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Overcoming First-year Fear

By Chayanin (Jing) Foongsathaporn, MD

Have you ever done something for the first time and had great anxiety about doing it? If your answer is yes, we are in the same boat.

When I started my residency training as a first-year psychiatry resident, I had many fears and worries. Imagine a doctor who has to work in another country, use English as her second language, and see patients in a diverse population. I had fear that my patients wouldn’t be able to understand my accent; fear of judgment from my colleagues; and fear of making mistakes. The working environment in the United States is far different from Thailand. I used to write paper chart back in my country, but now I have to type everything to the Electronic Medical Record (EMR). In Thailand we have Universal Health Care Coverage, unlike the healthcare system in the United States, where everyone has insurance.

Poster presentation at World Psychiatric Association in Berlin, Germany
Hiking at Lanikai Pillbox

When facing challenges and obstacles, you have the opportunity to learn and grow from it. There is a Chinese proverb that says “a wise man adapts himself to circumstances, as water shapes itself to the vessel that contains it.” I promise myself to be like water that adjusts to any condition. I study whenever I can. I practice oral exam as much as I can. I ask questions and I am open to feedback. Nonetheless, I was still very anxious when starting my U.S. residency. Fear of making mistakes initially took over my confidence.

One day, an attending told me, “You are here to learn.” He said, “Because residents don’t know, that is why residents are in training.” His statement shifted my perspective completely. My attending encouraged me to not be afraid of making mistakes and to continue to grow professionally and personally. After a long process of self-reflection, I reconsidered the role of a resident as “a learner” not “a perfectionist.” My dream to pursue training in the United States has come true and I should not spend it with distress, anxiety, worry and fear. Instead, I want my experience to be filled with gratitude, optimism, growth and joy.

Kayaking at Kailua Beach
My birthday dinner with friends from my residency program

The way to overcome first-year fear is to change your thoughts, because thoughts affect feelings, and subsequently affect behaviors. This is the principal of cognitive behavior therapy which I also utilize when I have automatic thoughts such as “I am afraid” or “I cannot make mistake.” If I tell myself “it’s ok to be afraid” or “everyone makes mistake,” then I will feel less likely that I am the center of the problem.

I am very fortunate to train in an incredibly supportive program in Hawaii. Not only do I have an opportunity to work with excellent attendings, but I also have a nurturing group of friends who care for each other. We are encouraged to take care of ourselves physically and emotionally because we believe that healthy doctors will take better care for their patients. I started to learn how to surf, I hike, I joined a dance class and I attend local meetings regularly. This fondly shapes my experience and helps me to be a well-rounded person.

Swimming with sharks but only one shark wanted to be in my photo

Although the first-year experience has been, at times, overwhelming, it is full of learning and improving. I proudly say that it has been one of the most rewarding experiences. I believe many J-1 visa residents would agree that they grow intellectually and mentally in the intern year as well. I would like to give advice to incoming first-year J-1 physicians: if you face any fear during residency, keep in mind that “this too shall pass.” Be like water, be aware of your automatic thoughts and be a life-long learner. You are not alone and there are people who are going to support you along your journey. I wish you the best and that we all have meaningful, flourishing and enriching experiences in the rest of our United States graduate medical education training.