Thread by @DrWuRadOnc

Ok here's my attempt at a thread for incoming PGY2's. First off congrats for finishing intern year. It's an accomplishment in itself. Although you don't know it yet, much of the doctoring skills you've developed will be the corner stone for how you work with patients! 1/25

PGY2 Radonc IMO is one of the most challenging years. Unlike other specialties in medicine where you spend 4 years of medschool to build on your medical knowledge and skills in an integrated fashion, Radonc maybe a 15 minute discussion in a class, if lucky 2/25

Even with away rotations it's just the surface of what radiation oncology is.Why is PGY2 such a shell shock? It's because intern year is just a stepping stone to getting into radonc. It's not your future. As an intern you're not invested in it as your categorical colleagues. 3/25

Managing the day to day of intern year is doable since it is only temporary for you where as when you start PGY2 Radonc that's the beginning of your formal training for your career. Things start to get real. You leave intern year full of confidence heading to PGY2 year...4/25

When you start day one of PGY2 it can be overwhelming. Not only are you meeting a new team of people, you're in a new environment, new specialty. You want to make a good impression while trying to figure out the millions of acronyms Radonc love to use. 5/25

In addition, unlike intern year where as the year goes on you get the hang of it, rotations in Radonc make PGY2 like ground hogs day. Feel lost -> Get the hang of it-> Rotate to a different site -> Feel lost, repeat. 6/25

On top of that you see the gap between you as a PGY2 to your colleagues in PGY3-4-5, let alone your attendings and you wonder how are you going to get there. And that's just clinic, add on research, leadership/admin, balancing work life, and... 7/25

...following what's going on with our field on social media, and worrying about your future, how can you not feel stressed out? Little known known secret is that you're not alone. PGY2 year is tough. It's the hardest year for me personally and I know many would agree. 8/25

So don't feel defeated. PGY2 is hard. It's not easy. But it is the gateway to the most amazing field (despite everything said online). We are cancer doctors! We are compassionate, we are knowledgeable, we are data driven and we believe in research. So...strategies for PGY2 9/25

1) Be open minded. Just like medschool go into training being open minded, you just don't know what you'll enjoy. I went into residency thinking I would never be a pediatric radiation oncologist and today I can't imagine being anything else 10/25

2) Use the first month or two focused on settling in. Meet everyone in your department. Learn their names, who they are, and what they do. Unlike intern year, we are specialists with teams of people that are excellent at their jobs so you can be excellent at yours. 11/25

3) Also within the first 2 months - work on understanding the workflow of your clinic and note documentation. Understand why a consult/follow up/on treat visit note is structured the way it is. Learn your EMR and planning software and how you can optimize your workflow. 12/25

4) Maybe a bit taboo but don't worry too much about memorizing trials and data in PGY2. Work on understanding the big picture. General management trees Pay attention to discussions your attendings have with their patients. There is a lot of knowledge there to be learned. 13/25

5) Work on your clinical skills and most importantly talking to patients. Here is where your skill sets from intern year will play a major role as you from intern to Radonc. Practice delivering good news. Practice delivering bad news. 14/25

6) For the first 6 months focus on points 1-5 and do not commit to or worry about research. By setting up a strong foundation, it'll set you up for the rest of residency so that you can explore everything Radonc has to offer. 15/25

7) Now aside from clinic, start developing your support team. Mentorship comes in different forms. Attending-resident, senior-to-junior resident, and even among colleagues (remember Radonc residents have diverse life experiences and they may be just who you need) 16/25

8) As research temporarily fall on the wayside, always keep your eyes and ears open to what's going on in your department and in your hospital system. This is because as winter rolls around and things have stabilized you may be ready to explore. 17/25

9) Study resources - everyone learns differently and finding the right resource is different for everyone. Talk to your senior colleagues and see what works for them before buying a bunch of stuff. Talk to your PD or junior faculty and find what works for you. 18/25

10) When learning Radonc, don't try and memorize everything in one go. That's just practical advice for most people. Learn in layers as you will ultimately see it again. Start with big picture and fill in the details. It's a marathon. 19/25

11) Study but also ask questions. You're at a teaching program. Everyone understands the learning curve is steep. Sometimes having a few basic concepts or questions answered will go a long way to building your knowledge base. 20/25

12) Do as much as you can. Residency is a training program and you're supervised by an attending. This is where you learn. So learn. But most importantly if you feel like you're not ready or need help, speak up! Knowing your limitations should be celebrated and not shamed. 21/25

13) Everyone in Radonc enters residency with unique background and experiences. Don't try and compete with your colleagues. Everyone learns at their own pace and has their own road to success. Again marathon(x2). 22/25

14) Work hard, learn, but also block of time for "me time". Spend time with your family and friends. As a wise resident said things pile up quickly so make sure to prioritize #selfcare. Again marathon(x3) 23/25

15) Trust the process. You will get there. Did I miss anything else for PGY2 recs? #radonc 24/25

😀😄😀😃😄😀😀😀First thread done. My understanding is with threads, you need emojis so here you go. I hope this helps. Welcome incoming PGY2 to #Radonc. Enjoy the process! 25/25