1/ Hey #MedTwitter! Been seeing a lot of questions floating around related to ‘intern year prep.’ @DoctorVig and I decided to put together a little tweetorial to try to ease that transition (and let you know that IT’S GOING TO BE OK!)
2/ We’ve broken things down into 5 main categories, mostly related to wellness, but also a ‘catch-all’ final category:
1. Physical wellness
2. Emotional wellness
3. Financial wellness
4. Medical knowledge prep
5. What to do when things get bad
3/ Let’s start with physical wellness, again these are our suggestions. Feel free to add more!
1. Start with nailing down a a routine (wake up time, meals, exercise, bedtime).
2. Exercise - if this is your thing, start doing it early, like before orientation week
4/
3. Food - this is crucial. Locate the grocery store, quick corner store options, and of course a few ‘cheat meal’ spots (ice cream, pizza, chinese, etc)
4. If you don’t cook. Figure out how to make quick and easy meals. Instant Pots are so versatile.
5/ Next is emotional wellness
1. Support network - residency can be tough, but people are there for you - friends, family, program directors, co-residents and #MedTwitter!
2. Immerse yourself (these are great people you are with)
6/
3. Do those things that make you HAPPY (“fill your cup”) - reading (non-medical), cooking, writing, etc
4. Breathe. Before, during, and after. You are going to work hard, but you are going to do just fine.
7/ Financial wellness - this may be foreign to a lot of us (read: me)
1. For many this is the first time with a real income and it’s important to live within your means
2. Learn about budgets and create one.
8/
3. You CAN save in residency. Read this list of the 5 big things to do as a resident from White Coat Investor https://www.whitecoatinvestor.com/the-five-big-money-items-you-should-do-as-a-resident/
4. The Roth IRA is a must!
10/ Medical knowledge prep -
1. Nothing. DO ABSOLUTELY NOTHING.
2. Enjoy yourself (see above tweets). You’ll get a little primer during orientation week.
3. Save that energy for learning (tons) during intern year.
11/ What to do if things get bad
1. Listen, we all get overwhelmed. You will encounter many stressful situations.
2. Having a nice work-life INTEGRATION will help you deal with this stress
3. The above tips will help you optimize everything going in…
12/ BUT, what do I do if I still feel stuck?
1. Reach out (your support network; or program director)
2. Find the activity that always makes you feel better: for me, its an extended exercise session followed by a poké bowl (freshido) and for @DoctorVig it’s cooking or reading
13/
3. Other things that help - journaling: write down everything that is stressing you out. Then circle the things you can control and ‘x out’ the things you can’t. Now tackle the circled items
4. SLEEP - we haven’t talked about this much yet…
14/
5. Depriving yourself of sleep (both acute and chronic), increases stress, reduces wellness, and increases errors - everything we would like to avoid.
6. Set sleep goals, and stick to them (write them down if necessary!)
15/
If you're like me and DO want to track sleep (without writing it down), check out this device: @WHOOP. It's helped me (A TON) to get more sleep. And @jjcolemanmd and I are both using it in ongoing research studies (for trauma attendings, and medicine residents, respectively)
16/ Well, hope that helps!
Feel free to add any comments, retweet, tag people who may be interested, etc.

I think this is actually relevant advice for all residents (and attendings too), even current ones. I’ll start with a few tags here:
ATTENDING ATTESTATION:

The following attendings have seen and examined the content of this #tweetorial in detail, and agree with the #tweetorial as written, with the following addenda:

Thank you to all that shared thoughts, with great advice from some of @PennStHershey's own
Work-life Integration:

@elianahempel:
This! (re: work-life integration) Work-life balance suggests that they are at odds with one another. Work towards finding ways which your work life and your personal life can fit together. It will rarely be a 50/50 split.
@andrewtinsley19:
Work life synergy is my goal - a combined effect greater than the sum of either one! And golf.
@jonathanstinemd:
My own personal take is that there is really no such thing as work-life balance. It’s impossible to put each into a bin and keep them separate, as home bleeds into work and work into home. Accepting this has been key for me.
@dkirch888:
@MySMFM has a first year fellow retreat every year. First of all, it’s wonderful. They use the term “work-life harmony”. Because balance is actual BS. But I like the idea of my work life and my out of work life living in harmony together.
Mission statement/productivity:

@KRakszawski:
recommend writing down your goals for future reference.
Simple things like (1) Exercise 3x/wk (2) Connect w/ a mentor (3) Call a different family member weekly. (4) Read a novel. Etc.
@jonathanstinemd:
Q (from a trainee, @davidshoremd): how do you better carve time for academia? Always seems like it has to sacrifice home time for it.
A: Find 15-30 minutes to write every day - doesn't have to be huge blocks of time!
@bcmcgillen26:
I advise folks to not try to learn ALL of IM or ALL of Cards, etc., when you’re rotating on these teams. It’s a long game...3-4 years for a reason. Read about your patients, but only for 15-20 minutes/day. Each day. Our brains can only take so much in 24 hours.
@bcmcgillen26 (part II):
Being mission-driven is so crucial. Times get tough, and it is sometimes easy to forget why you do this. Having a central mission—why you do this, and who you do it for—keeps you grounded. Write it down. Revisit it. Revise it PRN.
Other tips/tricks:

@AudreyUongMD:
I will say the best investment I made in residency was blackout curtains. Amazing for helping you go to sleep!
@dkirch888:
My life changed when I bought a sleep mask for after 24 hour shifts. Also, the Calm App.
@mike_p_pfeiffer:
I would add... every once & a while, pause & remember what the prior steps of training were like.
@JJcolemanMD:
My biggest piece of advice - be somebody that people want to be around - that means you show up early, you're nice, you're helpful, you care about the patients, you work hard, and are a good teammate :)
You can follow @AHajduczok.
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