The First Week of Residency: Expectations vs Reality

From Dreams to the First Day of Reality

Getting selected for general surgery training at a renowned and famous private institute felt like a dream come true. 

The journey to that point was not easy, and I had already shared the detailed struggle, sacrifices, and perseverance in a previous blog ( https://faithfatigueandthefuture.blogspot.com/2025/11/starting-over-my-journey-from-different.html ). 

Like many young doctors, I walked into this new phase with hope in my heart and ambition in my eyes. I believed this was the place where my professional identity would finally take a shape.

However, the first week of postgraduate (PG) training taught me a lesson that no textbook or entrance exam ever could: expectations can be beautiful, but reality can be brutally honest.

 “Sometimes what you imagine as a breakthrough turns out to be a breakdown before growth.”

My Expectations Before Joining Surgical Training

Before starting my training, I had a picture in my mind of how things would be:

- A professional and ethical working environment

- Helpful colleagues and supportive seniors

- Strong teamwork where everyone learned together

- Teaching-oriented consultants who guided residents at the bedside

- Hands-on learning with patients, ward rounds, and procedures

- A heavy workload, yes, but with meaningful learning and motivation

I believed surgery would be demanding, exhausting, and intense—but also fulfilling. I expected long hours, but I also expected growth.

Looking back, the first mistake I made was not researching the institute deeply enough before joining.

The Mistake of Not Doing Proper Background Research

I did try to gather some information, but not in the right way. 

I came across a registrar from the same institute on social media and messaged her. She shared all the positive aspects—good exposure, patient load, and learning opportunities. 

What she did not mention were the challenges, internal culture, or hidden struggles.

With time, I realized something important:

“People rarely talk about the dark side of a place they are still dependent on.”

Institutes often need workforce, and residents are the backbone of hospitals. Naturally, negative aspects are rarely highlighted.

Day One: A Saturday I Will Never Forget

My first day was a Saturday. 

I still remember walking into the hospital with mixed emotions—excitement, nervousness, and hope. 

But from the very first few hours, something felt off. I could not explain it logically, but the vibes were strange.

I was introduced to the chief resident, who immediately handed me over to my immediate senior—a resident who was six months ahead of me. She was told to teach me and guide me through the system.

Unfortunately, her attitude was the complete opposite of what I had imagined.

Encountering Arrogance Instead of Guidance

My immediate senior appeared arrogant, irritated, and visibly burdened by my presence.

 She expected me to automatically know things without explanation. Teaching seemed like an inconvenience to her, not a responsibility.

I tried to observe silently, understand workflows, and learn by watching. But the environment made it difficult.

 As I met more people, I noticed a pattern—ego-driven behavior, lack of approachability, and emotional distance.

No one offered guidance voluntarily. I had to ask for every small thing. Most people followed the rule of “mind your own business.”

 “The absence of mentorship can be more damaging than the presence of workload.”

OPD Day: Good Exposure, Minimal Teaching

It was an OPD day, and the patient load was massive. From a learning perspective, the exposure was excellent. I saw numerous cases and conditions. However, learning felt incomplete.

My consultant in charge and a medical officer stood out. The medical officer, in particular, helped me review patients, guided me through cases, and explained basics. She became my first friend in that institute, who was not a resident by a medical officer.

Her kindness reminded me that good people still exist, even in difficult systems.

From OPD to Ward: Reality Hits Harder

After OPD, we moved to the wards. Sorting patients, reviewing files, scut work, documentation—everything felt overwhelming. 

The focus was heavily on paperwork rather than structured surgical learning.

At one point, I had a strange realization:

“This feels less like a surgical training program and more like a corporate office with files instead of laptops.”

Patient care was happening, but resident teaching was not a priority.

The Warning Signs I Ignored

On the very first day, right in front of me, two residents resigned. They clearly warned me that this place was a waste of time and energy. They advised me to reconsider.

Yet, I chose not to listen.

Why?

Because it was only the first day. I believed that: 

You cannot judge a place in one day; at least give it a week.

And honestly, that belief was not wrong.

Emotional Conflict: Stay, Observe, or Quit?

That first day left me confused, emotionally drained, and questioning my decision. But I decided to continue—at least for a week—to understand whether adjustment was possible.

Postgraduate training is not just about learning skills,  it is also about emotional survival, resilience, and self-awareness.

So the whole week was all same and it passed very quickly. I had a schedule we had to rotate in opds , OR and wards sorting preop and post op patients. In that 1st week I also got 2 oncall duties that were less hectic as they did not burdened me on my calls rest of the week passed by adjusting with new people environment.

Practical Tips: What to Do in the First Week of PG Training

Based on my experience, here are some practical tips for anyone starting postgraduate medical or surgical training:

1. Observe More Than You React

Your first week should be about understanding the system, people, and workflow. Avoid emotional reactions.

2. Identify Safe and Supportive People

Every department has at least one kind soul. Find them—they will make your journey easier.

3. Ask Questions, But Choose the Right Person

Not everyone enjoys teaching. Learn who is approachable.

4. Don’t Assume All Institutes Are the Same

Each place has its own culture. Compare reality with your long-term goals.

5. Give Yourself Time—but Not Blind Loyalty

Give a fair trial, but don’t ignore repeated red flags.

6. Protect Your Mental Health

No training is worth losing your self-respect or mental peace.

Hard work builds surgeons, but toxic environments break humans.

Final Thoughts: Growth Is Not Always Comfortable

That first week reshaped my understanding of surgical training.

 It taught me that exposure alone is not enough; mentorship, respect, and learning culture matter just as much.

If you are starting your PG journey, remember:

Your degree will shape your career, but your environment will shape you.

Sometimes, staying is an act of courage. Sometimes, leaving is an act of self-respect. Wisdom lies in knowing the difference.

To be continued…