The theme of Welcoming the New Year means a little more in the transition from PGY2 to PGY3 year. Take it from me, a resident doing just that. The halfway point of the four years for PM&R residency training is a significant one—and now, we are charged with the responsibilities of being a “senior” resident when we were just junior residents the last month in June. The concept of “see one, do one, teach one” is magnified as you start the PGY3 year for this reason of overseeing responsibilities that we have recently learned for the first time ourselves in the two years leading up to this point.
This new year theme as a PGY3 encouraged me to start thinking about the seniors I worked with as an intern and a junior PGY2. I want to support my juniors using these experiences that I had myself as a junior, whether good or bad. More often is the case, I think, that these learned experiences are more memorable when they are “bad.”
Let’s start with the good. I completed my intern year in an academic institution that was rich with resources and funding, and as such had the luxury of abiding to all ACGME guidelines with strict follow-through. The moment I was over cap on my patient census, my seniors were the first to notice and start the ball rolling on making whatever moves necessary to ensure my cap was adhered to, shifting the over-capped patients to the next available resident. It was often my senior resident herself who took on the extra work in this fashion. With important responsibilities such as medication reconciliations, my senior residents would take the brunt of the work to ensure these were done correctly—all in the name of maximizing the benefit for the patient. I was previously unaware of just how important a discharging inpatient med rec could impact their medication regimen for years to come, and it was only with my senior residents emphasizing this and modeling the correct way for these to be done that I have taken the same onus—not only with my own medication reconciliations, but also now with the juniors I oversee.
However, I have learned just as important lessons with the “bad” seniors as well. I have seen, first-hand, senior residents spend minimal to no time with patients, but document otherwise. Even further, I have seen these same senior residents uphold an image of themselves, whether on social media or similar settings, as though they are the perfect inspiring spitting-image of a resident, despite knowing the product of their work and overall medical care in real-life.
In the end, I think it is important to start off the new year as a “senior resident” for our PGY3 class as a strong model of good, opposing the bad models we may have noticed or worked with when we were just junior residents in the recent months past. In order to advance the field of PM&R, it is important that we develop the good training skills that we are charged with now as residents, and part of that involves becoming strong seniors for the benefit of our juniors. In our field, which is popularizing but still generally not-so-well-known to the general public, we can start off the new year right by becoming strong advocates for our patients, who can further escalate our specialty by becoming ambassadors themselves if they are happy with our care. We cannot and should not underestimate how the foundation of doing so begins with developing strong residents, and perhaps the most direct and first-line responsibility that this falls under is our incoming PGY3 class mentoring our PGY2s. At least, that’s how I see it for my PGY2s. I hope they notice the good models I will try to produce for them, in the same way I noticed with my own seniors.