How to be an Upper Level Resident Rockstar

With the influx of new interns, there also comes a new crop of upper level residents. These residents were, just themselves interns a few short weeks ago. As you will soon discover, the transition from intern to upper level resident can be a rewarding yet challenging process.

For the non-medical folk, reading this. Upper level residents are seasoned residents who supervise new interns helping them learn the ins and outs of patient care.

While moving into my final year of residency, I have noticed 5 common qualities amongst great upper level residents. Keep these in mind when deciding on what type of upper level resident you want to be.

These traits will not only serve you well during your transition into becoming an upper level, but will aid you throughout the remainder of your career.



1. Flexibility

After working 80 hours a week for the past year, you have accumulated a significant amount of clinical experience. Likely you have a set way you go about treating various disease processes while making patient specific tweaks and adjustments as needed.

Flexibility - Upper level

It is easy to dismiss new resident’s ideas and opinions about treatment plans when they only have a fraction of your experience.

However, there is more than one way to skin a cat, and more than one way to treat hyperkalemia. Albeit the end premises are ultimately the same.

Your job is not to give interns orders to carry out. It is to allow them to develop as a physician and discover their own preferences for treating various diseases in a controlled and safe environment.

As long as their choices in treatment will be effective and not harmful to the patient, let them choose the regimen they feel is best. Allow them to take ownership of their patients while being a safety net to ensure patient safety.



2. Humility


You may think that you should know everything by this point in your training. There will be times when a medical student or intern asks you a questions you don’t know the answer to. And this is alright. 

No one expects you to know everything just because you are now an “Upper level”. Admitting that you don’t know the answer will help build trust between you and your interns.

The best upper levels I had were straight forward with me about their medical knowledge. I not only trusted them because of this, but respected them as well.

Don’t put on a facade of medical knowledge superiority. Admitting you will have to look something up or ask the attending will not only build a strong relationship amongst your team, but will ensure overall patient safety as well.



3. Team Player

You are probably starting to see the light at the end of the tunnel as intern year is coming to a close. The idea of no longer having to carry the pager is still something that fills my heart with joy.

As an upper level resident, it is easy to delegate tasks without performing any of them yourself. There is a fine balance between pushing your interns so they become more efficient and putting too much on their plate so they fall behind.

I have found that talking to my interns and asking if they need help has been the easiest way to find this balance. Whether it is the underlying stigma associated with asking for help or the inherit stubbornness that spans across most medical residents, most interns want to work hard and don’t want to ask for help unless absolutely necessary.

Offer to help them with an admit when you are 3 or 4 behind. Outline new patients on the list if it has been a busy day. Call back a page if they are on the phone with the ER taking an admit.

Don’t do their job for them, but do everything in your power to help them succeed without taking over. Trust me, they will appreciate it.



4. Organized


Check list - Upper level Along with the new responsibility of watching over the new interns, you will still be required to carry your own patients. While personally carrying 5-7 patients yourself and having to look over 1-2 interns’ patients as well can get confusing quickly.

Figuring out a way to stay organized is your best bet at making sure nothing gets missed. There are many different ways to do this and you have probably already found a way which has worked well for you on a small scale.

Whether you are doing some fancy list origami, are a highlighter aficionado, or make a mini checklist manifesto. Be sure to stay organized to prevent any mishaps and ultimately protect your patients from careless errors.




5. Honest

Many residency programs rely on current residents to train the newcomers by giving them constructive criticism as they make mistakes.

Most of you, including myself at that point in time, have never had to give formal feedback to your peers. This can be an awkward and unnerving process because, for the most part, these people are your friends.

Honesty - Upper Level

However, it is imperative that you give them an honest evaluation of their strengths and weaknesses so they can improve.

The best piece of advice that was handed down to me about giving feedback was to do it in a compliment sandwich. Find two small things that the intern did well. Use this as the bread and give the criticism in-between as the meat of the sandwich. This will give you the cadence of positive feedback, useful critique, positive feedback.

It may seem silly, but it is surprising just how well those on the receiving end of respond to this.

This also helps with their overall wellness, as only receiving negative feedback can wear down the most resilient interns.



Recognize both the good and the bad qualities in your current upper level residents. Try to emulate the good qualities from various uppers and recognize the bad ones in yourself. Be cognizant of how you are treating your new interns and don’t be afraid to ask for feedback yourself.

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Current PGY-2 Family Medicine resident at a Full-Spectrum FM residency program in the south. Fitness enthusiast, Investor, Husband, and future father come October 2018.


Current PGY-2 Family Medicine resident at a Full-Spectrum FM residency program in the south. Fitness enthusiast, Investor, Husband, and future father come October 2018.

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Welcome to the physician blogosphere! This article really hit the nail from all I know about being a resident from my husband. I’ll be sharing this with incoming interns every July.