As a therapist and physician spouse who works with physicians and physician couples, I’ve seen the excitement and difficulty of exiting medical training and becoming an attending. The shift is a celebratory culmination of the physician’s hard work and a jarring transition with its unique challenges. Here are six things a new attending can do to recover from their residency experience and build a thriving next chapter.
1. Process the impact of training. Residency can leave physicians feeling worn down, burned out, and jaded. Residency recovery should include taking some time to process the experience of residency. What were the best and worst parts of the experience? How did training shape beliefs around medicine and one’s specialty? How does it feel to be finished? This may include celebrating such a long-held goal and sense of competence (even if it is terrifying to then be put in charge). It may also include grieving the physical, financial, and emotional sacrifice required for training.
2. Reexamine priorities. A resident is encouraged to define success primarily in clinical terms, building clinical competence and research prowess. Recovering from residency means expanding the lens to begin building a successful life that includes – but is not limited to – career achievement. In addition to thinking about professional next steps, this may include thinking about things like satisfaction, stability, security, and balance. Prioritizing might look like saying no to the next conference to attend a best friend’s wedding. It might mean choosing the job located a little closer to home, even if the institution carries a less prestigious hospital name. It might mean taking the job that allows time to pick up a child from school a few days a week or have fewer days on call. And even those who prioritize the same things they focused on in residency can do so intentionally rather than out of sheer momentum from trying to succeed.
3. Map out financial plans. Part of the whiplash of medical training comes from spending a decade paying to train or making relatively little money, then suddenly earning a high salary. For many physicians, training ends with hundreds of thousands of dollars of loans. New attendings may feel overwhelmed by the pressures to pay down debt, “catch up” on earnings lost during their twenties and make large purchases that had been deferred during training. The process of settling into this instantaneous change in one’s financial reality includes getting on the same page with oneself and one’s partner about the near-term and long-term priorities and acknowledging the myriad pressures that come from this new financial phase.
4. Rediscover other parts of one’s self. Residency demands often force trainees to scale back or put outside interests on hold. Physicians I’ve worked with speak of how their life becomes one-note; they lose the feeling of being a multidimensional being with lots of passions and interests. Part of adapting to life after residency involves discovering one’s “ands.” They are physicians AND spouses AND runners AND church members. It means re-investing in those other identities. My clients sometimes confide their fear that they let these identities atrophy beyond repair. To this fear, I like to say those parts were hibernating, ready to awaken after a long winter.
5. Set boundaries. Medical trainees famously have little say in the conditions of their training. They must say yes to extra shifts, extended shifts (often far past mandated hour limits), academic presentations, and research assignments. After training, physicians may finally be able to articulate their needs by choosing a good job fit and setting limits. Yes, the profession remains demanding, and some specialties offer less flexibility than others. But attendings may still be able to unlearn the reflex of every automatic “yes, of course” and contemplate what parameters work for them.
6. Stop postponing relationship issues. Physicians are trained in the art of postponement. In the name of rigorous training, they put off important relationships, life steps, and emotional investment. But in relationships, postponement quickly turns to neglect. After residency, physicians can dedicate more time to these relationships, process the impact of training on those relationships, and re-balance household responsibilities that became skewed so the trainee could focus on training. Couples can take back control over the life decisions that were ceded to medicine’s timelines and demands. For many couples, that means shifting the question of the next job from a unilateral decision made by the medical establishment to a joint decision by the couple about where they actually want to live, who they want to be near, and how they want to structure the next phase of their careers.
Thriving after residency is all about integrating a physician’s career into the bigger context. This means processing the training experience, re-discovering other interests, investing in relationships, and deciding what success and balance look and feel like. After so many years in a rigid pipeline toward a singular endpoint, this expansion can be incredibly disorienting. As a new attending, the external pipeline setting the priorities disappears, leaving new doctors to re-discover their internal compass and start building the life they want to lead.
Sarah Epstein is a licensed marriage and family therapist.