The transition from resident to clinician is a significant milestone in a physician’s career, but it’s only another phase in the progression of life-long learning. It’s not unusual for physicians to struggle their first year out of residency because they aren’t prepared to manage independently without an attending to fall back on.
Therefore, a hospital’s medical leadership should take steps to support a smooth transition and cultivate a positive working and learning environment that sets new clinicians up for success.
“First-year clinicians need more than a badge and directions to the cafeteria,” said Beverly Gladney, MD, Executive Vice President, Chief Medical Officer, SCP Health. “They need real help and support, so share the wealth. Don’t make them search, wondering where to find what they need. Give them all the information you can and encourage them to ask for help.”
With practical input from Dr. Gladney, here are seven specific ways to support clinicians in their first-year post-residency.
Help them get to know the practice
The first step is to help them gain familiarity with the practice, including information like whom to call at night and the on-call administrator.
Also, give them insight into other staff members’ personalities: Whose office can you go into, who prefers not to talk in the hall, how consultants like to confer—upfront or after some time has passed. Teach them to troubleshoot problems before they happen by anticipating questions and needs.
Introduce new clinicians to other staff
Building positive relationships with the people they will interact with daily is vital to a new clinician’s career success.
Introduce them to the physicians, nurses, medical directors, administration, office manager, and other staff. Take them to hospital quarterly meetings and get them involved in a hospital committee—both are great ways to gain some recognition.
A new clinician is not only a member of the hospital staff but also the community the hospital serves.
Dr. Gladney said medical leadership should connect clinicians with hospital recruiters who can fill them in on community information, such as area schools, cultural and recreational activities, and other community resources. Embedding themselves fully into the community will promote a healthy work-life balance, improved engagement, and a better sense of belonging and job satisfaction.
Ensure scheduling equity
Make scheduling fair and equitable, which means not saddling new attendings with the worst shifts or leaving them always to be the ones working holidays, weekends, and nights. Also, Dr. Gladney stressed that it’s essential to keep watch on the number of shifts you assign and make sure no one is on a path to burnout.
Related Resource: Life After Residency: 4 Tips for Graduates to Manage the Transition
Give them time to study
They may need time to study for specialty board exams, which take place in the Fall or during May. That means making time in their schedule for study and fewer shifts in the month of their board exam.
Provide peer support
Pair them with older, more seasoned doctors whom they can call with questions. EMRs are challenging, and unanswered questions regarding their day-to-day use often become huge hang-ups.
They need a mentor to show them the ropes, shortcuts, and how things are done. Remember that a well-run “buddy” program is cyclical. New clinicians eventually become the seasoned partners and mentors.
Reinforce work-life balance
It’s not unusual for newly graduated residents to burn out in their first year of post-residency because they failed to maintain a positive balance. They get caught up in the job offers and take extra shifts to make a living and pay back student loans.
“Work-life balance is a patient safety issue,” Dr. Gladney said. “Some people are working 22 and 23 shifts, and that’s not good for anybody. You have to rest. You cannot make good decisions when you’re sleep-deprived.”
While the new clinician is responsible for showing up and working the entire shift, they can’t make work their life. They need a healthy work-life balance. Clinical leadership should provide wellness talks, presentations, and education on what that balance entails.
In addition, offer an Employee Assistance Program (EAP) with counselors available to provide psychological and financial counseling. Ensure the new employees know about the EAP and encourage them to take advantage of it when needed.
Offer constructive feedback
New clinicians need lots of feedback to improve their skills, so don’t be reluctant to give it.
“One of the most important things a medical director can do for a first-year clinician is to provide feedback,” Dr. Gladney said. “Giving one-on-one feedback is huge.”
Providing real-time feedback, such as debriefing after codes (e.g., what could we have done better or differently), makes a significant impact and helps new clinicians learn more quickly.
In addition, provide written feedback at regular intervals and don’t be afraid to have crucial conversations when called for. Praise and constructive criticism can make a big difference in a person’s career.
Conclusion
Coming out of residency can be an exciting but also uncertain time. Recent graduates will learn quickly that the “real world” of clinical practice is entirely different from residency training, so do all you can to prevent these new physicians from feeling overwhelmed.
Smooth the transition by acquainting them with their practice, introducing them to other staff members, and assigning shift schedules fairly. Also, give them time to study for board exams, provide peer support and mentorship, reinforce the need for work-life balance, and never fear offering feedback. Do these things, and you will prepare them for a long, fruitful career.
SCP Health believes in preparing young, emergent physicians for future medical leadership roles. That’s why we developed our Residency Resource Team to help new physicians, nurse practitioners, and physician assistants embrace this change with guided onboarding, additional clinical support, mentorship, and educational resources.
