“Malignant” programs lurk. ► Leave it to MDs to insert medical jargon where “toxic” or “bad” would suffice. A “malignant” placement can mean anything from a racist to unfriendly culture, says Dr. Shelby Reiter, a chief resident in Swedish’s general surgery residency program. Med students generally learn the specifics through the grapevine (Reddit threads count), but pre-interview dinners with a program’s current cohort can also offer a slightly less filtered view of reality, chief resident Dr. Danielle Hayes admits. Both Hayes and Reiter feel fortunate their intel steered them to a perfectly collegial experience learning from surgeons at Swedish. “The attendings are extremely approachable,” says Reiter.

Self-reliance is hubris. ► Talk to any resident and they’ll probably bring up the importance of having a staunch “support system” to endure the endless rotations. Dr. Cheyenne Enevold, a graduate of Virginia Mason’s internal medicine residency program, could thank her husband for looking after their two “furry children”—a cockapoo and goldendoodle (“you can’t think of things outside of being in the hospital”). Cohort member Dr. Sukhkarn Bains could lean on his wife and nearby family to make sure he slept, ate, and worked out enough. But Bains also notes that advocating for fellow residents is essential to boosting everyone’s wellbeing. Forums with leadership at Virginia Mason helped them raise concerns and ideas. That conversation isn’t happening everywhere. “I know of people in different programs who felt that they didn’t really have a voice,” says Bains.

Basic activities will be memorable reprieves. ► Long hours are a given during residency, which may reconfigure what one’s definition of escape feels like. For Dr. Danielle Hanssen, another recent graduate of Virginia Mason’s internal medicine residency program, the walk from the medical center on First Hill to her Capitol Hill apartment allowed her to prepare for and decompress from the hospital grind. But pizza helped too. She and a co-resident made it a ritual to unwind with a slice from Hot Mama’s Pizza on Pine Street. The food greased some poignant stories about patient outcomes. “We constantly talk about those memories that we had,” says Hanssen, “even though they were tough in the moment.”

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