Sole Purpose 12
So…How Do You “Win” Residency?

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During my initial three years of medical school, I vividly remember the emotional moments of Match Day. Watching the upperclassmen, whom I deeply admired, achieve their long-awaited dreams always brought tears to my eyes. Each year, my heart swelled with pride, knowing the immense effort they had put in. This year, on my own Match Day, I experienced a similar surge of emotions. Matching with my top-choice program filled me with overwhelming joy. Yet, more importantly, it was an honor to witness my friends achieve their goals alongside me, all while surrounded by loved ones and the faculty who had supported us in reaching our dreams.
 

Once the enchantment of Match Day faded, the daunting yet exhilarating reality dawned on me: I am moving across the country to begin my career as a doctor. Gulp. Adapting to change has always presented a challenge for me. I take solace in having a plan and being surrounded by the familiar, so stepping into the unknown naturally unnerves me. Nonetheless, despite my concerns, I've made a deliberate choice, and I'm acutely aware of the wonderful privilege I carry as I embrace this new path. The prospect of starting residency fills me with a mix of excitement and unease – everything will be fresh and unfamiliar, but WOW am I excited to learn.
 

In addressing this challenge, I've leaned into my strengths by delving into research on the crucial qualities, traits, and advice that lead to excellence as a resident. I sought to understand in advance what it takes to be the best resident possible – or put simply, how to "win" at residency. I'm sharing this insight here with my fellow fourth-year students who may be navigating the same blend of apprehension and anticipation as I am. I've diligently organized my discoveries into overarching themes and categories, drawing from the numerous articles I've reviewed.

What does the research indicate?

Unfortunately, there isn't an abundance of published studies on what makes an excellent resident, and even fewer specifically focusing on podiatric residents. In 2014, Dr David Shofler conducted an online survey aiming to explore podiatric resident selection. He created two separate surveys: one for fourth-year podiatry students and another for residency directors. These surveys comprised 21 points, rated on a 7-point scale ranging from "not at all important" to "extremely important." With 124 residency program director responses, resident success perception was also evaluated by the directors. The findings revealed that residency directors who were highly satisfied with their residents primarily selected them based on the opinions of current residents, attendings, and letters of recommendation.¹ This insight underscores the significance of finding a residency program that aligns well with both the program's culture and the student's goals. So, if you're heading to a program that excites you and where you feel welcome, take a deep breath – you're already on the right path toward becoming a successful resident.
 

In 2014, Nemani et al examined the characteristics of successful orthopedic residents. Their study drew upon anecdotal observations supported by previous research on resident satisfaction and success levels. They identified key qualities and skills shared by the best residents: trustworthiness, efficiency, self-directed learning abilities, attention to detail, professionalism, approachability, and academic commitment. Furthermore, these attributes typically manifest in residents who excel both in the operating room and clinic settings, perform strongly on orthopedic in-training exams, and actively contribute to the orthopedic community.² While this study provided tangible qualities to aspire to, it primarily relied on subjective anecdotal evidence, supplemented by limited research findings.
 

What do the Blogs say?

Various medical blog sites have underscored common themes crucial for success in medical practice. After perusing several articles, I've grouped the general themes below:

Time Management and Productivity

This collection of traits aligns closely with the principles instilled in us as students striving for success. These are the essential tasks we associate with excelling as externs as well: punctuality, seizing learning opportunities, demonstrating enthusiasm for learning, contributing reliably as a team member, and staying abreast of current literature through active reading. Additionally, it includes characteristics that become increasingly vital as one transitions from student to resident, such as organization, diligent notetaking, and maintaining a list of tasks for completion.

Continuous Learning and Development

This category embodies the image of the most intellectually engaged residents—those who eagerly grasp opportunities and seem to possess encyclopedic knowledge. Traits within this category include actively engaging in research and lecturing whenever possible, maintaining extensive reading habits to stay abreast of current literature, participating in conferences, and, importantly, pursuing personal interests within the field. While Dr Patrick DeHeer, my future Residency Director, strongly advocates for involvement with APMA (slightly biased – He’s Treasurer of the Board of Trustees of the APMA), other articles echo the same and unanimously agree on the importance of professional engagement.
 

Communication and Collaboration

These traits paint the picture of the exemplary resident who possesses impeccable bedside manners—a resident who warmly smiles, patiently listens to patients' histories, and provides reassurance effectively. Attributes in this category include demonstrating helpfulness as an assistant, exhibiting approachability and warmth towards patients, actively listening, asking questions to deepen understanding, fostering open communication with both patients and colleagues, building strong relationships within the healthcare team, exceeding expectations, and recognizing the significance of support for success. Embracing uncertainty and expressing concerns are also emphasized.
 

The most consistently emphasized advice across all articles is to LISTEN. Residency entails navigating unfamiliar territory, and the most crucial skill for interns is to pause and listen to instructions and guidance. Even if you were a standout student, residency presents an entirely new challenge.

Self-Care and Well-Being

It's heartening to see the recurring theme of self-care across the articles. Despite the demanding hours, prioritizing personal well-being remains paramount. Traits in this category encompass maintaining enthusiasm, being prepared, managing finances, prioritizing personal needs, practicing self-care, and ensuring overall well-being amidst the rigors of professional demands.

As nervous as I am, I'm also very excited about the future and eager to see what it holds for both me and my fellow fourth-year students. From all the research I've conducted, one clear conclusion emerges: there are abundant examples of outstanding resident exposure during externships.