Preparing for transition: What they didn’t tell you about your last year of residency
Since there is no manual for the transition from residency to practice, we asked Patrick Boreskie, MD, now in his fifth year of residency in Emergency Medicine at the University of Manitoba, for some advice.
Finding your niche
“At the end of residency, you have that opportunity to ask, ‘What is my niche? What am I good at?’ It’s good to explore that before you get out there as an attending.”
That final year of residency also needs to be a “dress rehearsal” for independent practice. “Have a conversation with attendings,” he says. “What I’m doing very early this year is having a conversation with my attendings before a shift. I want us to pretend that this is next year.”
Prepping for exams
When it comes to preparing for Royal College exams, Dr. Boreskie takes a team approach.
“For me I have a cohort of four and we have set a study schedule together, so it is something we can be accountable to each other for. Sometimes one or more of us may lag behind and we will help each other get caught up.”
While most of his preparation is through independent study, once a week the group goes over review questions they’ve created. “And every morning at 8:30 we have coffee together for 30 minutes and quiz each other with cue cards.”
A taste of independence
The most exciting times in residency, he says, are when you need to fly on your own: “Those validating moments when you realize you are going to be okay at this.” Sometimes things are so hectic in the ED that a resident has to temporarily work independently.
“It’s really exciting to be able to get a little taste of what things are going to be like after residency. You certainly learn a ton when you feel like you are the last line of defence.”
Trying new things
During his residency, Dr. Boreskie also does extra work as a house medical officer in the ICU, as well as staffing Stars Air Ambulance. These experiences “offer more responsibility and are very interesting. You feel like you are more independent and sometimes it’s a little bit of trial by fire.”
The last piece of advice he has for those approaching their final year of residency is about financial planning.
“It seems like there is a notorious lack of financial knowledge or financial teaching through medical school and residency. It really depends on you finding mentors that are able to teach that. In your last year, start mapping this out for next year in terms of how this is going to work out as a job, beyond this being your calling as a physician. Doing some of that financial planning can also be validating.”