Transition to PGY 2 Let it be smooth …

PGY2 Reflection on the past 3 years ... Personal experience .... The way to trouble free residency…

PGY 2 – Expectations … Know all the patients Lead the rounds Teach/guide interns- students Answer all questions Read Learn

PGY 2 – Expectations … Know all the patients Lead the rounds Teach/guide interns- students Answer all questions Read Learn That’s a lot !!

Tips For A Smooth Transition …

See the big picture ….

See the big picture …. If you don’t see the big picture, then it’s a big problem …

See the big picture …. Understand your own new role Be comfortable with your new role Understand your interns’ role Understand the attending’s role Do NOT take over someone else’s role Be supportive and helpful when needed

See the big picture …. Know that you will gradually work your way through PGY 2 and it won’t happen in the first week. Ask for feedback- be open to feedback- incorporate feedback .. Do not take ANYTHINIG personal .. Be the mature one !!

See the big picture …. Do not try to prove yourself in a very intense way – relax- focus on your work- be helpful to your interns especially at the beginning. Your interns are struggling to prove themselves too Do not compete with interns, they are stressed too and do not need this, Be supportive !!

See the big picture …. Team spirit/work is the most important thing It’s YOUR responsibility to create a good learning environment

See the big picture …. Teach what you know .. system stuff at first Do NOT teach stuff that you are not sure about ... if you don't know, say I don't know !! DO NO HARM .. (most)  interns are like a sponge .. they will take everything you say and make it a rule !!

See the big picture …. Learn from interns and students !! Observe them .. do not compete with them ... Show them how to do it ... teach them how to do it .... observe them do it ... support if difficulty ...

See the big picture …. When you happen to work with an intern who outsmart you .... don't be insecure !!! be happy you are LUCKY !!! BLESSED !!!  

See the big picture …. So easy for an intern to tell who if the senior is a PGY 2 or PGY 3 When you are a PGY 2.. you hope you get a good intern .. they hope they get a good senior ..

Reflect for a minute ... When you were an intern … were you in a situation before where Senior resident took your procedure and did not explain to you why Senior resident talked to your patient and did not update you Senior resident interrupted you during rounds- for non- important stuff Senior resident was not fair distributing patients/ admissions in between the team.

Reflect for a minute ... When you were an intern … were you in a situation before where : Senior resident did not help with anything and you had to do all the work Senior resident did not know the answer to your question and you were so busy so no one actually looked up the right answer Senior resident dumped the students on you Senior resident had you staff the new admissions with the MICU attending without even discussing anything in the assessment and plan

You are the senior resident now !!

Reflect back again … where you in a situation where .. Senior resident came early and new everything about the patients Senior residents taught you step by step how to do a procedure and was patient with your multiple failed attempts Senior resident gave you pearls and teaching points on your patients, some you could remember till now Senior resident gave you some tips on how to admit a patient, put the correct orders for stuff, do a good med rec and write a good discharge summary

Reflect back again … where you in a situation where .. Senior resident asked you for your feedback and whether they can do things differently Senior resident asked you if you are comfortable staffing a patient directly with the attending Senior resident staffed a complicated MICU patient with you before you presented to the attending Senior resident was with you side by side to evaluate a sick patient who is going to need MICU transfer.

You are the senior resident now !!

MTS 6/7 E # 29350 MTS 11E # 29037 Primary resident TOC resident 2 day Interns and 1 night intern 1-2 students

MTS 4N ( # 29351) 1 primary resident 1 TOC resident 2 day interns, no night intern 1-2 students Sign out time to 9E resident is 4.30 pm?

MTS 9E ( # 29349) 2 day residents 1 evening resident- cap is 6 ( admits also for 4N from 5-8) You will have days when there is only 1 resident You will respond to codes

Star/Night Float 2 alternating residents between star and night float 2 NF residents on Saturdays and Sundays One NF intern on week days Sign out time starts at 7, 7:15, 7:30, 7:45 Rules will be sent to you before NF Remember to respond to codes MICU resident might call you for back up

CCU 2 interns and 1 senior Each intern will get 1 day off a week so you will be covering their patients ER interns have teaching conference on Wednesday so you will be covering for them You will be asked to follow patients on step down until discharge ( this may change in the future) You have to review very carefully the discharge summaries and the scripts/lab follow up You will be asked to see consults ( some cardiologist will give the consults to you and you will distribute them among the team)

MICU First 3 blocks: 2 seniors, 3 day interns, 1 night intern Other blocks: 1 senior, 4 day interns, 1 night intern Sign out is 7 am from the PGY 3 night resident Rounds at 8.15 am

MICU Know during rounds who goes to GMB, tele, IMC, begin to fill the yellow sheets Follow the instructions on the yellow sheet. Call Triage for transfers Give verbal sign outs to attending and document that in the transfer note Follow up with your interns- run the list to make sure you are not missing any orders During the above, you will have codes, admissions, procedures, unstable patients- make sure you have a well-structured team with clear duties and expectations, especially when there are two seniors

AIM More patients Know NextGen Manage your PAQs and your partners’

Good Luck ….  Hala … Sairia… Sweta …