The Scariest Part of Residency

“Go ahead and push the etomidate.”

A few moments later, after administering the short-acting anesthetic and putting in a breathing tube, I toss the MAC blade away, listen for breath sounds, and give a thumbs-up to the intensivist peeking through the glass door.

I came into residency scared, only because I thought I was supposed to be. I was a new doctor with real responsibility and real people to take care of. In reality, I wasn’t that scared. I knew what I was getting into, and I’m fortunate to be in a very supportive program. Don’t get me wrong, there have been scary moments. I’ve run codes, given life-altering news, and lost patients I deeply cared about. I’ve done procedures, changed EMRs, and even consulted on a pregnant patient as an internal medicine resident. During all those nerve-wracking moments, I knew that I always had one of my medical mentors there to back me up. I’ve been blessed with what I consider some of the best teachers and attendings in the world. Knowing that they were there to validate my decisions and to be a safeguard gave me great confidence. A confidence that is likely to be quite short-lived.

As it turns out, the scariest part of residency isn’t your first intubation attempt with a pulmonologist looking over your shoulder. It’s not your first STEMI (heart attack) admission when a cardiologist has already ordered anti-platelets. It’s not even a rapid response during your first night shift when you know the nocturnist will be there by the time you can get a manual blood pressure. The scariest part of residency is when—after two and a half years of intense, supervised, training—you look up and realize that in a few months there won’t be anyone peeking through the glass door.

Rand Wasson, DO
PGY-3, Co-Chief Resident, Internal Medicine
Johnston Memorial Hospital