Crush Residency and Become the
Most Effective Intern in Your Program

40+ new videos from Dustyn giving you the right tools, methods and mindset to dominate intern year!

  • Learn what your program wants to tell you but can't.
  • Hear the unspoken, unwritten rules of residency that everyone will judge you on.
  • Understand the real expectations that everyone will have but won't explain.
  • Gain the right tools and hacks to be the best intern in your program.
  • Become more efficient and effective to not just survive, but thrive in residency.
Cat in hat

Matched, moved, and made it through orientation; congratulations!  Med school was the hardest four years of your life (ok, maybe not 2nd half of 4th year) and no one else gets that except those who went through it.  And you did it!

How'd orientation go?  I'm sure you heard a lot of things like how your work week will be capped at 80 hours and that you can always call your attending if you're in trouble.  You got "trained" on your EMR and were given a badge for every hospital you might rotate through.  I'm sure you totally felt oriented and that first day on the wards was a breeze, right?

Yeaaaah ... the thing is your program tells you what they have to tell you.  Orientation is a check list to get you through the door.  Trust me – a lot more is expected of you.  Intern year, all of residency, is going to be mentally and physically debilitating.  You're going to have to become as efficient and effective as possible to get through this.  And that's exactly what I'm going to help you do.

I'm going to tell you what your program wants to tell you but can't.  The unspoken, unwritten rules of residency that everyone will judge you on.  I'm going to tell you the real expectations they are going to have of you but won't tell you out loud.  Then I'll give you the tools and hacks to be the best damned intern in your program. 

Everyone develops their own system to survive. What if someone went through residency already, curated tips, tools, shortcuts, workflows and life hacks that made residency easier?  What if that same someone became an attending and spent years coaching his residents to success?  

If only there were someone like that ...

Residency will be the hardest thing you've ever done and ever will do. Start with the right tools, the right methods, and the right workflows. You'll be efficient, effective, and happier.

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    • Perfect Practice Makes Perfect.
    • Dustyn shares his own view on Malcom Gladwell's "10,000 hours" - the amount of time it takes to be an expert at something - and links it to residency training. The most important lesson of all is that if you train something the wrong way, you get really good at being bad. Practice does not make perfect. Perfect Practice makes perfect. And this course is designed to give you the tools, the experience, and the wisdom needed to start perfect practice from the start.
    • What Is The Bootcamp?
    • How to Use PACE to Prepare for Residency
    • Learn the roles, play your part.
    • Learn the MD team hierarchy and learn your place. We want to create a "no-blame culture for patient safety" (we do) but there's more to it than that. You don't know what your residents are doing, and you certainly don't know what your attendings are doing. Knowing your role on the team, learning the expectations, what you can do, should do, and should not do will help you fit in.
    • What Residency Programs REALLY want to tell you about Duty Hours.
    • 80 hours a week, huh? Ok. Learn what "Duty Hours" actually mean, why they came about, and hear all the things a program actually wants to tell you but can't.
    • How to dress, how to look, and how to behave.
    • Is it fair? No. Neither is life. This is about how OTHERS will PERCEIVE you, not Dustyn's personal perspective on what is right or wrong. Right or wrong, do these things to improve people's perception of you. Fix gender inequality and prejudgment by humanity later.
    • Ward Hierarchy
    • Clinical Hierarchy
    • OR Hierarchy
    • Team Caps
    • Time Off Scheduling
    • ACGME Requirements
    • Prioritize tasks with a common value: patient care.
    • Urgent things are things other people want done. Important things are things you want done. Learn to prioritize requests and tasks, but also learn how to say "no," or "I'll get to that later" the right way. 
    • More advanced prioritization based on the time it takes to get something done.
    • More than Urgent and Important, some tasks take time to complete (turkeys), and others have specific times (windows) where they are more likely to be done faster. Maximize time management by ordering tests, consults, and procedures when no one else is, and early, so that you can do other tasks while the "Turkey Cooks."
    • The book that manages your patients, day to day, that expedites decision making, note writing, and decision making.
    • The essential tool for tracking patients in the hospital day to day. Cultivated over Dustyn's residency, this is the final product that he used (and uses as an attending) to maximize efficiency, to plan his day, to identify trends, and to have it all in your pocket (without a 3-minute login time every time you want to look something up).
    • The daily tool that makes sure everything gets done for the day, and helps remind you today what you did yesterday.
    • Forgetting to do something may be obnoxious (AM labs) or catastrophic (changing antibiotics). To-Do Lists keep sanity to your day, ensure that nothing gets missed, allows for communication between residents, and is a tool that Dustyn used through residency and still uses today as an attending. Learn how to build them, use them properly, and the tips and tricks that maximize their utility.
    • Plan your day, plan your rhythm, to maximize efficiency and effectiveness.
    • Turkeys, windows, rounds, notes ... there's a lot to do in a day. Mapping out your day everyday, knowing what to do at what time, and preparing yourself for interruptions will make your day move even more smoothly. There will always be the emergencies, sure, but having a rhythm helps check your sanity and helps you practice perfect.
    • Efficiency, Effectiveness, Day by Day.
    • Seeing the Data Tracker and the To-Do list in action, Dustyn shows off the EMR he uses (but doesn't like). He shows you how cumbersome it can be to use an EMR. He also shows how utilizing the skills in the Time Management section may seem daunting, but are actually quite effective and efficient.
    • Training wheels. Do this one sloppy so you can make your data tracker look clean.
    • H&P Miner is the right side of the data tracker; the day of admit. It's the training wheels. Until you learn to manage such a tight space with a pen, use this page to remind you what you're supposed to extract out of the system and the patient. Allow it to be written quickly, sloppy, and with errors. It's the rough draft, the first pass. Once you have all that information, you can take the step again to enter it cleanly into your data tracker. Eventually, you wont need this. Dustyn just uses a folded 8.5 x 11 piece of paper and knows where things go. But as you warm up, this is a good way to keep track of an order and a check list to make sure you're getting it all down.
    • How Doctor's Think, How Doctors Want You To Talk.
    • Understand how doctors think. How to present a case. How to practice medicine. No matter what field you are in, everyone thinks like this and expects you to think (and therefore speak) like this.
    • How sure you need to be to give a treatment.
    • When you do give a medication? How sure do you need to be to treat something? Is it ok to treat two things at once?
    • Mental shortcuts that screw you up even while you're aware of them.
    • Mental shortcuts. You are not in control of your own mind. It will make shortcuts. And because of that, you will make errors. Learn the difference between analytical and intuitive reasoning, see the mental calculations attendings are making without telling you (don't just emulate them) and go beyond pattern recognition to reduce clinical error.
    • How to present a new patient to an attending.
    • Written H&Ps are supposed to be thorough, complete, and contain all the information possible. They do this so that anyone after you has access to the information they need. WHEN YOU SPEAK to an attending or a group, NO ONE WANTS THAT. Here's how you actually present a case, with tips and pointers along the way
    • How to present a patient in the hospital on daily rounds.
    • You have a Data Tracker, a To-Do list, you've seen the patient, and made decisions. Daily rounds should be concise, to the point, and relevant. Learn how to separate important from relevant (Spoken vs Written H&P) and also the format that an attending expects you to present in. Speed up your presentations, speed up rounds, sound more intelligent, get more out of rounds.
    • Know exactly what to say in each situation.
    • This has been the most difficult thing for Dustyn to teach residents as an attending. What he does is give different examples, playing off the iSOAP model from Spoken Daily Rounds, showing you how to expedite the presentation while still being appropriate. Know what to say, when to say it, and how to show the difference between what you think and did and what someone else thought and did.
    • Faculty Development for an Intern.
    • This is material that we coach exceptional attendings how to do. When a presenter is bad at giving a presentation, "be better" isn't very useful. Most attendings won't have this skillset; they may not even be able to identify what's wrong with your presentation. This allows the learner to show introspection, to identify where there own deficiencies are, and offers solutions to improve upon your oral presentation skills.
    • Old school trumps new school.
    • With the advent of EMR, putting in an order is really easy. But the computer now dictates care. How much lasix? Must be 20, because that's at the top. No. This teaches you how to write paper orders, prescriptions, to place orders into a paper chart. This throw-back teaches you what you never learned - WHY the orders look the way they do in the computer. Learning how to write paper orders helps you understand what you're doing, and lets you write orders when the system goes down.
    • Old school trumps new school, again.
    • Admit order sets are great for quality measures and attendings done in training. Admit order sets are just another box to check, and another way to practice poorly. Knowing how to do an admit order set will enhance your ability to admit a patient correctly. Learn what EVERYONE ELSE in the hospital needs to do their job, and learn the options you have, the requirements, and what you imply by what you write. 
    • When you need help, sound smart.
    • Calling consults is probably something you never did. Oral communication between a doctor and another doctor will facilitate the desired outcome. But there are some things you can do to prepare for the call, some etiquette you should follow, and some must dos to make the consult as effective as possible. 
    • Controlling yourself despite the most obnoxious, intrusive device ever created by humans.
    • The pager is the ultimate interruption. You are busy. They are busy. You are heated. They are heated. Learn to calm down, learn the proper etiquette, and what to expect (and usually not receive) when you return a page. Screwing this up is a massive withdrawal without you even knowing it. 
    • Make your life easier, use shorthand. Learning to annotate on paper makes your life infinitely easier.
    • Copying from and learning from an EMR system on how things should look and how they should be displayed, will make your life a living hell. Learn shorthand to speed up your day, make your time management tools more effective, and your life a whole lot easier. 
    • What YOU should expect and do during IDR.
    • IDR is not for you. It is everything OTHER than what you trained for. It is a time to make deposits into everyone else's accounts, to make ancillary staff feel appreciated and included, to let them vent. What is IDR? And how should you handle it? What should you do? What shouldn't you do?
    • The bad stuff you will go through that no one else will tell you about, or admit that they went through it too.
    • Residency is the hardest thing you have done to date. It will be the hardest thing you've done in your life. EVERYONE has gone through the 5 stages of death and dying. 1% will admit it. 0.01% will know how to help you. Learn what to expect at different points in your training, know that it is ok, and that there are people who can help, if you ask.
    • Introspection, energy, emotional bandwidth.
    • Your soul, your mental fortitude, your ability to process society and remain polite. Codified to your cell phone, this explores and identifies what drains you, the dangers of being drained, and finding how to recharge yourself.
    • Stress makes you grow, anything else doesn't.
    • Too little stress and you get bored. No growth. Too much stress and you panic, survival mode only. No Growth. Learn to push yourself to the limit, to bend the border of your ability and grow, but also how to spot (and then change) periods where you are not growing. At no other time will you have the supervision and ability to try, to fail, and to grow as in residency. Don't squander it.
    • What you can change, what you can't change, and what you shouldn't bother with.
    • Residency is hard. You will have little emotional and intellectual bandwidth after work, notes, personal care, and whatever other responsibilities you have in your life after all that. There will be things you can control (yourself), things you can't (famine, war), and those aren't hard to spot. But be careful of the things you could influence if you invested enough energy. Leaving completely drained ... is it worth fighting at this stage in your career? Learn "what's in your box" and what's not worth dumping whatever remaining charge you had left.
    • Internal vs External Motivation.
    • Motivate yourself. Motivate others. Carrots and Sticks vs Mastery, Autonomy, and Purpose. A reduced version of Dan Pink's book (and Ted Talk) "Drive" as it relates to residency.
    • Feedback and Evaluation
    • Change the way you see the world, people, and become more effective.
    • A cerebral look at your perspective on others. Establishing relationships with people becomes the key to growing your sphere of influence, or impacting change, and becoming more effective. The entire life of a medical student has emphasized "get ahead at all costs." Time to change that to "there is no grade, there is no class rank, only effectiveness." To do that, you must change the way you see people.
    • Codification of your relationship with every person in your life, including patients, staff, colleagues, and supervisors. 
    • Every relationship comes with its own emotional bank account. Learn how to make deposits, flush the accounts, and be rewarded for the efforts you make over time. Also see the potential catastrophe of withdrawals, what they are, and what happens when you overdraw.
    • Remaining effective for your patients and your team even if there is a disagreement.
    • When there is an argument, both of you are wrong. Learn how to effectively manage a disagreement without draining your own emotional battery or withdrawing from the emotional bank account.
    • Influence
    • Are We In Control?
    • Paradox of Choice
    • Character vs. Personality Ethic
    • Truth and Reality
    • All the elements required in an H&P to look good and bill well.
    • Learn the elements of an H&P which may seem trivial, but count a lot for a) helping future physicians who see this patient, b) applying the appropriate number of items so that your group can bill appropriately, and c) where can you take shortcuts with EMR, and where should you actually pay attention.
    • The most hated document by residents and the most important document you'll ever write.
    • Dustyn explores the different elements within a D/C Summary, his own personal beliefs on what makes a good one, and offers both how to do it right (communication between physicians) and how to just get it done (cheating using EMR). 
    • Copy and Paste. Autopopulate ... but do right that which you need to do right.
    • If you are doing the work well - caring for your patient, presenting on rounds, getting feedback, Dustyn shows you how you can cheat the system to make note-writing a breeze. He also identifies some pitfalls EMR has created that worsen your documentation. What you need for billing, what you need to do for communication, and how you make your life easier doing the most hated daily task of all.
    • Translate what you know as medical terms into the words the rest of the medical universe uses.
    • CMS language is irrelevant to you. But CMS language is the only language the rest of the medical universe uses. Case managers, quality control, insurers, the federal government, DHHS ... literally everyone else wants CMS language. From billing and coding to mortality prediction, to CDC publication of disease data, you must learn to say it right.
    • Efficiency, Effectiveness, and Meticulous Detail, in half a second. 
    • Dustyn shows you what he did in clinic. Autopopulate, copy and paste, prepare ahead of clinic. While EMRs are designed to help with billing and coding (this is NOT efficiency or effectiveness), Dustyn shows you how to use the EMR system to simultaneously deliver the optimal level of care while also satisfying bureaucratic requirements.
    • When you leave, make it so like the person who picks up from you, is you.
    • Step down notes, end-of-rotation notes. This is the time where it is the most difficult for the resident who picks up your patient to know what's going on. You've been cheating with your progress notes the entire month. Take the time to do it right. Learn the elements and the reasoning behind a transfer of care note that makes your life harder for one day, but makes the life of the oncoming resident infinitely easier for weeks, and makes massive deposits in their bank account.
    • Op Note
    • Death Note
    • Effectiveness, Respect, Professionalism in writing.
    • You've been writing emails your entire life. Now at the most professional level there is, learn what you should and should not do in emails to demonstrate professionalism and respect. But also learn how to write emails to get a response, and the response you want.
    • Patience, Respect, Professionalism in speak.
    • You know how to answer the phone, don't you? Learn the proper etiquette for making phone calls, taking phone calls, and speaking to people you don't know.
    • Asking for Favors

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