It's July Again ... New Residents, Fellows Meet Their New Patients, Attendings

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AnasYounes_JulyEvery July, the new academic year begins for U.S. medical training programs. It's a time when new interns and fellows join new hospitals to learn and to be educated.

In addition to taking care of new patients on their first day of service, they have to adapt to a new environment, know the nurses and doctors, find their way in new buildings and, sometimes, new cities, and take care of their own personal and family matters: the rent, car insurance, schools for their kids and finding new friends. I remember the first day of my July internship very well. When you're a doctor, it's a day that you never forget.

It was 1986. I had just moved to New York City three days before and was still trying to settle in. I found a studio apartment overlooking the Statue of Liberty and New York bay, bought new furniture and kitchenware, insured my car, got my phone and electricity connected, and got my clothes and medical books out of the boxes. Then came July 1st.

On my first day, I was very excited but nervous. The graduating intern introduced me to my newly assigned patients with a big smirk on his face that made me even more nervous. I bet that also made some of the patients nervous. 

I sat down for hours reading medical records, reviewing lab and imaging results, current medications and treatment plans. It turned out I also was on call that very first night. I remember having four admissions that night: uncontrolled diabetes with ketoacidosis, uncontrolled congestive heart failure with pulmonary edema, prostate cancer with metastasis, and a patient with HIV and pneumonia. I don't remember other medical details; after all, this was 23 years ago. But I remember everything else very well.

I remember that I was working very hard trying to catch up with my numerous responsibilities, so I didn't have time to eat dinner. But I also remember that my resident noticed and ordered Chinese food for both of us at midnight, which was -- to my pleasant surprise -- delivered to the floor.

I remember that I was getting tired and sleepy by 3:00 a.m. But I also remember that my resident was still awake watching me from a distance, making sure that I was doing all right and offering help. To this day, I remember him falling asleep on a chair behind a desk at 5:00 in the morning after spending the night with me explaining, helping and teaching me new things. We did blood cultures together, looked at blood smears, performed sputum gram stain, looked at chest X-rays, wrote progress notes, and ordered new medicine and laboratory tests. His kindness and generosity not only made me a better doctor, but also reassured patients and ensured their safety. I don't know how I could have survived that night without him.

Thanks to my resident from 23 years ago, I always ask to be assigned to the inpatient service in July. I know many of us like to work with more experienced and knowledgeable fellows while on service; a good fellow can make the life of an attending much easier. But, as odd as it may sound, I always look forward to welcoming and working with the new fellows in July.

So, if I'm not returning your phone calls or e-mails quickly these days, I'm not ignoring you. It's July, and I'm very busy on the inpatient service.

Learn more about medical education at M. D. Anderson

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