May 19, 2008

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Jeff Cleary Tarayn Fairlie

The Lowdown on High Expectations

I know they are coming; I’ve seen their photos, black and white with earnest smiles and the occasional cheesy backdrop. The replacements—the incoming class of pediatric interns—will be arriving in a mere 53 days. Sometimes, when the day has been especially long or tiring, I’ll look through their bios and photos that hang in the back room and breathe deeper. Those sheets hanging from the corkboard are proof that the end is, indeed, in sight. Internship will not last forever. Come July, I’ll be a resident, whose role focuses on something other than accomplishing the work of the day.

After two years of internship (one in family medicine and one in pediatrics), I can hardly believe that this is actually going to happen. I find it incredible that I won’t be an intern again next year but a supervisory, or senior, resident, one who fulfills a role that in our hospital is often equal to that of a third-year resident. Despite watching and learning from senior residents all year long, I still have no idea what this will mean for me. After hundreds of hours on the job side by side with senior residents, I still have very little idea of what they actually do at work.

Of course, I know that a senior resident’s job is to teach and to supervise interns, but how seniors organize their day and do their job on the most basic level eludes me. This worries me, because having a senior who doesn’t know how to do her job is something that can make or break an intern’s experience. I especially worry that I’ll be that senior whom interns dread working with because I may tend to take over their job since I’m more familiar with it.

I can picture this happening. While internship has taught me a great deal about how to take care of patients on a practical level, I’ve spent two years putting on hold things like keeping up with the latest journal articles and reading textbooks for background material. A good bit of my brain feels rusty from lack of use, and I know it will take a lot of work just to feel like I can teach anyone anything come July.

In short, I feel just as uncertain, underprepared, and nervous in the role of rising second year as I did in the role of new intern, but with added anxiety over my new responsibilities as supervisor and teacher. After all, when you’re an intern, there’s little expectation that you have much wisdom to share. Next year, the expectations are higher, and I’m not sure whether I can meet the challenge, bringing to mind what a chief resident once told me—that internship is the easiest, least stressful part of residency training. I had laughed at the comment, thinking to myself that nothing could be as tough as internship. Now, on the brink of becoming a senior, I know that the chief resident was right—and I can only hope that as a senior I can meet my own, and everyone else’s, expectations.

—Tarayn Fairlie, HMS ’06, is an intern in pediatrics at Baystate Medical Center in Springfield, Mass.

The opinions expressed in this column are not necessarily those of Harvard Medical School, its affiliated institutions, or Harvard University.


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Copyright 2008 by the President and Fellows of Harvard College