Resident Physicians. Uh, what are those?!
Daily, I find myself explaining who I am to patients. Who is this young, inexperienced, excessively thorough, very slow-to-get-things-done but has-a-lot-of-time-to listen person standing before them? I’m a Resident Physician. I’m “the future face of medicine.” This video explains some of what I do.
Many residents work longer hours than their attending (supervising) physicians, so you may find us at all hours of the night, roaming the hospital corridors on our way to assess a new patient or with our pager beeping incessantly, warning us that we’d better run to Obstetrics to “catch a baby” or that someone needs our help in the Emergency Room. On Scrubs, resident interns are bleary-eyed, sarcastic, self-doubting, dependent and righteous creatures. On Grey’s Anatomy, we are ethics-violating, emotional hardcore nymphomaniacs who get lunch breaks at lunchtime. But what are we really?
A resident physician is a person who holds an MD but who has not yet completed qualification requirements for either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC). We need to have a certain amount of hands-on technical and patient experience as well as passing written and situational qualifying exams. Fully licenced physicians supervise us at all times. Depending on the speciality, residents will do 2 to 6+ years of training in addition to their medical school and undergraduate work. Wikipedia has a lot more on the topic.
In residency, physicians in training rotate through various specialities, with the focus being on their chosen field. For example, in Family Practice, we spend a certain proportion of weeks in our Family Practice community clinic. We might spend a month doing a surgical rotation, but the emphasis is on pre- and post-operative management and practising basic surgical skills, rather than learning about complicated surgeries that we will never be performing as CFPC-certified physicians. This prepares us for real-world management of our patients who are preparing to have or are recovering from a surgery, and to do small surgical procedures – such as the excision of a mole – in the office.
Generally we have, in our medical school years, seen patients of all kinds, but we lack the experience to make the judgement calls that seasoned doctors are able to. Likewise, we may have never met someone with a certain condition, though we’ve probably read about it in a textbook. The problem is, the diseases don’t read the textbook. Rashes never look the same as they are supposed to. Lab values often don’t correspond to what we would expect in the case of such-and-such disease. But developing heuristics, pattern recognition, and a collection of experience is exactly what we are working at. And we are profoundly trained in how to find the answer to a problem and knowing when to ask for help.
As a new member of the Professional Association of Residents of BC (PAR-BC), I’ve started thinking more about my role as an advanced learner, a new doctor, and as a patient in this province. That, and the fact that our contract is up for re-negotiation in the spring and there’s room for improvement. I’ll be writing about these three perspectives in coming posts, and how each will impact the nature of our new contract.