Surviving the First Days of Residency

Check out these tips for how you can succeed in the first few days of your residency and beyond.

After graduating from your medical college, you’ll apply the skills you learned in real-life situations as a resident. How do you survive the first days of your residency following medical school? Whether you graduated from Harvard Medical or Saint James School of Medicine , you can use the tips below to navigate this transition smoothly.

Your first day of residency: From med student to resident

Many new residents find the first few days of residency easier and simpler than they thought. You may feel nervous, but your schooling and training have prepared you for this.

On your first rotation, you may not have to make big judgment calls on patient care or treatment. In many cases, the doctor on the previous rotation will have made a plan, and all you have to do is follow the plan.

On your first day, you will get a rundown from the previous rotation that focuses on:

• Who your patients are
• What the plan is for each patient’s treatment
• Information on their condition, medications, etc.

Then, you will take over. You can check in with each patient, but often, the decision of what each patient needs is already made — you just have to carry it out.

You may have a senior attending on call with you, and you may not. It may feel overwhelming at first: to balance an on-call schedule, a clinic schedule, and inpatient services and rotation hours. You will adjust and become more confident as you get more experience.

What To expect during your residency

In general, here’s what you can expect during the first days and weeks of your residency:

• Longer hours: Most high-powered careers require long hours. Prepare to put in 60 hours or more weekly, with shifts like “one week on, one week off.”
• Less flexibility: Less personal time often accompanies lengthy shifts, especially for those who have families and other obligations. Guard your recovery time fiercely.
• More responsibility: Perhaps the most shocking change is just how much weight your choices carry. Prepare to make decisions about patient care under stressful situations. However, know that your attending and seniors can answer your questions and help you make the right call.

When you admit patients, you have more responsibility than simply continuing another doctor’s care plan — you will help craft the care plan, prescribe medications, and decide what the patient needs. You will decide who to consult with, like surgeons, kidney specialists, or neurologists.

to decide when to diagnose, when to transfer a patient, and when to discharge.

Talking to patients as a resident

As an intern and on rotations, you have spoken to patients before, but you were likely not the most senior doctor in the room — you could always turn to your seniors to make the final call. During your residency, that changes.

Your patients will ask you questions like, “What do you think, doctor?” and trust your advice. In many cases, you will make the judgment call on advising a patient on their health. Trust yourself and your knowledge, but know that you can always run your decision by your attending.

Making decisions about patients’ treatment

The residency’s purpose is to prepare you to practice independently. Request help when necessary, but accept that independence makes you a stronger doctor. You may think, “I don’t know what dosage of this medicine to give this patient at this weight.” That is okay; there will be things that medical school didn’t teach you.

With help from your senior doctors, point-of-care medical apps, and papers outlining recommended treatment plans for certain diagnoses, you can pick it up and learn as you go. If you feel unsure of yourself and ask questions like, “Am I doing enough? Am I doing too much?” know that you are not alone.

Like many new residents, you might experience imposter syndrome. You can use this to your advantage by developing a continuous learning mindset. Be confident in your knowledge, but also don’t be afraid to ask questions.

Tips for surviving the first days of residency

As you adjust, you may find that residency is not as intimidating as you thought. Here are tips to help you make the transition:

• Listen to residency veterans. Doctors who have completed a residency can offer excellent advice on navigating the transition.
• Trust yourself, but don’t be afraid to ask questions. You will take on a new role with more responsibility. Trust your training and instincts, and your attending and other more experienced doctors can help you adapt to new situations, like knowing when to admit a patient or what treatment a patient needs.