Leadership & professional development: The tension in transition: Moving from trainee to hospitalist

The transition from training to unsupervised practice is complex and full of challenges. Transitions should be framed as critical intensive learning periods that embrace the unique circumstances of each new residency or fellowship graduate.1 Although this transition requires strategic adaptation, there are a few steps recent graduates can take to ensure the transition into their new role is a successful one. We suggest taking inventory of three important assets for a successful start.

BUILD YOUR TEAM

The collaborative learning environment extends beyond training and remains a critically important asset for early attendings. Your collaborative team should include a network of individuals that can spur personal development and provide diverse perspectives, exposure to meaningful career opportunities, sponsorship, and psychological support.² Two specific roles on your team may include a mentor(s) or a career-coach. Mentors on your team should provide support in the realms of scholarly content, clinical support, career trajectory, networking, and sponsorship. Some considerations for finding a mentor at a new institution or when taking on a new role; reflect on your interviews regarding who might be a good mentor, set up some 1:1 meetings with new folks and get to know them, and consider if there is a mentor from training with whom you will stay in touch.

In comparison, career coaches are hired professionals who provide systematic, one-on-one, goal-oriented career guidance. Career coaches can come from within healthcare but outside of your discipline, or from an industry outside of healthcare altogether. While such coaches may not be available everywhere, ask what resources, if any, may be available through your institution. Furthermore, tap into sponsors who may be able to serve as connectors.

TIME IS VALUABLE

Within your new attending role, your time is an important asset. Hospitalists must often learn how to balance increased clinical responsibility, administrative duties, education obligations, and academic productivity, among others. Working with your mentors to build a 1-year timeline with clinical, academic, and personal goals can set you on a course for incremental success. This yearly timeline helps to frame your short- and long-term career goals.

Once you have a long-term time line, consider what you can or cannot add to your plate during the transition. Use this period to pause and reflect if you have the time to dedicate to something new or if you need to use the time to wrap up prior work or gain more experience in a new clinical system.

LEARN YOUR RESOURCES

Developing a repository of resources means identifying reliable sources of institutional information. Recognize that you will need to ask for help understanding the new institutional context, culture, and history. Ask what your new workplace has for on-boarding processes and orientation. Consider asking for details about ongoing monitoring of performance and opportunities to receive iterative feedback. Don't be afraid to seek out this feedback, even if there isn't a formal process in place.

Making the transition to unsupervised practice can be difficult clinically, academically, psychologically, and personally. No amount of training can prepare you for everything the new role has to offer, so give yourself grace as you adjust. Curating a supportive team of mentors, creating a timeline of goals during the first year in your new position, and approaching the transition as a period of intense learning will set you up to thrive in your new role.

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