How to Make a Smooth Transition From Med School to Residency

How to Make a Smooth Transition From Med School to Residency

Medical school and residency are very different animals. While you already have hospital experience from clinical rotations during your med school training, residency will challenge you in brand new ways. 

The long, sometimes unpredictable hours can take a toll on your physical and mental health. Here’s what you can do to make a smooth transition into residency and how you can prepare in the months leading up to your placement.

1. Budgeting and Finances 

While there’s a popular stereotype out there that doctors are terrible with money, this does not have to apply to you. The financial decisions you make now will set the course for your financial future, so it’s vital to do your research, seek expert advice, and make wise choices. 

You are no longer a medical student paying for your education. You are a resident earning actual money—but don’t get ahead of yourself. A resident’s salary is far less than a full-fledged doctor, and it’s a fixed income. You will need to learn to budget, and it’s also critical to start paying down any student loans. 

Unfortunately, learning about finances isn’t something they teach in medical school, so it will be up to you to seek out reliable finance books, YouTube videos, and other resources. If you haven’t dedicated significant time to learning about the state of your finances, investment opportunities, the best way to pay off loans, and how to budget effectively, begin learning all that you can as soon as possible. 

2. Time Management

You will be working extremely difficult hours in residency. You’re no longer on your clinical rotations, which means you can’t be dismissed by the resident after you’ve worked a certain number of hours. You are the resident, so you have to get your work done before you go home.  

Unfortunately, this means you will have very little free time to dedicate to exercise, personal wellness, hobbies, and relationships. But of course, this does not negate the extreme importance of those activities. In residency, you must be intentional about carving out specific time for the activities and the human beings in your life who keep you sane. 

• Dating

Your love life will be a challenge in residency. You may only have a few hours a week to dedicate to your relationship, which is why it’s crucial to make specific plans, put them in your calendar, and do your best to commit to them, even with your busy schedule. 

When your schedule is especially tight, get creative about blending your other commitments. Find a way to turn cooking, grocery shopping, or even laundry into a date. Doing these tasks together makes them more enjoyable, and it ensures you have more opportunities to spend time together. However, make sure to schedule a real date as well—if you only meet up with your partner to do laundry, that romantic spark could fade quickly. 

• Errands and Chores

Aside from your relationship, doubling up on tasks is a great way to be more efficient and find more hours in the day. Multitasking gets a bad rap, but that’s only because it’s misunderstood.

Pairing an automatic task with a non-automatic task, like going for a walk while calling your parents, stretching while watching TV, or cooking while listening to a podcast, optimizes your downtime. Mindless chores like cooking and laundry still need to happen, so find ways to make the most of every moment of your day.

Buy back your time where you can, especially for tasks you don’t like doing. You may not have much extra cash as a resident, but you’ll have more than you did in medical school. Free time is incredibly valuable during residency. It may cost $100 to have your house cleaned, but that’s two hours you can spend however you want. Getting your groceries delivered or hiring a meal service may cost more but the time you save is invaluable.

• Exercise

Exercise is often the first thing people let go of when they get busy. It’s easy to say you don’t have time for it, especially during residency. But you do have the time if you manage your time effectively.

Regular exercise during residency is critical to maintaining a healthy body and mind. In order to fit exercise into a busy schedule, you’ll need to make it a consistent habit. You’ll also have to find creative ways to fit it into your busy lifestyle. 

For example, you might walk, run, or bike to work, saving you on your commute. You could build exercise into your social life by exercising with friends or your partner. You can also pair another passive activity with exercise, such as listening to a podcast or audiobook. 

In the weeks and months leading to the start of residency, take the time to dial in these habits and figure out what works best for you.

3. Sleep Management 

Sleep is essential to your health, but the long and unpredictable hours of residency will make getting that sleep tough to do. Depending on your specialty, you likely won’t be able to get the required 7 to 9 hours of sleep you need every night. 

However, all is not lost. One of the most essential things to understand is that sleep quality is more important than sleep quantity in terms of health, happiness, and staving off feelings of fatigue, confusion, and anxiety. 

6 hours of high-quality sleep is better than 9 hours of low-quality sleep. Dialing in your sleep habits leading up to residency and in your first few months of a hectic schedule will be key to your success.

The best thing you can do for your sleep is build a consistent night routine and sleep schedule by going to bed and waking up at the same time. During residency, this may not always be possible for you. If you know you will have overnight calls or irregular shifts, plan accordingly. If your shift is from 10PM to 8AM, a good approach is sleeping 4 hours before and 4 hours after your shift.

But this may not always be possible either. For example, you could have a night call after a full day at the hospital. In these cases, a power nap of 15 to 20 minutes can improve your alertness. Avoid longer naps, as these lead to sleep inertia. 

Sleep inertia is a period of mild cognitive impairment and motor dysfunction that happens when someone wakes from non-REM sleep, like after sleeping after a period of sleep deprivation. It can last between 10 to 120 minutes and can significantly negatively impact your performance and judgment—not something you want to happen while working in a hospital. 

Eating properly and drinking lots of water is also essential, as you burn calories during intense periods of work. Dehydration and reduced glucose levels can hinder your decision making on top of sleep deprivation. 

Even though it may not always be in your power to keep a regular night routine, do all that you can to get back to your routines when you’re not on call.

4. Moving to a New City or State

Take time to visit the city where you’ll be moving. Acclimatize yourself in your new environment while you have time to do so. Immerse yourself in the culture and connect with other residents who are living there. Where’s the best housing? What are the best restaurants and grocery stores? Is there a gym nearby? 

You don’t have to reinvent the wheel. The residents who are already at the hospital have just recently figured these things out, so reach out to them and seek their advice.

It’s also a good idea to arrive in the city early so that you're not overwhelmed by the change at the same time you’re overwhelmed by the workload of residency. Moving ahead of time can get you situated, and many residencies offer an orientation period in the summer where you can figure out the ins and outs of the city as well as the program. 

5. Reset Yourself Before the Rush Begins

You’ve spent at least 4 years in undergrad and at least 4 years in medical school, and on top of that, you’ve just endured the incredibly stressful match season. It’s safe to say you need a break, and this is the best time to take it. 

The months between matching and beginning residency are your golden months. It may be the most time you’ll have off until you retire. Most residency programs only have 2 to 3 weeks of vacation during intern year, and requesting that time off is more complicated than in other professions. 

The best thing you can do during the months leading up to residency is recharge. Spend time with your loved ones and strengthen those connections before the onslaught of residency begins. Travel, if you’re able to, and take time to do the things you love. 

This is also an ideal time to develop any healthy habits you want to maintain during residency. If your habits aren’t firmly in place before you enter residency, it will be that much easier to take shortcuts or skip the habit altogether. 

Develop a solid morning and night routine to improve your sleep quality, and create habits around mindfulness, healthy eating, and exercise while your schedule is relatively empty. This will make your habits more resilient and easier to stick to once the whirlwind of residency begins. 

Use your golden months to reset so that you’re in peak physical and mental form when you start your intern year.

Making a Smooth Transition

Making it through medical school and successfully matching into residency is no small feat but your challenges are far from over. Residency will test your discipline, stamina, and perseverance like never before.

It is critical that you use your months leading up to residency wisely so that you’re as healthy, rested, and prepared as possible before the challenging voyage begins.

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