Returning to Surgical Residency After Research Years: Top 5 Pieces of Advice

Following Jonathan Abelson’s recent blog post with spot-on advice for residents beginning their research years, I began thinking about what happens at the end of a research commitment. As a resident entering my final year in the lab, I have begun preparing myself to re-enter the clinical realm next year. In my unofficial polling of upper-level residents who have undergone this transition, 5 common pieces of advice emerged:

1. Guide your path to success by optimizing your rotation schedule.

It is likely that you already know what you want to do with your life when you come out of the lab. If not, you have narrowed it down to a few subspecialties. Speak with your chief residents (or whoever makes the schedule) to ensure that you will have a rotation schedule that allows you to shine. If you want to be a vascular surgeon, ask to do your vascular surgery rotation toward the end of the year when you’re back in the swing of things and more comfortable with operating and the day-to-day workings of the hospital. Avoid starting on that rotation at the beginning of the year when you’re still remembering how to be a good surgery resident.

2. Operate, operate, operate.

When speaking with those who make the schedule, request rotations that are more operative in nature for your first months back in the clinical realm. And when you are on those rotations, get to the operating room as much as possible. If you are placed on a less operative rotation, ask if you can cover some cases for another service or double scrub to gain exposure. Your technical skills are almost certainly rusty, but they will come back. The best way to ensure they do is by jumping in head (or in this case, hands) first.

3. Ask questions.

Your co-residents who started with you as interns but did not go into the lab are now chief residents or have finished residency. It may be awkward at first, but remember that they have had a lot of clinical experience while you were in the lab, so you shouldn’t be afraid to go to them for help. A lot changes in 2-3 years. Ask nurses, interns, etc. for advice on new protocols. Additionally, ask your attendings why something is done in a certain way if you are unsure. You learned critical thinking skills in your lab time, so use them! Faculty would rather teach someone who is interested and curious than someone who goes through a rotation simply nodding in agreement. If you remember an interesting and relevant article or presentation from a conference you attended, ask your attending’s opinion on the topic.

4. Don’t beat yourself up.

It is difficult to change your day-to-day activities in such a significant manner. You’ve done it at least once before when you began your intern year, so you already have the experience and can do it again. You just have to believe in yourself! You may feel behind clinically compared to your fellow residents who went straight through. Don’t beat yourself up. Instead, focus on how you can improve and remind yourself that you have not had as much recent experience as others around you. However, do not use “I was in the lab” as an excuse. Work hard and you’ll catch up quickly.

5. Take time to live life.

It’s difficult to shift from controlling your own schedule entirely to having very little control over your schedule. Keep up with a hobby, spend time with your family, or just take time to decompress by yourself. Don’t forget that in the grand scheme of things, you are making meaningful differences in patients’ lives and residency is the time to dedicate the vast majority of your time to learning how to best treat patients. However, you can certainly take 10 minutes a day to do something for yourself. If you can’t make it an everyday ritual, take 20 minutes every other day. Set a timer and dedicate your focus in that time to your hobby, family, or self. You might surprise yourself by how much more you are able to concentrate on your surgical education when you take this time for yourself. Having a hobby has been shown to be associated with lower occupational stress in a recent study of Korean surgeons.¹ All of the images in this blog post were painted by me in the past year. If running Tough Mudders is more your style, go for it! Don’t let it detract from your surgical training, but instead allow it to complement it. Who knows, maybe my artistic endeavors will lead me to illustrate a surgical atlas one day.

Do you have any advice for residents re-entering clinical surgery residency after years in the lab? Leave it in the comment section below.

Special thanks to Michael Megison, Alicia Waters, and Bob Hollis for their candid advice and Daniel Chu for his thoughtful guidance.

References:

1. Kang SH, Boo YJ, Lee JS, Han HJ, Jung CW, Kim CS. High occupational stress and low career satisfaction of Korean surgeons. J Korean Med Sci. 2015;30:133-9.