally what you are just describing, which thank you.
Ashley:I'm so glad you're in human medicine. Veterinary medicine is incredible and I think it probably has set you up to be the most compassionate communicative pediatrician, because I go to my vet's office and they are amazing. I leave there feeling so motivated to be a better clinician and to be more sympathetic to my patients because they just sit on the floor with my dog who's so nervous and they just love him and they're offering medical care. They are, but they're offering comfort first. And my dog who's so nervous? And they just love him and they're offering medical care. They are, but they're offering comfort first. Yes, and I think that's so important, especially for you, especially working with pediatric patients, but you are also working with their parents, right, very intimately, very intimately. So, so thank you to your mother. And what an incredible opportunity.
Ashley:The NIH. I'm going to include something about that in the show notes because I think that is such an interesting outlet for some people that maybe might be interested in doing something similar. Not necessarily that, but you know there are opportunities out there to really help exactly where you are, and it can be life-changing, as it was for you. Let's get back to being a veterinary technician, because this is the first time I've heard of somebody who started off pre-vet and then shifted an entire species to humans, which I think has been so good. But your path to medicine? So you mentioned a couple of things a clinical technician, a veterinary technician, which is animals, and then a medical interpreter also. We've known how that has led you to medicine. But are those things, those historical things, still impacting the way that you practice right now.
Dr. Garrido :Yeah, absolutely. It's funny I mean you touched on it already with going to your veterinarian's hospital, to the veterinarian business. I would say it's kind of like one of my first building stones patient care, but also customer care because in veterinary medicine we are making sure that, one, the pet, which is our patient, is comfortable. And because they're scared, they don't know what you're doing, they're like who are you? You're a stranger. The caregiver, which is a parent, also feels comfortable and, like you, care for their pet and like you know what you're doing. And three, they don't speak to you. So you know a lot of our pediatric patients. They're obviously on the younger ones.
Dr. Garrido :You have to treat symptoms really often and you have to be a detective on what is happening and you have to rely on the parent and caregiver history to piece together your puzzle, to see okay, well, one, what are they telling me? Two, what does that mean? Three, like, how am I going to treat or what am I going to do about it? Am I going to treat it as something treatable? Also, again, you're mostly interacting with the caregiver and with the parent and I did learn a lot of customer care and you know dealing with people.
Dr. Garrido :You know we're not the easiest. You kind of have to die to yourself a little bit and you know that pride has to go down. And so, excuse me, you like I learned to to as the years pass. This is something you learn with time to be a listener and my background in veterinary being a veterinary assistant they're you know. They know best. They're with their child 24-7. When they come in and say I don't know they're not walking right, the walk may look insignificant to you but it's not to them. So you have to listen to them and you have to take everything they say as something serious. And so I did start to learn. Like that kind of gave me a building block on listening.
Ashley:Which is it's something that's so. It seems so elementary. Of course we listen to our patients, but I think the more we practice and I'm so glad you mentioned kind of that dying to self, that humility, because it is a morning reminder every single day that we've already started thinking about when we see the patient description on the computer when they arrive, put all of those aside and listen first, listen first. I love in PA school they tell you to give the patient their five minutes of fame. So they say, right, you just listen for five minutes. A lot of patients want more than five minutes and a lot of patients need five minutes or longer. But but you know we have to be reminded to listen. So I'm so glad you brought that up. And I think that veterinary medicine because your animals, unless you're interacting with a very cool parrot, they're not going to talk to you. I think that is so cool and I think it's such an incredible introduction to patient care and how to interact with others. So I think that is so cool.
Ashley:Now let's go back to medical school. So you went to DA school and you briefly explained a little bit about that Overall big overarching theme. How was medical school for you? Was it a walk in the park after you'd taken all those science classes? Was it still pretty challenging?
Dr. Garrido :Yeah, it was the most challenging educational experience I've ever had in my life. It was really tough. And so, also to get to medical school, I ended up doing a master's program. So my medical school offered that master's program for pre-med students who hadn't gone into med school initially or wanted a gap break to see if this is what they actually wanted. So I did that program which gave me guaranteed acceptance to medical school. Now that was like a nine month like fast paced learn all the sciences. But it was such a good building stone for me because I had, by that point I had been out of college for two years and honestly, my study habits were not very good Like high school and college. Like I was very. It was easy for me to learn and get through but I wasn't very applied. And so going through this master's program made me meet people who already had really good study habits and it kind of just gave me that building block on how I needed to study for medical school.
Dr. Garrido :Medical school was still hard, like it was still hard, but I knew what to do. I came in with a good knowledge Like I had my anatomies down, I had a lot of immunology sciences down and histology, kind of embryology, like basic sciences down, that were super helpful. But I think that the hours that you have to put into medical school, the amount of time you have to put into studying and the amount of time you kind of have to again die to yourself because you're giving up your twenties to study and you are in school most of the time. It's lectures, exam labs, go home and study Lectures, exam labs, go home and study. Four, four years, well, two years of just didactics but just classroom learning. Those were really tough, and then two years of clinical learning, which I liked much better. It was a sigh of relief for myself once I got into those clinical years.
Ashley:Yeah, I mean as a people person. It makes sense too. At that point you're starting to apply that knowledge that you've worked so hard to learn over the last two years and you really start to see the finish line. At that point I mean it's still very far away, but you do see the finish line At least you're using your knowledge to improve the lives of others and it does help. There's still a lot to do, but it does help. So at that point you graduate from medical school and from DO school and you have obviously been interested in pediatrics from the beginning. You apply for a pediatric residency. Is that how that works?
Dr. Garrido :next, apply for a pediatric residency. Is that how that works next? Well, another plot twist, because while I was in medical school I went in initially like okay, I like kids, I'm going to be pediatrician. But while I was preparing to go to medical school, I was working. I worked in an operating room. I really did like that. As a veterinary technician.
Dr. Garrido :Before all of this, I got to do a lot of hands-on work and I liked using my hands. I was like I like surgery, I like fast-paced, I like the hospital. I don't want to be in a nine to five, I don't want to be clinic. So I went into medical school, kind of just like with the uh, I'm open. Through medical school I started to think like, well, I like surgery, but I would only do it with kids. And then I had a long period of time where I was like, well, I like emergency medicine, but with kids, and I just wanted to do the fast-paced, the hard, the hands-on, immediate gratification.
Dr. Garrido :And by my fourth year I thought I was going to apply to surgery and I really thought about it. So surgery is a five year specialty. So a five year residency, that's general surgery. And then you have to apply an extra for an extra two years after that to do pediatrics if you want to do kids, and so it would be seven years at least for pediatrics, you need research in the middle. So you know, a gap year plus two years kind of. It works kind of that way and I was like I didn't have the best grades, which honestly I'm thankful for. Now. It's given me a lot of humility and I struggled through medical school. I have so much, you know, compassion for people who are struggling too, and I applied, I got an audition so for in your third and in your fourth year of medical school, once you start applying you have to go through this system similar to your medical school application page, and you go through the system and you apply to the specialties that you want and to the programs that you want. But a big thing is doing audition rotations where you go in person and you act as an intern kind of and if you similar um, and you basically do a life as a resident for a month and, and so I didn't do many of those and I had one set up for surgery and like pretty much about a week into it with talking with one advisor I did our school did like mock interviews for us, and I was doing one mock interview for surgery. It went fine. But looking at my scores, my medical school grades and my actual desire to just be a pediatric surgeon, I ended up deciding no, that's not going to work. And so I ended up only applying for pediatrics. And so I ended up only applying for pediatrics and so I put in a bunch of applications for pediatrics and I didn't get in.
Dr. Garrido :By the end of all of this application system, my anxiety was off the roof pretty much every medical student because you feel like, oh my gosh, if I don't get a residency, my life is over. I have debts, crazy debts, and I have nothing to do with this degree because you really don't in the United States. You have nothing to do with your degree. And so I freaked out. When it got to what we call match week, which is at the end of the application cycle in the spring. Everybody gets a letter that says hey, you got in somewhere or you did not get in anywhere. And I got the letter or the email that said I didn't get in anywhere. That was extremely devastating. That day I spent that match week doing back-to-back kind of like like.
Dr. Garrido :What is it like rapid fire interviews with programs that hadn't filled all of their spots, and so I basically, the same way you apply initially, you apply for what this is called.
Dr. Garrido :This is the SOAP, so Supplemental Offer of Acceptance Process or Program, not sure.
Dr. Garrido :And I did this week of where I applied to all of the open pediatric specialties and I applied to some family medicine specialties because my advisors told me to I was not interested in that but I want a job, right, and I did all of that I had.
Dr. Garrido :I don't even know like I had a lot of interviews within four days where you just get hey, you get a phone call from a program director, hey, we're interested in you, our program needs a couple of spots to fill. Can we talk at 1 PM? And it's like you know noon or something, and you're like, oh my gosh, so you have zoom interviews, you have phone calls it's cold calls, everybody's calling you so for three days. And then on at the end of those three days, I got a, I got offers. So you get offers from the place. That that's. It's kind of like the same process, just condensed. Speed dating, yeah, Totally speed dating with prospective programs. And so I got multiple offers. I got some family medicine offers and I got some pediatric offers and of course that's when I chose out of the few pediatric ones where I am.
Ashley:I am so grateful that you shared that experience this is a story for a lot of people and it is terrifying.
Dr. Garrido :It's terrifying.
Ashley:And last episode, I just spoke to a man who works with students a little bit of a different thing, but works with PA students who have failed their board exam. So they went, they went through two years of school. They have to pass this board exam in order to use their degree and they have failed and they have failed, and they have failed and they're on their fourth failure and they're panicking because, like you said, you have debt and you have dreams I forget about. And they're panicking Because, like you said, you have debt and you have dreams. I mean, forget about debt for a second. You have dreams, and it's hard.
Ashley:And hearing these success stories and you are in this incredible position right now, despite all those challenges and perhaps because of those challenges oh, it's just so great. So thank you for sharing that, because I know that's going to resonate with people deeply. It resonates with me deeply. Tell us about a day in your life. Now you have arrived, you are fulfilling your dream, you're working with your patients and their caregivers. I'm sure every day it is exactly what you want to do, but I'm also sure that there are challenges. So walk us through a day in your life as a resident physician, walk us through a day in your life as a resident physician.
Dr. Garrido :So a day in my life depends on which rotation I am in. So in residency, depending the residency that you're in. But because there are so many subspecialties with every medical specialty, residency is like a general let's get you prepared for everything and kind of, you know, get you prepared for everything that you may want to do. But we need to make you a good general practitioner as well. And so, depending on the rotation that I am, um, my day, my day, varies. For example, I talked to you about, like my roughest rotation. That's when I'm in the hospital. So when I'm in the hospital we just do the general pediatric service and this is just like, hey, when kiddos are sick, they go to the hospital. It could be anything as simple as just a really rough cold, they've got the flu, they have to be in the hospital, or RSV for babies and or something you know as complicated as hey, car crash completely you know, kiddo, all of these things, and we see that spectrum of patients from super healthy to really critical condition.
Dr. Garrido :So in the general pediatric hospital floor my day starts at 545, 550 am and we work 12 hour days 5, 45, 5, 50 AM and we work 12 hour days and so I am there until six, six thirties, which ends up being 13, 14 hours, right, and we do this for five to six days at a time and when we're in that hospital and that's that month. So I basically I mean I snooze to the end. Oh my gosh, I'll go to bed, grab my coffee and get to work. When we get to work, the practice is to sign out. So the hospital has coverage 24 seven. So we have the night residents who are there taking care of the patients overnight, and you have the day residents. If you are in the day team, you get in right before 6am.
Dr. Garrido :At 6am sharp we start signed out and the sign out is just a brief kind of just who the patients are one by one and what happened during that shift or significant events that happened during that shift and what needs to be done during the coming shift. So we talk about that. That takes about, depending how busy the services between you know, 15 minutes to an hour, it just depends how busy the services. And after sign out is done, then we have teams. So you have senior residents, usually one senior per team, one senior resident, one or two interns, so that's your first year residents, and you may have what we call off services, so residents from family medicine or emergency medicine that have to do the rotations with us, and you may or may not have med students with you rotating. So the senior resident which is the second year or the third year resident, leads that team, divide all my patients up and say, okay, you're seeing these patients, these patients, divide them up between the team and then you sit down and start reviewing all of your patients, who they are, what is happening, what do we need to do? Because you're a physician, right? Your job is to make the decisions and call the actions.
Dr. Garrido :So this is the time when you're preparing yourself for meeting with your attending, which is, you know, your head doctor for the team. So during all that time I'm taking care of learning the patients, but I'm also answering phone calls from the nurses and, you know, running to each room to see what's happening if there's an issue, right. So it's a really hectic time but it can also be a really calm time, it just depends on the day. But that's that morning part. And then at around nine o'clock generally, you meet with your attending and you go see all of the patients again.
Dr. Garrido :So between 6 30 to 9 AM you have to review all of your patients, decide what you're going to do with them, prep all of those things, answer phone calls, you know, send prescriptions that weren't sent right, go see all of those patients that you just reviewed, listen to them and do a physical exam, listen to the parents, because that's very important, and then be ready for your attending. And at 9 am we meet our attending and we do the same thing again. We just go one by one, each of the patients on our list, see them, present them to our attending, so tell them what the patient is and what we want to do with them.
Dr. Garrido :Your attending may or may not do some teaching, depending on the day. I love it when they do do teaching, because that's what I'm here for, right. I'm here to learn, and I really do love it when they take their time to teach us. And then you go inside you see your patient. The attending says, okay, I like your plan, or actually that plan. I think that we should do something different today. And you move on to the next one and you do that until lunchtime and then around 12 or one we don't have scheduled lunchtimes because we're in medicine, healthcare providers usually don't and you just have to go. So we are really good about just like making sure we go grab lunch, but we usually bring it back to our workstations and just write our notes. So you have to sit down and kind of just document the events of the day for each patient. You're still answering phone calls from orders and nurses, but you're also receiving patients that are being admitted through that day. So the rest of the afternoon is just paperwork, phone calls and rechecking on patients that you need to check on and admitting new patients, and that's kind of just divided between you know the whole team. It's quite the long day.
Dr. Garrido :On those hospital days Now, depending on our year, first year you have five maybe hospital months which are different specialties. You do some nights. If it's nights you kind of do the same thing but you don't meet with your attending. We rotate through the neonatal intensive care unit. Those are really long days too. Those are 12 hour days, really similar to what I just explained. We rotate through also outpatient emergency medicine. So the emergency room it's a little less structured just because of the nature of the emergency room. And then we do outpatient rotations.
Dr. Garrido :So we have clinic. Clinic days are just general outpatient, you're. You know, 845 to 5 PM. You see patients for their general yearly well child checks or some kiddos who've got the sniffles or viral infections. You see them, we see those and we talk to our attendings who are overseeing everything we do. And then we also have specialties or electives. So our electives are the best ones. We call some of them like our vacations, because you're not expected to know the ins and outs of a medical specialty, of people who have done fellowship. So you are genuinely there to learn. So they're, they basically treat you as they're like hey, come here You're my apprentice and they bring you with them and you do their work hours, whatever their work hours are, and you do either a lot of shadowing or a lot of just like a history and physicals, and then you present to your attending and then they tell you what they're gonna do and you take that time for learning. So it varies a lot.
Ashley:No, I'm so glad you were so comprehensive with that, because I think people think pediatric residency or just in clinic all day. You are literally learning every element of pediatrics Whether that's gonna end up being what you choose to do after residency which I know that there are certain fellowships that you can go and do after this and further specialize, depending on like we joked about earlier, depending on if you want to make education a career at that point. Right, I mean, how long do you want to be in school? But your education is so comprehensive and everything that you are doing is so involved and so varied. This is a hard subject to talk about in any element of medicine, but I can't imagine not getting burned out and not getting worn down and worn out at the end of those 14 to 16 hour days, five to six days a week. What tell me about that? What does that feel like for you?
Dr. Garrido :Tired it is. It is very tiring and I'm going to tell you this like pediatrics is one of the specialties that has a better work-life balance. Not every specialty does that, but burnout is real. We do have a lot of like. I guess for me, like I see it, a lot in irritability, and not just myself.
Dr. Garrido :But a big sign of burnout for a lot of medical professionals and residents is irritability, cynicism and you start to have lack of interest, so things that used to give you passion. You just don't care anymore. And you know sometimes your patients come in and every patient is different, but you may have seen 15 patients with the same complaint that you. You know your last one is coming in and, because you've been there for five days, today is day six of 12 hours. Now you're seeing this one patient with the same thing Again.
Dr. Garrido :The parents are even more worried and they're upset because their child hasn't been taken care of in the amount of time that they wanted them to be taken care of, just doing all the things at once and you start to get cynical and you start to get irritable and I don't think that that's conducive to patient care. I really, really hate that and so I see that a lot in myself. I try and do my best not to be irritable with my patients Like you go in and it's a fresh patient you've seen for five hours and you go in with the same smile because they don't know that you just saw that 5 million times before. But I see that in myself. You have a lot of anxiety and your anxiety gets worse, lots of worry, and that can cloud your judgment.
Dr. Garrido :So you can see judgment clouding as well, and we have decision fatigue, and so toward everything a physician does is to make decisions.
Dr. Garrido :So you're making decisions, you have the final say. So everybody's going to you to make a decision, and it can be. You know, hey, can I give this patient Tylenol? But you're so tired that you're sitting there like who is this patient? Why don't they have Tylenol on? Do they have a reason for me not to give Tylenol? Those are things you have to think through, as simple as Tylenol may sound, but you were so tired that sometimes you don't want to think about it. And that's a simple decision. What if you have a patient that comes in with a surgical issue that you have to talk to? Surgery Burnout can lead you to not think properly on how to take care of this patient. Well, I think it's something that's scary and that really needs to be worked on in all fields of medical training and the severity of the specialty, the severity of burnout increases and the risk associated with your burnout increases.
Ashley:I think that is so hard, and cynicism in medicine is not fun. Patients can read, they read that. They see that they feel that Not being patient with your patients is a big one too. We've spoken with a lot of guests on the show who have experienced this. This is not rare. This is not just in residency, this is throughout medicine. You know, and we develop ways to overcome this. And tell me about some of the things that you do. When you're feeling anxiety setting in, when you're feeling cynicism setting in, how do you take that breath and how do you get clarity?
Dr. Garrido :I'm going to be really transparent. In medical school toward the end, I was getting really burned out. I was having a lot of anxiety over my board exams. I take medication, so I take an SSRI for my anxiety, but I also did therapy while I was in medical school. So I did both in combination, which is also proven by research that the best way to handle any you know anxiety or depression or is in combination pharmaceutical and therapy. And so I went to therapy.
Dr. Garrido :I learned a lot about looking into myself and learned about how to not just understand where this anxiety is coming from, but also how to deal with it day to day. What are you going to do Knowing? Yeah, I know where my anxiety comes from. But what if I'm right here in front of my patient and I'm anxious, like, what am I going to do right now? Right, and I learned a lot of breathing exercises, grounding yourself. I don't do them in front of my patients all the time, but those are things.
Dr. Garrido :Taking breaks was a big one, even if it's a literal one minute or 30 second break, because that's all you have. It's a 30 second break to sit down and do what you know, what's called like a breath prayer or you know where you just say, okay, I understand this is hard, but I can do it. Or you just come up with your own, and these breath prayers are really important. I think that that's been a big key. Yes, my pharmaceutical therapy has been incredibly helpful.
Dr. Garrido :I was on the scale of anxiety where I was having the thoughts of you know doom, like something terrible, and initiating you know pharmaceutical therapy for that has really helped me do like a reset. That's kind of what I call it Amazing. But having the skills from therapy have helped me stay able, like stay calm or cope with when I'm feeling anxious and so, like I mentioned, just taking a minute, stopping what I'm doing. You can set a timer if you want to, because I've done that before and no nothing. Sit down and breathe for the five seconds or 10 seconds, and sure, it's not the most ideal and it's not going to fix all your problems, but it's going to help you get the next thing done.
Ashley:Exactly, that's exactly right, and thank you for that transparency, because so often people expect our physicians to be super women and superhero men, and we are also still human and unfortunately, as a pediatric physician you mentioned, you know feelings of doom. Sometimes there is doom in the next room for you, you know, and in order to manage that, you have to take care of yourself, and this is just. This is not just for medical providers, this is for humans in general. We have got to take care of ourselves and we've got to pour in to our own health and to our own physical health, mental health, emotional health and we also have to recognize when they're becoming unhealthy, which is a lot of therapy. A lot of therapy is identifying things that are going to negatively affect our health, and not just mental health. So I'm so glad you brought that up, because this is something a lot of physicians struggle with. This is something a lot of PAs, nps all of them struggle with.
Ashley:I think that's so important. We would all really Burnout, would be far less if we could take a six-week vacation to oh, I don't know Provence, france, and wine and dine our way down you know the beautiful coast. But we can't. We'll do our 30 minute breath prayers and that will get us there, and we'll just watch YouTube videos of Provence, france.
Ashley:Oh, dr Greedo, I you have just given so much insight in this conversation and, I think, really have shown that you can be desperately passionate about what you do and also recognize that it is very hard and that you are working impossibly hard some days, but there's an end goal that is bigger than you and me and the hospital that you're working for or the practice that you're working for, and that end goal is other people and improving their lives. What would you say to a person who might be interested in medicine and they hear these stories about burnout, about the challenges, about the risks, about maybe not getting accepted to the program you want or maybe not passing your board exams. What would you tell them on the other side of all of this, where you're at right now?
Dr. Garrido :Yeah, it is difficult for sure, but I think that it's worth it At least in my experience. It's worth it. It's worth the experience that's worth it. It's worth the like. Make sure you don't lose that core of why you're, why you went into medicine, and it's people. It's taking care of people, providing health for them, even just teaching people about health and about taking care of themselves and giving health literacy, but just helping them navigate their health, their bodies, and helping them get better when they don't feel well.
Dr. Garrido :I think that I like research, so for me, I think that also really important and like a big thing in medicine that I really do love and I keep going forward is new breakthroughs in medicine and ways to treat diseases or challenges that we just don't have treatments for yet.
Dr. Garrido :But if you are interested ins in medicine and ways to treat diseases or challenges that we just don't have treatments for yet, but if you are interested in going in medicine, make sure that that's the only thing you want to do, that's the only thing that you are going to be happy doing, and really look into yourself and say, well, if you would rather do something else, try that something else first, because if not, you're always going to think well, what if? What if? And you may end up not completing your training because it is very hard and it is very difficult to do. It's going to be the most challenging years of your life to get through this training. You are going to be beat down not just by patients, but also by preceptors. You have to have enough of a desire to be a physician, but also a really good support system to get through this. Make sure this is the only thing you want to do to make sure you have a good support system to get you through this. This is something you shouldn't do alone.
Ashley:And that is exactly our goal here at Shadow Me Next and why I am so grateful for you, dr Gr, and the challenges that have brought you here is just invaluable to students who might be looking for that, or even for patients who are thinking you know, I want to get to know my healthcare provider a little bit better.
Ashley:I want to know why my clinician is doing what they are doing, because that's important to me as a patient to understand where they're coming from. So I think that that is so great and I'm so glad for shadow me next, for you guys joining us and sharing your stories. I mean, it's it doesn't get any better than this. Thank you so much for taking the time. I want to go back in time and be a pediatric patient and jump on your schedule, because I just think you bring so much joy and light into what you do and I know your patients love it. But, more importantly, I know their caregivers feel the support that they are experiencing in the room with you. So thank you for what you do for us at Shadow Me Next, for pre-health students by sharing your story, but more importantly, for the field of medicine. It is wonderful.
Dr. Garrido :It is. It is a wonderful field.
Ashley:Thank you so much, absolutely Thank you. Thank you so very much for listening to this episode of Shadow Me Next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram Access. You want stories you need. You're always invited to Shadow Me Next.
