Living in the trenches of a surgical internship can be a gut wrenching, lonely experience for many.  The journey from medical student to resident to surgical attending is a notoriously steep trek, necessitating our long 6+ years of training. Surviving intern year remains as hard as ever despite the significantly greater resources and awareness that exists among residency programs today.

These burdens are felt by all specialties and have tragically led to suicides among interns in the past year.  A wonderful New York Times op-ed last fall described some of the complex issues and emotions experienced by medical interns.

For surgery interns and residents, these feelings are augmented by the added challenge of continuous high-stress situations and the need to develop surgical abilities in a field with notoriously high attrition rates.  Below are some key phrases and perspectives that have been passed down over the years, originating from the many ex-residents who figured out how to survive surgical residencies and even make it look easy.

1. Love hate love. Your year will continually be filled with ups and downs.  You will have a love-hate relationship with work, with great and terrible moments; sometimes on the same day. You must rely on your friends and family to help guide and balance you.  They will keep you grounded, and keep up the love for the challenge of becoming a surgeon.

2. Water off your back. In all workplace environments, conflicts arise, intense situations develop, and you will be faced with colleagues who deal with stress in different ways, and who may be more or less gifted at providing constructive feedback.  Through the stress, try not to take anything personally, which is admittedly easier said than done.  Do your best to accept and grow from feedback, learn from mistakes and teach others from them.   Remember that errors don’t define who you are, but how you react to them are part of your character.

3. Customer is always right. Your focus, care and dedication should always be towards your patients.  You can’t teach caring; so stay focused on what matters most.  Never loose perspective that no matter how hard things may get for you, our patients are the ones who are vulnerable, scared and entrust us to do our best to provide them with excellent care.

4. They can’t stop the clock. For the days that are overwhelmingly sad, frustrating, infuriating, disappointing or that make you feel inadequate — remember, that time stops for no one. No matter how challenging a day or experience has been, a new day will start soon; your week will be over soon, and a new year will come.  Residency is a temporary condition where the rough days are training you to deal with the rough days that may occur when you’re fully on your own as an attending.

5. Everyone survives. Many others equal to you, with similar strengths and weaknesses, have passed through the same halls you now occupy.  Use your friends, family, colleagues to gain perspective, advice, love and support.  You must hold steadfast in your passions and see the light at the end of the tunnel.  Hard work, passion and determination have surely gotten you this far — double down on all three, roll with the punches, and you too will soon be looking back fondly on the craziness that is intern year.

Rajendra Sawh-Martinez is a plastic surgery resident.  This article was originally published in PRS Resident Chronicles, the official resident blog of Plastic and Reconstructive Surgery (PRS) and PRS Global Open (Journals of the American Society of Plastic Surgeons).