You’ve Got This: Tips for Graduating Residents

My first job post residency (the same one I have now) is as clinical faculty at my residency, so I never left and have had the luxury of having familiar faces and trusted partners to ask for help, advice, or just a little reassurance that I wasn’t going to kill someone.

I guess that makes me a PGY-10.

Regardless of where you find yourself after graduation, many of us encounter the same questions, concerns, thrills and existential crises. The graduating residents of Grant Family Medicine gave me some questions to ponder on what awaits them. Here are my answers:

What was the best part of being a new attending?

Being on my own.

What was the scariest part?

Also, being on my own.

What were the biggest lessons I learned during my first year out of residency?

I learned that I could indeed trust myself and my training. Every time I had that deep sense of unease and felt like I must go run a clinical question by someone before making a decision, I usually already knew the answer. I just wasn’t used to trusting myself. I’d frankly prefer we err on the side of caution and not be overconfident, but my training had prepared me to do this work. Yours has, too. It’s OK if it takes you time to adjust.

Though there may be some inherent insecurities when it comes to lack of experience, the importance of your voice cannot be overstated. Understandably, there is often the idea of getting “settled” as an attending before joining leadership or advocacy efforts, but don’t be afraid to jump in. Your perspectives as a new physician are needed at every meeting, conference, and table where decisions are made. As a new physician you are closer to understanding the environment for medical students and residents. You are entering spaces for the first time with fresh eyes that can see things that maybe just don’t make a lick of sense.

Question things.

Speak up. 

I have felt like I don’t belong at the table many times, but my voice has also made a difference more times than I expected.

What are some practical tips for new graduates?

Write less in your notes. Nobody is looking over your shoulder anymore to check your medical knowledge and reasoning. Save yourself time. (This may soon be a moot point with the emergence of AI. I hope.)

Find what works for you and your patients when it comes to issues like paperwork processes and no-show policies. You may work for an employer that has certain standards, but there is often flexibility around this when it comes to implementation in your office. Use your judgment and remember that we’re treating patients who must navigate a lot to receive health care, and that care is sometimes dependent on paperwork we fill out and a bus line that may be running behind or a child who got sick. Automate things as much as you can, whether that’s order sets, templates or other EMR shortcuts.

You still need mentors, right?

Absolutely. I think all attendings can quickly rattle off the names of at least five other family docs we’d call or text when we needed to talk. And though it’s great to continue the mentoring relationships that you had during residency, don’t be afraid to branch out and make new connections in your new settings or through organizations like the AAFP and your state chapter.

How do you approach CME?

When you attended CME courses as a resident, you may have been told that you didn’t really need to worry about that just yet, but now that you have a big kid medical license, you have to track your CME to keep that license and board certification. My advice here is to not stick with your favorite niche subjects all the time. Yes, foster those interests, but also remember that part of the wonderful thing about family medicine is its breadth. Switch things up to keep it interesting. I have been to a variety of CME events, but the AAFP really does set the bar. And no, the Academy is not paying me to write this.

What if you hate your first job?

Good thing you’re a family physician and can do such a wide variety of things in basically any location. You will always be employable. Always. I’m not making light of a miserable job situation, but I am saying that you have options. Lots of them.

This is an exciting time for you, and I’m so proud to call you my colleagues. Remember to trust your training.

Find your own groove.

Use your voice.

Now more than ever, we need new family physicians to help guide primary care (and medicine) to the future and change health care for the better.

Welcome to the team.