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

🩺 Intern Day-One Action Guide

Top 15 Things 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.

✅ 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 the Nurses’ Names , Build Team Trust

🤝 Your real reputation is earned from those beside you, not just above you.

1. Introduce yourself to every nurse on your floor , early effort pays off all year.

2. Ask how they prefer communication (text, call, in-person) , then follow it.

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

✅ 5. Ask: “What Should I Review Tonight?”

📚 Curiosity earns more respect than cramming.

1. Ask your senior: “Anything I should review from today’s cases?”

2. Actually read it briefly that night (UpToDate, video, summary),and mention it the next day.

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

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