When you crossover to becoming a first-year resident, you will notice multiple subtle changes overnight. This includes having a greater level of responsibility, as a doctor, and needing to perform efficiently in a hospital. One aspect of this is to carry the proper items on you.  Besides receiving a longer white coat with extra pockets, now you get to have them filled up with extra “stuff”. Below is a comparison of what I personally carried as a 4th-year student, versus a 1st-year resident.

4th Year Externship

1st-year Resident On-Call

Black pens Crozer book/ Prism book Manuscript article Scissors 4×4 gauze Kerlix Iodine swabs Paper tape Monofilament Smart Phone ID

Multicolor pen Red pen Black pen Bandage scissors Suture removal kit Nail clippers Kerlix Kling Sterile Q tips Adaptic ACE bandage Coban 4×4 gauze ABD pad Xeroform Iodine swabs Saline flush Alcohol pads Hand Sanitizer Wound Culture swabs #15 blade disposable Clear tape Maxipore tape Paper tape Monofilament Rounding list Gum Breath mints Sprite/Coke can Granola bar Mini Notebook iPhone iWatch Pager ID

 

What I carry in my white coat pockets now, 1st year podiatry resident edition:

1. Multicolor pen – You can label a specific color for a specific attendee. I use red for emergency notes, or reminders.
2. Red pen – Back up
3. Black pen – Back up
4. Bandage scissors – Cut down previous dressings, cut down splints. Very versatile. You can add an ID reel, so you can keep it on you at all time and never lose it!
5. Suture removal kit – When you need something sterile to cut those small simple sutures.
6. Nail clippers – Because you are a podiatrist… duh. You can get 1, 2.. or 5 nail consults in one day.
7. Kerlix – For dressing wounds and holding 4×4 gauze in place.
8. Kling – small gauze rolls for those small wounds, or when going through the small openings in external fixation devices.
9. Sterile Q tips – Because you have to check if the wound probes to bone, and it comes with a paper measuring device that is disposable!
10. Adaptic – For those attendees that don’t like xeroform.
11. ACE bandage – ACE stands for “All Cotton Elastic”, appropriate to place slight compression on bandages.
12. Coban – For the attendees that want extra compression or don’t like ACE wraps.
13. 4×4 gauze – Whoever invented this is filthy rich. Just saying.
14. ABD pad – For those patients that cannot stop bleeding, add the Army Battle Dressing pad for an extra absorption layer (higher absorption than 4×4 gauze).
15. Xeroform – The yellow dressing that contains the element Bismuth. Classic pimp question.
16. Iodine swabs – to dry off wounds, and sterilize the area before giving injections.
17. Saline flush – expensive purified water for wounds, trauma cases, and contaminated skin.
18. Alcohol pads – always clean the area before injection, or to clean small areas.
19. Wound Culture swabs – The most important item to have on you at all times, especially in late night ER consults. Having a culture for aerobic, anaerobic, and fungal testing is essential. This little tube decides the kind of treatment the patient will receive during his/her course in the hospital.
20. #15 blade disposable – For debridement of ulcers, scabs, and calluses.
21. Clear tape – 1 inch multi-specialty medical clear tape
22. Maxipore tape –  Wider tape for bigger bandages.
23. Paper tape – Old school tape.
24. Monofilament – For your neuro exam.
25. Rounding list – Also known as THE LIST. The list of all your patients, room numbers, and writing updates that you have scribbled on. You will print a new one every day hoping the inpatient count has not doubled overnight.
26. Gum – for extra calories and giving you a fresh clean breath.
27. Breath mints – You never know when the last time is you will brush your teeth. When you are on call you may go 2-3 days straight with little to no sleep. You are going to be around others in close quarters.
28. Sprite/Coke can – For that sugar rush you need and a boost of energy at 5:00 am when you cannot wake up or 3:00pm when you are tired
29. Granola bar – The only nutrition you may get, especially if you are on call over the busy holidays.
30. Mini Notebook – where you can write notes, reminders, and most importantly patient information to log on Podiatry Residency Resource (PRR) for your residency numbers. You have to collect the patient’s MRN or account number, age, male/female, and the procedure.
31. iPhone – You will be texting A LOT. You will text attendings, residents, students, other doctors, etc. Nowadays, hospitals have apps where you can text and give orders to nurses directly. This is great technology but the biggest challenges was getting to find phone service inside a concrete hospital. I recommend the iPhone since it lags less and it compatible with most WIFI hotspots. In addition, I downloaded Hippocrates and UpToDate for quick references and studying.
32. iWatch – My wrist vibrates every time for notifications so I can remind myself of the notification, in case I forget later. Works with calling, readings texts, and looking up info in case my cell phone battery is low.
33. Pager – You will learn to dislike its beeping sound, especially at 4:00am in the morning.
34. ID badge – The master key to the hospital, without it you cannot maneuver in this place.

 

Yes, all of this was able to fit in my white coat. You get better at stuffing your pocket every morning before you round, that way you can move quickly between patients. Time is the most valuable thing you have. If you learn to be quicker, more efficient, and think 3 steps ahead, you will expedite your day. Remember this is how it looks usually for a resident while he is on call on a Podiatry hospital rotation. It definitely changes when you are on a different rotation service. Each resident is different, but this is just a glimpse of what you can expect!

By: Roberto De Los Santos