Alexander Torres, DO, PGY-4
Comanche County Memorial Hospital
Transitional career phases are, without a doubt, an emotional rollercoaster filled with anxiety, nervousness, and fear, to name just a few. As an emergency medicine physician, you will be continuously challenged throughout your career, no matter how seasoned you become. There is no doubt that you possess the intelligence and strength to succeed in emergency medicine, but whether you are a medical student, resident, or even an attending physician, you should be afraid. Why?
The rapid shift from medical school to internship is terrifying. No matter how many pages you read or how well you try to prepare, no intern truly feels ready to start their first day of post-graduate training. The thought that “things have to get easier,” helps you to persevere throughout the year, yet every minute of every shift has the potential to produce a nerve-racking experience. So, things must get easier, right?
Fast forward to assuming the responsibilities of an upper-level resident. The time flew by, and although there were days you thought would never end, internship is successfully completed. Now you are known by the nurses, attendings, and hospital staff and it seems everything should be easier, but it’s not. The accountability and duties intensify, such as documentation, managing an increased number of patients, working on research projects, and supervising interns and medical students. Again, every minute of every shift has the potential to produce a nerve-racking experience. You have your senior residents and attendings to back you up, so it can’t be too scary, can it?
Now you are the senior, maybe even the chief resident. You have surmounted the early years; graduation and “attending” status is in sight. By the time you realize that you have been given additional responsibility, there is nothing easy about it. You are required to teach the junior residents, interns, and medical students. You are expected to begin functioning near junior-attending level, as well as make schedules, prepare for your national board exam, interview for jobs or fellowship, and prepare for possible permanent relocation. Once the year-long, daily “circus show” is over and you have successfully completed all these seemingly impossible tasks, it is graduation day. You’ve made it! You are going to be an attending physician. So, things must get easier, right?
But wait, now you have essentially reverted to intern-status. As a new attending, you are the expert in charge, but you are terrified. There are no senior residents to supervise you. You are residency trained and have been well prepared, so why should you be terrified? Because every minute of every shift has the potential to produce a nerve-racking experience.
As an emergency medicine physician, you frequently hear the familiar phrase, “just when you think you have seen it all…” In this specialty, there is no way to truly prepare for everything that you will encounter. You must believe in yourself, your training, and trust your skills needed to save lives. You will encounter a “zebra” diagnosis or an “ED thoracotomy,” and be terrified time and again. As physicians, especially in emergency medicine, you are privileged to great opportunities and possess unparalleled skills to perform a job that very few are able to accomplish. Be grateful. If you have successfully completed medical school and residency, and your residency program director felt you were competent enough to practice independently, that is a great achievement.