Year-End Cleanout: Organizing Notes, Emails, and Lists Before PGY Upgrade

The way most residents limp into July carrying three years of digital clutter is a liability, not a badge of honor.

If you’re about to move from PGY-1 to PGY-2 (or PGY-2 to PGY-3, etc.), you’re not just leveling up your responsibilities. You’re also dragging along thousands of notes, emails, and half-finished lists that will either help you move faster—or quietly sabotage you.

Let’s fix that. On a timeline. Step by step.

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4–6 Weeks Before July: Set Up the System You Wish You Had

At this point you should stop thinking “I’ll clean this up when things slow down.” They won’t. You need a light, realistic plan that fits into a resident schedule.

Step 1: Choose Your Core Tools (1 evening, 30–45 minutes)

At this point you should decide where future you will actually live:

• One note system (max two):
  • Example: OneNote or Notion or Apple Notes + a small paper notebook.
• One task manager:
  • Examples: Todoist, Things, Microsoft To Do, or even a well-structured Notes list.
• One email triage method:
  • Typically: Outlook or Gmail with a folder/tag system you stick to.

Stop hopping between six apps. It’s killing your retrieval speed.

Create this minimal backbone:

• Notes app:
  • Notebook/space: “Residency”
  • Subsections:
    • “Cheat Sheets”
    • “Teaching & Pearls”
    • “Procedures”
    • “Admin / Program”
    • “Career / Fellowship”
• Task app:
  • Project/labels:
    • “This Week – Clinical”
    • “Admin / Program”
    • “Personal”
    • “Follow-up / Reading”

You’re not organizing old stuff yet. You’re building containers that old stuff can flow into.

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3–4 Weeks Before July: High-Level Map and Big Trash

Now you create the map of your chaos and take out the obvious trash.

Step 2: Inventory Your Digital Mess (1–2 short sessions)

At this point you should quickly map where your information currently hides:

• Email accounts:
  • Hospital email, personal Gmail/Outlook, program-specific.
• Note sources:
  • EMR scratchpads, OneNote, Apple Notes, Notion, Google Docs, random Word files.
• List sources:
  • iPhone Reminders, task apps you abandoned, paper lists, whiteboard snapshots, text messages to yourself.

Open a plain note and write a quick “Info Map”:

• “Clinical pearls – scattered: OneNote ‘General’, iPhone Photos, random PDFs”
• “Admin stuff – Outlook inbox, Downloads folder, text from chief, WhatsApp thread”
• “Teaching slides – Email attachments, Desktop folder ‘Talks’, hospital shared drive”

This isn’t organizing. It’s reconnaissance.

Step 3: Brutal First-Pass Deletion (two 20-minute blocks)

At this point you should do the easiest, most satisfying cleanup: trash obvious junk.

Block 20 minutes twice this week. Set a timer. Move fast.

Focus on:

• Email:
  • Delete:
    • Old cafeteria menus
    • “Thanks!” / “Got it” replies
    • Expired meeting invites
    • Old shift swap threads that resolved months ago
  • Mass-unsubscribe from newsletters you never open.
• Files:
  • Delete:
    • Duplicate slide decks
    • Old board review PDFs you’ll never touch again
    • Outdated program policies replaced by new versions
• Photos:
  • Delete:
    • Blurry whiteboard pictures
    • Duplicate EKG snapshots you never refer to
    • Random screenshots of memes

If you ask “Will anyone die or get in trouble if I delete this?” and the answer is no, it can probably go.

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2–3 Weeks Before July: Clinical Notes and Pearls

This is the gold. Your brain in written form.

At this point you should start curating the stuff that actually makes you better at your job.

Resident Digital Clutter Breakdown

Category	Value
Clinical Pearls Worth Keeping	15
Outdated/Redundant Notes	35
Admin Emails	25
Random Screenshots	25

Step 4: Consolidate Clinical Pearls (2–3 sessions of 30 minutes)

Goal: one main, searchable “residency brain” instead of 14 partial versions.

1. Create structure in your notes app:

   • Clinical:
     • Cards/pages by topic:
       • “CHF exacerbation”
       • “DKA management”
       • “Seizure workup”
       • “Pre-op eval”
   • Call / Night Float:
     • “Common overnight issues”
     • “Cross-cover scripts”
   • Procedures:
     • “Intubation”
     • “Central line”
     • “LP”

2. Pull from scattered sources:

   • EMR “personal” macros
   • Old rotation notebooks
   • Photos of whiteboards or attendings’ notes
   • Typed lists saved in email drafts or random docs

3. For each useful nugget:

   • Drop it into a topic note.
   • Use short, quick headings:
     • “Initial orders”
     • “Red flags”
     • “Dispo criteria”
     • “One-liner explanation”

You’re not writing UpToDate. You’re building a fast trigger for 3 a.m. brain fog.

Step 5: Kill Redundant and Outdated Clinical Notes (same sessions)

At this point you should stop hoarding every half-baked note you ever wrote.

As you migrate:

• Delete:
  • Old guidelines superseded by new ones
  • Rotations from institutions you’ll never work at again with different protocols
  • Overly long “novel” notes you never reference
• Keep:
  • Attendings’ one-liners that stuck
  • Quick algorithms you actually use
  • Local workflow quirks (e.g., “CT abdomen after hours needs attending approval first”)

If you wouldn’t pull it up on a busy call night, it’s not worth keeping.

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10–14 Days Before July: Email Reset and Admin Sanity

At this point you should stop letting your inbox set your priorities.

You’re about to get more responsibility. You need a system that surfaces the right things, not everything.

Step 6: Build a Simple Email Folder/Label System (1 session, 30 minutes)

Keep it stupid-simple. For most residents, this works:

• Action
• Waiting / Follow-up
• Reference – Admin
• Reference – Education
• Reference – Program
• Archive (or just let “All Mail” serve that purpose)

Now create 3 rules for yourself:

1. No using the inbox as a to-do list.
2. No more than 50 messages in the inbox at any time by July 15.
3. Anything needing more than 2 minutes moves to:
   • Your task manager (for action)
   • Calendar (if time-bound)
   • “Waiting / Follow-up” (if you’re waiting on someone else)

Step 7: Triage the Inbox in Phases (3–5 short chunks)

You are not going to “clean the inbox” in one hero session. Do it like this:

Phase 1: Bulk Archive (15–20 minutes)

Sort by sender or subject.

• Mass-archive:
  • Old listserv digests
  • Completed committee emails
  • Past conference announcements

Use search:

• “before:2023/01/01” then quickly scan and archive 90% of it.

Phase 2: Admin + Program (20–30 minutes)

At this point you should make sure nothing important for the PGY upgrade falls through.

Search these terms, then file appropriately:

• “Schedule”
• “Orientation”
• “Credentialing”
• “Compliance”
• “Duty hours”
• “Rotation”
• “Block”
• “Contract”

Create a short note: “PGY Upgrade – Admin To-Do” and list concrete tasks you see in emails (e.g., “Upload BLS card by June 30”, “Sign new contract in portal”).

Phase 3: Education + Career (20 minutes)

Search for:

• “Grand Rounds”
• “Lecture”
• “Conference”
• “Abstract”
• “Poster”
• “Fellowship”
• “Mentor”

File:

• Slide decks → Reference – Education
• Important threads with mentors → Reference – Career (or similar)
• Dead opportunities / past deadlines → Archive

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7–10 Days Before July: Lists, Tasks, and Loose Ends

You probably have 14 different “to-do” universes. Time to collapse them.

Step 8: Centralize All Task Sources (1 focused hour)

At this point you should bring everything into a single “inbox” list in your task app or one master note.

Pull from:

• Old task apps (Asana, Todoist, Reminders, etc.)
• Paper lists
• Sticky notes
• Notebooks
• Screenshots in your photo roll
• “To self” emails
• Notes titled “To Do”, “Don’t forget”, etc.

Dump them verbatim into one long capture list.

Then process:

• Delete:
  • Already done
  • No longer relevant
  • Vague things like “read more about sepsis” (replace with a specific task or let it go)
• Clarify:
  • Convert “check fellowship” → “Email Dr. Smith about pulm fellowship by July 10”
• Categorize:
  • Clinical
  • Admin / Program
  • Teaching / Academic
  • Personal

Now you’ve got reality in one place.

Step 9: Create Your “PGY Upgrade” Checklist (30 minutes)

You want to hit July 1 without scrambling.

Make a short, focused checklist split into two buckets:

1. Must-be-done-before-July:

   • Sign new contract
   • Complete hospital modules
   • Update pager/phone contacts
   • Confirm new rotation schedules
   • Save new call schedules locally
   • Check vacation blocks are correctly entered

2. Nice-to-have-before-July:

   • Update personal “cheat sheets” for new responsibilities (e.g., ICU, senior resident tasks)
   • Clean up locker and work bag
   • Refresh procedure notes
   • Create quick scripts for common senior tasks (sign-out format, cross-cover expectations, consult structures)

Put specific dates next to anything with real deadlines.

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Last 5–7 Days of the Year: Physical + Digital Workspace Reset

At this point you should be shifting from “clean-up” to “reset.”

You’re building default environments that support your new role.

Step 10: Physical Space Sprint (30–45 minutes)

You don’t need a Pinterest desk. You need a functional one.

1. Empty your bag/locker/desk onto a surface.
2. Make three piles:
   • Keep – in regular use
   • Archive – might need once a year
   • Trash – you know the drill
3. For “Archive”:
   • Label a single folder or small box: “Residency Archive – PGY1”
   • Toss in:
     • Old handouts you might reference
     • Evaluations you want to keep
     • Letters/forms not needed daily

For “Keep,” intentionally choose:

• 1 small notebook or index card stack
• 1 pen color for notes, 1 for urgent tasks
• A few key printed cheats (codes, emergency protocols, pager numbers)

Everything else is friction.

Step 11: Digital Home Screen Reset (20–30 minutes)

At this point you should be able to find your key tools in 2 taps, half-awake.

On your phone:

• First screen only:
  • EMR app (if allowed)
  • Email
  • Task manager
  • Notes app
  • Calendar
  • Hospital communication app (Teams/WhatsApp/etc.)
• Move social media and distractions to a back page or into a “Later” folder.

On your laptop:

• Desktop:
  • 1 folder: “Residency – Active”
  • Inside:
    • “Slides & Teaching”
    • “Admin & Program”
    • “Research”
• Create a “Year-End Archive – PGY1” folder and drag old, resolved stuff in.

You want to stop spending mental energy just remembering where things live.

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Last 72 Hours: The Rapid Review and Future-Proofing

Now you’re not really cleaning anymore. You’re tuning the system and rehearsing with it.

Year-End Cleanout Timeline

Period	Event
4-6 Weeks Before - Choose core tools	Tools
4-6 Weeks Before - Map info sources	Inventory
3-4 Weeks Before - Delete obvious junk	First pass
3-4 Weeks Before - Build clinical structure	Pearls setup
2-3 Weeks Before - Consolidate pearls	Clinical merge
2-3 Weeks Before - Build email folders	Email system
1-2 Weeks Before - Centralize tasks	Task inbox
1-2 Weeks Before - Create PGY checklist	Upgrade plan
Last Week - Reset physical space	Desk reset
Last Week - Reset digital space	Home screens
Last 72 Hours - Review key notes	Quick refresh
Last 72 Hours - Set habits	Future proof

Step 12: 1-Hour Clinical Pearl Review (Day -3 or -2)

At this point you should walk through your consolidated pearls as if you were coaching your intern.

In one uninterrupted hour:

• Skim:
  • Top 10 bread-and-butter topics for your specialty
  • Cross-cover notes / overnight issues
  • Procedures you’ll be expected to supervise soon
• As you read, mark:
  • “Update later” sections (but don’t fix now)
  • Gaps (e.g., “Need IA dosing cheat for X antibiotic”)

This pass isn’t for new studying. It’s for knowing what tools you now have.

Step 13: Micro-Automations and Shortcuts (30 minutes)

These small moves save you hours across the year.

• Create:
  • Text snippets for common notes (e.g., discharge instructions, sign-out structure).
  • Email templates:
    • “Schedule request”
    • “Consult follow-up”
    • “Thank you for teaching / mentorship”
• Save:
  • Key phone numbers and paging codes in:
    • A pinned note
    • Favorites in your phone
• Pin:
  • Your “PGY Upgrade Checklist” and “Overnight Cross-Cover” note in your app.

Time Saved Per Week After Cleanout

Category	Value
Email triage	30
Finding notes	20
Recreating lists	15
Searching files	10

Even saving 15–20 minutes a day compounds into real sleep and actual breaks.

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First 7–10 Days as New PGY: Lock in Habits

The cleanout only matters if you keep the system light.

At this point you should stop tinkering with structure and just use what you built.

Step 14: Daily 5-Minute Reset

At the end of each shift (or as you sign out):

• Inbox:
  • Move anything actionable → task app or “Action” folder.
• Tasks:
  • Check off what got done.
  • Move leftover items to specific days, not “later.”
• Notes:
  • Drop any new pearls into the right topic file immediately.
  • Don’t maintain random floating notes—file or delete.

Five minutes. Set a timer. Then leave.

Step 15: Weekly 20-Minute Review (Choose a Consistent Day)

Pick a relatively stable time—maybe post-call afternoon, or one weekend block.

Each week:

• Scan:
  • Upcoming PGY-specific responsibilities
  • Admin deadlines
  • Teaching commitments
• Glance through:
  • One or two clinical topic notes (whatever you struggled with that week)
• Archive:
  • Finished mini-projects (e.g., QI meeting notes, completed committee tasks)

You’re adjusting the system with real data from your actual schedule, not imaginary future productivity.

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Time Before PGY Upgrade	Primary Focus Area	Main Actions
4–6 weeks	Tools & Mapping	Choose apps, map info sources
3–4 weeks	Junk Deletion & Structure	Trash obvious clutter, set clinical sections
2–3 weeks	Clinical & Email	Consolidate pearls, build email folders
1–2 weeks	Tasks & Checklists	Centralize to-dos, create PGY upgrade list
Last week	Physical & Digital Reset	Clean desk/bag, simplify screens and folders
First PGY week	Habits	Daily 5-min reset, weekly 20-min review

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If you remember nothing else:

1. Decide on one home for notes, one for tasks, and a simple email structure—then force everything into those lanes.
2. Do the cleanout in small, time-boxed phases: trash first, then consolidate pearls, then reset your spaces.
3. Lock it in with a 5-minute daily reset and a 20-minute weekly review so your PGY upgrade starts faster, cleaner, and a lot less chaotic.