What should a graduating resident do before they leave their program?

[ladysmanfelpz]

Besides the big 3: Job, medical license, and board sign up, is there anything else a graduating medical resident should do?

I am going into fellowship, so skipped the job thing, and actually may include my board thoughts at the end of this post. Was there anything else you did before leaving you programs? Saving dot phrases, lectures and powerpoints from program, etc? And what is the easiest way to do all this for someone that is not the most teach savvy? Some sort of google drive or external hard drive. It'd be a shame to leave a bunch of resources behind.

And lastly regarding my board thoughts, I got my license the last day of board sign up. So I would sign up late. I have a lot of life changes: marriage, moving, graduation, starting fellowship somewhere new. Would it be acceptable to delay my board sign up for the following year after graduating and take both? For 2025 gen psych boards are Sep 8-9 and Forensic boards are Oct 14-18. Would that be enough of a gap to study for both? Obviously many things come into play here. Including funds, timing, drive, missed opportunities. I will have my state license which is enough to moonlight if I want to without being boarded. Then we plan to move after fellowship and with a big move I don't plan on starting a job July 1st and may push it back giving some dedicated study, move, and travel time. Thoughts?

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[comp1]

Omph. If you can avoid delaying, take the boards as quickly as you can. You're the smartest you're ever going to be in your life at the end of residency (in terms of book smarts that are tested on the boards). Every year, you lose some of this with the most rapid loss during the first several years after you are out of training and if you've spent a full year doing subspecialty stuff in forensics, you're already facing a headwind. It only gets harder from here to take tests. There's nothing in particular to save from your residency. You might need contact info for letters of reference for new jobs if your first doesn't work out or if you want to take on a second job? But you likely already have that. Dot phrases are almost certainly very specific to your training sites and if you're planning to stay at your training program as an attending, you probably wouldn't be asking all this. I can't imagine referencing any of the Powerpoints or lectures post residency...

 

[SPsych6]

1. Exchange personal emails with fellow residents so you can use them for references. Every job wants multiple doctor references. Do this soon, just in case. You will keep meeting new docs but nice to have ones who know you well.
2. I saved templates and Dot-phrases, but I just threw them into google drive to copy and paste elsewhere. You won't always have Epic etc.
3. I pushed boards to one year after, it wasn't an issue, but if you are in fellowship it may be a bit more difficult? I just took off work a few days here and there to study. I DO think you should study, I know others are going to say "it is so easy" etc. but people fail every year. But, don't waste too much time studying neuro, there just isn't that much on the boards anymore
4. Ask attendings what they like to do for CMEs or what articles/websites they use for reading etc. You may already know or have your list, but I think it was a good thing to ask
5. If you like your co-residents, see if you all can set up a conference that others would like to attend together in the future! Stay connected
6. Look into Compact Licensing (IMLC) if you live in one of those states, it might give you some other moonlighting opportunities
7. See if you have any up-to-date CMEs and get the certificates before you leave residency just in case. It might be too early to use those if you are not taking your boards right away though.
8. Something I wish I did, but didn't do...write a letter to each attending I worked with over the last 4 years and tell them how much you learned from them and what you appreciated about working with them. It would mean a lot to all of them. Academics is hard, lots of personalities to manage and things like that go a long way.
9. Start updating or creating your resume. You may have done this for fellowship, but we all kind of forget to do this during residency.
10. Have a fun rest of residency, it can get a little lonely after that, especially if you go into outpatient.

 

[Stagg737]

DISABILITY INSURANCE!!!

You're going into fellowship, so you'll still get "in-training" rates for another year. However, you can get own occupation (specialty specific) coverage at much lower rates when you're a resident or fellow than they offer when you're an attending and those rates will stay lower once you're an attending. Get this done now while you're still able to otherwise you may end up paying 2-3x what you would for the same coverage if you buy it as an attending for the first time.

 

[Merovinge]

1. Exchange personal emails with fellow residents so you can use them for references. Every job wants multiple doctor references. Do this soon, just in case. You will keep meeting new docs but nice to have ones who know you well.
2. I saved templates and Dot-phrases, but I just threw them into google drive to copy and paste elsewhere. You won't always have Epic etc.
3. I pushed boards to one year after, it wasn't an issue, but if you are in fellowship it may be a bit more difficult? I just took off work a few days here and there to study. I DO think you should study, I know others are going to say "it is so easy" etc. but people fail every year. But, don't waste too much time studying neuro, there just isn't that much on the boards anymore
4. Ask attendings what they like to do for CMEs or what articles/websites they use for reading etc. You may already know or have your list, but I think it was a good thing to ask
5. If you like your co-residents, see if you all can set up a conference that others would like to attend together in the future! Stay connected
6. Look into Compact Licensing (IMLC) if you live in one of those states, it might give you some other moonlighting opportunities
7. See if you have any up-to-date CMEs and get the certificates before you leave residency just in case. It might be too early to use those if you are not taking your boards right away though.
8. Something I wish I did, but didn't do...write a letter to each attending I worked with over the last 4 years and tell them how much you learned from them and what you appreciated about working with them. It would mean a lot to all of them. Academics is hard, lots of personalities to manage and things like that go a long way.
9. Start updating or creating your resume. You may have done this for fellowship, but we all kind of forget to do this during residency.
10. Have a fun rest of residency, it can get a little lonely after that, especially if you go into outpatient.

Ergh I really wish I did more of this along the way. I worked with such great attendings and said good things about them behind their backs, but I wish I would have said it to their face.

 

[TexasPhysician]

I tried saving dot phrases and realized it was a waste. Other EMR’s are so much easier with better template opportunities. Dot phrases are a thing of the past in my life. They are as useful as cassette tapes now.

You definitely need disability insurance if you haven’t gotten a private policy yet.

According to my Chair and PD, board pass rates decrease for every year you delay boards. At least for CAP, you have to pass general before you are eligible to apply for CAP. I know a couple people that delayed general boards, then failed a couple times, and before you know it, they are no longer eligible to take the CAP boards at all. I wouldn’t delay any boards. My opinion: they weren’t hard when I took them right away.

 

[clausewitz2]

I am someone who can't stand check box or radio-buttoned templates, so I have no regrets about saving dot phrases. I still use some of the ones I developed in residency. My ideal note format from an EMR is a blank textbox that will get the h**l out of the way and let me use whatever arbitrary format I've currently settled on.

Agreed that the boards were a non-event taken immediately after doing residency.

 

[FlowRate]

DISABILITY INSURANCE!!!

You're going into fellowship, so you'll still get "in-training" rates for another year. However, you can get own occupation (specialty specific) coverage at much lower rates when you're a resident or fellow than they offer when you're an attending and those rates will stay lower once you're an attending. Get this done now while you're still able to otherwise you may end up paying 2-3x what you would for the same coverage if you buy it as an attending for the first time.

This, especially looking into GSI for anyone with otherwise disqualifying PEC's.

 

[Merovinge]

Besides the big 3: Job, medical license, and board sign up, is there anything else a graduating medical resident should do?

I am going into fellowship, so skipped the job thing, and actually may include my board thoughts at the end of this post. Was there anything else you did before leaving you programs? Saving dot phrases, lectures and powerpoints from program, etc? And what is the easiest way to do all this for someone that is not the most teach savvy? Some sort of google drive or external hard drive. It'd be a shame to leave a bunch of resources behind.

And lastly regarding my board thoughts, I got my license the last day of board sign up. So I would sign up late. I have a lot of life changes: marriage, moving, graduation, starting fellowship somewhere new. Would it be acceptable to delay my board sign up for the following year after graduating and take both? For 2025 gen psych boards are Sep 8-9 and Forensic boards are Oct 14-18. Would that be enough of a gap to study for both? Obviously many things come into play here. Including funds, timing, drive, missed opportunities. I will have my state license which is enough to moonlight if I want to without being boarded. Then we plan to move after fellowship and with a big move I don't plan on starting a job July 1st and may push it back giving some dedicated study, move, and travel time. Thoughts?

Delaying the boards is almost always bad so you need to make a compelling case to yourself about why you are going to be the exception to the rule. I hear you that a lot of things are happening now, but are a lot of things also going to be happening a year from now when you prepare to be an attending etc etc?

 

[milesed]

Make sure you are trained in setting up a private practice even if never intending to do so. We had a series of lectures with a local private practice psychiatrist who went over the ins/outs of it all. Also, training on job benefits, contracts, malpractice insurance types, pitfalls they have seen psychiatrists get into with lawsuits, license suspensions, etc.

 

[Merovinge]

Make sure you are trained in setting up a private practice even if never intending to do so. We had a series of lectures with a local private practice psychiatrist who went over the ins/outs of it all. Also, training on job benefits, contracts, malpractice insurance types, pitfalls they have seen psychiatrists get into with lawsuits, license suspensions, etc.

Yup, we even got copies of all their forms/procedures which was very generous of them. I still have the binder in case I make a pivot in the second decade of attendinghood.