I recently began my third and final year of residency. With each passing day and shift, I am closer to reaching that goal and becoming a full-fledged emergency physician.
Last week, I went into my first moonlighting shift. I was a little bit (okay, a lot) anxious walking into a new hospital with new staff and working on my own. Somehow, I sat down at the desk, saw my first patients, and felt right at home. I didn’t know where the ultrasound or the tonopen or pretty much anything else was, but I was just home. I started passing the “Third Year Test.”
I recognize that some programs are 4 years, but for the sake of this article, I’ll refer to all final year residents in emergency medicine as third years. When residents are entering their third year, we are experiencing a myriad of emotions. We are often tired, excited, and scared rolled all up into one. A good portion of our lives up until this point have been heavily structured for us with only a small amount of input from our own choices as far as medical training goes. At the end of this year, we finally exit and enter what feels like an abyss.
Morgan Sweere, MD, MPH
Editor-in-Chief, EM Resident
Secretary, EMRA Board of Directors
University of Florida - Jacksonville
The first 2 years of residency are a whirlwind, and they provide a world of perspective when it comes to a career in emergency medicine. Unfortunately, for some, they also contribute to the beginning of burnout. Several studies cite burnout rates among third-year residents as greater than 40 percent. Residency is tough and exhausting, and there are so many factors that contribute to this. This job is not easy by any means. It may be one of the most difficult jobs there is. I still think this is the best job in the world. I couldn’t imagine myself doing anything else.
We’ve all heard of the “3 AM Test” — the test we all had to pass as medical students trying to match into our dream emergency medicine residency. Essentially, you have to be a person who is interesting, personable, and normal enough that other people would want you working beside them at 3 am, when they are their most tired and at a sometimes dull portion of their shift.
I think I’d equate this test to what I would call the “Third Year Test.” You are at the end of your residency and your most exhausted, crispy, ready-to-go self you have ever been since starting your medical training. You cannot wait to spend days outside of the hospital walls. If you love this specialty and love coming to work on those days, then I believe you’ll love it forever.
I think this is the test that makes me realize I chose the correct specialty. Obviously, I am just a third-year resident, so I can’t account for the experience of those who have had long careers and may feel differently. I can only account for my own experiences, thoughts, and hopes for a long, happy, fulfilling career.
There is truly nothing else like our specialty. When I look at the future of our specialty, where many may see overwhelming challenges, I see so much opportunity.
As I look at students becoming residents matching into our specialty, I see people not so different from myself.
When I worked as an ED tech for years prior to residency, I once had a physician tell me to “go to vet school” if I was going to do emergency medicine, because I might as well be entering the jungle.
I smirk a little bit remembering this, because when I think about students matching into our specialty, I see myself: Just like me, our new EM residents love this field. Just like me, they can be told they’ll be “entering the jungle” but they’ll do it anyway, because — just like my experience — no one can convince them there’s a better fit elsewhere.
That’s what I see students doing every day as they enter this specialty: They are choosing emergency medicine. We are matching residents who want to be here, working alongside us for the betterment of the specialty. We are capturing those residents who crave this work and will contribute massively to the care of their patients.
Those same residents will get to the end of their grueling residency process and pass the “Third Year Test.”