Yes, it's almost been seven months since my last post. My sincerest apologies. As I look back on previous posts, I realize this is the first one of R3 year, which is about halfway done by now. By this time last year, I had already written four posts about R2 year. Even though the blogging pace would eventually drop off to just two posts over the latter half of R2 year, I was curious about what might have changed this year.
For some insight, I reflected on a previous post, The Circle of Residency Life, where I tried to anticipate what R3 year might be like. Apparently at the time, I was concerned about doing semi-autonomous work without the immediate availability of attendings in the outpatient setting. Surprisingly, that has probably been the least worrisome aspect of being an R3. There have been only a couple of times where I had to urgently consult with an attending in real-time about a patient while the patient was in my office. For the most part, clinical decision-making has not been the issue. Instead, the focus of improvement for the remainder of R3 year will most likely be time-management (which was only a blurb of an afterthought last year), specifically improving my time-management while working in the office and living life outside of the office.
In terms of time-management in the office, keeping logistics running smoothly at clinics hasn't been too much of a problem. Rather, it's the effect that time-management might have on my clinical style. For the remainder of R3 year, I need to make sure that efficient interviewing/documenting doesn't get in the way of building rapport and establishing an emotional connection with patients (a common conundrum in all medical fields), a balance that I hope to achieve with the help of my various clinic supervisors.
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[What I imagine when I think of balancing efficiency with patient rapport.]
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Just as important this year has been learning how to manage my time outside of the office. The awesomeness of the R3 psychiatry schedule (with no work on the weekends or major holidays) still stands true. However, with great power comes great responsibility. As I reflect on why it's taken me so long to update my blog as an R3, I realize it was because I was still doing a lot of clinic work outside of the office during the early part of the year. I was spending a lot of time trying to chart-review patients and pre-writing notes ahead of time in an attempt to be efficient during office hours. In some clinics this strategy does pay off, but recently I've come to realize that this isn't always the case; some of these efforts were resulting in diminishing returns and not really saving me time. Thus, part of the change in time-management has been figuring out what patient information I need to know ahead of time and when I can Let It Go with other information, a change that has allowed life outside the office to settle down to the point where I can do things like update my blog.
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[Something else to do in my free time: watch "Frozen" and finally see what all the fuss is about.]
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Although I'm not necessarily "at a loss" for what to do as an R3, I think I'm still transitioning from certain habits developed after years of largely inpatient work. Fortunately, as one of my supervisors told me, all of the components of outpatient work are in my grasp; it's just a matter of learning how to wield them correctly, with both efficiency and empathy. If I continue to push myself to work outside my comfort zone (which involves limiting the amount of work I do outside the office), I can trust the process will yield results in the end.