Wednesday, November 4th, 2015

Transitioning Into Residency

Daniel R. Paull, M.D.

An attending once told me that a being a good medical student is like having good aim at a shooting range, while being a good resident is like surviving in battle. While I thankfully have never been in battle, I can say that residency definitely poses its own unique challenges that are hard to prepare for.

The transition to residency is nerve racking for almost all soon-to-be interns. I can remember anxiously pacing around my apartment the night before my first day. What is it going to be like? I hope I don’t get too overwhelmed. I really hope I don’t mess anything up and hurt someone! These are thoughts that I, and no doubt many others had before taking the plunge into residency. If you find yourself scared about starting residency, don’t worry. Everyone is. If someone tells you otherwise, then they probably aren’t telling you the entire truth.

One of the first differences you will feel is the weight of responsibility. Even though you will have a whole team to help you out, there will still be decisions that you have to make on your own. It’s a strange feeling going from a medical student, to a sought after intern in the eyes of the nursing and ancillary staff. And much to their frustration and your chagrin, sometimes you won’t know the answers to the questions you’re asked. It can be a humbling experience, especially when you are “supposed to know”.

And then there is the time requirement. Without question, you worked hard in medical school. I can remember as a medical student finishing up my work at the hospital for the day, and then anxiously asking the resident I was working with, “is there anything else you need?” I tiredly hoped that the answer would be, “No, nothing else you need to stay for. I’ll see you tomorrow.” Every time I heard those words I felt an immense relief and satisfaction in knowing that I could go home and try and reclaim some balance in my life. I never really thought about the fact that the resident was still in the hospital. What were they doing? Handing off patients to the night team? Paperwork? As a medical student, once you’re out the door it ceases to matter. Fast forward a little, and now I am the one telling the medical students to go home. I am the one staying in the hospital. In medical school my free time was precious, in residency it is priceless.

Keeping balance in life during residency is, typically much more difficult than in medical school. Finding time for hobbies and exercise is not easy when you are pushing the eighty hour work week. “Golden weekends” for those who aren’t familiar with the term, are weekends where a resident is not on call and does not have to work. To the rest of the world, they are simply known as weekends. Not having the weekends to recover will definitely wear on you, especially after a long and taxing week. Drumming up the motivation to work out when you get home at 9PM can at times be impossible. At some point early on in your residency, you will accept the fact that you just have to stay late some days, and the activities that you wanted to do outside the hospital on those days will, unfortunately, have to wait.

While residency certainly will take its toll on you, I can say with confidence that I enjoy it more than medical school. During medical school, there was always an element of trying to impress your residents and attendings in order to get a good evaluation. Of course you’re trying to absorb as much medical knowledge as possible, but the element of grading was inescapable. Now, I’m more concerned with trying to do right by my patients, while gaining as much medical knowledge and skill as possible. My continual goal is becoming a better physician. I enjoy taking a greater part in my patients’ medical care, and the responsibility that comes with it.

Another rewarding aspect about residency (besides being able to use the bathroom whenever I want), is the confidence that you’ll gain as you make the transition to an attending. Seeing and treating the same pathologies day in and day out will engender a confidence that I never experienced as a medical student. And it feels good to be able to speak intelligently to your medical team and patients alike.

So, yes, the thought of residency can be scary for a soon to be medical school graduate. Just like in medical school, difficulty in residency runs in cycles. Sometimes you will be extremely busy on a difficult rotation, while other times you will find yourself less sleep deprived and with more free time during an easier rotation. Rather than view residency as another trying stepping stone towards becoming an attending, see it as an opportunity to learn and grow both as a doctor and as a person. And take joy in seeing your skills and knowledge grow while helping those who need your help.

About Daniel R. Paull, M.D.

Daniel R. Paull, M.D. is the author of So You Got Into Medical School… Now What? A Guide to Preparing for the Next for Years. He received his medical degree from the University of Miami Leonard M. Miller School of Medicine. He also holds a bachelor of science in physics, which he earned from New York University. Currently he enjoys mentoring medical students through his role as a third orthopedic surgery resident.


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