Category: medicine

Five mistakes I made choosing my first job

Five mistakes I made choosing my first job

We all have either experienced the fears of starting our first job or will eventually do so at some point in our careers.  It only happens once for everyone.  Those of us who are in the market for a job change will end up reliving some of the challenges in job hunting—hopefully we all have learned from our past mistakes. As I am advising upcoming graduates during their job hunt, I have decided to collate some of the mistakes I experienced when I was seeking out my first job:

Not understanding the options for academic medicine

Not all academic doctor jobs are created equally.  Medical graduates really only experience one or two academic scenarios from their training.  What you might not like about your own experience of academic medicine may not necessarily be reality in all cases.  Not all academic doctors conduct research.  Not all academic doctors actually teach, believe it or not! How one’s compensation in the academic world also isn’t necessarily tied to academic productivity or clinical productivity. In fact, there are plenty of academic jobs that essentially function identical to that of private practice. 

If your attending always seems to be jet setting across the world giving lectures and attending meetings in nice places, it doesn’t mean that your life in the same setting would pan out similarly.  You might not necessarily realize the sacrifices that they make to have that sort of lifestyle.  

Not knowing what I could ask for

Nearly everything is negotiable. Period.  The caveat is that you have to realize what authority your potential employer actually has in negotiations.  If you are negotiating with a small medical practice, it is likely that anything and everything is negotiable, even a stipend for a nanny! If you are in talks with a large HMO company, it is possible that the department head may have less leverage than you realize no matter how much they want to recruit you.  Having a relative sense of what a potential employer can control will give you a better sense of what can be discussed on the table.

At some point, you have to raise the price on your worth…

Underestimating the time it took to get up to speed

One of the problems with finishing your residency or fellowship is feeling that you’ve mastered your trade.  It gives you a false sense of security. This rings so true especially if your training spanned an inordinate length of time. Why wouldn’t you feel confident about your skills if you spent the last six, seven, or more years doing the same thing?

In reality you really only are fluent if you remained at the same institution, and even then there with be hiccups with independent decision making.  There is a difference between practicing medicine knowing that there is someone responsible for you and calling the final shots.  When you take on a new job, you have to learn how the EHR works, who the hospital protocols are, where the parking garage is, and how to get from one wing of the hospital to the emergency room without getting lost. 

Frankly, all of the hiccups involved with a new job can be overcome with time. It takes more time than what you’d realize to become comfortable with a new gig.  A rough estimate of the timeline to fluency is as follows: 

  • Learn where the doctor’s lounge is: 1 week
  • Learn hallways of the hospital system: 3 weeks
  • Learn electronic health system: 4 months
  • Feel like work is second nature: 2 years

Expecting to make a whole lot of money

I must be getting old, but I get the sense that all of the new graduates want to work four days a week and make half a million dollars.  Sure, medicine still does provide a relatively stable lifestyle but there’s really no free lunch.  Some doctors find ways to carve out additional green in creative ways, but I tell every new graduate (or anyone else whose asked for my opinion), DON’T GET GREEDY. If you do, you will ruin it for the rest of us

Some specialties will have a better lifestyle or remuneration than others, but no specialty will be perfect.  Some of us are okay moving out to the boonies to practice medicine in exchange for a better lifestyle or compensation.  Only you (and your family) will be able to decide for yourself what is important.  Don’t chase the buck. It’ll get old pretty quickly.

Not everyone is your friend

This speaks from my cynical side, but realize that there is still business in medicine.  It doesn’t matter if you are negotiating with a single doctor, medical group, hospital, or venture capital firm—the negotiations have to be profitable for both sides.  While not every employer will be out to squeeze every penny and second of work out of a new doctor, there is always that possibility.  

The world is full of sharks.  Sometimes you have to deal with them.  If you are unlucky enough to be suckered by one of them you still have a chance to learn from your mistakes.  Sometimes the issues arise from negotiating pitfalls, where the junior associate ends up taking the bulk of the overnight calls, or simply limitations with growing her practice.  Maybe the new doctor gets shipped out to satellite offices where there is limited volume initially. Some of the dealings I’ve seen are so devious that it boils my blood to realize how much the world can take advantage of naive doctors. 


That’s it for now.  Make a checklist when you are in your job hunt. Figure out your priorities, and good luck! If you have any comments or questions, sound out in the comments section!

Do you want to get the latest Smart Money MD posts in you inbox?
Get the FREE Smart Money MD Financial Cheatsheet for signing up!
Why doctors have trouble controlling expenses

Why doctors have trouble controlling expenses

This post was first published on January 2019 on Smart Money MD.

It’s easy to judge when you don’t experience the same difficulties that others do. The classic scenario in medicine is an internist, who runs marathons and bikes to work, tells his morbidly obese patient to lose weight.  How would the scenario work if the doctor were mildly overweight, or has a body mass index of 30.5? 

The same judgment is frequently seen in the online financial blogosphere.  Why does a doctor earning $200,000 have to moonlight to make ends meet? Or why does my Hospitalist colleague pull in nearly twice the number of shifts as everyone else still need more money? You really don’t know what someone else goes through unless you live in their shoes.  They might need the money because they need fund their excessive habits, or they might just be sending 60% of their income to their family in a third world country. 

Financial mindset as a baseline for financial success

Doctors or other people with relatively high incomes can spend a high percentage of their incomes before feeling the hurt, but once the hurt begins it is very difficult to reverse the damage.  Most people would agree that since you (and your family members) control your wallet, you have full reign over your financial destiny.  You mindset, however, is only the beginning.

How many of you know people who might have unsustainable financial mindsets?

We all need to have some understanding of what is sustainable.  Most of us can make rationale decisions most of the time, but the reality is that you can’t always control everything you’re faced with. 

Children and dependents

Most people are going to have children at some point in their lives.  No matter how much you can control your expenses, the only time your kids will save you money is when you claim them as a dependent on your tax return.  Clothing and toys just cover the tip of the iceberg.  Think big expenses, like daycare, nannies, medical care, and schooling costs.  You could expect to drop at least $2,000 for infant formula for the first six months of life.  Daycare in metropolitan areas may run over ten thousand dollars a year, and a nanny will be at least two to three times more.  
The problem with being a doctor is that our profession requires us to have relatively inflexible hours.  If you end up running late to pick up junior from daycare, you are looking at paying penalties by the minute.  If you want a nanny with a resume in the big cities, expect forking over $40-$50k a year.  Yes, that’s more than the private college tuition that you argued with your co-worker that wasn’t worth it. 

You might also like: Should you encourage your kids to attend college?

There are exceptions in every case. Some doctors’ spouses opt to become stay-at-home parents. Financially this actually makes a lot of sense if your spouse’s income after taxes was similar to that of the cost of hired help.  Sometimes it still makes sense for the spouse to be working despite a wash on the financial end simply to keep one’s skills fresh.  The point is that everyone is in a different situation, and don’t think that you’re going to be the demographic who doesn’t end up paying for private tuition or a nanny that consumes your spouse’s entire salary. 

Elder care follows along the same line. I’ve seen some doctors renovate and expand their homes to bring in aging parents. Others have subscribed to long-term assisted living facilities for their elderly family members. Those of you who are familiar with these facilities know that they are EXPENSIVE.  They are so expensive that I’ve considered looking into purchasing REIT funds for these entities. However, for those who are on the receiving end know that elder care can run into a six-figure annual expense easily.

Unexpected health expenses

There is seemingly little talk about what can go wrong with your health, and the younger financial crowd supporting early financial independence all leverage youth on their side. Sure, eating a ketogenic diet and biking to work is great to combat a sedentary lifestyle, fight obesity, and fend off hypertension, but everyone has different interests and time commitments.  We can all strive to become healthy, but you clearly have to be strongly motivated to put health at the top of your priorities to succeed. If you accidentally chose a profession that consumes 65 hours of your life a week, you have to be doubly motivated to put health as a priority. 
Sometimes prioritizing health isn’t even enough.

Look at Dr. Paul Kalanithi, who passed away soon after finishing his neurosurgery residency from metastatic lung cancer.  There was little that he could have done to prevent getting such a devastating disease. 

The healthcare conundrum is that your wallet will take a severe hit if anyone in your family develops a major medical condition. You can lower your annual income all you want to get a health subsidy for the marketplace health insurances and carry a $5,000+ deductible, but if you break a leg or develop a problem requiring recurrent care, your bills will rack up quickly.  As a doctor caring for many patients in these high deductible plans, I also see how insulting the reimbursements are for providing care on these plans. 

The only winners are those who buy into these plans but never gets ill.  The statistics for being healthy are still on your side, but you might have less control over your health than you realize. Doctors, by virtue of working long hours, may even be more prone to developing health issues.

Herd susceptibility

Finally, there is the bucket of expenses that doctors mostly have control over but are tempted to buckle when compared to her peers.  Most of the expenses are within our control, but it’s not that difficult to want to buy more.  The most common issue is that many doctors’ incomes are in the six figure range, but not necessarily significantly higher than that of many other professions.  Therein lies the problem—maybe doctors work too hard in residency for such low pay that by the time they get their first job, they mistakenly believe that a six-figure salary can purchase more than they realize.  Maybe the work to income ratio for doctors is skewed in that we expect to have a much more “luxurious” lifestyle than what our incomes would allow us to have. 

Their products are so good…

There is something about our profession that leads us to set our financial mindset level higher than what it should be. When that happens, we lose our ability to control our expenses.

What other variables interfere with your financial mindset?

Seven top physician job interview mistakes

Seven top physician job interview mistakes

All of us have or will encounter a job interview during our careers, either as the applicant or the employer.  How we fare in these stressful situations often correlates with the number of prior interviews we’ve participated in, but some of us seem to make the same mistakes no matter how many situations we’ve encountered.  We’re all capable of learning from experience, but unless you’re a professional job seeker (or interviewer) you don’t have that many opportunities to improve your interview game.

Sometimes you can be in over your head without knowing it!

Ironically the name of the game is to avoid having to go through so many interviews in our careers.  You want to find a job and hold onto it until you retire.  After all, with every new start comes additional stress, disruption of a routine, and financial strain.  Clinical medicine is different from the business administration realm where everyone is expected to move on after a few years.  
With the job hunt in mind, the following are some of the more common mistakes that we see with applicants:

Asking about income on the first interview — Even though income is the most obvious criterion for most people, discussing this appears to violate societal norms.  This formality applies to all other industries as well.  You don’t discuss salary until you get an offer.  Some recruitment personnel also seem to break with convention by asking applicants how much they are willing to accept—that’s also against convention.  Do not give a recruiter your income expectation if asked. Remember, any job is about the fit.  It is your job to assess all of the non-income aspects of the job during your interview.  There is a different and more appropriate time to discuss financials.  It is also a moot point to inquire about salary as it conveys to the employer that they would offer you the job even though they haven’t.

Asking questions to the wrong people — I often see applicants ask physicians details about the benefits or other questions more pertinent for human resources.  There is nothing wrong with doing so, but realize that the physician may not necessarily be attuned to all of the details.  Likewise, if you are interviewing with the CEO of a practice it’s important to realize what is a useful and appropriate question to ask.  

Not identifying what they can bring to the table — The interview provides an opportunity for the applicant to display her strengths that aren’t perceived on paper.  There is obviously a delicate balance so that you don’t appear to be a braggart.  How you can highlight your strengths is an art form, but this is an important aspect about the interview process especially if the position you are seeking is in a competitive market.

Accepting a contract as a final offer — Most physicians are going to have a contract reviewer or lawyer review the contract.  Many large institutions and hospitals, however, have boilerplate contracts that they would rather not pay their legal team to revise.  The take-home for the applicant is that everything is negotiable, but it has to be within reason.  You can’t just ask for minutiae changes just because you’d don’t like the wording.  If your employer really thinks that you’re a good fit, they will likely try to work with you.

Not willing to compromise — Just as how you shouldn’t settle on things that are dealbreakers, one of the most annoying things is to act like you’re doing a favor to a potential employer by letting them hire you.  It is important to know your value, but also realize that there are financial and logistical constraints to a new hire, no matter how valuable that person may be to the organization.  

Appearing to lack interest — We have all gone through interviews and know that being interested in the job goes a long way.  These interview days are often long, tiring, and repetitive.  Sometimes there’s simply nothing exciting about a potential job.  Even though you might not be interested, you should still pay attention out of courtesy.  All of the parties involved in your interview have volunteered their time.  An uninterested applicant simply conveys a lack of respect to others. Don’t make that mistake. 

Asking for feedback — We are all going to apply for jobs where we don’t receive offers for.  Rejection is never fun, and we want to improve so that we don’t make the same mistakes in the future.  I’ve seen advisors recommend applicants ask the employer for interview feedback. Don’t do this.  Only your closest friends are willing to tell you the truth.  A potential employer is not going to be able to tell you exactly why they decided not to make you an offer.  Don’t try to put them in an awkward situation.  This is why corporate folks simply say that an applicant “wasn’t a good fit”.  

Interviewees, please take notes of these scenarios and think about the last times you’ve gone in for a job and what instances could have been changed to improve the outcome for both parties.

What other interview mistakes have you seen?

Six strategies to use your CME during a pandemic

Six strategies to use your CME during a pandemic

Most employed physicians receive dedicated funds for continuing medical education (CME).  This can range anywhere from $2000 to even $10,000 for the most generous of employers.  These CME funds are often used for meetings, and do not carry over to the following year.  The most common gripe we hear about CME funds is that it is never enough—medical conferences are expensive especially when vendors decide to gouge physicians.

Use your CME funds in paradise

Fast forward to 2020.  Most of us have unused CME funds, especially since most in-person conferences have been axed for the year and probably the early part of 2021.  Not sure how to use up your CME funds? Here’s a list of six options to use up the money that you are entitled to:

  1. Sign up for the White Coat Investor (WCI) Financial education courses.  For the week of Nov 23-30, they are offering 10% off all courses as well as free access to the Park City virtual course, which typically sells for $299.  There is a lot of financial education from well-known experts, and best of all, you can satisfy your CME requirements too.  There’s nothing like using your money to help you be smarter with your own money.
  2. Pay your society dues.  This includes your local, state, and national profession societies.  Most people don’t think to prepay subsequent years, even though it is usually possible.  If the website doesn’t have an option, just contact the administrator to your board.  They can often take payment via phone to pay several years’ worth of dues (if they are smart). 
  3. Buy electronics.  Laptops, chargers, phone battery packs, and other accessories that could help improve your efficiency at work often qualifies for CME funds.  Check with your employer for specifics on what is covered.
  4. Purchase personal protective equipment (PPE).  We all need it.  Masks and face shields are key to protection during the pandemic.  Even though your hospital or employer provides you with masks, it is prudent to have your own.  We have all put masks on rotation during the beginning of the pandemic and known how nasty that can be.  
  5. Buy apparel.  Scrubs and white coats have come a long way in fashion and pragmatic use.  Having spare scrubs to change into after work before you hop into your car goes a long way to minimize fomite transmission of disease.  Modern scrub designs are more flattering with practical pocket designs to make you more stylish and functional.
  6. Buy books, apps, and medical reference material.  All of us are pressed for time to read, but having updated reference material will help you out in a pinch.  Uptodate and subscription-based phone apps are helpful for quick calculations on your inpatients.  Now is the time to subscribe and get armed for the new year.

Remember, don’t leave money on the table.  If your employer provides CME funds, be sure to use them up.

What other strategies have you implemented to use CME funds this year?

Physician Burnout – an alternative analysis

Physician Burnout – an alternative analysis

Physician burnout has been a much discussed subject in recent years.  The term itself is often broadly defined, but the general consensus is that burnout frequently describes a feeling of unhappiness.  This unhappiness is often directed towards or fueled by the activities that one has to endure throughout the day, week, or an entire career.  Some people have described burnout as having to deal with a series of activities that we dread.  In response to physician burnout, hospitals and employers have invested into significant programs to “remediate” their physicians. 

I have yet to find any legitimate study supporting the efficacy of these remedial programs, but there is clearly an increase in coaching services, self-help manuals, and aids to combat this growing problem. 

Sometimes we are burning on down to the wire.

The source of physician burnout has been attributed to a multitude of reasons, many stemming from increasing regulatory demands in the workplace, more menial work with electronic health records, and even motivational huddles mandated by administrators to combat the very same problem.  There is no doubt that these issues contribute to disgruntled physicians, but there is another problem in our modern healthcare system that is not as commonly discussed.

Your patient is part of the problem

Medical training emphasizes the need to put patients before ourselves.  The Hippocratic oath reminds us not to do harm, and we frequently go out of our way in order to get patients the best outcome.  In medical school, we undergo simulated scenarios to diffuse conflict.  We are taught to emphasize with the patient.  Doing so is entirely reasonable and an appropriate exercise for everyone in healthcare, but is it the right approach?  Empathy is certainly the socially acceptable answer, but the dark side to empathizing with those we care for is that undoubtedly we end up biting our tongue and perhaps compromising what our moral compass tells us otherwise.  

We’ve all had our unpleasant patient and workplace encounters.  It’s part of the job, and somehow we’re all expected to brush aside these experiences and continue throughout our days as though it were only a scratch.  But we can all attest that the frequency of these encounters has gradually increased over recent years.  No matter how insignificant, these battle scars build up.  We internalize the pain.  We remember the good and the bad cases, and not infrequently, the bad ones are the ones that gall us during our entire career.  They cause us to toss and turn in our sleep, disrupt our family lives, and even cause physical ailments.
These unpleasant experiences are uncommonly justified, and they sting.  Here are a few scenarios that we end up dealing with in our daily lives:

  • A patient demands a refund on their copayment after a visit because they are unhappy for their care.  Then they ask for a copy of the visit record. (You can’t legally void a patient visit afterward if you are accepting health insurance.) 
  • An unreasonable patient lashes out with an unfounded social media review on a 3rd party ratings website.  The physician’s office is unable to remove the review because these websites actually hold business reviews hostage.  But these websites are quick to push their services onto your practice.
  • A patient hammer calls the office with questions that should be asked during a patient visit in order to avoid paying a visit charge.  

Medical practice is burning us out
If doctors have always taken care of patients, why are we only burning out now?  Two reasons come to mind: (1) the healthcare environment is constantly evolving, and (2) both good and bad information is more readily accessible to the lay public.

The healthcare system is complex.  Much of the complexity is due to trying to fund uncontrolled expenses with a finite and insufficient budget.  For the workers involved in direct patient care, this has translated into limitations on our resources.  Our profession was built on physician autonomy.  Physicians have always chosen how to diagnosis ailments, and how to treat them.  Our current system imposes strict financially driven boundaries on how physicians can practice.  In principle it is great to make healthcare decisions based on prudent cost-saving measures.  However, drug formularies are not all created equal.  We have all experienced health insurance denials of our recommended treatment regimens only to find that what is recommended by health insurance is not equivalent by any standard.  Physicians are now having to fight more than ever with insurers and regulators.  This is a mentally and physically exhausting endeavor.

Properly informed patients are a blessing, but there are problems when people are armed with misinformation or are unable to arrive at the appropriate conclusion even with correct information.  This situation is increasingly more common with easy access to online information.  We see this among healthcare workers as well—we are sometimes armed with the wrong information, but unable to correct our shortcomings due to pride and ego.  As physicians we have always struggled with the paternalistic desire to do the right thing, offer the facts, and arrive at the best possible solution for a given situation.  It is a struggle whenever we our recommendations do not align with what our patients expect.  The patient as a person is not the problem.  It’s the availability of unfiltered content open to erroneous interpretation that causes stress.  When you throw in the complexities of health insurance that no one truly understand completely, you have are surely going to struggle.  Repeated struggles will burn anyone out.

Bringing the sources of burnout to light

Physicians shouldn’t have to dread their work.  Our patients don’t deserve to have doctors who are burnt out either.  But our current system has made it easy to stress out and find blame.  Those of us near the end of our careers can surely attest that practicing medicine just isn’t what it was used to be.  It is now up to the current and future generations of physicians to make medicine great again.

What aspects of medicine do you dread?

Protecting your financial future from other physicians

Protecting your financial future from other physicians

Unfortunately, hospitals and healthcare systems are not the only ones that take advantage of doctors.  Physicians in private practices are just as likely to take advantage of their colleagues, and sometimes the severity may be much greater than what you’d see in the hospital setting.

Those of you younger doctors in outpatient specialties, take note.  This list includes gastroenterologists, ophthalmologists, vascular surgeons, oncologists, internists, or anyone who would join a medical practice with another doctor.  Anytime there is a younger physician joining a practice run by senior physicians, there will always be potential for inequity.  Why do these problems arise?


Greed of money, and greed of exploiting someone else. It just happens.  Perhaps the senior doctor thinks that she put in blood and sweat into a practice that a junior associate is simply getting in for free.  Blood must be drawn in order for a new doctor to be accepted. 

How you can get taken advantage of as a junior doctor
Most of us learn from getting burned ourselves.  These situations can occur in any of the common three ways:

  1. Reneging on a prior promise — This is typically the most obvious scenario that younger doctors encounter.  A new doctor joins a practice with the promise of partnership after a certain period of time.  When that time is reached, the owner-physician declines the partnership offer for some infraction.  The junior doctor is then stuck remaining as an employee indefinitely or move elsewhere.  Sometimes this cycle repeats with a new hire.
  2. Withholding critical financial information — Sometimes a partnership isn’t really a partnership.  Or maybe not all partners are created equal.  The problem with healthcare is that there are business nuances that you will only learn with experience in your profession.  This is where a less experienced physician can get taken advantage of during a partnership agreement.  
  3. Exploiting mentorship role for financial gain — Greed.  It never makes sense to me that a physician who has had an entire career of earnings would feel the need to maximize financial gain of a younger physician.    Typically the amount of financial gain is quite negligible for the senior doctor’s retirement plan.  I’ve seen instances where the senior doctor owns the building in which the practice rents from, and the lease arrangements benefit the landlord significantly.  I’ve seen instances where the junior doctor is heavily dependent upon the senior doctor’s goodwill to refer patients over, but the senior doctor does nothing to help the cause.

Justification of greed
Why do we even see doctors getting exploited by others in their profession? The answer likely lies in the competitive nature of those who enter the profession.  Look back to medical school—we all have been witnesses (or instigators) to cutthroat behavior in medical school.  There is a desire to get ahead.  These behaviors carry over onto everything we do. 
Those of you just starting your careers will need to be aware that malfeasance can happen anywhere and anytime.  Even if you ask the right questions and do all of the right things, you can still get swindled financially by a fellow physician.  
Those of you who are senior physicians bringing on junior physicians, be mindful of what you went through and try to mentor your younger colleagues properly and fairly.  Do the right thing. Our profession needs to stick together to fight the good fight. 

Survival tips for new interns – 2020 Edition

Survival tips for new interns – 2020 Edition

It is never easy starting a new job.  For medical doctors, July 1st typically marks a transition to a new role: medical student to intern, intern to PGY-2, or senior resident to attending.  Some aspects of these transitions are easier than others, but there will always be challenges in medicine.  This year includes another level of complexity for the transitioning medical crew, notably COVID-19.  What a mess.  Not only do doctors have to master their trade, they also have to stay alive and figure out how to treat disease that our profession knows very little about.
Those of you in a hospital-based practice or are still in training, kudos to you.
Looking back at my own experiences as an intern, I wish that I had a list from my future self to follow.  But a time machine doesn’t exist [yet], so I’d figure that I could share some of my experiences that could have made my own internship a bit simpler.

Take care of yourself

Self care is ironically neglected in medicine.  Patient care, presentations, studying, and whatever else it takes to get through the wards often get prioritized. Residency is taxing no matter how you spin work hour restrictions.  However, you are in it for the long haul.  Don’t forget to take care of yourself.  This means:

  • Get adequate sleep – No intern ever gets enough sleep.  There are simply too many tasks to contend with, and obligations to fulfill.  Somehow we all manage, possibly because most doctors in this point of our careers are still young and have enough energy to power through on inadequate sleep.  Just because you can power through on minimal sleep doesn’t mean you should.  Don’t forget to find a free weekend to rest.
  • Implement an exercise plan — I wish I had done this during my training years.  This is difficult especially if you were never one to exercise even if you had free time.  However, we all know that physical activity is mandatory for good health.  Start slowly if you normally do not exercise.  Walking, yoga, stretching, or even brief exercise warmups are a great start.  You’ll sleep better, and feel better.  That’s why you tell your patients to exercise, right?
  • Don’t forget to eat — This also means trying to eat as healthily as circumstances allow.  That occasional binge on potato chips is probably okay the night before you present grand rounds, but you’ll feel better if you eat better.

Work hard

Medical training is probably the only time in your medical career where you will be learning and working in a protected environment.  What this means is that you have like-minded peers who are going through the same highs and lows, and mentors who could help guide you.  Some of the most challenging yet gratifying experiences we will ever encounter will be during training.  There is a time limit on your training, so don’t lose sight that working hard during this time will carry you through your entire career.  

Are you lost yet?

Don’t forget that you work with sick people

Yes, you are a physician.  That means there will be bodily fluids, ways to contract and spread illness, and basic rules that you ought to follow.  Many of my colleagues would wear their hospital shoes through their homes.  Don’t do that.  Here are a few more recommendations for hygiene:

  • Change your clothes — It doesn’t matter whether there is a pandemic in the world—it is always a good idea to keep your hospital work clothes and shoes separate from everything else.  There are plenty of contagions and simply filthy substances that healthcare workers encounter in their daily routine.  Some can impact your health, others simply should not mingle with the carpet that your children crawl on. While you’re at it, consider taking a shower right when you get home or even at work before you leave.
  • Keep that mask on — If you are working in an area where there is a risk of aerosolized contagion, keep that mask on.  This includes sign-outs between teams even if you are not directly in an area with patient care.  The less you are touching your face and eyes, the less likely you can also transmit disease.  Don’t be like that person who takes off his mask while talking. 
  • Hand hygiene matters — Sure, some of us have been guilty of scarfing down that breakfast sandwich during morning rounds or carrying that coffee while you’re rounding in the ICU.  It doesn’t mean that you should make a habit out of it.  Hospitals have cracked down on this over the past decade, but it is still important to be cognizant of what our hands touch and where we are working.  Yes, hygiene hypothesis has validity, but most of us will get plenty of exposure through raising kids!

There is light at the end of the tunnel

Don’t forget that there is a finite time for internship and residency.  Work hard and you will be prepared to build upon your experience for the rest of your career. 

For those of you who survived internship, what other tips do you have for the newbies?