So What Really Is The Purpose Of A Medical Residency?

Going through rotation after rotation as a third year medical student, I often wonder if I’m really retaining anything. Some days prove to be so overwhelming that I often wonder whether I can truly perform as a physician in the field. The sheer volume of knowledge that we are expected to muster in a quick and efficient way is quite jarring.

So, I thought maybe residency will help me out with this. As I started talking to residents on each rotation, they all gave me different takes on the value and utility of a medical residency. One description in particular has stuck with me, breaking down our progression as clinicians from the first day of residency all the way to our (hopefully) long tenure as attending physicians.


1. Safe

As first year residents, we know a lot, and there’s no doubt about it. However, the importance of establishing patient safety and understanding the concept of “do no harm” takes primary importance. It’s ok to not know what to do rather than doing something unsafe. Our actions are often life changing and you want to make sure that you start off your clinical practice on the right foot by determining the safest approach.


2. Good

As you progress further along in residency right as you are entering the median years, the focus is on building on safety and integrating effectiveness. You finally start to pick out unsafe patient situations, promote safe interventions, and take steps that benefit a patient. Your understanding of medicine progresses from a mere recorder and middleman for decisions to actually coming up with solutions and implementing them yourself.


3. Fast

Finally, as the end of residency is on the horizon, you are gearing yourself to work independently without the supervision of seasoned physicians. Your responsibilities grow and you are expected to manage a lot more in the same amount of time. So, you develop efficiency while still maintaining patient safety and effectiveness, whether it be on the wards managing 20 patients at a time or in the OR throwing knots faster than the eye can see.


4. Innovate

After eventually graduating from a medical residency, you finally have your wings to go forth and do the work that you got into medicine to do in the first place. You care for patients, understand their problems, find solutions, and implement them on a regular basis. As you get better and better, you start to recognize things that can be changed, improved, or developed as novel interventions right from scratch. This is when you innovate, either through your involvement in research, quality improvement, or some other avenue.


The important point to get out of this step-by-step process is to not skip steps. If you try to innovate while you are starting to learn patient safety, it’s more than likely not going to work out. The structure of every medical residency is to nurture future physicians who can do the bare minimum first, which is “do no harm,” followed by helping patients in an effective and efficient manner, and finally furthering the field as a whole if they have some time to spare.


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Yash Pandya

Yash Pandya is a science writer at The "Almost" Doctor's Channel. He is a rising third-year student at the University of Pittsburgh, majoring in Emergency Medicine with minors in Neuroscience and Chemistry. Yash plans on attending the University of Pittsburgh School of Medicine in Fall 2016 with guaranteed admission. In addition to the usual humdrum of academic involvement, Yash loves to play Ping Pong, catch up on the latest "Big Bang Theory," and travel. Having lived in India for half his lifetime, Yash aspires to expand his horizons into international healthcare by practicing medicine globally.