Advice for Medical School Residents

Margaret Manus is a young physician who just recently started at the Houston Methodist Primary Care Group as a primary care doctor. Here she explains the transition from a resident to a practicing physician, while offering her fellow peers advice.

RR: You recently finished your internal medicine residency and transitioned into practice. Tell us a bit about your academic background and training.

MM: I have had the privilege to study and train all across the country. I grew up in Houston, Texas and went to boarding school for high school at Phillips Academy in Andover, Massachusetts. I received my undergraduate degree at Vanderbilt University in Nashville, Tenn. where I majored in Neuroscience and Spanish. I then moved to San Antonio, Texas where I attended the University Of Texas School Of Medicine at San Antonio for my medical degree. I most recently completed my internship and residency at Cooper University Hospital in Camden, N.J.

RR: What are some of the most notable differences between being a resident and a physician in practice?

MM: There are so many! I think one of this biggest differences initially was transitioning from being in the practice of walking out of a patient's room and presenting cases with another physician to acting independently. Every new practitioner feels a huge sense of responsibility and weight on their shoulders knowing that the decisions they make or advice they give comes from them alone. Medical training is very much like a rollercoaster. You go from feeling like you know nothing at the start of your internship to feeling pretty confident by the end of residency. You then go right back to feeling like you know nothing again when you go into practice. That being said, residency trains you to become an expert sleuth, knowing to where to find an answer is equally as important as knowing the answer itself.

Another significant difference between being a resident and a physician in practice is learning to navigate the complex landscape of coding and billing. Residency training globally gives very little attention to the intricacies of billing. Most of what you learn about how to code is done through workshops provided by your employer, the reading you do independently, or from your partners.

RR: What are some of the most significant challenges related to treating patients as a young physician?

MM: There are certainly many ups and downs to being a young female physician. Especially in training, I was often mistaken to be the nurse rather than the physician. When approaching a patient's room, I was always cognizant of the need to show authority. Even to this day, I wear a white coat when most of my partners do not. It is just a small thing that helps to establish my role from the start.

A positive that has come from being young is that patients are often looking for a provider who is going to be practicing for many years to come. Very often they lament that the provider they were with many years has retired or is no longer practicing. People are looking to build relationships and that is something I relish!

RR: The healthcare policy landscape is in constant flux. How does the situation of most major insurance companies coming off the exchange and pulling out of Texas impact your practice?

MM: For myself and my practice, the more people who have health insurance, the better. Primary care is all about prevention of serious illness. With major insurance companies coming off the exchange and pulling out of Texas, I worry that fewer people with have access to coverage and therefore less access to preventative care.

RR: What advice would you give residents who are scheduled to finish their residencies this summer and transition onto a fellowship or private practice?

I would advise them to start looking for their jobs early. I started interviewing with my group a full year before I started. This gave me plenty of time to interview with several groups, contemplate the kind of practice I wanted to join, as well as not feel rushed when it came to negotiating a contract. I would also advise residents to speak with the other providers in the group they are contemplating joining. Don't be afraid to ask details about things like vacation time, dedicated administrative time, compensation, and patient volume expectations. There is very little public data available to new graduates to help guide these conversations. Colleagues are your best resources!