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You've Graduated Medical School! Now What?

— Take time to relax and prepare ahead of residency

Ƶ MedicalToday
A photo of a female medical school graduate during the graduation ceremony.

Congratulations! You're done (or nearly done) with medical school and you've matched into residency. But now you're faced with the perpetual question of medical training: What's next?

After all these years of non-stop studying and passing high stakes exams, you're looking forward to residency. You're finally able to use your knowledge and skills to help patients, and you get to be the doctor. Of course, there will certainly be a lot of learning along the way. This large responsibility may be weighing on you as you finish up medical school. You may think, "Am I ready for this? Did I prepare enough?" Imposter syndrome is real, but these feelings are normal and expected as you transition from student to physician. Remember, you deserve to be here. Generations of physicians have gone through this training and have become excellent doctors -- and you will too! You'll have help from your seniors who were all in your shoes not long ago. There will be ups and downs, but you'll get better every day and eventually you'll look back and be amazed at how far you've come.

Now that I'm a senior resident, I have medical students asking, "What should I do in between medical school graduation and the start of residency to prepare?"

First, relax! When I was a fourth-year medical student, my seniors would tell me that the best part of residency is the fourth year of medical school. This statement -- although sarcastic -- has some truth to it. This will be one of the last periods of time you can truly schedule at your own discretion, so it is important to plan out how you'd like to spend it.

I generally offer students the Three R's of Residency: relocation, routine, and relaxation.

Relocation

The first rule of residency: always ask your seniors! Don't struggle on your own. Reach out to the junior residents in your future residency program and ask about their experience moving to your new city or region. They can offer tips on the best moving companies, apartment complexes, neighborhoods, renting versus buying, commutes, grocery stores, restaurants, gyms, and cultural/religious venues in the area. This can help quickly narrow down your search. They may already have spreadsheets or FAQ handouts that they can share from helping previous classes of new residents -- after all, this is a yearly event! Do your due diligence and find housing early (March-May) to ensure you have the best move-in experience and can start residency off on the right foot.

Routine

Medical school is hectic, but so is residency! However, during residency you get to pursue your desired field and begin rotating in familiar rotations with familiar attendings. This helps you develop more of a routine, since you learn what to expect from every rotation. Gone are the days of clerkships where you jump from specialty to specialty and spend a lot of time trying to learn the expectations. Now, you can finally start planning a residency routine that makes your life more efficient. Even with a routine, the first 3 to 6 months of residency can be challenging because of the steep learning curve. But developing a good routine now will decrease some of the stress and uncertainty of beginning residency.

Other self-made routines will come in handy too.

As a resident you'll be pushing your mind to its limits, and keeping yourself healthy will help ensure success. Try to get into meal planning as a fourth-year medical student so you're in the habit early -- this can involve cooking on your own, purchasing from a meal preparation company, eating out, or accepting food deliveries from gracious family members. Knowing what you will be eating most days of the week is a huge stress saver for the busy resident. By having easy go-to meals, you won't have to resort to eating frozen pizzas multiple nights of the week. Trust me...it can happen. I'd also recommend developing an exercise routine. You don't have to be Arnold Schwarzenegger or Eliud Kipchoge, but find something to keep yourself active.

Another routine to develop in your final year of medical school is studying daily. Wait, what...? You have to keep studying...everyday? Wasn't that what medical school was for?

Yes, but we have to make studying a lifelong habit to give our patients the best care. In residency, you'll learn a bunch of practical, applicable knowledge on the job; however, you'll need to learn more specifics for your field. Developing a routine is helpful. I've been told by my seniors and attendings that if you can try to read 1 hour a day outside of work hours, you'll be in a great spot for future in-training exams and board exams. Consistency is key, and that's why it's important to develop a routine at the end of medical school, even if you're not required to study.

My recommendation is to look at and read over the intern content (free to medical students), especially if you are doing an internal medicine-based intern year. This will help you prepare for Step 3, and knowing the most common diagnoses and plans will help you feel more comfortable as an intern on day one. Also, try to take Step 3 as early as possible in your intern year -- you'll thank me later.

The final routine to develop is financial wellness. As a medical student, you may have had to take out hundreds of thousands of dollars in loans. Now, as a resident you'll likely be making approximately a few thousand dollars less than the yearly median U.S. household income. Although you'll probably earn more later as an attending, good habits start early. Talk to residents in your program about the cost of living and how they manage their finances. Since resident salary is standardized in the program, you can try to plan out a budget prior to starting residency. Of course, this will change when you get there as there will be unexpected expenditures, but making a money management plan is essential.

Relaxation

Last but not least is relaxation! You've earned it. Completing medical school is an honor. You've experienced highs and lows, and have had opportunities to connect deeply with patients. That is exciting, but also a huge responsibility that can be mentally exhausting. Use this time to recharge and hang out with your family and friends. Try to experience new things and create memories with those who you love and have helped you get to this point in life. Whether that is going on a vacation or simply taking a walk in your neighborhood, these are the memories that will help you keep going when things get tough. However, this doesn't mean you should neglect your family and friends when you're in residency. Mental health is key, and keeping in touch is essential to thriving as a resident.

Although it may seem like a long list of things to do before residency, it is all about consistency. Building good habits will carry you far and allow you to focus on being the best resident you can be. Don't worry about being perfect, just work on making yourself a little better with time and the results will compound. And remember, don't get overwhelmed! You deserve to be here and we're all looking forward to your future success.

is a physical medicine and rehabilitation resident at the University of Missouri School of Medicine. He is a member of Ƶ's The Lab.