In my article, “The Dermatology Job Search Timeline: Reflections from a Resident Still in the Interview Process,” I focused on what I needed to do during my last year of residency to secure a job. The job search takes up a surprising amount of space on the calendar. There are interviews, contracts, licensing, credentialing, board prep, and decisions about where to live. It is easy for the entire year to become focused on what comes next.
At some point, I realized I also wanted to pay attention to where I was at that moment.
There are things about being a resident that are uniquely temporary: faculty readily available to answer questions, co-residents who you see every day and are also the faces sitting next to you at a conference, trainee pricing for meetings, and an entire institution built around helping you learn. Your last year is a chance to take advantage of those things while also getting ready to leave.
Before “Trainee” Disappears from Your Badge
One of my priorities this year was identifying skills I wanted to strengthen while I still had close faculty supervision. If there is a procedure you haven’t done, a repair you want another supervised repetition of, or an area where you still hesitate, now is the time to seek it out.
I also found myself asking faculty different questions during my last six months. How do you structure your clinic? How do you make operational decisions? What would you do differently? Who do you call when you need help? These conversations felt different toward the end of residency. Faculty knew I would soon make these decisions without them down the hall and were excited to tee me up for success as a future colleague.
There are also practical benefits to still having “resident” on your badge. Conferences become wildly more expensive after graduation, so go to the meetings you have been eyeing. Apply for trainee scholarships, travel grants, and young investigator awards; many of these are only available for trainees or new grads, so don’t miss this opportunity.
Finally, think about what you want to carry with you. Export the dot phrases you created. Save your own patient education and teaching materials, and exchange personal contact information with mentors before your institutional email disappears. I also kept track of things I liked about how different clinics operated and things I hoped to do differently. After years of watching faculty build clinics, teach, and work with staff, I want to arrive at my first job knowing which pieces I’d like to bring with me.
Don’t Accidentally Rush Through the People Part
My co-residents were my rock for three years. It can be tempting during a stress-fueled year to become laser focused on studying, job applications, and work that spending quality time with them goes to the wayside. But I challenge you to prioritize making new memories with your people in this last year. Residency is such an odd and unique time as we know, but never again will you spend this much time with colleagues enduring the same experience as you. My co-resident started a trend our first year of having all of us belt the notorious Natasha Benningfield’s “Unwritten” together at karaoke. It became a fabulous tradition at nearly every birthday, baby shower, or BBQ over the last three years. The universe decided to bless us with a parting gift by having none other than Natasha Benningfield herself traveling through our town for a concert in our last week of residency for us to all lose our voices together in unison one more time.
We have a running joke that we “can’t wait to see each other at the AAD in 10 years,” which truly would be my worst nightmare. Thankfully, we have made no such attempt at a clean break. We still text nearly every day from our new jobs and new cities, and already have plans to visit each other. The proximity may be gone, but these are friendships I want to be intentional about carrying with me.
Even if your relationship with your co-residents is more formal, I think part of maximizing this last year is recognizing the people who shared it with you. Reflect on your years and how far you’ve come, and take some time to thank the folks who have taught you. Residency asks us to spend so much time focused on what we still need to learn that we can forget to notice how we got there and who helped us achieve this feat, especially as the last few months start moving a little too quickly.
Prepare for the Very Unglamorous Logistics of Leaving
Moving is exhausting and expensive. A moving stipend certainly helps, but many of us will still need to pinch some pennies, purge, and start planning much earlier than we think. I was moving from a house with a basement in a rural area to an 800-square-foot city apartment, which meant confronting more than three years of accumulated belongings. Had I started sooner, I probably could have sold more on Marketplace or Poshmark. Instead, in my last two months I created a little “Kristan’s Closet” sale at work and donated the rest. The clothing rack unexpectedly became one of my favorite parts of leaving. For weeks, staff and colleagues would proudly arrive in their “new” sweater, pants, or purse. Now that I am thousands of miles away, it makes me smile knowing that a dozen people are walking around with a little piece of me.
There were also countless administrative tasks that took far longer than expected. I had accumulated years of tax documents and health records, so I spent a few afternoons at my local library scanning what I needed, emailing copies to myself, and shredding the originals rather than paying to move boxes of paper across the country. I made sure I had personal contact information for faculty and staff before losing access to my institutional email. I completed health screenings, used my remaining CME funds, and spent time working on licensing, credentialing, and my DEA registration. Each task was manageable on its own, but I would strongly recommend not having all of this converge in May and June alongside boards preparation, graduation, work, and final memories with your coresidents. Anything you can scan, sell, schedule, submit, or close out earlier is one less thing competing for your attention during those last few weeks.
Be a Tourist in Your Own Town
You’d think that after living in a rural town for three years, I would feel like I had done it all. It was quite the opposite. As graduation approached, I started feeling real FOMO about leaving before doing certain things. I never made it off the bunny slope to become the star snowboarder I envisioned despite living so close to ski resorts. I wish I had gone to more concerts by the lake, hiked more of the mountains around us, and taken more road trips through coastal New England or up to Quebec and Montreal. I’ll miss the magic of Halloweens there and this unique time in my life when a white Christmas and a real tree were almost guaranteed.
I was never really a bucket-list person, but I truly believe this is the time to make one. Life gets incredibly busy during those last six months. Soak up where you live while you still live there, and don’t save everything for that mythical period “after boards.”
Manifest a Little
I recently started a manifest journal with a fellow vulvar dermatology friend. I don’t know that either of us truly knows if we’re doing it “right,” or if there even is a right way to manifest journal. But there is something to be said for making a concerted effort to think about what you want, your goals, how you are different from even a year ago, the things that scared you as a first-year resident that you’ve now mastered, and who you want to be as you enter this next stage.
Some of what we write down are reach goals and some are more like tasks. All of it will change. Still, there is something quite powerful in writing it down and telling someone else what I want. We’re at this inflection point where life can take on a million different flavors. What do you want yours to look like? What will it take to get there? And who do you want in your inner circle cheering you on?
To be undoubtedly cheesy (and you must have known this was coming), but we’re finally at the point where we get to decide what comes next. We have spent years following a fairly prescribed path, and suddenly there are many different directions life can take. So, now more than ever is the time to open up a window, “feel the rain on your skin.” You get to decide what this chapter holds… “the rest is still unwritten.”
Photo Credit: Kristan Schiele, MD
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