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In this 149th episode I discuss common challenges to the transition from intern year to CA1 year including some of why it’s difficult, the mistakes commonly made, the causes of those mistakes and some suggested solutions. Although I focus on the intern to CA1 transition, much of this applies to any major transition in life.
CME: https://earnc.me/YHvb9n
I really did not enjoy my [internal medicine] intern year. Though this was admittedly and regrettably not the best mindset at the time, as I stood on never-endings rounds or completed yet another “social” admission, all I kept telling myself was “This is not what I want to be doing with my life.” However, it provided a useful contrast during CA1 year, because whenever I found myself facing challenges or frustrations, I could at least remind myself that these are EXACTLY the challenges I wanted to face because this is finally what I WANTED to do be doing. I found keeping that in mind kept me motivated.
CA1 year is hard and everyone faces challenges. Stick with it and know you are not alone!
Real story: there was a talk about imposter syndrome at the MGH/Martinos center, the worlds premiere medical imaging research facility ( although I might be biased). On the question if they thought they didn’t belong there about 200 hands ( of about 200 attending) went up. Next question was : Who of you thinks” yes but they just THINK they are an imposter but I really am one” .. about 200 hands. Those hands are attached to about 150 PhD’s, a few professors and the rest grad students (MIT, Harvard and HST which is both) visiting researchers and my wife who is a triple master, PhD and assistant professor at HMS. I did not attend because I’m an MD pretending to do research and have only just finished a PhD in neuroscience which I’m sure I don’t deserve. I published a bunch of papers but that is probably mostly luck.
After doing anaesthesia for 8 years (after 3 years of ICU) I’m mostly convinced I’m mildly good at pretending to be a doctor.
So amazing, and sad, that this is so pervasive!
Whenever I catch myself compulsing, I reference this algorithm (developed during my CA-1 year):
1 Avoid internal defensiveness, don’t justify errant behavior (hurts personal reputation, growth, and conscious; discourages evaluator of providing future feedback; encourages culture of poor mistake resolution; doesn’t help victim of mistake)
2 Describe exactly what happened
3 Claim the blame if belongs to you
4 Problem solve from present situation (not fixating on what could have been), collaboratively
5 Apologize where appropriate
6 Review and record how to avoid similar mistakes in future
Fantastic advice!