The three years of residency following med school (and an extra year of internship for anyone wishing to specialize) are well-known to be the toughest years of your medical education. Sure, you may have the nifty white coat and the "MD" after your name, but when it comes to the hospital environment, you're at the bottom of the pecking order. "You're constantly in a state of panic, constantly being scrutinized by your superiors, and you're basically just trying not to screw up or piss anybody off," says Jared Aelony, a second-year resident at Oakwood Hospital in Detroit. "Your superiors can be pretty rough on you, because once you leave to go into practice, it means you've got their seal of approval, and they really want that to mean something. They want to harden you to things so you'll be able to deal with the situations that you're eventually going to be faced with."

Grace Under Pressure
Tough love from the higher-ups aside, just being in the hospital environment is enough to drive you home to bed. The problem is, bed is something that you gave up when you signed up for this career. With typical work weeks ranging from 50 to 80 hours and several nights a week spent on-call (meaning you have to stay overnight in the hospital to keep an eye on everybody's patients), you'll be lucky to get three hours of sleep on a cot in the back room. Some specialties aren't as bad as others--particularly the areas that deal with elective procedures, such as dermatology and pathology--but specialties that deal with the unexpected, such as trauma and transplant surgery, require more demanding hours. "Trauma is something that happens whenever it wants to, not just from 9 to 5. When it happens, you've got to get up, be up, and go in," says Aelony.

This is going to be the time that you pull some skills out of your toolbox that they might not have given you in med school. The first three to five months of residency will be the hardest, as your body adjusts to the lack of sleep, surplus of work, and constant reprimanding that comes with the territory. Once you physically adjust to the schedule, there are still the emotional aspects to deal with. "You've just got to be able to leave work behind and cool down. You're going to get yelled at, probably even sworn at by your attending, but you have to take it and just go on," says Aelony. "You're there because you like what you do, you chose to do it, and that will get you through it."

Certainly it helps to love your job, whether it's medicine or music. One of the benefits of a career that entails years of training is that by nature, the people that don't want or don't deserve to be there are weeded out, leaving only those dedicated to the field. These people, particularly your co-residents, are not only going to be the ones that you rely on in the workplace, but they'll be the ones with whom you talk about it later on--after all, not many others can understand what you're going through. Having a support network is key to balancing your work and home life, especially when your work life weighs as heavily as that of a resident's: "Whatever little simple pleasures you can have outside of the hospital are good things," says Aelony.

The Real Question Is, Is It All Worth It?
If you're in it for the right reasons, then you bet it is. After three years, you'll be able to become an attending physician, and pay it back on down the line, tough love and all--that's why Aelony and so many others refer to medicine as a "dysfunctional family." Not only that, but along the way, you'll be doing things you never even dreamed of doing, and saving lives you never dreamed of saving. The human body and mind are marvelous things, and before you know it, yours will have adapted to the grueling pace required to save the bodies and minds of others. "I guess it's all relative; after you've been doing something for a long time, you kind of get used to it," says Aelony, "and it becomes the norm. At this point, I don't even remember what it's like to not be a resident."

Your patients wouldn't want it any other way.