For many residents and fellows reaching the end of their training, they’re riding a wave of emotions from excitement and fear to relief, anxiety and plain old exhaustion. While this can be a stressful time, it’s also a perfect opportunity for reflection. AMA Wire® asked several graduating residents about their experiences. Here are their honest perspectives—and advice every new physician in training needs.
Reflections on the early months of residency
The first few months as a resident often present memorable first-time experiences. Graduating residents recount some of those moments:
- “One instance that particularly comes to mind is a patient I responded to with acute respiratory distress. I was a fresh intern and the first provider on the scene of a rapid response. “Although I was fully equipped and trained on managing the patient, I remember frantically calling my senior in the middle of the night to double check. He agreed with my medical management, and we were able to successfully stabilize the patient.” —Rezwan Ahmed, MD, a fourth-year resident at Marshall University in Huntington, W.V.
- “In OB-GYN, we have a lot of big emergencies that you can’t truly prepare for. One of them is bleeding or hemorrhages after delivery. “I remember I was out early rounding one morning on the floor, and as the only resident in sight, I was called into the room on a post-prime hemorrhage. This was three weeks into residency, so I hadn’t seen one yet. And this woman was bleeding everywhere. I had read what to do in books before and knew all the theories. But the actual exam and someone being in that much danger was just terrifying. “I was fortunate that my upper-level resident came into the room and saw that I was on the right track. She talked me through it, and I was able to stabilize the patient.” —Brandi Ring, MD, a fourth-year resident at York Hospital in York, PA
Coping with patient death for the first time
Losing a patient is a tough experience for any resident, and learning from those first encounters is important.
- “I had a patient who had end-stage heart failure, but [he began to feel] better. His vitals were stable; he was eating and sitting up in his own chair. It looked like he was going to be discharged at any moment. “Yet the patient one morning kept telling me, ‘I’m going to die. I’m going to die.’ But I assured him that he was doing better. The labs showed it. “Well, that afternoon he coded and died, and we never knew why. I kept blaming myself, wondering if maybe I should have listened to him more. The way I coped with it was talking to my attending. He told me, ‘No matter what you do, for some patients, it really is their time. You have to stop blaming yourself, but you have to learn from this.’” —Jonathan Ang, MD, a fourth-year resident at Montefiore New Rochelle Hospital in New Rochelle, N.Y.
- “I remember taking care of a patient who had end-stage liver disease. The patient’s belly was distended, and he became progressively confused. After discussion with several specialists, it was decided that the patient needed an urgent liver transplant. I remember working arduously to facilitate this. I discussed various options and the plan of care with a renowned transplant surgeon. “[But the patient didn’t live to receive the transplant.] The entire situation was very challenging for me to comprehend, and I felt a deep remorse for the patient’s family. “A few weeks later, I received a letter from the patient’s wife, stating how appreciative she and her family were of our efforts and she was comforted knowing that we tried everything we could to help the patient. Although this provided me some solace, it was nevertheless difficult to cope with.” —Dr. Ahmed
The rewards of treating patients
No matter the long work hours, residents loved treating patients in their programs:
- “It’s wonderful in OB-GYN when you can truly establish relationships with patients because you see them every month and every week. You really get to know them. They’re really motivated to change, and … you can get folks who may not otherwise have stopped smoking to quit for good. I find that really motivating. And being able to openly deliver the baby is just fabulous.” —Dr. Ring
- “The incredible privilege of a physician-patient relationship is often forgotten. As providers, we have such a unique privilege to help another human being. I’ve noticed that I find the most satisfaction in this profession when I put aside personal matters and simply listen to the patient.” —Dr. Ahmed
How residency was different from expectations
Residents shared how their experiences compared to what they anticipated coming out of medical school:
- “It’s way harder than you expect. Just the constant stress every single day of trying to do your absolute best for every patient who walks through the door. You’re wrong sometimes. As smart, high-functioning people, we residents hate to be wrong—particularly when it affects someone else, instead of ourselves, then we really hate being wrong.” —Dr. Ring
- “It’s one thing to know medicine, but the art of practicing it is completely different. That’s where the training comes in. For instance, one thing I have learned specifically in training is how to talk to families. I’ve learned how to get to know them and establish trust through a relationship with my patients. That’s one thing that’s never taught in medical school. That’s only taught by experiencing it.” —Dr. Ang
Advice for those in early stages of residency
The first few months of residency mark a major life transition. Here are tips these residents found for successfully surviving it.
- “I would tell myself to take it easy at times and not to stress over circumstances that were beyond my control. The time spent toiling over little things could have been repurposed to a better use of my time, yielding more quality time spent with my friends and family. “And don't lose your sense of self. After all, that's what makes us who we are. I've found that patients appreciate authenticity, and it is the only effective way to make an indelible impression in the lives of others.” —Dr. Ahmed
- “A smile goes a long way when it comes to people you’re working with. Nurses or assistants can be your best friends in the world and help you with everything. Or you could end up doing things on your own, so being nice and friendly to people can actually make your life much easier. “Also, communicate with your team. Don’t be one of those residents who just writes something down in a chart and expects everyone to know it. Let your nurse know your plan for your patient and be aware of how you’re expressing yourself with others.” —Dr. Ang
- “Be good to your co-residents. Being good to each other creates an environment where you’re happier, and your satisfaction is higher. When residents do things together—go out to dinner, hang out and become actual friends—the quality of life in residency is totally different.” —Dr. Ring
Practical insights for graduating residents
If you’re a graduating resident, make sure to check out AMA Wire’s practical advice for advancing into the next stage of your career. Tips include:
- How to get your finances in order after residency
- 4 things every resident should know before a job search
- Things to consider before you choose a practice setting
- How to discover the perfect practice location
