6 Essential Steps Every PGY1 Needs to Take Before Their Residency
You just matched into a residency program, and a new chapter of your career is about to begin.
Is it exciting? Sure! (Finally, some patient care! Cases that are actually complex! A chance to wear that long white coat! You’re one step closer to your dream!) But it can also be a bit daunting—there are so many things to think about and plan for.
Let’s walk through what you need to know—and do—to prepare for residency.
How does residency work?
During residency, you'll be a doctor-in-training either in a hospital or office. Residents diagnose, manage, and treat health conditions under the supervision of physicians. Gradually, residents receive more complex cases and gain extensive clinical experience.
Residency is known for being intense, with long working hours and extensive studying for future board exams.
There are protections in place, however. The Accreditation Council for Graduate Medical Education (ACGME) has these guidelines in place:
- Residents’ work weeks are capped at 80 hours
- Overnight call frequency is limited to no more than one in three
- Straight shifts are limited to 30-hour maximums
- Residents are to be given at least 10 hours off between shifts
These restrictions are in place to optimize patient safety, resident education, and resident well-being.
What do you do in residency?
Your residency will last 3-7 years, and during that time you’ll:
- Give examinations
- Record medical histories
- Order and interpret diagnostic tests
- Perform medical procedures
This means that you will no longer be just observing like you were during clinical rotations.
If your residency is in a hospital, you’ll likely rotate through different units. Whether in the NICU or emergency department, residents spend a large part of the mornings in a group of healthcare professionals on rounds, going from person to person assessing their health, and discussing treatments. Many hospital residency programs have midday conferences where a lecturer discusses a topic relating to the care of your patients. Afternoons are likely spent calling consults, ordering tests, reviewing results, and updating patient information.
Residents in clinics or offices participate in examinations and treatments. They also coordinate other health services as needed, so you’ll spend time calling consults, ordering tests, and reviewing results.
What do first year medical residents do?
First year residents—referred to as interns—usually focus on learning to coordinate patient care. This requires an exceptional amount of growth, and interns learn to:
- Consult with patients and their families
- Work with a team of residents, physicians, nurses, and technicians
- Write orders
- Work with electronic health records
As you move through this first year, you’ll be supported by senior residents, attending physicians, your program director, chief resident, and more. Attending physicians and senior residents will supervise the medical care you provide.
How long is residency?
Your residency will focus on a particular medical specialty and last from three to seven years depending on that specialty and if you pursue a fellowship or not.
- Internal medicine residencies typically last three years
- Pediatrics residencies typically last three years
- Med-peds residencies typically last four years
After completing your residency, you may want to pursue a fellowship in subspecialty training. Depending on the pathway you choose, this will add one to four more years to your training.
6 steps to prepare for residency
You’ve got the medical knowledge to proceed to residency, you’ve got the long white coat, and you know where you’re headed on the map.
Let’s go a little deeper into the mechanics of prepping to be a PGY1 and answer some daunting questions: Should you study before starting residency? How should you prepare your family for this next step? What can be done to set yourself up for financial success?
1. Equip your loved ones
Even though you have a fairly clear picture of what the next few years of residency will be like, your loved ones may need to be briefed on what it will be like for you.
Before you start 80-hour work weeks, connect with friends and family to discuss how the time commitment and stressors of residency will impact your relationships. Gently set the expectation that residents have little free time, are physically and emotionally exhausted, and may even be adjusting to a new home in a new place.
But don’t forget to share your excitement, too! Afterall, your parents and best friend have been rooting for you throughout your med ed journey and will want to share in your joy.
And when you do make the transition to residency, be intentional about your interactions with loved ones. Carve out time in your calendar—even if it's just for a phone call. Connecting with friends and family can provide a greater sense of well-being, restore your sense of purpose, and help you overcome challenging situations.
2. Research your (new) city
Many PGY1s will be moving to a new city to start their training. If you’re one of them, consider the following as you're planning your move:
- Ask your program if they know of any housing resources
- Commit to a date to find your new home
- Consider your budget and plan accordingly. Keep in mind relocation costs, utility costs, public transportation costs, or parking fees that you’ll incur due to your new commute
- Have fun researching the various neighborhoods and what they have to offer, but remember that the closer you are to your residency location, the better
3. Think about how you'll study
Time will be one of your most precious commodities during your intern year. Do not waste it using study methods that don’t actually work! The best way for residents to lock the must-know medical information into long-term memory is by using the evidence-based learning techniques found in the MedStudy Method. The fun-to-read StudyWise guide explains our method and goes through how long term memory works, the myths and truths of learning effectively, and how the best learning techniques are implemented into MedStudy's easy-to-apply, three-phase approach to learning (Preview, Study, Review).
Other study hacks for PGY1 residents include:
- Keep a running list of interesting topics encountered
- Study multiple subjects at a time by using interleaving (explained in StudyWise)
- Start studying with the MedStudy Method when residency begins
Remember: Residents take the In-Training Exam every year. And while you’re not encouraged to study for it, interns are tested on what is learned throughout the experience. MedStudy gives you a learning gameplan with your own virtual Personal Trainer to confidently take on the ITEs!
4. Get your finances in order
The good news: You'll finally be earning a paycheck! But don't forget the added financial responsibilities of being out of med school, like student loan payments and taxes.
To get started on the road to making smart financial decisions, consider contacting one of your medical societies like the AMA and AAMC. They have financial literacy and planning resources available for members that are entering residency.
Consider a Roth IRA
There is an earning cap on those contributing to a Roth, so take advantage of your chance to sock away some money now—you’ll be ineligible for the tax benefits of a Roth once you start making more later on.
5. Work-life balance
Take the next few months to recharge and reassess. Are there any unhealthy habits you need to leave behind? What healthy habits can you establish now to make for a better intern year?
If you don’t already do these things, use this time off to learn to meal prep, develop a sustainable exercise regimen, establish good sleep habits—anything to help you stay healthy and give you time for yourself during your 80-hour work weeks.
Ways to maintain work-life balance include:
- Make time for reflection to cultivate self-awareness
- Develop and accept your own professional boundaries
- Appreciate and focus on the positive things
- Cultivate strong, healthy habits
6. Take time to relax
You won’t get this much down-time again for years. Now is the time to relax, go on a trip, spend time with loved ones, and take long walks on the beach.
You studied hard in med school and just finished up months of clinical rotations. Now is not the time to put in intense hours of review—especially because your intern year will be an intense learning process where you’ll slowly be given more responsibility. Remember: Residents aren’t expected to know everything on the first day.
You’ve been studying hard for years. Allow yourself to rest and recharge so that you can move into the next phase of your training with renewed energy and focus. You’ve earned it!
