Yesterday, I performed my third circumcision, this time under the direction of my senior resident (my first was supervised by the Attending and a senior who served as my assistant but who had to help after the adhesions I broke turned out to be between the prepuce and the mucosal layer; the second was supervised by the Attending who had to glove up to make my cut a bit longer). This time, I required no extra hands to help; the senior just stood at the ready and offered feedback. My adhesion-breaking technique is getting better and I’m a little more dexterous with the tools but ever since I saw an Attending perform a practically bloodless procedure in less than 15 mins during which the patient peacefully sucked away on sucrose and made nary a complaint, I’ve been on a quest to perform the perfect circ. (more…)
Archive for the ‘pediatrics’ category
Note – this post was originally created on October 1st but you know, residency.
Residency is no joke! Just when you think you’ve reached some understanding or gained some competency, you’re thrust into a new situation that makes you realize just how little you know. The challenge is handling those situations as if you do know what you’re doing because even though you aren’t realistically expected to know it all (at least, not by one’s senior residents or attendings), you are expected to be on top of things. On inpatient teams blocks (‘teams’ or ‘days’), you are assigned to a max of 8 patients for the duration of their hospital stay (the average pediatric inpatient stay is 2 days but can vary wildly from 1 to 21 or more) and for these patients (and their families), you are their primary physician. The expectations are as high as the turnover rate and while there is the occasional laugh to be had, there were some tense moments, some strange standoffs and (for a crybaby like me), some tears shed.
Question for all the new docs on the block: have you ever had that awkward moment when you meet an attending who introduces him/herself saying “Hi, I’m Dr. So-and-so” and you’re unsure of how to respond? Replying with my title almost seems as ridiculous as it would if a five-year-old introduced himself as “Mr.” Usually I end up introducing myself as “Crys, one of the residents” to peers (accompanied by a giant grin and a little lilt in my voice because I still can’t believe how awesome it is to finally be a resident) and as Dr. B to patients. I certainly don’t want to be one of those people who is so enamored of their M.D. that they can’t resist letting everyone know about it (my mom does that enough for me) Has anyone else had this dilemma?
I don’t know how I could have thought that I’d have more time for writing as a resident than I did as a med student. I did have a post written for July but in the midst of a pretty intense first block and settling into my new city, I never had a chance to publish it (that will soon be remedied). However, I now have an opportunity to introduce the next series of 医者の卵: The Residency Chronicles! Read all about the trials and travails of a pediatric resident – all the awesomeness, all the zaniness and everything in between. Hopefully, I’ll be able to update at least once per block. I hope these humble ramblings are amusing, if not informative and interesting. As always, thanks for reading!
My official start date as an intern at the Children’s Medical Center of [Midwestern City] isn’t until July 3rd but orientation begins on June 18th (two days before the big 3-0!) and time is rapidly pushing me toward the day when I must leave my beloved Queens and move to the midwest. In advance of orientation, I’ve already been given my PALS and NRP materials to study/complete and I’m working my way through the Harriet Lane Handbook so that I don’t seem like an idiot on my first day. We’ve been given our schedules for the first year of residency, which is broken into 13 four-week blocks beginning on July 3rd. I’ll have to be on my toes right out of the gate – my first block is heme/onc.