Around this time, back when I was an R3 (which feels so distant, somehow), I had what was multiple small breakdowns with staff and friends alike. Residency is HARD. And the breakdown was after years of pretending like it wasn't.

Actually, there was an ease to the silence throughout residency - the mask, the charade of being an internal medicine resident. I could say nothing, show up and do my work, and mask that I was struggling. I'm not sure that I would've admitted it out loud, anyway.

BUT, I had made several deadlines for myself. This was on the background of seeking mental health help & cipralex (which I continue to this day). I would tell myself- if I didn't feel better by the end of block X, I would take time off or even quit.

I never did, although some of my classmates did. When I matched - the sense of relief was overwhelming. At the time, we didn't write our Royal College exam until our R4 year. There was not much else to think about, that year, I was allowed time to heal.

This is not something that is longer afforded to the R3s who, as senior residents, support juniors, medical students and their staff in running an often very busy internal medicine service. There are pros and cons to writing your exam in your R3 vs R4 year. I won't go into that.

The residents are on AUTOPILOT, with or without pandemic. They are there, all the time, always caring for patients, to the best they know how. They are AWESOME. Literally. They are so good at medicine, it is wild. And they are human, and parents, and siblings, and friends.

So while I acknowledge that the pandemic has placed excess pressure on the @Royal_College exam, I hope that a more sustained conversation of how we can support our R3s during this very stressful and high stakes time occurs even after the pandemic ends.

And if there is anyone questioning if there is a "place" for them in medicine, or if they should "continue" or "take a break" - know that I and so many others have been there too. For me, the journey has been worth it. But it has taken me a lot of time to know that.