Matched, sorted: Tips to transition from student to resident

You've matched. Now what? The first and most important step, according to Abby Spencer, MD, MS, FACP, is to take a moment to pause and celebrate. “For that moment, feel the joy and excitement of knowing that you are on your way to becoming a board-certified internist.”

Next, contact your new program director. “Let her or him know you are happy and excited to be coming to their program,” said Dr. Spencer, who is the director of the internal medicine residency program at Cleveland Clinic. She stressed the importance of always responding promptly to the program director's emails, keeping track of program-related deadlines, and ensuring that the program director has all your correct contact information. “Don't be shy about reaching out,” she said. “Remember, this place will become your future home, and they are just as excited to have matched you into their training program.”

Chandler Park, MD, FACP, a hematologist/oncologist in private practice in Louisville, Ky., who has opined online about how not to be a “problem resident,” said developing a positive relationship with the program coordinator from the start is also important, since “This person will be responsible for everything from vacation scheduling to helping you complete ACGME paperwork.”

Dr. Park also recommended asking the program coordinator for the chief resident's contact information, since that is who will be in charge of completing the call schedule for the year. “Many programs don't allow residents and interns to take vacation during inpatient service. Therefore, if there is an event you will need to attend one month, it would be wise to ask the chief resident if you can have an elective or do outpatient work for that month,” he suggested.

Similarly, if you will only be completing an internship in your new location with plans to move on to complete your residency the following year somewhere else, Dr. Park recommended requesting that the chief resident schedule your last month to be an elective rather than inpatient service.

“It would be very difficult to move in June of your internship year if you are scheduled to start PGY2 in another city that same month,” he said.

Residency programs do not generally offer financial assistance for moving, although Dr. Spencer said they will offer guidance and point you toward helpful resources. “The residency program will also likely have a welcoming committee or team of residents that you could talk to about housing, rent, furniture, transportation, and so on,” she said.

Leverage social media

Most residency programs use social media to help connect new residents with current ones. Dr. Spencer recommended asking the chief resident about any dedicated chatrooms or threads for connecting members of your new program. These often offer a wealth of information and early connections to the program and city, she said.

“A few weeks before starting residency, check #tipsfornewdocs on Twitter. It has very helpful information on a variety of topics, such as loan repayment, clinical pearls of wisdom, professionalism pearls, and plenty of survival tips,” Dr. Spencer said.

For many physicians-to-be, the move from medical school to their residency program is the first time they face moving as an adult, said Arun Ganti, MD, MPHS, an emergency medicine physician at UCSF Fresno in California.

“When you moved to college and med school, you didn't have a lot of stuff, so you threw it in your car or your buddy's truck,” he said. “Now, you've possibly gone through a few life transitions, and you are moving a spouse and maybe some kids along with you. That's going to change your calculus. You have to ask if you want to spend more time moving, or more money?”

When planning his own move for residency, Dr. Ganti found that he was able to lower his costs by coordinating with a moving company's existing customer. Since The Match leads to many people moving from one academic medical center to another medical center all at the same time, Dr. Ganti and a few friends created backlode.com, a free web platform that connects people so they can coordinate their moves and share costs.

“People give the details and dates of their moves, the app connects them, and then they are able to negotiate with moving companies to save time and money,” Dr. Ganti said. “We do not endorse companies or get involved in the logistics.”

Get to know your new home

If your program is in a new city, Dr. Spencer and Dr. Park recommended visiting it in April or May if possible, to get a feel for where the hospital is in relation to neighborhoods where you might want to live and to see what the city has to offer overall. Dr. Park also suggested telling the chief resident you will be in town and asking whether they might be available to meet in person, if they can connect you with other residents, and if they can point you toward realtors familiar with the areas where residents like to live.

“Your co-residents are really going to be your friends and family for the next three to seven years, so keep in mind how much easier it will be if you're all living only within 10 minutes or less of each other,” said Dr. Ganti. “That will help with spontaneity for things like getting together for a drink, needing emergency child care, or just needing someone to talk to.”

Also use the time to meet with realtors or to find out if there are any graduating residents who might want to “pass down” their housing, said Liz Lawrence, MD, FACP, chief wellness officer at the University of New Mexico in Santa Fe and a featured expert in an ACP video on mental health and wellness during residency. “Ask the residents you meet about their recommendations for school districts if you have children, safety concerns in the neighborhoods, and what they wish they would have known when they matched,” she said.

“Try to have your living situation lined up by the end of May,” Dr. Park recommended, since most programs begin orientation or any necessary advanced cardiovascular life support or basic life support courses in June. “And don't wait until the last minute … to get a feel for things such as where the grocery stores are, places to eat, etc.,” he said.

Create community

Especially in the larger programs, Dr. Spencer said there will be numerous orientation activities for new residents to start building community. “If you are traveling with family, I recommend bringing your partner, spouse, or children to family-oriented events,” she said. “Let people get to know you outside of work. Those friendships will help you throughout your residency.”

“You want to be sure to immediately start building a community around you,” Dr. Ganti said. “You will need each other.”

Although residency is an amazing experience, the learning curve can at times seem overwhelming, Dr. Lawrence cautioned. “Remember, you're not alone. All your classmates are going through this. It's important to talk to your peers,” she said.

Having friends and coworkers who understand the stress of residency will be critical to your success, Dr. Park said. And if you find you need confidential help, talk to your chief resident, he said, as they are trained to address these situations. “Whatever it is, it is best to start when it is a small problem so it can be remedied,” he advised.

Dr. Spencer agreed. “Let your seniors, chief residents, and/or program director know if your worries are more than your usual worries,” she said. “Most residency programs are well-equipped and experienced in helping interns through this exciting, albeit daunting, transition.”

Dr. Lawrence stressed the importance of making time for yourself. “I never thought I had time to do it [during residency], but taking care of yourself enables you to provide better [patient] care,” she said.

“Above all,” said Dr. Spencer, “practice self-compassion.”