New Intern? What Your Chiefs, Faculty, and Program Directors want you to know on Day 1 of Residency

🩺 Intern Day-One Action Guide (Tip #5 is a BIG ONE)

Top 5 Tips That Will Actually Help You Succeed in Your First Month
Advice from Dr. Brian + Mission Residency alumni who've done it.

🧭 Quick Summary

You’re not a med student or an applicant anymore. You’re a PGY-1 resident and your reputation starts on Day 1.

Your test scores, personal statement, and visa status won’t matter on the floor. What matters now is who feels comfortable asking you for help, what you actually contribute to the team, where you step in without being asked, when you take responsibility, why others feel they can trust you, and how you make the people around you feel.

This guide gives you 15 actionable tips to help you succeed in your first month of residency. The advice comes from me, Dr. Brian, and from alumni who’ve gone on to become chief residents, attendings, and even program directors.

And if you’re a Mission Residency alum, know this: if you ever have a rough day or need a little encouragement, I’m just a call or text away.

✅ 1. Everyone’s on the Same Playing Field Now

📌 Your Step scores don’t matter anymore,what people see from you now is what counts.

1. Arrive AT LEAST 30 minutes early , settle in, get mentally focused, and show you’re dependable.

2. Use that quiet time to greet staff , saying hello before the chaos starts builds early trust.

3. Offer a quick hand to the night team , helping wrap up or carry over tasks earns big respect.

✅ 2. Don’t Try to Impress. Try to Be Useful

✋ Be helpful, not a kiss-ass.

1. Make sure your team has the updated patient list, digitally or printed,before anyone asks.

2. Anticipate clinical needs before they’re verbalized , for example, grab a guaiac kit if a rectal exam is coming.

3. Practice using the EMR early , if you’ve never used your hospital’s system (Epic, Cerner, Meditech, etc.), take time to learn the layout before rounds. Even if you have used it before, still practice early/often until using it it becomes second nature to you.

✅ 3. Visibly Take Notes , and Ask Smart Questions

🧠 Show that you're learning and paying attention.

1. Keep a clean, professional notepad in your coat pocket , use it during rounds or teaching moments.

2. Ask one thoughtful clinical question per day , not to impress, but to learn something important.

3. Stay off your phone unless absolutely necessary , even at lunch. If you're sitting with others, keep it in your pocket. If you need to take a call or check something, step into a private area (like a bathroom stall or empty hallway). Be present with your team.

✅ 4. Learn names of every important person…which means EVERYONE, Build Team Trust

🤝 Your real reputation is earned through mutual respect. Your goal needs to be making everyone you come across feel important, valued, and smart (yes, even if they are wearing a red MAGA hat)

1. Take a moment over the next 1-2 weeks to introduce yourself to the people that make your ability to do your job possible - that’s EVERYONE with a nametag that works at your hospital:  Nurses, Security guards,Janitors, Cafeteria staff, faculty. TIP: keep a note on your phone with their name and any identifying features that help you remember him/her and what you might’ve spoken about previously (i.e. - Nurse Jennifer, has red glasses, mentioned going on a cruise vacation on July 14th, remember to ask how the trip was)

2. Be everyone’s DOPAMINE ‘Hi!’: Make it a habit to spread positivity - it’s as simple as taking an extra 5-10 minutes stopping by the security guard, nurses station, program coordinators office…simply to say something positive, “Good morning, {insert name here}…have the best day ever!” or ‘Good evening! Thanks for everything you did today, hope you get some rest tonight!”.

3. Say thank you or I appreciate you, out loud, every time you get help, a heads-up, or a correction.

✅ 5. REMEMBER YOUR ROLE: “You’re there to learn & grow…”

📚 Curiosity & Proactive-ness earns more respect than cramming.

1. DO NOT be AFRAID to ask Questions: If you can’t figure out the answer on your own, DO NO Hesitate to ask - the nurses, senior residents and faculty members know what things you may struggle with in the beginning. Even if its a question no one has ever asked before, EVERYONE on your team knows you’re in training AND they’d rather you ask the ‘dumb’ question than DO something dumb that could harm the patient & the team.

2. Make it a habit to learn or study something that you came across that day (UpToDate, video, summary). If you’re not sure what’s high-yield, ask your seniors what they recommend…and thank them later after you’ve read/studied their recommended topic.

3. Track what you review in a casual list or journal, consistency > volume.

Important Bonus tip: Take a deep breath. You belong there just as much as everyone else. It may take some time to find your footing, but that’s part of the process. Everyone that you’re going to be learning from there was where you are right now….the new, next chapter of what will be one of the best parts of the rest of your life! You’ve earned this, now make the most of it!

Your mission… is OUR mission.
We’re proud of you,and we’re here for you.

By Brian M B, MD | Match & Residency Contributing Expert