Starting residency just a couple of months ago has been an absolute roller coaster! While there’s no white coat ceremony in residency, it was still a proud moment to don the long white coat for the first time. The clinical responsibilities of residency, while rigorous, have been exhilarating. I’ve even gotten a few sternotomies under my belt!
Now that I’ve had some time to reflect on it all, I wanted to share some pleasant surprises of residency that I didn’t anticipate as a medical student. Because contrary to what you may hear, there are some really great things about being a new resident!
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1. You don’t have to know everything the second you start residency.
During medical school, I remember hearing the new residents discuss patients and thinking “Wow, how did they already learn their entire specialty?” From personal experience, I’m glad to share that I haven’t learned all of cardiothoracic surgery in my first few weeks as an intern!
The truth of the matter is that you’re learning during all of residency, and even the rest of your career as an attending. There’s truly so much to know and oftentimes, you simply don’t know what you don’t know.
So breathe a sigh of relief knowing that you’re not expected to master everything at the beginning. There’s a lot of time and plenty of redundancy in your training, so you can learn the essentials. Just focus on being a sponge and take in what you can!
2. You’re now directly responsible for patient care and safety.
While it sounds kind of obvious, this was hard to fully understand until I placed my first-ever order. I remember double-checking a simple chest X-ray order to make sure nothing was out of place.
In medical school, there are several safety layers in place to ensure patient safety. As a resident, while those safety checks are still in place, you take on a more active role. For example, one time after I pushed alteplase into a chest tube with a persistent pleural effusion, I couldn’t help but keep checking for bloody output.
But increased responsibility is actually great news, considering this is exactly why we went to medical school in the first place! It’s important to be mindful of the gravity and privilege of being able to practice medicine, and ensure you’re doing proper due diligence in patient care.
In addition, a big change you might notice going from medical school into residency is that you transition from a reporter role to one in which you’re actively making decisions. For example, you may be the first person to respond to a page in the middle of the night regarding unstable vital signs in a patient on the floor. You have to start assessing the situation and begin thinking about whether this person requires an ICU-upgrade, fluids, and/or intubation.
Again, there will be support available, but you have more responsibility than you did before, and you’ll start to feel more comfortable with medical decision-making.
3. Your training is what you make of it.
Another important part of residency is that you have to take charge of your training. And it’s important not to get complacent in this regard.
For example, it’s easy to place orders that your senior tells you to. However, take the time to understand why a patient is being surgically instead of medically managed or vice versa.
During my thoracic surgery rotation, we were frequently consulted for pleural effusions. Depending on the patient’s overall clinical picture, some of these patients got a chest tube, TPA/dornase, video-assisted thoracoscopic surgery, thoracentesis, or observation. Understanding the nuance between different management options is the crux of being an excellent physician!
While a lot of learning during residency is from clinical duties, simultaneous independent study is also critical. Depending on your specialty, you may benefit from going to the simulation lab or watching YouTube videos about a procedure. It may even be helpful to make flow diagrams of treatment algorithms about conditions like hyponatremia. Regardless, take the time to build healthy study habits, as this will help you in both patient care and board exams!
A big adjustment may be that there is no more formalized education, with lectures every day followed by an exam at the end of the rotation. It’ll be more similar to your experience during the clerkship years as compared to the preclinical ones. While there are still weekly education sessions, it varies by program, and they may be resident lectures with faculty serving as moderators.
Be prepared for a change in mindset, too, regarding learning from thinking about grades and evaluations to focusing on mastering the core foundational knowledge of your specialty. Seek out every learning opportunity you can get!
4. You can begin to mold the trajectory of your career.
You can use your time in residency to determine what kind of practice you’d like to have down the road. Do you want to be an academic or private practice doctor? Or maybe you don’t know yet. Nonetheless, you can use residency to explore your interests and discover what kind of career you want.
For example, I’ve found some research projects I’m passionate about. I was also able to connect with attendings that have experience in those fields and create mentoring relationships. You don’t have to do clinical research, though, if that’s not an interest. There may be a resident advisory council at your program or a national resident association with a committee or leadership position you can apply for. I also have colleagues who are pursuing quality improvement and community outreach work.
Another option is that you don’t have to pursue any of these avenues. Becoming trained in your specialty is already more than enough work and takes a lot of sacrifice. So enjoy your hobbies whenever you can find the time!
5. You get benefits.
A great part of residency is that you’re part of the house staff, and as such get a salary and benefits. While a 12-14 hour workday is a bit more exhausting as a resident than it was as a medical student, it certainly feels a lot better coming home with some cash in your pocket!
There are also additional perks that come with the job. For example, my hospital offers a quarterly lifestyle fund to get reimbursed for eligible purchases, which has been a lot of fun!
While I don’t recommend that you choose a residency program solely for its extra compensation, it’s worth considering the cost of living and the total package you’re being offered, especially if others may be moving with you.
6. Residency has a completely different feel than medical school.
While I enjoyed being exposed to so many topics in medical school, constantly jumping from one subject to the next can feel overwhelming.
In residency, now I can focus deeper on skills that I’ll use throughout my career. So for anyone going through a rough patch in medical school, I want you to know that the next stage is very different and you may end up liking it more!
My Final Takeaways From Intern Year…
I’ve found intern year to be incredibly fulfilling, even with all the challenges I’ve faced so far. It’s been a huge adjustment, but it’s also been a time of tremendous personal growth. And I know that this, too, is just a transition to something better—for if medical school was like being a caterpillar, and residency is the cocoon stage, then transforming into an attending is akin to becoming a butterfly!
During this great transition, keep in mind one caveat: don’t forget about the world outside the hospital doors. Something that has always resonated with me is a quote by Allen Saunders, popularized by John Lennon: “Life is what happens to you while you’re busy making other plans.”
While the days are long in residency, the weeks and months will fly by. So enjoy the ride, and don’t forget that the rest of life is still going on (and be sure to take part in it). Good luck with your residency applications, and be sure to reach out to Blueprint if you have any questions!
