A Day in the Life of a Postgraduate Trainee: Conquering Difficult Interactions

We’ve all felt it before – the nagging feeling that we somehow did not earn our residency position but instead got here by pure accident, a fluke in the system. As residents, we are prone to imposter syndrome. We convince ourselves we don’t deserve to be in a specific residency program, despite all the hard work we’ve put into pharmacy school, pharmacy organizations, and, in some cases, a PGY1 residency. For me, this feeling is most present when I am serving in the preceptor role or when I get questions on rounds that I cannot immediately answer. When facing these situations, it is important to address our concerns head-on, remind ourselves how we got here, and not let our fears hold us back from completing residency requirements.

Learning to precept a pharmacy student can be challenging because we are still navigating the space between learner and teacher. Sometimes, students view the resident as a peer rather than a true preceptor, so distinguishing this early on is vital to the rotation’s success. During both of my residency years, I had the opportunity to precept students on multiple rotations. One situation stands out to me as particularly challenging. I had a student who triggered my imposter syndrome by speaking to me in a condescending manner, which made me question my abilities as a pediatric pharmacist and preceptor. At this point, I decided I needed to take my concerns to my preceptor. She encouraged me to address the situation with the student in order to gain a better understanding of the student’s critiques of my precepting abilities. After this, the student and I had a professional conversation to help me understand their thinking. We also discussed my concerns as well as the goals and expectations for the remainder of the rotation.

Tackling imposter syndrome and learning to become an effective preceptor can seem intimidating; however, talking with pharmacists who have been in similar situations can help identify the appropriate steps to take. Here are the steps I found most helpful when faced with a difficult scenario.

Identify Conflict Early On

Early recognition is vital to managing conflict. The “wait-and-see” approach can be difficult when we have only a short rotation with students. Conflict that goes unresolved can lead to decreased morale and reduced quality of patient care. Moreover, addressing conflict early on allows students more time to identify where they can improve and show progress during the remainder of the rotation. This also helps create a more productive learning environment and a better experience for both the resident and the student.

Prepare for a Discussion

In my situation with the learner, I was encouraged to prepare for the discussion beforehand so that I was organized. First, I reflected on the source of the conflict – my concerns, how I expected them to be addressed, and what changes I wanted to see the student make. Second, I reminded myself of my accomplishments, acknowledging that I was qualified to be a PGY2 resident at Cleveland Clinic and deserved to be respected as a preceptor. Finally, I made sure to be concise and remain objective throughout the interaction. This type of interaction can make preceptors and students emotional or defensive. To avoid this, preceptors need to remain unbiased and be attentive listeners. This will help us directly address the student’s concerns throughout the conversation.

Follow Up

Documentation is key! After interactions like these, it is important to document what was discussed and which changes are expected to take place. In my case, the conversation ultimately led to a better experience for both the student and me. The student gained a better understanding of the layered learning model and respect for resident preceptors. I obtained more experience as a preceptor. Indeed, of all of my residency opportunities, I believe this situation best prepared me to be a confident pharmacist.

Imposter syndrome can creep into anyone’s mind. In such situations, we can all fall into this pattern of thinking. As residents, we can often feel the need to hold ourselves to impossible standards, such as always needing to know the answers to clinical questions without getting more information and having the same knowledge level as our preceptors who have been practicing for years. In residency, we often see becoming a clinical expert as the end goal, but learning to be confident in our ability to build trusting working relationships with students, and even providers, is a soft skill we should also be learning.

About the Author:

Emma Matherne is the PGY2 pediatric pharmacy resident at Cleveland Clinic Children’s. Emma completed her PGY1 residency at Le Bonheur Children’s Hospital in 2021 and graduated from the University of Arkansas for Medical Sciences College of Pharmacy in 2020. After residency, Emma will be the pediatric intensive care unit clinical specialist at Children’s Hospital New Orleans.