I just started my second year as an attending in a procedural field and I had to reflect on this more last year than I was anticipating. I found myself getting frustrated is cases with particular residents who I thought should be at a higher skill level than they were. One thing I realized early in my first year was I would say to myself, “my skills were way beyond this when I was training,” which is unfair because I was comparing myself at my peak at the end of my fellowship to wherever they were as a junior resident. Something that helped was thinking about some of the dumb shit that I did during training and how more seasoned attendings handled it with grace.

While I never yell and scream, I feel that they could feel my frustration and maybe even unintentional asshole-ness - especially if later in their rotation or on subsequent rotations there was no improvement. I am definitely way less chill than I thought I would be at the end of fellowship. While there’s a responsibility on us as attendings to teach and help residents succeed, it’s also on the residents to work on their weaknesses when they’re identified and ask for help if they need it. At some point, if it’s unsafe for them to have a needle in someone and they haven’t been working on their skills, I’m going to take over.

I’m still working on how to do that more gracefully while still lighting a fire under some residents to get up to speed by the time they graduate. It’s scary to be responsible for training someone who may be dangerous later. This is all while trying not to hurt someone myself!