Attitude
- Be professional, be collegial. Be the doctor the public actually thinks we have the time to be. Adopt a persona of unflappable, professionalism
- Deal with conflict by actively, aggressive professionalism and humor–Treat personality defects as if you are a kindergarten teacher
- Attitude-be cheerful and enjoyable, even if you have to fake it–do this ALWAYS! Unless you are really hurting, then go find someone you trust and tell them
- Lateness-it seems small, it seems minor, it is not. If you are late, apologize far out of proportion to the crime
- Never, ever lie–about anything, no matter how small. Your life will be miserable if you do.
- Use Non-Violent Communication
- Add a space between replies and response
- In that space, when you are about to say something that feels really good in the moment–DON'T SAY IT!!!!!
Learning
- Read-read constantly, read consistently, read everything you can get your hands on
- Remember your medical school science. It all matters, except histology. No use for that f–ck-n class.
- Abhor integration of unexamined-received wisdom
- Be a critical thinker–question EVERYTHING, but mentally, not verbally. Go home and find out if what you are told is true.
- If you want to ? your attending, have them walk you through their reasoning rather than questioning their authority
- Look for which attending you will be on with. If they are a known teacher, bring ?s. Especially if they have a niche
- EBM–be able to support your beliefs with EVIDENCE, or tell folks what you are saying is only opinion. Remember evidence is only half of the equation. Clinical experience is what allows the translation of evidence to the bedside and the individual patient in front of you. You can gather all the EBM you want, but you are still a clinical rookie.
- Most decisions you face will be easy, ask yourself what is best for the patient. And if you don't know ASK THE PATIENT.
Make things happen
- Write it Down!!!
- Said is not ordered, ordered is not done, done is not done right
- ALWAYS BE ROUNDING
- Dispo is destiny
- Work Clean
Interns
- Report Accurately, get as full a story as possible–but not medical school level
- Hypothetico-deductive Filtering
- Do what you say, say what you do
- Get the orders in ASAP
- Do what you say
- Be ready to Sit-Rep
- Keep on top of yo ur patients
- Gently Stretch yourself
How to Be Financially Sound
- Live like a resident
- Save like a miser
More on EMCrit
Additional Resources
- EMCrit RACC-Lit Review – March 2024 - March 28, 2024
- EMCrit 371 – Iodinated Contrast Issues: Part 2 – Contrast Reactions - March 24, 2024
- EMCrit Wee – Zentensivism with Matt Siuba - March 15, 2024
Great advice Scott. One big thing you missed is telling them to treat the nurses, RTs, RDs, PCTs, and Pharmacists well. Critical care is a Team sport !!!
thought i hit that on the cheerful/enjoyable section
Hey Scott, great episode. People should look into backdoor roth IRA as it’s still possible to get money into a roth ira even for high income earners.
Absolutely Brother! Was going to mention, but I am guessing the option may disappear for 2023 tax year. For anyone interested, here is the White Coat Investor link: <a href=”https://www.whitecoatinvestor.com/backdoor-roth-ira-tutorial/”>WCI Backdoor Roth</a>
Fantastic advice. Might seem obvious but too many of us are so tired/cranky we don’t realize we can come off as dicks/unfriendly.
Being the friendly/approachable/respectful MD will make your life 10x easier.
Good reminder. Thanks Scott.