The graduation from medical student to physician is transformative on many levels. There is the physical transformation of receiving a longer white coat, and the responsibilities that come with it. There is the metaphysical transformation of finally being called “doctor” (and maybe an initial delay in response because you’re not used to your new title). There may even be a change in location such as leaving a favorite city or a beloved coast due to the randomness of the Match process. These various changes can make transitioning from student to resident difficult but it does not have to be. Here are 5 rules for life I have adopted in residency to make being a resident slightly easier.
Rule #1: Be prepared and know your patients.
This requires being on time if not early, especially during intern year. It also requires some pre-reading, whether reading a carefully crafted sign out from the prior team or spending some time pre-charting prior to your clinic visits. As you grow in the years, you will realize that the time that it takes for you to get to know your patients will diminish. Experience will help you home in on the pertinent information faster, but until that time, putting in the extra effort will help you with efficiency and time management both in the clinic or on the floors.
Rule #2: Be involved!
Read on material related to your patient care. Write your questions down and research them on your down time. My best interns have been the ones that have asked me 1,000 questions and picked my brain when it comes to patient management, asking me specifically how and why I chose to do things. This is one of the best ways to learn patient care in a non-judgmental fashion. The same applies to learning procedures. Pay attention on rounds. It may be difficult when you have a patient panel of your own, but queuing into your co-intern’s patients may help you learn the management of an interesting case that you might not have come across. It will also alleviate the anxiety of having to cover their list when it is your time to do so.
Rule #3: Practice patience.
When you start intern year, things will be difficult. Taking care of 8-12 patients versus the 2-4 you carried as a medical student or sub-intern is a big change. There are rites of passage that you will be walking through, for example, repeating your presentations and assessments and plans until they are considered perfect per your attending. Your seniors will correct you on the spot and try to guide you in the right direction. Let them do so. Try not to take this guidance personally. There are some growing pains in residency but with patience, you will be able to conquer all.
Rule #4: Trust but verify.
You’ve heard this before, I'm sure. This not only applies to verifying the work of others but practicing a system of checks and balances with yourself. Double check your orders. Look up dosages you don’t know or call the pharmacy to confirm a medication you are not familiar with. Do your own physical exam on each patient even if they have been seen by 100 doctors already and have become resistant to further “probing.” A word of caution: “The patient was sleeping” is never a good excuse to skimp on history and examination. Verify a patient’s med list with their pharmacy when they are unsure, as this extra step can help prevent unnecessary medication errors and help divert unnecessary health care expenditure. Finally, learn to trust your intuition as this will one day become the driving force behind your clinical judgment as you work your way through residency.
Rule #5: Determine and develop your own style of work early on.
Do you like to prepare a lot prior to going into a shift or are you able to do so without much prep? What parts of patient care make you feel overwhelmed and how can you deal with that stress? Thinking ahead on these scenarios is key. Planning out how to tackle stressful rotations — such as two weeks of night float or ICU when you will not have much time for food prep or laundry — will be important in managing your mental health and surviving residency.
For me personally, I learned early on that I like to do my homework. I devoted time to reading up on my patients prior to starting a fast-paced floor block or pre-charting prior to my clinic appointments, which helped me immensely with time management and doing what was actually important: giving more face time with my patients. This pre-work not only allowed me to have the time I needed to be as thorough as I needed to be during my office visits, but also helped me finish my notes on time, allowing me to never bring any leftover work home and thus leading to better work-life balance.
Residency will ask a lot of you. I hope incorporating some of the above recommendations into your residency workflow and during your transition to resident physician can make some of these asks a bit easier to answer.
If you've completed residency, what would be your five rules? If you haven't, which rule is likely to be the most useful for you? Share in the comments.
A native New Yorker, Dr. Babar is passionate about classic literature, studying novel advancements in medical therapy, and helping younger generations foster a shared curiosity for all things science. Dr. Babar is a 2021–2022 Doximity Op-Med Fellow.
Illustration by Jennifer Bogartz