How to excel in Residency? - Road 2 Residency 

Making a good first impression, everyone remembers the first impression 

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Do the blood culture, if the lactate is high, order the lactate, if the patient doesn’t have a central line and talk about it, if the patient is not doing great, talk to the nurses they know the patients and they know the patient dynamics.

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You will think you are the residents you need to study less, we have medical students from the chicago i learn from the medical students, the residents and the nurses and I thought statin had to be given at night for better work but that is only atorvastatin and the others we can give that any time, baclofen we can give it for hiccups 

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Don't show you are in a rush and give time to listen to the patient and then listen what to do, it is not what you say it is how you say it. 

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The patient is the boss and the family is the boss and nowadays we don’t impose our on the patient, we listen to the patient. 

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They know their body. Patient center approach "I am an expert on health care”

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They are residents presenting with the dietician and pharmacist. 

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When they call you quickly, if you see any labs it is abnormal and you tell the patients, be available for the nurses, family. Nurses can make your live miserable so he advices to be very nice to them. Be there for the attending. 

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Stay extra 5 min and look at the chest x ray, stay late 5 or 10 min extra and dont leave anything for others and when you are giving sign outs try to be very vigilant and work hard 

Sending the progress is not at 5 in the afternoon and he makes his own note and so don't send them very late. Those are sent early and some of the notes which I messed up and the attending messed up and I have to write it quickly and schedule appropriately and the important thing is time management. 

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Learn to work under pressure, sometime you can not multitask 

There are 3 patients you have to do the HnP, and positive attitude.

Even the senior residents from day 1 who can help you can guide you, other residents from another hospital. And you need to nurture the relationship and always stay in touch with things such as keep in touch and express gratitude. that will stay until you die and sometimes call them and sometimes text them. 

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I will help you with the arterial lines

I know that 4 Bangladeshis got kicked out of residency, 2 went back to their home country and 2 went to other programs. 

We are lacking professionalism, from the first day indulge into it, for you to be into it, and when you are preserving into it. Constructive criticism, if you can not take criticism you can not improve and at one point you will see you will improve, and that is how you improve in residency. Residency is hard work like physical and mental work. 

The country is totally different. You have to speak confidently and I have a soft spoken voice and everyone tells and it was very challenging to talk loud and confidently. 

Showing up on time is very very important, track every morning report and noon conference, initially for an intern is to learn the EMR system, some hospital have CENAR and some have EPIC if there are intern are there just try to get familiar with the EMR before you start residency and just a few day be with the senior how to write the progress and the dot phrase and that is the short version for medications, treatment, how to do the chart review quickly and they will give you 10 patients each and it will be very overwhelming at first. We just see the patient and don't do the chart review and we lie to the attending. It is very wrong practice try to see the patient then do the chart review or vice versa. They appreciate it if they tell the truth. 

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