How to Be a Standout Junior Resident: 6 Best Practices

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The internet medical education space is full of great guides on how to excel at different points along the medical journey. You’ll find plenty of material on excelling as a medical student, being a fantastic intern, and smoothing the transition to fellowship and/or attending-hood.

But like a middle child, the junior resident can be forgotten. Everyone along the journey will be a PGY-2 or -3 at some point, which means it is just as important as any other stage in your professional evolution to get the right resources. Read on to find out how to excel in this role, lift up your interns and medical students, and dazzle your chiefs and attendings as a junior resident.

1. Be a liaison from chief/attending to MS/intern

Being in the middle of the totem pole puts you in an interesting position as an ambassador between medical students and those attending. It is up to you to bridge the gap in medical knowledge, communication skills, and professionalism. The best way to do this (without adding any extra work to your already full plate) is to lead by example.

Let your actions be the “how-to guide” for your medical students and interns. This includes not only the way that you interact with your patients and their families, but also in the way that you report to your chiefs and attendings. This way you can “teach” them without doing any extra work.

But of course, you will have to do some extra work. Medical students and interns can read the book to learn more about the medical factoids, but you will still need to provide some academic direction. Give them something more useful than, “Keep reading.” Your job here is to teach them the unwritten curriculum: how to navigate the complexities of the interpersonal relationships of the medical team, how to “handle” other services and consults, and how to keep one’s chin up during the throes of MS3/4 and PGY-1 years.

2. Teach while learning

As a junior resident, you’ve still got a lot to learn. And you’ve also got a lot to teach. You’ve developed a strong fund of knowledge, and it’s your duty to share this with the greener members of your team. Remember to teach within the boundaries of your own knowledge.

Medical students, hopped up on esoteric Step 1 knowledge, often come forward with obscure questions that test your knowledge. Share what you know, and understand that it’s okay to plead ignorance if you don’t. Let them know you will investigate it, and you will all learn something. Or better yet, gracefully task them with researching it to further their knowledge, as well as your own.

3. Hold the phone

I’ll never forget those nights on call as a medicine intern, working a 30-hour shift and cross-covering a list of 60+ patients, too many of which had checkboxes next to them. And on top of overnight PTTs to follow up on, I was caring for a quarter of the hospital’s patients, any one of whom could need a rapid response at any moment. If there was an opportunity to sleep, it was often stolen by anxieties. That is, until my senior said, “I’ll hold the phone for the next three hours so you can get a break.”

I am still indebted to that PGY-2 (Thanks, John!) for giving me some moments of mercy in a gauntlet of responsibility. The smallest pleasantries go a long way: buy your intern a coffee, write up a progress note for them, or help them with their presentation at rounds tomorrow. Because of the difficult nature of being a sub-intern or intern, a little bit goes a very long way.

4. Be available

Your skills and medical knowledge mean absolutely nothing if you are not there when the phone rings. Few things trump availability, because without it, you offer nothing! Feel free to challenge your intern by letting them work through things on their own. Allow them to incur a manageable amount of stress if you think it will make them better. Just be there for them when they need you.

5. Know your own limits

Junior residents are humans too. It’s okay to reach the end of your rope for the day. We’ve all been there: your frustrated attending has come down on you, patients are being difficult or are getting sicker, you’ve got a pile of work you haven’t had a chance to get to…

It’s okay to say, “I can’t teach you that right now. Just ask me at another time.”

Plus, it’s hard to teach (and learn) things after midnight. While we often learn the most while on call, if everyone’s hands and minds are shaky after 20 hours of work, feel free to forgo the finer technical aspects of a procedure until sun-up.

Reaching out to your chief is not a sign of weakness. If you need to consult someone wiser and more experienced than yourself, pick up the phone and call. They would rather be bugged by you than for you to bite off more than you can chew.

6. Hone your tone

Oftentimes, it’s the way in which you say something, more than what you say, that leaves an impression. As you transition from a learning role to a didactic one, the tone in which you use to teach becomes incredibly important. It can be the difference between being helpful and friendly, versus being cold and stern, even if you are saying the same exact thing. Ask your interns for feedback to make sure you are hitting the mark, and sharing your knowledge in an effective and beneficent way.

Unless you have the memory of a goldfish, it hasn’t been that long since you were in the shoes of your MS3/4 or PGY-1. It can be a tough couple of years, so take what reserve you’ve got to help them along, just like that amazing resident who helped pull you through.

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By Brian Radvansky, MD