 With match day finally behind you, you're excited to start your new journey as a doctor or need to realize you have no idea how to get ready to actually be a real physician. So today we're going to break down exactly how to prepare your first year of being a brand new doctor. Let's get into it. Hey friends, welcome back to channel. In case you're new here, my name is Lux. I'm an internal medicine physician and here at the MD journey, we make content to help people like you succeed on whatever journey you're on, but doing it with less stress. Now as the making of this video, match day was just this past Friday, I was excited to see people on social media find out where they're going to go for residency for the next three to up to seven years of their life. And as I was going through those posts, it definitely brought back memories from my own match day where I found out where I was going for my internal medicine residency, which coincidentally I happened to finish this year. And so today I'm going to use those three years and experience to help break down my favorite tips to give to brand new doctors and interns to really help you prepare and become a superstar physician from the very get go. And if you enjoy any of the content today and you feel like you got some value and you want more where that came from, definitely recommend checking out our interns survival guide where there's a lot more detail and step by step advice. And pretty much everything that you need to excel in your first year as physician, that'll be linked down below. One of the most common questions that I get from fourth year med students that are about to go into residency is how do they prepare before their first day on the job? And the simple answer is one, you have to accept that you're not going to learn everything and two, you have to really focus on what are the things that are going to make you the most uncomfortable from day one. And there's going to be a lot of them, but the best thing you could do for yourself is to one, create essentially a hit list of all the things that you know, that you don't know. For example, when I started residency, a few things that really made me uncomfortable included things like ventilators, pressers, pain management with things like opioids, things that you don't really deal with enough as a medical student, as well as diseases that maybe you just didn't get to see enough in medical school. For me, those are things like sickle cell, as well as some OB-GYN emergencies. And this list will contain really broad topics, things like antibiotics, as well as things that require daily practice, things like reading a chest x-ray, reading EKGs or whatever it may be for your particular field. But the first step you have to really do is to create that hit list and be okay with adding things as you come up with more and more. Aha, I still don't feel comfortable with that as well. Add as your hit list and then we'll get into the second step. Now, once you have some kind of outline for your hit list, the next thing you have to remember is that the goal is not to get through everything by day one, but the goal is essentially to go through it by your level of confidence. So the things at the top of the list should be the things that were you the most. So for example, if you're not comfortable with dealing things such as pain management or pressers or ventilators, either because you haven't done so or you haven't done it enough, then make sure that those are the first things on your list and the things that you somewhat feel comfortable with, but you maybe want to review before your first day on the job or later in the list. Now, tip number two, going into your first year as a brand new physician is that you have to transition becoming problem focus. Typically medical school teaches a lot of how to take a good history, take a good H&P, do a good physical exam, and then we spend some time on the assessment and plan just because we're learning the medicine. We tend to spend the least amount of time there, but that's really where the value in for you as a brand new doctor is going to be. So the first thing that I always try to teach my brand new interns is what is this patient's main problem? Or what are their first two to three problems before you even read their H&P or ask the patient how they're doing. You can quickly look through their charts, their vitals, their medications, and then descriptions of what the patient was brought in for about the emergency provider to really get an idea of like, okay, this is the reason this patient is coming to my service. If you can identify those top two to three things, then you can ask, okay, what work do I need to do for problem one, problem two, problem three, and what treatments or PRN treatments do I want to start doing for each of those? This allows you to already start getting into doctor mode because you surely will have instances as a brand new doctor where you're going to have a lot of patients getting admitted at once and you may not have enough time to think about the entire patient at that time. So the biggest thing is going into saying, what are your problems like? Are you having shortness of breath? Are you having chest pain? Are you having a fever? Are you having a pneumonia? Like what are the top things that I'm considering? How do I want to work them up? How do I want to treat them? And then you can put those orders in and then go in and using that as a structure of quickly finishing your notes and again, taking care of that patient. Now this by no means is an easy thing to learn. I'm still learning three years into residency, but it is something that helps me to get into the mindset that whenever I see a patient either a brand new one or a one that I have been seeing for quite some time, I simply start to ask, what are the two to three things I'm going to do for you to really help move the needle in your care? So again, stop focusing as much on the subjective objective instead start asking what problems the patient has because the benefit of it is one, you're going to get better at realizing how to identify problems, but two, during your first few months of being an intern a brand new physician, you're not going to be able to know exactly all the things to order, all the things to take care of, all things to consider for a specific problem. You may see a patient that has shortness of breath and your differential is going to be very short, but as you do this more and more, your upper levels, your attendings, you're going to be able to help you broaden and then narrow that differential, then it helps you understand what treatment modalities and workout modalities you have available to you. So the more that you practice this problem focused mentality, you'll realize that your confidence as a brand new physician is going to skyrocket once you start seeing the same problems over and over again. And then step number three is to go through that list slowly, but shortly. Again, the goal is not to get through your entire list by day one, but simply to get through those bulky, anxiety-provoking topics while you're still working on the next things on that list. And that also means to have a schedule that's very easy to say yes to in terms of getting through that list. So as a fourth year med student or somebody about to start residency, you likely have a few months where it's really much more important to relax than it is to try to get through your list and make it cumbersome as if you're preparing for a board exam. So instead, I would recommend picking a very easy amount of times of week, whether that be two or three times, that you can say, I'm going to go through the next thing on my list. And so for example, you can say on Monday I'm going to cover the first topic, Wednesday I'm going to cover whatever's remaining for the first topic, and then Thursday or Friday, I'm going to go ahead and move to the next thing on the list. And again, if your hit list contains topics that require daily amount of practice, for example, if you have, I need to learn EKGs better or I need to learn chest x-rays better, that's completely okay. A simple way to do this is once you decide I'm going to commit to, for example, three times a week, you may say for the first 10 or 15 minutes, I'm going to devote it to my daily practice. I'm going to say on Mondays, I'm going to do 15 minutes of EKGs, and maybe two or three EKGs that I get done during that time, but that's okay. On Wednesday, I'm going to go ahead and do 15 minutes of chest x-rays, maybe I can read two or three and then get some feedback based off of what I missed. And then on Friday, I'm going to repeat the process. And then you can spend that remaining time, so if you had committed to an hour, that means you have 45 minutes to go to the next thing on your hit list. Again, this is a very easy to commit structure and all of it is designed to just get through the next boulder that is in your way before you get onto the next one, that's a little easy to process. And to avoid making this episode too long, if you're interested in all of my favorite resources to really make medicine a lot easier, if you go ahead and check out this episode right here, on how I learned medicine as a full-time physician, I really break down some of my favorite resources, but just to quickly list them out, some of my favorite resources include just basic review articles, websites that are just super high yield, things like the EM Crit blog, which again, I mentioned in that episode and how I study as a physician, as well as apps that are just super engaging, things like the Human DX app, as well as podcasts that I can listen to on my drive, things like clinical problem solvers. So again, if you want all of my resources recommended in one place, go ahead and check out that episode on how I study as a full-time physician. So tip number three is you have to keep asking this question, what would it look like if it was faster? In addition to just not being confident with the material, really the thing that limits most interns is the idea of efficiency. How do I get my notes done in time? How do I see my patients in time? How do I just have a good workflow that's consistent and predictable and don't let all the pages and nurse requests and patient requests and requests from my seniors and attendings, all those style to pilot, but how do I do my work efficiently and still learn to become a good doctor? And the thing that's really helped me as well as the interns that I worked with that I've seen the biggest growth in is that they start to ask themselves this question of what is the thing that's causing me to be the most inefficient? Is it my note-rodding? Is it taking too slow? Is it taking me too long to see my patients? Or is it too long to put my orders in? Or just am I getting distracted? Like where is the biggest issue? Where is the biggest boulder that I need to move? And once you start asking, like what would it look like if your note-writing, for example, was the thing that was causing you the most inefficiency? What would it look like if it was faster? Well, maybe I can start writing my problems before I even see the patient and start practicing that problem mentality that we talked about earlier because if a patient is short of breath, there's gonna be the same things you're gonna do. And when you see them, they're probably not gonna tell you much different that's gonna prevent you from ordering things like a chest x-ray or a breathing treatment if you know that they have asthma or COPD. And so for me as an intern, things like note-writing and seeing my patients in the morning definitely started to be the biggest reasons for my inefficiency. So I started asking, like what would this look like if it was faster? How could I write my notes faster? How could I make my patient interactions more efficient and more focused on making sure that they're being helped? And doing those made little small improvements. Some things I would try and I wouldn't really budge the needle at all or make things worse. But then sometimes I would try something like, ha, done with my notes, it's 10 o'clock, that's beautiful. And you would repeat the process over and over again and then you realize you become this super productive machine without getting rid of the quality, the high quality they want to practice providing your patients. And the biggest benefit of all of that is that now you have a lot more time to actually learn the medicine required to take care of your patients and just feel more of a sense of relaxation. That's probably the biggest thing that's helped me avoid burnout in my last three years is that I was able to focus on efficiency and then learn the patient care. And now I'm both efficient and overall competent in taking care of my patients and don't feel like I have to spend a lot of time doing either of those. And again, because I'm such a huge geek on learning and teaching those high efficiency skills, if you are interested on how to become a more efficient first year physician, definitely consider checking out the intern survival guide where I definitely talk about how to see patients faster, how to write notes faster, how to come up with diagnosis and management much quicker as well as many other skills. Again, no pressure but if you are interested that'll be linked down below. And tip number four is to create a goal for balance. The biggest discrepancy that I see between third year residents who really feel like residency was amazing. I feel like I'd consider myself in that shoes. And those were like, I just want this to be over with. People that are dreading the process who already hate their jobs at their later 20s which honestly seems a little crazy to me is that in the two votes, one of them, the people who really enjoyed residency really had a life outside of it despite residency getting really crazy with ours. How can I make sure that I'm focusing on my fitness? So for example, last December, I made sure I had enough time to train and run my very first marathon despite having a busy residency schedule. And all of those really allowed me to feel like, okay, my doctor life is growing, my knowledge life is growing, my relationship is growing, my personal fitness is improving. All of those have helped me feel like a more improved person by the time my residency is over not just somebody who's dreaded and worked their butt off to become a better physician but the rest of their life has been kind of left in the dust for the past three to seven years. And so really start creating a goal for balance and that really starts by doing this since day one. So if you have important people in your life, make sure they're still important despite being busy in ICU's or in surgeries or whatever you're doing with your life. If you want to make sure your fitness is still part of your life and don't want to say, oh, I've gained the 15 pounds to drive my first year of residency, then make sure fitness is still part of it. Either work out two to three times a week and then escalate from there if your free time allows it. And I encourage you to try to learn about things outside of medicine, things like cooking, playing an instrument. My personal favorites include things like reading about personal finance and investing because there's gonna be skills that I'm gonna need to know in a few months when I'm making an actual attending salary and I don't want to just figure out at that moment. But all of those can fit into my schedule because I have created the habit of finding balance despite residency and being really hectic. Again, when I'm working 75 hours like I did last week, main focus is make sure you get some rest, make sure you exercise, still spend time with your wife with a limited amount of free time you do have. But those times where I'm working, for example, this week, maybe 40 hours, I'm gonna make sure I'm making videos for you guys. I'm gonna make sure I'm running. I'm gonna make sure I'm learning about all those other things that are on my list to do. And that overall creates a sentiment that yes, being a doctor has been hard, but it's been worth it. But on the flip side, all those things that are considered to be important are still growing alongside me through this journey. So those guys are some of my favorite tips to give to brand new doctors. So again, if you match recently as watching this video or if you match at any time in the future, congratulations, it is a big step going forward. If you, again, if you want any help to help your intern in first year as a physician succeed and excel a little bit faster, then go ahead and check out the Endurance Survival Guide or drop your comments down below. If you guys did get any value out of this at all, just go ahead and all I ask is to hit that like button. If you haven't joined the community, consider hitting that subscribe and notification bell to get more videos like this on a weekly basis. If you're listening to this on a podcast consider hitting that follow and subscribe on your favorite listening platform as well as leaving an honest review on iTunes. But as always, my friends, thank you so much for being a part of my journey. Hopefully I was a little helped you guys on yours. If you did enjoy this episode, check out this one right here on how I study medicine as a full-time physician, as well as this one on how much money I make as a full-time doctor. Hopefully you guys enjoyed this and I'll see you guys in the next one. Peace.