10 keys to help 4th-year medical students thrive in residency

Always have a fresh pair of socks handy, and nine other hard-won bits of advice from the AMA’s top physician expert on graduate medical education.

By
Brendan Murphy Senior News Writer
| 5 Min Read

AMA News Wire

10 keys to help 4th-year medical students thrive in residency

Mar 23, 2026

As medical students prepare to transition to life as interns, one question may recur frequently: What does it take to succeed in residency? 

There’s no single answer, according to John Andrews, MD, the AMA’s vice president for GME innovations. He believes some of the keys to success as a resident physician include a desire to keep learning, a community of support and comfortable socks.

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Citing a mix of evidence, opinion and experienced observation, Dr. Andrews, who spent decades working in resident training, offered his 10 tips for thriving in residency. Here’s a look at his list.

Competence

The desire and need to keep growing as a physician will serve you well in residency training. That also means seeking out learning opportunities during your final months in medical school that will prepare you for residency.

“By the time you’re in the fourth year in medical school, in many ways you are moving past the things that are going to contribute to your application to residency,” Dr. Andrews said. “I encourage you to continue to learn and ask the questions you may have been embarrassed to ask previously.” 

Professionalism

Residency is a job. For some residents, it may be their first job in a professional setting.

“I’ve watched people struggle in the transition to residency from medical school as they confront the reality that whether or not they are there and attending to responsibilities matters,” Andrews said. “When you join a residency program, you are joining a health care organization that has expectations of you.”

Motivation

The path through medicine and medical school is one in which trainees strive for achievement. The measures of achievement change when you leave medical school.

“It’s important to understand once you enter residency, the feedback about performance will be different,” Dr. Andrews said. “You don’t get grades. You get feedback about what you did right, wrong, and areas you need to develop. You’re doing this to become the best doctor you can be—not to get a good grade.”

Find out how the AMA Reimagining Residency initiative is transforming residency training to address the workplace needs of the current and future health care system. 

Self-care

Dr. Andrews believes that you can’t effectively serve others unless you are serving yourself. That includes proper diet, sleep hygiene and a regular exercise routine.

“In addition to physical health, maintaining balance with things like exercise and diet is going to aid your emotional health and it’s going to protect against burnout,” Dr. Andrews said.

Community connection

Going into residency, Dr. Andrews recommends that medical students have a plan for staying in touch with their support system. The connection to your community during residency will make you more satisfied with the job you do.

“Think about your place in your community, and how it impacts your relationships with friends and family,” he said. “Think about who knows you outside of work and how you can stay connected with them. You are more than your job and others know that about you.” 

True collegiality

You want relationships in the workplace to be more than functional.

“The better you know your colleagues, the better you are going to work with them,” Dr. Andrews said. This doesn’t mean you have to be best friends with everyone you work with. But having connections with them will better support the work you are doing. Medicine is a team sport.” 

Life outside residency

This is another aspect of health and well-being. Sometimes you need a reminder of what you enjoy and are good at outside of work. This could be playing in a sports league or practicing an instrument.

“It’s important to identify the things that you love and how you are going to stay engaged with them during your residency training,” Dr. Andrews said.

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Sense of purpose

It’s easy to lose sight of the reasons you are pursuing a career as a physician.

“Medicine isn’t the only profession in the world,” Dr. Andrews said. “You need to understand the broader context for what you are doing and—within that context—why you are doing it. Sometimes it’s difficult to maintain a sense of that as you become focused on your moment-to-moment responsibilities. A sense of purpose complements the work you are doing.”

Mentoring

As a new resident, it can be helpful to have someone to speak to about the experience of transitioning to the next level of your training. It can be a mentor on a personal or a professional level.

“You may want to seek advice about who you are before you leave medical school,” Dr. Andrews said. It’s important to have a trusting relationship with someone with whom you can be honest and vulnerable, “someone who helps you see you. There are things about you [that] you may not understand without someone helping you to see them.”

Comfort

This is where the socks come in, said Dr. Andrews, who referred to it as “the best piece of advice I got.”

“It’s important to be comfortable,” Dr. Andrews said. “Always have a new and comfortable pair of socks at hand. Nothing feels quite so good after a night on call.”

The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook takes a deep dive into the needs of learners along the continuum of medical education—from the beginning of medical school through the final stage of residency. The handbook guides residents in acclimating to the various settings and expectations along the spectrum of the medical training environment. Download the handbook now.

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