Second year is a time to survive, like that idiot hawaii yoga instructor that got lost in the forest for 17 days. Despite making literally every possible incorrect move – she wandered off the trail, followed her “gut,” fell down a cliff, ate unknown plants, drank standing water, and somehow lost her shoes – nevertheless, she persisted.Cognitive learning skills this analogy for the R2 year is astoundingly robust, when you think about it.

Second year can be is often a dark time, both figurative and literally.Cognitive learning skills figuratively, because you will come home at points and envy the regular and simple schedule of the sanitation worker hitting the button on the trash compactor on the back on the garbage truck.Cognitive learning skills he does not need to wake up after four hours of restless, benadryl-and-melatonin-induced daysleep to go back to yet another twelve-hour shift discharging the worried well with colds and stubbed toes.Cognitive learning skills

Speaking of which (and on a serious note), after a particularly prolonged run of nights this winter I became globally sad enough to actually seek help.Cognitive learning skills if you know me well, you know that me going voluntarily to any kind of mental health professional is about as likely as getting eaten by a shark.Cognitive learning skills while being struck by lightning. On a sunny day.

My lowest point of residency so far was probably in april, which despite being my birthday month contained the last four weeks of a six-week solid run of pure night shifts.Cognitive learning skills no days. No sunlight. No circadian rhythm. Just unrelenting night shift after night shift, punctuated by the occasional day off where you have a choice between briefly flipping your sleep schedule back to normal and having a zombie-like encounter with friends, or sleeping during the day and spending your night off binge-watching ted bundy documentaries until the sun rises and you go back to sleep.Cognitive learning skills

This month, happily, I get the other end of the stick. For the first two weeks of may, I had exclusively day shifts. Now, I’m on “home elective,” which I have learned is code for “do as much nothing as possible.” I’ve slept, on average, 7-8 hours a night.Cognitive learning skills I am awake when the sun is in the sky. I am asleep when the 4 AM cortisol low rolls around. The bringer of life came to visit.

Enter residency.Cognitive learning skills as an intern, I was too freaked out and confused to realize my place in the system, besides that I was at its bottom. As a second year, you see a little more of the underpinnings of the hospital because you have a bit of cognitive space to do so.Cognitive learning skills hospitals are not run by doctors, although the C-suite executives often have “MD” after their name. Real power resides in nursing.

Two. Keep your head down.Cognitive learning skills second year is when you start to realize that different attendings have different practice patterns, often based on zero science or evidence and wholly on their own training and experience.Cognitive learning skills two different attendings may treat the same patient completely differently – one might admit and the other might discharge the same patient.Cognitive learning skills I’ve had a patient with a very mild form of diabetic ketoacidosis (a complication of diabetes) and admitted them to the ICU on an insulin drip, and I’ve taken a sicker version of the same patient, treated them in the ER, and sent them home.Cognitive learning skills

These differences are now expected. The trap is to disagree or argue with your attending’s management plan, whose license is ultimately on the line if something goes bad.Cognitive learning skills in particular, when you want to send someone home and the attending wants that same person admitted, it’s tempting to argue your case. This is because it is less work for you to discharge a patient than to admit them.Cognitive learning skills

Three. Supervising procedures is exceptionally scary. While I am a medically subpar resident at best, I consider myself both a decent proceduralist and a good teacher.Cognitive learning skills despite this, when helping a junior learner – med student, senior intern, random friend of patient with a head laceration who I let cut the suture ends (don’t tell) – perform a novel procedure, my internal dialogue tends to mirror the same emotional state you have as when an unaware idiot almost merges into you on the highway:

cognitive learning skills

I recently supervised a resident performing a lumbar puncture, where you stick a needle into someone’s back and take out some fluid for analysis.Cognitive learning skills this relatively safe (if uncomfortable) procedure is one I’ve done a zillion times. I’m proficient at lps. The patient was a skinny guy with easily palpable landmarks.Cognitive learning skills we were set up for success.

Four. No one actually knows how to deal with the nights. One of our faculty members here is an esteemed sleep medicine expert and researcher.Cognitive learning skills when he found out I was self-dosing with different varieties of sedatives to try and achieve restful sleep during the day, he was nearly apoplectic.Cognitive learning skills he printed out study after study that proved, beyond a doubt, that pharmacologically-induced sleep was bad for learning, sleep quality, memory, survival, your immune system, and strangely your seizure threshold.Cognitive learning skills with an open mind, I thus asked him a simple question.