Perspectives On Residency Transitions From a Resident and an Attending: Part 1

This blog is part 1 of a 2-part series, the first of which examines a resident's point of view.

One Resident’s Perspective: Transition from Podiatric Student to Podiatric Resident

With the start of my second year of residency just a few months away, I feel it is a great time to look back on this past year and reflect on how I have stepped into the role of a resident. The transformation from a student to a resident physician marks a period of absolute growing pains that I think every colleague feels, and it is important to acknowledge this time as a marked indicator of growth.

As the first few days of residency go by, you quickly realize that the mindset required to be successful in residency shifts. The ambiguously passive role as a student fade away as the active, decision-oriented mindset of a physician takes hold. Residents are often the first point of contact when it comes to decision-making. You begin to understand that the weight of words is much heavier when they come from your own mouth and begin to slow down to make sure you appropriately communicate with patients as well as your attendings. If your residency is or was anything like mine, you discuss many patient care decisions with co-residents and attendings. As a new doctor, the pressure to make the right decisions can be quite daunting, but having a safety net helps you develop that confidence. Regardless, you may fumble through some cases, yet proceed like a rock star through others. But as you build trust in your own skill set, you develop more efficient ways to read through a patient’s chart or arrive to a plan of care. And, as you develop hand skills and understand decision-making during surgery, you begin to feel more like a true surgeon.

The perioperative arena certainly presents its own unique set of challenges. I and many of my peers often heard throughout podiatry school, from professors and older colleagues, the importance of thinking a step ahead. If you ever find yourself having the opportunity to function as a second assistant, it is a great opportunity to showcase this concept. Being a good assistant requires knowledge of the case and procedure and being ready with instrumentation and retraction at the right time before the attending even completes the previous step. I cannot help but to echo these sentiments and to add to it as well. This pursuit begins before you or the patient even arrives to the surgical facility and continues after they leave: evaluating the patient in the pre-operative holding area, completing the paperwork, ordering the right medications, making sure that the necessary equipment is in the room, transferring the patient to the operating bed, prepping correctly, maintaining sterility, retracting properly, having the proper instruments ready, and applying proper postoperative bandaging.

The responsibilities go on and on for all of the skills that you begin to develop as a resident. You quickly realize that these are all very important steps in providing adequate patient care and ensuring that the surgery runs smoothly. In my experience, your attendings will notice, they will appreciate it, and they will begin to trust you more. That trust builds to the point that they may become comfortable enough to pass you the blade. Being handed the knife and proceeding forward with a procedure is a privilege; an earned opportunity. As you begin to hone your proficiency with surgical instruments and understanding of cases, you work towards the day that your attending may not have to even scrub.

As a student, it is a delicate balance to be helpful enough to demonstrate your value as a potential residency candidate, but not overstep. It is a fine dance that can prove stressful at times, but you learn quickly. At the end of the day, student externships are as much of a job interview as they are your chance to soak up information. These extended job interviews are not just a chance to show off who you are, but an opportunity for you to acquire a feel for the people at and hospital where you may potentially work.

I often heard as a student that programs look for hard-working candidates. While I can say a dedicated co-resident certainly is great to have, I would much rather have someone that is a great teammate and leader. Residency can oftentimes be frustrating and overwhelming. Having a cohesive, well-functioning team that you can count on makes these days much more bearable. However, arguably the characteristic most important to have from a physician-resident standpoint is to be coachable. Being able to admit mistakes and acknowledge where you come up short is as critical to your growth as a physician as it is important for safe, patient-oriented care. As much as we strive for perfection, we all come up short at times. Admit to your shortcomings early; adjust, adapt, and overcome.

Residency is a unique time on the path of your career. It is a chance to soak up the lessons and skills of experienced physicians. Some of what you see during residency may not necessarily reflect what you do after residency. Be hungry to learn and constantly improve. Take advantage of these moments to absorb as much as you can and you can decide later how you can mold these skills to best suit your style.

Dr. Adame is a first-year podiatric resident at McLaren Oakland Hospital in Pontiac, MI.

Dr. Husain is the Residency Director of the McLaren Oakland Hospital Podiatric Surgery and Medicine Residency Program in Pontiac, MI. He is a Fellow of the American College of Foot and Ankle Surgeons and a Fellow of the American Society of Podiatric Surgeons. Dr. Husain is also the President of the Michigan Podiatric Medical Association and Chairman of the Michigan Podiatric Residency Consortium.