1. Transition to PGY 2
Let it be smooth …

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

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

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

5. Tips For A Smooth Transition …

6. See the big picture ….

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

8. 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

9. 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 !!

10. 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 !!

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

12. 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 !!

13. 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 ...

14. 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 !!!

15. 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 ..

16. 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.

17. 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

18. You are the senior resident now !!

19. 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

20. 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.

21. You are the senior resident now !!

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

23. 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?

24. 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

25. 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

26. 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)

27. 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

28. 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

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

30. Good Luck …. 
Hala …
Sairia…
Sweta …