New Kid in the OR

A new year means new beginnings.

For some people it might be a new job, a new school, a new home or a new focus.

For me, 2021 brought an all too familiar change… a TDY rotation.

If you are not familiar with “TDY” it stands for Temporary Duty Assignment, and it is when the military sends you to a new location for training. Some examples of TDY for an active duty physician can be deployment specific training or providing COVID relief in a hard hit hospital.

My general surgery residency is essentially built on TDYs. My base is located in a suburban location and we are about 2 hours away from the closest metropolitan area. This means that a lot of the subspecialists we work with in residency are not easily accessible in our city. To ensure that we have a well rounded education, my program sends us TDY to different locations so we can train with a wide variety of surgeons and have exposure to patient populations we might not otherwise encounter.

When I was first researching this program, the idea of frequent travel and a life on the road sounded exciting. Spoiler alert, it’s not. Not only does the novelty of living out of a suitcase in a hotel in a new city wear off very quickly, but you are the perpetual “new kid”. As someone who grew up being the new kid not too infrequently, I know the gnawing nervous pit in my stomach all too well, I just assumed I would’ve outgrown it by the time I hit my late 20s!

If you have ever worked in healthcare, you understand what a nightmare in-processing is. You have to be credentialed, complete hours of online training and safety briefings, be finger printed, drug screened, and TB tested. Now imagine doing that every 6 weeks… in addition to learning a new city, a new hospital layout, new faces, oh and not to mention coping with the usual stress of a general surgery residency. YIKES. By the time I finally feel like I have my feet under me, its usually time to pack up and start all over somewhere else.

While the travel grows weary at times, in reflecting on the experiences offered to me by my program, I have to say the good out weighs the bad. Because of this set up, I get to train with some of the best subspecialists in their respective fields. Just recently I finished a Burn ICU rotation at Brooke Army Medical Center which is arguably one of the most influential facilities in burn care and management with several of the staff surgeons being innovators within the field. I was able to do my Transplant surgery rotation at a high volume transplant center, and I get exposure to trauma surgery in two different large cities exposing me to be blunt and penetrating trauma. I work with a large group of attendings, fellows and residents helping me make an expansive career network which I’m sure will be useful when it comes time to applying to fellowship or applying for jobs.

Now that I’m a couple years into my program, I think I’ve finally figured out this whole traveling thing and I wanted to share just a few tips or tricks to help you in-process at a new facility.

  1. Prepare ahead of time: there is nothing worse than getting ready the night before a first day at work and realizing you didn’t start the 2 hour long orientation video or you didn’t set up a badge photo appointment. Several weeks before you are slated to start somewhere new, reach out to your point of contact and ask how you can make your transition into your new role go more smoothly.
  2. Don’t be afraid to ask for help: I firmly believe it doesn’t matter how far along you get in your career, first days will always be awkward and make you feel self-conscious whether you are starting out as a volunteer or being hired on as the CEO. Everyone can remember how difficult it was to adjust to a new role at some point in their life, so most people are more than willing to help someone out when they recognize you are new. If you don’t know how a process works, where to find supplies, or how to get to the cafeteria, don’t be afraid to ask someone! As long as you are respectful and read the room (i.e. don’t ask a nurse who is in the middle of sign out to show you where to find gauze) you will likely find the answers you are looking for!
  3. Advocate for yourself: In my 10 year career in medicine, I have gotten a needle stick twice. As Murphy’s law would have it both times I have gotten stuck have been on my first day at a new hospital (maybe due to first day jitters?). Despite these events happening several years apart, in two different hospitals in two different states, my experiences were nearly identical. After I reported the incident to my point of contact, I was met with blank stares. As a visiting medical student and resident, there always seems to be ambiguity on if you are able to be treated in student/employee health like a permanent party employee. Ultimately, you need to know what your school/program’s policy is in your teaching agreement. I guarantee that there is some plan in place on whether you require medical attention while away. Regardless of if you know the policy, know that you may get some push back. After my most recent needlestick on a 24H call shift, the first person I spoke to suggested I drive back home (~3.5 hours one way) to have my prophylaxis labs drawn. A quick call to my program director sorted the matter out quickly and I received the medical attention I required. Don’t expect the program you are visiting to have your best interest at heart frankly because they probably don’t know who you are! You need to know when to stand up and make sure that you are being taken care of when necessary.
  4. Be engaging: this is just a good life hack for any situation you are meeting someone new. People looove to talk about themselves, its a fact, so ask them questions! However, be cautious. Too many questions may seem disingenuous or like you are interviewing whoever you are speaking with. My tip is to ask questions they might not get asked every day. Ask a subspecialist why they chose their specialty. Ask the scrub tech what is the one food place they recommend while you are in town. Not only does this break the ice, but it usually gives enough fodder to keep the conversation going.
  5. Keep your chin up: I won’t sugar coat it; living on the road is tough. I miss my family, I miss sleeping in my own bed, I miss seeing familiar faces at work, or knowing my way around the city I live in. There are several days when the stress of it all really gets me down.. and that’s okay! You’re allowed to have bad days and you’re allowed to be frustrated with the process as long as you keep moving forward. Ultimately my work assignments are 6-7 weeks long, which means if I’m assigned to a team where I don’t mesh with the team well or don’t enjoy the surgeries, after 6 weeks I get to leave and start fresh somewhere new!
  6. Bring a piece of home with you: it is almost laughable how much luggage I started bringing with me on my away rotations. Over the past few months I have added to my arsenal a spin bike, a sewing machine, and an indoor garden… all of which I’m sure look utterly ridiculous when I lug them into my hotel room on a luggage cart. However this year I’m slated to spend 40+ weeks on the road and I find comfort in having the things that remind me of home. I love that I can participate in some of my favorite hobbies even though I’m in a new city. I am also very fortunate that I can bring my sweet travel-loving cat, Mabel on the road with me and I absolutely recommend traveling with a pet (as long as they aren’t stressed with adapting to a new location and your hotel allows it). Although I can’t be surrounded by my whole family, having my cat here with me alleviates the loneliness and brings a little piece of home to my hotel.

Do you travel for work? If so how often? Any tips or tricks you’d recommend to alleviate the stress of moving? I’d love to hear from you!



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