May 21, 2018

Fifteen years ago this month, I started my residency. No, not my medical residency. That would come later. This was a residency in journalism.

I was hired in the spring of 2003 in the “two-year residency program” in the Metro department of the Chicago Tribune. It was a chance to leap from my previous job as a wire service reporter at The Associated Press to one of the biggest and best-regarded newspapers in the country.

This summer, I am completing a one-year fellowship in cytopathology, a sub-specialization which comes on the heels of a four-year residency in pathology. I never expected to go through residency twice, much less in such different fields, but I’d like to think that my first one, in journalism, prepared me in some ways for the one that came along later.

Looking back, there are some ways that the two experiences were similar – and some that made them distinct.

Yes, the hours are long

The “resident” reporters in the Tribune newsroom were younger people, as they mostly are in medicine, usually in their 20s, at the beginning of their careers. Some were “cub reporters” just out of college, while some, like me, came after a few years of good experience elsewhere.

The residents at the Tribune worked long hours, weekends and holidays. We were often the first reporters to arrive in the newsroom and the last to leave at the end of the day. We were always on call if a big story was breaking. We slept with pagers next to our beds — something all too familiar to any medical resident.

We were the frontline reporters for the paper’s Metro section each day, which freed up the senior reporters to focus on bigger fish, beats and long-term projects — an arrangement not unlike that of medical residents and senior attending physicians. The Tribune residents reported the daily drumbeat of big city stories — and in a city like Chicago, there is no shortage of stories.

We had to be ready to go anywhere at any time. We were sent to fires. We covered fatal automobile accidents. We covered press conferences, political campaign events and trials. We wrote obituaries.

As you proved your ability to handle a story, you were given more complex and higher-profile assignments. You could say that this was a form of “graduated responsibility” — a description often used for medical residents as they accumulate experience and demonstrate competence.

As in medicine, residents worked at a lower salary than the permanent staffers around them (although in medicine, the bump you expect to receive after training is a bit more). There was no guarantee of a job at the paper after the two years, but the experience was invaluable in obtaining permanent positions even if it ended up being elsewhere.

On my fourth day at the Tribune, I was assigned to cover the opening of a $23 million state-of-the-art African animal facility in a renovated part of the beloved Lincoln Park Zoo. For a kid who’d grown up infatuated with zoos, it was a big fat fortuitous softball. My story landed on the front page. It was the first time I could hold up a paper, hot of the press, with my byline on A1. I was ecstatic.

Ten years later, after the turmoil in the newspaper industry had set in, I began my medical residency in pathology. It came, of course, after four grueling years of medical school. After years of intense studying, I had been looking forward to residency being more like a job, but it's really some sort of limbo between working and still being a student.

Some describe medical residency as a kind of apprenticeship. Clearly, it is a bargain — you provide inexpensive labor at long hours for the hospital and in exchange, you get the experience and training you need for your career ahead.

The first medical residency programs were pioneered in the late 19th Century at Johns Hopkins Hospital under Sir William Osler, a giant in medicine. The word “residency” derives from the fact that residents lived — “resided” — at the hospital. It offered maximum experience in which residents worked upwards of seven to eight years, devoting themselves to their profession, and living, according to Hopkins history, a “restricted, almost monastic life.”

Medical residents today don’t exactly live at the hospital — but depending on which specialty you enter and which rotation you’re on, it may feel like it. Medical residencies vary from three years (primary care, such as family medicine, pediatrics and internal medicine) to seven years long (neurosurgery).

It's a given that you'll work many holidays and weekends. In hospitals and newsrooms, the work never truly stops. In fact, in many medical specialties, they refer to a weekend in which a resident gets two full days off as a “golden weekend” because it so seldom occurs.

There is a cap on the number of hours you can work as a medical resident — an average of 80 hours a week, over the course of a month. Eighty hours! Which is, of course, twice what is considered the standard work week.

In pathology, unlike in specialties like surgery, we did not push up against that 80-hour limit very often, which, frankly, is one of the reasons it appealed to me. After all, I was going through residency in my early 40s, with three young children at home. Still, I learned new levels of exhaustion in my medical training — and yet you find ways soldier on.

The trade-off of a pathology residency is that there is a ton to learn and the two-day board-certifying exam looming at the end of training is a behemoth. So the need to study is still there, every day, even as you work long hours. And studying isn’t even included in that work equation. It’s extra. 

No, being a quick study isn’t enough

In a newspaper residency, the more you know, the better off you’ll be. You can handle a wide range of assignments and write with authority. But, other than keeping up with the news, there’s not much studying. At the end of a long day at the Tribune, we were more likely to head over to The Billy Goat Tavern for beers than to head home and hit the books.

At the Tribune, I benefited from my AP experience in being able to track down and quickly write up a story. Six months after starting the Tribune residency, a permanent general assignment reporter position opened up in the paper’s west suburban bureau and I got the job.

That sure as heck didn’t happen in medical residency. There are no shortcuts. In order to be board-certified, you have to complete the allotted amount of time in order to make sure you develop the skills and confidence to take on a lead role in patient care.

This spring, as I finally neared the end of my medical training, I returned to the site of my first residency, the beautiful, historic Tribune Tower, on Chicago’s Magnificent Mile. The current corporate owners of the Chicago Tribune, Tronc Inc., recently sold the building and it soon will be converted into condos — a sad sign of the times.

In March, the senior editors at the Tribune graciously hosted a gathering for reporters and editors — current and former — to bid farewell to the newsroom. About 500 people showed up. I was proud to be one of them. 

Despite the bittersweet circumstances, the newsroom again had a boisterous buzz. It was a rush of nostalgia and emotions, for me and everyone there. There were hugs and laughs and Facebook posts. It felt like part college reunion, part wake. But an Irish wake at that. The editor-in-chief toasted us all and thanked us for our blood, sweat and tears.

The memories came rushing back. As I strolled by the newsroom cubicle where I’d worked the phones and filed my stories as a resident 15 years ago, I couldn’t help feeling that there was still a part of that paper residing in me.

Residencies, whether in medicine or in journalism, have a way of sticking with you down the road even if your journey takes a dramatic turn.

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John Biemer, MD, is a first-year resident in pathology at Loyola University Medical Center in Maywood, Ill. He is a former reporter for the Chicago…
Dr. John Biemer

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