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. 2020 Sep;95(9):1421-1427.
doi: 10.1097/ACM.0000000000003474.

The Transition From Medical Student to Resident: A Qualitative Study of New Residents' Perspectives

Lucy Y Chang  1 , Kinga L Eliasz  2 , Danielle T Cacciatore  3 , Abigail Ford Winkel  4
Affiliations

The Transition From Medical Student to Resident: A Qualitative Study of New Residents' Perspectives

Lucy Y Chang et al. Acad Med. 2020 Sep.

Abstract

Purpose: To understand the learner's perspective on the transition from medical school to residency and to develop a conceptual model for how learners experience the transition from student to resident.

Method: This prospective qualitative study explored the experience of first-year residents using semistructured, one-on-one telephone interviews. Ten first-year residents who participated in the Transition to Residency elective as fourth-year students at the New York University Grossman School of Medicine in April 2018 participated from December 2018 to April 2019. Using a 3-phase coding process and grounded theory methodology, the authors identified categories, which they organized into broader themes across interview transcripts and used to develop a conceptual model.

Results: From the perspective of new residents, developing professional identity is the core construct of the transition experience. The residents focused on individual aspects of the experience-professional identity, self-awareness, professional growth, approach to learning, and personal balance-and external aspects-context of learning, professional relationships, and challenges in the context of their new role. Across these 8 categories, 5 broader themes emerged to describe an abrupt change in educational environment, an immersive experience of learning as a resident, ambivalence and tensions around the new role, navigation of professional relationships, and balance and integration of working in medicine with personal lives and goals. A conceptual model illustrates this phenomenon as a cell where professional identity and growth (the nucleus) is surrounded by interactions with patients and other members of the medical team (in the cytoplasm) that create a substrate for learning and development.

Conclusions: This study suggests that being immersed in the residency experience is how medical students transition to resident physicians. Educational interventions that allow learners to acclimate to the experience of being a doctor through gradual exposure to authentic interactions have the potential to bridge the abrupt transition.

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