The attending-resident physician dynamic shapes both patient care and a trainee’s career trajectory as a physician. A fruitful working relationship is instrumental in a resident physician’s growth.
A recently graduated resident, Polly Wiltz, DO, has experienced firsthand what makes for a successful relationship. Dr. Wiltz, who is soon to be an emergency medicine attending physician in the Pacific Northwest, offered these tips for resident physicians looking to build strong, meaningful connections with their attendings.
Preparation is paramount
The most effective way to earn an attending’s trust is to be ready. Starting with intern year, Dr. Wiltz made it a point to be fully prepared when presenting patients.
“If I was going to staff a patient with my attending, I wanted to make sure that in my head I had everything sort of listed,” said Dr. Wiltz, an AMA member. “What are my life-threatening differentials? What am I missing? And then say, ‘Here’s where I could use your help.’”
If you can cover the basics on your own, your interactions with attendings will allow them to teach more advanced, nuanced content.
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Stay curious, enthusiastic
Residents who are open to feedback and eager to improve tend to get the most out of their relationships with attendings, Dr. Wiltz said.
“Coming into work with a growth mindset—being open and receptive to feedback, whether it’s positive or constructive—has served me really well,” she said. “It’s about rolling up your sleeves and being ready for whatever happens on shift.”
Even when cases seem repetitive, it’s key to see each shift as a learning opportunity.
“Being excited about the potential for every patient encounter helps prevent stagnant behaviors within medicine,” she said. “Because if you see the same chief complaint, the same type of patient over and over again, it’s easy to develop a pattern and that’s when you start to miss those most sneaky sick patients.”
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Try to remain affable
For both sides of the attending-resident dynamic in emergency medicine, Dr. Wiltz mentioned the “3 a.m. test.”
To pass the test, Dr. Wiltz said you should consider these questions: “Are you somebody who's approachable? Are you somebody who's receptive to teaching? Are you somebody who can decompress from a shift with a sense of humor?”
Passing the test means being the kind of person others trust and can rely on in those moments.
Dr. Wiltz—a member of the AMA Resident and Fellow Section—added that cohesion in the hospital can foster a thriving mentor-mentee relationship that extends beyond the clinical realm.
“It’s been very rewarding to have relationships where I am on a first-name basis with my attendings,” she said. “I can talk to them about a patient, about their workup—but also how am I going to start paying down my loans? What should I be doing as I transition into attendinghood?”
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Observe and absorb
For Dr. Wiltz, one of the most meaningful aspects of her relationships with attendings has been their ability to model the kind of physician she aspires to be.
“Attendings who practice what they preach—you might call it role modeling and mentorship—are really important,” she said.
That modeling goes beyond clinical reasoning. It’s about how these attending physicians communicate, how they handle pressure and how they carry themselves within the team dynamic.
“It’s one thing when you’re being talked at and given advice. It’s another when an attending says X, Y, Z, but then you watch them do X, Y, Z, in a patient encounter—it tends to stick”
