All Posts
Residency

50 Things I Know About Being A Surgery Resident

Liz Malphrus, MD, MPP
Liz Malphrus, MD, MPP
June 13, 2026
50 Thing I Know
  1. I know that every shift ends eventually.
  1. I know that there are always snacks in the PACU.
    - Corollary: I know that there are always sandwiches in the emergency room.
  1. I know that some of what we do in medicine is based not on evidence but on tradition, comfort, experience, and inertia. That’s fine—in fact it’s probably good—but it’s important for you as the physician to know what the real medicine is. Look up all of the things.
  1. I know that whichever ringtone you pick for your pager/consult phone during intern year will haunt you for the rest of your days. Choose carefully.
  1. I know that building a level of immunity to embarrassment will make you a better doctor. If you look something up and you’re still confused, ask the question even though it makes you feel stupid. Don’t assume the people more senior to you know better: sometimes they don’t, and they’ll thank you later for speaking up.
  1. I know that if you find a secret bathroom, you should keep it a secret.
  1. I know that the main thing that distinguishes residents from other professionals in the hospital is that they are willing to try to solve a wide variety of problems that others are not, and they do it because they have to. Those problem solving skills are painful to build, but they make you stronger.
  1. I know that everyone will think unkind thoughts about patients at some point in residency. The key is to recognize that this is a symptom of burnout, and find a way to fix it.
  1. I know how to see a consult efficiently, completely, and without generating interpersonal drama
  1. I know that you shouldn’t mess with the charge nurse’s desk/computer. Same goes for the circulator. Other than that, don’t let anybody tell you that a computer in a communal space belongs to them; it doesn’t.
  1. I know that if you eat hospital chicken fingers for lunch two days in a row it will become very hard to stop eating hospital chicken fingers every day.
  1. I know that hydrogen peroxide will clean blood off anything, but that you can’t get it in anybody’s eyes.
  1. I know that compression stockings are annoying to put on but you should do it anyway because they make you feel better at the end of the day.
  1. I know that when it comes to feedback and evaluations in residency, no news is good news. If you’re not keeping up, I promise they will tell you, but you should not expect the level of positive feedback that you got in med school. Want more feedback? You gotta ask for it.
  1. I know that residency isn’t a stepping stone to something else. It’s part of your real life. You will have bad days and bad weeks but you shouldn’t be having a bad life. If you are, you need to do something about it.
  1. I know that getting into your body is the most effective way to get out of your head. Stretch. Gym. Feel your feet in your compression socks and your fingers in the fuzzy pockets of your Patagonia hospital jacket. Take some square breaths. Feel something.
  1. I know that nobody teaches you how to have good OR manners; you’re just expected to figure it out for yourself
  1. I know that appealing to authority to address an interpersonal problem tends to turn out sub-optimally for all parties involved (though obviously there are situations where it becomes necessary). Use your words. Be direct. Be kind. Don’t let the turkeys get you down.
  1. I know that if you make a mistake, you have to take responsibility unequivocally and once, and then get right back to work. Honesty is the single most important residency value.
  1. I know that you will ultimately forget a lot of residency, especially the parts that happened when you were extremely sleep deprived, because that’s how your brain works.
  1. I know that all tools are multi-tools, and that hemostats are the most multi-toolinous.
  1. I know that you should save hospital people’s numbers in your phone and then greet people by name the next time they call. It is disarmingly humanizing in a system that tends to make everybody feel anonymized and disempowered. The rest of that conversation will go better. This is especially powerful for consult calls.
  1. I know that Medihoney does not taste like regular honey.
  1. I know that you have a small window of time at the start of your training to establish your reputation and good hospital habits. Use all that built up pre-intern year reserve to be extra on top of things in your first weeks/months. This will pay off in the future when you mess something up because people will already know that you take your job seriously.

  2. I know that when it comes time to think about your first real doctor job, you need to talk to people outside of your residency for advice. Everybody at your program has the same sort of job and made the same sort of choices. You need to hear from some people who made different ones before you decide for yourself.
  1. I know that you will never have a magical big block of time to study like you did in med school. Stop waiting for that and figure out how to read and study anew in this version of your life.
  1. I know that you still have to go to the dentist even though it feels impossible. Doctor, heal thine own teeth.

  2. I know that in residency, your education is your responsibility and yours alone: you need to advocate for yourself to make sure you get what you need from it.
  1. I know that most “bad” patient behavior is driven by fear, and that you should try to address it in that context.
  1. I know that if you tap your badge in quick succession on two adjacent scrub dispensers, you can get an extra set of scrubs to stash somewhere for a day when the machine is out of your size.
  1. I know that residents are severely undercompensated.
  1. I know that going through a traumatic experience with someone creates strong social bonds, so you’re probably stuck with at least a couple of your co-residents forever.
  1. I know that anesthesia doesn’t like being called “anesthesia,” they have names!
  1. I know that you will forget a lot of your trauma consults, but those patients will remember you as long as they live.
  1. I know that there’s something that can substitute for a hair tie in almost any hospital drawer or cabinet.

  2. I know that if you feel like you hate everything, you need to eat
    - if you feel like everybody hates you, you need to sleep
    - whatever bad feeling you have: you need to shower.
    ‍
  3. I know that the word “professionalism” carries a lot of weight in residency and is often used as a way to enforce compliance rather than as an actual marker of quality doctoring.
  1. I know that you should always (barring emergencies) be on time for rounds because that is how you show respect for everybody’s limited sleep time.
  1. I know that 1000g of tylenol, 4mg of zofran, and a glass of water will fix most of those annoying things your body tries to do to keep you out of work in a system where sick days aren’t a thing.
  1. I know that your emotions lie in wait until you have a tiny bit of free time and then they attack. This is normal, and you’ve just gotta find a way to let it out.
  1. I know that the hospital needs you more than you need it, though this fact will never be acknowledged.
  1. I know that the point of rounds is primarily to listen, not to talk
  1. I know that at least 50 percent of the time people claim that something that you’re trying to do is against “hospital policy,” they aren’t able to produce any supporting documentation so you shouldn’t take it too seriously.
  1. I know that no matter how hard you work and how much you sacrifice, your attendings will always think they had it worse. The reality is that residency now is just totally different and it’s not a contest anyway.
  1. I know that you will never really know how you measure up relative to your co-residents, but the further along you get in your training, the more you will realize that it doesn’t matter.
  1. I know that all patients—ED, clinic, floor—are looking you up on the internet. You should periodically google yourself so you know what they’re seeing.
  1. I know that the only way to get more sleep in residency is to go to bed earlier.
  1. I know that residency is a zero sum game, where if you aren’t at work or don’t do something, that work will always fall on your co-resident. Setting boundaries only works if it’s through collective action. In the meantime, take care of each other and acknowledge that it’s the system that’s the problem, not the people trapped in it.
  1. I know that all emergency department needle drivers are garbage and should be launched into the sun.
  1. I know that if you get to the end of residency without experiencing conflict, without getting feedback that was hard to take, without crying in a stairwell, without a couple of hard days that will live rent free in your head for the rest of your life, you probably didn’t do it right.

Related Blog Posts