I’ve never worked this hard. It’s only been one month, but it is already apparent just how much harder I will be working over the next few years than I have ever worked before. As a medical student, I had spent 2 years pretending to be an intern, and I thought I had it down. But there are at least 3 key differences between being an intern and being a student.
- No one double checks your work. As a student, 99% of everything you do is repeated by someone else. Whether it’s your history, your physical exam, the orders you write, the documentation, almost all of it is duplicated by a supervising physician. Of course I still have supervision as a physician-in-training, but as opposed to 99% duplication, it seems like there’s only about 10%. That means extra vigilance on my part and an added layer of responsibility if I miss something.
- Volume. As a student, you are typically assigned a small number of patients to follow. As a resident, you are expected to be a work horse. My first month was in the emergency department, often evaluating and working up four or five patients simultaneously (the more senior ER residents frequently carry seven or eight or more at a time, boggling my mind).
- Real responsibility. As a student, you may write notes, orders, see patients, but if you don’t, someone else is responsible for covering what you don’t get done. Not anymore. If I don’t do it, it simply doesn’t get done. That means zero slacking off, delivering 100% on commitments that I make.
I’ve quickly become to feel like a machine at work, powered not by my own volition, but simply by the demands of the environment. This leads to a certain sense of disembodiment, as though I am watching all of my actions from above, but not directly motivating them. It almost makes the work easier, as I don’t feel the need to exert willpower to get the job done. I can just watch myself get it done. But with that comes a degree of depersonalization, and I hate to say that I now can understand the vacant stares I’ve seen on residents’ faces over the last two years. They weren’t deliberately ignoring me, uninterested, or rude, they were just working hard. I hope that my realization of this will allow me to fight back against such mechanization and help me to continue to be a human being throughout this process.
