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Things I Wish I Knew About PGY1 & Residency

Starting out as a HO this year? Thinking about which Residency programme you should join?

INSIGHT spoke to two newly-minted Residents, Dr Jeanne Ng (Internal Medicine) and Dr Kalyanasundaram Ragavendra (Paediatric Medicine), on their PGY1 experience and how being a SingHealth PGY1 helped them decide which Residency programme to join! 

​Dr Jeanne Ng
Year 1 Internal Medicine Resident

​Dr Kalyanasundaram Ragavendra
Year 1 Paediatric Medicine Resident

1. Tell us about your PGY1 experience – what did you enjoy most and least about it?

Dr Ng:

What I enjoyed most: Making surprisingly close friends out of colleagues. Looking back on my PGY1 year, the highlight is that these experiences were shared with them. When work is heavy and you shoulder on together, tough times form lasting bonds. Long days are made infinitely better with good company 😊

What I enjoyed least: Having less time for commitments outside of work – but maybe that's why colleagues eventually become such good friends too, so even then I suppose there is a silver lining.

Dr Ragavendra:

What I enjoyed most: The relationships that I've forged through my various rotations, be it with my fellow PGY1s, seniors, MOs and even the consultants are truly precious! Slogging it out through the tough times together has helped to build friendships like nothing else. Having friendly and approachable seniors in SingHealth has also made going through PGY1 training a lot more enjoyable.

What I enjoyed the least: I think one thing all PGY1s can concur on is that nothing drains the soul out of you like bad calls, otherwise known as 'character-building' calls. When it's 2am and you have been stuck with a difficult plug for the past half hour while admits keeps piling in, your phone has been ringing non-stop and your dinner lies untouched in your call room, it's not hard to understand why. But eventually, the admits are clerked, the changes are done, the sun rises and you get through your call, as have generations of PGY1s before you. It's really a trial by fire, which toughens you up for the challenges to come. 

​Dr Ng (second from left) with fellow HOs
in CGH Vascular Surgery 

​Dr Ragavendra (second row, third from left) with
fellow HOs at KKH 

2. Share TWO challenges you faced in transiting from medical school to your PGY1 year, and how you overcame them.

Dr Ng:

Challenge #1: Getting used to calls
Calls are a rite of passage for all of us, but I was really thankful for encouraging and patient MOs, and co-HOs who appeared in times of need (they are friends indeed!). In particular, I remember a day in KKH Paeds when I was feeling overwhelmed – it was 7pm and I had more than 10 new admissions to see. I walked into the ward and to my surprise, found 2 of my friends in the MO room pre-clerking them. I was very moved and grateful.

Also, I realised keeping hunger at bay goes a long way while on call – so I always make sure to stock up pre-call and keep snacks in my pocket.

Challenge #2: Working weekends
During schooling years, our weekends were usually free, so it did take some adjustment to have to work on weekends during HO year. I used to accumulate a 'sleep debt' on weekdays, which I would pay off over the weekend, but since HO year, I've learnt to be a lot more disciplined in sleeping early during the week. Some people can function without much sleep though, and I envy them!


Dr Ragavendra: 

Challenge #1: Taking on more responsibilities and making decisions by yourself
Even though I was the most junior in the team, I had to make decisions which would affect patient care. Having just exited medical school, this was daunting for me, knowing that my actions now had real-life consequences on others. But with time, I became more confident in making these decisions, while learning what should be escalated to my seniors.

Challenge #2: Managing work-life balance
Working hours are definitely longer than medical school days, so it was really challenging to find some semblance of work-life balance initially. It took a while, but finding a good way of managing my time outside of work even allowed me to develop other interests/hobbies. Having breaks interspersed with travel or relaxation also gave me something to look forward to before going back to work! 

​Dr Ng (bottom right) and her colleagues managing to grab a bite during a particularly hectic day
​Dr Ragavendra (first from left) on a diving trip to Gili Islands
with friends and colleagues

3. On hindsight, what are some things you would have done to better prepare yourself for PGY1?

Dr Ng:
It's hard to feel fully prepared for PGY1, though I did find the period of SIP/SAP being extremely helpful in terms of learning on the job, while being closely supervised. In LKCMedicine, since our internship period was after our final MBBS exam, it was a good opportunity for me to familiarise myself with my roles as a HO, as well as the systems and processes in the various hospitals. These were things that I could only learn through experience.

Dr Ragavendra: Sleep more so that you can pay off your sleep debt! But honestly, I think the most important thing to do is to take care of yourself both mentally and physically during this period without letting work consume you completely.

Ensure that you always set aside some personal time for yourself to pursue your own interests outside of work and take your off days to rest and recharge in whatever way you deem fit before going back to work. Physician burnout is real, but it's something that you can avoid if you remain aware of it and choose to prioritise yourself. 

4. How did being a SingHealth PGY1 help you to decide on a Residency programme?

Dr Ng: It was really helpful that as SingHealth PGY1s, we were able to indicate our preference for the order in which we are rotated through the postings. I knew I was interested in IM, but had hoped for a little more work experience before making the decision. Going through SGH IM as my first PGY1 posting definitely guided my decision of Residency programme.  

Dr Ragavendra: Being a SingHealth PGY1 allowed me to rotate through the various specialities that I was interested in and to gain exposure to the clinical work in these specialities. Being part of the teams helped me understand the working environment and dynamics, which is really important if you are going to be choosing it as your career. Through these rotations, I also got to know the seniors and faculty members from that speciality – some of whom subsequently became my mentors in the Residency programme!

​Dr Ng (right) with co-HOs
in SGH Internal Medicine

​Dr Ragavendra (second row, in blue scrubs) 
with KKH Paediatrics colleagues 

5. Share one useful piece of advice/some major considerations that helped you in choosing your Residency programme. 

Dr Ng:
My list of major considerations included:

  • Sustainability/work-life balance in the long term
  • The 'bread and butter' patient/diseases seen by that specialty
  • Personal interest in topic content
  • Work culture

Based on the considerations, it came down to either Family Medicine or Internal Medicine, but I realised I enjoy hospital work most. The choice was clear from there.   

Dr Ragavendra: If you are thinking of applying for residency after your PGY1 year, do take the time to understand a bit more about the scope and role of medical officers and residents in that department. Often, it is easy to get sucked into your duties as a House Officer, but it is also important to be aware that those roles change, as you take on more responsibilities as a Resident.

Express your interest early and your seniors will guide you into having more exposure, be it in procedural skills, clinics or various other responsibilities. Use that as a guide for whether this is something you can see yourself doing in the long run.