HealthFebruary 12, 2020

How to avoid these four common medical resident mistakes

By: Marilyn Chau, MD
Some medical resident mistakes are inevitable, but you can be prepared beforehand. Here are four common mistakes and how to avoid them.

The transition from medical student to resident physician is a dramatic one. When you’re a student, your mistakes have relatively little impact on patients, but when you become a resident, they can have significant consequences for the patient as well as the doctor you’re working with.

Missteps are inevitable, but you can try to avoid making some that come up often. Here are four common medical resident mistakes to watch out for.

1. Overthinking a nonessential decision

As a new doctor, you suddenly feel the weight of every decision you make when you start to sign orders for the first time. While double-checking is a good habit for anyone regardless of of their career stage, it can become something of a trap for fresh residents. An important lesson you can learn from more seasoned residents is that not all medical decisions should be weighed equally. Your workload will often demand more time than you know how to find, and devoting too much of that time to nonessential decisions can set you up for early burnout.

A co-resident of mine was recently laughing about his first night on call as a new intern. He had spent 20 minutes looking into if Tylenol or an NSAID would be a better option for headache relief for a patient during a night call shift. While there are some situations when this decision would truly be an important one, questions like this should not, for the most part, be the ones you’re stressing over at 11 p.m.

Taking a moment to stop and consider what impact (or lack thereof) a decision will have on a patient will help avoid unnecessary stress.

2. Not using your hospital’s resources

With the huge amount of responsibility you’ve been granted, it’s easy to feel like you need to demonstrate your abilities by doing everything yourself. However, residency is meant in part to be a training experience. You’re not supposed to start it knowing everything.

A turning point in my own intern year was when I realized how valuable a resource my unit’s pharmacist was. While I can’t speak for all hospitals, many facilities with residents have pharmacy staff that are more than willing to answer questions and provide advice. Looking up drugs and reactions on your own is important too, but being humble enough to reach out to your pharmacy staff for help will likely save you time and energy. You should learn from the experts.

3. Not advocating for your patient

When you’re a resident, you’re at the bottom of the totem pole, so you’re usually operating under the assumption that your attending’s word is gold. But you should realize that just like everyone else, attending physicians can sometimes be wrong. Not questioning your attending’s stance is an easy mistake to make, but you also need to recognize that the best way for you to learn is by asking questions frequently throughout your training.

If you feel that your attending’s decision is wrong, you should be bold enough to present your questions to them. Think of yourself as someone who is there simply to learn as much as possible rather than as the lowest-ranking member of the physician team. If you focus on learning, you and your patients will benefit.

Even if you disagree with the ultimate decision made by an attending regarding a situation, having been bold enough to ask “Why?” or “Why not?” will help you in your learning process.

4. Not allowing yourself to feel your emotions

Even though you might be at the bottom of the ladder, your title of “Doctor” still puts you in a position of authority when it comes to other members of the healthcare team. The weight of this authority combined with the stresses of your new role can make it tempting to ignore your feelings.

As a new resident, I found myself making the mistake of telling myself I needed to stay strong and detached during emotionally exhausting times. This might have helped me when it came to emotional burnout, but it prevented me from making connections with my patients and their families. You need to acknowledge your emotions and let yourself feel when appropriate, as this can help to break down barriers between people. I’m more grateful for the times that I’ve allowed myself to cry with a patient’s family than for the times that I “stood strong.”

As a resident, you’ll make mistakes, but with luck, they won’t have drastic negative impacts on your patients or yourself. Most will be learning opportunities more so than legal problems, so give yourself grace to grow as a physician by learning from your medical resident mistakes and experiences, and listening to the advice of your colleagues who have gone ahead of you.

Marilyn Chau, MD
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