The reality is just setting in: I’m months away from finishing my family medicine residency! I want to yell it from the mountaintops, but let me also channel my elation into some advice. This is for the next generation: all you phenomenal DO and MD students who are on the cusp of becoming physicians.

In deciding where to rank highly, I cannot overstate the value of being in a place where you have significant support: parents, siblings, close friends. Residency is harder than anything most of us have ever done, and you’ll need that hot meal, last-minute – or in my case, continuous – childcare, or shoulder to cry on.

When you pick an apartment or house to live, think hard about your budget and what you can afford. Living frugally in residency can empower you to start paying back debt earlier and invest more in your retirement accounts.

If you’re trying to figure out why you are cranky on your day off, do the same thing we do with babies who are crying: follow a checklist. For me, that checklist usually includes eating, sleeping, re-caffeinating, going for a jog, and lying on the couch doing pretty much nothing. One of those things usually works.

Give yourself permission to do less in your home. If you have the resources, hire a cleaning service. Order food from your favorite healthy place. Let the house get a little messy from time to time.

When the time comes, and you have the mental space, maybe towards the end of residency, think seriously about getting a financial advisor who is a fiduciary. Get somebody who knows the system to help you prioritize your financial goals.

Give yourself permission to “scale back.” It turns out that being a resident is essentially twice the work of many full-time jobs. Hobbies, research, advocacy, and community projects can wait and will be waiting for you to return when you have more time.

Let go of the tendency to compete with your co-residents. It’s a poisonous activity, and you’ll see that everybody is struggling and growing in their own ways. Remember that medicine is a lifelong career, and you’ll spend the next few decades acquiring skills that are relevant to your community or practice setting and letting go of whatever is not relevant.

For a short book that gave me some crucial guidance, check out Ben Brown’s 50 Simple Things to Save Your Life During Residency. It has some wonderful, pithy pointers on how to navigate medical training.

I shared some of these thoughts on Twitter and was struck by the additional valuable advice shared. Dr. Grotke, a self-identified PGY-21, says: “when your spouse is grumpy, you need to realize and accept that they are probably right in being frustrated with you. You may not be able to do much about it in the short term, but acknowledging it for them and for yourself will go a long way.”

Dr. Pancholy added: “If you feel like you hate everyone, you probably need to eat. If you feel like everyone hates you, you probably need to sleep.”

I hope these pointers serve you well. May your journeys be marked by an auspicious beginning.

Devesh Vashishtha is a family medicine resident and can be reached on Twitter @DMVashishtha.

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