One issue that comes up a lot during residency is payback. If you get sick or take a leave for some other reason, should you offer to pay back the people who covered you (by covering something for them)?
In theory, I believe the answer is no.
I feel like it always evens out in the end. I didn't "pay back" any of the residents who covered me during maternity leave because that would have been pretty much impossible. But later in my residency, I did tons of coverage for others: people on vacation, doing interviews, and for other people on family leave. At some point in residency, most people do need coverage, and at some point, most people receive coverage. It's the Circle of Coverage.
In practice, things are a little different. I'm going to tell two stories about interns who are not me, but that I worked with closely. There are no secrets in internship. I've changed details to protect their privacy.
The first story is about a categorical medicine intern named Jane. Jane's father was diagnosed with cancer and since she was very close with her dad, she became very emotional and started having trouble focusing. She made some mistakes with patients and broke down crying during a call, and when confronted about it by her program director, she admitted what was going on. Her program director made the decision to give her a week's vacation, starting immediately. Jane was on a wards rotation and had one call left, which was on Thanksgiving. She begged the program director to let her do the call, but he decided she was not safe to work and made her take the vacation to regroup and be with her dad.
When she returned to work, she heard that people were mad at her for not covering her call. She was open about her experience and why she had left, but she still heard that people were angry. When her father was doing better, she asked the chief for the name of the person who had covered her call. It was a transitional intern named Don.
Jane approached Don. She told him she had a month of elective coming up in May, and she wanted to repay the call he had done for her on any weekend he wanted. Don angrily told her that he would be on a surgery month, so she would not be able to cover any calls for him. He made it very clear that he did not appreciate having to cover for her.
Jane later found out that Don had actually been pulled second to cover her call. He had covered for another intern named Mike, who had plans for Thanksgiving. Mike had already paid Don back by doing a call for him. Jane then offered to do a call for Mike, who thanked her and said not to worry about it.
After the death of several of her patients in the ICU, Mary became very disillusioned with medicine and told her program director that she was thinking about quitting. They talked it over and she was given a month of leave to think over her decision. Coverage was difficult with an intern unexpectedly gone, but everyone worked together and they got through it.
Mary ultimately made the decision to stay in her residency program, and she resumed her internship. Later in the year, an intern named Sue had to go to a wedding, and she asked Mary (who was on an elective) if she could cover a call for her.
Mary already had plans for that weekend. She felt wracked with guilt. She finally said to Sue that she couldn't do it.
"You know," Sue said. "We all worked really hard covering for you when you were gone."
Mary held her ground, although the fact that she was gone for a month did make her feel obligated to automatically give in to anyone's requests for coverage.