Transitions: How to Handle Your New Role

Andy Jensen, MD MBE

June 26, 2018

Residency is full of transitions.  As soon as you’ve aced the spine exam, it’s on to your sports rotation.  Feel comfortable taking in-house calls as a junior resident?  Next thing you know, you’re a senior resident with a whole new set of responsibilities.  Every new clinical rotation is a transition to a service with different norms and expectations, and every new academic year is a transition to a new role within the hospital system.  It can be a stressful time!  But don’t worry – here are some tips to help you transition through rotations and post-graduate years like a champ.

1 Identify a role model resident

As you start to understand your residency program, find a more senior resident who seems to have it “figured out”.  Reach out and ask him or her for advice on starting new rotations.  You’ll be surprised at how willing your colleagues are to help out!  Faculty may be able to point you in the direction of an ideal resident to learn from.

2 Get a great signout

A day or two before a new rotation starts, get on the phone with the resident you are replacing.  Learn the patients on the service and tips for succeeding on the rotation.  If there is a document about the service created by prior residents, read it and know what to expect going in.  If there is not a document already in existence that facilitates these regular and predictable transitions, consider creating one yourself – Sharepoint is a great medium to keep these files on!  Trust me, your attendings will thank you for it!  And don’t forget to pay it forward – give good signouts to those following you!

3 Start each rotation with an open mind

Consider each new rotation as if it’s the subspecialty you will be forging your career path in. Each rotation will have its own set of clinical norms based on attending preferences.  Skin closure, dressing changes, DVT prophylaxis to name a few. Just because a previous service did things a certain way does not mean your new attendings must do those things the exact same way. A critical facet inherent to your residency training is picking up on these subtle nuances as preferential differences.  If you keep an open mind, you can learn from each clinical experience and, ultimately, develop your own style and set of preferences.

4 Don’t sweat the small stuff

Every new rotation has a million little details that need to be ironed out.  Where does this computer print to?  Why won’t the scrub machine accept my ID?  Am I even allowed to park here?  Focus on patient care first and your education second – and those little details will sort themselves out in due time!

5Aim to be “a level above”

When it comes to starting a new clinical year, I always say that you should strive to get to the level above.  If you’re starting intern year – aim to be seeing consults like a junior.  If you’re starting junior year – aim to be operating like a senior.  If you’re starting senior year – aim to be independent like an attending.  This does not mean you should abdicate your current clinical responsibilities but, rather, set a high goal for yourself and try to exceed expectations!

Starting off your clinical rotations and academic years on the right foot can make or break your residency experience.  You want to hit the ground running and demonstrate that you have what it takes to thrive.  By using these five tips, you will be a pro at transitioning in no time.  And for good reason…because the biggest transition of all – from resident to attending – awaits!

DISCLOSURE: Dr. Jensen is an AAOS Board or committee member

Read the AAOS Discussion Group Terms, Conditions and Disclaimers HERE

Copyright© 2019 by the American Academy of Orthopaedic Surgeons

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