Life as a Medical Resident – What to Expect in Your First Year

You’ve officially made it—you matched into residency and earned the title of “doctor.” But now comes the real challenge: your first year as a medical resident, also known as PGY-1 or intern year.

Intern year is intense, eye-opening, exhausting, and incredibly rewarding. It’s a massive shift from medical school, and no matter how well you think you’ve prepared, nothing fully simulates what it’s like until you’re in it. If you’re wondering what to expect, here’s a real-world look at what life as a first-year medical resident is really like.

The Transition

The moment you step into the hospital as a resident, everything changes. You’re no longer the med student following along—you’re now writing orders, calling consults, and making decisions.

Expect to feel:

• Overwhelmed (totally normal)
• Responsible for real lives (because you are)
• Exhausted (hello, 80-hour weeks)
• Unsure of yourself at times (imposter syndrome is real)

But with support, repetition, and some grit, you’ll get better fast.

Daily Routine

There’s no “typical” day in residency, but most intern days start early and end late.

Here’s what a general day might look like:

1. Pre-rounding (5:30 – 6:30 AM)
   • Check labs, vitals, overnight events
   • See your patients and update your notes
2. Team Rounds (7:00 – 10:00 AM)
   • Present patients to the attending and discuss management
3. Work Time (10:00 AM – 5:00 PM)
   • Place orders, update families, respond to pages
   • Admit new patients, write notes, coordinate care
4. Sign-out (5:00 – 6:00 PM)
   • Handoff patients to the night team
5. Call/Night Shifts
   • You’ll rotate through nights and weekends too, depending on the program

This rhythm can vary, but it gives you an idea of the long, structured days.

Learning on the Fly

You’ll quickly realize that you don’t need to know everything—but you do need to know how to ask for help, how to look things up, and how to learn fast under pressure.

Key learning moments include:

• Being corrected (often and repeatedly)
• Presenting cases to attendings
• Getting feedback during sign-outs
• Debriefing after difficult cases or codes
• Reading up after your shift ends

Intern year is all about growth—give yourself space to improve.

The Emotional Toll

Let’s talk about something often overlooked: the emotional impact. You’ll see patients die, make mistakes, and carry the weight of responsibility for the first time.

Be prepared to feel:

• Anxiety
• Frustration
• Sadness
• Burnout

But also:

• Pride
• Gratitude
• Fulfillment
• Deep empathy

Don’t go through it alone. Lean on co-residents, mentors, or a therapist when needed.

Time Management

One of the hardest skills to learn as an intern is how to manage your time. You’ll be juggling patient care, documentation, phone calls, pages, teaching, and eating—if you’re lucky.

Tips for surviving the chaos:

• Learn to prioritize tasks
• Set time limits for writing notes
• Carry a to-do list
• Ask for help when needed
• Don’t aim for perfection—aim for safe and efficient

Efficiency comes with time and repetition. Be patient with yourself.

Procedures and Responsibilities

Depending on your specialty and rotation, you might be expected to perform:

• IV placements and blood draws
• Foley catheter insertions
• Central line assists
• Intubations (in the ED or ICU)
• Running codes or assisting during emergencies

You won’t be perfect—but you’ll learn by doing.

You’re also responsible for:

• Following up labs and imaging
• Updating families
• Communicating with other services
• Knowing when to escalate to your senior or attending

You’re no longer the observer—you’re part of the team.

The Hierarchy

In residency, there’s a clear structure:

• Interns (PGY-1) handle most day-to-day care
• Senior residents supervise and guide you
• Attendings oversee everything and make final decisions
• Medical students look up to you now (yes, really)

Respect flows both ways. Ask questions, take feedback, and remember: everyone’s learning.

Work-Life Balance

It’s tough—but not impossible. Your personal life might take a hit, but here’s how to survive:

• Protect your post-call days for rest
• Schedule time with friends or family
• Meal prep or use quick food options
• Make sleep a top priority
• Celebrate small wins

You don’t need to “do it all”—you just need to take care of yourself enough to keep going.

The First-Year Mindset

Intern year is about survival, growth, and building foundations. You’ll go from unsure to competent faster than you think—but only if you show up, stay humble, and keep learning.

You will make mistakes. You will be corrected. You will feel tired.

But you will also:

• Save lives
• Build resilience
• Earn the trust of patients and colleagues
• Become a real doctor

Intern Survival Tips

Survival Tip	Why It Helps
Ask for help early	Avoids mistakes and builds safety
Write everything down	You’ll forget if you don’t
Use templates for notes	Saves time and keeps you organized
Debrief after tough cases	Helps you process emotions
Stay humble	You’re still learning, and that’s okay

Your first year as a medical resident will challenge you like nothing before—but it will also shape you into the physician you’ve been training to become.

Expect the long hours, the tough lessons, and the steep learning curve—but also expect moments of pride, growth, and deep purpose. No one is ever “fully” ready for intern year, but if you’re willing to learn, adapt, and keep going—you’re ready enough.

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