Jan 31, 2015
Navigating the unique hybrid of school and work
By Miriam A. Knoll, MD, Mt. Sinai Medical Center
Graduating medical school is an amazing experience, not only because you will finally be called “Doctor,” but also because you can do what you’ve always truly wanted—be responsible for patients. Transitioning from medical school to residency can be difficult because this new accountability comes during a period where you are still learning how to practice medicine well. You are working and you are also learning. The truth is that residency is a hybrid of school and work. Here are five suggestions for managing that transition successfully.
1. You are getting paid!
That means you’re working. You may not get paid well, but you are now in a work environment. You have a limited number of vacation days, sick days, parental leave days, etc. For example, in the United States, if you have a child during residency, your entitlement to time off is dictated by the federal Family Medical Leave Act (FMLA). So find out what your contract says and be sure you understand it completely. If your contract mentions you are governed by a House Staff manual, read that too.
Miriam A. Knoll, MD
2. You have a boss and a program director.
Your boss is the hospital, and your direct supervisor is usually the Chair of your department. But you’re also beholden to your program director, who is responsible for your training. That means there are duties you have as a trainee that have nothing to do with your“job” of taking care of patients. For example, you mayhave to attend didactic lectures, give presentations, and conduct research. These things may need to be done on your own time, when you’re not technically at work. That’s why these activities usually do not count as duty hour violations, either.
3. You now belong to a national medical specialty.
In addition to the Accreditation Council of Graduate Medical Education (ACGME), which governs all U.S. residencies, medical specialties have their own organizations which will ultimately administer your board examinations. These organizations also determine standards for trainees, including the requirements for types of rotations, logging cases, boards, and many other aspects of your work. Your program director will fill you in on the details, but they don’t make the rules. So don’t just lay back as a “student.” Take the initiative and find out the requirements—this information is readily available online. Ultimately, you are responsible for your own training and licensing.
4. You have long-term coworkers.
You will no longer constantly meet new coworkers, as you did with each clerkship in different departments and hospitals. Now, you’ll be working with many of the same nurses, attending physicians, and administrative staff for years, depending on how long your residency lasts. It’s important to keep in mind that your new coworkers understand the hospital work culture better than you do. They’ve been working there longer than you. So take time to learn the ins and outs of the environment and do your best to get along with everyone. You’ll need their support to help take good care of your patients, which is your ultimate goal.
5. Your co-residents are both coworkers and co-trainees.
It’s easy to get competitive with your co-residents. You are all trainees, and secretly everyone wants to know the most information and do the best job. Along the long road to becoming a doctor, students learned to aim for the “A” (which is how you got into medical school, by the way!). Do your best not to let competition come between you and your co-residents. You need to help educate each other and take care of patients as a team. Keep in mind that whether or not you like a co-resident, neither one of you is likely to switch residencies. You’ll need to figure out a way to work together, no matter what.
I believe that keeping these five things in mind will help you make a successful transition from medical school to residency. You’ve finally made it—here’s to wishing you success in all your endeavors!