Final Chapter

I just completed the seemingly mundane task of updating my signature for my work email on my iPhone.  For many this may be an unnecessary task or a head scratcher as in "what?" or "you have a signature in your email?"  For me however, it's not.  My email always has a proper intro and a formal ending with of course what else but my always up to date signature.

Today is the last day of my 3rd year of residency training.  End of so far the fastest year of my residency.  I am slightly shocked by how fast this year has gone by and now as of tomorrow I am a PGY-4.  Next year on this day I will finally be done with my training.  So many emotions go through my head when I think of where this year is headed.  I think I don't want to think about it for a few months.

My signature update included changing my PGY-3 designation to PGY-4 and most importantly removing the "Psychiatry Chief Resident" title from the body.  It was a mix of nostalgia, sadness and slight sense of relief.  I am not the chief anymore.

I won't be getting dozens of emails about millions of different little things that I used to do from schedules (until I did them) to class schedules, to putting out little fires here and there, to big things that happen in every group that has 20 different adults of various ages and personalities, to many emails that I had to write to ask for this or that to be done.  I am not doing the orientation this year nor am I responsible for anything else chief residents have to do.  I mean there is no set job description as is and yup still no magic wand.  While I feel like I will miss the daily churn and the feeling of being needed that came with the job, it is probably going to be pretty nice to have a relaxing final year of training and being back in the middle of the group in the meetings rather than at the front of the room.

It is going to be a big adjustment because at this point I have more time as a chief in the program than just being a resident.  I am fully aware of this transition and that it will be a bit of struggle for me because I have a tendency to try to handle things when they present or take upon myself projects to handle things I think need handling.  My title gave me enough autonomy to do so while I was in the role, like figuring out patient hand off between incoming and out going residents or taking on updating our website or changing the ER rotation structure when I felt like it needed changing.  That is a place from where I have to mindfully step back and let the newbies get their feet wet and make their own mistakes and take up their own projects.

If I had a chance to do it all over again, I would probably do it despite of the frustrations and stresses and extra work it gave me.  These past two years also gave me a lot of experience to look back on and learn from my mistakes.  I am sure because of these two years I really want to think about what do I want from my life after this year is over.

I am finally ready to let the responsibility go and enjoy what is left of my residency training.  In the end as I edited my signature today to take my place back in the middle of the group, I realized that sometimes the seemingly little or mundane acts like hitting the backspace and delete keys are all it takes to take a load off and put up your feet.  Of course, it helps that now I am officially allowed to do so.
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As some one once said "Don't close the book, just turn the page."  so here I am and I think the final chapter is going to be the most exciting.  

Tis' the season to be Jolly!

Here it is again.  It seems just like yesterday when presents were given and parties were thrown, families got together and emotions were mixed.  Time sure flies when you are having fun.
Sounds like Christmas and for the graduates from all walks of life, it might as well be.  The diplomas that are handed to these graduates all over the U.S. are like the Christmas present you get from your grandparents and you know what is in it because you told them a thousand times what you wanted but now you aren't sure you picked the right present or worst would you be able to use the present as intended?

I have come to love the graduation season almost as much as Christmas because well really what's not to love?  It's not cold and there are flowers (unless you have allergies and then it sucks), sunshine, Facebook feed with a slew of gleaming pictures with grads and their proud families; and best of all Target and Home Goods have stellar sales for the grads.  I mean come on now, who doesn't like a good sale any time of the year?

Just like other academic settings this is also the time of the year when medical students, senior residents and fellows are graduating and other residents are moving up the PGY ladder.  What a great time!  I am going to be a 4th year in about 3 weeks.  When I started writing this blog I was in the middle of my 2nd year of training and here I am now finishing my 3rd year and being the senior most upper level resident.

I am graduating from PGY-3 to 4.  There is a virtual party in my head 24/7.  Well in the background at least.  It also is the last year of my training and I find myself getting sad at times thinking about losing the comfort cushion my program has provided me.

I call my program "The mothership" when I am on an away rotation and all of us have pretty much adopted that term.  Just like a mother, it provokes loving and secure feelings in us; while at the same time we have conflicting feelings towards it, making it what the Kleinians refer to as the bad object.  I have another year left at the mothership before it ejects me in the outer space to navigate on my own.  Talk about anxiety.

There is also the transition of the patients I have seen for a whole year and have formed relationships with.  It has been a hard transition for many reasons.  Some patients I wish I could keep but I am capped and some patients I have struggled with myself.  To find a new resident, that I feel may fit them or vice versa; has been a challenge.  Hand offs in residencies are not well organized for the most part and with mental health patients it can be even more sensitive and chaotic esp. for the patients.

This is also the year I will step down from my position as a Chief Resident for the past two years.  This has been one of the most challenging roles I have played during the residency and I say this with a five year supervisory role prior to starting residency.  Being a chief in a residency program is nothing like being a supervisor.  This is a position of a certain perceived power where depending on your PGY ladder position in the program; you may have peers, juniors and seniors to manage and think about.  I have learned of my weaknesses and strengths and I have made mistakes and done good things for us as a group and hopefully for the program.  The best lesson I have actually reaffirmed for myself is that as long as you do the right thing, and as long as you are willing to step back to look at yourself and your peers critically; you will do okay.

People are generally reasonable if you are fair and honest and by that I mean that you can sleep at night knowing that there is no nagging little voice tugging away at you from somewhere deep inside.  Because your only job at all times, whether you are a chief or not; is to take note of that little voice that we like to call the superego.

So here I am in the last stretch of my chief time and PGY-3, passing the hat on to the next chiefs; and passing a lot of patients to incoming PGY-3.

Next year it will be my time to graduate as we bid farewell to our current PGY 4s next week.

As the lyrics go:

As we go on
We remember
All the times we
Had together
And as our lives change
Come whatever
We will still be
Friends Forever

So if we get the big jobs
And we make the big money
When we look back now
Will our jokes still be funny?
Will we still remember everything we learned in school?
Still be trying to break every single rule
Will little brainy Bobby be the stockbroker man?
Can Heather find a job that won't interfere with her tan?
I keep, keep thinking that it's not goodbye
Keep on thinking it's a time to fly and this is how it feels.      

"Graduation by Vit C."