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Reflections on Residency from a PGY-3: The Beginning of the End

It’s the beginning of my third and final year of residency, and I can finally see the light at the end of the training tunnel. Second year was challenging — the first half was filled with weeks of nights, a crash course in pediatric intensive care, and months on the pediatric hematology and oncology floor. Adrenaline rushes evolved into an adrenaline infusion — and it took me six months to realize I was burning out from the inside. After a half a year of being the first person at the bedside of really sick children, my first block of 2017 threw me back into the world of community pediatrics. However, I needed to learn how to be a supervising senior resident, so I ceded the role of primary provider to my interns. I finally felt like a senior, a team leader, a future attending. But I sorely missed cultivating the physician-family relationships that make pediatrics so personally fulfilling for me. I realized that becoming the boss could mean that I am simultaneously everyone’s doctor and no one’s doctor, and I briefly grieved for that.

Thankfully, I was able to return to the bedside every week during my continuity clinic — a safe space in which I could abandon the training hierarchy for one-on-one time with families who know me as “Dr. Laura.” The second half of the year was defined by this love affair with outpatient pediatrics and a life-changing medical trip to Haiti. Preparation for the trip was characterized by near-total uncertainty in the setting of emotional and mental exhaustion — a far cry from the hyper-aware state residents inhabit during any given day in the hospital.

However, the timing of this challenge was impeccable. I did my best to absorb it all: landscapes similar to those in my beloved Greece, families with unmatched resilience in the face of intractable poverty, lack of basic life necessities like clean water, and a depth of hunger and sleep that only follow days of true labor. Afterward, I felt refreshed but battled reverse culture shock for weeks. The guilt finally eased by the time my partner and I traveled to Europe for our first vacation together since the start of residency. Whereas Haiti was refreshing, Europe offered recovery. We toured thoroughly, ate slowly and slept peacefully — a perfect and necessary respite.

Now, I have finally emerged from the prolonged anxiety attack that follows any major decision and will not be pursuing a fellowship. I have loved aspects of every rotation I have experienced in residency, and in this moment I have no strong preference for any subspecialty. However, saying this out loud to my specialist mentors has been harder than I imagined. As I look back on 10 years of consecutive post-secondary training, the absence of a definitive next step is unnerving. I guess I’ll apply for a job? What a relief to be reminded that I have reached the beginning of the end, and “it’s just life ahead.”


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