February 29, 2016

REBEL Cast Episode 22: Advice to the Graduating Resident – Anand Swaminathan

We are getting closer to the end of the year and pretty soon 3rd year residents will be graduating and moving on to their first jobs as attending physicians.  My own residents have been asking for advice, and I thought this would be a great opportunity to ask some EM educators what their advice would be. Essentially, I asked each of them two basic questions and let them steal the show. For our inaugural first episode I asked Anand Swaminathan if he could give us some of his words of wisdom.

REBEL Cast Episode 22: Advice to the Graduating EM Resident – Anand Swaminathan

Click here for Direct Download of Podcast

2015-11-12-11.05.521Anand Swaminathan, MD
Assistant Professor of Emergency Medicine
NYU/Bellvue, New York, NY
Twitter: @EMSwami

What 3 things would you tell yourself when you graduated residency?

  1. Emergency Medicine is a marathon, not a sprint: Early on in your career you want to say yes to a lot of activities, as you are trying to figure out your career niche. It is however, equally as important to take a step back from time to time and see if what you are currently doing is sustainable for 30 – 40 years. It is important to get sleep, stay healthy, and have social relationships outside of your work. If you are happy in your personal life you will be even happier in your career. You want to be as energetic and robust at the end of your career as you are at the beginning of your career.
  2. Have a Learning System After you Graduate: Throughout our education from undergraduate to medical school we are spoon fed what to read and study, but once you graduate it is up to you to keep up with your education. Establish a learning system that will continue to push you. Don’t only push yourself in medical knowledge, but also push your self to keep up with your skills. It is important to pick a course or two a year to work on skills such as ultrasound and/or airway skills just to name a couple.
  3. Always Think When You say yes to Something, Will it Make you Happier: Don’t say yes only because it is expected. Maybe early on it’s ok to say yes, but once you figure out your career goals, try and say yes to things that will help you get to that next level of your goals.

What are the 3 biggest mistakes you see new EM graduates making?

  1. Don’t Live Outside Your Financial Means: Live like a resident for the 1st two years out from residency. With graduation comes a huge jump in income. The first thing most people want to do is go out and buy that new car or million-dollar home. Try to pay off your debts, and put money into your savings. If you grow right into your paycheck, right away, it’s very difficult to come back down.
  2. After Your Board Exams, Your Education Does Not End: Keep reading. There is constantly new research coming out that changes the way we take care of our patients. The Board Exams are your ability to take a test, not your ability to take care of patients. It’s important to keep up both your book smarts (Board Exam/Core Content) and your Street Smarts (New Research/Bedside Care).
  3. Say Yes to Everything Early On, but at Some Point it is Important to Stop and Reflect: You don’t know what your niche will be, and by saying yes early on, who knows what will fall in your lap. There may be things that don’t sound like they will be fun but at some point, two years out, three years out…it is important to stop and reflect. Find the things that you enjoy and have harmony with each other and try and consolidate to focus your time and energy. A common mistake is to keep doing 5, 10, 20 different things that don’t fit together. Work smarter, not harder. As Amal Mattu says, “What are the big rocks in your life?”

If you have your own advice for graduating residents, or thoughts on the topics discussed above, be sure to leave us your comments below.

Cite this article as: Salim Rezaie, "REBEL Cast Episode 22: Advice to the Graduating Resident – Anand Swaminathan", REBEL EM blog, February 29, 2016. Available at: https://rebelem.com/advice-to-the-graduating-resident-anand-swaminathan/.
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Salim Rezaie

Emergency Physician at Greater San Antonio Emergency Physicians (GSEP)
Creator & Founder of REBEL EM
  • Steve
    Posted at 02:44h, 10 March Reply

    Dr. Rezaie,
    My name is Steve Montag, OMS-IV. I want to start by thanking you for all your work contributing to my education. Your recent podcast on advice for graduating residents brought to the forefront something I’ve been struggling with these last few months since the calender flipped over to graduation year; what should I be studying/reading now as a graduating medical student? I’d love to hear your suggestions as to what you would want a PGY1 to have studied in the months leading up to beginning residency.

    • Salim Rezaie
      Posted at 12:20h, 10 March Reply

      Hello Steve,
      My advice to you is enjoy your time off before residency. You will have plenty of time to read when residency starts. When residency starts most of your core content will come from whatever book your program has chosen. Most programs use Tintinalli’s or Rosen’s but certainly there are other ones out there. Relax, congratulations on your upcoming graduation and please let us know how else we can help.


  • Jordan Spector
    Posted at 12:43h, 10 March Reply

    Echo Swami’s call for frugality – you have lived with limited financial means for years, 6 to 12 extra months in the small apartment, with the same old jalopy car will go a long way to helping you quickly build a reserve fund for when a large financial outlay is needed, or if gosh-forbid calamity strikes.
    Also echo the marathon analogy – I think physicians just coming out of training experience a unique phenomenon that many of our non-physician peers cannot relate to. Up until the moment of residency graduation, life has been a series of discreet obstacles to overcome – I can’t wait until I (FILL IN THE BLANK – get into my clinical years in MSIII – get through this surgical clerkship – match in an EM program – finish up MSIV year so I can start making $$ – finish my PGY1 year so I can run trauma cases – get through this string of overnights – finish up residency and start making REAL $$, etc.). Then you finish, you take your first job, you struggle (as we all do) refining your practice approach, dealing with the stress of being the attending – and what are you wishing for now?!? There’s no more finish line. There’s no more hurdle to clear that will give you smooth sailing thereafter. Wishing away time until retirement is not how any of us want to live. Up until attending life, I personally think that “work-life balance” is largely just quantity of time away from work. But as an attending, I think its important to truly be cognizant of what gives you happiness…..what nurtures and replenishes FOR YOU…..if you are busting your hump at work for a week, and you get a weekend off, 24 hours of binge-watching ‘Breaking Bad’ may not rejuvenate. Those EM docs with passionate hobbies do better with this, in my opinion. If you dig rock climbing and spend two days of in nature, that may work for you. But for many others, it is important to be thoughtful about how you are spending your free to be healthy and satisfied.

    • Salim Rezaie
      Posted at 12:46h, 10 March Reply

      Appreciate the input Jordan….all I can add is amen!!!


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