Ease the transition from residency to practice with these tips

Nervous. Excited. Scared. Eager.

Those were among the many feelings I had as I approached my first day as an attending. The excitement of finally starting my first real job as a family physician and serving my community clashed with the racing questions in my mind: Was I ready to practice independently? What would I do if I didn’t know what to do? What if I made a mistake?

Everyone’s transition from residency to practice is different, depending on job setting, training and organization culture. But some common tips for a successful transition to practice kept coming up when I spoke with my fellow residents about our experiences.

Maintain contacts so you don’t feel alone after residency

One of my biggest fears stepping into attending life was having no oversight. I trusted my training and knowledge, but the thought of no one checking my plans worried me. I quickly realized that fear was unfounded.

From residency group chats to text threads with faculty friends, make time to stay in touch with your residency contacts. These connections are invaluable when you need advice, a quick second opinion or a reassuring word after a tough day.

Your new colleagues were also once in your shoes and recognize how overwhelming the transition can be. They’re usually glad to give advice on complex cases or answer questions, and more often than not, they’ll confirm you’re already doing the right thing. Sooner or later, you’ll find they start asking you questions about their own patients, too.

Find your place

Finding the right fit starts before you sign a physician employment contract. When you’re looking for your first job, take time to dissect the culture and setting of the practices you’re considering. That sets the tone for everything that follows, including whether you find a team you can truly work with—not just your colleagues, but also your medical staff and management.

Be honest with yourself about what kind of environment you need. If you thrive with clear structure and defined expectations, look for a practice with established workflows and strong leadership. I personally thrive with flexibility and less micromanaging, so I joined a clinic with an autonomous culture that allows me to prioritize my personal career aspirations in advocacy. Neither is better; what matters is that it matches you.

Also, look closely at the resources the practice has to support you. Is there enough clinical staff? Your medical assistants will be the ones supporting you through your day-to-day work, so gauge whether the support staff is helpful and works as a team. During interviews and site visits, watch how people interact, ask to shadow a clinic session if you can, and talk with the medical assistants and nurses, not just the physicians. A supportive team makes it far easier to carry out your work.

A few questions I found worth asking during interviews:

Don’t be afraid of change

It can be difficult to stay on the forefront of change. But the quicker you adapt, the more chances you have for success.

You can change jobs

It’s easy to get locked into your first job simply because it’s comfortable. Remember that you always have the ability to leave and find a new position. Whether you need a different organizational culture, different management or a different lifestyle, let what you’ve learned guide your search. Before you sign an employment contract, also be cognizant of physician employment contract terms, such as notice periods and any restrictions on leaving.

Try new things

The more you open yourself up to new experiences, the more successful you can be. When I first started at my current practice, I had the opportunity to delve more into HIV medicine from my colleagues. It was a skillset I never thought I would be able to incorporate in my practice, but it gave me the chance to reach a new population of patients.

I have continued to brush up on skills from residency to continue to use in practice including osteopathic manipulative treatment (OMT), and in-office procedures like joint injections, IUDs and toe nail removals. Doing so keeps my skills fresh and polished, adds variety to my day and keeps doors open if I ever want to specialize down the road.

There is always room to learn, and the transition out of residency is one of the best times to do it, since you can build directly on the foundation you gained in training while it’s still fresh. Treat your first years as an extension of your education rather than the end of it.

Embrace technology

Stay on top of technological changes and use AI to your advantage. It can lighten your workload, especially for administrative tasks and for drafting patient-friendly notes about lab results. That frees up time for better work-life balance and, more importantly, for talking with your patients.

It’s OK to not know everything

Medicine is constantly changing; it’s impossible for anyone to know everything. It’s OK to not know something. Patients often understand this, and many will appreciate you for being honest about it.

I experienced this recently while examining a patient with a severe rash. I wasn’t sure of the diagnosis, so I brought in a colleague for a second opinion. Later, the patient told me how much she appreciated that I did. To her, it showed that I was truly invested in her care and cared enough to ask someone else. Getting a second opinion is never wrong and it doesn’t make you an incompetent doctor.

What matters is recognizing when you don’t know something, because that awareness lets you shape better patient care. Consult a specialist, ask a colleague, or look it up and tell the patient you’ll get back to them. Patients would much rather receive correct, evidence-based information later than risk harm from a guess now.

Set boundaries

Knowing your boundaries can be a work in progress as you learn to navigate both patient relationships and work relationships. It starts with knowing what your own limits are.

Prioritize your effort

As a family physician, you’ll constantly receive patient messages, lab results, prior authorization requests and requests from management. You can’t give everything the same level of attention, so learn to prioritize and figure out where your effort is best spent.

One rule I use with lab results: If I find myself writing more than a few sentences or going back and forth with a patient over the portal, I bring them in for a visit instead. It usually means the results need more discussion. This saves me time, and I can often explain things better in person than I can by typing. Don’t be afraid to bring patients back for another appointment when they need one.

Protect what makes you happy

Recognize which activities bring you joy and don’t let them fall away, because work-life balance is essential. For me, that’s dance. I make time to work out at least three times a week and attend a dance workshop once or twice a month. It’s a great stress reliever, and it keeps me going to show up for my patients.

Speak up at work

If something in your workflow feels overwhelming or could be done better, consider bringing that feedback to your management team. They may be able to help you build a more efficient process. No one will know your ideas unless you tell them, so share your critiques and feedback and make your workflow work for you.

Know your resources

You don’t have to figure this transition out alone. The AAFP has several resources that I found especially helpful.

Final thoughts on transitioning from residency to practice

The transition from residency to practice is a big one, and the nerves you feel are normal.

Lean on your people, choose your environment thoughtfully, stay curious, and be honest about what you do and don’t know. Protect your time and your joy, and use the resources available to you.

You’re more prepared than you think.

Prachi Thapar, DO, completed her residency training at University of Texas Southwestern Medical Center and is currently practicing at the Southwest Family Medicine community clinic in Dallas.