Finishing medical school is a huge milestone. The grueling years of medical school have finally come to an end. While this is a huge relief for many, it also marks the beginning of another arduous journey in the life of a future physician – residency.
Preparing for Residency. So much to learn before you leave for your first day of Residency. You must also consider where you will live, how you will pay your bills, and how to maintain a level of physical and mental well-being while being extremely busy. The months prior to Residency offer a lot of time to prepare. Utilize this time wisely.
Getting ready in the months leading up to your residency is a matter of getting ready for a number of things to change for you. With some planning, you can be ready for all of the changes in store for you and have an easier transition into your new role.
Understand What Will Change
Medical school is demanding, but residency brings a different type of pressure.
Follow-up care, communication with family members, making life-or-death decisions in emergencies, completing paperwork, and working closely with nurses, attending physicians, pharmacists, and many other members of the health care team are just a few of the expectations placed upon the new resident.
Higher expectations for the soon-to-be-resident, as their decisions will have immediate consequences.
While residents are still in training and are not expected to know everything, the demands of practicing medicine are greater than in medical school. Residents are expected to make decisions quickly and to work more independently. This requires stronger time management skills than are typically expected of medical students.
If possible, complete some clinical work before residency. This will aid in becoming familiar with basic clinical work such as presenting a patient to a team of healthcare professionals, developing a differential diagnosis for a patient’s complaints, reviewing a list of a patient’s medications and noting any discrepancies or potential interactions, and recognizing when a situation requires the involvement of a senior.
Just as important, expect a learning curve.
This initial impression of slowness will erode as your clinical knowledge, familiarity with the hospital, and confidence grow.
Research Programs Beyond Their Reputation
In assessing various programs, residency applicants focus on factors related to a program’s reputation, location, and specialty strength. However, these factors can give the applicant an incomplete sense of what life is actually like in a given program for residents.
The everyday experience of residents can vary significantly between programs.
Scheduling practices, call policies, patient loads, teaching opportunities, research opportunities, and support from attending physicians are all things to look into when finding out about the resident experience at a program.
Culture matters too.
Just because a program is very prestigious does not mean it will be the best fit for you. The culture and way that residents are supported is just as important as the program’s reputation. Even programs that have great specialty strengths can have poor ways of supporting their residents.
When interviewing for a residency program, it is a good idea to ask the current residents in the program a number of specific questions about their experiences. This can give you some sense of the real life of residents in the program, and help you to find out things that are not in the official literature. You can ask, for example, how often do the residents in this program’s schedules change? How does the program give feedback to residents? Do residents in this program have mentors, and if so how do they get assigned to a mentor? What happens to residents in this program who are having trouble?
In addition to the typical information about programs (e.g. ranking), the Association of American Medical Colleges (AAMC) has information on the typical process of residency application as well as preparation for the transition from medical school to graduate medical education.
While information from the AAMC can be useful to help students prepare for residency, the best way to get a true sense of a program is from the residents in the program currently. Ask lots of questions.
Prepare for the Financial Shift
Even though a physician is now in residency and receives a regular salary for the first time in his/her training, new expenses will soon surface.
At the same time, new expenses often appear quickly.
In addition to income from your residency, you will also have to pay for things like student loans, moving costs, deposits on apartments, furniture, and other things that you have not had to pay for before.
This time frame is ideal for getting a handle on your finances too.
Start by estimating your expected take-home pay (after taxes, health insurance, 401(k), etc.) before signing up for the program. Then build up a budget that can handle the inevitable ups and downs of residency.
Create a realistic monthly budget for a resident by outlining the following fixed expenses:
- Housing
- Utilities
- Transportation
- Food
- Insurance
- Loan payments
- Professional expenses
Leave room for unexpected expenses too. A small reserve for emergencies will help prevent unexpected car repairs, medical bills or other costs that could become expensive problems.
Student debt: As noted above, for many medical students, student debt is one of the biggest factors in choosing a program, as different programs offer different repayment options and structures, some of which can be better for some students than others. Additionally, when looking at total costs, it is wise to look at the different repayment options offered for different types of student debt, and how choosing one option over another will affect not only current payments, but also future payments, and federal protections. For example, would repaying medical school loans through an income-driven repayment plan be better for you than trying to pay them off as soon as possible? How would refinancing medical student loans affect your situation?
Everyone’s financial circumstances are different. Therefore, a plan would have to be tailored around the individual’s income, type of loan(s) and his/her future plans and financial goals.
Choose Housing With Your Schedule in Mind
A seemingly cheap apartment can actually end up being quite expensive, particularly if the commute to work is long and arduous, and adds to the long hours that you are already required to work as a resident.
For residents, location is more important than when you were in medical school.
Before you agree to a lease, calculate how long it will take to get to the hospital during typical hours, as well as during early morning, night, and weekend hours. Remember, residents typically have early morning starts and are expected to be on call or come in for late shifts. Thus, your commute could be long before public transportation is running, and late after services have slowed.
Parking is another detail worth checking.
Some hospitals even charge for parking. That can add up over the year. Some hospitals, however, have a special lot for residents or even offer transportation for residents.
Furthermore, it is worth noting that other everyday amenities that are in close proximity, i.e. for example, a gym, a laundry, etc. could greatly facilitate the resident’s daily routine.
Your home does not have to be fancy. It just has to make things easier for you.
Prepare Without Trying to Predict Everything
Nothing can prepare you for the challenges of residency.
Schedules will change. Difficult cases will happen. Some rotations will feel harder than expected. You will occasionally make mistakes, ask questions you think you should already know, and experience days when everything seems to take longer than it should.
Preparation still matters.
This will give you better systems to deal with these situations.
Review your finances, learn as much as you can about your program and get a place to live that will work for you. Work on developing systems to handle the stress of your job, create effective communication methods and learn how to protect your time.
