Resident Roundup: Katherine Lee, MD, MSPH

Friday, June 21, 2019

Katherine Lee, MD, MSPH
Katherine Lee, MD, MSPH

I knew residency would be difficult. The profound degree of new responsibility, steep learning curves, and long hours of caring for patients and charting are all challenges I anticipated. I was most surprised, however, by the unique challenge of training away from my specialty. We call this time “off-service” — periods when we rotate within non-family medicine specialties like pediatrics, internal medicine, and even surgery.

When we are “off-service,” we are not unlike exchange students (without the exchange) or temps walking into a new job each month. We bring with us our family medical knowledge and dive into another specialty’s world. We learn the language, adjust to the culture, and try to glean as much information and skills as possible to add to our broad family medicine toolkit. Some residents are excited to step into the shoes of other specialties. For others, the experience can be isolating, as your peers and workplace turn over each month.

I struggle with the difficulty of building competence in each of these areas of medicine essential for my training. I spend one month caring for women in labor, but then I am back to square one when I arrive at the Durham VA Medical Center’s intensive care unit, and again the next month at Duke Children’s Hospital. While my underlying knowledge base is undoubtedly evolving, it can be difficult to see and acknowledge my own progress.

This time “off-service” has given me a strong sense of pride in so many of my colleagues and partner departments. Each month, residents, attendings, and staff fold family medicine residents and other off-service trainees into their teams. Chances are, we will never work together again, and I am repeatedly impressed by their help acclimating me and their enthusiasm teaching me, a temporary teammate, their craft.  Whenever I emerge from another specialty rotation, I am sad to leave my team and patients. However, I am a better, more fulfilled physician with these new relationships and role models.

My Home Base

One of the reasons I chose family medicine was to be the home base for my patients – a central point to guide their care – and to work in a specialty where any patient who walks in belongs with us. Upon arriving to Duke Family Medicine last July, I received a list of patients assigned to me as their primary care provider and wondered what on Earth to do next. Over time, my patients have been a grounding force as they allow me to take part in the triumphs and challenges of their health.

When I return to family medicine for a half day of clinic or longer rotation, I realize that it has become my own home base in this year spent in many corners of medicine. There are small comforts of knowing where the break room is or being greeted by my name. I know how to get work done, and I know where to ask for help. As a special treat, I might even run into one of my five fellow first-year residents, all of whom are also flying in different directions and yet, have shepherded each other forward. Together, my colleagues know what it means to be a family medicine physician and light the path toward this goal. I am moved by the peace I find every time I come back to Duke Family Medicine. I will not pretend any part of this career is peaceful. Medicine is still this boundless explosion of information, skills, and humanity. But in family medicine — my not-so-new home — it’s beginning to make more sense.

Katherine Lee is a first-year resident with the Duke Family Medicine Residency Program. Email with questions.
Editor’s note: Duke Family Medicine residents guest blog every month. Blogs represent the opinion of the author, not the Duke Family Medicine Residency Program, the Department of Family Medicine and Community Health, or Duke University.