It's an interesting experience when you realize you are going to be on your own in one year as a practicing emergency medicine physician. I'm talking about when you really feel it. We all know we are going to get there at some point after the 10 years of work (or whatever interesting path gets us to that point) but it’s different when the reality really hits you: I'm not going to be a resident anymore.

I was working our trauma/critical care pod on a series of nights, which I attribute as a major shaper of the doctor I have become at this point in my career. My bird's eye view of the room and my confidence was really solidifying. I was playing the role of third-year and having a lot of fun with it delegating and teaching. 

A pregnant asthmatic arrest came in the witching hour, known as 6 a.m. It was one of those hair-raising cases we all train for. The OB was at bedside ready to perimortem if needed and the room was buzzing. Things went smooth. What stuck with me was a simple subtle gesture during that case. I remember my attending looking at me and saying, "What do you want to do?" While the resident-attending hierarchy of truly knowing who was boss in that moment was still there, this was distinctly different in the way it was conveyed. It was a question from a colleague to a colleague, less from the top directed down. The gap was much thinner between the two of us. My confidence and situational awareness and command of the room didn't require anyone stepping in on my case and my attending knew it. I had been a third-year for one shift. I can't say I was ready to go solo at that time, but it was certainly a preview. When that impending freedom starts to seem closer than it is far, it's quite exciting - and a little scary.

I don't know what moment it will be for you, but there will come a time when you realize, I'm not going to be a resident anymore. And if you’re like me, it's going to launch a million questions. Am I ready for this? What do I need to do to make sure I'm ready? What is a democratic group, really? What is independent contracting? How does this whole process work? How do I make my CV perfect? Are interviews going to be anything like the residency trail? What kind of different groups are there? How do I get an honest picture of what these groups are offering? The big questions can really start to swirl in a formidable angst tornado. 

The good news is you have lots of time. Enjoy those eye-opening moments of professional development. They are unique and you will never forget them. And even more good news is that there are some great resources you can use to help answer those big questions that will begin flying around in your mind (I provided links to some of them below). You can do this. Just be diligent in your job-finding process to ensure you get a job that fits you - and enjoy the ride. 

To read valuable resources and access videos to help in your career decisions as an EM doctor, click here.