Five Years, Mubashir Shabil Billah

Five Years

“That’s why residency is five years,” my attending joked as I struggled to secure the seat belt on the patient in the operating room. I smiled but my struggles continued until my attending walked over and made me look like a fool as he did it effortlessly. As my five years comes to a close, I think back to that learning experience and many more. Five years is a long road, but it is incredible to see how far I have come in that time.

Residency is different from any other teaching methodology that we grew up with. Through your early education years, you sit in a classroom from morning until afternoon being spoon fed information. Each lesson is carefully taught and reviewed. Every detail is combed over, and hours of homework are given to reinforce the material. Then you make your way to college and classes are barely a few hours a week. Most of the studying takes place at your own pace between the myriad of social activities. Supposedly, it is called “adult learning,” but maybe it’s just a sneaky way for professors to get out of teaching all day every day. Then you get to medical school and one of my friends put it quite aptly. “If college was like sipping at a fountain of water, medical school is like taking a firehose to your mouth.”

Then you finally get to residency, and all of that is thrown out the window. There are no more classrooms, no more laboratories, no more lectures. Okay, maybe there are a few lectures, but the real classroom is the hospital. It feels like a bygone era of apprenticeship. A common phrase among surgeons is, “see one, do one, teach one.”

I was working with my junior resident, and she exclaimed her struggles with clinic patients. As she prepared for her clinic phone calls, she went through each chart, sorted the patients by difficulty, and started with the easy ones. I was confused by all this extra effort. When I went through my clinic, I just started at the top of the list and worked my way down, not a care for what challenge lay ahead. She reminded me, “You’re the chief now. You forget what it’s like to be a junior. Before I call a challenging patient with advanced stages of cancer, I have to read through the book to sound more educated. Patients realize when you don’t know the answer right away. I have to read first before I can talk to those patients.”

Then it dawned on me; not long ago, I was there. I used to read before each patient because I wanted to be prepared. I did not want to seem clueless when a patient asked a question. I wanted to be ready for what came and that meant I went slower than my chiefs and attendings, but I was still learning. Five years later, I am now the chief. I know the answers. I take care of patients quickly, confidently counsel patients and make definitive plans. Five years is a long time, but it is amazing how far I have come. I don’t know exactly when this transition occurred but now, I am the chief. Now I am the one with all the answers.

Residency feels like an apprenticeship, and I am forlorn by its impending conclusion. It has been quite the journey. From start to end, I have been fortunate to stand on the shoulders of giants and grasp at whatever knowledge I could learn from each. In my eyes, the apprenticeship does not end when I graduate. I hope to continue learning by osmosis from those around me. Maybe one day, I will find a struggling resident and remind them that residency is five years for a reason.

Mubashir Shabil Billah, MD PGY-5, Chief Urology Resident Rutgers New Jersey Medical School