Moments You Can’t Get Back

Paternity leave is a less common request for residents, but for Kevin Dueck, MD, the time off was invaluable for bonding with his three young children. Dr Dueck, now 33 and a resident in the family medicine program at McMaster University in Brampton, Ontario, Canada, knew early on that he didn’t want to wait until after medical training to start his family.

The first of his three children with his wife, Kim, was born 6 weeks before he started medical school. The second was born in his third year of school. This year, his third child was born in July, when Dr Dueck was supposed to start residency. He decided to arrange paternity leave for more than 6 months, beginning in January, and pushed back his start date until August. His program was very supportive, he said, adding that senior faculty told him, “I wish that had been available when I had young children.”

Dr Dueck says he gets congratulated for taking time off, and he’s uncomfortable with that because women don’t often get the same congratulations. Time off should not be seen as unusual for either sex, he says. The delay put him off cycle, so he will need to find work to fill a 4-month gap after graduation if he wants to pursue fellowship training.

He acknowledges that there has been little time for social activities outside those with family, and he has had to learn to say “no” to some professional projects and meetings. However, he says that’s a small price to pay for quality bonding time, to fully celebrate his children’s birthdays, ride bikes, take family excursions, and spend time at home with his family, before medical responsibilities compete for his attention. “Those are moments you can’t get back,” he says.

He adds that his experience as a young father helps him as a doctor. “Taking leave and having a family has helped with connecting with patients, especially those expecting or with young children. I’ve found having that lived experience to be an asset in clinic,” he said.

Excerpt from Marcia L. Frellick. Taking Leave in Residency: Tips and Traps – Medscape – Dec 08, 2017 [LINK]

Advertisements

Staying Organized

I recently posted on Twitter about setting up for 2018 and was asked about staying organized.  As mentioned previously in my Medical School Tips staying organized is essential, especially with multiple projects on the go, deadlines, and other responsibilities.  I’ve used to-do lists all through graduate school and my medical training.  For a while it was simply scraps of paper and a calendar on my phone.  Over the last few years I’ve tried different planners/pocketbooks and incorporated elements of bullet journaling. Thought it might be time to talk about to-do lists and staying on top of things.

With so much going on at times having a system to keep things organized is needed.  Over time I’ve come to prefer the analog systems.  There is something satisfying about checking a box or crossing off a goal.  They are also nice to look back on and see progress or many little accomplishments.  I use a dash for events, a dot for to-do lists. Items range from gymnastics for our oldest to dental appointments and keeping up with my N95 fit tests and ACLS certification. I enter major events on the monthly calendars and use each Sunday to jot down a weekly list of important items. In the dotted section at the back of the Hobonichi I keep a list of books read, movies watched, publications, etc.

I tried using a Hobonichi in 2016 and enjoyed the set up, the quotes, and compact nature of the planner.  It was thin and didn’t bleed with fountain pens, so it was fun to use.  The positives were having a page a day, a yearly calendar, monthly spreads, and some fun facts in the back.  For 2017 I used an A6 Midori MD lined planner.  It gave a lot of freedom and I used it as a bullet journal.  For 2018 I planned to use a couple grid Midori A6 notebooks, but they got lost in transit, so I ordered a 2018 Hobonichi Techo to use for the new year (the grid notebooks did arrive after ~2 months).

The Hobonichi has a lot of great features, but there as some shortcomings:

  • Despite using Tomoe River paper like the Seven Seas journal I’ve used previously, it seems to dry even slower. This makes it harder to quickly jot down entries if carrying it with you all day or having to use some blotting paper to sop up ink.
  • Some days only need a few lines for events or to-do items.  With a page per day space feels wasted.
  • There is no weekly to-do section

Along with the Hobonichi my set up includes an A6 pocketbook for notes on the wards.  At the end of a block I transfer notes from the pocketbook to a simple notebook of tips/tricks, clinical teaching, and step-by-step instructions for procedures.  A set of practical notes to complement the textbooks/lectures.

I’ve mentioned journaling before and for 2018 I wanted to do something different.  Instead of a lined A5 journal as I’ve used before I decided to use a larger A4 blank journal.  I hope to do more doodling and enjoy the greater flexibility in my entries.  I have 4 pens chosen for journaling and will alternate between them.

Trying my best to stay organized in 2018 balancing home life with my training.  Going to be a busy one as I transition to my final year of Family Medicine, write 2 large exams, and need to make many decisions about my future.

Hobonichi Techo in Midori MD paper cover

IMG_4652

Midori MD A4 blank, Hobonichi Techo, and Leuchtturm1917 A6 softcover.

Year in Review – 2017

Finished my last shift for the year doing consults in the Emergency Department and even had enough time to grab a coffee and use the bathroom, so not too bad…  Today we enjoyed Christmas as a family and tomorrow we head off for a large family gathering.

This last year was unique as I took over 6 months of paternity leave before returning to residency in August.  It was great to have that time with my family and some time for myself.

Back in February a call went out from in-House for reflections on the first year of residency and I thought being on leave was something different, so I wrote a short reflection.  It was well received and has since been reposted to KevinMD and lead to my being interviewed on a CanadiEM podcast along with a Medscape article (free registration required for full article).  Glad to see people are receptive to my perspective on taking leave and making family a priority.

This year I also became more involved in the Health Humanities.  From February to October I was the Humanities Intern at CMAJ and was involved in peer review, development of a rubric for evaluating submissions, and help to develop the new Graphic Medicine section. In addition, I had a short comic published on in-House, my poem Handsome Cat was published, and a number of older pieces of writing found venues for publication.

The time off also gave me a chance to do some reading, some mentioned in a previous post. I also took a few courses including a Joule self-awareness/leadership course and a few continuing faculty development courses through U of Toronto (mentorship, teaching health humanities, etc.).  These would be far more difficult to fit into my schedule during residency or when in practice, so it was nice to explore some of my interests during the break.

After many months at home and family time including trips to Niagara Falls, I headed back to residency in the fall and joined the incoming R1 cohort. As expected I was a bit slow the first few days and found that my DDx was narrowed.  Things have gone well since and I’ve completed blocks of Hospitalist, ER, OB/Gyn, and just started my block of General Internal Medicine.  With my being off schedule my R2 year of Family Medicine starts in a few months and have 2 large exams in the coming year.  Still not sure if I will do a +1 year, but am trying to arrange things to continue my involvement in the medical humanities.

Thanks everyone that has followed my journey in medicine via the blog and my Twitter @AbootMedicine over the last few years.

 

Back

Last week I headed back to the world of medicine. The time off passed quickly, especially with packing and moving to a new place in the spring.  Was great to be home and spend time with my family.  This summer we have enjoyed a few family trips and had some visitors. I may do a longer review at some point of my pat leave, but put simply I’m glad I had the opportunity to spend the time at home.

The first week back was a lot to take in. My home clinic was happy to see me, nice to catch up with the staff. I’m a bit rusty and slow seeing patients, in part because the EMR there was updated recently. On top of that I’m starting my first hospital based rotation and learning their EMR and they way they like things done. Got through the first week and even had a few kind comments from patients.

The Hidden Curriculum Narrative

During an interview for residency I was asked about my previous article about the hidden curriculum. I spoke of the lessons outside the textbooks and lectures; lessons of hierarchy, role modeling, and more. The interviewer then asked about if there were positive aspects of the hidden curriculum. I told a story from clerkship and recently made a comic about that experience. It was recently published on in-House and is my first attempt at graphic medicine. Enjoy: Lessons

Hitting the Books

A little over a month left of my pat leave, my return to the wards is quickly approaching. Soon I’ll be back in clinic and at the hospital caring for others.  This time with my family was wonderful, from seeing our son’s first steps to being present to celebrate two of our children’s birthdays next month.

Part of this vacation was also time for myself.  Medical school with a growing family was a challenge, and meant I had to put aside some things I enjoy.  As mentioned in previous posts I enjoy reading (1, 2, 3).  Over the last ~6 months I’ve enjoyed reading/listening to many books in addition to my time with family and occasional writing.  I have a long list of books in my queue, some I sought out, some given by friends, and some inherited. Going over my list I’ve finished 31 books and 5 graphic novels this year.  Great to have time to read for pleasure and not rush through what I’m reading.

Some favorites:

  • Letters from a Stoic – Seneca
  • The Pleasures of the Damned & Run with the Hunted- Charles Bukowski
  • Pale Blue Dot – Carl Sagan
  • Tokyo Ghost – Rick Remender
  • 50 Years of Memorable Cases – Dr. Herbert Fred
  • One Doctor – Dr. Brendan Reilly
  • JR – William Gaddis (2nd reading)

 

Physician Wellness

Imagine you are a first-year medical student and just moved across the country to start your training. It is a stressful time, adjusting to a new city, a school and new people. How do you find your way around campus? Do you need a car? Who should you contact if you need help?

As part of their mental health month in-Training included an article about the design and lessons drawn from Western Vitals (mentioned here), a medical student wellness initiative I co-founded. The project includes a website, awareness activities, and targeted workshops to support medical students at Schulich School of Medicine & Dentistry. Check it out: Check Your Vitals