Ask Andy

First off, congratulations and welcome to you and all of our incoming UCSF residents! We are so excited to have you here. And to all those continuing or graduating, congratulations on inching one big step forward this year.

I think this question applies to all of us: those just coming in and those continuing on. The incoming interns are becoming doctors for the very first time. Others are stepping into more senior roles, perhaps fellowship, perhaps a first attending job.

Before starting intern year, I remember wanting to know what secret piece of advice would make the transition feel smoother and less intimidating. The honest answer is that there probably is no single secret. But if I could go back and tell myself one thing, it would be this: you are not behind.

Intern year has a strange way of making very capable people feel newly incompetent. You go from being a successful senior medical student to a brand-new physician, where suddenly every small action feels like it carries enormous weight. You may feel slow pre-rounding. You may stare at an order set wondering whether you are missing something. You may watch a senior resident call back a consult, update a family, and triage three pages with what looks like effortless calm, and think: how will I ever get there? Imposter syndrome can feel especially loud at a place like UCSF, where you are surrounded by people who are brilliant, thoughtful, accomplished, and somehow also seem to have found time to run marathons, publish papers, raise children, and make sourdough.

I also wish I had known that I would make mistakes. Not because mistakes are acceptable in some casual way, but because medicine is complex and unexpected outcomes happen. There may be a close call, or a moment when something does not go the way you hoped. These moments feel awful, because you care about your patients. Hold onto that. Be truthful when you are unsure. Ask for help early. Follow through on the things you say you will do. Treat staff, colleagues, patients, families, and yourself with respect. Develop a system, then keep improving it. Eat when you can. Sleep when you can. Let other people help you.

Growth in residency happens quietly. To paraphrase one of my favorite reels from Dr. Glaucomflecken: do a little bit better every day. Did I do well today? If not, did I do a bit better than yesterday? If not, promise to do a bit better tomorrow. Then one day, almost without noticing, you will have grown a ton. You will reassure a medical student who reminds you of yourself. You will realize that the things that once felt impossible now feel familiar.

So to our incoming residents, and to all of us stepping into something new: you are not behind. You are becoming the kind of physician others will look to with that same impossible-seeming calm. And until then, we are all trying to do a little bit better every day, together.

Great question! Research can be one of the most rewarding parts of academic medicine because it gives you space for curiosity and creativity and often grows naturally out of patient care. You may notice something on rounds, identify a gap in the literature, and come up with a clinical question that turns into a project that ultimately improves patient care.

My advice would be to start with a question you truly find interesting, ideally in a field or subspecialty you may want to pursue. Find a mentor who is responsive, understands your schedule, and values your personal and professional growth. Be honest up front about your availability. A good project for residency is scoped well enough to be completed in a reasonable timeframe. 

The right type of project also depends on your goals. Basic science can be incredibly exciting, but it often requires larger blocks of protected, uninterrupted time over many years. If that is your path, look early for research tracks, grants, elective time, or fellowship structures that can help you carve out space. For most residents, clinical research, quality improvement, and education projects will be more feasible.

As you point out, time is the hard part. Residency is already a full-time commitment, and the “free time” outside the hospital is often not so free. For that reason, I recommend choosing fewer projects you genuinely care about rather than collecting many small projects just to add lines to a CV. A few thoughtful projects you see through to completion will be more meaningful and more satisfying than several half-finished ones sitting in a folder.

As for finding the time, there is no magic answer. Sometimes it happens during lighter rotations, quiet stretches of nights, or protected elective time. More often, it happens by making research a steady habit: one hour here, one draft there, one meeting every few weeks. Progress in residency usually comes from consistency rather than heroic bursts of productivity. It also helps to make concrete next steps rather than vaguely planning to “work on research.” Carve out smaller chunks for specific tasks: draft the introduction, clean one table, review five papers, or email your mentor with an update.

Finally, research is also a way to build community. It can connect you with mentors, collaborators, medical students, conferences, and future colleagues. It can also be an opportunity for leadership by bringing in medical students or junior residents to help move a project across the finish line. 

In sum, choose fewer but more meaningful projects rooted in clinical questions you truly care about, the kind that keep you motivated even on the days when you would rather curl up on the couch and watch TV, and remember that steady progress happens one small step at a time.

Definitely! One of the best perks of living in San Francisco is just how amazing and diverse the food scene is. I’ve been keeping a running Google Maps list of restaurants since moving here, and at this point there are so many saved spots that zooming in feels a bit like staring at a constellation. So many stars, so hard to pick which one to recommend.

Parnassus

I have to give a shoutout to the Ladle & Leaf at Parnassus. Since relocating to its current spot, it’s quietly become one of the most reliable quick options on campus (and it takes FastPay). Fresh, customizable salads, soups, and sandwiches, consistently fast, and with an unbeatable view from its renovated sunny seating area.

Just a short stroll down, 9^th Ave has really been on a roll lately:

• Tadaima: A beloved Japanese café from the Mission that’s made its way to Inner Sunset, known for its matcha drinks and pork katsu sandwich.
• Fiorella: A great gathering spot for pizza and pasta. I highly recommend going upstairs to the heated outdoor rooftop patio, which also works well for larger groups.
• Sweet Glory: Some of the best crepe cakes I’ve ever had, available by the slice.

Mount Zion

I admittedly do not come here for my rotations, but Pac Heights is full of amazing restaurants. If you’re with a group or looking for something a little more substantial, Daeho is worth a stop. Their kalbijjim is iconic and very shareable (get it with the cheese and purple rice!).

Mission Bay

You’ve probably already been to SPARK Social SF at some point for a residency social. Tons of variety with its park of rotating food trucks, always something new to try, and a fun, easy atmosphere for groups.

Whenever I’m at Mission Bay, I usually end up spending most of my meal card money at Publico Urban Taqueria. Everything is made fresh, and their daily specials are reliably good.

ZSFG

Not exactly in the three zones you mentioned, but I have to put in a plug for Lucky Coffee at ZSFG. It’s a small, family-run takeout counter on the first floor of Building 5, easy to miss if you’ve never taken that right turn before the elevators. They now take FastPay, and I often find myself grabbing both my morning coffee and lunch there. Try their mango, I’ve heard they ripen them in their basement for weeks to get that amazingly sweet taste.

First off, congratulations to the newly matched residents who will be joining us at UCSF! We’re so excited to welcome you this summer. Enjoy these last few weeks of medical school, you deserve to relax and celebrate after all your hard work getting to this point. Please don’t hesitate to reach out to your new co-residents and senior residents as you think about housing, moving logistics, or anything else we can help with.

Welcome to the Bay Area

I have good news for everyone joining us: it is very easy to have a fantastic day off during residency here. San Francisco makes this simple; you are never far from something beautiful, relaxing, or fun. Especially when the work picks up and stress starts to build, this accessibility becomes one of the best parts of living here.

Starting the day with exercise

One recent day off stands out. It was a cheery, sunny Saturday, when I awoke luxuriously without an alarm clock and made some breakfast and tea at home. My partner and I headed over to the Parnassus Millberry Fitness Center for their weekly badminton open gym. The games are fast-paced and intense, and it doesn’t take long to work up a sweat chasing down smashes and trying (unsuccessfully) to keep up with some of the regulars who seem like they must have played competitively at some point.

Mini road trip

We had picked this day to show our friends how to go mussel picking for their first time because low tide fell at just the right time in the afternoon. Picking mussels is something we discovered when we moved here and now love doing. On our way down to Half Moon Bay, we made a necessary stop at In-N-Out, still my favorite burger and, honestly one of the many reasons I was excited to come out West. We also briefly considered the Taco Bell in Pacifica (famously one of the most scenic in the world). 

Sun, sand and sea(food)!

Arriving at Mavericks Beach, it doesn’t look like much from the street, but once you walk along the rocky shoreline towards the headland, the landscape opens up into a panoramic view of the coast, where the misty horizon blends into the ocean in the distance. At low tide, the jagged rocks give way to tidepools filled with sea life, and suddenly the whole place feels alive. We spent the afternoon picking mussels, timing the waves to avoid getting splashed, and having an unforgettable time laughing together in the cold air and saltwater. 

We brought everything back to a friend’s place and cooked the mussels, steaming them in a garlic white wine broth. The meal was particularly satisfying knowing we not only prepared the food, but also found it ourselves. As the evening went on, there may or may not have been some karaoke involved.

It felt like a true reset, going somewhere only a short drive away but experiencing something that felt like a full vacation. It’s days like these, so easily accessible here, that help me recharge and come back the next day ready to give my very best.

When the GME team first reached out to ask whether I would be interested in writing an "Ask Andy" column for fellow trainees, I was hesitant. What exactly could I offer? I am surrounded by so many extraordinary co-residents at UCSF, people whose intelligence and clinical acumen continually impress me, whose research pushes the boundaries of their fields, and whose character and empathy shape the way they care for patients.

The idea of positioning myself as someone with “advice” felt uncomfortable.

But, perhaps, if I do not have sage wisdom to dispense, I can at least offer something more honest: reflections from someone still very much in the process of becoming a better resident, a better physician, a better colleague.

So, who’s Andy?

I am currently a third-year neurology resident at UCSF. We may have crossed paths, perhaps with me as a (hopefully) friendly consultant, or as someone reaching out for your expertise.

I was born in Taiwan before my parents whisked our family away to Canada in search of opportunity. I spent my early years in that snowy wonderland before we eventually returned to Taiwan, where I found myself navigating life as a third-culture kid, reconnecting with an identity that was supposed to feel familiar but initially felt foreign. Over time, I rediscovered my roots and even picked up enough Mandarin to become certified to use with patients.

After that, I spent a formative and fantastic decade in Boston for college and medical school before finally making my way west to UCSF.

This year, I had the privilege of helping with our department’s residency recruitment efforts as one of the chiefs. Sitting on the other side of the table was eye-opening. The applicants were energizing, their accomplishments staggering, and their aspirations bold.

More than once, I caught myself thinking: How did I ever manage to match here?

Applicants asked many of the same questions I once asked:

• What is the culture like?
• Will I find mentorship?
• Will I belong here?

This interview season reminded me of why I love being at UCSF. This is a place of growth and belonging--somewhere you truly could stay forever.

Match Day is quickly approaching on March 20. I am so excited to see where this year’s applicants land, and I hope many will choose to join us here at UCSF. Please reach out and welcome our incoming colleagues into this community that has been such an important part of our lives.

As we begin this column, I would love to hear from you.

• What questions do you have?
• What challenges are you navigating?
• What topics would be helpful to explore together?

If this column becomes anything worthwhile, I hope it will not be because one resident has all the answers, but, rather, because we are all in the process of becoming better together.

Looking forward to the conversation.

Andy