How to survive intern year of residency: The basics

This post will give you some tips on how to better meet your basic needs of food, water, warmth, and rest so you can survive intern year.

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What if you’ve started intern year in a residency program, and you’ve realized that you’re one of the unlucky few who have matched into a tough residency?  

OK, let’s be real:  there are no easy residency programs.  There is more work to be done than there are hands available to do it.  This is especially true for surgery programs, which by design usually match fewer residents than medicine training programs.

When I think back to my general surgery intern year, it was challenging to even meet basic human physiological needs.  This post will give you some tips on how to better meet your basic needs of food, water, warmth, and rest during intern year.

Since I’m a surgeon, these tips will have a bit of surgical flavor to them.  But much of what I write will be universal to all types of medical training programs.

Maslow’s Basic Needs

As Maslow outlined in his “Hierarchy of Needs,” there are four basic needs to keep your body running smoothly: food, water, warmth, and rest.  These basic needs must be met first before you can focus on any other needs.  So let’s leave aside other higher needs such as safety, belonging, and self-esteem.  Don’t even get me started on self-actualization. Maybe you can self-actualize in your chief year.

But in intern year, it’s all about trying to learn as much as possible, while still meeting these basic needs.  Let’s take them one by one.

Food

There’s a saying in surgery residency:  “Eat when you can. Sleep when you can.”  This is a golden rule of how to survive intern year.

Basically the message here is to take advantage of any opportunities to eat and sleep.  

It’s important to take advantage of time after morning rounds and between consults to hit the cafeteria for some chow.  If your residency program gives you a food allowance, make sure to use every penny of it. If it’s a generous allowance, use the remainder to take snacks back to the call room.  Store snacks in your overnight bag or hide them in a drawer, because at 2AM when you’re starving and the cafeteria’s closed, they’ll come in handy.  

On a diet?  Don’t beat yourself up if you can’t keep strictly to your diet during intern year.  Sleep deprivation, midnight munchies, and the constant cortisol flood from stress will all make weight gain likely.  There’ll be time for diets and Crossfit during your research year, don’t worry!

Water

Hydration is very important.  After all, you can’t be an efficient rounder if you are sidelined by kidney stones!  But to survive intern year, I recommend selective hydration.  

For example, perhaps it’s not the best idea to over-hydrate before going to retract in a liver transplant or retro-peritoneal lymph node dissection.  Both of these cases can take over twelve hours. And if your attending doesn’t take a bio-break, you can’t either. So that full bladder isn’t going to do you any favors.

It’s a fairly common practice to limit fluids before a big case, and then bolus some water afterwards to catch back up.  And don’t forget to pee before a big case, even if you’re running late! Trust me.

While on the topic of hydration, let’s touch on two very special drinks that will also help sustain you during intern year. 

Coffee

This might be more essential to intern year than even water.  Personally, I’d start off my day by chugging a large cup of coffee with ice cubes mixed in to cool the brew.  That would hold me until around lunchtime, when I’d drink another large cup to fend off the mid-afternoon slump.  Finally, I’d have a cup before my drive home so I was less likely to rear end someone on the highway or side-swipe parked cars on the street.

If it was an overnight call day, all bets were off.  The coffee would flow like beer during a game of med school flip cup.

Coffee’s actually really good for you, so don’t feel guilty. Read about my research on its health benefits.

Alcohol

While most of the time during the week you’ll likely be too tired to enjoy a glass of wine over dinner, drinking with you co-interns during your time off is important to your intern year as well.  These are the people you’ll be relying on in life or death situations during the next 5-6 years of your life. You’ll likely spend more time with your co-residents during your training than your spouse or even your children.  It behooves you to befriend them.

While alcohol certainly isn’t a necessity, it does act as a shortcut. It quickly breaks down the walls of social convention and creates a (perhaps false) sense of camaraderie.

These social bonds really help smooth over stressful situations and help nurture the team mentality that’s so essential to making intern year tolerable.

Warmth and Rest

The two last basic needs to survive intern year are warmth and rest.

Remember the saying, “Eat when you can, sleep when you can?”  It’s good advice. Because before you know it, the pager will ring, bringing with it the next ER consult or inpatient floor disaster.  And that half hour that you spent blearily thumbing through Facebook on your phone will be gone, never to return. You could have been taking a refreshing cat nap instead.

While a comfy bed at home is somewhat of a given, the quality of your call room could leave much to be desired.  From personal experience, your call room probably has a lumpy, saggy bed and is overly air conditioned. It’s probably right next to the elevator bank or doors that slam all night long.  And maybe the blinds are broken and you can’t make the room dark enough to try to nap.

I survived these conditions by taking an overnight bag with a few extras packed along with my toiletries:  a sleep mask, ear plugs, and a plush travel blanket.  

If all you’ve got are a precious few hours to grab sleep before you’ve got to print out those rounding lists, you’d better make them count.

So put on that sleep mask, set the pager to vibrate, and stick in those ear plugs.  

Check out the links below for a curated on-call care package. Yes, these are affiliate links that cost you nothing to use!

Conclusion

If I’m making intern year sound horrible and crazy, perhaps I’m exaggerating.  But I’m not exaggerating much. For many, it’ll be one of the most challenging experiences of your life. It can feel challenging at times just to survive intern year!

Hopefully you can use these tips to meet your basic human needs for food, water, warmth, and rest.

Don’t worry! You may feel like you’ve bitten off more than you can chew, but you can and will get through this.  You’ll be fine.

But if you’re not fine, there are alternative paths that we will explore more fully in later posts.

–TDD

Overnight call care package

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