Career transitions, particularly the transition from residency to your first attending position, can be filled with many emotions: relief that one chapter of your career is completed, excitement about starting a new position, and fear of the unknown. You have worked countless hours, built relationships, and learned an incredible amount in a short time. Now, it’s time to move on. Here are a few things to keep in mind as you transition into practice. (Note: Many of these tips also apply to established physicians transitioning into a new practice.)
1. Take time off if possible. Residency is a grind, and you likely could use some downtime before you take on a new position. As a family physician, you are in high demand. Most employers will be flexible with start dates if you ask, so take some time off to catch your breath, relocate if needed, and travel if desired. You will hopefully return to medicine refreshed.
2. Develop a trusted network. The training environment allows residents to easily seek advice about patient care from faculty and co-residents. Look for new colleagues who can fill that role, or use a group messaging app to maintain your residency brain trust.
3. Explore the area. If you are new to the area, find out what resources exist that could help your patients, such as parks available for exercise, nearby pharmacies, lab services, and physical therapy locations.
4. Know your employee benefits. Inquire about the benefits you are entitled to, such as retirement plans, flexible spending accounts, and health savings accounts. Start contributing right away if you can, or at least make a plan to do so within the first year. Understand the leave and other employee policies so that you’ll know how to make the most of your benefits.
5. Ensure insurance is in order. You have a short window of time after your start date to make elections for life, health, dental, and vision insurance. Make sure you don’t miss those deadlines. Ask your human resources representative any questions you might have. Consider purchasing disability insurance as well (see “A Practical Guide to Physician Disability Insurance”).
6. Take advantage of training opportunities. Your employer may offer training about their organizational structure, electronic health record, shared savings, etc. Even if you are already familiar with these topics, try to attend the sessions or meetings. You may learn something useful. Ideally, these sessions will occur a few weeks after you have started so that you can ask any questions that have come to you.
7. Introduce yourself to your new team. The other physicians and staff in your office are critical to your professional and personal satisfaction. Learn their names. Ask what they love about their job and what’s within the scope of their job. Also, ask how you can make their job easier and how you can do your job better.
8. Personalize your workspace. If you are fortunate enough to have an office or a desk space of your own, bring in items that bring you joy (photos, mementos, plants, helpful reference charts, etc.). It will help you feel more at home and can help others get to know you better.
9. Understand your relative value units (RVUs). Each CPT code for services you provide has a work RVU assigned to it. For example, a 99212 E/M service has 0.7 work RVUs, while a 99214 has 1.92 work RVUs. (You can search for RVUs in the Medicare Physician Fee Schedule using this tool.) Your employer likely has set productivity targets based on RVUs, along with rewards for exceeding them or repercussions for not meeting them. Know what the targets and incentives are, and ask for regular reports of your RVUs to ensure they accurately reflect the work you are doing.
10. Clarify expectations. Particularly if your position requires multiple roles (clinical care, teaching, research, etc.), discuss your employer’s expectations of you. You need to ensure that you will have time in your schedule to do all that is required — and to do it well.
11. Think about the future. Spend some time writing down your 1-, 5-, or 10-year plan and talk to your leadership about it to make sure what you are doing now is in service of your goals. Your career plan can, and will, change over time, but having a road map for your future is the best way to achieve your goals.
12. Feel comfortable saying “No.” Your employer and your colleagues will be excited to have you join their team and may present you with additional opportunities to get involved. But it is OK, and wise, to hold off on committing to too many tasks until you are sure of the time your primary responsibilities will require. You also want to leave room for pursuits you are passionate about that may come your way.
13. Be an active learner. You will need some orientation to your new duties, but be proactive in this regard. As you encounter new tasks (rounding, billing, procedures, etc.), initiate a “shadowed” experience in which you are the primary person completing the task rather than a “shadowing” experience in which someone else completes the task while you watch. The former will be a more productive use of your time.
14. Don’t be afraid to ask for help. You are not expected to know everything. The hundreds of patient encounters you completed in residency cannot begin to capture the full breadth of situations you will encounter in family medicine. Use the resources available to you, including the physicians and staff in your office. Most will be willing to help if you’re polite and respectful of their time.
15. Believe in yourself. You have been well-trained and have a great deal to offer your new practice and patients. While you may find that you practice differently from some of your colleagues, that doesn’t necessarily mean your approach is wrong. There are usually many options available to care for your patients in a safe, appropriate, and evidence-based way. Don’t diminish the unique style, qualities, and strengths you bring to the practice. Leverage them for the good of your patients.