The First Cut’s the Deepest: 5 Tips for Surviving Residency With Only Minimal Blood Loss
By Dr. Vicki Archer, PGY5, McMasterU (Guest Blogger)
July, 2025 – Congratulations! You’ve matched into general surgery, which, in my completely unbiased opinion, is the best specialty out there. The next five (or more) years will undoubtedly be some of the most challenging of your life, but also incredibly rewarding. Starting residency isn’t just about learning to become a surgeon; it’s also about figuring out where the one decent bathroom is, or how to navigate the mysterious art of discharge medication reconciliation (I’m still working on this one). You might look at your staff and think they were born performing intracorporeal anastomoses flawlessly, but I promise you, they were once just as nervous and unsure as you are now. By this point, you’ve probably heard the classic advice: “Eat when you can, sleep when you can, and don’t mess with the pancreas.”, but today, I want to share a few different tips to help you not just survive residency but truly thrive.
- Trust, but Verify
Trust is everything in surgery. Trust the nurses, the other services, and your co-residents. But also, trust yourself enough to double-check. Medicine is complicated, and even the best people make mistakes. Read your own imaging, do your own exams, and verify orders yourself. Speaking up when something feels off isn’t mistrusting, it’s being thorough. We rely on each other to catch errors and keep patients safe.
- Honesty is the Only Policy
Honesty isn’t just the best policy. It’s the only policy. If you don’t know something, say so. If you mess up, own it. Lies or half-truths don’t just erode trust — they can have serious consequences. Your team will respect you far more for owning your mistakes than for trying to cover them up. PGY-1 is a year of introductions and first impressions — don’t be the person remembered as untrustworthy.
- Just Go See the Patient
As a PGY-1, you’re still building your spidey sense for “sick or not sick.” Your seniors weren’t born with it; they developed it by examining countless patients. Early on, you won’t have the experience to decide who needs to be seen overnight over the phone. No amount of notes, labs, or imaging can replace actually seeing your patient. When in doubt, just go see. You’ll sharpen your pattern recognition and reassure patients and families. Plus, nurses appreciate you taking the time; their trust and support are essential to surviving residency.
- Reps, Reps, Reps
Surgery is a craft, and like any craft, skill comes with practice. Don’t shy away from opportunities to do procedures. If asked if you’ve done something before, your answer should be “No, but I have read about it and would love to try”. So, scrub in, hold retractors, or tie knots – even if it feels awkward or anxiety inducing. The more you do, the more natural it becomes. Mastery is a marathon, not a sprint, so embrace every chance to learn and improve.
- It Takes a Village
Residency can be overwhelming, and having a support system is crucial. Find colleagues who get what you’re going through, whether that’s your co-residents, mentors, or friends outside of medicine. These are the people who’ll celebrate your wins, help you through tough calls, and remind you to laugh when things get tough. Building connections isn’t just nice, it’s essential for your wellbeing.
Residency will challenge you mentally, emotionally, and physically. You’ll have days when you feel like you’ve finally got it, and others where you question if you belong. That’s imposter syndrome talking, not reality. Remember: trust your instincts (but verify), be honest, see the patient, get your reps in, and most importantly, find your people. No one does this alone. You’re not expected to be perfect — just to keep showing up, learning, and trying. You’re already doing better than you think.
Vicki Archer, PGY5, McMaster University, is a Resident Liaison to the Ontario Association of General Surgeons (OAGS) representing one of six general surgery programs in Ontario.