Thursday, July 30, 2015

MiM Mail: Studying in residency

I'm a 4th year medical student with young kids wondering how others carve out time to study in residency? Of course I'm sure I'll be learning quite a bit "on the job," but I'm certain I'll still need to be learning and studying more outside the hospital as well.

I recently finished my MS3 year and was able to have a strong performance on the wards and shelf exams this year because my husband was a rock star; there were so many times that I stayed at the hospital after a 12 hr day studying and he put the kiddos to bed on his own. I also got babysitters on the weekends before exams so he wasn't doing everything on his own. And of course I carried around study materials and studied whenever I could like when I was waiting to pick up my kids from activities. I'm just curious what other solutions people have come up with. I don't want my husband to feel like a single dad forever; needless to say 3rd year was tough for him because he also works full-time. My youngest (and last!) will be 2.5 years old when I start residency and my older children will be in elementary school. I'm going into anesthesiology.

Thanks so much!


  1. I rarely studied during residency outside of the hospital. I did have to prepare the occasional presentation or something, but that was a few hours while watching TV at night. I took 2 or 3 weekends to study for my boards at the end of residency, but that was plenty after practicing it and going to morning report and noon conference for three years. This was Internal Medicine, if that makes a difference.

  2. I'm also an internist and I also rarely studied during residency, except for preparing presentations. Sometimes the attendings gave us articles to read, and sometimes they asked us to pull articles on a specific topic. I usually had time to do that during the day.

    I spent a whole summer (nights and weekends) studying for the Boards and probably didn't need to.

  3. During intern year, I started studying about 6 weeks before step 3 and did all the online cases (really the most important part) and about... 1/2(?) the USMLE World question bank. Totally overstudied for this test. This year (CA-1), I've been trying to read when I have time, like 15 minutes a day or some such. Sometimes it doesn't happen. It's fine.

  4. I am a new anesthesia attending and just passed my boards last year.

    My advice is:

    Don't bother trying to learn any anesthesia during intern year. Just survive the year and pass Step 3 (which I studied for for a week and scored even higher than Step 1).

    When you start CA1 year, find a study group or just a study buddy. Set a curriculum for yourselves where you go over some review questions (either a chapter in Hall or ACE questions) once a week or every other week. Review questions are easy to do while you are in the OR because you can get through one or two before you inevitably get interrupted by doing your actual job. I found sitting down and reading a chapter of Miller or Barash almost impossible unless I was assigned a specific topic to address by an attending for our case the next day.

    All of these names will become familiar soon, don't worry.

    And as a final piece of advice-- when I was entering CA1 year, one of my anesthesia Critical Care attending a told me, very wisely, that the first 6 months of CA1 year will be the hardest and most stressful of your life. I don't think any other field has such an abrupt assumption of responsibility. But you will get through it and at some point, you'll stop waking up in the middle of the night thinking you fell asleep during a case and somehow all the monitors fell of the patient and now you have to put them back on! (My husband was the patient and did not appreciate being woken up by his half-asleep wife trying to put Imaginary EKG leads on him)

    Good luck!

  5. I'm an anesthesiologist (finished residency two years ago) and I agree with everything Another mother MD wrote about study plans and CA1 year. Everyone learns differently and I am a person who has to study...I don't pass tests or get by just reading. For me what worked best was looking up keywords (topics covered by the ABA in training exam), reading a few paragraphs about them in Miller, and taking notes. Review questions were also very helpful, especially close to test time. I never read whole chapters of textbooks.

    I had my son during residency, and my husband was a resident too, so it was hard for me to find time to study. As a result, my first ITE and AKT scores were very low. Eventually, I found it easiest to do 30 min-1 hour of studying a night. Two months before the boards, I told my husband he needed to take all the childcare responsibilities so that I could study after work and weekends. In turn, I would do the same when he was preparing for his boards. If he was working and I needed to study, I hired a babysitter. It was really hard to be away from my son but I looked at it as an investment for his future--I needed to be a board-certified anesthesiologist! It paid off as I went from poor test scores to slam-dunking the written boards.

    Everyone is different but when you have kids to think about, you have to manage your time well and stay on top of your studying.

  6. I also didn't study much during residency, you pretty learn through osmosis. I don't know though, why do we worry so much when our men have to bear the majority of the burden of taking care of their kids? Do male doctors/medical students worry about their working wives feeling like single moms? If you count up the hours that you had worked during your third year med school, I am sure it was more hours than your husband had spent working at his job and taking care of his kids. Having said that, being working a full-time job is exhausting enough without having to take care of kids so I highly recommend hiring as many people as you can afford to help out. It is so worth it!

  7. I'm not in anesthesia, but a surgical subspecialty. It's impossible to learn enough by osmosis in my field. We simply have to read. Breaking down the annual curriculum into 20-30 pages per night is enough to get through it in a year. I struggled to get through it all last year (heavy call, still pumping 2-2.5 hours/day for the first 4 months). I've learned enough while at work that what I read now makes a lot more sense, but it will still take dedicated study time for me to become competent in my specialty.

    At this point, I study after my toddler goes to bed. An alternative would be getting up early to study, but I'm married to a night owl so pushing myself to get up earlier just isn't worth it right now.

    Just about every weekend day and evening I had off for a couple months leading up to our inservice exam last year, my hubby took on full childcare duties. We do have family in town so we were able to arrange some Saturday playtime elsewhere and give him a chance to get some work done too. He is not in a medical field so has more flexibility with his schedule but keeps busy too.

  8. When I was in anesthesia residency, I didn't do too much besides make it a goal to read for 15-30 minutes each night. I kept a text by my bed in order to do so. Other outside study seemed too daunting to do. There were a lot of residents with families in our class, so study groups just weren't done. Other than that I agree with the points above made by Another Mother MD.

  9. Well, I suggested the study partner/group thing not because it's what I did (i did start studying with a friend but not until the end of CA3 year), but because I think finding another person and planning studying together forces you to actually achieve the goals you set for yourself (because I promised Lisa that we'd go over the Pulm/Crit Care questions next Saturday).

    I found in my anesthesia residency that it was far, far too easy to find yourself at the beginning of CA3 year without having really studied very much. And the anesthesia boards cannot be passes by stuff learned on the job alone. Being a good anesthesiologist and passing the board are different creatures since the practicalities of the field are far removed from the pharmacokinetics, physics, and minute physiology in peds, OB, neuro, etc etc that are required knowledge for passing the boards. This is all also residency dependent. My residency was pretty universally known for great practical, clinical training but zero to no boards prep. There are residency programs that have lots of designated teaching time and are pros at getting their residents to pass the boards.

    Anyway, just my two cents. Hope it helps!

    1. Good point, I didn't think about how there was some built-in written and oral boards study in our program. Hopefully the poster's program also has that!

    2. Hello! I'm a 4th year student applying to anesthesia as well. I have a 3 year old so everyone's advice was very helpful! To those anesthesia moms, when is the best time to have a baby in residency?


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