Tips for new docs (Twitter)

This is a summary of tweets I came across by people that have “been there” or have something to recommend to junior residents. These are popular around July 1st for some reason… Have a look at some of those people’s profiles; some of them are rock stars!

Don’t make up exam or history findings. Ever. Simply say, “I didn’t ask” or “I didn’t do that” and then go back and do it. @EMSwami

The nurses can smell your fear. Bring chocolate, not attitude @rfdsdoc

Stay fed and hydrated, read - listen, and ketamine @embasic

“He did earlier” is not an appropriate response to the question “Does the patient have a pulse? @bungeechump

You want to save lives? Wash hands @rfdsdoc

You will feel stupid all the time and that never really goes away. Don’t worry though, everyone else feels the same way. @dr_ashwitt

“I don’t know” is sometimes a perfectly acceptable answer @DavidJuurlink

Always say “hello” and introduce yourself, before you start poking at people! @dancingfish

Don’t be a dick to the nurses @NandySelson

If asked by colleagues to treat or perform a procedure, make your own decision if it’s indicated or contraindicated. @HildenLA

Don’t confabulate; Pay attention to the little details @docsuzy

Above all, avoid diagnostic momentum. Make your own assessment - diagnosis regardless of whoever did it before. @cabreraERDR

Blood stains come out with peroxide @SJA_TM

Don’t immediately add the title “Dr.” to everything with your name on it. It just makes you look like a douche. @DrCouz

Don’t take off your clothes in call rooms. Regardless of how awesome it looks on Grey’s Anatomy. @DrCrouz

Take up running. Even if you hate it, it’s the best workout you can fit in whenever, wherever. @DrCrouz

It’s ok to hate residency. It doesn’t mean you’ll hate your career. @DrCrouz

Introduce yourself to the nurses, they will really help you. @McWhirterEmily

The magnesium - calcium - phosphate replacement guidelines are the most used document on my phone. AntiBs protocol comes 2nd. @fakethom

Ask your ward pharmacist - we’re here to help! @PlaceboJo

Learn to know when to do nothing @malcolm1771

Always say please on an X-ray request form! @dramandam1

Realize there’s more than one way to do many things in medicine. Different from how you trained may be ok. @Doctor5and2

Share every mistake with your fellow new docs to help avoid them @macfining

Your own clinical judgement is an essential part of any evidence-based assessment - treatment plan @AntifragileDoc

Trust your first impression and follow your instinct @macfining

Always have a plan B @macfining

Trust, but verify @BBMD10

Don’t be afraid to have a go at formulating a management plan for a patient. We learn by having a go and getting it wrong. @DrJHurley

Make sure you take your breaks, even if the department is busy. A rested doctor = a safer doctor @DrHurley

Count the respiratory rate yourself. It matters! (and it’s not always 20) @umanamd

Working hard and honesty will get you far - already knowing (or pretending to know) all the answers won’t @chartierlucas

When called to a convulsion, if the patient is still texting - tweeting, it’s a pseudoseizure. @drlfarrell

Respect the knowledge of the nurses. Especially in the ICU. And always treat them with respect. @doc_swallow

If you don’t know what you are doing, do nothing. Good advice given during my own training. Applies elsewhere in life too. @AntifragileDoc

Welcome to the world of grey zones, where art and science exist in glorious tension @amy_a_neilson

Uncertainty is not an ignoble state @drlfarrell

Never ever wear suede shoes @drlfarrell

Watch the “Empathy” video from the Cleveland Clinic @couragesings

Pull up a chair, sit down, & really listen. Let people tell you their story. It is a worthy 10 mins. Plus you get to sit! @amy_a_neilson

Learn early on to think of the ringing phone as a background music. Don’t answer it! @amy_a_neilson

Run to the code, but walk into the room. @JCBeausoleilMD

Work hard to maintain friendship outside of medicine, avoid losing perspective on life beyond your bubble @ashley_miller

Don’t piss off the nurses. Everyone in the hospital has more experience than you at this point. @EMurgentologist

Good luck to all who now have bigger shoes to fill. Accept the challenge. Rise to the occasion! Be well. Be smart. Be save @ERmentor

You can call them “legs” and “arms”. You’ll still be a doctor @ZackBergerMDPhD

Sometimes the single best thing you can do for a patient is to do nothing. Wait for more data before you jump the gun. @cheeler

Renal dosing for 99.9% of drugs are based on creatinine clearance. Never say “GFR” to your clinical pharmacist. @shery1santos

Never condone medical mistakes. @drlfarrell

It’s NEVER lupus!!! @BadGluteus

That hot surgeon you see, don’t hit on him, he’s already married. @BadGluteus

Get a mentor. @cabreraERDR

Ask about what the patient enjoys. Or what they are reading. What music they listen to. @ZackBergerMDPhD

Improve your handwriting @SaifAhmedKhan97

Try to get the most out of you off-service rotations, even if you don’t think it’s useful! @ER_Swan

Discipline yourself to do medical readin every week. It will pay off in the long run. @WMedAdmissions

Some people ARE going to die today. Some may make it JUST long enough to get to you. This is not your fault. @CaseyClmnts

The only difference between a drug and a poison is dose @EMEducation

Remember to check the medlist on D/C; look for critical interactions before adding a new med. @EMEducation

When you write orders review them with a nurse and ask if you have missed anything. Say thank you. @dboyceMD

Know what you know. But if you don’t know, get the consult. @TheWellnessLife

Take the time to really listen to your patients - medical history and the people behind the illness. @DRjhopkins

Your librarian especially likes a “thank you” every now and then @hammerslibrary

Don’t steal cookies from the nurses! @socalexmd

Please learn about Harm Reduction & understand that patients don’t always do what you want - but we care for them regardless @NurseNerdy

Welcome to the team! Remember it takes a metropolitan to care for a patient and we do it better as a team! @NurseNerdy

When increasing or decreasing a dose, write up or down error to let us know the change is intentional @CommPharm

Keep hand written order legible and provide contact info. Please print name. @TDaungst

One may not be the smartest, so do everything to not be the dumbest! @DanielVelaMD

Don’t be afraid to ask for help. Competence includes knowing your own limitations @TChanMD

Before leaving the patient’s room, say “Have I answered all of your questions?” @drjfrank

Write legibly, fill out your med charts properly & be kind to the patients & other staff. Healthcare is a team sport @Nurse_Sibs

C’est la vie “That’s life”. Some people get hurt, some people get sick. Majority get better, some don’t. Don’t blame yourself! @W40SYM

You will be judged by the quality and legibility of your documentation and notes. Write NEATLY and fill in form COMPLETELY. @mjslabbert

Don’t drive tired. Get a taxi or even power nap in your car. It’s a mistake you can’t un-make. Loof after yourself (please!) @_NMay

Sit DOWN when you talk with patients and encourage them to be educated en empowered. @MeridithGould

Bring fruits and healthy snacks to the night shift. @HildenLA

Do what’s best for the patient not the administrator. @Want2BeMD

If med is not for you, that’s OK. You haven’t failed. Your life isn’t over. Get help. The “outside” world will welcome you. @JenWords

If a nurse, janitor, or any other member of the team mentions you haven’t washed your hands, be thankful & wash those hands! @couragesigns

Surgery for you might be mechanical & routine; for the patient, it is terrifying. @couragesigns

Discipline yourself to do medical reading every week. It will pay off in the long run. @drjfrank

It’s never too early to make a personal financial plan. Yes, really. @drjfrank

Don’t commit yourself before presenting to an attending. Always leave yourself an out. @abbashu

Don’t forget to take care of yourself. You are a new doc, but you are far more than just a doc @CareyCuprisin

MARC-EMILE PLOURDE, MD

Lead Author

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