The transition from medical student to a resident physician can certainly be a dramatic one. As a medical student, you don’t have a lot of responsibility for patient care. Instead, your role is to learn as much as you can in the classroom and clinical setting, perform well academically and on your board exams, and earn a coveted spot in a residency program. 

Once you enter residency, as a first-year resident, your responsibility for patient care increases exponentially, even if you have a senior resident and attending physician above you. If you make a mistake—especially when you advance to patient care—you most likely will be blamed. The reality of residency is that you know enough to get by, but you’re still in training. 

Hands-on learning

In medical school, you learned the nitty gritty of disorders, treatments, and physiology. But residency is the time to learn how to treat patients in a clinical setting, how to do procedures and how to communicate with your patients’ families and loved ones. 

More often than not, we enter residency with inflated egos. After all, we graduated medical school with an MD and matched into a coveted residency program. We are doctors. Yet we still have so much to learn. 

Statistics on residency mistakes 

A recent study of a 548-bed teaching hospital, with 286 residents in nine residency programs, revealed that 95% of these residents admitted to self-perceived medical errors. One in five of these errors was classified moderate to severe.

Fatima S, Soria S, Esteban-Cruciani N. Medical errors during training: how do residents cope?: a descriptive study. BMC Med Educ. 2021;21(1):408.

 

 

Medical mistakes in residency are prevalent and happen due to various factors, including burnout, poor communication, lack of senior supervision, and (not yet) knowing the answer.

West C. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294

 

 

 

You may be forced to run a code as the only doctor in the room, and you will quickly learn that very sick patients don't end up doing well. You will be challenged, you will be wrong, and there will always be someone who knows more than you.

The key is to learn from your mistakes. It’s crucial to admit them, talk about them, and learn from them so you can improve as a doctor—and an individual. 

Ask for help

You may think you know it all, but there will be times when you don't know what to do in a clinical situation. Instead of trying to be a superstar doctor and potentially risking your patient's welfare, ask for help from a nurse, a senior resident, or an attending. Asking for help means you’re putting your ego aside for the patient's safety.

 

Rely on your team

Where you went to medical school, your test scores and your knowledge no longer matter. What matters is how well you can work with your fellow doctors and nurses to care for your patient. You’re never alone in a hospital, especially during residency. You have a team of caring, intelligent doctors who want to help you and your patients. Take advantage of that.

Engel K, Rosenthal M, Sutcliffe K. Residents’ responses to medical error: coping, learning, and change. Acad Med. 2006;81(1):86–93.

 

 

It's always your fault (especially when it isn't)

As a first-year resident, you’re usually the first individual your patient sees each morning, as you’re the primary person examining them and checking their labs. As a result, you’re the lightning rod for all of their anger and frustration, since being a hospital patient isn’t fun. 

During my intern year, when I did pre-rounds on my patients, nearly every one complained and yelled at me. But they weren’t angry at me. Rather, I was the first person they could take their anger out on, and although it was hard to not take it personally, I knew it wasn’t my fault. 

Later that day, all of my patients apologized. The take-home lesson: patients, nurses, and other residents will blame you or yell at you, but usually because you’re the person who is there at that moment.

Virtual Mentor. After the apology: coping and recovery after errors. AMA Journal of Ethics 2011;13(9):593-600.