Whoever says residency is not challenging is mistaken. It’s not meant to be easy, given that it is a 3-year experience all intricately orchestrated to fit into 1 year. But these series of challenging experiences are much like the movements in a musical symphony – each trial representing a beautiful and unique rhythm, tempo, and emotional intensity, ultimately leading to harmony of growth both in your personal journey and your professional journey.

Just as a symphony progresses from one movement to the next, PGY1 residents navigate through their clinical experiences, encountering moments of crescendo where they find challenges that seem insurmountable, followed by periods of diminuendo where they find solace and resilience. The purpose of a PGY1 residency is to provide aspiring clinical specialists with diverse training that ultimately produces well-rounded pharmacists, equipped to take on the next phase of their growth. This is achieved through gaining experience in a variety of learning experiences with a focus on building progression. As a resident, no matter what service I was in, there was a set expectation for me to progress – whether in my clinical knowledge, the number of patients I was working up, or simply the degree of confidence I was bringing to the table during rounds. The level of progression also depends on your background or what previous rotations you’ve completed both as a student and as a resident. A resident who has had two critical care rotations is expected to progress faster than a resident who has had none. Some services will be more clinically challenging than others. During these moments, the beaming crescendos of longitudinal project deadlines will clash with the demands of managing the care of high-acuity patients. During these moments, however, residents learn how to embody perseverance and become resilient. Because our clinical experiences vary, there will also be moments of diminuendos when the noise of demands levels out and you can enjoy the memorable moments of being a resident. These moments include networking at conferences, building a family of peers with your coresidents, and creating lifelong relationships with preceptors who inspire you.

Like a composer crafting a symphony, residents can orchestrate their PGY1 experience, finding harmony amid chaos and creating a beautiful narrative of resilience and personal growth throughout their experiences. As residents, we are often asked what our goals are for rotation, and preceptors are more than willing to tailor the experience according to what we want out of it – this applies both to the level of challenge and the level of support that we are seeking. Many aspects of a PGY1 program can also be customized to our interest areas such as our research project and our continuing education presentation, or Grand Rounds as we refer to it. For my program, the teaching certificate has two tracks that can cater to a resident’s interest. We have a clinical track, which focuses on precepting in clinical experiences, and a didactic track, which is geared more to those who have an interest in academia. Ultimately, these experiences are intricately composed to build strong critical thinking skills, create a good foundation in efficiently evaluating literature, and instill clinical knowledge in the next generation of pharmacists.

Much like a maestro coordinates different instruments at different paces to create a symphony, PGY1 residents must learn time management and hold on to their vision. This year of training is composed of multiple moving parts that are meant to produce a melodious product built on the fruits of a resident’s perseverance. It is essential that residents adapt to the higher level of time management that this training requires while also keeping their eyes on the initial purpose that brought them to pursue residency. These two key aspects are important in ensuring that residents make the most of the training they receive. In the end, this symphony of challenges that we often refer to as a residency is the loud and beautiful testament to a human spirit’s ability to endure, adapt, and ultimately thrive in the face of adversity.

About the Author: Marion Javellana is a current PGY1 resident in Emory University Hospital in Atlanta, Georgia. She will be staying with Emory for another year as next year’s PGY2 Internal Medicine resident. Marion is a big fan of exploring new restaurants, baking different concoctions of banana bread, and hiking long trails with her three puppies (Angel, Willie, and Ollie).