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Free association on lessons learned as a new attending psychiatrist

Garrett Rossi, MD
Physician
November 18, 2021
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There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to make the necessary sacrifices to be a physician. The next transition occurs as you leave the academic portion of medical training and enter clinical rotations. This process culminates with the intern year of residency. This will be the first time you are fully responsible for patients and have the autonomy to make important medical decisions. What each of these transitions has in common is they can all be nerve-racking experiences. Trust me, I’m a psychiatrist. I hear it from students and residents all the time.

Residents fantasize about attending life, and in difficult times, this can help you through some challenging circumstances. However, attending life comes with its own set of trials, and the one constant in medicine is the need to keep growing and learning. As a recent residency graduate and new attending psychiatrist, I’ve learned many lessons in my short career. I want to share with you the growth mindset I’ve used to make the transition to attending life easier and how I analyze my daily work to become a better attending, educator, and psychiatrist.

You will likely have a moment as a new attending where you ask yourself, am I prepared for this? It may be when a challenging case presents itself, or it may be the first time you perform a procedure unsupervised, but that moment will come. What I’ve learned to do is trust my training. You have spent the last several years practicing for this time, and you know a lot more than you think. The times when an interaction or treatment did not go as well as it could have, was because I questioned myself at a critical time? My experience has taught me to trust fully in my judgment. After all, I’ve spent a good portion of my life developing it.

I’m always looking to improve my knowledge and perform better clinically. A great way to improve these skills when you are early career is to analyze your cases with a critical eye. I’m never satisfied with a good enough outcome. I constantly ask myself with each case, “What could I have done differently that would have improved the outcome.” This is not just for cases where things did not go as well as planned, it should also be applied to cases where the outcome is optimal.

If you want to take case analysis even further, you can discuss your challenging cases with a peer. I try to schedule weekly calls with my best friend from residency to go over cases together. Having another person you trust to offer their clinical opinion can offer a different perspective and will almost always lead to learning something new.

The final thing that I need to remind myself about is to watch my stress levels. Contrary to popular belief, your stress levels will increase as a new attending. As a resident, all those things you were not responsible for are now a part of your daily life. Sometimes it will be necessary to remind yourself to continue important activities like proper diet and exercise routines which combat burnout. You want to grow into the best physician you can be, but not at the expense of your wellbeing. Take time to enjoy the outdoors, spend time with friends, and engage in some fun activities. After all, life is not all about work.

Garrett Rossi is a psychiatrist who blogs at Shrinks in Sneakers.

Image credit: Shutterstock.com

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