The Resident's Survival Guide: Thriving, Not Just Surviving

Residency (or Registrar training) is a transformative period. You enter as a novice and leave as a consultant surgeon. In between lies a gauntlet of sleepless nights, exams, difficult consultants, and the steep learning curve of operative surgery.

It is easy to get overwhelmed. This guide offers practical, tactical advice for navigating the trenches of orthopaedic training.

1. Triage and Time Management

The hospital will take 24 hours of your day if you let it. You must be ruthless with time.

• The List: The List is God. Update it constantly. Prioritize tasks:
  • Urgent/Important (Sick patient): Do now.
  • Not Urgent/Important (Op Note): Do before leaving.
  • Urgent/Not Important (Admin request): Delegate or do quickly.
• Batching: Don't run to the ward for every fluid chart. Go once, do them all.
• The "Golden Hour": Arrive 30 mins early. Pre-round on your patients. Know their bloods before the Consultant asks. Competence buys freedom.

2. Politics and People

Orthopaedics is a team sport.

• Nurses: They run the ward. Be kind, bring donuts, and listen to them. If a nurse says "I'm worried about Mr. Smith," Mr. Smith is likely dying.
• The Theatre Team: Introduce yourself to the scrub nurse and anaesthetist. Every time.
• Your Co-Residents: You are a band of brothers/sisters. Cover them when they are sick. Don't throw them under the bus. Your reputation as a "good colleague" travels faster than your surgical skill.

3. Learning on the Job

You are drinking from a firehose. How do you retain anything?

• The Logbook: Log every case immediately. Do not let it pile up.
• Pre-Op Prep: Never scrub into a case you haven't read about. Read the technique the night before.
• Post-Op Debrief: Ask your consultant ONE question after the case. "Why did you choose that approach?" Feedback is the breakfast of champions.

4. The Exam (The Cloud)

The exam looms over everything.

• Consistency: You cannot cram for the exit exam. Study 1 hour a day, every day, for 4 years.
• The "Viva Voice": Practice speaking out loud early. Knowledge in your head is useless if it doesn't come out of your mouth.

5. Physical Survival

You are an industrial athlete.

• Eat: Never skip lunch. If you can't sit, eat a protein bar walking. Hypoglycemic surgeons make bad decisions.
• Sleep: Post-call sleep hygiene is critical. Blackout curtains. Phone off.
• Hydrate: Theatre air is dry. Drink water between cases.

6. Mistakes

You will make them. You are human.

• Own it: "I made a mistake. Here is what happened. Here is how I fixed it/will fix it."
• Don't hide it: The cover-up is always worse than the crime.
• Learn from it: M&M (Morbidity and Mortality) meetings are painful but necessary.

Conclusion

Residency is hard, but it is also the most fun you will ever have. You are seeing things few humans get to see. You are fixing broken bodies. Keep your head up. Support your mates. And remember: This too shall pass.