Fake it until you make it

The title of this post pretty much summarizes how I felt throughout my residency, especially during intern year. After the novelty of being called a doctor and having a pager on my belt wore off (which wasn’t very long), I quickly realized, in many instances, I had very little idea what I was doing.

Yes, I studied my butt off through four years of medical school, but unfortunately book knowledge didn’t transfer automatically over to real life application. I still remember doing my first lumbar puncture on a baby and having the mom and grandmother both in the room asking me if I had ever done this before. Thankfully I had a great senior resident, and everything turned out just dandy.

It’s a bit of a strange paradox, being officially a doctor as a resident in title, but lacking the skills and knowledge that patients expect you to have. And it is through residency training that you acquire (hopefully) the skills necessary to be a competent physician. In many ways, it is pretending to know what you are doing until you actually figure it out.

It’s interesting how this parallels our spiritual lives. Apart from God we have all fallen short of God’s standards, and as a result, await judgment and God’s wrath. But because of Christ’s death on the cross, through faith in Jesus, all our sins are put onto Him, and all His perfect obedience is given to us. And so, instead of standing before God as sinners, in Christ we are justified, positionally perfect before God.

But yet, in our character, attitudes, and behaviors, we are far from perfect. We still struggle with sin, and we will continue to until the next life. And while Christ’s death made us right with God, the Holy Spirit then comes and makes us perfect within as we are perfect positionally before God, the process of sanctification.

So from this knowledge of who we are, holy and redeemed in God’s eyes, we are then commanded to obey even when naturally we might not. Not that we are to pretend and put up a false image of being all put together(although there might be a temptation to do that). But none of us are as loving, as patient, as considerate, as whatever as we know we should be. And in our obedience, the Holy Spirit gradually transforms us so that eventually the reality of positional holiness will be true of our inner self as well.

We are saved only by God’s grace. Let us not forget that we also grow only by God’s grace, through the work of the Holy Spirit. And while there is nothing we can do on our own to produce this kind of change, let us position our hearts in a way that allows the Holy Spirit to do His work.

“I am the vine; you are the branches. If a man remains in me and I in him, he will bear much fruit; apart from me you can do nothing.” John 15:5

 

Medical Training Advice: Starting Internship!

Dun Dun Dun!

With the first day of internship just around the corner, many are pooping in their pants just thinking about the start of the end of their normal existence for the next three plus years. Don’t worry, you are in good company. Patients are probably also shifting uncomfortably in the beds of teaching hospitals across the US. Here are some helpful (hopefully) tips to keep in mind:

1. Make sure you know the location of all the bathrooms, this is very important. Don’t hold your pee; go if you have to.

2. Don’t go to the gym in your scrubs. You just look like you are showing off.

3. Don’t lie. If your senior resident or attending asks if you did something but you forgot, say you forgot. Don’t say that you did it, and certainly don’t make up anything because eventually you will get burned.

4. Remember you are an intern. You job is to learn and people are even expecting you to make mistakes. Don’t avoid things you aren’t good at or don’t know how to do because you might feel embarrassed. It’ll be much worse when you still don’t know when you are a senior.

5. Be nice to the nurses. They know much more than you how things work.

Just a few excerpts from the practical tips section of my book. My prayers go out to all who are starting this journey. It may not feel like it, but the next years will go by so fast so make the most of the experience!

The most reassuring thing someone said to me before I started? “Don’t worry. The human body is resilient. It’s actually pretty hard to kill someone accidentally.” I guess that’s true. You shouldn’t push your luck though.

Medical Training Advice: How to Prepare for Residency

Congratulations to all who matched into residency! For those who don’t know, last Friday was Match Day where everyone who got accepted into a residency program found out where. During your fourth year of medical school, you apply to residency programs in your field of interest. After your interviews (hopefully you get some), you then submit a list of the programs in order of preference. The residency programs also rank all the students they would like to accept and by some magical (and complicated) formula, you are “matched” with a residency program based on the respective rankings.

Where you match is where you have to go, unless you decide to take the year off and try again the next year. It’s a bit of a lottery so it’s quite nerve wrecking. During match day there’s usually some sort of ceremony where all the envelopes with the match results are laid out with your name on it and it’s a royal rumble affair to get your envelope. Some schools have students individually come up to get their results (extra torture). Usually there’s a lot of rejoicing, but there’s also disappointment for those who don’t get their top choices. But regardless of where you match, it’s a huge achievement so my congratulations again.

People ask what they should study or if they should do really hard rotations near the end of medical school in order to prepare for residency. To that, I reply with a resounding NO. There definitely is preparation to do, but not in medical knowledge. That’s what the 1st three and a half years of medical school was for. Medical school is hard, no doubt about it. Residency, though, is on a whole other level. You need to establish and re-establish some life-lines.

What are life-lines? These are the things most important to you that renew you, encourage you, and support you. These are things that will give you the strength to get up again after being beat-down, sleep deprived, and emotionally trashed, and do it again and again. These are probably things you have neglected because of all the studying and rotations during 3rd year. First and foremost are your relationships.

The most important is your relationship with God, and it really is time to reconnect with Him and build into your routine the basic spiritual disciplines. If you didn’t have time during medical school to read your Bible and pray, then anticipate not having much of a relationship with God in residency. You have to be very intentional about carving time out for God, and if you are in the habit of doing that when you do have time, you’ll build up the discipline to do that when life gets busy.

Now is a good time to start scoping out churches where you will be training. Hopefully you took into consideration the church community in your ranking process. If you don’t have a church home, it might be a good idea to find a church with different services so that you can go if you are on call on Sundays or post-call. Fellowship with God and other believers is going to be key in reviving your soul and reminding you of why God called you into medicine.

Next is your relationship with your significant other, especially your spouse. They will be your number one fan, but they also will be affected by the difficulties of residency. The long hours and the emotional drain will cause big strains so it’d be wise to strengthen your marriage prior and continue to tend to your relationships during the process. This is a huge topic just by itself, you can read this article for more on the subject. Of course your relationship with your family and friends are important so make an effort to build up your encouragement base before the craziness starts. You’ll need all the support you can get.

Lastly, I’ll just mention you need to connect again with the activities that give you joy, whether it’s a sport, hobby, or special routines. Medicine isn’t just about caring for others, you have to care for yourself first. Again, residency will be hard. There will be times when you can’t do all that you want to do (or know you should do). Hopefully by building up the support and habits now, you can not just survive residency, but thrive.

What are your life-lines?