Dr. Brennan Kruszewski is a practicing internist and primary care physician in Beachwood, Ohio. He graduated from Emory University School of Medicine in 2018, and recently completed his residency in Internal Medicine at University Hospitals/Case Western Reserve University in Cleveland. He enjoys writing about a variety of medical topics, including his time in academic medicine and how to succeed as a young physician. In his spare time, he is an avid cyclist, lover of classical literature, and choral singer.
You did it! After years of working 80 hours a week, surviving off of break room coffee, graham crackers, and a seemingly never-ending stream of pages, you’ve found yourself at the end of your residency training. Now that you can see the light, you’re probably left thinking to yourself: what happens after residency?
While everyone’s path is different, here are five experiences you might have when you finish residency:
1. You Might Feel Disoriented.
It’s normal to feel like you don’t have everything “figured out” the moment you finish residency. While during residency, you have a built-in structure of attending physicians, mentors, and program directors to ensure you develop all the tools needed to practice medicine independently, after residency, you’ll have to take charge of your own education. You’ll also be responsible for studying for and passing board exams, as well as fulfilling continuing medical education requirements to maintain your license.
While this might feel a bit overwhelming, the same skills you’ve grown accustomed to during your training will serve you well after you finish. My best advice? Keeping up-to-date on clinical guidelines in your specialty, looking up unusual cases or presentations, and listening to medical podcasts or lectures to expand your knowledge are all just as important to stay fresh after residency as they were when you were first learning the material.
The same strategies I used for success in residency keep me sharp as a lifetime learner.
2. You Might End Up Working a Lot Less – at Least Compared to What You’re Used To!
For the average Resident, working 10-12 hours per day, 6 days per week is the norm. You might go from this type of schedule to a hospitalist job with 7 days on followed by 7 days off, or to working in an outpatient clinic from 9-5 with weekends off. While the time you physically spend in the hospital or clinic might be less than before, you still might find yourself dealing with paperwork, teaching, or studying during those “off” hours. You might also end up answering questions from patients or residents you supervise at home, depending on the type of job you choose. For me, setting clear boundaries and expectations with myself, my patients, and my colleagues was essential in preserving a healthy work-life balance. Be clear with your staff and colleagues from the start on things like how to reach you after hours, when to call with questions, and who will be covering for you when you’re not available.
3. You Might be Making a Lot More Money.
While the average resident might be making anywhere from US $55-65k each year, a new Attending physician may find themselves making four times that amount – or more, depending on your specialty! With this higher income often comes higher expenses in the form of paying back student loans, moving to a new city, and paying for a medical license, and board preparation. While it’s exciting to see your hard work (finally) paying off, it’s important to budget that new money carefully to avoid overspending. Avoiding buying big-ticket items like a new car, boat, or expensive house can help you pay down your loans faster and keep you financially secure as you adjust to your new role. Speaking of that new role…
4. You Might be Looking for a New Job.
While some residents stay at the hospital where they did their training, most will go on to work somewhere else, or at least in a different role than what they’re used to. During residency, you’ll learn a lot about how to be a good doctor, but usually less about how to search for a job, write a CV, network, or negotiate that new contract.
By the time you finish residency, you’ll likely already have a new job lined up, whether it’s moving on to more subspecialized training in fellowship, a new position as a hospital employee, or starting an independent practice. Be sure you understand all the details of your contract before you sign it, including how your pay is calculated, how many patients you will be expected to see every day, and how much (if at all) you will be expected to be on-call. For me, this meant hiring a lawyer to review my contract and point out any “red flags” that needed attention.
If you haven’t quite found a new job yet or are unsure where to look for work, that’s okay! Traditional or online job fairs are a great place to start your search, and inquiring with the HR department of hospitals in your target city can be a great way to get in touch with physician recruiters. If you’re looking at starting a practice on your own, connecting with local doctors’ offices or your local medical society can be the perfect introduction to the opportunity that’s a good fit for you.
5. You Might Have to Rediscover Yourself.
With so much time spent at work during residency, you may find that activities you used to participate in regularly have fallen by the wayside. You may have even realized that you’re no longer interested in medicine as a career, or in your chosen specialty.
In the toughest moments of residency, I found it helpful to go back and reread my medical school personal statement. If you’re questioning your choice of specialty or career, what was it that drew you to medicine in the first place? Was it teaching, or the opportunity to use science to help people? Perhaps you could use your degree to become a guest lecturer or a clinical researcher. Was it the doctor who treated you after a sports injury, or the one who led your volunteer medical mission trip? Maybe you could volunteer your time with a local sports team, or staffing a free clinic. Taking the time to reconnect with your passions might be the perfect way to recover your sense of self and recalibrate your career trajectory.
As with all times of transition, the end of residency can be an exciting and challenging time in your life. Be sure to celebrate your achievement, doctor – you’ve earned it!