We are in the thick of interview season and I’m enjoying the lovely dinners Stanford provides for us to schmooze with the applicants, answering questions about the program over wine and burrata — I feel quite fancy sipping a swanky red and shoving my face full of cream-stuffed cheese.

Actually, our modus operandi is actually to get there at 6 with Shanta, walk around with her and chat about the program and generally about children in residency and how I feel that Stanford and my very understanding partner made that manageable, and then be out at 6:50 so Shanta can go to bed around 7:15 before she starts trying to put her whole fist into the burrata plate and feed other people.

Regardless, what I’ve learned after my three residency experiences is that what really separates programs is their culture of “wellness.” Sure every program is going to say “stay home when you’re sick, of course we have a jeopardy pool to call someone else in!” but that’s not the question — the question is do they follow through? Is there a culture of not expecting you to damage your body physically, mentally, and emotionally during residency? I feel lucky, both at MGH and Stanford Internal Medicine I felt well supported.

When evaluating programs, please do ask the residents if it seems as though the program cares about them in a meaningful way: Do you have a jeopardy pool that is frequently used? Do you have access to mental health resources available to you? Can you make a primary care appointment for yourself? Can you physically make it to any appointments for yourself? Do you have access to a gym in the hospital? How hard is it to navigate sick leave?

That being said, a program can only go so far though — it’s critical that before starting you stop and think about what’s important to you. What will you absolutely not give up? I got that advice before starting IM residency, and made a priority list:a list of things I wouldn’t give up. In no particular order:

1. My sleep – I refuse to get less than seven hours consistently. Mind you this changed post-baby, but now we are (thankfully) back on track. Even on my ICU rotations I made it a point to get seven hours if I can. I think better and I feel better on more sleep.
2. My fitness – we keep hearing about the manifestations of insulin resistance on CV and neurologic outcomes, and the primary prevention part of my brain pushes me to exercise. I’m not suggesting do hours of crossfit but rather a more manageable 20 minutes 4-5 times a week, and that was my goal when I started residency. I don’t like going to the gym, so I bought some 8lb free weights and do popsugar fitness videos. I’ve been doing them for four years now. Yeah, I fall off the wagon, and I get back on. Can’t do popsugar? Walk at a fast pace. Don’t have time/ability to do that? March in place in front of your TV (that’s what I did postpartum when it was smokey here and I wanted to slowly work on my strength after pushing out a little human)
3. My Family – My relationships with Tyler and Shanta are critical to my happiness. We decided a long time ago that we wanted to pursue academics and that our relationship came before it all.
4. My Food – I love food. I love making it, I love eating it, I love watching other people eat the food I make and like it. I didn’t want to eat garbage during residency. Linking in with fitness, I have a strong family history of insulin resistance, what I fuel myself with matters to me a lot.

Make your own realistic priority list before starting residency. Evaluate yourself, figure out what’s most important to you. Make a list of things you won’t give up, post it up somewhere. Keep yourself accountable because no matter what residency you go to, it’s hard and it can eat away at you. Centering yourself before you start is so important for your wellbeing during the whole training process and will shape how you enter your career.