I’m nearly done with residency. Now what?
Up to now in your medical career, with each advancing level of training, you have been at the mercy of the admissions committee of the medical school or the residency program as they sorted through many applications. While there was an element of choice in where you applied, it still felt like you had to impress them more than they needed to impress you.
Now, as you look for your first job after residency, you will have more control when it comes to looking at offers. It is an opportunity to look broadly at what you most enjoy in medicine and what kind of job would fit with those interests. It is also a chance for you or you to think about where you would like to be for more than 3 to 5 years. Often being closer to family or good friends becomes an important factor. For others, salaries and opportunities for increasing earnings are a key factor.
In conversations with graduating senior residents, they often ask me (KJW) if things get easier once you finish residency. My response is that it isn’t easier, just different. The good part is that you are operating independently, not waiting to staff with the attending or waiting for the intern to finish their H & P.
You have more control over your schedule, depending on the type of practice you are in. The difficult part is that you are independent. You are the responsible attending physician. You are the one who has to be there until the work is done, even if it’s more than the 80 hours you were limited to in residency.
One of my residency faculty told me that he felt he learned more in his 1st year of practice than at any other time. Because his patients were completely his responsibility, he reviewed topics every night, not wanting to miss anything important. Over time, as he saw more and more patients, he became more confident and felt better prepared to sort through the common and less common problems.
Physician recruiters, Calvin Bruce and James St. Clair in
Make Yourself More Marketable give the following advice to those entering the job market:
“The more impressive candidates have done their homework. They understand what drives the employer's search, the market trends in the given draw area, and how an employment offer would potentially be a good match in terms of mutual professional expectations. In an interview, they clearly communicate why they consider the current opportunity to be a good, long-term career move. Realistically, it will take several years before you become fully productive to the practice. Nevertheless, prospective employers need to be convinced that they will get a good return on their investment, including the cost of hiring you. That involves initial compensation, relocation expenses, and perhaps a signing bonus. This being the case, be prepared to share some thoughts on how you intend to build a loyal patient base. During an interview, mention the reason for your attraction (and connections) to the area and the kinds of professional contacts you intend to develop as a springboard for practice development.”
Taking a Break Before Practice
I do recommend that, if possible, those who have just finished residency take sometime off before starting their first job. After the demands of residency and given the intensity of the first year of practice, it’s a good idea to take some time off where there won’t be pagers going off or numerous phone calls to return. Vacation time in residency is short, as it might be at first in practice. This can be an opportunity to spend valuable time with family or friends who have also struggled through your lack of time during residency. It is restorative to have time with no schedules, no clinical responsibilities. For some people, it can be a time to reflect both on what they have accomplished and what they hope for in their next opportunity.
As you approach the end of residency, talk more with your mentor, faculty, program director, peers, family and friends about options. Consider the different roles you are in (see
Duty Hours topic on this website) and how those roles may influence the paths you may pursue. You are not alone with the excitement and anxiety that accompany this stage of your career, so seek support and advice along the way. If you find stress or circumstances interfering with this, please contact RWBC. We’ll be happy to consult with you and support your successful entry to your career.